Master of Science / Department of Industrial & Manufacturing Systems Engineering / Jessica L. Heier Stamm / The main goal of public health emergency preparedness efforts is to mitigate the impact of events on the health of the population. However, decision-makers must also remain conscientious of the costs associated with these efforts. Planning is further complicated by uncertainty about the location and volume of demand that will need to be met in an emergency, the speed with which demand must be met, and the potential scarcity of needed items once an emergency occurs. To address these challenges, public health emergency planners often keep inventory stockpiles that are distributed when an event happens. Managing these stockpiles is a difficult task, and inefficient stockpile location and equipment distribution strategies can be costly both in terms of cost and public health impact. This research is motivated by challenges faced by state public health departments in creating stockpile location and equipment distribution strategies. The primary emphasis is on facemasks and respirators used by health workers during an influenza pandemic, but the approach is generalizable to other scenarios. The model proposed here uses a two-stage approach to generate a holistic solution to the problem. The first stage uses a pull distribution strategy to make stockpile location decisions. Additionally, it determines how counties should be assigned to stockpiles to minimize both storage and distribution costs. The second stage adopts a push distribution strategy to determine optimal delivery routes based on the county assignments made in stage one. This stage offers guidance for public health planners who have made location-allocation decisions but who then face a different distribution scenario than what was anticipated in the original planning phase. Recourse methods for managing demand uncertainty are also proposed. A case study of the state of Kansas is conducted using the methods introduced in the thesis. The computational results yield several significant insights into the tradeoffs and costs of various facility location-allocation and vehicle routing decisions: • For the tested range of storage and distribution cost parameters, multiple stockpile locations are preferred over a single location. • In a pull distribution system, storage costs play a greater role in location-allocation decisions than distribution costs. • In the push distribution system, finding an optimal vehicle routing plan is computationally intensive for stockpiles with a large number of assigned counties. • Efficient heuristics perform well to design recourse routing plans when realized demand is greater than expected. • In the event that planners wish to specify routes well in advance, the results of this research suggest adopting a robust routing plan based on higher-than-expected demand levels. This thesis makes three important contributions. The first is an optimization approach that considers multiple distribution strategies. This is especially relevant when stockpiling for an influenza pandemic where stockpiles need to be located significantly before the material is needed, during which time the distribution strategy may change. Second, the case study demonstrates that the proposed methods are applicable to a large-scale problem arising in practice. Finally, this research illustrates for decision-makers the tradeoffs between different stockpile management strategies and between optimal and heuristic methods.

Many healthcare providers are at risk of compassion fatigue and burnout from prolonged occupational stress, which can adversely affect workers, patients, and the healthcare system. This qualitative research project inquired into eight female healthcare providers’ experiences of sustaining their own wellbeing. Participants (27 to 60 years old) engaged in semi-structured interviews and participant observation of a self-care activity. Themes were found relating to the variety of self-care strategies used, challenges and supports in the work context, and the important role of authenticity in health promotion practice. Self-care strategies included: social support, pacing, taking breaks, exercise, nutrition, emotional self-care, adapting self-care routines over time, goal setting and prioritization. Supports to wellbeing included: flexible scheduling, taking personal responsibility for wellness, workplace wellness programs, and positive relationships with supervisors, colleagues, friends and family. This arts-informed research project is presented in graphic novel form to enhance its accessibility.

Many healthcare providers are at risk of compassion fatigue and burnout from prolonged occupational stress, which can adversely affect workers, patients, and the healthcare system. This qualitative research project inquired into eight female healthcare providers’ experiences of sustaining their own wellbeing. Participants (27 to 60 years old) engaged in semi-structured interviews and participant observation of a self-care activity. Themes were found relating to the variety of self-care strategies used, challenges and supports in the work context, and the important role of authenticity in health promotion practice. Self-care strategies included: social support, pacing, taking breaks, exercise, nutrition, emotional self-care, adapting self-care routines over time, goal setting and prioritization. Supports to wellbeing included: flexible scheduling, taking personal responsibility for wellness, workplace wellness programs, and positive relationships with supervisors, colleagues, friends and family. This arts-informed research project is presented in graphic novel form to enhance its accessibility.

