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6

RISK COMMUNICATION IN OCCUPATIONAL SAFETY AND HEALTH

Reaching Diverse Audiences in an Evolving Communication Environment

Juliann C. Scholl, Donna M. Van Bogaert, Christy L. Forrester, and Thomas R. Cunningham

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the National Institute for Occupational Safety and Health.

Introduction

As of 2015, the United States civilian workforce totaled over 157 million people (Bureau of Labor Statistics, 2015). Many American workers face threats to their safety and health in the form of exposures, injuries, illnesses, and even death, which cost over $250 billion in medical costs and productivity losses in 2007 (Leigh, 2011). However, such estimates are considered low because they do not include such costs as those associated with labor turnover, pain, and suffering. Another cost has to do with the lost impacts from “presenteeism” (or self-rated sickness presence), which is the tendency to go to work even while sick, often reducing productivity (Aronsson & Gustafsson, 2005; Guest & Conway, 2009; Hansen & Anderson, 2008). In an evolving workplace, this context shows there is significant need for information and interventions to address the risks posed by occupational exposures, such as illnesses attributed to chemical and other environmental hazards (Riegelman & Kirkwood, 2015) and fatal and non-fatal injuries (e.g., slips, trips, and falls) (Turnock, 2016). Fulfilling this need requires navigating several complex domains to reach workplace audiences:

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This chapter first describes the field of occupational safety and health and the only US government agency specifically devoted to OSH research, the National Institute for Occupational Safety and Health (NIOSH). Next, the chapter discusses the role of risk and health communication in OSH and the changes in dissemination due to digital media. The chapter goes on to examine the challenges and opportunities created by new and emerging media technology and channels, and it concludes with recommendations for best practices and future research.

Background

Since the beginning of the Industrial Age, the domain of occupational safety and health has developed significantly on a global level. Alli, in Fundamental Principles of Occupational Health and Safety (2008), recognized the many facets of OSH in defining it as “the science of anticipation, recognition, evaluation and control of hazards arising in or from the workplace that could impair the health and well-being of workers, taking into account the possible impact on the surrounding communities and general environment” (p. vii). In other words, OSH is concerned with preserving the health and safety of workers and with reducing or preventing illness, injury, and death resulting from workplace exposures and hazards.

Many OSH standards and best practices have been endorsed by longstanding international leaders in the field, including the International Commissioner of Occupational Health (ICOH, founded 1906), International Labor Organization (ILO, founded 1919), World Health Organization (WHO, founded 1948), the Occupational Safety and Health Administration (OSHA, founded 1970), and the National Institute for Occupational Safety and Health (NIOSH, founded 1970). Several countries, including the United States and United Kingdom, established acts that mandate safe and healthy work environments for employees. In the United States, agencies were established for developing research to apprise hazards and enforce safety and health regulations. Federal agencies include NIOSH and OSHA, as well as the Mining Enforcement and Safety Administration (MESA) and the Mine Safety and Health Administration (MSHA), which were created in 1973 and 1977 respectively (MSHA, n.d.). There are currently 28 US states and territories that have OSHA-approved state plans, or federally funded safety and health programs (OSHA, n.d.).

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National Institute for Occupational Safety and Health

Established by the Occupational Safety and Health Act of 1970, the NIOSH is the federal agency responsible for conducting research and making recommendations to ensure safe and healthy work conditions for all US workers. As reflected in its stated mission and values (NIOSH, 2016, January 11), NIOSH provides national and world leadership to prevent work-related illness, injury, disability, and death by gathering information, conducting research, and disseminating products, solutions, and services tailored to meet stakeholders’ needs. As an institute within the Centers for Disease Control and Prevention (CDC) of the US Department of Health and Human Services (DHHS), NIOSH has more than 1,300 employees in eight research laboratories and offices across the United States. These represent a wide range of disciplines, including industrial hygiene, medicine, epidemiology, psychology, economics, statistics, communication, and engineering. NIOSH’s mission is to generate new occupational safety and health knowledge and to translate or convert that knowledge into safe practices, procedures, and policies to protect workers (NIOSH, 2015, October). NIOSH is not a regulatory and enforcement agency; however, the institute often works with key federal regulatory partners, the Occupational Safety and Health Administration (OSHA) and the Mine Safety and Health Administration (MSHA) in the Department of Labor, to advance recommendations and best practices that reflect current research conducted by NIOSH and its partners (NIOSH, 2015, November 4).

