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TheroleofevidenceinoccupationalsafetyandhealthDrStephanieStockwell,GiuliaMaistrello,DrSarahBall,JessicaDawney,MichaelWhitmore,DrNickFahyFormoreinformationonthispublication,visit/t/RRA2153-1AboutRANDEuropeRANDEuropeisanot-for-profitresearchorganisationthathelpsimprovepolicyanddecisionmakingthroughresearchandanalysis.TolearnmoreaboutRANDEurope,visit.ResearchIntegrityOurmissiontohelpimprovepolicyanddecisionmakingthroughresearchandanalysisisenabledthroughourcorevaluesofqualityandobjectivityandourunwaveringcommitmenttothehighestlevelofintegrityandethicalbehaviour.Tohelpensureourresearchandanalysisarerigorous,objective,andnonpartisan,wesubjectourresearchpublicationstoarobustandexactingquality-assuranceprocess;avoidboththeappearanceandrealityoffinancialandotherconflictsofinterestthroughstafftraining,projectscreening,andapolicyofmandatorydisclosure;andpursuetransparencyinourresearchengagementsthroughourcommitmenttotheopenpublicationofourresearchfindingsandrecommendations,disclosureofthesourceoffundingofpublishedresearch,andpoliciestoensureintellectualindependence.Formoreinformation,visit/about/principles.©2022Lloyd’sRegisterFoundation,Allrightsreserved.Nopartofthisbookmaybereproducedinanyformbyanyelectronicormechanicalmeans(includingphotocopying,recording,orinformationstorageandretrieval)withoutpermissioninwritingfromtheLloyd’sRegisterFoundation.RAND’spublicationsdonotnecessarilyreflecttheopinionsofitsresearchclientsandsponsors.PublishedbytheRANDCorporation,SantaMonica,Calif.,andCambridge,UKR®isaregisteredtrademark.Cover:AdobeStockIIISummaryUsingevidenceinoccupationalsafetyandhealth(OSH)decisionmakingmayhelpreduceratesofoccupationalincidentsanddiseases.However,theroleevidencecurrentlyplayswithinOSHisunclear.ThisreportdescribesastudyexploringtheroleofevidenceinOSHdecisionmaking.Italsoconsiderswhatevidenceisproduced,sharedandused,andbywhom.WedevelopedtwoconceptualmodelsbasedonliteraturefromaRapidEvidenceAssessment(REA)thatincluded28articlesandstakeholderengagement(viasecondaryanalysisofexistinginterviewdata,aglobalsurveyandprimaryinterviews).Thefirstillustratestheactorsandagenciesinvolvedinevidenceproduction,sharinganduseandtheirinterrelationships.Theseconddemonstratestheprocessesinvolvedindecisionmakingatthelocal(anisation/business)andsystemslevelandtheroleevidenceplaysintheseprocesses.Ourresearchsuggeststhatlegal,regulatory,businessandculturalfactorsinfluenceOSH-relateddecisionmaking,andareoftenprioritisedoverOSHevidence.

