E1: Research Roundup Total Worker Health® 1

Construction well-being efforts often emphasize individual-level solutions and lack sustainability. The Built to Last (BTL) Toolkit offers a structured, participatory process that builds leadership capacity and empowers frontline workers to co-create practical, jobsite-ready solutions that focus on root causes. Grounded in evidence-based programs-Foundations for Safety Leadership (FSL) and the Healthy Worker Participatory Program (HWPP)-BTL address safety and well-being. The toolkit advances industry efforts by: (1) integrating mental health into core safety culture practices, (2) bridging leadership training in role modeling, empowerment, and feedback with participatory design methods to produce both culture change and tangible tools, and (3) providing a systems roadmap that links physical job demands, organizational practices, and mental health outcomes.

The toolkit explicitly examines how physical and environmental jobsite conditions (e.g., long hours, unsafe conditions, high production pressures) contribute to stress, burnout, and poor mental health. Through its multi-step process -Plan, Design, Implement, Evaluate- organizations identify the root causes of poor worker well-being and workers co-design solutions from new work practices to supervisor supports and peer systems. By targeting upstream contributors rather than individual coping alone, BTL delivers practical strategies that reduce or eliminate jobsite stressors to build stronger, healthier crews. 

This case study provides insights from a NIOSH-funded collaborative research study with a mid-Atlantic health system, studying the organization's ongoing efforts to implement an equitable culture of health and well-being (HWB). We will describe HWB data aggregation and analysis efforts and leadership interviews and front-line worker focus group feedback on perceptions of culture of health and workforce health inequities.

Review study findings set the context for an interactive discussion about the value of identifying and mitigating HWB inequities, tying them to employee health outcomes and organizational business metrics. Further discussion will describe a collaborative process used to engage HR leadership to co-create an evidence-based equitable health and well-being roadmap for change, approved by the organization's executive leadership. We will highlight organizational actions that foster equitable employee HWB, provide insights for engaging the C-suite, acknowledge potential barriers and limitations. Our goal is to facilitate a discussion about employee health equity as a strategic priority for organizations that want to recruit and retain a high-quality workforce. Currently, researchers are working on implementing a coaching and mentoring intervention to promote low-wage worker well-being and enhancing career development opportunities that foster retention. We expect that operational challenges experienced are not unique to this organization, and that the lessons learned will be valuable to others.