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Implementation of an ergonomics intervention in a Swedish flight baggage handling company: a process evaluation
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76 Gävle, Sweden.ORCID iD: 0000-0001-9612-3766
Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76 Gävle, Sweden.
Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76 Gävle, Sweden.
Unit of Intervention and Implementation Research for worker health, Institute of Environmental Medicine, Karolinska Institutet, SE- 171 77 Stockholm, Sweden.
2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 3, article id e0191760Article in journal (Refereed) Published
Abstract [en]

Objective

To conduct a process evaluation of the implementation of an ergonomics training program aimed at increasing the use of loading assist devices in flight baggage handling.

Methods

Feasibility related to the process items recruitment, reach, context, dose delivered (training time and content); dose received (participants’ engagement); satisfaction with training; intermediate outcomes (skills, confidence and behaviors); and barriers and facilitators of the training intervention were assessed by qualitative and quantitative methods.

Results

Implementation proved successful regarding dose delivered, dose received and satisfaction. Confidence among participants in the training program in using and talking about devices, observed use of devices among colleagues, and internal feedback on work behavior increased significantly (p<0.01). Main facilitators were self-efficacy, motivation, and perceived utility of training among the trainees. Barriers included lack of peer support, opportunities to observe and practice behaviors, and follow-up activities; as well as staff reduction and job insecurity.

Conclusions

In identifying important barriers and facilitators for a successful outcome, this study can help supporting the effectiveness of future interventions. Our results suggest that barriers caused by organizational changes may likely be alleviated by recruiting motivated trainees and securing strong organizational support for the implementation.

Place, publisher, year, edition, pages
2018. Vol. 13, no 3, article id e0191760
National Category
Occupational Health and Environmental Health
Identifiers
URN: urn:nbn:se:uu:diva-316466DOI: 10.1371/journal.pone.0191760ISI: 000426896800008PubMedID: 29513671OAI: oai:DiVA.org:uu-316466DiVA, id: diva2:1077893
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1761Available from: 2017-03-01 Created: 2017-03-01 Last updated: 2018-05-22Bibliographically approved
In thesis
1. Working conditions and musculoskeletal disorders in flight baggage handling
Open this publication in new window or tab >>Working conditions and musculoskeletal disorders in flight baggage handling
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: Baggage handling is considered to be a heavy manual handling job including biomechanical exposures suspected of increasing the risk for musculoskeletal disorders. Aims: To document low back pain (LBP), shoulder pain (SP), and physical and psychosocial factors in baggage handlers, and to evaluate the implementation of an ergonomic intervention aiming to increase the use of loading assist devices. Methods: A questionnaire was utilized to characterize pain and psychosocial work conditions in 525 baggage handlers. The postures of 55 baggage handlers during 114 shifts were measured using inclinometry, half shift video-recordings were made for subsequent task analysis, and the number of aircraft handled was registered. Associations for psychosocial and biomechanical exposures with pain were assessed using regression analyses. An ergonomic intervention was implemented and evaluated using questionnaires and repeated interviews. Feasibility, intermediate outcomes, barriers and facilitators were assessed. Results: The prevalence rates of reported LBP and SP were 70% and 60%, respectively. Pain interfering with work (LBP - 30% and SP - 18%) and high pain intensity (LBP - 34% and SP - 28%) were associated with poor psychosocial working conditions. Extreme postures with arms elevated >60° occurred for 6.4% of the total time, and in trunk flexion >60° for 2.1% total time. In contrast, 71% of the total time was spent in a neutral trunk posture. The 90th percentile trunk forward flexion was 34.1°.  Daily shoulder pain increased in approximately one-third of all shifts and was positively associated with extreme work posture and the number of aircraft handled; this association was modified by influence and support. The intervention was delivered as planned, and dose received and satisfaction were rated as high. Motivated trainees facilitated implementation while lack of manager support, opportunities to observe and practice behaviors, follow-up activities, staff reduction, and job insecurity were barriers. Conclusion: The high prevalence rates of LBP and SP in baggage handlers were associated with psychosocial exposures, and daily shoulder pain was associated with higher biomechanical exposure. Barriers to implementation can be minimized by recruiting motivated trainees, securing strong organizational support, and carrying out follow-up activities.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. p. 59
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1321
Keywords
epidemiology, low back pain, shoulder pain, physical exposures, psychosocial exposures, inclinometry, implementation, process evaluation
National Category
Medical and Health Sciences
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:uu:diva-316468 (URN)978-91-554-9868-9 (ISBN)
Public defence
2017-05-17, Frödingesalen, Ulleråkersvägen, Uppsala, 09:30 (Swedish)
Opponent
Supervisors
Available from: 2017-04-26 Created: 2017-03-27 Last updated: 2017-05-05

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