Lit review youth workplace injuries by Brenna Coles

Running Head: YOUTH WORKPLACE INJURIES

Youth Workplace Injuries: Education-based Prevention Brenna Coles B00529042 Injury Prevention and Safety Education: HPRO 3351 Julian Young Dalhousie University March 2, 2011

YOUTH WORKPLACE INJURIES Youth Workplace Injuries: Education- based Prevention “According to Statistics Canada in 2007, workplace injuries were reported in well over half a million Canadian Workers” (as cited in Workplace injuries. Home, n.d., para. 1). There is cause for concern especially regarding our youth, statistics have shown that, “young workers aged 16 to 19 years have twice the injury rate of workers of all ages” (as cited in Schulte, Stephenson, Okun, Palassis & Biddle, 2005, p. 2). Studies show that workplace injuries can be life altering because they have the ability to affect both the physical and emotion being (Children, Youth and Women's Health Service [CYMHS], n.d.) There are many factors contributing to this population vulnerability for example “inexperience. . . , unsafe equipment . . . , eagerness to please when asked to do hazardous tasks . . . , lack of awareness and/or compliance with the child labor laws . . . , developmental characteristics that make them more vulnerable to injury . . . , and inability to voice concerns about safety” (Miara, Gallagher, Bush, & Dewey, 2003, p.1-2 ). Researchers “estimated 80 percent of youth work at some point during their high school years” (Miara, Gallagher, Bush, & Dewey, 2003, p. 1). Although the staggering evidence on the increased number of youth workplace injuries there are many other incentives that make the youth want to work, such as the independence of having a job, the sense of responsibility and accomplishment , make new friends, gain work experience and of course the pay cheque. (Children, Youth and Women's Health Service [CYMHS], n.d.; Miara, Gallagher, Bush, & Dewey, 2003). More recently, Canada has started to design programs targeting the youth population because in the past, most if not all programs were only meant to target the adult workforce and

YOUTH WORKPLACE INJURIES overlooked the youth (Miller, 2004). However, recently there have been considerable efforts to protect the safety and well-being of our youth. The most recent trends include, school based and mass media based work safety education programs, community based programs, computerbased learning and on-line learning referred to as E-Learning. These preventative measures that have all been taken in Canada and all have been tailored specifically to target young workers (as cited in Breslin, Smith, Mustard, & Zhao, 2006; Canadian Centre for Occupational Health and Safety [CCOHS], n.d.). In Canada alone there are more than 75 educational programs targeting youth in hopes to increase workplace safety and awareness (as cited in Breslin, Polzer, MacEachen, Morrongiello, & Shannon, 2007; Olszewski, Parks, & Chikotas, 2007). The numerous educational programs are designed to teach young workers about workplace hazards, workers rights, (Breslin, Polzer, MacEachen, Morrongiello, & Shannon, 2007). Other forms of prevention are “modification of job tasks, behavior-based training, ergonomic solutions or workstation redesign, and issuance of personal protective equipment” (Gatty, Turner, Buitendorp, & Batman, 2003, p. 2). Buckley and Sheehan (2009) state that, “well-designed curriculum programmes have been shown to prevent and reduce risk taking and injury among adolescents” (p.1). However, follow- up evaluation is necessary to determine the actual long-term effects of these education programs. This literature review will be looking at the educational programs that target youth ages 14 to 25 with the aim to teach injury prevention and workplace safety. Methods The peer reviewed articles used in this literature review were found on the CINAHL database and any other resources were found using “Google” search engine. The key search words