Thisstudy’sfindingssuggesttheneedformoreeffectivetranslationofevidenceforlayaudiencesalongsidemoreeffectivetoolsandtechniquesforsharingknowledgeaboutOSHevidenceandpracticesatalocalandsystemslevel.Promotingapositivesafetyculture(e.g.whereemployeesappreciatethevalueofsafetypracticesratherthanviewingthemasaninconvenience)isalsoimportantforusingevidenceinOSH,particularlyatalocallevel.Thisisbecauseindividualattitudes,values,perceptionsandbehavioursheavilyinfluencetheuseofevidenceinpractice.Atasystemslevel,methodsneedtobedevelopedtomaptheevidenceecosystemsforspecificcountries,sectorsandtopicsofinterest,asthemodelsdevelopedinthisworkaregenericandmaydifferbasedonthesefactors.Finally,ourfindingssuggestasubstantialtimegapbetweenidentifyingaproblemandusingevidencetoaddressit,possiblycallingforincreasedsystemcapacityforrapidevidenceassessmentandresponsetoissues.VExecutivesummaryIntroductionOccupationalaccidents,illnessesandfatalitiesareprevalentglobally;between2000and2017,anestimated1.9million[1]to2.78million[2]globaldeathswereattributabletooccupationalaccidentsordiseases.Thepastdecadehasseenwork-relatedaccidentandfatalityratesplateauinmanyhigh-incomecountries[2-7].However,safetyoutcomesanddisparitieswithinandbetweencountriesremainprominentissues[1,2,8,9].Enhancingworkingconditionsandmakingworkplacessaferisnecessarytodecreasethenumberoffatalities,injuriesandcasesofoccupationaldiseases,andtopromoteandsafeguardpsychologicalwelfare.Onewaytomakeworkingenvironmentssaferisbyusingevidencetoinformguidelines,regulations,practicesanddecisionmaking.However,somesuggestthatoccupationalsafetyandhealth(OSH)underutilisessystematic,scientificevidenceandover-reliesonexpert-basedrecommendations[10,11].Itiscurrentlyunclearwhatevidencetypesareusedtohelpmakeworkenvironmentssafer,whousessuchevidenceandforwhatpurpose.Intheabsenceofexistingevidence,itmaybebeneficialtoproducenewevidenceforusewithinorganisationsandgovernments.However,itisunclearwhichagenciesareinvolvedinproducing,translatingandsharingevidence

withendusers.ItisalsounclearhowOSHdecisionsareinformedandwhatroleevidenceplaysinthisprocess.ResearchquestionsThisworkaimedtoanswerthefollowingresearchquestions(RQs):RQ1:WhattypesofevidenceexistinOSH?RQ2:WhoisusingtheevidenceinOSHandwhatfor?RQ3:HowareOSHdecisionsinformedandwhatroledoesevidenceplayinthisprocess?RQ4:Whichagenciesareinvolvedinproducing,translatingandsharingevidenceinOSH?ResearchapproachTheresearchundertakenwasdividedintothefollowingactivitiestoanswerthefourresearchquestions:ARapidEvidenceAssessment(REA):WeconductedsearchesofPubMedandthecitationindexesviaWebofScienceandperformedaseriesoftargetedgreyliteraturesearchesofGoogleandtenkeyorganisations’websites.WeextractedandVI Theroleofevidenceinoccupationalsafetyandhealthsynthesiseddatafromthe28articlesthatmettheinclusioncriteria.Stakeholderengagementactivities:First,weanalysedexistingdatafrom240interviewsconductedbetween2018and2020withOSHleadsandHumanResourcesDirectorsfromnationalandinternationalorganisations.Second,weconductedanonlinesurveyofOSHstakeholdersfrom25May2022to22June2022,capturinganswersfrom132participants.Third,weinterviewedanadditional13individualsinvolvedinOSH(researchers,practitioners,regulators/policymakersandmembershiporganisationrepresentatives).Developmentofconceptualmodels:UsingdatacollectedfromtheREAandstakeholderengagementactivities,wedevelopedtwoconceptualmodels:onemappedthedifferentactorsandagenciesinvolvedinOSHdecisionmaking(structuralmodel,Figure5),andtheotherhighlightedtheprocessesinvolvedinOSHandtheroleofevidenceatanoperationalandsystemslevel(processmodel,Figure7).Analysisandsynthesis:Lastly,guidedbyourconceptualmodels,weanalysedandsynthesisedfindingsfromtheREAandstakeholderengagementactivitiestoanswerthefourkeyresearchquestions.FindingsOurfindingshighlightedthatnosingledefinitionof‘evidence’existedintheOSHspace.Theliteratureandstakeholdersweconsulteddrewuponvariousinformationandresearchsourcesfordecisionmaking.TheOSHevidenceecosystemcontainsmultipleactorsinteractinginwhatwedescribeasthelifecycleofevidence,whichreferstotheproduction,synthesis,sharinganduseofevidenceatanoperationalandsystemslevel.Although

