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Abstract：
BACKGROUND: State and Territorial Health Departments (SHDs) have a unique role in protecting and promoting workers\' health. This mixed-methods study presents the first systematic investigation of SHDs\' activities and capacity in both Occupational Safety and Health (OSH) and Workplace Health Promotion (WHP) in the United States (US).
METHODS: National survey of OSH and WHP practitioners from each of 56 SHDs, followed by in-depth interviews with a subset of survey respondents. We calculated descriptive statistics for survey variables and conducted conventional content analysis of interviews.
RESULTS: Seventy percent (n = 39) of OSH and 71% (n = 40) of WHP contacts responded to the survey. Twenty-seven (n = 14 OSH, n = 13 WHP) participated in follow-up interviews. Despite limited funding, staffing, or organizational support, SHDs reported a wide array of activities. We assessed OSH and WHP surveillance activities, support that SHDs provided to employers to implement OSH and WHP interventions (implementation support), OSH and WHP services provided directly to workers, OSH follow-back investigations, and OSH standard and policy development. Each of the categories we asked about (excluding OSH standard and policy development) were performed by more than half of responding SHDs. Surveillance was the area of greatest OSH activity, while implementation support was the area of greatest WHP activity. Respondents characterized their overall capacity as low. Thirty percent (n = 9) of WHP and 19% (n = 6) of OSH respondents reported no funds at all for OSH/WHP work, and both groups reported a median 1.0 FTEs working on OSH/WHP at the SHD. Organizational support for OSH and WHP was characterized as \"low\" to \"moderate\". To increase SHDs\' capacity for OSH and WHP, interview respondents recommended that OSH and WHP approaches be better integrated into other public health initiatives (e.g., infectious disease prevention), and that federal funding for OSH and WHP increase. They also discussed specific recommendations for improving the accessibility and utility of existing funding mechanisms, and the educational resources they desired from the CDC.
CONCLUSIONS: Results revealed current activities and specific strategies for increasing capacity of SHDs to promote the safety and health of workers and workplaces - an important public health setting for reducing acute injury and chronic disease.
METHODS: National survey of OSH and WHP practitioners from each of 56 SHDs, followed by in-depth interviews with a subset of survey respondents. We calculated descriptive statistics for survey variables and conducted conventional content analysis of interviews.
RESULTS: Seventy percent (n = 39) of OSH and 71% (n = 40) of WHP contacts responded to the survey. Twenty-seven (n = 14 OSH, n = 13 WHP) participated in follow-up interviews. Despite limited funding, staffing, or organizational support, SHDs reported a wide array of activities. We assessed OSH and WHP surveillance activities, support that SHDs provided to employers to implement OSH and WHP interventions (implementation support), OSH and WHP services provided directly to workers, OSH follow-back investigations, and OSH standard and policy development. Each of the categories we asked about (excluding OSH standard and policy development) were performed by more than half of responding SHDs. Surveillance was the area of greatest OSH activity, while implementation support was the area of greatest WHP activity. Respondents characterized their overall capacity as low. Thirty percent (n = 9) of WHP and 19% (n = 6) of OSH respondents reported no funds at all for OSH/WHP work, and both groups reported a median 1.0 FTEs working on OSH/WHP at the SHD. Organizational support for OSH and WHP was characterized as \"low\" to \"moderate\". To increase SHDs\' capacity for OSH and WHP, interview respondents recommended that OSH and WHP approaches be better integrated into other public health initiatives (e.g., infectious disease prevention), and that federal funding for OSH and WHP increase. They also discussed specific recommendations for improving the accessibility and utility of existing funding mechanisms, and the educational resources they desired from the CDC.
CONCLUSIONS: Results revealed current activities and specific strategies for increasing capacity of SHDs to promote the safety and health of workers and workplaces - an important public health setting for reducing acute injury and chronic disease.
摘要：
背景：州和地区卫生部门（SHD）在保护和促进工人健康方面发挥着独特的作用。这项混合方法研究首次对美国（US）的SHD在职业安全与健康（OSH）和工作场所健康促进（WHP）方面的活动和能力进行了系统的调查。
方法：全国56个SHD的OSH和WHP从业人员调查，随后对一部分调查对象进行了深入访谈。我们计算了调查变量的描述性统计数据，并对访谈进行了常规的内容分析。
结果：70%（n=39）的OSH和71%（n=40）的WHP接触者回答了调查。二十七(n=14OSH，n=13WHP）参加了后续访谈。尽管资金有限,人员配备，或组织支持，SHD报告了一系列广泛的活动。我们评估了OSH和WHP监测活动，SHD向雇主提供的实施OSH和WHP干预措施的支持（实施支持），直接向工人提供OSH和WHP服务，OSH后续调查，以及职业健康健康标准和政策制定。我们询问的每个类别（不包括OSH标准和政策制定）都是由一半以上的响应SHD执行的。监视是OSH活动最活跃的区域，而实施支持是WHP活动最多的领域。受访者认为他们的总体能力很低。30％（n=9）的WHP和19％（n=6）的OSH受访者表示，OSH/WHP工作根本没有资金，两组均报告在SHD使用OSH/WHP的FTEs中位数为1.0。对OSH和WHP的组织支持被定性为“低”至“中等”。为了增加OSH和WHP的SHD容量，访谈受访者建议将OSH和WHP方法更好地整合到其他公共卫生举措中(例如，传染病预防），以及OSH和WHP的联邦资金增加。他们还讨论了改善现有筹资机制的可获得性和效用的具体建议，以及他们希望从疾控中心获得的教育资源。
结论：结果揭示了当前的活动和具体策略，以提高SHD的能力，以促进工人和工作场所的安全和健康，这是减少急性损伤和慢性疾病的重要公共卫生环境。
方法：全国56个SHD的OSH和WHP从业人员调查，随后对一部分调查对象进行了深入访谈。我们计算了调查变量的描述性统计数据，并对访谈进行了常规的内容分析。
结果：70%（n=39）的OSH和71%（n=40）的WHP接触者回答了调查。二十七(n=14OSH，n=13WHP）参加了后续访谈。尽管资金有限,人员配备，或组织支持，SHD报告了一系列广泛的活动。我们评估了OSH和WHP监测活动，SHD向雇主提供的实施OSH和WHP干预措施的支持（实施支持），直接向工人提供OSH和WHP服务，OSH后续调查，以及职业健康健康标准和政策制定。我们询问的每个类别（不包括OSH标准和政策制定）都是由一半以上的响应SHD执行的。监视是OSH活动最活跃的区域，而实施支持是WHP活动最多的领域。受访者认为他们的总体能力很低。30％（n=9）的WHP和19％（n=6）的OSH受访者表示，OSH/WHP工作根本没有资金，两组均报告在SHD使用OSH/WHP的FTEs中位数为1.0。对OSH和WHP的组织支持被定性为“低”至“中等”。为了增加OSH和WHP的SHD容量，访谈受访者建议将OSH和WHP方法更好地整合到其他公共卫生举措中(例如，传染病预防），以及OSH和WHP的联邦资金增加。他们还讨论了改善现有筹资机制的可获得性和效用的具体建议，以及他们希望从疾控中心获得的教育资源。
结论：结果揭示了当前的活动和具体策略，以提高SHD的能力，以促进工人和工作场所的安全和健康，这是减少急性损伤和慢性疾病的重要公共卫生环境。
