The Relational Fit in Organizational Interventions-What Can Organizational Research Learn from Research in Psychotherapy?

There is a growing interest in organizational interventions (OI) aiming to increase employees' well-being. An OI involves changes in the way work is designed, organized, and managed. Studies have shown that an OI's positive results are increased if there is a good fit between context and intervention and between participant and intervention. In this article, we propose that a third fit-the Relational Fit (R-Fit)-also plays an important role in determining an intervention's outcome. The R-Fit consists of factors related to (1) the employees participating in the OI, (2) the intervention facilitator, and (3) the quality of the relation between participants and the intervention facilitator. The concept of the R-Fit is inspired by research in psychotherapy documenting that participant factors, therapist factors, and the quality of the relations explain 40% of the effect of an intervention. We call attention to the importance of systematically evaluating and improving the R-Fit in OIs. This is important to enhance the positive outcomes in OIs and thereby increase both the well-being and productivity of employees. We introduce concrete measures that can be used to study and evaluate the R-Fit. This article is the first to combine knowledge from research in psychotherapy with research on OIs.

Is perception of safety climate a relevant predictor for occupational accidents? Prospective cohort study among blue-collar workers.

Objectives The capability of safety climate to predict accidents has been the target of widespread debate in occupational health and safety research. The objective of this prospective cohort study was to employ a shortened five-item safety climate survey to investigate whether safety climate reports in 2012 are predictive for accidents reported within the last 12 months in 2014. Methods In both 2012 and 2014, 3864 blue-collar workers answered the Danish Working Environment and Health Cohort Study. Logistic regression was used to study the association [odds ratio (OR)] of reporting a work-related accident (yes/no) with more than one day of sickness absence (outcome) within the last 12 months in 2014 with the number of safety climate problems (predictor). The analyses were cumulatively adjusted for age, gender (model 1), socioeconomic class, occupational group, lifestyle (model 2), and previous accidents in 2012 (model 3). Results Of the safety climate problems reported in 2012, 1017 (28%) participants reported one problem, 357 (10%) reported two and 614 (17%) reported three or more problems. Using the number of safety climate problems as a continuous variable, all models showed a dose-response relationship between number of safety climate problems in 2012 and at least one accident in 2014 (trend-test, P<0.001). Compared to participants with no safety climate problems, participants reporting two safety climate problems in 2012 had a higher risk for reporting an accident in 2014 [OR 1.84, 95% confidence interval (CI) 1.22-2.77], and the risk was higher for participants reporting three or more safety problems (OR 2.22, 95% CI 1.60-3.09). Conclusions A higher number of safety climate problems progressively increased the OR for reporting at least one accident within the last 12 months at the two-year follow-up. The five-item safety climate survey is a simple and important tool that can be used as part of risk assessment in blue-collar workplaces.

Contradictory individualized self-blaming: a cross-sectional study of associations between expectations to managers, coworkers, one-self and risk factors for musculoskeletal disorders among construction workers.

BACKGROUND: Within work sociology, several studies have addressed construction workers' practices of masculinity, class, economy, safety risks and production. However, few studies have investigated room for agency in relation to bodily pain or musculoskeletal disorders and even fewer have made a quantitative approach. Accordingly, by means of a questionnaire, we examined the association between construction workers' room for agency and physical exertion, bodily and mental fatigue, and lower back pain. METHODS: A total of 481 Danish construction workers who responded to a multifaceted questionnaire were included. Drawing on previous studies and a Foucauldian inspired concept of agency, agency was quantified through specially crafted questions and examined in relation to established measures on physical exertion, physical and mental fatigue and pain in the lower back. Associations were tested using analyses of variance (general linear models) and controlled for age, gender, job group, lifestyle and depression. RESULTS: When asked about options for agency reducing the burden of work, few workers believed themselves to be prime agents of such practices. When asking about their view on performing alternative agency implying caring for the body, 39-49% expected negative reactions from management, and 20-33% expected negative reactions from colleagues. In contrast, only 13-18% of the participants stated that they would give a negative reception to such alternative practices. Using the expected reception outcomes (positive, neutral, negative) to alternative practices as predictors, the statistical regression analyses showed that negative expectations to management were associated with higher levels of physical exertion 0.62 (95% CI = 0.14-1.09) (scale 0-11), bodily fatigue 0.63 (95% CI = 0.22-1.04), mental fatigue 0.60 (95% CI = 0.07-1.12), and low back pain 0.79 (95% CI = 0.13-1.46) (scales 0-10). CONCLUSION: In our study, construction workers answered questions about work and MSD. The answers indicated a contradiction between perceived responsibility and room for agency. Based on the study, a number of target areas could fruitfully be addressed in aiming to reduce MSD among construction workers. To change workers' expectances to the reception of lowering work pace if needed to take care of the body, their expectances to the reception of sickness absence as a result of pain, of discussing physical exertion in work and of demanding appropriate technical assistive devices are such examples. Our results emphasize that management plays an important role in this.

