Lisa Brosseau, ScD, CIH Associate Professor School of Public Health

1
Lisa Brosseau, ScD, CIHAssociate
ProfessorSchool of Public Health

• What Motivates Owners of Small Businesses to
  Improve Health and Safety?

2
Outline

• Why Study This?
• What is Known?
• My Research
• What Next?

3
Why Study This?
4
What is Intervention Research?

• Study of planned applied activities designed to
  produce designated outcomes
• Types of HS Interventions
• Engineering - control at source
• Behavioral - encourage use of controls
• Administrative - control through policies

5
What makes a good study?

• Interventions of sufficient duration, frequency
  and intensity
• Use experimental study design
• Theoretical basis for designing study selecting
  and developing intervention activities

6
Selecting Interventions

• Current Approach
• Hierarchy of controls as selection tool
• OHS professionals deliver interventions
• Workers are usually target of intervention

7
What do we know about small business owners
motivations for improving HS?
8
Knowledge Beliefs
9
Knowledge about Hazards

• 64 think chemical products present no or small
  risk 8 think there is high risk
• 30 do not know or are incorrect about effects of
  chemicals they use
• 90 think they have good knowledge of products
• Material safety data sheets are available but
  rarely consulted

Biggs Crumbie, 2000, HSE UK (hairdressers,
electroplaters, dry cleaners, woodyards, garages)
10
Knowledge about Hazards

• Most electroplaters understand PPE
• But 25-30 of dry cleaners and hair dressers do
  not
• 60 cannot interpret symbol for harmful/irritant
• 70 do not know meaning of carcinogenic
• Owners only slightly better informed than
  employees about chemicals
• 30 managers do not know about chemical
  regulations

Biggs Crumbie, 2000, HSE UK (hairdressers,
electroplaters, dry cleaners, woodyards, garages)
11
What owners say about HS

• Workers are careless, unsafe behavior is the
  major reason for injury
• Hazards are not controllable or changeable
• Personal protective equipment is primary method
  of controlling exposures

J. Eakin, University of Toronto
12
What owners say about their roles

• 20 Come Down Hard
• Make rules
• Discipline failure to follow rules
• 60 Leave it Up to Workers
• Say they are not responsible

J. Eakin, University of Toronto
13
What Owners Say About Accidents

• Who has greatest impact on accident frequency?
• Workers 46
• Managers 4
• Workers/Managers Equally 46
• How often are accidents due to factors that can
  be controlled..
• By managers 49 not often
• By workers 89 usually or frequently

National Federation of Independent Businesses,
1995 (3200 owners in mfg, service, trade,
construction businesses)
14
Who Do Owners Listen To?
15
Owners sources of HS information

• Chemical information from
• container labels (60)
• suppliers sales reps
• MSDS
• Suppliers sales representatives most trusted
  sources of information

National Federation of Independent Businesses,
1995 (3200 owners in mfg, service, trade,
construction businesses)
16
Owners rely on a small network of trusted
business acquaintances for information about new
technologies
17
Barriers and Incentives
18
Why owners improve HS

• Cost of workers compensation insurance (59)
• Right thing to do (51)
• Increase profitability (33)
• State/Federal Rules (31)
• Too Many Accidents (29)
• Direct experience with accidents (self,
  colleague, friend) (12)

National Federation of Independent Businesses,
1995 (3200 owners in mfg, service, trade,
construction businesses)
19
Why Owners Dont Improve HS

• Already complying with rules (31)
• Costs (18)
• Wouldnt improve safety (10)
• Disruption of business (9)
• Lack of information (8)
• Employee resistance (6)

National Federation of Independent Businesses,
1995 (3200 owners in mfg, service, trade,
construction businesses)
20
National Federation of Independent Businesses,
1995 (3200 owners in mfg, service, trade,
construction businesses)
21
What Types of Information do Owners Want?
22
Types of help owners say they want...

