D Van Eerd

Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence

The burden of disabling musculoskeletal pain and injuries (musculoskeletal disorders, MSDs) arising from work-related causes in many workplaces remains substantial. There is little consensus on the most appropriate interventions for MSDs. Our objective was to update a systematic review of workplace-based interventions for preventing and managing upper extremity MSD (UEMSD). We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis. 6 electronic databases were searched (January 2008 until April 2013 inclusive) yielding 9909 non-duplicate references. 26 high-quality and medium-quality studies relevant to our research question were combined with 35 from the original review to synthesise the evidence on 30 different intervention categories. There was strong evidence for one intervention category, resistance training, leading to the recommendation: Implementing a workplace-based resistance training exercise programme can help prevent and manage UEMSD and symptoms. The synthesis also revealed moderate evidence for stretching programmes, mouse use feedback and forearm supports in preventing UEMSD or symptoms. There was also moderate evidence for no benefit for EMG biofeedback, job stress management training, and office workstation adjustment for UEMSD and symptoms. Messages are proposed for both these and other intervention categories.

Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions: An Update of the Evidence and Messages for Practitioners

Purpose The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results Seven electronic databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability.

545 Workplace practices and policies to support workers with depression

Introduction The burden associated with the effects of depression in the workplace is extensive. Workers with depression lose more health-related productive time, have higher rates of absenteeism and short-term disability, and experience higher rates of job turnover than those without depression. Our objective is to synthesise evidence from the scientific literature, practice evidence (workplace policies and practices), and experiences from OHS stakeholders. Methods Our study sample is OHS stakeholders: workers, managers, and consultants in workplaces from our contact database (approximately 700 OHS contacts across Canada willing to be contacted for research). Data collection includes a web-based survey, focus groups (ongoing), and interviews (ongoing) with stakeholder representatives from multiple sectors. We are collecting information about workplace practices and policies to prevent productivity losses, promote stay-at-work, and support return-to-work for workers with depression. The synthesis is a two stage process: first synthesising practice evidence gathered from stakeholders and then combining that with evidence from the scientific literature. Results Preliminary results (n=400, 73% workers, 27% managers/consultants) reveal a willingness among participants to share their experiences with depression and work. Workers report practices related to non-judgemental listening and external supports were most helpful to them. Managers/consultants suggest non-judgemental listening and employee assistance programs were most helpful. However, workers often feel workplace support is lacking and report non-supportive supervisors as a key barrier to receiving needed support. Managers indicate a lack of training and knowledge about depression are the main barriers to providing support to workers. Workers did not feel providing information was helpful whereas managers often did. Conclusion Preliminary results reveal the importance of non-judgemental listening as a workplace support for depression. However, responses reveal workers and managers do not have similar experiences of workplace support. Synthesising practice and scientific evidence will help guide policies and practices to support workers with depression.

603 Workplace practices and policies to prevent msd: developing an implementation guide

Introduction Musculoskeletal disorders (MSD) continue to be a major burden for workplaces and workers as well as insurance and health systems. Evidence-based approaches are desired but research-to-practice gaps remain. One reason for gaps is the necessary research of sufficient quality is often not available. However evidence-based practice considers both scientific evidence as well as practitioner expertise. Our objective is to synthesise evidence from the scientific literature, practice evidence (policies and practices), and experiences from stakeholders. Methods Scientific evidence from recently published reviews, including a recent review our team completed, will be synthesised. Evidence from practitioners’ expertise and worker experiences are being collected using a web-based survey, focus groups, and interviews with representatives from various stakeholder groups from multiple sectors. We are using the Public Health Agency of Canada’s best practices portal to structure data collection of workplace practices and policies. We are synthesising the evidence gathered from stakeholders with that from recently published systematic reviews. Result Recent systematic review results revealed 61 high and medium studies addressing MSD. The studies described 30 different intervention categories. There was strong evidence that resistance training has a positive effect and moderate evidence that stretching, using a feedback mouse, and workstation forearm supports have positive effects. However the level of evidence was too low to make recommendations for many other interventions. The survey and interview/focus groups to collect practice-based evidence are ongoing. Discussion The presentation will focus on current policies and practices described by our practitioner and workplace audiences as compared to the scientific evidence. The discussion will outline the synthesis of evidence and co-creation (with OHS stakeholders) of a practical guide to help workplaces develop and implement effective practices and policies to prevent MSD and help workers with MSD return to work safely.

