Research Perspectives on TWH

These papers are considered foundational for establishing the scientific rationale for a Total Worker Health® approach. The set of papers captured in the Overview of Integration of Health Protection and Health Promotion, discusses issues related to the topic of integration as it relates to health protection and health promotion specifically. The set of papers in Specific Populations or Health Outcomes of Interest focus on integration with respect to specific populations or health outcomes of interest.

The list is in reverse chronological order. For the papers that are NIOSH-funded or available to the public without charge, the title is hyperlinked and will direct you to the publication or the NIOSHTIC-2* abstract.

* NIOSHTIC-2 is a searchable bibliographic database of occupational safety and health publications, documents, grant reports, and journal articles supported in whole or in part by NIOSH.

The National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health, convened a workshop, “Pathways to Prevention: Total Worker Health®—What’s Work Got to Do With It?external iconon December 9–10, 2015, at NIH, in Bethesda, Maryland. The purpose was to address the following questions:

  • What studies exist assessing integrated interventions?
  • What are the known benefits and harms of integrated interventions?
  • What are the characteristics of effective integrated/combined interventions and programs?
  • What factors influence the effectiveness of integrated interventions?
  • What are the key evidence gaps?

During the 1½ -day workshop, invited experts discussed the body of evidence and attendees had opportunities to provide comments. An evidence-based practice center had also conducted a systematic review and presented its findings during the workshop. An archived videocast of the workshop is available at: icon

After weighing the evidence, an unbiased, independent panel prepared a report that summarized the workshop and identified future research priorities. Below are the reports that resulted from the workshop, published in the Annals of Internal Medicine.

In 2014, NIOSH and the Institute of Medicine (IOM) convened a public workshop to identify prevalent and best practices in small, medium, and large workplaces. Participants included employers and employees in small, medium, and large workplaces; employer and employee associations; academia; government agencies; and other stakeholder groups. The workshop featured invited presentations and discussions on:

  • Best or promising practices associated with the design, implementation, and evaluation of an integrated approach to worker health, including factors associated with successful implementation;
  • Barriers to implementing programs and ideas for overcoming those barriers, and
  • Measures being used or considered for evaluating program effectiveness.

The workshop report is available for download. For the workshop agenda and link to the report, please visit: icon You may access the presentations and audio recordings by visiting: icon.

Effectiveness of Total Worker Health Interventions.external icon 
J. Occup. Health Psychol 2015; 20(2): 226-247.
Review of 17 interventions with at least some elements of health protection and/or health promotion.

Promising and Best Practices in Total Worker Health: Workshop Summaryexternal icon
Institute of Medicine. Washington DC: The National Academies Press. 2014.

Employment Status Matters: A Statewide Survey of Quality-of-Life, Prevention Behaviors, and Absenteeism and Presenteeism
JOEM 2014; 56 (7): 686-698.

Total Worker Health Supplementexternal icon 
JOEM 2013:55 Suppl 12S
Highlights multiple dimensions of Total Worker Health, and is a collection of presentations from the 2012 Total Worker Health Symposium, coordinated by the University of Iowa Center Healthier Workforce Center for Excellence with support from the NIOSH TWH Program.

Research compendium: the NIOSH Total Worker Health program: seminal research papers 2012
DHHS (NIOSH) Publication No 2012-146
Updates the three papers commissioned for the 2004 NIOSH STEPS to a Healthier Workforce conference.

Occupational safety and health in the USA: now and the future
Ind Health 2012;50(2):80-3.

Interaction of occupational and personal risk factors in workforce health and safety
Am J Public Health 2012;102(3):434-48.

Worksite health promotion: Integrated worker health: The fusion of worker health protection and promotion
ACSM’S Health & Fitness Journal 2012;16(1):37–40.

Preventing chronic disease in the workplace: a workshop report and recommendations
Am J Public Health 2011;101 Suppl 1:S196-207.

Workplace health protection and promotion: a new pathway for a healthier –and safer– workforcepdf iconexternal icon [ACOEM guidance statement]
J Occup Environ Med 2011;53(6):695-702.

Statement on national worklife priorities
J Ind Med 2011;54(1):10-20.

Integrating occupational health, safety and worksite health promotion: opportunities for research and practice
Med Lav 2006;97(2):240-57.

Integrating employee health: A model program for NASAexternal icon 
Institute of Medicine. Washington DC: National Academies Press. 2005.

The Economics of Integrating Injury and Illness Prevention and Health Promotion Programspdf iconexternal icon
Paper commissioned for the 2004 NIOSH STEPS to a Healthier Workforce conference.

Examining the value of integrating occupational health and safety and health promotion programs in the workplacepdf iconexternal icon
Paper commissioned for the 2004 NIOSH STEPS to a Healthier Workforce conference.

Steps to a healthier US workforce: Integrating occupational health and safety and worksite health promotion: State of the sciencepdf iconexternal icon
Paper commissioned for the 2004 NIOSH STEPS to a Healthier Workforce conference.

The integrated model: implications for worksite health promotion and occupational health and safety practice
Health Educ Q 1996;23(2):175-90.

Translating social ecological theory into guidelines for community health promotion
Am J Health Promot 1996;10(4):282-98.

Integration of medical care and worksite health promotion
JAMA 1995;273(14):1136-1142.

An integrative perspective on work-site health promotion
J Occup Med. 1993 Dec;35(12):1221-30.

An ecological perspective on health promotion programs
Health Educ Q 1988;15(4):351-77.

Workplace health promotion: a commentary on the evolution of a paradigm
Health Educ Q 1987;14(2):181-94.

Prevalence of Coronary Heart Disease or Stroke Among Workers Aged 55 Years — United States, 2008–2012
MMWR 2014; 63(30);645-649

Cancer Prevention and Worksite Health Promotion: Time to Join Forces.
Prev Chronic Dis 2014; 11:140-127.

Conceptual heuristic models of the interrelationships between obesity and the occupational environment
Scand J Work Environ Health 2013;39(3):221-32. Epub 2013 Apr 15.

Advancing workplace health protection and health promotion for an aging workforce
J Occup Environ Med 2013;55(5):500-506.

Promoting integrated approaches to reducing health inequities among low-income workers: Applying a social ecological framework
Am J Ind Med 2013 [Epub ahead of print].

Healthy aging for a sustainable workforce: a conference reportpdf iconexternal icon
Society for Occupational and Environmental Health (SOEH), Association of Occupational and Environmental Clinics (ACOEM). 2009 Feb 17-18; Silver Spring, MD.

Workplace health protection and promotion through participatory ergonomics: an integrated approach
Public Health Rep 2009;124 Suppl 1:26-35.

Protecting and promoting mental health in the workplace: developing a systems approach to job stress
Health Promot J Austr 2007;18(3):221-8.

Reducing social disparities in tobacco use: A social contextual model for reducing tobacco use among blue-collar workers.
Am J Pub Health 2004;94(2):230-239.

Worksite tobacco control programs: the role of occupational health
Respir Physiol 2001;128(1):89-102.