Sigurdur Oli Sigurdsson

When workplace safety depends on behavior change: Topics for behavioral safety research

INTRODUCTION Comprehensive interventions that address public-health concerns invariably include behavior-change strategies. In occupational safety and health, behavioral safety is an approach designed to improve safety performance directly through peer observations of safe behaviors, goal setting, performance feedback, and celebrations or incentives for reaching safety goals. Although the basic components of behavioral safety processes have been studied and widely documented, the current safety literature reveals several gaps in knowledge. These gaps are associated mostly with wide practice variations among the common process elements and uncertainty about the influence of organizational and other external factors. IMPACT TO INDUSTRY A major objective of this paper was to highlight not only key topic areas that warrant further research, but also to propose a list of research questions that are tied to uncertainties about various intervention practices. If only a portion of these topic areas and research questions are addressed through systematic reviews, field interventions, surveys, and laboratory-based studies, then the knowledge gained will significantly improve the delivery and effectiveness of behavioral safety interventions and thus their impact on worker health and safety.

Maintenance of reinforcement to address the chronic nature of drug addiction

BACKGROUND Drug addiction can be a chronic problem. Abstinence reinforcement can initiate drug abstinence, but as with other treatments many patients relapse after the intervention ends. Abstinence reinforcement can be maintained to promote long-term drug abstinence, but practical means of implementing long-term abstinence reinforcement are needed. METHODS We reviewed 8 clinical trials conducted in Baltimore, MD from 1996 through 2010 that evaluated the therapeutic workplace as a vehicle for maintaining reinforcement for the treatment of drug addiction. The therapeutic workplace uses employment-based reinforcement in which employees must provide objective evidence of drug abstinence or medication adherence to work and earn wages. RESULTS Employment-based reinforcement can initiate (3 of 4 studies) and maintain (2 studies) cocaine abstinence in methadone patients, although relapse can occur even after long-term exposure to abstinence reinforcement (1 study). Employment-based reinforcement can also promote abstinence from alcohol in homeless alcohol dependent adults (1 study), and maintain adherence to extended-release naltrexone in opioid dependent adults (2 studies). CONCLUSION Treatments should seek to promote life-long effects in patients. Therapeutic reinforcement may need to be maintained indefinitely to prevent relapse. Workplaces could be effective vehicles for the maintenance of therapeutic reinforcement contingencies for drug abstinence and adherence to addiction medications.

Institutionalization and Response Maintenance in Organizational Behavior Management

Abstract A review of the Journal of Organizational Behavior Management(1991–2002) was conducted to determine to what extent researchers in OBM programmed for “institutionalization” of applied interventions. Criteria for the term “institutionalization” were derived from McSween and Matthews (2001), and Grindle, Dickinson, and Boettcher (2000). Four dependent measures of institutionalization were developed that addressed the extent to which internal staff was involved in the design of the intervention, whether in-house employees were trained in implementing any component of the intervention, and whether interventions incorporated formal systems of collecting data or dispensing consequences that were overseen by internal personnel. Data on intervention effectiveness and maintenance of intervention effects were collected. Results indicated that the majority of interventions incorporated at least one institutionalization element, and that the average study incorporated two institutionalization elements. A statistically significant outcome was obtained for a regression analysis in which number of institutionalization components in an intervention was used as a predictor variable, and effect sizes calculated between baseline and intervention phases was used as a criterion variable. A non-significant regression coefficient was, however, obtained when effect sizes calculated between baseline and maintenance phases were used as a criterion variable, and number of institutionalization variables as predictor. The failure of the regression analyses focused on effect sizes calculated between baseline and maintenance phases to reach statistical significance may have been due to the low number of studies that were included in the analyses (n= 7).

Discounting the value of safety: Effects of perceived risk and effort

INTRODUCTION Although falls from heights remain the most prevalent cause of fatalities in the construction industry, factors impacting safety-related choices associated with work at heights are not completely understood. Better tools are needed to identify and study the factors influencing safety-related choices and decision making. METHOD Using a computer-based task within a behavioral economics paradigm, college students were presented a choice between two hypothetical scenarios that differed in working height and effort associated with retrieving and donning a safety harness. Participants were instructed to choose the scenario in which they were more likely to wear the safety harness. Based on choice patterns, switch points were identified, indicating when the perceived risk in both scenarios was equivalent. RESULTS Switch points were a systematic function of working height and effort, and the quantified relation between perceived risk and effort was described well by a hyperbolic equation. CONCLUSION Choice patterns revealed that the perceived risk of working at heights decreased as the effort to retrieve and don a safety harness increased. IMPACT ON INDUSTRY Results contribute to the development of computer-based procedure for assessing risk discounting within a behavioral economics framework. Such a procedure can be used as a research tool to study factors that influence safety-related decision making with a goal of informing more effective prevention and intervention strategies.