Equally important to its research on occupational risk factors are the recommendations NIOSH provides for protecting the health and safety of the American worker. NIOSH must translate those findings into practical prevention information and communicate that information through guidance documents (which are non-binding or not enforceable), recommendations, educational materials, and interventions to improve working conditions. Communicating the information effectively is a challenge because of the continual changes in existing and emerging hazards and in the composition of the American workforce (for example, more part-time, temporary, aging, and small-business employees) (Bureau of Labor Statistics, 2013; Cummings & Kreiss, 2008).

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Other significant challenges include cutting through Web information overload and competing for the attention of diverse audiences in the virtual environment; privacy mandates that prevent government agencies from fully engaging in customized content; and rapidly changing communication technology and norms. Amidst these challenges are opportunities for NIOSH to explore and use strategically in its OSH communications.

Communication Opportunities

One opportunity is better use of the advanced, interactive technologies now widely available. These technologies enable rapid dissemination of scientific knowledge. They also provide sophisticated networks that allow users to deliver content in multiple ways over numerous channels and modalities. Such technologies allow for consistent presentation of messages across several types of media.

Another opportunity is to better leverage the NIOSH identity, which is based on its long-established reputation for leadership and research excellence within the OSH community. NIOSH is recognized as an important and trusted source for information and resources that help advance worker health and well-being (NIOSH, 2016, January 11). Therefore, in meeting its mission to provide information that resonates with its diverse audiences, NIOSH works to uphold its reputation as a respected communicator through successful content creation and dissemination strategies.

NIOSH information products are grounded in research to identify risk factors and enable recommendations to prevent worker injury, illness, and death. The extent to which NIOSH information and resources are used, adapted, and adopted in the workplace, however, depends heavily on factors extending beyond risk factors and basic research findings. To that end, NIOSH relies on two initiatives—the NIOSH translation research program and the NIOSH Research to Practice (r2p) framework—to guide translation and transfer of NIOSH information, interventions, and technologies.

Translation Research

Translation research is the scientific investigation of how the products of research can be effectively translated or converted into practice and have an impact; it also encompasses the study of the barriers that prevent this process (Straus, Graham, & Mazmanian, 2006). In 2015, NIOSH established a translation research program, identifying translation research as one of four major research categories central to NIOSH. The program is built on four phases of exploration, which are based on the approach used by the National Institutes of Health (Khoury, Gwinn, & Ioannidis, 2010; Zerhouni, 2003).

The first phase studies the movement of basic risk research findings, such as pilot studies or case reports, into applications that have the potential to be turned into a global outreach effort or intervention. This involves generating solutions to workplace risks and engaging in limited testing. The second phase assesses internal validity by using observational and experimental testing of new interventions, processes, or training programs for their potential impact on an industry or workplace (such as a local construction site). Phase three focuses on external validity by moving evidence-based interventions and recommendations into well-accepted practice within the OSH field. This is done through diffusion research to identify barriers and facilitators to large-scale delivery and dissemination for adoption by broader audiences (such as the construction industry). Phase four studies the “real world” health outcomes or impact of newly developed interventions and recommendations. During this phase, research is conducted to examine the population-level outcomes of translation efforts, particularly their impact on injuries, illnesses, and fatalities.

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Research to Practice (r2p)

The r2p framework drives the adaptation and adoption of NIOSH knowledge, interventions, and technologies into effective workplace practices and products. The framework does this by engaging six core elements: partnerships, intramural science, extramural science, technology transfer, communication, and impact evaluation. Each of these elements uniquely contributes to workplace safety and health; however, it is in their interactions and confluences that they fully align with NIOSH’s mission and promote measurable impact (see Figure 6.1). The core element of communication is crucial to the way NIOSH science is translated into products and then disseminated to intended audiences. Through communication, evidence-based strategies and tools are employed to deliver NIOSH information in ways that are understood and used by key stakeholders (NIOSH, 2015, December 4).

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Communicating Risk

OSH Information

As in other areas of risk communication, the perception of risk is critical to motivating protective and preventive behaviors (Turner, Skubisz, & Rimal, 2011). Health-related risk is concerned with hazards or dangers to be identified, characterized, assessed, and managed for prevention of an adverse outcome (McComas, 2006; Parrott, 2004). In OSH, risk refers to the likelihood that harm will occur and is related to the hazards and exposures that exist in the workplace (Friend & Kohn, 2010). Risk communication involves directing information and persuasion toward diverse audiences to elicit behavioral changes (Olaniran & Scholl, 2016).

