Effectiveness of the Labour Inspection Authority’s regulatory tools for work environment and employee health: study protocol for a cluster-randomised controlled trial among Norwegian home-care workers

Abstract

IntroductionThere is a need to evaluate whether, and to what degree, labour inspections or other regulatory tools have the desired effects on psychosocial, organisational and mechanical work environment, and employee health. The Norwegian Labour Inspection Authority (NLIA) uses different tools and strategies to enforce compliance with occupational safety and health (OSH) legislation. The aim of the present study is to evaluate the effects of labour inspections and other regulatory tools employed by the NLIA. The home-care service is one of the fastest growing occupations and a prioritised area for the NLIA, hence the present study will investigate regulatory tools in this sector.Methods and analysisThe research project has been designed as a longitudinal, cluster-randomised, controlled trial and will be conducted among Norwegian home-care workers. The objective of the research project is to evaluate the effects of the NLIA’s regulatory tools (inspection and guidance) on: (1) compliance with OSH legislation and regulation; (2) psychosocial, organisational and mechanical work environment; (3) employee health in terms of musculoskeletal and mental health complaints; and (4) sickness absence. Public home-care services have been randomised to three intervention groups and one control group. Home-care services in the intervention groups will receive one of three intervention activities from the NLIA: (1) inspection from the Labour Inspection Authority; (2) guidance through an online interactive risk-assessment tool; and (3) guidance on psychosocial, organisational and mechanical work environment through workshops. The interventions will be performed at the organisational level (home-care service), and the effects of the interventions on the working environment and health complaints will be measured at the individual level (home-care employees).Ethics and disseminationThis project has been approved by the Regional Committees for Medical and Health Research Ethics (REC) in Norway (REC South East) (2018/2003/REK sør-øst C), the Norwegian Center for Research Data (566128), and will be conducted in accordance with the World Medical Association Declaration of Helsinki. The results will be reported in international peer-reviewed journals.Trial registration number NCT03855163.

Effects of the Labour Inspectorate Authority’s regulatory tools on psychosocial and biomechanical work factors in Norwegian home care services: a cluster randomised controlled trial

“…The study is part of a larger project, and a full description can be found in the published protocol. 22 In addition, we conducted a process evaluation. 23 This evaluated, using questionnaires, whether the interventions had been conducted as planned.…”

“…This range was chosen to reduce intracluster variability and thus reduce the needed sample size. 22 Ineligible municipalities were municipalities that had recently, in 2017–2018, had labour inspections. Based on sample size calculations (see protocol 22 ), 132 of the 187 eligible municipalities were randomly assigned to one of four trial arms.…”

“… 22 Ineligible municipalities were municipalities that had recently, in 2017–2018, had labour inspections. Based on sample size calculations (see protocol 22 ), 132 of the 187 eligible municipalities were randomly assigned to one of four trial arms. The project lead conducted the randomisation using random numbers assigned to each municipality, followed by sorting, and allocating the first 33 to the first arm, the next 33 to the second arm, etc.…”

“…The dropout rates were 67.3%, 64.2% and 64.1% for the control, inspection and guidance groups, respectively. Figure 1 , adapted from the study protocol, 22 presents a flowchart of the interventions and data collection process for this study.…”

“… Flowchart illustrating cluster allocation, intervention implementation and data collection, adapted from Indregard et al . 22 …”