Return-to-Work After Work-Related Injury in the Construction Sector: A Scoping Review.

Purpose Construction remains one of the most hazardous and disabling industries worldwide. This scoping review was completed to identify barriers and facilitators related to return-to-work (RTW) after work injury in the construction industry and gaps in the literature. Methods We searched ten databases from 1990 to 2020 for academic and grey literature. Two independent reviewers screened citations for inclusion. One team member charted the data and a second team member reviewed the coding. Articles were included if they identified any barriers or facilitators to RTW in the construction industry. The findings were synthesized into overarching themes. Results Our search identified 6706 articles for screening, with 22 articles included in the final sample. Three articles used qualitative methods, while the remaining articles were quantitative. The majority of articles were from North America and published in academic journals. Overall, findings are organized under seven main themes: worker sociodemographic characteristics; injury characteristics; worker motivation; workplace goodwill; modified work and disability management; work disability systems; and access to healthcare. Some barriers and facilitators are more relevant to the construction industry compared with the general working population. Conclusions: The findings suggest that accommodations are possible for this industry but barriers still exist in identifying suitable work. More research is needed to investigate the role of union involvement, work disability management systems, gender, and organizational characteristics, such as multiple worksites, in relation to RTW in the construction industry.

Development of a Questionnaire Measuring Preventive Behaviors at Work.

Purpose This study aimed to develop a questionnaire measuring preventive behaviors at work. Methods A three-step design, including qualitative and quantitative methods, was followed: (1) item generation, (2) experts' validation of content, and (3) pretesting. Results For step 1, 49 relevant existing scales were reviewed, and a pool of 172 items was generated. Redundant items were deleted (n = 48), and unclear items were reworded (n = 27). For step 2, 14 experts (five occupational therapists, four researchers, and five workers) assessed the representativeness, relevance, and clarity of each item through content validity indices (CVIs). An average overall CVI of 0.97 was obtained, and 87.5% of the experts stated that the questionnaire was comprehensive. During this step, 63 items were deleted, and 35 were modified. For step 3, the tool was pretested in the clinical settings of four dyads (occupational therapist-worker). The thematic analysis of interview content allowed several changes to be made to the questionnaire, including the addition of information and format changes. Conclusions Overall, this three-step study led to the construction of a 61-item French questionnaire entitled the Échelle de fréquence des comportements préventifs au travail [Frequency Scale of Preventive Behaviors at Work]. In rehabilitation settings, this tool could be useful to support professionals in enabling workers to adopt preventive behaviors, thereby fostering a healthy, sustainable return to work after a disability period. However, further metrological property assessment is required. A validating study using a large pool of workers is ongoing.

Looking for capacities rather than vulnerabilities: The moderating effect of health assets on the associations between adverse social position and health.

To increase capacities and control over health, it is necessary to foster assets (i.e. factors enhancing abilities of individuals or communities). Acting as a buffer, assets build foundations for overcoming adverse conditions and improving health. However, little is known about the distribution of assets and their associations with social position and health. In this study, we documented the distribution of health assets and examined whether these assets moderate associations between adverse social position and self-reported health. A representative population-based cross-sectional survey of adults in the Eastern Townships, Quebec, Canada (n = 8737) was conducted in 2014. Measures included assets (i.e. resilience, sense of community belonging, positive mental health, social participation), self-reported health (i.e. perceived health, psychological distress), and indicators of social position. Distribution of assets was studied in relation to gender and social position. Logistic regressions examined whether each asset moderated associations between adverse social position and self-reported health. Different distributions of assets were observed with different social positions. Women were more likely to participate in social activities while men were more resilient. Resilience and social participation were moderators of associations between adverse social position (i.e. living alone, lower household income) and self-reported health. Having assets contributes to better health by increasing capacities. Interventions that foster assets and complement current public health services are needed, especially for people in unfavorable situations. Health and social services decision-makers and practitioners could use these findings to increase capacities and resources rather than focusing primarily on preventing diseases and reducing risk factors.

Associations Between Resilience, Community Belonging, and Social Participation Among Community-Dwelling Older Adults: Results From the Eastern Townships Population Health Survey.