Risk communication requires understanding the nature of the target audience (Heath & O’Hair, 2010), particularly how they perceive the likelihood of a harm and its severity. Heath, Palenchar, and O’Hair (2010) argue, “There would be no discipline called risk communication if all of the people of any relevant society perceived the same risks, perceived them in the same way, and reacted to them as of one mind” (pp. 475–476). This claim underscores the importance of recognizing the diversity of the target audiences and how important it is to understand the variation with which they perceive and respond to risk. According to the risk perception attitude (RPA) framework (Rimal & Real, 2003), such variations can be seen when segmenting audiences according to their perceptions of a risk and their efficacy beliefs, particularly for the purpose of designing interventions that seek to change health-related behaviors (Rimal, Brown, Mkandawire, Folda, Böse, & Creel, 2009). The RPA framework suggests that individuals can be responsive (high perceived risk, high efficacy), avoidant (high risk perception, low efficacy beliefs), proactive (low risk, high efficacy), or indifferent (low risk, low efficacy). Real (2008) contends that “creating theoretically meaningful groups, communication researchers can make predictions about safety information-seeking and general safety behaviors” (pp. 342–343). Real’s application of the framework to a study looking at manufacturing workers found that workers with greater efficacy beliefs displayed more positive safety behaviors. Moreover, the study found that responsive individuals reported safer outcomes than avoidants, while the proactive workers reporter safer outcomes than did indifferent workers.

Within the OSH field, perception of risk encompasses a wide range of concerns. Though the focus is on preserving the safety and health of individuals in the workplace, by association, OSH includes loss prevention and the protection of natural and facility resources (Friend & Kohn, 2010). OSH research not only results in specific recommendations for individual worker exposures but also has far-reaching implications. It propels the development of policies and procedures that help employers and workers reduce exposures to hazards or risk factors that contribute to illness and injury. In the course of assessing risk and recommending solutions, the OSH field also contributes to organizational efficiency and quality. For example, finding better ways for warehouse employees to move boxes from one place to another not only can help prevent back pain but also can reduce time spent on the task, thus increasing productivity. Consequently, OSH audiences include multiple stakeholders beyond safety professionals, including policy makers, efficiency experts, facility designers, and employers.

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Theories Underlying OSH and Risk Communication

Risk communication requires not only an understanding of how risk-related messages are formed, sent, and received but also how individuals make decisions given the perceived levels of risk they face. The risk communication process has traditionally meant identifying and verifying the evidence (e.g., statistics, facts) associated with a particular risk, communicating and explaining that evidence to a community at risk, and creating partnerships with stakeholders to understand how to control the risks (Fischhoff, 1995; Morgan, Fischhoff, Bostrom, & Atman, 2002). Partnership development is argued to be an important component of this process, which promotes two-way communication between the community and the entity informing them about the risk (Chess, Salomone, Hance, & Saville, 1995).

Building relationships with stakeholders is exemplified through the application of the CAUSE model (Rowan, 1991; Rowan, 1994; Rowan, Botan, Kreps, Samoilenko, & Farnsworth, 2009; Rowan, Sparks, Pecchioni, & Villagran, 2003), which suggests five communicative goals: (a) Confidence—certainty felt by the audience in the message and the source; (b) Awareness—attention to the warning signs of the risk and being knowledgeable about the topic; (c) Understanding—ability to visualize larger structures and complex processes related with the risk; (d) Satisfaction—agreement with the proposed solution(s); and (e) Enactment—moving an audience from agreement with the message to action. These goals represent the ways risk messages can address the tensions experienced by audiences, such as skepticism about the message or source, lack of awareness about the risk, and inadequate understanding about the terms and complex processes associated with the risk (Rowan et al., 2009).

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The risk communication literature acknowledges that specific risk communication theory is limited in terms of application to diverse audiences (Lundgren & McMakin, 2013) and the uneven risk levels experienced by different populations. The most vulnerable populations have the most difficulty in accessing the information and resources they need to combat those very risks, despite the information they receive through health campaigns (Olaniran & Scholl, 2016). Moreover, not all cultures and populations view a risk the same way or with the same severity (Lachlan, Burke, Spence, & Griffin, 2009). Some racial and ethnic minorities use communication channels that are different from those used to disseminate crucial risk information, often leaving them without the information they need (Lachlan et al., 2009). The effective development of content and use of communication channels should take these population variances into consideration.

