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Implementation of an ergonomics intervention in a Swedish flight baggage handling company - a process evaluation
University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.ORCID iD: 0000-0001-9612-3766
University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.ORCID iD: 0000-0003-1443-6211
University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.ORCID iD: 0000-0002-7322-9346
Unit of Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institutet.
2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203Article in journal (Refereed) Submitted
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(recruitment, reach, context, dose delivered, dose received, satisfaction); intermediate outcomes (skills, confidence and behaviors); and barriers and facilitators of the training intervention were assessed by qualitative and quantitative methods. Results: Implementation proved feasible 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, our study can help supporting the effectiveness of future interventions. Our results show 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
2017.
Keyword [en]
implementation barriers, implementation facilitators, musculoskeltal disorders, loading assist devices, qualitative methods
National Category
Environmental Health and Occupational Health
Identifiers
URN: urn:nbn:se:hig:diva-21685OAI: oai:DiVA.org:hig-21685DiVA: diva2:938244
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1761
Available from: 2016-06-16 Created: 2016-06-16 Last updated: 2017-09-26Bibliographically 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. 59 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1321
Keyword
epidemiology, low back pain, shoulder pain, physical exposures, psychosocial exposures, inclinometry, implementation, process evaluation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hig:diva-25324 (URN)
Public defence
2017-05-17, Frödingesalen, Ulleråkersvägen, Uppsala, 09:30 (English)
Opponent
Supervisors
Available from: 2017-09-27 Created: 2017-09-26 Last updated: 2017-09-27Bibliographically approved

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