taking an evidence-based total worker health™ …...behav inform tech 2003;22:339‐351. formative...
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Taking an Evidence-basedTotal Worker Health™ Online
Diane Elliot, MD; Kerry Kuehl, MD, DrPH;and Linn Goldberg, MD;
Division of Health Promotion & Sports Medicine; Oregon Health & Science University; Portland, Oregon
STTR R41 TR000357
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PHLAME is distributed through the Center forHealth Promotion Research at Oregon Health &Science University (OHSU). Future PHLAMEderivatives will be available through OdysseyScience Innovations, LLC.
Diane Elliot, MD, Linn Goldberg, MD, & Kerry Kuehl, MD, DrPH, have a financial interest in the commercial sale of those products. This conflict of interest is being managed by the Conflict of Interest Committee at OHSU.
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Taking science to service presents challenges:
Evidence is only one factor influencing users’ program selection
Formats easily modified for piloting and initial use may not be best for dissemination
Technology is advancing rapidly
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In 1999, NIH asked for new models in behavior change, funding 19 studies as the Behavior Change Consortium.
Firefighters are at higher risk for cardiovascular disease, cancer, and injuries. Backfilling absences is a major expense. Fire departments are relatively stable, predictable worksites.
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PHLAME (Promoting Healthy Lifestyles: Alternative Models Effects)
Shifts at a fire station meet weekly for 12, 60-minute, peer-led scripted sessions and work through a curriculum concerning health and safety
Studied in randomized, controlled trial involving more than 600 firefighters
PHLAME informational video: www.youtube.com/watch?v=PG0YRFki9O0
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History of Paper-based PHLAME
One-year significant behavior change benefits.Occup Environ Med 2007;49:204-213.
Reduced injuries, illnesses and workers’ comp claims.Occup Med 2013 Apr;63(3):203-9.
Mediated by knowledge, peer norms and social support. J Occup Health Psychol 2011;16(4):501-13.
Durable trajectory of improvement four years after the intervention. Qualitative findings indicated combined work/TWH missions resulted in culture change.
Am J Health Behav 2013;37(5):693-702.
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Career firefighters are busier, with less department funding, fewer stations and more runs/station.
Training online, videos, gamers, and almost all have smartphones.
Move PHLAME online, enhance its user experience, make it fun and educational, while maintaining its mediating components (knowledge, norms, social support).
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Partnering with Web-development & Design Companies
Identify potential partners
Review their portfolios, talk with references, meet and ask for a bid
Plan a responsive website – accessible on any device, with speed and support
Identify individuals assigned to the project (developer, design, manager)
Make sure that you own the code/intellectual property
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eLearning Activity Each Shift, Individual/Team Goals, Competions & Electives
www.elearningguild.com/DevLearn/Health Promo Practice 2013;15(1):86-90.
Games: What’s a serving sizeSuper fruits and vegetables quizSleep jeopardy
Videos: Maximum oxygen uptakeAnimations
Whiteboard lectures: Power nap
Brain on alcohol
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Formative Assessments for Proof-of-Concept
Firefighter consultants during initial design
Heuristics
Usability testing – talk aloud analysis
Pre- and post- surveys and post-focus groups
Usability.govUsability inspection methods. New York, NY: Wiley, 1994:25‐64.International J Medical Informatics 2009:78:340‐353.Behav Inform Tech 2003;22:339‐351.
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Formative Assessment Findings
Assessed among 2 departments (one had done PHLAME)
Total 64 participants, average age 35
92% had a smartphone, all self-described as competitive and liked games
Preferred learning was videos (60%), last was reading (13%)
Easily on-boarded and >90% found it fun and easy to use
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1 2 3 4 5
Program fun
Like competing
Firefighters could use
Would benefit firefighters
Survey After Trial Findings
Strongly agree
Strongly disagree
Neutral
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Talk Aloud and Group Interviews
Likes: It was real easy to use. That’s the first thing that comes to mind.
I felt that we all went through…All the topics were well done, I thought. I thought it was easy to keep track of your goals. I mean, a lot of the stuff we were doing on shift together, so it was easy to keep track of marked down and did it.
I think once you got everybody on board and get them educated and everything, I think it would work well. Yeah.
Suggestions: Specific workouts
More charting and knowing where they ranked among all firefighters
Options for reminders – how frequently and type of pushed messages
Provided themes concerning what they liked and specific suggestions:
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Taking Science to Service
Online PHLAME’s proof-of-concept is an example of steps when building a web-based TWH program.
Not shown is a critical role for endorsement and distribution partners (IAFFs).
Next steps would be building out the entire program and evaluating its impact.
Building an evidence-based program isn’t enough, and additional abilities in marketing, business plan development and commercialization are needed.
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Taking an Evidence-basedTotal Worker Health™ Online
Diane Elliot, MD; Kerry Kuehl, MD, DrPH;and Linn Goldberg, MD;
STTR R41 TR000357
[email protected]; 503-494-6554
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