Other risk communication models have focused on individual-level audience information-seeking behaviors. For instance, PRISM, or the planned risk information seeking model (Kahlor, 2010), is an effort to link variables predicted by the theory of planned behavior (TPB; Ajzen, 1991) and the risk information seeking and processing model (RISP; Griffin, Dunwoody, & Neuwirth, 1999). PRISM conceptualizes an individual’s efforts to seek information about the risks to their own personal health. Kahlor’s test of this theory suggests that personal information-seeking has social-psychological complexities. Moreover, certain predictors, such as whether health issues are related to the environment or the difference between what an individual knows and what they need to know, can apply across specific health situations.

When considering risk communication at the level of organization or mass audience, scholars and practitioners can apply many different approaches to communicating risk (Breakwell, 2014; Morgan et al., 2002; Paek, Hilyard, Freimuth, Barge, & Mindlin, 2010). Most of these approaches are informed by health communication theory as well as theories in communication and other social sciences, such as psychology and anthropology. Table 6.1 provides some of the foundational theories used in teaching and practicing health communication.

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There is room for expansion of digital and new media theories. New media refers to content that is available online and accessible through digital devices; such content enables user participation and feedback (Manovich, 2003). Theory development in digital and new media might address how risk and health information impacts on users and how they share and adopt recommendations and guidance. For example, Sublet, Spring, and Howard (2011) argue that Social Exchange Theory (Homans, 1958) can help explain the interactivity users might perceive with the channels they use, particularly blogs. Social exchange proposes that people assess the potential risks and benefits of their relationships and that most would abandon one when the risks become greater than the rewards. Based on this premise, Sublet, Spring, and Howard argue that blogs allow readers to go beyond consuming information by allowing them to connect with the people on the other end (that is, the blog writers and commenters), thereby creating the potential for connections that have their costs and rewards. Other scholars have identified ways new media have transformed intercultural communication (c.f., Shuter, 2012), and the ways new media support coordinated communication among individuals working together (i.e., media synchronicity theory, Dennis, Fuller, & Valacich, 2008; Dennis & Valacich, 1999).

Besides making information consumers feel a connection or relationship with the media they use, the ultimate goal of OSH risk communication is propelling behavior change that leads to prevention. To that end, and in addition to health communication theories, OSH risk communication must involve outreach efforts using ecological models of health behavior that “emphasize the environmental and policy contexts of behavior, while incorporating social and psychological influences. Ecological models lead to the explicit consideration of multiple levels of influence, thereby guiding the development of more comprehensive interventions” (Sallis, Owen, & Fisher, 2008, p. 503). In OSH, the levels of influence often include individual, community, organizational, and public policy (Sallis, Owen, & Fisher, 2008).

Communicating OSH Information in the Evolving Digital Media Environment

Communicating OSH information and workplace recommendations to the public has required OSH professionals to adapt to changes in the media landscape. The primary shift has been from paper-based to electronic documents, which has presented both challenges and opportunities in the way OSH organizations develop content, determine channel selection, and evaluate information dissemination. The Web and social media have also created an environment where anyone can publish—and do it quickly. The result is competition for audiences’ attention in an environment where cognitive overload, navigation and search strategies, and information design are critically important. The great shift from traditional mass media (e.g., television, print magazines, radio) to a digital media environment has facilitated the emergence of new theory and best practices. Every organization is faced with figuring out to what level their target audiences have embraced the digital environment and how to effectively reach those audiences with new and traditional media channels. For most organizations, the new media environment has posed questions and required new decisions about where to place resources for communication efforts.

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Like many longstanding OSH organizations, NIOSH historically relied on paper-based and hard media products such as journal articles, NIOSH documents, CD-ROMs, and videotapes to deliver OSH information. Just as they continue to do today through digital media, NIOSH has also relied on intermediaries to disseminate its research through print forms. Intermediaries are organizations or key individuals who have established connections to businesses and employers and can share NIOSH information (Cunningham & Sinclair, 2014). Such intermediaries have included health service providers, labor organizations, trade associations, insurance companies, and chambers of commerce. Evaluating the impact of these dissemination strategies largely rested on tracking publication distribution numbers, number of journal articles published, and citations of NIOSH journal articles. Though technical and educational documents continue to represent the most significant institute output, use of traditional printing and postal service for producing and disseminating document end products has been reduced significantly.