• Best practices guides
• On-site assistance for payback comparisons and
  process improvements
• Telephone assistance
• Model facilities site tours
• Reduced rate loans
• Internet sites

Minnesota Office of Environmental
Assistance Manufacturers rank pollution
prevention assistance, 1999
23
Types of help owners say they want...

• Improving plant layout
• Mistake-proofing the manufacturing process
• Implementing more efficient technologies
• Identifying full costs of using one material or
  technology versus another

Minnesota Office of Environmental
Assistance Manufacturers rank pollution
prevention assistance, 1999
24
My ResearchPast and Present
25
MN Wood Dust Study

• Problem Lower personal wood dust exposures
• Types of Interventions
• Encourage owners to adopt more better
  ventilation controls
• Increase owner and worker knowledge of health
  effects and effectiveness of ventilation
• Motivate owners to maintain or improve existing
  ventilation systems
• Goal Lower personal exposures by 30 in
  intervention vs. control shops from baseline to
  follow-up (one year)

26
MN Wood Dust Study

• After technical assistance to owners and worker
  training
• Exposures dropped 11 more in intervention shops
  from baseline to follow-up
• Intervention shops showed greater increases in
• Availability and use of dust controls
• Ventilation system efficiency

Effectiveness of a work site intervention to
reduce an occupational exposure The Minnesota
Wood Dust Study. American Public Health
Association Journal, in press, Lazovich et al.
27
Employee Survey Results

• Employees in intervention shops say they are
• More informed about dust control
• More likely to use dust control
• More likely to change their work behavior to
  lower dust levels

28
MN Wood Dust Study

• Owners in intervention shops implemented more
  recommendations than those in control shops
• 4 more likely to install a dust collection
  system designed to exhaust dust from all tools
• 33 more likely to increase availability of dust
  controls for sanding tasks

29
Questions remain...

• Expected 30 decrease in dust exposures in
  intervention vs. control shops.
• What do differently?
• Focus on owners - sell ventilation controls
• What motivates owners to make changes?
• Who do owners listen to?

30
Survey of Owners HS Intentions

• Develop survey to measure small business owners
  beliefs, attitudes and intentions for improving
  health and safety
• Use theoretical model of behavior to develop and
  test survey
• Use survey results to identify future
  intervention activities

31
Behavioral Models

• Individual Behavior
• Theory of Planned Behavior
• Social Learning Theory
• Trans-theoretical Model (Stage of Change)
• Interpersonal Behavior
• Social Networks and Social Support
• Community Group Behavior
• Diffusion of Innovations

32
Theory of Planned Behavior
Beliefs that the behavior leads to certain
outcomes
Attitude toward the behavior
Beliefs that specific referents think I should or
should not perform behavior
Subjective norm
Intention
Behavior
Control beliefs about barriers and supports
Perceived Behavioral Control
Ajzen Fishbein
33
Intentions

• Measure intentions, rather than actual behavior
• DEFINE the behavior
• Good workplace health and safety results from
  set of actions (behaviors)
• Which actions define good workplace health and
  safety?
• Combine actions into an index of health and
  safety behavior

34
Index of HS Behavior (Sum 9 Actions)

• Talk to employees about HS rules
• Reward employees for following safe work rules
• Wear safety equipment when enter the work area
• Walk through business identify safety hazards
• Check that employees are wearing safety equipment
• Make sure access is clear to exits
  extinguishers
• Talk to employees about hazards of their job
• Train employees to handle emergencies
• Ask employees for recommendations on safer way to
  do their work

35
Elements of Behavior

• Must be specific with respect to
• Time when action occurs
• Action
• Target at which action is directed
• Context or location in which action takes place
• In the next six months, how likely is it that you
  will try to improve worker health and safety in
  your business?

36
Attitude
Beliefs About Outcomes

• How likely is it that improving worker health and
  safety in the next six months will...
• make your employees happier?
• increase your costs?
• increase your employees productivity?