YOUTH WORKPLACE INJURIES included: education, health promotion, injury, interventions, occupation, occupational-relation, prevention, programs, safety, well-being, workers, workplace, young and youth. A total of 14 peer reviewed articles are used in this literature review, while five educational programs are discussed in more details. Skills for Preventing Injury in Youth (SPIY) The Skills for preventing injury in youth (SPIY) is a school-based injury prevention program. This program used the theory of planned behaviour aimed at reducing risk- taking behaviour and was implemented in a ninth grade health class. The foundation for this program was “teaching and supporting skills” in youth on “risk –taking and associated injury” (Buckley & Sheehan, 2009, p. 3). The program “sought to do so by reducing their involvement in risk taking, increasing their protective behaviour towards friends and improving injury management skills” (Buckley & Sheehan, 2009, p. 3).The program was delivered over an eight week period. The students received almost 7 hours in total of this program. The main elements taught in this program were first aid and changing risk-taking behaviour. The program was delivered through several presentations, where a “scenario of risk taking and injury to contextualize the activities in the lesson” (Buckley & Sheehan, 2009, p. 3). In hopes of increasing the perceived severity and risk of each scenario the program uses actual local events that ended in injury. Teaching methods targeted towards youth learning involved various interactive activities, focus groups, mapping exercise of resources and a student workbook was also given to each student that “support the activities in the curriculum” (Buckley & Sheehan, 2009, p. 4). Also the use of the theory of planned behaviour was a calculated decision since it provided “logic, internal consistency and structure” (Buckley & Sheehan, 2009,

YOUTH WORKPLACE INJURIES p. 3). See Appendix A for examples of the themes, concepts and example quotes of behaviours that follow the logic model (p. 13). Additionally, the teachers who were implementing the program would be more likely do a more precise job in implementing the program. (Buckley & Sheehan, 2009). In the end after an evaluation of the program researchers concluded that the program “was effective in reducing risk-taking behaviour” (Buckley & Sheehan, 2009, p. 3). ProSafety Model of Injury Prevention The ProSafety Project “was designed to reach high school students enrolled in the ProStart culinary arts program, where safety training could be taught within the context of learning and practicing technical skills” (Ward, de Castro, Tsai, Linker, Hildahl, & Miller, 2010, p. 2- 3). The Project was implemented in order to prevent and reduces the number of workplace injuries specific to the restaurant work setting. The Project was first implemented in “ProStart” schools but is now a nationwide intervention found in many school curriculums. The Project is split into two key elements, one is the classroom learning and the second is a hands- on workplace setting where students apply what they know from the classroom (Ward et al., 2010). The ProSafety Project curriculum is based on interactive activities such as “presentations, discussions, games, and activities, the classroom lessons build positive, shared student experiences around workplace safety” (Ward et al., 2010, p. 4). Like the SPIY program it deals with “reallife scenarios and consequences” (Ward et al., 2010, p. 4). Also to make leaning fun and easy the ProSafety Project uses many different teaching method including “PowerPoint slides, DVDs with viewing guides, and a computer-based learning module” (Ward et al., 2010, p. 4). The aim is to “emphasizes risk assessment and hazard response, seeking to build students’

YOUTH WORKPLACE INJURIES knowledge and confidence in their ability to contribute to workplace safety” (Ward et al., 2010, p. 4) (see Appendix B, p. 14) The ProSafety Project uses the Social Cognitive Theory (SCT) (See Appendix C, p. 15). The theory states that “a desired behavioral outcome is a product of the interaction among characteristics of behaviors, individuals, and the environment” (Ward et al., 2010, p. 3). The SCT is shown to be effective because it focuses on the positive reinforcements which are created by the individual’s behaviour (Ward et al., 2010). For example, if a student is taught to wear oven mitts when taking out the products out of an oven and do not get burnt, the positive reinforcement would be not getting hurt; the student would then continue this action (see Appendix D, p. 16). In conclusion the students who participated in the ProSafety Project are now considered “as highly qualified, skilled, and safety-promoting contributors to the work force” (Ward et al., 2010, p. 5). Health & Safety Teaching Tools The Canadian Centre for Occupational Health and Safety (CCOHS) realizes that they must take action and protect the well-being of our youth in the workplace. So they have designed the Health & Safety Teaching Tools, which is a program that targets youth and educates about work safety(Canadian Centre for Occupational Health and Safety (CCOHS), n.d.).. The Health & Safety Teaching Tools program is implemented in school by teachers. The program “is based on best practice principles and techniques” (Canadian Centre for Occupational Health and Safety (CCOHS), n.d., Scope para. 1).

