2.3.3. *Total Worker Health*® Research Methodology Workshop

One such recent and vital effort that NIOSH, the NIOSH-funded Centers of Excellence for TWH, and several other external partners undertook was to assess methodological and measurement issues for TWH intervention research and establish concrete examples of how challenges can be overcome to drive research practices in the field of TWH. There were multiple goals for the workshop. The first was to respond to two of the eight recommendations put forth by the Independent Panel of the Pathways to Prevention 2015 Meeting, co-sponsored by NIH and NIOSH: *Total Worker Health*®: What's Work Got to Do With It? [18]: (1) expand research and evaluation design options to include a range of rigorous methodologies; and (2) develop a core set of measures and outcomes that are incorporated into all integrated intervention studies. The second was to respond to the intermediate and activity/output goals (Sections 1.3; 1.3.2–1.3.6) to apply and develop rigorous, standardized methods for TWH interventions, as outlined in the National *Total Worker Health*® Agenda [12]. More detail on the impetuses and need for such a workshop have been previously published in publicly available papers [12,19,23].

Accordingly, in 2017, the University of Iowa's College of Public Health and Healthier Workforce Center of the Midwest hosted the *Total Worker Health*® Research Methodology Workshop. An open-access peer-reviewed article summarizing this workshop, by Tamers et al. (2018), highlights the TWH research methodological and measurement approaches currently in use and suggests others that the workshop experts believe have the potential to advance the field through rigorous and repeatable TWH intervention research [24].

#### 2.3.4. Worker Well-Being Framework

Another key TWH accomplishment in recent years is NIOSH's partnership with the Research ANd Development (RAND) Corporation to develop a framework for worker well-being and its subsequent still-in-development survey instrument. The framework was published in 2018 [25] and will serve as a conceptual model for future research on worker well-being. The continued work of NIOSH and RAND to develop the survey will be useful in advancing the understanding of issues related to worker well-being.

#### *2.4. Advances in TWH Practice*

The practice goals in the National *Total Worker Health*® Agenda center on the need to increase the implementation of evidence-based programs and practices [12]. Although the scientific evidence base is relatively new, the uptake of the integrated concept of TWH has gained substantial traction among leaders and practitioners in safety and health [26]. A testament that advancements in worker safety, health, and well-being are not entirely an academic enterprise is also demonstrated by industry and other private sector interest in TWH strategies [27,28].

#### 2.4.1. Tools and Resources

A number of tool-kits, actionable guidance, web-based training, continuing education courses, and other practice-based resources that have been developed in recent years are available on the NIOSH TWH website and on the Centers of Excellence for TWH websites [22]. An increasing community of stakeholders receive information about these tools and resources regularly through a multitude of dissemination channels (i.e., social media, e-newsletters, and other media outlets) and through other outreach efforts and engagement programs. One of the most widely consumed outputs of NIOSH's communication efforts has been an electronic newsletter, *TWH in Action!* [29]. Published quarterly since 2012, this e-newsletter now has more than 80,000 subscribers. Another highly popular resource is the NIOSH *Total Worker Health*® Webinar series [30]. This free, online training platform features the latest research and practice in the field of TWH and has provided continuing education credits to more than 1000 physicians, nurses, health educators, and others.