OBJECTIVE: To examine the associations between resilience, community belonging, and social participation, and the moderating effect of resilience on the association between community belonging and social participation among community-dwelling older adults. DESIGN: Cross-sectional; secondary analyses of the Eastern Townships Population Health Survey. SETTING: Community. PARTICIPANTS: A sample (N=4541) of women (n=2485) and men (n=2056) aged ≥60 years was randomly selected according to area. Most participants had <14 years of schooling, owned their dwelling, were retired, had 1 or 2 chronic conditions, and did not have depressive symptoms. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Self-reported data on age, education, depressive symptoms, social participation, community belonging, and resilience were collected by phone interviewer-administered questionnaire. A social participation scale measured frequency of participation in 8 community activities. A 4-point Likert scale ranging from "very strong" to "very weak" estimated sense of belonging to the local community. Social participation and sense of belonging questions came from Statistics Canada surveys. Resilience was assessed with the 10-item Connor-Davidson Resilience Scale, capturing the ability to cope with adversity. RESULTS: Controlling for age, education, and psychological distress, greater resilience and community belonging were associated with greater social participation among women (R2=.13; P<.001) and men (R2=.09; P<.001). The association between community belonging and social participation varied as a function of resilience, especially in men. Greater community belonging further enhanced social participation, especially among women (P=.03) and men (P<.01) with greater resilience (moderator effect). CONCLUSIONS: Resilience moderates the association between community belonging and social participation among community-dwelling older women and, especially, men. Interventions targeting social participation should consider the potential impact of resilience on improving community belonging. Future studies should investigate why resilience moderates associations between community belonging and social participation, and how to enhance resilience among older adults.

Implementation process evaluation of an ergonomic train the trainer program: How to learn from mechanisms and the temporal structure of processes?

In implementation process evaluation, the analysis of the temporal structure of processes is key for understanding the successive interactions between the flow of practitioners' actions and evolving workplace reactions and context. However, capturing the temporal structure of processes in data analysis is a methodological challenge, and available literature to overcome this challenge is scarce, especially for workplace ergonomic interventions. The aim of this paper was to perform an implementation process evaluation of an ergonomic train the trainer program taking into account the temporal structure of processes. We provided a method for qualitative data analysis based on a three-stage strategy: 1) producing the timeline of the implemented intervention, 2) identifying influential factors, 3) identifying determinant mechanisms (sequence of influential factors that intervened in the implementation process). This method allowed us to identify six determinant mechanisms positioned on the timeline of the intervention. Obstacles and levers were identified as a sequence of interrelated causes and consequences rather than isolated factors. We recommended success strategies for practitioners, while also shedding light on how organizations can better be prepared to undertake the intervention and their required actions to attain targeted intervention objectives.

Moving toward an integrated prevention approach for mental health at work: Promoting workers' involvement through concrete actions.

BACKGROUND: Work-related mental health problems are a primary cause of disability and lead to the absence of 500,000 workers each week in Canada. There is a growing body of literature suggesting integrated approaches of prevention are necessary to improve mental health at work. The involvement of numerous stakeholders inclusive of government agents, employers, and workers is recommended. However, only minimal information is available to suggest actions workers may adopt toward an integrated approach of prevention to improve mental health at work. OBJECTIVE: The aim of the study was to identify behaviors workers may adopt to foster mental health at work. METHODS: Following a descriptive qualitative research design, semi-structured interviews were conducted with researchers, professionals, and workers. Data were analyzed using a template analysis strategy. RESULTS: A total of 49 concrete behaviors were identified, grouped into ten sub-themes, and three broad themes. These main themes identify those behaviors that appear to be useful throughout the prevention continuum: 1) adopting a reflexive practice, 2) acting for one's own mental health, and 3) acting for mental health of others. CONCLUSIONS: In harmony with the integrated prevention approach, this study offers a framework to organize workers' concrete actions contributing to mental health.

Evaluation of the Quebec Healthy Enterprise Standard: Effect on Adverse Physical and Psychosocial Work Factors and Work-Related Musculoskeletal Problems.