Improving Treatment Integrity in a Human Service Setting Using Lottery-Based Incentives

The present study was conducted to improve implementation fidelity of discrete trial training procedures. Three participants were selected from a special education school providing services for students with intellectual disabilities. Staff behaviors measured included the correct implementation of a prompt hierarchy, the accuracy of data recorded, the correct delivery of prompts, and whether procedures were correctly set up for the following days activities. Intervention consisted of daily verbal and graphic feedback and a lottery-based incentive system in which staff had to perform at a set goal level for the week in order to be eligible for entry into a drawing. A multiple-baseline-across-participants design was utilized to evaluate the effects of the intervention package, and integrity improved consistently for all participants during the intervention.

Behavioral Safety in the Food Services Industry: Challenges and Outcomes

During the course of a 6-year behavioral safety consult at a food and drink industry site, data were collected on the number of Occupational Safety Health Administration (OSHA) recordable incidents, number of lost and restricted days, and number of peer safety observations. Employees were trained to identify safe and unsafe behavior, conduct peer observations, and provide peer feedback. Data collected from observations were utilized to deliver graphic feedback. Managers were encouraged to review graphic feedback with employees weekly, provide prompts for observation, and praise employees for conducting observations. A committee composed of employees and managers met monthly to address safety concerns. Reductions in incidents were observed over the course of the behavioral safety intervention, but a reversal to baseline could not be implemented. A negative correlation was observed between number of peer observations and number of recordable incidents. Results suggest that when employees conduct peer observations more frequently, the number of recordable incidents decreases.

Propensity to work among chronically unemployed adult drug users

Analyses were conducted to compare rates of employment before, during, and after employment at the therapeutic workplace, which is a novel employment-based treatment for drug misuse. Participants in two clinical trials attended the therapeutic workplace at higher rates than they worked before intake and six months after discharge. These data suggest that unemployed chronic drug misusers will attend work at higher rates at the therapeutic workplace than in the community when paid modest wages, and that the failure of chronic drug misusers to obtain employment in the community may not result from lack of interest in work.

Evaluating Preference for Graphic Feedback on Correct versus Incorrect Performance.

The current study evaluated preferences of undergraduate students for graphic feedback on percentage of incorrect performance versus feedback on percentage of correct performance. A total of 108 participants were enrolled in the study and received graphic feedback on performance on 12 online quizzes. One half of participants received graphic feedback on percentage of correct performance on the first four online quizzes and then received feedback on percentage of incorrect performance on the following four quizzes. The order was reversed for the other half of participants. Participants were then asked whether their feedback on the final four quizzes should depict percentage of correct or incorrect performance. Participants who completed the study overwhelmingly preferred feedback on correct performance. The type of feedback students received for the first four quizzes did not affect subsequent quiz performance, and feedback preference was not related to performance on quizzes.

Automated Measurement of Noise Violations in the Therapeutic Workplace

The present analysis was conducted to validate an automated measurement system of noise violations by participants in the therapeutic workplace, which is a model workplace that offers paid employment and vocational training programs to illicit drug users. We collected data on dB levels via an electronic dB meter in a computer classroom with many different sound sources, and defined noise violations as sounds exceeding 55 dB. Human observers recorded whether staff or participants were responsible for violations, the types of events that resulted in violations, and whether these events were a result of participant behavior. Our analyses revealed that participants caused the majority of noise violations. These results suggest that the automated measurement system collects valid data on participant behavior that contributes to noise violations. Our results also suggest that these behaviors can in principle be modified to reduce the frequency of noise violations. Suggestions for replication in other settings and interventions designed to reduce behaviors leading to noise violations involving feedback and incentives are discussed.

Sustained effects of a visual prompt on dish storage in a hospital unit

We evaluated a strategy for decreasing improperly stored dishes in a hospital unit. A humorous sign and a neutral sign were posted to remind staff to store dishes properly, and follow-up data were collected to determine maintenance effects. Relative to baseline, fewer dishes were stored improperly when a sign was posted, regardless of sign content. These effects were maintained during a 4-month follow-up. Results of social validity questionnaires showed low acceptability for the humorous sign and moderate acceptability for the neutral sign.