Safety and Health Programs in Alaska's Seafood Processing Industry: Interviews with Safety and Health Managers.

Background: The seafood processing industry is critical to Alaska's economy and hazardous to workers; however, limited research has addressed workers' safety and health. Safety and health program management is a decisive factor in preventing fatalities, injuries, and illnesses. We interviewed managers to gain their views on their safety and health programs.Methods: Semi-structured interviews were conducted with 14 upper-level managers who oversaw programs for Alaskan worksites. Interviews were audio-recorded and transcribed. Qualitative content analysis techniques, including inductive coding, were utilized to explore participants' experiences and views regarding: management and workers' roles; hazard control systems; safety and health training; regulatory and economic factors; and programs' challenges and successes.Results: The 14 participants represented 13 companies that operated 32 onshore plants and 30 vessels with processing capabilities. Participants reported managing programs for an estimated 68% of the Alaskan seafood processing industry's workforce. Based on participants' responses, we identified five factors that could be modified to improve safety and health industry-wide: manager training and knowledge sharing; worker training; organizational aspects related to safety culture; application of ergonomic principles; and work hours. Participants reported that fully engaging workers in programs was beneficial.Conclusions: Industry members should more widely share their best practices for protecting workers' safety and health. Occupational safety and health practitioners and researchers should support the development and evaluation of (a) training for non/limited-English-speaking-workers, (b) ergonomic interventions, and (c) fatigue risk management systems. Future research should engage worksite managers and workers to characterize their safety and health experiences and needs.

Better Respiratory Education and Treatment Help Empower (BREATHE) study: Methodology and baseline characteristics of a randomized controlled trial testing a transitional care program to improve patient-centered care delivery among chronic obstructive pulmonary disease patients.

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of hospitalizations. Interventional studies focusing on the hospital-to-home transition for COPD patients are few. In the BREATHE (Better Respiratory Education and Treatment Help Empower) study, we developed and tested a patient and family-centered transitional care program that helps prepare hospitalized COPD patients and their family caregivers to manage COPD at home. METHODS: In the study's initial phase, we co-developed the BREATHE transitional care program with COPD patients, family-caregivers, and stakeholders. The program offers tailored services to address individual patients' needs and priorities at the hospital and for 3months post discharge. We tested the program in a single-blinded RCT with 240 COPD patients who were randomized to receive the program or 'usual care'. Program participants were offered the opportunity to invite a family caregiver, if available, to enroll with them into the study. The primary outcomes were the combined number of COPD-related hospitalizations and Emergency Department (ED) visits per participant at 6months post discharge, and the change in health-related quality of life over the 6months study period. Other measures include 'all cause' hospitalizations and ED visits; patient activation; self-efficacy; and, self-care behaviors. DISCUSSION: Unlike 1month transitional care programs that focus on patients' post-acute care needs, the BREATHE program helps hospitalized COPD patients manage the post discharge period as well as prepare them for long term self-management of COPD. If proven effective, this program may offer a timely solution for hospitals in their attempts to reduce COPD rehospitalizations.