YOUTH WORKPLACE INJURIES The Health & Safety Teaching Tools has a curriculum containing five chapters. Each chapter covers “the major topic areas of workplace health and safety that are likely to impact young workers” (Canadian Centre for Occupational Health and Safety (CCOHS), n.d., para. 3). The five chapters include: chemical hazards, ergonomics, physical hazards, biological hazards, and sociability issues. Also the program offers various activities, handouts and tests for the students to complete. In addition, there is a CD that is included containing all slides, activity handouts and tests which makes it easily assessable to all students (Canadian Centre for Occupational Health and Safety (CCOHS), n.d., para. 3). In conclusion, this is an effective program and “it has been proven that integrating workplace health and safety education into the classroom has helped in the prevention of accidents and injuries” (Canadian Centre for Occupational Health and Safety (CCOHS), n.d., para. 1). National Rural Youth Health and Safety Initiative (NRYHSI) In the United States of America, the national organization Farmers of America (FFA, formerly Future Farmers of America) created the National Rural Youth Health and Safety Initiative (NRYHSI). This initiative as implemented as “a school-based agricultural education program in public schools” (Lee, Westaby, & Berg, 2004, p. 1). Again like the others discussed previously it used various multimedia teaching methods such as “videotapes, CD-ROMS, printed resources, and instructions” (Lee, Westaby, & Berg, 2004, p. 1). However, through a comprehensive evaluation it was found that this initiative had unsuccessful results; “matched data from 3081 students and 81 advisers revealed no significant effect of this initiative on agricultural health and safety knowledge, safety attitudes, leadership,

YOUTH WORKPLACE INJURIES self-concept, and self-reported injuries of project participants” (Lee, Westaby, & Berg, 2004, p. 1). The reason for this initiatives failure was that the “program implementation was inconsistent” (Lee, Westaby, & Berg, 2004, p. 1). Healthy People 2010 “Healthy People 2010 is considered a prevention agenda for the nation . . . provide the information and knowledge about how to improve health.” (Chikotas, Parks, & Olszewski, 2007, p. 1). In the 2010 edition of Healthy People it the major objectives related to workplace safety were to “reduces deaths from work-related injuries, reduce work-related injuries resulting in medical treatment” and “ lost time from work, or restricted work activity” (Chikotas, Parks, & Olszewski, 2007, p. 2). A few of the proposed strategies to reach these objectives are to “Provide educational awareness and outreach efforts to inform workers, employers, and others” (Chikotas, Parks, & Olszewski, 2007, p. 5) and “occupational health nurses can play a key role in developing and implementing workplace safety and health promotion programs” and overall reduce workplace injuries and fatalities. (Chikotas, Parks, & Olszewski, 2007). Conclusion Although some of the preventative methods have yet to be evaluated, for the most part school-based programs have been proven an effective method to prevent youth workplace injuries if the programs are well planned and well implemented. (Breslin, Smith, Mustard, & Zhao, 2006). In summary, this literature review examined a handful of studies on workplace injuries and education- based prevention. The school- based programs we looked at were the SPIY, the ProSafety Project, the Health & Safety Teaching Tools and the NRYHSI. Finally a few strategies to prevent youth workplace injuries were presented in Health People 2010.

YOUTH WORKPLACE INJURIES In school- based programs the best outcomes occurred when the following were used, real life scenarios, multimedia teaching methods and role-playing or internships for students to apply what they have learned (Buckley & Sheehan, 2009; Canadian Centre for Occupational Health and Safety (CCOHS), n.d.; Lee, Westaby, & Berg, 2004; Ward et al., 2010). Numerous studies suggested that school nurses, public health nurses, occupational health nurses, along with many other healthcare professions can raise awareness and provide abundance of workplace safety information and resources (Chikotas, Parks, & Olszewski, 2007; Higgins, Tierney, Lins, & Hanrahan, 2004; Lee, Westaby, & Berg, 2004; Miller, 2004; Ward et al., 2010; West, de Castro, & Fitzgerald, 2005). Even parents can contribute greatly to the safety and well-being of their own children by advocating (West, de Castro, & Fitzgerald, 2005). Future Recommendations To insure the most effective programs are being implemented a few common critics of past programs will be provide. Since most education programs are school- based it does not give those who leave school early a chance take part in these specialized programs. These high-risk groups are mainly males and coincidentally, males are more prevalent to workplace injuries than female (Breslin, 2008). Therefore there is a need for more “workplace training/supervision initiatives or community-based social marketing programs on work safety for vulnerable subgroups” (Breslin, 2008, p. 4). Also there is a need for programs that are specially tailored to individuals who have learning disabilities (West, de Castro, & Fitzgerald, 2005). Finally, “employers and employees must understand and believe in the value of injury prevention to affect attitudinal and behavioral changes. This may be achieved through intense, continuous, and job-specific education and training that solicits input from the worker” (Gatty, Turner, Buitendorp, & Batman, 2003, p. 9).

