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Proposed National Total Worker 

Health Tm Agenda Town-Hall 

1St International Symposium to Advance Total Worker HealthTM 

Oct. 6-8, 2014 

Sara L. Tamers, PhD, MPH, Health Research Scientist and Coordinator for Research 

Program Development and Collaboration 

Office for Total Worker HealthTM Coordination and Research Support, National 

Institute for Occupational Safety and Health, CDC 

The findings and conclusions in this presentation have not been formally disseminated by the National Institute for 

Occupational Safety and Health, and should not be construed to represent any agency determination or policy. 
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Purpose of Town-hall Meetings 

Elicit oral comment from stakeholders to 

develop the most relevant National Total 

Worker HealthTM (TWHTM) Agenda 

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TWHProposed Strategic Goal 1 

Research: Advance and conduct etiologic, 

surveillance, and intervention research that 

builds the evidence base for effectively 

integrating health protection and health 

promotion activities in the workplace. 

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Proposed Strategic Goal 2 

Practice: Increase the awareness and adoption 

of effective, integrated occupational safety 

and health protection and health promotion 

activities in the workplace. 

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Proposed Strategic Goal 3 

Policy: Create guidance for policies that 

promote integration of occupational safety 

and health protection and health promotion 

activities in the workplace. 

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Proposed Strategic Goal 4 

Capacity-Building: Build professional capacity 

to strengthen the TWH workforce and TWH 

field to support the development, growth, 

and maintenance of integrated occupational 

safety and health protection and health 

promotion activities in the workplace. 

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Questions to Consider 

1. Do you see your own organization's goals 

reflected in the Proposed National Total 

Worker Health Agenda? 

2. What are the bridges between your own 

work and the Proposed National Total 

Worker Health Agenda? 

3. Are there any missing components or gaps in 

the Proposed National Total Worker Health 

Agenda? 

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TWH_ TO'CAL WORKF;R HE:AI:Cli 

How will the NIOSH Total Worker 

Health Program Select Partners.? 

Potential consideration identified: 

—suitability criteria for employers to meet in 

order to engage in a TWH-related partnership 

with NIOSH 

NIOSH undertaking simultaneous effort to 

develop "partnering" criteria 

Models to consider include the OSHA Voluntary 

Protection Program criteria 

Stakeholder input for other criteria will be sought 

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TWH_ TnTA1. W(1RItFR NF.AITH — 

Rules for Townmhall Oral Comments 

Introduce yourself (name and affiliation) 

Limit comments to 5 minutes maximum 

—Questions to NIOSH are included in the 5 

minute time allotment per speaker 

Highlight critical points to be included in the 

National TWH Agenda 

— Remaining points should be submitted to the 

Docket 

Oral comments given at the meeting will be 

recorded and included in NIOSH-275 Docket 

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Opportunity for Written Comment 

Submit written comments (CDC-2014-0014, Docket 

Number NIOSH-275) by one of the following: 

— Internet: http://www.regulations.gov Enter CDC2014-0014 in the search field and click "Search." 

— Mail: National Institute for Occupational Safety and 

Health, NIOSH Docket Office, 1090 Tusculum Avenue, 

MS C-34, Cincinnati, Ohio 45226-1998. Identify the 

submission for NIOSH Docket-275 

Written comments must be made by 11:59 PM EST 

on December 22, 2014 

All comments will be reviewed and responded to 

accordingly 
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Auxiliary Slides 

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Strategic Goals and Sub-Goals 
TWH I'OTAL WORKEK F1EAI:C11 

Proposed Goals 

• Proposed National TWH Agenda includes four strategic 

goals: research, practice, policy, and capacity-building 

• Achievement of goals will move Nation towards creation 

of work environments that support TWH approaches 

• Each strategic goal supported by sub-goals that lead to the 

achievement of the strategic goal 

• Intent is to jumpstart national conversation and elicit 

input/comment from stakeholders to develop the most 

relevant TWH agenda 

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Research Goals 

Strategic Goal 1. Advance and conduct etiologic, 

surveillance, and intervention research that builds 

the evidence base for effectively integrating health 

protection and health promotion activities in the 

workplace. 

Etiologic/health effects research 

Investigate work and non-work contributions to 

worker safety and health conditions to better 

understand their sources and identify TWH 

interventions. 
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Research Goals (cont'd) 

Surveillance research 

• Improve surveillance systems to expand study of risks to 

worker safety, health, and well-being by incorporating more 

information on: 

— work-related exposures in public health surveys and other 

surveillance systems; and 

— non-work conditions and exposures in occupational safety 

and health hazard surveys and other surveillance systems. 

• Expand current surveillance systems or develop new ones to 

track the adoption and reach of TWH interventions over time. 

• Develop measures to guide integrated interventions in 

organizations, such as Health Risk Appraisals, that reliably 

capture both work-related and non-work exposures that pose 

safety and health risks. 
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Research Goals (cont'd) 

Intervention research 

• Investigate the merits of integrated interventions relative to 

comprehensive but parallel worksite health promotion (WHP) and 

occupational safety and health (OSH) protection interventions, and to 

unilateral WHP or OSH interventions. 

