Work and Health Research Centre
A staged approach to reducing MSDs in the workplace (HSE)
Professor Cheryl Haslam
Professor Roger Haslam
Health & Safety Executive
Musculoskeletal disorders (MSDs) remain the most common form of occupational ill-health in Great Britain. Behaviour is a crucial factor in the reduction of many of today's health problems, including MSDs. Despite this, evidence suggests that ergonomics consultants focus largely on the physical aspects of the work, tending to overlook the more 'psychological' factors such as risk perception or management commitment (Whysall et al., 2004). Such an approach also overlooks psychosocial factors, which have been found to be associated with MSDs.
This research attempted to improve the efficacy of interventions by applying the stage of change approach (Prochaska & DiClemente, 1982) to the workplace. The stage of change model acknowledges the importance of addressing attitudes in order to achieve behaviour change, and assumes that any behaviour change involves movement through distinct stages. An individual's stage determines their receptiveness to, and the likely efficacy of, particular methods of education.
The project has involved several phases:
Phase 1: Tools were developed to assess individual worker and organisational stage of change towards reducing the risks of MSDs. These tools were administered and tested in a range of occupational sectors, and were found to demonstrate high levels of reliability.
Phase 2: The research team worked with a number of participating organisations to develop and implement MSD solutions tailored to their readiness to adopt change. The effectiveness of tailored compared to standard interventions was measured in terms of stage of change and self-reported musculoskeletal discomfort. Short-term follow up at 6 months post-intervention indicated tailored interventions to be more successful than those that progressed in the usual manner.
Phase 3: To determine if the positive findings seen at 6 months persist over the long term, a longer-term follow-up of the interventions was carried out at 15 months and 20 months post-intervention. As in phase 2, the effectiveness of tailored compared to standard interventions was measured in terms of stage of change and self-reported musculoskeletal discomfort. The results show that the benefits in behaviour change and symptom reduction persist over a longer period of follow-up.
The findings provide strong evidence for the long-term effectiveness of tailored interventions versus standard interventions in promoting behaviour change and reducing musculoskeletal discomfort.
- Prochaska, J.O., & DiClemente, C.C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory Research and Practice, 19, 276-288.
- Whysall, Z., Haslam, R. and Haslam, C. (2004). Processes, barriers and outcomes described by ergonomics consultants in preventing musculoskeletal disorders. Applied Ergonomics, 35, 343-351.
- Whysall, Z.J., Haslam, C., & Haslam, R.A. (2005). A staged approach to reducing musculoskeletal disorders (MSDs) in the Workplace. HSE Research Report 379. HSE Books: Sudbury, UK.
- Shaw, K., Haslam, C., & Haslam, R.A. (2007) A staged approach to reducing musculoskeletal disorders (MSDs) in the workplace: a long term follow up. HSE Research Report 545. HSE Books: Sudbury, UK.