Thesis (Ph. D.)--University of Minnesota, 1983. / Includes bibliographical references (p. [169]-179).

Introduction: This thesis evaluated the effectiveness of an educational intervention for Toronto Transit Commission (TTC) employees exposed to a traumatic event at work. Methods: This study used a sequential mixed methods design. The primary outcome was the proportion seeking mental health treatment after an educational intervention (BPI) compared to a group not receiving an educational intervention (TAU). Qualitative interviews aimed to understand what compelled participants to seek help and perceptions of the educational intervention. Results: 60 TAU and 50 BPI participants were recruited. A larger proportion of BPI participants sought specialty mental health treatment compared to the TAU (p=0.034). Reasons for seeking treatment were varied and we found overall positive responses to the educational intervention, particularly normalization of reactions. Conclusions: A greater proportion of those receiving the educational intervention sought help. However, the interviews showed that although the educational intervention was helpful, it was not central to this decision.

Introduction: This thesis evaluated the effectiveness of an educational intervention for Toronto Transit Commission (TTC) employees exposed to a traumatic event at work. Methods: This study used a sequential mixed methods design. The primary outcome was the proportion seeking mental health treatment after an educational intervention (BPI) compared to a group not receiving an educational intervention (TAU). Qualitative interviews aimed to understand what compelled participants to seek help and perceptions of the educational intervention. Results: 60 TAU and 50 BPI participants were recruited. A larger proportion of BPI participants sought specialty mental health treatment compared to the TAU (p=0.034). Reasons for seeking treatment were varied and we found overall positive responses to the educational intervention, particularly normalization of reactions. Conclusions: A greater proportion of those receiving the educational intervention sought help. However, the interviews showed that although the educational intervention was helpful, it was not central to this decision.

Doctor of Philosophy / Department of Psychology / James C. Shanteau / Unintentional injuries represent the leading cause of death among Americans aged 1-44 years. While there have been many life-saving advances in engineering, attempts to save lives by changing people's behavior have been less successful. For instance, safety and health communications have sometimes led to increased knowledge and self-reported intentions to comply with recommendations, but traditional efforts to demonstrate changes in actual target behaviors have often failed. Research in many settings has shown that narrative communications have exceptional power to persuade and affect peoples' decisions. This suggests that safety and health messages might be more effective if they include narratives, such as brief stories about people who have been injured. The purpose of this dissertation is to determine if safety communications that include stories about injuries result in superior behavioral compliance when compared with traditional abstract safety messages. Teams of two participants assembled a swing set, using written instructions that contained relevant safety messages. Fifty-four teams were randomly assigned to three conditions: story-based safety messages, concrete nonstory safety messages, and traditional abstract safety messages. Compliance with safety messages was defined as the number of compliant components in the finished swing set. After adjustment for covariates, story-based messages resulted in a 20 percent improvement in compliance, compared with concrete nonstory and traditional abstract messages. Covariates included age, gender, (log) childcare experience, equipment assembly experience, presence of observer, and a final covariate related to timing of experimental sessions conducted by different experimenters. A positive relationship was noted between behavioral compliance and immediate (but not delayed) recall of message content. Narrative transportation was also positively related to compliance, but only within the story-based condition. Behavioral compliance was not related to remindings or judgments about the likelihood of injuries. The research is important because of its potential for improving safety communications and saving lives. Stories about injuries improved safety behavior even though the stories were brief and not designed to be entertaining or transporting. In contrast, the lack of correspondence between observed behavior and many surrogate measures suggests caution is in order when evaluating interventions using self-report measures, delayed memory, and other common dependent variables.

Master of Agribusiness / Department of Agricultural Economics / Brian P. Niehoff / This thesis is the tool for moving companies to the next level in safety. I believe through this plan we can keep people safe in the agribusiness industry. This is very important, so that we can keep cost down and be able to stay in business; or avoid costly litigation / arbitration hearings because someone was injured on the job. When I was hired my job was to develop procedures that meet Occupational Safety and Health Administration (OSHA) standards, reduced injuries, and would be a continuous improvement type of program. The thesis will be introductory information in regards to safety followed by a sample safety manual that I have created by working with different safety professional in the safety industry.