• Improving worker health and safety in my business
  in the next six months is...
• convenient/inconvenient
• necessary/unnecessary
• important/unimportant

37
Subjective Norm
What Referents Think

• How much do you agree?
• __________ think I should improve worker health
  and safety in my business.
• My employees
• My workers compensation carrier
• My customers
• My vendors or suppliers

• How much do you agree?
• People who are important to me support my
  improving worker health and safety?

38
Perceived Behavioral Control
Control Beliefs

• How much do you agree with the following?
• I have enough resources available for improving
  health and safety in my business
• I am well-informed about how to improve health
  and safety in my business
• My employees are supportive of my efforts to
  improve health and safety in my business
• I have enough time to improve health and safety
  in my business

• How easy would it be for you to improve worker
  health and safety in the next six months?

39
Other Variables

• Past Actions
• In the past 6 months, how many times did you try
  to improve worker health and safety in your
  business?
• Moral Norm
• I have a responsibility to improve worker health
  and safety in my business.
• Demographics
• Age, gender, race, education, position, number of
  employees, length of time in business

40
Methods
41
Survey Development

• Telephone survey with 16 small business owners to
  build responses
• Outcomes - What happens when you work on health
  and safety?
• Influences - Who encourages or discourages you?
• Barriers and Supports - What helps or hinders you?

42
Testing the Survey

• Face Validity - 6 experts and 6 business owners
• First Pilot Test (mailed)
• 120 owners randomly selected from 6000
  manufacturing businesses in Minnesota (in
  business at least one year with 5-50 employees)
• Second survey to non-respondents with 2
  incentive
• Second Pilot Test (mailed)
• 120 different owners

43
Main Study

• Sample drawn from database of Minnesota
  manufacturers
• 5 to 50 employees
• individually-owned businesses (not subsidiaries)
• in business at least two years
• 600 randomly drawn from sample of approx. 7000
  businesses

44
Data Analysis

• Regression analysis
• HS Intention Index Attitude, Subjective Norm,
  Behavioral Control
• Correlations indicate association of each factor
  with intentions
• Divide sample into high low intention to
  examine differences in underlying beliefs

45
Results Main Study
46
Response DemographicsMain Study

• Response rates ranged from 51-54. (N347 for
  main survey)
• Main Survey Demographics
• Mean age 49 yrs
• 86 male
• 96 white
• Average education 2-4 years post-secondary
  school
• Average time business in operation 30 years
• Average time worked in industry 23 years
• Average time owned business 16 years
• Mean of production employees 14
• Mean of total employees 22

47
R2 0.49
Beliefs About Outcomes
Attitude Toward the Behavior
0.49
What Referents Think
Subjective Norm
0.14
Intention
0.15
Perceived Behavioral Control
0.2 (NS)
Control Beliefs
0.45
plt0.05 plt0.01
48
Beliefs about outcomes

• Owners with high intentions more likely to say
  that improving HS
• Makes employees happier
• Makes employees healthier
• Increases employees productivity
• Shows they care about their employees
• Lowers workers compensation costs
• Increases quality of their business products

49
Stage of Change

• Significant differences between owners in first
  three stages in their intentions to
• Train employees in emergencies
• Talk to employees about hazards
• Talk about safety rules with employees

• 9 pre-contemplation
• 57 contemplation
• 30 preparation
• 5 action

50
Summary of Results

• Owners with high levels of Attitude toward health
  and safety were more likely to have plans to
  improve HS in the next six months.
• Owners with higher levels of past HS actions
  were also more likely to have high intentions to
  improve HS in the future.
• Higher number production employees associated
  with higher intentions to improve HS.

51
Summary of Results

• Owners with high intentions more likely to
  believe that improving HS will
• Make employees happier
• Make employees healthier
• Show employees they care
• Lower WC costs
• Increase product quality

• High vs low intention owners not different in
  beliefs that improving HS will
• Increase costs
• Cause employee complaints
• Cut into profits
• Take too much time
• Lower business productivity

52
Where Next?

• Design interventions that target Attitudes
• Focus on owners relationships with employees
• Emphasize doing the right thing
• Use peers (other owners) and employees to deliver
  messages
• Partner with suppliers and vendors