OBJECTIVE: The aim of this study was to evaluate the effect of the Quebec Healthy Enterprise Standard (QHES) on adverse physical and psychosocial work factors and work-related musculoskeletal problems (WMSP). METHODS: Workers of 10 organizations completed questionnaires before (n = 2849) and 2 to 3 years following (n = 2560) QHES implementation. Outcomes were assessed using validated instruments. RESULTS: Workers exposed to adverse physical and psychosocial work factors had a higher prevalence of WMSP. After interventions, the prevalences of one adverse physical and three adverse psychosocial work factors were lower among workers exposed to interventions. Among men exposed to physical and psychosocial interventions, the lower prevalence of neck WMSP is compatible with a beneficial intervention effect. Other results generally showed few effects on WMSP. CONCLUSION: Results suggest that QHES implementation lead to a decrease in some adverse physical and psychosocial work factors. Few effects were observed on WMSP.

Evaluation of the Quebec Healthy Enterprise Standard: Effect on Adverse Psychosocial Work Factors and Psychological Distress.

Adverse psychosocial work factors are recognized as a significant source of psychological distress, resulting in a considerable socioeconomic burden. The impact of occupational health standards that aim to reduce these adverse work factors, such as the Quebec Healthy Enterprise Standard (QHES), is of great interest for public health. The aim of this study was to evaluate, for the first time, the effect of QHES interventions targeting adverse psychosocial work factors on the prevalence of these factors and of psychological distress among ten Quebec organizations. These outcomes were assessed by questionnaire using validated instruments before (T1, n = 2849) and 2-3 years following (T2, n = 2560) QHES implementation. Beneficial effects of interventions were observed for two adverse psychosocial work factors: low rewards (ratio of prevalence ratios (PRs) = 0.77, 95% CI = 0.66-0.91) and low social support at work (ratio of PRs = 0.89, 95% CI = 0.77-1.03). Moreover, beneficial effects of interventions were also observed on the prevalence of high psychological distress (ratio of PRs = 0.86, 95% CI = 0.75-0.998). Psychosocial interventions implemented in the context of this standard improved the psychosocial work environment and had beneficial effects on workers' mental health.

Taking Account of Gender Differences When Designing Interventions in Occupational Health? Lessons from a Study of the "Healthy Enterprise" Standard in Québec: Les différences de genre sont-elles prises en compte lors de la conception des interventions de prévention en santé au travail? Résultats d une étude sur la norme "Entreprises en Santé" dans les entreprises au Québec.

The literature shows substantial differences in occupational exposures between men and women, both between and within occupations, but remains very sparse on whether interventions are tailored to gender differences in the workplace. Our objective was to determine whether gender differences are taken into account when designing prevention interventions. This study is part of a project on the evaluation of interventions implemented in the framework of the "Healthy Enterprise" standard in Quebec organizations. Three sets of quantitative and qualitative data were collected in seven organizations and triangulated. Our results show that in the process of elaborating and implementing activities, the main objectives were to reach a maximum number of workers and meet the needs identified in a health and risk diagnosis. Activities were not tailored to the needs of specific subgroups of employees, such as gender or age. Not distinguishing men's and women's situations in this diagnosis may play a role in intervention design. Résumé La littérature montre des différences d'exposition au travail importantes entre les hommes et les femmes, y compris à catégories d'emploi identiques. Les études sur l'adaptation des interventions de prévention aux différences de genre dans les milieux de travail sont quasiment inexistantes dans la littérature. Notre objectif était de déterminer dans quelle mesure les différences de genre sont prises en compte lors de la conception des interventions de prévention. Cette étude fait partie d'un projet d'évaluation des interventions mises en œuvre dans le cadre de la norme «Entreprises en santéé au Québec. Trois séries de données quantitatives et qualitatives ont été collectées auprès de sept organisations et analysées par triangulation. Nos résultats montrent que lors du processus d'élaboration des activités, les principaux objectifs étaient d'atteindre un nombre maximal de travailleurs et de remplir les besoins identifiés dans le diagnostic des risques et de la santé des travailleurs. Le fait que la situation des hommes et des femmes n'ait pas été analysée séparément dans le diagnostic peut avoir joué un râle dans ce résultat. Les activités de prévention n'ont pas été conçues en tenant compte de sous-groupes de travailleurs en fonction du genre ou de l'âge.