NIOSH and the World Wide Web

As with other government agencies, the availability of the World Wide Web has resulted in a significant shift in the generation and dissemination of NIOSH information. Since 1997, the NIOSH website (i.e., the NIOSH Web) has been the primary dissemination channel for NIOSH research, guidance, and information products. Primary audiences have included OSH professionals (NIOSH’s primary intermediaries for reaching workers), workers, employers, decision-makers, and the general public. An early adopter of the Web, NIOSH originally offered plain-text information that was mostly accessed via file sharing by researchers and more savvy users of technology. In 2007, NIOSH added GovDelivery, a subscription service that enables users to set up automated delivery of regular NIOSH updates and newsletters via email. NIOSH expanded communication efforts to social media platforms including MySpace, Facebook, the NIOSH Science Blog, eNews (the NIOSH monthly electronic newsletter), and program-specific electronic newsletters. To reach hazard/industry-specific audiences, NIOSH has also added social media channels as their importance in key audiences emerged (www.cdc.gov/niosh/socmed.html). Impact measurement evolved to include the tracking of website views and visits as well as document downloads.

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Many government agencies in the US and other countries find that Web and new media channels are an efficient and timely way to provide large amounts of information to the public (Wigand, 2010). In addition to functioning as a virtual library and archive, the Web allows agencies to improve the way they generate and disseminate information, as well as create products that intermediaries are more likely to share. These changes have also influenced how government researchers and communication specialists, and their stakeholders, approach the way they do their work. For example, through such channels as the NIOSH Science Blog, the NIOSH Web has become a virtual meeting place for NIOSH researchers, stakeholders, and the general public to obtain and share the latest information as well as leave comments.

Also, NIOSH has dedicated staff to write OSH-related content for Wikipedia, the second largest non-search engine driver to the NIOSH website. NIOSH became only the second federal agency and the first federal scientific agency to develop a formalized collaboration with Wikipedia (Temple-Wood, 2015). This partnership not only improves the availability of occupational safety and health information but also effectively extends the reach of NIOSH scientific findings and resources—to a far greater population than NIOSH could reach alone.

New Digital Communication Technology and Rich Media

Two significant aspects of new communication technology are media-rich products and evolving digital devices. Rich media are communication technologies that involve or combine audio, video, animation, and interactive features. Both audience attention and cognitive processing preferences are tied to rich media. The effect of rich media forms has been explained by media richness theory (Daft & Lengel, 1986), which ranks various communication media on the extent to which they allow for various social cues, such as gestures. Originally intended to refer to computer-mediated communication, media richness theory also finds relevance in more contemporary formats, such as text messaging.

Since the iPhone was introduced in 2007 (Reed, 2010), there has been a shift in ownership and use from personal computers to more media-rich mobile devices (Heggestuen, 2013). Mobile usage in the United States continues to increase, with people spending a majority of their time in digital media engagement on mobile apps (Marous, 2014). The demand for content delivery via mobile technologies is only expected to increase (Reed, 2014).

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As media-rich digital products become increasingly prevalent in the communication environment, NIOSH and other government agencies continue to expand into other digital communication technology such as Web and mobile applications (apps). Apps are effective tools for taking knowledge gained from basic research and applying it to the field, as demonstrated by the NIOSH Ladder Safety App (www.cdc.gov/niosh/topics/falls/mobileapp.html) and NIOSH Pocket Guide to Chemical Hazards mobile web app (www.cdc.gov/niosh/npg/mobilepocketguide.html). These products often blend research, guidance, and training into a single tool. Such a tool creates the potential for more effective information and knowledge transfer, along with skill building.

Collaborative Content

Perhaps the most significant change in the digital environment is in how content is created and how information sources, such as government agencies, have to compete for audience attention when disseminating that information. While audiences are limited in the amount and kind of information they can retrieve from traditional media, users of new media have access to greater information storage, can demand quick delivery of content, and can give instant feedback on the content they consume (Wahl & Scholl, 2014). This interactivity with new media is characteristic of the “democratization” of the creation and consumption of media content (Manovich, 2003). Whereas users are consumers in traditional media, new media allow users to be producers, which implies more control over the information they can access.

Prior to the Web, the public relied on subject matter experts who were trained and credentialed in their fields and, as such, had access to authoritative printed references for their specialties. Subject matter experts included physicians and lawyers as well as industrial hygienists and other OSH professionals. By virtue of closed professional systems, such as peer-reviewed journals, they were information gatekeepers. As the World Wide Web became universally accessible, the gates opened and specialized information became easily available to everyone. Because the new media environment has encouraged users to be their own gatekeepers of information, audiences are far less beholden to more traditional gatekeepers and are even able to bypass gatekeepers altogether to retrieve the information they need and even redistribute it as they see fit.