wedistinguishbetweenthesecategoriesforclarity,theyareinterdependentprocessesinpractice.Theactorsinvolvedinthisecosysteminclude:Theacademicandresearchcommunity(mainlyevidenceproductionandsharing).Governmentagencies,regulatorybodiesandpolicymakers(evidenceproduction,sharinganduse).Intermediariessuchasprofessionalbodies,consultantsandOSHprofessionals(mainlyevidencesharing).Organisations/businesses(evidenceproduction,sharing–mostlyinternally–anduse).Oneoftheprimaryusesofevidenceistoinformdecisionmaking.Wedevelopedaconceptualmodeltoillustratethetwolevelsatwhichevidenceisusedtoinformdecisionmaking:(i)alocallevel(i.e.withinanorganisation/business)and(ii)asystemslevel.Atalocallevel,webasedthelifecycleofevidenceonacontinuous-improvementcycle(alsoknownasa‘plan-do-study-act’or‘Deming’cycle)[12].Atasystemslevel,webasedthecycleontheInternationalLabourOrganisation’s(ILO)OSH-managementsystem[13],whichincorporatespolicies,aims,organisation,implementation,evaluationandimprovement.Eachstagecommonlyusesdifferenttypesofevidence.Severalfactorsinfluencedecisionsandevidence-useinthedecision-makingprocess.Broadlygroupedandpresentedbystakeholdergroups,thesefactorsinclude(inascendingpriority):thelegalbasisandregulations,thebusinesscase(e.g.finances,staffing),cultureandfinally,evidence(e.g.existence,VIIaccessibilityandrelevance).Anorganisation’sisakeyinfluenceonsafetyoutcomes,sizecanalsoimpactthesefactors(i.e.largerandisgreatlyinfluencedbyorganisationalcompaniesarelikelytohavegreaterresourcesleaders’anddecisionmakers’valuesandandmorespecialiststaffthansmallerexpertise.Whiletheremaybeaperceptioncompanies),ascanthecountry(affectingthatevidence-basedpracticeistime-regulations,expectationsandculture).consumingand/orcostly,organisationalleadersshouldbeeducatedabouttheDiscussionandrecommendationsbenefitsasaferworkenvironmentcanOurREAandstakeholderengagementfindingsoffertheirorganisation(e.g.increasedqualityandprofitability).Thepromotionofhighlightacomplexevidenceecosystemapositivesafetycultureamongallworkersinvolvingmultipleactors,agenciesandislikelytobebeneficial.influencesontheproduction,synthesis,•Forresearchers:sharinganduseofevidencewithinOSH.»FurtherresearchisrequiredtobridgeBasedonthiswork’sfindings,wepresentfiverecommendationsforfuturework:theknowledge-to-actiongapinhow•Forevidencesharers:greaterinvestmentevidenceisused(ornot)toimplementspecificchange.Thismaybeginwithisrequiredinknowledgetranslation.Toevaluationstounderstandtheuseandmaximiseitsimpact,workplace-safetyeffectsofshared/translatedevidenceevidencemustbetailoredtowarditsinpractice,includinglong-termintendedaudiences,whoareoftennotfollow-ups.academicresearchers(e.g.workers,»Cost/benefitanalysesofevidence-policymakersandorganisationalleaders/decisionmakers).Asastartingpoint,basedpracticearerequiredtoprovideacademicliteraturemustbetranslatedempiricalevidenceaddressingintoeasy-to-digestformatssuchasperceptionsthatevidence-basedinfographics,videosandmanualsforpracticeiscostly.Theresultsnon-OSH-specialistaudiences.Manymaystimulateculturalchanges,organisations–particularlysmall-and-encouragingorganisationstoutilisemedium-sizedenterprises(SMEs)inevidencetheymayhavepreviouslydevelopingcountries–needfurtherhesitatedover.supportutilisingacademicresearch»Collectingdataonorganisationsizesevidenceindecisionmakingandpractice.wouldbebeneficialwhenconductingNetworksandcommunitiessupportingfutureresearchaboutevidenceevidencedissemination,mutuallearning,utilisationinOSH,aswefoundthistocriticalthinkingandliteracyarelikelybeakeyinfluence.Inaddition,greaterbeneficial.AsinglepointofreferenceforeffortstoincluderepresentationfromOSHevidencegloballymaybebeneficiallow-and-middle-incomecountriesandhelpovercomeissuesrelatingto(LMICs)areneeded,whichmayrequireidentifyingandaccessingrelevantevidenceadditionalresourcesandincreasinginatimelymanner.capacityandcapabilitiesinLMICs.•Forworkplaces:aworkplace’ssafety»Thereisoftenadelaybetweentheculture(comprisingpsychological,emergenceofsafetyissuesandthebehaviouralandsituationalaspects[14])provisionofnewevidencethathelpsVIII Theroleofevidenceinoccupationalsafetyandhealthaddressthem.Therefore,systemcapacitymustbeinplacetominimisethetimebetweenproblemsarisingandtheavailabilityofevidencetorespond,whetherthroughtheproductionofnewevidenceand/orthesynthesisofexistingevidence.Itmayalsobebeneficialtoconducthorizonscanningforfuturepotentialissuesfortherapidmobilisationofevidencewhenneeded.Moreover,itmaybeworthconsideringabody/councilofrepresentativesfromLMICsthatcouldchampionand

