1.5 Planning and Logic Model1.4 Resources | 2.1. Introduction to the Program: Overview
NIOSH has a long history of organized planning to optimize its relevance and impact. During the 1980s, NIOSH conducted a series of national symposia on the leading causes of occupationally-related illness and injury. Those meetings resulted in 10 written strategies for prevention that guided NIOSH research programs during the early 1990s (including occupational lung diseases). In April 1996, NIOSH and its partners unveiled NORA, a framework to guide occupational safety and health research into the new millennium—not only for NIOSH but for the entire occupational safety and health community. Approximately 500 organizations and individuals outside NIOSH provided input into the development of NORA. The NORA process resulted in a list of 21 research priorities in occupational safety and health (http://www2a.cdc.gov/nora/). Teams of researchers and other stakeholders were organized primarily according to types of health problems or disciplinary approaches for each of these priority areas. Many of the teams published agendas for research. NIOSH researchers were prominent in those efforts.
During the NORA process, NIOSH developed a strategic plan from 1997 and followed it until 2002 (http://www.cdc.gov/niosh/gpran1a.html). A new plan has been developed for 2004 to 2009 (http://www.cdc.gov/niosh/docs/strategic/). The strategic goals of this plan are to:
NORA is being updated to address the needs of another decade (http://www.cdc.gov/niosh/NORA/). The second decade of NORA is being organized to prepare research agendas primarily along the lines of major industrial sectors. As was the case in the initial NORA process, research agendas are being developed with broad involvement and input from all parties with an interest in occupational safety and health. This renewal for NORA is intended to bring NIOSH even closer to the problems of U.S. industries and workers.
NIOSH has developed an operational logic model to assure that its strategic planning activities are logical, appropriate, and optimize NIOSH’s relevance and impact (Figure 3). The logic model formally depicts the planning process. It moves from left to right across the chart, beginning with production and planning inputs. Those inputs lead to NIOSH research activities. The outputs of NIOSH research activities lead to customer activities. Some NIOSH customers are intermediaries who use or adapt NIOSH outputs before they reach the final customers: employers, employees, industries, educators, and regulators. Their actions help NIOSH to contribute to the improvement of safety and health in the workplace. This process is affected by a variety of external factors including economic and social conditions and the regulatory environment.
Figure 3: The NIOSH Operational Logic Model
A brief discussion of logic model elements follows.
Planning inputs are data that guide NIOSH to research action. Many sources, in addition to NIOSH sources, build these data summaries. They come from workplaces, surveillance, risk assessments, intervention effectiveness data, and from the Institute’s stakeholders and customers. One of the major planning activities for NIOSH is the collection, analysis, and interpretation of health and hazard data. NIOSH uses illness, injury, fatality, exposure, and hazard data for those purposes. NIOSH actively engages in surveillance to obtain data that can guide its efforts. The “NIOSH Worker Chartbook,” now in its second edition, is an important source of occupational health surveillance data (A1-3). An often-overlooked issue is that inputs do not only turn activities on. They also serve to turn off activities that have been completed, have become lesser priorities, or have otherwise outlived their usefulness.
Activities encompass a broad range of items including many types of research; field investigations of workplaces; surveillance; policy development; and health communications. There are over 1,000 active research projects being conducted at NIOSH. In broad terms these projects encompass a large number of areas and disciplines, such as:
Another type of activity is the HHE Program. Under Section 20 of the Occupational Safety and Health Act of 1970, NIOSH performs inspections and investigations into workplace hazards. This activity frequently results in development of research knowledge that is beneficially applied in the workplace. All programs contribute to this effort, and a broad range of expertise is required. The goal is to assist employers and employees by evaluating and recommending solutions to workplace safety and health issues. Typically between 300 and 500 HHE requests are received annually. HHE reports are available to other customers and stakeholders.
Another NIOSH activity is operation of two programs in fatality investigations, one in fire fighter fatality investigation and prevention and another in fatalities among other groups of workers. In 2003, the latter program focused on deaths of workers under 18 years of age, deaths in roadway construction zones, and deaths involving machinery. This program is currently active in 21 states. In both programs, investigators assess the circumstances surrounding each fatality to formulate prevention strategies. Plans are then designed for the dissemination of those strategies.