Association between occupational lifting and day-to-day change in low-back pain intensity based on company records and text messages.

Objective This study aimed to investigate the association between occupational lifting and day-to-day change in low-back pain (LBP) intensity. Methods Each day for three consecutive weeks, 95 full-time workers from 51 Danish supermarkets with frequent occupational lifting replied to daily text messages about LBP intensity (scale 0-10). Supervisors at the supermarkets provided information about daily working hours and load (number of different pallets handled) for each worker during the three weeks. Linear mixed models with repeated measures tested the association between variables controlled for LBP during the previous day and various confounders. Results Workers handled on average 1212 [standard deviation (SD) 861] kg and worked 8.5 (SD 1.8) hours per workday. LBP intensity was higher in the morning after work- compared with non-workdays [difference of 0.55, 95% confidence interval (95% CI) 0.39-0.71]. A cumulative effect of consecutive workdays existed, ie, pain intensity increased approximately 0.30 points per day for up to three days. For three consecutive work- compared with non-workdays, the difference was 0.92 (95% CI 0.50-1.34). Higher load resulted in higher pain intensity in the morning after workdays [0.16 (95% CI 0.02-0.31) per ton lifted], while no effect was found for number of daily working hours. Conclusion Among workers with frequent occupational lifting, workdays are associated, in a cumulative manner, with increased LBP intensity. Furthermore, an exposure-response association exists between workload and increased LBP intensity. However, the increase in pain intensity was small and future studies should assess whether long-term consequences exist.

Associations between Wage System and Risk Factors for Musculoskeletal Disorders among Construction Workers.

Piece rate and performance based wage systems are common in the construction industry. Construction workers are known to have an increased risk of pain and musculoskeletal disorders (MSD). In this cross-sectional questionnaire study, we examined the association between wage system and (1) physical exertion, (2) time pressure, (3) pain, and (4) fatigue. The participants comprised 456 male Danish construction workers working on one of three different wage systems: group based performance wage, individually based performance wage, and time based wage system. The statistical analyses indicated differences between the wage systems in relation to physical exertion (ηp = 0.05) and time pressure (ηp = 0.03) but not to pain or fatigue. Workers on group based performance wage scored higher (i.e., worse) than workers on individual performance based wage and workers with an hourly/monthly wage. In conclusion, group performance based wage was associated with higher levels of physical exertion and time pressure. Accordingly, group performance based wage can be viewed as a factor that has the potential to complicate prevention of MSD among construction workers. Since performance based wage systems are common in many countries across the world, more attention should be paid to the health effects of these types of payment.

Participatory intervention with objectively measured physical risk factors for musculoskeletal disorders in the construction industry: study protocol for a cluster randomized controlled trial.

BACKGROUND: There is high prevalence of back pain and neck-shoulder pain among blue collar workers in Denmark. Excessive physical exposures such as heavy lifting or working with bended or twisted back are risk factors for back pain among workers in the construction industry. Technical evaluation of awkward postures and kinematics of upper/ lower extremities (accelerometry) during work combined with the level of muscular activity (EMG) and video recordings can improve quantification of physical exposure and thereby can facilitate designing preventive strategies. Participatory ergonomics potentially increase the success of interventions aimed at reducing excessive physical exposures. The objectives of this study are to; 1) determine which work-tasks in selected job-groups involve excessive physical load of the back and shoulders during a normal working day (measured with accelerometers, EMG and video recordings). And 2) investigate whether a participatory intervention can reduce the excessive physical workloads, drawing on measurements from phase 1. METHODS/DESIGN: A two-armed parallel-group, single-blind, cluster randomized controlled trial with allocation concealment will be conducted in the Danish construction industry. Approximately 20 construction gangs (≈ 80 subjects) will be recruited and randomized at the cluster level (gang). We will record in situ physical workload using technical measurements (EMG, accelerometers and video recordings) during a working day before and after the intervention. Based on these measurements a physical load matrix for each worker will be developed. The participatory intervention consist of three workshops: 1) One at baseline, involving presentation of video clips of the work-tasks with excessive physical load customized for each gang, followed by a participatory development of solutions on how to reduce excessive workloads, leading to development of an action plan on how to implement these solutions at the workplace. 2) A second workshop where the implemented solutions will be further developed and qualitatively evaluated during group discussions. 3) A final workshop at follow-up to enhance long-time organizational sustainability of the implemented solutions. DISCUSSION: The results will provide knowledge about the level of physical exposure of the back and shoulders during specific work tasks in the construction industry, and will provide information on options to implement participatory interventions aiming at reducing excessive physical workload. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02498197), registered 29 June 2015.