facilitateLMICresearchinclusioninatimelymanner.Ourresearchhighlightedsignificantvariabilityintheavailableevidenceandhowitisaccessedandimplementedacrosscountriesandsectors.Itmaybebeneficialtomapevidenceecosystemsforspecificcountries,sectorsandtopicsofinterest.AccuratemappingexercisescouldhelpidentifyOSHissues,highlightingareasthatwouldbenefitfromfurtherresearchortailoredinterventions.IXTableofcontentsSummaryIIIExecutivesummaryVFigures,tablesandboxesXAbbreviationsXIAcknowledgementsXII1.Introduction12.Researchapproach32.1.Researchquestions32.2.RapidEvidenceAssessment42.3.Stakeholderengagement62.4.Conceptualmodels92.5.Synthesisandreporting93.Findings113.1.Whattypesofevidenceexist?(RQ1)113.2.Actorsandagenciesinvolvedinproducing,sharing,translatingandusingevidence(RQ2&RQ4)143.3.Howaredecisionsinformedandwhatroledoesevidenceplayinthisprocess?(RQ3)234.Discussionandrecommendations374.1.Recommendations385.Conclusion41References43TheroleofevidenceinoccupationalsafetyandhealthFigures,tablesandboxesFigure1.Overviewofapproach3Figure2.Surveyrespondents’professionalroleswithinoccupationalsafetyandhealth8Figure3.Channelsusedforevidencesharing13Figure4.Thestructureoftheevidenceecosystem16Figure5.WhoaretheOSHdecisionmakerswithinorganisations?23Figure6.Aprocessmodeloftherelationshipsbetweenevidence,occupationalsafetyandhealthsystemsandlocalimprovement26Figure7.TypesofOSHdecisionstakenbydecisionmakers29Figure8.Indicationoftheprioritiesrelatedtothedecision-makingprocessandtherolethatevidenceplays32Figure9.“TheavailableevidenceonOSH...33Table1.REAinclusionandexclusioncriteria5Box1.StepsintheInternationalLabourOrganisationmodelofOSHmanagementsystemapproach[13]27XIAbbreviationsHICsHMICsHSELICsILOLMICsNGOOSHREARQSMEsUEAWP