The shift away from the more traditional notion of gatekeeping can be characterized as gatewatching (Bruns, 2008). Gatewatchers can take the form of sites that publish niche news or information that appeals to specialized audiences. Although gatewatchers cannot control what information passes through channels, they keep an eye at the “gates” for relevant information and choose what flows through those gates to pass on to others. According to Westerman, Spence, and Van Der Heide (2013), gatewatchers have a great deal of power in their promotion and diffusion of information. The emergence of gatewatching has created more demand for collaborative content, that is, content that can be written, edited, and managed by multiple users on a common platform. Online encyclopedias like Wikipedia are examples of formats with collaborative content because they can be edited by virtually anyone without the filter of peer review. The growing normalization of collaborative content has had a radical impact on traditional, centralized sources of information and opened wide the concept of citizen journalism. However, the prevalence of gatewatchers has made determining author expertise often difficult or impossible. Nevertheless, gatewatchers represent a new aspect of the digital media environment, which OSH communication science should seek to understand for more effective dissemination.

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Despite the obvious challenges of collaborative content creation, communication norms have shifted. Users want to be involved in content, whether as contributors or as evaluators. To remain relevant to audiences, OSH organizations need to embrace and find appropriate ways to engage in this communication paradigm shift. NIOSH and other authoritative OSH resources are learning the importance of developing strategies to engage stakeholder and user collaboration in the creation and dissemination of health and safety information. For NIOSH, this has meant constructing Web content with the assumption that visitors to its website will likely reuse that content. This involves developing products and using Web content management systems that make it easy for users to retrieve information and repurpose it to meet their specific needs. Such an approach helps to ensure the integrity of highly technical research while allowing content to be translated into meaningful, impactful information products that fit the needs of audiences with diverse literacy levels, technical language, and demographic characteristics.

Opportunities and Challenges of New Media Channels

Technology is only part of the challenges and opportunities that face OSH organizations in developing risk communication strategies. For one thing, there is a lack of theory to guide strategy. Although there is a well-established theoretical foundation for the science of communication (as noted above), theory to guide newer types of digital, interactive communication modalities are not developing as rapidly as the technology. Moreover, the nature and systems of digital technology affect content and product development in ways that make it difficult for agencies to keep up with audience needs and demands. In addition, new media communication has created the need for alternative ways to measure impact (Barnes, 2015). Researchers and practitioners increasingly must document their work by faster measures (Priem, Piwowar, & Hemminger, 2012) and must consider a broader range of activities, such as online discussions and adoption in real-life settings, to show impact. Beyond these technology-driven challenges, OSH organizations must negotiate the additional complications of communicating to a diverse and changing workforce.

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As the US workforce adapts to demographic shifts related to immigration and age diversity, OSH professionals must know more about how physical, mental, and cultural differences inform risk and prevention in the workplace. Some of the most significant changes in audience demographics are increasing numbers of temporary or contingent workers (Cummings & Kriess, 2008); workers employed by small businesses (Choi & Spletzer 2012; Cunningham, Sinclair, & Schulte, 2014); older workers (Hayutin, Beals, & Borges, 2013; Silverstein, 2008; Society for Human Resource Management, 2014; Toossi, 2012; Truxillo, Cadiz, & Hammer, 2015); female workers (Toossi, 2012); and vulnerable worker populations such as young immigrants (NIOSH, ASSE 2015) and Latinos (Diuguid, 2014).

Language is another dimension of variability among NIOSH audiences. Many immigrants to the United States are employed in jobs with high rates of injuries and fatalities, such as construction and agriculture (NIOSH, ASSE 2015). These workers are often unaware of their rights under US labor laws and lack critical English language skills that might otherwise make them less vulnerable to occupational hazards. Language barriers also can hinder the comprehension and usability of online and print resources designed to reduce illnesses, injuries, and fatalities, which occur more often among immigrant workers than workers born in the United States (NIOSH, ASSE 2015). While there remains a critical need for translating OSH information into languages other than English, OSH research has also demonstrated the need for culturally tailoring materials to meet the needs of specific audiences (Flynn, 2014).

Trends indicate that the digital communication environment will continue to evolve at a rapid rate (Holliman, 2017). OSH organizations will need to have more agile communication technology systems, which allow organizations to respond to new audience demands and regulatory changes faster, and to communicate with audiences across virtually any channel. Along with more agility, rich media content will need to include complex and interactive graphics, sound, video, and multiple data streams from digital device sources like GPS and photos. In addition, wearable technologies (e.g., smartwatches) and virtual reality products are expected to be commonly used and occupy more of the technology market by 2020 (Page, 2015). Creating such products requires new, high-level skills and problem-solving abilities such as identifying and removing program bugs and advanced graphic design (Robert Half Technology, 2015).

