A staged approach to reducing musculoskeletal disorders (MSDs) in the workplace

PROJECT AIMS: For over a decade, work-related musculoskeletal disorders (MSDs) have remained the most common cause of work-related ill health in Great Britain, and despite an initial decline in prevalence rates, figures appear to have reached a plateau in recent years. The failure for prevalence rates to diminish further in 2001/02 and 2003/04 may be an indication that further health and safety interventions are failing to have any additional notable effect. Behaviour is a crucial factor in the reduction of many of today’s most widespread diseases and health problems, including MSDs. As with the effective reduction of any health or safety risk, not only do managers first need to take action to implement risk-reducing measures, but employees then need to change their routine ways of working to incorporate new methods, equipment, or working practices. 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: i) precontemplation (resistance to recognising or modifying problem behaviour) ii) contemplation (recognition of the problem, thinking about changing, but not ready to act) iii) preparation (intending to change in the next 30 days, and/or having made specific plans to do so) iv) action (having engaged in behaviour change, no longer than 6 months ago) v) maintenance (initiated changes over 6 months ago, working to consolidate gains made and avoid relapse) An individual’s stage determines their receptiveness to, and the likely efficacy of, particular methods of education.