High-IncomeCountriesHigh-and-Middle-IncomeCountriesHealthandSafetyExecutiveLow-IncomeCountriesInternationalLabourOrganisationLow-and-Middle-IncomeCountriesNon-GovernmentalOrganisationOccupationalSafetyandHealthRapidEvidenceAssessmentResearchQuestionSmall-and-Medium-sizedEnterprisesUniversityofEastAngliaWorkPackageXII TheroleofevidenceinoccupationalsafetyandhealthAcknowledgementsRANDEuropewouldliketothankmembersoftheexpertpanelfortheirfeedbackandcontributionstotheprojectandDrHelenFitzhughandProfessorKevinDanielsfromtheUniversityofEastAngliafortheirsecondary

analysisofinterviewdata.TheresearchteamwouldalsoliketothankDrRobRomanelli,DrBrandiLeachandMrWillPhillipsfromRANDEuropefortheirqualityassurancecontributionsthroughouttheproject.11IntroductionAnestimated1.9million[1]to2.78million[2]globaldeathswereattributabletooccupationalaccidentsordiseasesbetween2000and2017.Thepastdecadehasseenwork-related-accidentandfatalityratesplateauinmanyhigh-incomecountries[2-7].However,safetyoutcomesanddisparitiesinoutcomesbetweencountriesandwithincountriesremainprominentissues[1,2,8,9].Inarecentglobalpollofworkers(n=150,000)across142countries,19%reportedthattheyhadbeenseriouslyinjuredatwork[15].Aswellasthepersonalimpactontheworker,occupationalaccidentsanddiseaseshavesocietalandeconomicimpacts.Consequencesincluderelianceonwelfareandhealthcaresystems,insuranceclaimstocovermedicalexpensesandeconomicissuesarisingfromlostproductivity,whichmayimpactacountry’seconomicgrowth[16-23].Therefore,thereisaneedtoreducework-relatedfatalities,injuriesanddiseases,requiringnewtoolsandtechniquestoensureworkingenvironmentscontinuebecomingsafer.Evidencecanhelpimprovework-environmentsafetybyinformingguidelines,regulations,practiceanddecisionmaking[11].Evidencecanbedefinedas‘Theavailablebodyoffacts

orinformationindicatingwhetherabelieforpropositionistrueorvalid’[24].However,evidenceisunderutilisedinoccupationalsafetyandhealth(OSH),andrecommendationsforimprovingworkplacesafetyareofteninformedbyindividualopinion(whichmayincludeindividualOSHexperts)ratherthandirectconsultationofmorerigorousevidencesources[10,11].Therefore,itisvitaltounderstandthetypesandroleofevidenceinOSHandidentifypossibleopportunitiestoimproveitspositiveimpactonsafetyoutcomes.ItiscurrentlyunclearwhatevidencetypesexistinOSH,whousesthemandforwhatpurposes.Intheabsenceofexistingevidence,itmaybebeneficialtoproducenewevidencefororganisations,workplacesandgovernments.However,itisunclearwhichagenciesareinvolvedinproducing,translatingandsharingevidence.ItisalsounclearhowOSHdecisionsareinformedandwhatroleevidenceplaysinthisprocess.Therefore,thisstudyaimedtoexploreandidentifyglobally:(i)whattypesofevidenceareproduced,sharedandused,andbywhom,and(ii)howOSHdecisionsareinformedandtheroleevidenceplaysinthisprocess.32ResearchapproachThissectiondescribesourstudy’sresearchapproach.Weconsideredexpertinputfromthefunders(LRFandNSC)alongsideinputfromanindependentexpertpanel.2.1.ResearchquestionsTheprojectendeavouredtoanswerfourresearchquestions(RQs)toachieveitsaims:RQ1:WhattypesofevidenceexistinOSH?RQ2:WhoisusingtheevidenceinOSHandwhatfor?Figure1.Overviewofapproach

RQ3:HowareOSHdecisionsinformedandwhatroledoesevidenceplayinthisprocess?RQ4:Whichagenciesareinvolvedinproducing,translatingandsharingevidenceinOSH?TheprojectundertookfourmainactivitiestoanswertheseRQs:(i)arapidevidenceassessment(REA),(ii)stakeholderengagement,conceptual-modeldevelopmentand(iv)synthesisandreporting.Figure1(below)outlinesthemethodsusedineachactivity.Activity

RapidStakeholderConceptualSynthesisevidenceengagementmodelsandreportingassessmentTasksOutput