1597c Sharing solutions in participatory ergonomics – a key to sustainability

Introduction Musculoskeletal disorders (MSD) and slips, trips, and falls (STF) are a major source of workplace injuries. In Ontario, MSD account for upwards of 40% and STF account for almost 20% of all lost-time claims depending on sector. Our objective was to integrate stakeholder perspectives about the implementation of a participatory ergonomics program. Methods The project builds on a recently completed pilot study and process evaluation of the Employee Participation in Change (EPIC) program in three work sites (391 workers) within one organisation. Individual interviews were conducted with Program Champions (n=3) and an interactive stakeholder workshop, including a moderated focus group (n=13), was held. Data from Program Champions informed the interactive workshop. Focus group data centred on strategies for knowledge sharing and program recommendations. Transcripts and field notes were analysed for emerging themes. Results Participants reported positive experiences with program implementation. EPIC has been sustained and incorporated into existing health and safety procedures at all sites. Improvements in communication about safety were noted in all cases. Funding to implement changes remains a challenge in all sites. Program champions, site administrators and worker representatives led discussions consistently noted positive changes but also described the need for iteration in solution development. Focus group results included suggestions to reduce program training and paperwork burdens. Key barriers included the time it takes to implement solutions. Frontline workers continue to use EPIC hazard identification tools and practices, and communicate about hazards and solutions regularly. The ‘raised awareness’ from EPIC has persisted. A key facilitator to success included the role of ergonomics consultants. Conclusion EPIC program stakeholders participated in an interactive workshop to inform improvements in program delivery and evaluation of a participatory intervention. Participants noted that sharing solutions across sites would have been useful earlier. Future implementation research will incorporate solution sharing opportunities.

963 Iwh research alert – staying current with ohs literature

Introduction Keeping abreast of the current literature is difficult for any researcher but OHS researchers have particular difficulty because the literature cuts across a variety of fields, such as medicine, public health, psychology, and business. To address this issue, the IWH Library provides a current awareness service called Research Alert. This weekly email provides a listing of recent OHS literature. The alert was originally disseminated to internal researchers but due to popularity is now distributed to external researches and is posted on the Institute’s website. The purpose of this poster is to describe our approach to provide OHS researchers with current, relevant OHS literature as well as highlight and disseminate IWH authored literature. The poster will also describe key elements of the literature retrieved for these alerts. Methods We conducted a citation analysis of an internal database containing the references of literature cited in Research Alert from 2011 – 2016. We note sources for identifying this literature, journals that appear most frequently, journal impact factors. Additional analyses will be conducted on the distribution of these alerts. Results 4997 references were analysed over the six-year period. The alerts average 70 articles per month. JOEM, OEM, JOR, SJWEH, and JCE were the top cited journals. The main methods of identifying literature were hand-searching of journals (n=3331), followed by journal alerts of new issues (n=712), saved database searches (n=563), and suggestions by internal scientists (n=287). Conclusion IWH’s Research Alert highlights and disseminates recent OHS literature from various sources for IWH researchers. While the literature may be located through a number of different mechanisms, we found some specific OHS journals are most relevant for this field. The methods we use to locate and disseminate the literature may be used by others in their field.

547 Systematic review evidence in one minute or less

Introduction Getting research evidence to knowledge users is a challenge. The Institute for Work and Health (IWH) initiated a systematic review program in 2004 to synthesise scientific literature on prevention of workplace injuries and disability. IWH systematic review products include 2–3 page lay summaries (called Sharing Best Evidence). The lay summaries are popular but are considered long by some knowledge users. Our objective was to produce and post short videos that summarise key findings of systematic reviews in one minute or less. Methods Video shorts are created by a multi-disciplinary team including a researcher, a video producer and a communications expert. The video shorts are based on high quality research (e.g. systematic review findings). Key messages are created in consultation with stakeholders. The production process begins with a storyboard (frame-by-frame outline). Development requires careful attention to style, pacing, tone, clarity, visual interest and audience appeal. Videos are tested with members of the target audience before being posted. Video shorts typically take about four weeks to complete. Results Two, 1 min videos were developed by IWH made to reach busy stakeholders with evidence they need in their work. The first video, posted since October 2016, is popular receiving over 1100 hits to date. Length: Videos are kept as short as possible, less than one minute. Format: No voice-overs are used. Simple graphics, images, text and short video clips are used, with instrumental background music. Content: Key messages from research findings are delivered in brief snippets of text. Conclusion Our videos are designed to serve two purposes: provide viewers with key evidence they can use, and link the viewer to the IWH website where they can read more information. Consultations with stakeholders on the key messages are important. One-minute research video shorts are an effective means of disseminating key research findings.