Designing Occupational Safety and Health Training Materials for Clear Communication.

INTRODUCTION: Printed materials are an essential part of occupational safety and health programs. Public health professionals at the Centers for Disease Control and Prevention (CDC) have created a Clear Communication Index (CCI) to guide design of health education materials for the general public. METHODS: We revised an existing handout on heat exposure hazards in construction using the CCI and tested the old and new versions of the handout with an audience of 425 construction apprentices and journey-level workers. RESULTS: Some features recommended by the CCI-such as the use of subheadings, numbering, and other visual cues-strongly conditioned the readers' understanding of the main message. CONCLUSIONS: Design and layout have a significant impact on the delivery of messages in written materials. A communications-based rubric such as the CCI can help writers preparing written occupational safety and health materials for workers and general audiences.

A Framework for Integrating Environmental and Occupational Health and Primary Care in a Postdisaster Context.

CONTEXT: Integration of environmental and occupational health (EOH) into primary care settings is a critical step to addressing the EOH concerns of a community, particularly in a postdisaster context. Several barriers to EOH integration exist at the physician, patient, and health care system levels. PROGRAM: This article presents a framework for improving the health system's capacity to address EOH after the Deepwater Horizon oil spill and illustrates its application in the Environmental and Occupational Health Education and Referral (EOHER) program. This program worked with 11 Federally Qualified Health Center systems in the Gulf Coast region to try to address the EOH concerns of community members and to assist primary care providers to better understand the impact of EOH factors on their patients' health. IMPLEMENTATION: The framework uses a 3-pronged approach to (1) foster coordination between primary care and EOH facilities through a referral network and peer consultations, (2) increase physician capacity in EOH issues through continuing education and training, and (3) conduct outreach to community members about EOH issues. EVALUATION: The EOHER program highlighted the importance of building strong partnerships with community members and other relevant organizations, as well as high organizational capacity and effective leadership to enable EOH integration into primary care settings. Physicians in the EOHER program were constrained in their ability to engage with EOH issues due to competing patient needs and time constraints, indicating the need to improve physicians' ability to assess which patients are at high risk for EOH exposures and to efficiently take environmental and occupational histories. DISCUSSION: This article highlights the importance of addressing EOH barriers at multiple levels and provides a model that can be applied to promote community health, particularly in the context of future natural or technological disasters.