•Evidencescoping•Finalisationof•Initialconceptual•Synthesisoffindings•Databasesearchessurveyquestionsandmodeldevelopment•Reporting•Screeningofresults•interviewprotocol•Collateexpertviews•Dissemination•DataextractionConductsurveyandandfurtheriterateinterviews•Targetedsearchof•Analysisandgreyliteratureinterpretation•AnalysisandinterpretationPreliminaryfindingsFindingsfromFullydevelopedFinalreportandandfinalisedlistofcommunicationsstakeholderinsightconceptualmodelstakeholdersnarrativesQualityassuranceandengagementwithexpertadvisorsTheroleofevidenceinoccupationalsafetyandhealth2.2.RapidEvidenceAssessmentOverviewofREAmethodsOurliteraturereviewapproachfollowedtheprinciplesofanREA[25].ItaimedtodevelopanunderstandingofthecurrentroleofevidenceintheOSHfieldratherthandirectlyassessingorcomparingtheeffectivenessofparticularapproachestoOSHevidencegeneration,disseminationoruse.WeransearchesofacademicliteratureinPubMedon10January2022andviaWebofScience(ScienceCitationIndexExpanded(SCI-EXPANDED)),SocialSciencesCitationIndex(SSCI)andtheEmergingSourcesCitationIndex(ESCI)on19January2022.WealsoconductedsearchesofgreyliteratureviaGoogle(16searchesbetween9and10February2022)andtargetedsearches(1and2March2022)oftenkeyorganisations’websitesdeemedlikelytoproduceorpostinformationrelevanttothetopicofinterest.Onereviewteammemberscreenedarticlesforinclusion(SS,JD,orGMscreenedacademicpapers;orSBscreenedgreyliterature)usingpre-definedcriteria(Table1).Anyuncertaintieswereresolvedthroughdiscussionbetweenreviewers.Fortworeasons,weexcludedarticlesfocusedontheeffectivenessofspecificOSHinterventionsorinterventiontypes.First,thehighvolumeofcorrespondingarticles

precludedtheirinclusioninthisreview’sscope.Second,theparticularnatureofsucharticlesdidnotdirectlyaddressthisreview’sresearchquestionsabouttheevidencetypesproduced,sharedandusedinOSHandbywhom.Forexample,oneoverviewofstudiesidentifiedthroughacademicsearches[11]included25systematicreviewsontheeffectivenessofbehavioural,relationalandmixedinterventionsinpreventingoccupationalinjuriesanddiseases.Similarly,weexcludedspecificexamplesofOSHevidencegeneration,studiesrelatingtooccupationalmedicine(thebranchofmedicineconcernedwiththemaintenanceofhealthintheworkplace)orworkplacehealthpromotion,andthosefocusedsolelyonidentifyingorclassifyingindicatorsforthemeasurementofOSHoutcomes.WeincludedpublicationsifthetopicwasrelevanttotheOSHresearchlandscapeorthegeneration,dissemination,needfor,orpracticaluseofevidence,includingthosefocusedonidentifyingprioritiesforfutureresearchbasedonneed.Weexcludedpublicationsonoccupationalmedicine,interventioneffectivenessorspecificevidence-generationexamples.AsourREAincludedvarioussources,noformalqualityassessmentwasconducted.Therefore,wedidnotexcludearticlesbasedonquality.Threereviewers(GM,JDandSS)usedanExceltemplatetoextractdatafromtheincludedsources.5Table1.REAinclusionandexclusioncriteriaIncludeExcludeTopicfocusJournalarticlesandgreyliteraturesourcesSourcesreportingon:focusedon:•Theeffectivenessofaparticular•Thetopicofthegeneration,interventionorinterventiontype(unlessdissemination,needfor,orpracticalusefocusedonthenatureoftheevidenceofevidenceinthefieldofoccupationalbaseoridentifyinganeedforevidence)safetyandhealth(OSH)•Examplesofevidencegenerationor•TheOSHresearchlandscape,includingidentificationofknowledgegapsinthosefocusedonidentifyingprioritiesspecificfieldsorpopulationsthatcouldforfutureresearchbasedonneedinforminterventions(e.g.asurveyofserviceworkersinnorth-easternMalaysiaonknowledge,attitudeandpracticeconcerningleptospirosisprevention)•Studiesrelatingtooccupationalmedicine(thebranchofmedicineconcernedwiththemaintenanceofhealthintheworkplace)orworkplacehealthpromotion•SolelytheidentificationorclassificationofindicatorsforthemeasurementofOSHoutcomesPublicationReviewarticlespublishedsince2012Reviewarticlespublishedbefore2012dateOriginalarticlesandgreyliteraturesourcesOriginalarticlesandgreyliteraturesourcespublishedsince2017publishedbefore2017SourceArticlesandreportsreportingonresearchResearchprotocolstypestudiesofanydesignOpinionpieces,commentariesandeditorialsLanguageWritteninEnglishWritteninalanguageotherthanEnglishOverviewofstudiesincludedintheREAWeidentified4,985recordsfromelectronicdatabasesearchesafterremovingduplicates.Ofthese,28publicationsmettheinclusioncriteriafordataextractionandsynthesis;23wereacademicjournalarticles,and5weregreyliteraturereports.Thejournalarticlesincludedreviewarticles(n=8),primaryresearchstudies(n=9),commentaries/conceptpapers(n=4),andguidance/recommendationpapers(n=2).Allarticleswerepublishedbetween2012and2022.

