Carol Brown, PhD, University of Colorado Anschutz Medical Campus – Center for Health, Work & Environment; Lynn Dexter, MS, MPH, University of Colorado Anschutz Medical Campus – Center for Health, Work & Environment; Natalie Schwatka, PhD, University of Colorado Anschutz Medical Campus – Center for Health, Work & Environment and Department of Environmental and Occupational Health; Miranda Dally, MS, University of Colorado Anschutz Medical Campus – Center for Health, Work & Environment and Department of Environmental and Occupational Health; Liliana Tenney, DrPH, University of Colorado Anschutz Medical Campus – Center for Health, Work & Environment and Department of Environmental and Occupational Health; Lee S. Newman, MD, University of Colorado Anschutz Medical Campus – Center for Health, Work & Environment and Department of Environmental and Occupational Health
Based on our understanding of Total Worker Health (TWH), we should expect that the well-being of employees, will be better preserved if they perceive health and safety climates to be strong even over the course of the COVID-19 pandemic.[1,2] In order for TWH practices to be effective, employees must perceive that they are supported for participating in activities that promote safety, health, and well-being and that leaders are committed to occupational safety and health, as reflected by measures of safety and health climates.[3-6]
We hypothesized that employees at organizations with better health climate, safety climate, and well-being scores pre-pandemic will maintain climates and well-being scores during the pandemic. Further, employees at organizations with TWH leadership training pre-pandemic will better maintain employee well-being over time (during the pandemic) than organizations who did not participate in leadership training.
COVID-19 has elevated the importance of OSH) employee benefits, and organizational culture.[7,8] Small businesses have faced challenges, including closures, lay-offs, and limited cash on hand. How an organization responds to the COVID-19 pandemic can effect the safety, health, and well-being of its employees. Safety climate research demonstrates a relationship with a number of outcomes, including motivation, knowledge, and safety practices.[9-13] Health climate has been shown to be related to outcomes such as physical health and health behaviors.[14-16] There has been a call for research to better understand the long-term impacts that COVID-19 has on workplaces.[17-19] The current study is an important first step in understanding the impact of the pandemic on health and safety climates and employee well-being.
This current study was an added component to an ongoing study of a randomized, longitudinal TWH intervention in small businesses.[2,20] The study focused on promotion of worker health, safety and well-being, utilizing the TWH approach developed by NIOSH. Enrolled organizations participated in a TWH initiative that includes an organizational assessment, certification, and advising. Participating organizations were randomized to participate in a TWH leadership training. In Spring 2020, when it became evident that COVID-19 had fundamentally shifted the way businesses operated, we developed a COVID-19 Employee Impact Survey to send to our participating organizations. The survey included a subset of items from the Health and Safety Culture Survey (HSC) that targeted the constructs of health climate, safety climate and employee well-being, with additional work/life questions specific to the pandemic.
To be included in the present study, employees must have completed any 2 of the 3 surveys from the HSC, COVID I (May 2020), and COVID II (September 2020) Employee Impact Surveys. The final matched business cohort included 31 organizations and 261 employees; leaders from 12 organizations had previously received the TWH leadership training and the remainder had not.
Chi-square or Fisher exact tests were used to test for differences between categorical variables and t tests were used for continuous variables. The main outcomes of interest were changes in employee perceptions of health and safety climates and well-being across the three time-points. Linear mixed effects regression was used to examine the change in primary outcome over time.
Data analysis is complete. A decline in mean well-being score was observed between baseline and the COVID I survey in both groups. In the no intervention group, health climate scores were observed to decline by -0.19 points on average from the COVID I to COVID II surveys (p=0.03, 95% CI: -0.355, -0.020). There were no observed differences for health climate in the intervention group, though mean safety climate increased by 0.24 points (p=0.03, 95%CI: 0.031, 0.454), whereas no significant differences were seen for the no intervention group on safety climate.
These findings show that employee well-being decreased from before COVID-19 to the two points during COVID-19. The effects of a TWH leadership training on health and safety climates and well-being was mixed. Health and safety climates are relatively stable over time, while employee well-being declined in both groups from pre-pandemic levels Due to the network of participating organizations in our study, we were able to quickly recruit small business employees to participate, providing timely information about the challenges and opportunities faced by employees. However, a limitation is that businesses and employees who were most impacted by COVID-19 were likely not represented in this study as the organization may have closed or reduced hours or employees may have been no longer working for the business.
COVID-19 has fundamentally impacted small business and employees. There is a real opportunity to implement organizational changes that will improve health and safety in the workplace and positively impact employee well-being. As businesses continue to adapt to the operational changes that are brought about by the COVID-19 pandemic, it is more important than ever for organizations to focus on building strong safety and health climates. Future research will need to examine how the workplace continues to change as we emerge from the COVID-19 pandemic.