Worksite health and safety climate: Scale development and effects of a health promotion intervention

Background. Environmental influences on health and health behavior have an important place in research on worksite health promotion. We tested the validity and internal consistency of a new measure of organizational health and safety climate that was used in a large randomized trial of a worksite cancer prevention program (the Working Well Trial). The resulting scales then were applied to assess intervention effects. Method. This study uses data from a subset of 40 worksites in the Working Well Trial. Employees at 20 natural gas pipeline worksites and 20 rural electrical cooperatives completed a cross-sectional questionnaire at baseline and 3-year follow-up. Results. A factor analysis of this self-report instrument produced a two-factor solution. The resulting health and safety climate scales had good internal consistency (Cronbach's α = 0.74 and 0.82, respectively) and concurrent validity. The health climate scale was correlated more highly with organizational measures that were indicative of a supportive health climate than those indicating supportive safety climate, while the reverse was true of the safety climate scale. Changes in health climate were associated with the number of smoking and smokeless tobacco programs offered at the worksites at the time of the 3-year follow-up (r = 0.46 and 0.42, respectively). The scales were not correlated with most employee health behaviors. The health climate scores increased at intervention worksites, compared with scores at control worksites (F[1,36] = 7.57, P = 0.009). Conclusions. The health and safety climate scales developed for this study provide useful instruments for measuring organizational change related to worksite health promotion activities. The Working Well Intervention resulted in a significant improvement in worksite health climate.