Another activity supported by NIOSH is training. NIOSH-supported training prepares professionals in occupational safety and health and also serves the function of transferring NIOSH research into the workplace. NIOSH developed university-based Education and Research Centers (originally named Educational Resource Centers) in 1977 to meet the needs for trained safety and health professionals. NIOSH currently funds 16 Education and Research Centers at leading universities to provide graduate and continuing education programs in occupational medicine, occupational health nursing, industrial hygiene, safety, and other related disciplines. These centers also serve as regional resources for all those involved with occupational safety and health including industry, labor, government, academia, and the general public. The centers are funded for up to five years through a competitive peer-review process. NIOSH also supports approximately 40 smaller training project grants that are also focused on providing qualified professionals for the field.
Outputs and Transfer: The result of research is new knowledge. New knowledge serves society by providing practical guidance on matters of importance to the population. Research programs are obligated to contribute to the advancement of society by integrating this new knowledge. NIOSH carries out the responsibility to disseminate results of its research with a variety of outputs such as: reports, publications, recommendations, workshops, databases, tools and methods, training and education materials, demonstration projects, best practices, developmental technologies, and licenses and patents.
Efforts to maximize the impact of NIOSH outputs through effective transfer to customers are coordinated by the Office of Health Communications (OHC). The NIOSH OHC works with each research program to plan and execute communications strategies designed to reach a variety of customers for those outputs. Customers include employers and their groups, employees and their groups, standards-setting organizations, professional associations, and the general public. NIOSH researchers publish in peer-reviewed publications and present their work at conferences. They also publish NIOSH documents and other information products. The NIOSH publications office stocks more than 4,200 NIOSH document titles. It distributed nearly a million printed publications and CD-ROMs in 2003. A survey of four occupational safety and health professional organizations indicated that NIOSH is effectively reaching several of its intended audiences with credible and useful information.
A special kind of output is NIOSH documents, testimony, and other communications on criteria for recommended standards for safety and health hazards in the workplace. These criteria represent the formal link between NIOSH and OSHA or MSHA; and between research and rule-making. For example, NIOSH scientists recently testified to OSHA about their proposed new rule on hexavalent chromium, a carcinogen and skin irritant. In FY 2003, NIOSH prepared science-based comments on 15 regulatory activities at the Departments of Labor, Transportation, and Justice. NIOSH also provided testimony for CDC at two Congressional hearings in 2003, one on the subject of aircraft cabin air quality and one on anthrax detection and sampling.
Since its inception, NIOSH has been strongly committed to transferring its outputs to customers. In recent years, this effort has been enhanced by newer electronic media. NIOSH has a Web site that supports approximately 500,000 user sessions (and about 2.8 million page views) per month. NIOSH also operates a technical information inquiry service that includes an 800 number and an internet inquiry response service. In FY 2003, NIOSH responded to more than 100,000 inquiries by phone and almost 3,800 by internet.
In 2004, NIOSH created an Office of Research and Technology Transfer to provide formal administrative support for the concurrently developing NIOSH Research to Practice (r2p) Initiative. The office and r2p policies help ensure that NIOSH considers these issues in making funding decisions and that NIOSH researchers consider issues such as translating their research findings into best practices, products, and technologies and dissemination of those products from the very beginning of their research projects.
Outcomes: As NIOSH research is transferred, the Institute often moves into more dependent partnerships with others, and has less control of what happens. The resources required to have an affect are less predictable, the outcomes are less sure, and the results harder to verify. These partners include employers, labor and industry groups, and regulatory bodies. In addition, there are manufacturers who adopt new NIOSH technologies as products for the marketplace, or help develop them further. These customer activities and outputs are crucial to NIOSH having real-world impact. Influencing and motivating the actions of others is an intermediate outcome.
An outcome is a NIOSH contribution to reducing morbidity or mortality due to occupational injuries or diseases. Especially for diseases of long latency, such as induction of cancer by carcinogens, objective evidence of reduction in causative exposures may be considered a surrogate outcome, as in the NIOSH PART goal specifying reduction in coal mine dust exposure.
In many instances it is difficult to effectively trace the contribution of NIOSH to end outcomes. Many groups contribute to reducing occupational injuries and illnesses and to creating safer places to work. Still, NIOSH is strongly committed to developing objective measures of its real-world performance. If the best measures of performance relate to motivating and enabling others to make work safer, this in no way diminishes the importance of the accomplishment.