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To be relevant in the digital communication environment, the OSH community will need to apply the same standards of evidence used in their research to measuring the performance and impact of new communication technologies, channels, and content types. To do this requires focused exploration in defining meaningful metrics. Web 2.0 interactivity has introduced new social tracking factors into communication and suggested new interpretations of impact. Use of new media has led OSH organizations to utilize “alternative metrics” or “altmetrics” to measure attention to research outputs (Priem, Taraborelli, Groth & Neylon, 2010). Altmetrics measure influence, reach, and engagement by tracking traffic to and conversations on NIOSH webpages, social media activity, and new media products such as the NIOSH Science Blog and Wikipedia. Used as qualitative attention indicators, altmetrics provide a broader picture of audience interaction with information. Although altmetrics do not measure the quality of information, they can provide a more comprehensive picture of how target audiences access and engage with information that fits their specific needs.

Digital communication is a system of complex subsystems influenced by a variety of audience factors. More than ever before, strategic planning is a paradox. The rapidly changing digital environment makes it difficult to plan very far into the future. However, organizations must still make decisions about a highly significant number of resource allocations. This requires a fundamental strategy and the ability to make effective choices in a media environment of endless opportunities. This is particularly true of many OSH organizations that are connected to governmental structures, often with modest resources. Strategic plans are essential, and in the digital environment they need to cover shorter periods of time and include subplans for complex subordinate components such as digital product strategies, Web plans, and mobile lifecycles.

Research supports continuing to use the Web as a platform for organizational communication (Klimchak, Sherman, MacKenzie, & Ward, 2013; Powell, Horvath, & Brandtner, 2016; Saffer, Somerfeldt, & Taylor, 2013). To this end, communication technology experts in government agencies like NIOSH need to maintain Web environments that are simple, flexible, and sustainable. For example, NIOSH has developed a Web and new media strategy that is informed by the history of the NIOSH Web that has incorporated significant changes in communication technology. The strategy identifies key Web challenges NIOSH and other government agencies will experience in the coming years, such as adapting Web content for mobile Web delivery, preparing for growth of current and new digital products, and assessing the sustainability of these products.

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Recommendations for the Future in New Media and OSH Risk Communication

Communication strategies continue to undergo dramatic change as new technologies and channels emerge. To stay abreast of the changes and ensure optimal application of research, communicators can benefit from a number of key areas of research and best practice guidance. One area is the continued building of new media theory, which includes understanding the impact of new media on diverse audiences, particularly to promote behavioral change (Korda & Itani, 2013). While OSH research focuses on the environmental risks and nature of work, research cannot rely solely on traditional communication and health communication theory. New media has created the need for more interdisciplinary research and theory development in the areas of psychology, neurology, and technology-mediated communication and learning. One possible recommendation is to use case study methodology, which provides a look into the specific environments in which new media are used. Case studies allow for mixed methods and place more focus on risk communication geared toward applied environments (Urquhart & Vaast, 2012).

More specifically related to media theory is understanding how communication technologies influence and are used by different workforce audiences. This means extending knowledge beyond reach (that is, message exposure) to discerning the factors influencing audience engagement and understanding how to reach and engage audiences on specific issues (Hudson & Hall, 2013). OSH communication professionals must understand not only how information is shared but also how it is adopted and is influential in reducing worker illnesses, injuries, and fatalities. Specifically, there is still a lack of information on how social media can be used for health or risk communication, especially in determining the effectiveness of different types of social media (Moorhead, Hazlett, Harrison, Carroll, Irwin, & Hoving, 2013). More focused research into gatewatching (Bruns, 2008) could be beneficial. Understanding what kinds of content are more likely to be shared by users can shed light on what is relevant and useful to target audiences.

Another area is understanding the role of new media in translation research. One knowledge gap that still exists is the extent to which we understand how media can be used to increase the likelihood that products designed to reduce injuries and support safer work practices will be sought out, adopted, shared, and used in the workplace. This is especially the case where little information is available on the perceived value of downloadable apps in the field (Iris, Ellis, Yoder, & Keifer, 2016). More research is needed to discover how digital media can help move guidance, recommendations, and technology into practice in ways that maximize worker safety and health, well-being, and loss control in the most efficient and impactful ways possible (Desmarais & Lortie, 2011; NAS, 2009; Rantanen, 1999; Schulte, Okun, Stephenson, Colligan, Ahlers, Gjessing, Loos, Niemeier, & Sweeney, 2003).

