Risks, solutions and implementation of a participatory ergonomic intervention in 16 day nurseries: A process evaluation of the TOY wait-list cluster-randomized controlled trial

More evidence-based initiatives to reduce physical work demands during childcare work to prevent ill health and promote the ability to care for the children among childcare workers are needed. In a process evaluation performed alongside a two-arm, cluster-randomized study with a waiting-list control among 16 day nurseries lasting 20-weeks that significantly reduced musculoskeletal pain-related sickness absence we investigated 1) risk factors and solutions perceived by the childcare workers, and 2) implementation of the intervention. Most of the perceived risk factors were categorized as physical (70 %) with most of the suggested solutions also being categorized as physical (61 %). The remaining risk factors were categorized as organizational risk factors (16 %) and psychosocial risk factors (13 %). The remaining solutions were distributed almost equally between the organizational (20 %) and psychosocial categories (19 %). About half (51 %) of the action plans showed high implementation success. Of 16 workshops, 100 % were delivered with a fidelity of 83 %. Average participation, exposure, responsiveness and implementation were 68 %, 56 %, 83 % and 47 %. The implementation score differed for timing of intervention but not for nursery characteristics. This study showed that complex and diverse participatory ergonomic interventions should focus on physical, organizational and psychosocial factors to have a positive effect

Improving work for the body - a participatory ergonomic intervention aiming at reducing physical exertion and musculoskeletal pain among childcare workers (the TOY-project): Study protocol for a wait-list cluster-randomized controlled trial

Background: The prevalence of musculoskeletal pain (MSP) is persistently high throughout the world. Work-related factors such as high physical workload (lifting, bending and twisting of the back) are considered to be among the main causes of MSP. Work in childcare includes the need to lift, carry, and support children in a range of activities, requiring several demanding postures and movements, such as bending forward and twisting of the back and sitting on the floor. Participatory ergonomics may represent a solution for decreasing the physical workload to reduce MSP. We present the protocol of a study aiming to evaluate the effect and process of a participatory ergonomics intervention designed to reduce physical exertion during work and MSP (including MSP interfering with work) among childcare workers. Methods/design: This study will use a two-arm cluster-randomized design employing a wait-list control, with childcare institutions forming the clusters. Three workshops will be conducted during the 4-month intervention period. Participants will identify risk factors for strenuous work and MSP, develop solutions for reducing the identified risk factors, and implement them in their team. An ergonomic consultant will guide the process. The data collection will consist of questionnaires and objective measures of heart rate and physical activity, observations of physical workload, and information on sickness absence based on company records. Primary outcomes are physical exertion during work and MSP (including pain-related work interference) measured at 4 months. Secondary outcomes measured at 4months are sickness absence due to MSP; objectively measured occupational physical activity and heart rate; and self-reported self-efficacy, employee involvement, and need for recovery. Alongside the trial, a process evaluation and an economic evaluation will be conducted. Discussion: The study will evaluate the effect and process of a participatory ergonomics intervention to reduce physical exertion at work and MSP among childcare workers. By performing a cluster-randomized controlled trial with an effect evaluation based on both objective and self-reported measures with the addition of a process evaluation and economic evaluation, this study will contribute to the evidence for prevention of MSP among a less studied occupational group. Results are expected in 2018-2019

Improving work for the body – a participatory ergonomic intervention aiming at reducing physical exertion and musculoskeletal pain among childcare workers (the TOY-project): study protocol for a wait-list cluster-randomized controlled trial

Abstract Background The prevalence of musculoskeletal pain (MSP) is persistently high throughout the world. Work-related factors such as high physical workload (lifting, bending and twisting of the back) are considered to be among the main causes of MSP. Work in childcare includes the need to lift, carry, and support children in a range of activities, requiring several demanding postures and movements, such as bending forward and twisting of the back and sitting on the floor. Participatory ergonomics may represent a solution for decreasing the physical workload to reduce MSP. We present the protocol of a study aiming to evaluate the effect and process of a participatory ergonomics intervention designed to reduce physical exertion during work and MSP (including MSP interfering with work) among childcare workers. Methods/design This study will use a two-arm cluster-randomized design employing a wait-list control, with childcare institutions forming the clusters. Three workshops will be conducted during the 4-month intervention period. Participants will identify risk factors for strenuous work and MSP, develop solutions for reducing the identified risk factors, and implement them in their team. An ergonomic consultant will guide the process. The data collection will consist of questionnaires and objective measures of heart rate and physical activity, observations of physical workload, and information on sickness absence based on company records. Primary outcomes are physical exertion during work and MSP (including pain-related work interference) measured at 4 months. Secondary outcomes measured at 4 months are sickness absence due to MSP; objectively measured occupational physical activity and heart rate; and self-reported self-efficacy, employee involvement, and need for recovery. Alongside the trial, a process evaluation and an economic evaluation will be conducted. Discussion The study will evaluate the effect and process of a participatory ergonomics intervention to reduce physical exertion at work and MSP among childcare workers. By performing a cluster-randomized controlled trial with an effect evaluation based on both objective and self-reported measures with the addition of a process evaluation and economic evaluation, this study will contribute to the evidence for prevention of MSP among a less studied occupational group. Results are expected in 2018–2019. Trial registration ISRCTN, ISRCTN10928313 . Registered on 11 January 2017

Improving work for the body – a participatory ergonomic intervention aiming at reducing physical exertion and musculoskeletal pain among childcare workers (the TOY-project): study protocol for a wait-list cluster-randomized controlled trial

Abstract Background The prevalence of musculoskeletal pain (MSP) is persistently high throughout the world. Work-related factors such as high physical workload (lifting, bending and twisting of the back) are considered to be among the main causes of MSP. Work in childcare includes the need to lift, carry, and support children in a range of activities, requiring several demanding postures and movements, such as bending forward and twisting of the back and sitting on the floor. Participatory ergonomics may represent a solution for decreasing the physical workload to reduce MSP. We present the protocol of a study aiming to evaluate the effect and process of a participatory ergonomics intervention designed to reduce physical exertion during work and MSP (including MSP interfering with work) among childcare workers. Methods/design This study will use a two-arm cluster-randomized design employing a wait-list control, with childcare institutions forming the clusters. Three workshops will be conducted during the 4-month intervention period. Participants will identify risk factors for strenuous work and MSP, develop solutions for reducing the identified risk factors, and implement them in their team. An ergonomic consultant will guide the process. The data collection will consist of questionnaires and objective measures of heart rate and physical activity, observations of physical workload, and information on sickness absence based on company records. Primary outcomes are physical exertion during work and MSP (including pain-related work interference) measured at 4 months. Secondary outcomes measured at 4 months are sickness absence due to MSP; objectively measured occupational physical activity and heart rate; and self-reported self-efficacy, employee involvement, and need for recovery. Alongside the trial, a process evaluation and an economic evaluation will be conducted. Discussion The study will evaluate the effect and process of a participatory ergonomics intervention to reduce physical exertion at work and MSP among childcare workers. By performing a cluster-randomized controlled trial with an effect evaluation based on both objective and self-reported measures with the addition of a process evaluation and economic evaluation, this study will contribute to the evidence for prevention of MSP among a less studied occupational group. Results are expected in 2018–2019. Trial registration ISRCTN, ISRCTN10928313 . Registered on 11 January 2017

Additional file 1: of Improving work for the body â a participatory ergonomic intervention aiming at reducing physical exertion and musculoskeletal pain among childcare workers (the TOY-project): study protocol for a wait-list cluster-randomized controlled trial

SPIRIT 2013 checklist: Recommended items to address in a clinical trial protocol and related documents. (DOC 121 kb