Administrative and behavioral interventions for workplace violence prevention.

BACKGROUND: Violence in the workplace accounts for 1000 fatalities and over 20,000 nonfatal events annually in the United States. The occupations with the most fatalities are taxicab drivers, employees in retail establishments, and law enforcement officers. Environmental strategies as well as behavioral and administrative measures could be employed to address violence. METHODS: This paper reports a critical review of the published literature on administrative and behavioral interventions directed at addressing workplace violence. Searching 17 different databases, we identified 137 papers that described workplace violence intervention strategies. Papers were further categorized according to whether they provided empirical data about an intervention or merely suggested intervention ideas. Suggested interventions were categorized according to applicability to types of workplace violence and organized according to the Haddon Matrix. RESULTS: Forty-one reports suggested intervention strategies but provided no empirical data; nine reported results of intervention evaluations. All intervention studies were based in the health care industry and addressed violent encounters between workers and patients. Overall, the research designs employed were weak and the results inconclusive. None used experimental designs. CONCLUSIONS: The lack of rigorous research to assess administrative and behavioral measures to address workplace violence represents a significant gap. Intervention research needs to draw on appropriate theoretical and conceptual frameworks, address the multiple contexts in which violence occurs, and employ strong evaluation research designs, including attention to process, impact, and outcome measures.

State gun control advocacy tactics and resources.

CONTEXT: Enacting state laws to regulate firearm use, availability, or manufacture is one plausible strategy for preventing firearm-related injuries. Organizations that use a wide range of advocacy tactics may be successful in promoting gun control policies. OBJECTIVES: To describe tactics commonly used by groups that advocate for state gun control laws and to assess whether financial resources were associated with groups' use of these advocacy tactics. DESIGN/PARTICIPANTS: We identified 679 local and state organizations potentially active on state-level gun control issues in 1998 and mailed a 153-item questionnaire to the groups' leaders. MAIN OUTCOMES: Organizations' use of 35 gun control advocacy tactics. RESULTS: Seventy-nine percent (n=538) of groups responded to our survey, and, of those eligible, eighty-one percent (n=207) completed questionnaires. Organizations commonly used public education, media, and legislative lobbying tactics, and fewer engaged in electioneering and litigation. Except for lobbying, no associations were found between groups' use of advocacy tactics and their level of financial resources. CONCLUSIONS: Organizations advocating for state gun control laws have a varied tactical repertoire, with fewer using electioneering and litigation than other approaches. Financial resources do not appear to be the determining factor in the advocacy methods employed.

Local option policies and alcohol availability in North Carolina counties.

Concerned about social problems related to alcohol, communities are considering legal alternatives for restricting its availability. Whether restrictive local policies are realistic means for curtailing the physical availability of alcohol is unknown. Using North Carolina's 100 counties as the unit of analysis, the extent to which 1994 local option policies predicted 1995 rates of alcohol permits, controlling for other factors related to the demand for alcohol, was examined. Counties with restrictive policies were found to have lower rates of alcohol permits than counties with permissive policies, after accounting for alcohol demand. Local option policies may be a reasonable strategy for limiting the physical availability of alcohol. In turn, limiting alcohol availability may be effective in reducing alcohol-related community problems such as traffic crashes and violent assaults.

Effects on alcohol related fatal crashes of a community based initiative to increase substance abuse treatment and reduce alcohol availability.

OBJECTIVE: This analysis tested whether comprehensive community interventions that focus on reducing alcohol availability and increasing substance abuse treatment can reduce alcohol related fatal traffic crashes. INTERVENTION: Five of 14 communities awarded Fighting Back grants by The Robert Wood Johnson Foundation to reduce substance abuse and related problems attempted to reduce availability of alcohol and expand substance abuse treatment programs (FBAT communities). Program implementation began on 1 January 1992. DESIGN: A quasi-experimental design matched each program community to two or three other communities of similar demographic composition in the same state. MAIN OUTCOME MEASURES: The ratio of fatal crashes involving a driver or pedestrian with a blood alcohol concentration of 0.01% or higher, 0.08% or higher, or 0.15% or higher were examined relative to fatal crashes where no alcohol was involved for 10 years preceding and 10 years following program initiation. RESULTS: Relative to their comparison communities, the five FBAT communities experienced significant declines of 22% in alcohol related fatal crashes at 0.01% BAC or higher, 20% at 0.08% or higher, and 17% at 0.15% or higher relative to fatal crashes not involving alcohol. CONCLUSIONS: Community interventions to reduce alcohol availability and increase substance abuse treatment can reduce alcohol related fatal traffic crashes.

Epidemiology and prevention of injuries among adolescent workers in the United States.

In the United States, most adolescents are employed at some time during their teen years. Provisions of the Fair Labor Standards Act, the nation's child labor law, address some of the risks of adolescent employment; however, > 70 teenage workers are estimated to die from work-related injuries each year, with greater risk among males, whites, and older adolescents. Furthermore, the nonfatal work-related injuries of the > or = 64,000 teens who receive emergency department care each year are believed to significantly undercount actual injuries. Many of these nonfatal injuries are severe, with 15%-45% leading to work restriction or permanent disabilities. Significant methodological issues limit the ability of existing surveillance systems to monitor youth worker injury. Risk factor and intervention research is very limited, but does suggest the role of some worker characteristics, management practices, and training issues. However, these factors need more careful study. This review considers existing information about occupational injuries among adolescents and identifies needs for research and policy attention.

Improving safety for teens working in the retail trade sector: opportunities and obstacles.

BACKGROUND: Using both quantitative and qualitative data, this study examined teen workers' perceptions about their work environments and the ways in which teens believe workplaces can be made safer. METHODS: We conducted telephone interviews (n = 117) and six focus groups (n = 49) with two separate samples of North Carolina teens who worked in the retail trade sector. RESULTS: Survey findings indicate one-fifth of teens used equipment they thought dangerous; nearly 40% always or often felt rushed at work; and about half received training on how to avoid injury. Teens in the focus groups expressed concerns about workplace physical hazards, the threat of assault, being rushed, and having little power in the work environment. They also indicated that their workplace safety training was ineffective and that child labor laws were unnecessary. CONCLUSIONS: In order to be effective, interventions targeted at working teens need to address the organization of work and adolescent-manager interaction patterns.

The downside of adolescent employment: hazards and injuries among working teens in North Carolina.

Occupational injuries are major adverse outcomes of teen employment in the United States. Using data from a survey of teens employed in three different retail trade settings (food service, grocery, and other retail) in the state of North Carolina, we examine how experience, gender, work setting, and the pace of work are associated with hazard exposures and injury experiences. Multivariate analyses show that, after controlling for individual and job-level variables, perceived work-pace pressure and hazard exposure are positively associated with variation in the types of injury experiences. We emphasize the need to include characteristics of the workplace and the labor process when assessing the adverse consequences of work on adolescent well-being.