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Further investigation can help uncover the barriers that hinder certain translation efforts and approaches, such as passive methods that fail to reach those most affected in the workplace (Baker, Chang, Bunting, & Betit, 2015) and limited engagement of the audiences that are reached (Brace, Padilla, DeJoy, Wilson, Vandenberg, & Davis et al., 2015). To this end, the aforementioned NIOSH translation research program was established to broaden research in the areas of large-scale delivery, dissemination, and diffusion. As it relates to health communication and digital media, NIOSH is focusing translation research efforts on how audiences’ awareness of NIOSH activities and outputs can be enhanced. To advance more audience-based research at NIOSH and to address the scarcity of this paradigm of research (Rantanen, 1999), health communication specialists are currently developing a database of survey items that can be used to collect audience data such as media preferences, health beliefs, and other communication and psychological characteristics that provides insight into the messages and dissemination strategies that resonate with certain audiences.

A third area of research and development is in best practice standards for creating new media content, particularly for diverse audiences that can be considered “moving targets” (Livingstone, 2004). Content about a particular topic or issue must be tailored to not only be relevant to the audience but also fit differences in literacy and languages (cultural and occupational). Content must also address communication barriers that contribute to health disparities across cultural and occupational audiences, because these disparities include access to worker protections (NIOSH, ASSE, 2015), disproportionate incidences of illness and injury (Pinkerton, Harbaugh, Han, Le Saux, Van Winkle, Martin, Kosgei, Carter, Sitkin, Smiley-Jewell, & George, 2015), and inadequate access to information or health promotion programs (Baron, Beard, Davis, Delp, Forst, Kidd-Taylor, Liebman, Linnan, Punnitt, & Welch, 2014).

Content development must also be informed by the format or delivery mechanism (such as a Web page or smartphone app). This requires creators to be more fluid in visualizing finished products. The digital device environment requires content to be more flexible, less static, and more dynamic. Dynamic content allows for the best user experience on any device. Standards are needed to guide the development of content versions for different devices. For instance, how should authorship be determined for versioned content (De Alfaro & Shavlovsky, 2013)? These content versions, or scalable content packages, in some cases are edited differently, depending on who is using it and where it is being used. Versioned content allows users to either pull smaller bits of information from a larger content source and repackage it for their own purposes or pull shorter versions from different devices. More strategies may be needed to guide both development and management of versioned content as new channels of media continue to emerge.

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A final area of continued research is in performance metrics, or tracking the use of OSH information for impact. Accurately measuring impact depends on knowing who is accessing and using OSH information. Continued focus can be placed on decision makers and intermediaries who are in the position to adopt and implement the guidance and recommendations in the workplace (Smith, 2008). Although intermediaries continue to be a prime audience for NIOSH, expanding internet use means that more audience-based research is needed to know who is accessing the information and how communication patterns have changed (Chou, Hunt, Hesse, Beckjord, & Moser, 2009).

Information seeking by target audiences is another important indicator of impact, which reflects the shift from the print-dominant paradigm to the current digital paradigm. Traditional ways of tracking the impact of research have included citation frequencies and journal impact factors. However, as previously discussed, alternative metrics (or altmetrics) are gaining more influence in discussions of impact and its definition. Future research must explore the weight carried by engagement and movement of information through social media networks in determining impact. Moorhead, Hazlett, Harrison, Carroll, Irwin, and Hoving (2013) recommend using a variety of research methodologies to determine the long- and short-term impacts of social media on best practices.

Conclusion

With the safety and health of 157 million US workers and 3 billion workers worldwide (Torres, 2013) at stake, effective communication of occupational risk is critical. Since 1970, NIOSH has been a world leader in risk communication. The Institute has demonstrated this through its theory-driven and evidence-based strategies and best practices in communicating research in occupational exposure, its progressive translation research program, and its track record for communication innovation.

The rapidly changing digital communication environment presents many opportunities and challenges. There will continue to be areas of risk communication in which NIOSH and other agencies need more foundational research on communication strategies and technology. These key areas include: (a) building new media theory; (b) identifying the role of new media in translational research; (c) developing best practice standards for new media content; (d) developing change and process management strategies; and (e) effectively evaluating impact through alternative and other communication performance metrics.

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