摘要：Objectives . We sought to determine the relative effectiveness of different methods of worker safety and health training aimed at improving safety knowledge and performance and reducing negative outcomes (accidents, illnesses, and injuries). Methods . Ninety-five quasi-experimental studies (n=20991) were included in the analysis. Three types of intervention methods were distinguished on the basis of learners’ participation in the training process: least engaging (lecture, pamphlets, videos), moderately engaging (programmed instruction, feedback interventions), and most engaging (training in behavioral modeling, hands-on training). Results. As training methods became more engaging (i.e., requiring trainees’ active participation), workers demonstrated greater knowledge acquisition, and reductions were seen in accidents, illnesses, and injuries. All methods of training produced meaningful behavioral performance improvements. Conclusions . Training involving behavioral modeling, a substantial amount of practice, and dialogue is generally more effective than other methods of safety and health training. The present findings challenge the current emphasis on more passive computer-based and distance training methods within the public health workforce. An understanding of how best to implement worker safety and health training is a critical public need in light of the tragic events of September 11, 2001, as well as ongoing efforts to prepare emergency responders and professionals in related areas to do their jobs safely and effectively. 1 The need to gain a better understanding of the effectiveness of safety and health training is also apparent in a broader context given that millions of injuries and illnesses are reported annually in private industry workplaces, 2 and health and safety training is globally recognized as 1 means of reducing the costs associated with such events. 3 Indeed, researchers from different fields, including business, psychology, engineering, and public health, have long recognized the need for comprehensive, systematic evaluations of safety and health training to address these types of critical public- and private-sector concerns. 4 – 7 The conclusion from several narrative reviews has been that most training interventions lead to positive effects on safety knowledge, adoption of safe work behaviors and practices, and safety and health outcomes. 5 , 8 , 9 However, these qualitative reviews are speculative as to the specific factors that enhance the relative effectiveness of safety and health training interventions in reducing or preventing worker injury or illness. 10 – 12 Notably, a fundamental question remains unresolved within the scientific literature: What is the relative effectiveness of different methods of safety and health training in modifying safety-related knowledge, behavior, and outcomes? Attempts to address similar broad-based questions related to the benefits of work-related health and safety interventions 13 have revealed the need for a large-scale, quantitative analysis of the extant literature. Results from such an analysis would not only help improve safety and health training programs but also provide evidence of the benefits of these programs, securing both new and continued support from the public as well as the private sector. With these ends in mind, this study was designed to meta-analytically examine the effectiveness of different types of worker safety and health training, across industries and occupations, from 1971 to the present. In the section to follow, we describe different methods of worker safety and health training and offer hypotheses concerning the relative effectiveness of these methods.