• Address a broad range of outcomes to include: 

— subclinical (e.g., biomarkers), health status (morbidity and mortality), 

and health-related quality of life indicators of illness, injury, and wellbeing to better understand the efficacy and effectiveness of 

integrated intervention strategies; and 

— measures of organizational effectiveness (e.g., turnover, 

presenteeism, and other performance indicators) and economic 

indicators to better understand the cost-effectiveness of TWH 

programs and help establish the business case for integrated 

prevention strategies. 

• Give further attention to the theoretical underpinnings of TWH 

intervention studies to better understand why and under what 

circumstances TWH interventions can be effective. 
TWil I O"fAL WORKER HEAI:f H` 

Research Goals (intervention-cont"d 

• Investigate organizational policies and practices that support or 

detract from the adoption, development, effectiveness, efficacy, and 

sustainability of integrated occupational safety and health 

protection and health promotion programs. 

• Investigate the broader integration of: 

— workplace prevention activities (i.e., benefit programs and 

policies, Employee Assistance Programs) together with 

occupational safety and health and health promotion activities; 

and 

— community and public health prevention activities together with 

workplace prevention activities. 

• Design TWH interventions to target workers at high-risk for 

exposure to both work-related and non-work hazards. 

• Design TWH interventions for especially prevalent and costly 

conditions (e.g., mental health outcomes) that result from joint 

exposure to work-related and non-work hazards. 
TWHPractice Goals 

Strategic Goal 2. Increase the awareness and adoption of effective, integrated 

occupational safety and health protection and health promotion activities in the 

workplace. 

• Increase adoption of TWH best practices developed based on research evidence 

and scientifically-derived consensus statements. 

• Establish partnerships with corporate, labor, government, professional, and 

academic organizations to foster the uptake of TWH practices in the workplace. 

• Increase awareness among workers, employers, professional associations, labor 

unions and other stakeholders of TWH practices and their benefits in order to 

promote adoption of TWH approaches. 

— Increase translation and dissemination of TWH research information and 

practice models. 

— Develop an internet-based open source system for disseminating TWH best 

practices recommendations, tool kits, mobile apps, and model programs. 

— Organize national and regional conferences, distance-learning events, and 

other web-based educational offerings on TWH. 

— Conduct a national survey to assess the adoption of TWH practices to target 

dissemination and promotion activities. 
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Policy Goals 

Strategic Goal 3. Create guidance for policies that promote 

integration of occupational safety and health protection and 

health promotion activities in the workplace. 

• Develop policy guidance on TWH best practices. 

• Establish mechanisms to promote corporate TWH 

responsibility and sustainability. 

• Offer direction on TWH approaches specifically for high-risk 

worksites and small- and medium-sized companies. 

• Explore strategies for the transfer of integrated OSH 

prevention activities to the general health care delivery 

system. 
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Capacity-Building Goals 

Strategic Goal 4. Build professional capacity to strengthen the TWH 

workforce and TWH field to support the development, growth, and 

maintenance of integrated occupational safety and health protection 

and health promotion activities in the workplace. 

• Identify training needs and develop core competencies and guidance 

for certificates, degree programs, and continuing education fostering 

integration of occupational safety and health protection with health 

promotion. 

• Identify existing educational programs and curricula that support TWH 

concepts and training, and the best ways that federal programs and 

granting agencies can support these educational activities. 

• Promote events and foster partnerships among TWH, OSH, public 

health, health promotion, and other stakeholders from multidisciplinary sectors to strengthen the TWH field. 

• Explore the benefits of creating a professiona) organization for TWH 

professionals. 

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Background 

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T V V H i'OTAL WORKER HEALTFI 

National Occupational Research Agenda 

• National Occupational Research Agenda (NORA) is a 

research framework for NIOSH and the Nation 

• Fuels innovative research and enhanced workplace 

practices 

• Stakeholders collaborate to pinpoint vital issues in 

workplace safety and health and identify goals 

• NORA organized by 10 sector programs and 24 cross-sector 

programs 

• Total Worker HealthTM (TWH TM) is a cross-sector program, 

with potential to impact each sector 

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T V V H_ ('OTAL WORKER N 1''"' 

Proposed National Total Worker Health Tll 

Agenda 

• First national effort to create agenda for field of integrated 

occupational safety and health protection and health promotion 

• Includes goals to address priority areas in TWH 

— Internal and external stakeholder input 

— Evidence-based sources: Cherniack, Henning et al. 2010, 

Hymel, Loeppke et al. 2011, Sorensen, Landsbergis et al. 

20111 NIOSH 2O12... 

• Provides guidance for TWH stakeholders/audiences 

— Research funding entities, labor, industry, safety and health 

practitioners, health promotion professionals, future TWH 

workforce... 

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