YOUTH WORKPLACE INJURIES References Breslin, F. (2008). Educational status and work injury among young people: refining the targeting of prevention resources. Canadian Journal of Public Health, 99(2), 121-124. Breslin, F., Polzer, J., MacEachen, E., Morrongiello, B., & Shannon, H. (2007). Workplace injury or "part of the job"?: towards a gendered understanding of injuries and complaints among young workers. Social Science & Medicine, 64(4), 782-793. Breslin, F., Smith, P., Mustard, C., & Zhao, R. (2006). Young people and work injuries: an examination of jurisdictional variation within Canada. Injury Prevention, 12(2), 105-110. Buckley, L., & Sheehan, M. (2009). A process evaluation of an injury prevention school-based programme for adolescents. Health Education Research, 24(3), 507-519. Canadian Centre for Occupational Health and Safety (CCOHS). (n.d.). Publications: Health & Safety Teaching Tools. Retrieved from http://www.ccohs.ca/. Chikotas, N., Parks, C., & Olszewski, K. (2007). Occupational safety and health objectives of Healthy People 2010: a systematic approach for occupational health nurses -- part I. AAOHN Journal, 55(2), 65-74. Children, Youth and Women's Health Service (CYMHS). (n.d.). Workplace safety. Retrieved from http://www.cyh.com/. Gatty, C., Turner, M., Buitendorp, D., & Batman, H. (2003). Students for WORK. The effectiveness of back pain and injury prevention programs in the workplace. Work, 20(3), 257-266.

YOUTH WORKPLACE INJURIES Higgins, D., Tierney, J., Lins, M., & Hanrahan, L. (2004). School nurses: a resource for young worker safety. Journal of School Nursing (Allen Press Publishing Services Inc.), 20(6), 317323. Lee, B., Westaby, J., & Berg, R. (2004). Impact of a national rural youth health and safety initiative: results from a randomized controlled trial. American Journal of Public Health, 94(10), 1743-1749. Miara, C., Gallagher, S., Bush, D., & Dewey, R. (2003). Developing an effective tool for teaching teens about workplace safety. American Journal of Health Education, 34(5), S-30s-34. Miller, M. (2004). Linking practice & research. Young adolescents in the work force -- a population at risk. AAOHN Journal, 52(11), 461-464. Olszewski, K., Parks, C., & Chikotas, N. (2007). Occupational safety and health objectives of Healthy People 2010: a systematic approach for occupational health nurses -- part II. AAOHN Journal, 55(3), 115-125. Schulte, P., Stephenson, C., Okun, A., Palassis, J., & Biddle, E. (2005). Government, politics, and law. Integrating occupational safety and health information into vocational and technical education and other workforce preparation programs. American Journal of Public Health, 95(3), 404-411. Ward, J., de Castro, A., Tsai, J., Linker, D., Hildahl, L., & Miller, M. (2010). An injury prevention strategy for teen restaurant workers: Washington State's ProSafety Project. AAOHN Journal, 58(2), 57-67. doi:10.3928/08910162-20100127-01

YOUTH WORKPLACE INJURIES West, C., de Castro, A., & Fitzgerald, S. (2005). The youth work force: unique occupational health considerations and challenges. AAOHN Journal, 53(7), 297-305. Workplace injuries. (n.d.). Home. Retrieved from http://www.workplaceinjuries.ca/

YOUTH WORKPLACE INJURIES Appendix A

Themes, concepts and example quotes of behaviours (Buckley & Sheehan, 2009)

YOUTH WORKPLACE INJURIES Appendix B

ProSafety Curriculum (Ward, de Castro, Tsai, Linker, Hildahl, & Miller, 2010)

YOUTH WORKPLACE INJURIES Appendix C

ProSafety Logic Model (Ward, de Castro, Tsai, Linker, Hildahl, & Miller, 2010)

YOUTH WORKPLACE INJURIES Appendix D

ProSafety program model of positive reinforcements (Ward, de Castro, Tsai, Linker, Hildahl, & Miller, 2010)

YOUTH WORKPLACE INJURIES