Structured Abstract

Contents

• Preface
• Acknowledgments
• Technical Expert Panel
• Peer Reviewers
• Executive Summary
• Introduction
  • Background
  • Existing Guidelines
  • Rationale for Evidence Review
  • Scope and Key Questions
  • Analytic Framework
  • Organization of This Report
• Methods
  • Topic Refinement and Review Protocol
  • Literature Search Strategy
  • Risk of Bias Assessment of Individual Studies
  • Data Synthesis
  • Strength of the Body of Evidence
  • Applicability
  • Peer Review and Public Commentary
• Results
  • Introduction
  • Results of Literature Search and Screening
  • Key Question 1 Characteristics of Studies Evaluating Total Worker Health Interventions
  • Key Question 2 Effectiveness and Harms of Total Worker Health Interventions
  • Key Question 3 Characteristics of Effective Integrated Interventions
  • Key Question 4 Contextual Factors
  • Key Question 5 Evidence Gaps
  • Key Question 6 Future Research Needs
• Discussion
  • Key Findings and Strength of Evidence
  • Key Question 1 Characteristics of Studies Evaluating Total Worker Health Interventions
  • Key Question 2 Effectiveness and Harms of Interventions
  • Key Question 3 Components of Effective Interventions
  • Key Question 4 Contextual Factors
  • Key Question 5 Research Gaps
  • Key Question 6 Future Research Needs
  • Findings in Relation to What Is Already Known
  • Limitations of the Review Process
  • Limitations of the Evidence Base
  • Conclusions
• References
• Appendix A Literature Search Strategies and Yields
• Appendix B Exclusions
• Appendix C Risk of Bias Ratings
• Appendix D Strength of Evidence Tables

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. 290-2012-00008-I. Prepared by: RTI International–University of North Carolina Evidence-based Practice Center, Research Triangle Park, NC

Suggested citation:

Feltner C, Peterson K, Palmieri Weber R, Cluff L, Coker-Schwimmer E, Viswanathan M, Lohr KN. Total Worker Health^®. Comparative Effectiveness Review No. 175. (Prepared by the RTI International–University of North Carolina Evidence-based Practice Center under Contract No. 290-2012-00008-I.) AHRQ Publication No. 16-EHC016-EF. Rockville, MD: Agency for Healthcare Research and Quality; May 2016. www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the RTI International–University of North Carolina Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2012-00008-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

One co-investigator, Dr. Laurie Cluff, received funding from the CDC for Contract 200-2013-M-53964B, “Research and Recommendations in Support of the NIOSH Safe-Skilled-Ready Workforce Initiative,” which was active from 9/1/2013 to 12/31/2014. No studies related to this initiative were identified, included, or excluded during any part of the process for this systematic review. None of the other investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies, may not be stated or implied.

This report may periodically be assessed for the currency of conclusions. If an assessment is done, the resulting surveillance report describing the methodology and findings will be found on the Effective Health Care Program Web site at www.effectivehealthcare.ahrq.gov. Search on the title of the report.

1

5600 Fishers Lane, Rockville, MD 20857; www​.ahrq.gov