Nachemson lecturer shared lessons from 20 years of tracking impact at NIOSH

Lecture by Dr. Paul Schulte examined efforts to measure impact at U.S. federal research agency

In the world of occupational health and safety research, much effort has been made in the last 20 years to evaluate the impact of research on workplace practices. While progress has been made, there are challenges remaining, and a clear understanding of the link between research findings and social or economic outcomes is still under-developed.

This is according to the director of education and information at the United States National Institute for Occupational Safety and Health (NIOSH), who was speaking at a lecture hosted by the Institute for Work & Health (IWH) in Toronto last November.

We all know that it is difficult to assess the impact of guidance and research, said Dr. Paul Schulte, speaking at the 2014 Alf Nachemson Memorial Lecture. There’s a large gap between the conduct of research and the management of workplaces. Intervening factors—jurisdictional, social, legal, political factors—make it challenging at times for research evidence to be transferred into the decision-making of employers.

The annual lecture series was established in 2002 to examine the use of research evidence in decision-making. It’s named after the late Dr. Alf Nachemson, a renowned Swedish orthopaedic surgeon and a founding member of IWH’s Scientific Advisory Committee.

In his lecture, Schulte said that when NIOSH was first formed in the 1970s as the U.S. federal research agency tackling work-related illness and injuries, little thought was put into how the agency would measure its impact.

The hazards were too big. Impact assessment was not a priority; doing something about the hazards was the priority, he explained. And as seen in the decline over two decades of falling death and injury rates in the workplace, this intuitive approach to reducing exposure to hazards was the right approach—up to a certain point.

But improvements eventually slowed, giving rise to questions about the continued impact of NIOSH research and guidance on the more persistent hazards. The backdrop to this growing interest in impact was a shift in thinking about the relationship between science and society (with greater focus put on the application and utility of science), a recognition that knowledge is itself an asset that needs to be managed, and growing pressure on all federal departments and agencies to account for decisions on where to allocate funds.

Partnering with research users

Schulte outlined a number of initiatives taken within NIOSH over the years to measure impact. One initiative introduced in 2004, called “Research to Practice,” placed a focus on knowledge transfer.

We have to translate the findings of our science into practice. We have to be able to move people to action with our research, said Schulte. This thinking, he added, is so ingrained at NIOSH that researchers now try to obtain input from stakeholders before starting on a research study. We ask, ‘What are the problems you face?’ We try to fashion the research to address that problem. And, consequently, when we are finished, we expect there will be stakeholders who use that research.

Another important internal initiative is called the National Occupational Research Agenda (NORA), which places partnerships with stakeholders at the very foundation of a research program. It was based on the realization that no one agency could address all the occupational safety and health problems. There weren’t enough resources. We had to partner around priorities that everyone could agree on, said Schulte.

Through these partnerships, called sector councils, stakeholders such as trade associations, unions and insurance companies play a key role in helping set NIOSH priorities and goals across 10 sectors and 24 cross-sector programs. Sometimes stakeholder input is not merely overarching; it can get very specific, setting out activity goals and performance metrics. This was one of the requests of many of the stakeholders in those sectors, and it has been a very effective means of developing programs, and communicating and translating research to practice, said Schulte.

In another impact assessment initiative, NIOSH engaged the National Academy of Sciences to conduct a review of the agency’s eight major programs. This was an extensive effort, he said, but it showed that all of the programs were having significant impact.

However, Schulte noted that impact science remains in development, especially when it comes to understanding what happens between output and outcome. The linkage between outputs and outcomes is mediated by a lot of factors. We don’t control what happens at the companies, on the factory floors or in the workplaces, he said.

Schulte also acknowledged that there are limits to how far impact science can go. Citing the words of another academic on research assessment, he said research outputs enter a pool of knowledge that’s fed by many sources, and the effort to track the impact of each drop in the pool can end up costing more than the cost of conducting research in the first place. But on balance, he added, the world of occupational health and safety research needs to invest more into understanding impact.

We need to improve impact science, define it better, and figure out what kinds of capacity building, what kinds of methods or approaches we can use, said Schulte. And it’s not just so that we can say we’re doing the most important things and making a difference. It’s so we can make a better difference.

To see Schulte’s lecture as a slidecast, go to: www.iwh.on.ca/nachemson-lecture.

Source: At Work, Issue 79, Winter 2015: Institute for Work & Health, Toronto

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