CaveatsTheREA’sfocusednaturemeanssomepotentiallyimportantarticlesandpertinentinformationmaynothavebeenincluded,aswepurposefullysampledtheselection.Similarly,wemayhavemissedsomepotentiallysignificantwebsites,documents,orrelevantinformationbyconfininggreyliteraturesearchestospecificdates/websitesandthefirst50hitsonGoogle.Furthermore,weonlyincludedarticles/documentswritteninEnglish,thusexcludingthoseinotherlanguages.Lastly,onlyoneTheroleofevidenceinoccupationalsafetyandhealthreviewerscreenedrecords,whereasdoublescreeningmayhaveidentifieddisagreementsbetweenreviewersandresultedintheinclusionofadditionalarticles.However,wedouble-screenedasampleofarticlesaspartoftheinitialpilotingofthescreeningprocessandcriteria,whichdemonstratedgoodagreementbetweenreviewers.Furthermore,reviewerserredtowardsinclusionduringscreeningandresolvedanyuncertaintiesthroughdiscussion.2.3.Stakeholderengagement2.3.1.SecondaryinterviewanalysisAuniquesourceofaddedvalueforthisstudywasasetofinterviewsconductedbetween2018and2020withOSHleadsandHumanResourcesDirectorsfromnationalandinternationalorganisationsaspartofanotherstudy(seebelow).Theseinterviewsofferawealthofinformationnottypicallyaccessible,manageable,oraffordablewithinourproject’stimescales.TheoriginalresearchThedatawerefromaUniversityofEastAnglia(UEA)andRANDEuropeESRC-fundedprojectonunderstandingthesuccessfulimplementationofwell-beinginitiativesintheUK.Theprojectaimedtoidentifyfactorsinsuccessfullyintroducinghealthandwell-beingpracticesinorganisationstofosterincreasedproductivitylevels,staffengagement,healthandwell-being,focusingonabroadconceptionofwell-beingratherthanonOSHspecifically.Atotalof240qualitativesemi-structuredinterviewswereconductedwithleaders,well-beingpractitionersandemployeesacrosseightorganisationsbetweenJanuary2020andJuly2021.Participatingorganisationsincludedarangeofindustriesandbothlarge(construction,finance,pharmaceutical,facilitiesmanagement)andsmall(education,informationservices,webdevelopment,media

production)organisations.Theinterviewsassessedeachcompany’swell-beingandperformanceapproach,anyrelatedinitiatives/programmes,anychangestotheirwell-beingandperformancestrategy/action,andtheextentofemployeeengagementanddialogue.There-analysisThere-analysiswasundertakeninfourstages:familiarisation,textsearching,codingandanalysis.Firstly,theresearcherfamiliarisedthemselves