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Profiles of Total Worker Health® in Small Businesses Show Commitment and Leadership Matter for Employee Engagement

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Researchers from the Center for Health, Work & Environment (CHWE) at the Colorado School of Public Health have published a paper in BMC Public Health studying the profiles of Total Worker Health (TWH) in small businesses. The study, led by a team at CHWE, is one of the first to examine how small businesses operationalize the TWH approach through a business strategy and leadership commitment as well as how organizational climate supports its daily use. The overall emphasis was on whether these working conditions were associated with employee engagement in health and safety practices.

“We wanted to identify the strengths and differences of how TWH operates in small business,” explained lead author Dr. Natalie Schwatka. “Our findings help us understand how the trifecta – business strategies, leadership, and climate – all impact employee engagement.”

The publication is based on the Small+Safe+Well study, a longitudinal study conducted in Colorado over the last five years with data from 97 Colorado organizations and over 2,800 employees. Businesses were categorized into one of four profiles based on their results from the Business Healthy Workplace Assessment™ and Employee Safety and Health Culture Survey. CHWE researchers found that businesses in the most advanced profile, meaning they had robust TWH business strategies, strong leadership, and climates, had employees who were overall more engaged in workplace health and safety.

“It was interesting to find that small businesses are operationalizing TWH in several different ways,” said Schwatka. “Some were focused on having TWH business policies and programs, while others were focused on creating a culture that supported employee safety and health through leadership and strong climates. But it was clear that the most successful small businesses focused on the trifecta.”

The Smart + Safe + Well study has presented opportunities to help small businesses enhance workplace strategies and leadership practices that improve worker health and safety behaviors. The recently published paper highlights the importance of creating a working environment where TWH is valued and practiced. The results show that regardless of the types of TWH programs, employees are most engaged in safety when businesses have a strong foundation of leadership support and a climate that makes TWH the norm.

“We were encouraged to see that there is an obvious relationship between those businesses very committed to TWH and how much their employees are engaged in workplace TWH initiatives,” adds Schwatka. “This makes the case for all small businesses to prioritize TWH through leadership and culture building in our post-pandemic world where employee health and safety is of the utmost importance.”

TWH infographic


About the Center for Health, Work and Environment

The Center for Health, Work and Environment (CHWE) at the Colorado School of Public Health is one of six Centers of Excellence for Total Worker Health® and houses the Mountain and Plains Education and Research Center, one of 18 centers of its kind supported by the National Institute for Occupational Safety and Health (NIOSH). Main offices for the Center are located at the University of Colorado Anschutz Medical Campus in Aurora, Colorado. The Center team works with faculty, students, and community partners on numerous projects in occupational and environmental health, safety, and well-being.

About the Colorado School of Public Health

The Colorado School of Public Health is the first and only accredited school of public health in the Rocky Mountain Region, attracting top tier faculty and students from across the country, and providing a vital contribution towards ensuring our region’s health and well-being. Collaboratively formed in 2008 by the University of Colorado, Colorado State University, and the University of Northern Colorado, the Colorado School of Public Health provides training, innovative research and community service to actively address public health issues including chronic disease, access to health care, environmental threats, emerging infectious diseases, and costly injuries. Learn more and follow Colorado SPH’s updates on FacebookTwitter and Instagram.

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