In public health, prevention is a fundamentally political process as both the selection of problems to be addressed and solutions recommended reflect decisions that are informed by economic, social and cultural forces. Yet prevention is often presented as a monolithic enterprise, an objective and scientific discourse that does not take sides. Behind this facade of political neutrality, diversely positioned individuals and groups often fail to find and/or sustain a common ground for shared prevention initiatives. Increasingly, many prevention awareness campaigns focus upon true accounts or injury narratives that serve both as a catalyst to build multipartite consensus through developing shared collaborative prevention discourses and practices and to mobilize public support for health and safety issues. While the use of the true account form is a recommended strategy in the public health literature directed toward practitioners, the engagement of true accounts in prevention campaigns has not been adequately problematised and examined from a critical social theoretical perspective. A qualitative, sociologically oriented case study of the use of the true account form, the commemorative, in young worker safety campaigns is proposed to deepen our understanding of this particular type of prevention intervention in particular and prevention as an enterprise more generally. The study investigates the socio-historical context in which the Young Worker Memorial LifeQuilt, a Canadian young worker educational initiative, emerged and unraveled as a multipartite prevention campaign centered upon the true account form of consensus commemoratives. A key finding is that true accounts of young workers killed on the job are socially mediated to diffuse blame and build consensus between diversely positioned occupational health and safety practitioners and the family survivors of workplace tragedies. What is included and excluded from these true accounts of workplace injuries, as socially constructed narratives in multipartite prevention awareness campaigns, may be, in part, a product of the terms and conditions negotiated between lead players. The true accounts included in collaborative, cross-institutional prevention campaigns, while referencing real events, may be told in ways that accommodate and harmonize the political perspectives of diversely positioned stakeholders. Conversely, the true account form is a potentially problematic strategy for collaborative prevention discourses and practices, as consensus commemoratives can be retold as critical remembrances of workplace death, with the result that the unifying narrative of a shared, collective memory project is undermined. This dissertation finds that the activity of collaboration shapes prevention as a socio-political activity/practice.

In public health, prevention is a fundamentally political process as both the selection of problems to be addressed and solutions recommended reflect decisions that are informed by economic, social and cultural forces. Yet prevention is often presented as a monolithic enterprise, an objective and scientific discourse that does not take sides. Behind this facade of political neutrality, diversely positioned individuals and groups often fail to find and/or sustain a common ground for shared prevention initiatives. Increasingly, many prevention awareness campaigns focus upon true accounts or injury narratives that serve both as a catalyst to build multipartite consensus through developing shared collaborative prevention discourses and practices and to mobilize public support for health and safety issues. While the use of the true account form is a recommended strategy in the public health literature directed toward practitioners, the engagement of true accounts in prevention campaigns has not been adequately problematised and examined from a critical social theoretical perspective. A qualitative, sociologically oriented case study of the use of the true account form, the commemorative, in young worker safety campaigns is proposed to deepen our understanding of this particular type of prevention intervention in particular and prevention as an enterprise more generally. The study investigates the socio-historical context in which the Young Worker Memorial LifeQuilt, a Canadian young worker educational initiative, emerged and unraveled as a multipartite prevention campaign centered upon the true account form of consensus commemoratives. A key finding is that true accounts of young workers killed on the job are socially mediated to diffuse blame and build consensus between diversely positioned occupational health and safety practitioners and the family survivors of workplace tragedies. What is included and excluded from these true accounts of workplace injuries, as socially constructed narratives in multipartite prevention awareness campaigns, may be, in part, a product of the terms and conditions negotiated between lead players. The true accounts included in collaborative, cross-institutional prevention campaigns, while referencing real events, may be told in ways that accommodate and harmonize the political perspectives of diversely positioned stakeholders. Conversely, the true account form is a potentially problematic strategy for collaborative prevention discourses and practices, as consensus commemoratives can be retold as critical remembrances of workplace death, with the result that the unifying narrative of a shared, collective memory project is undermined. This dissertation finds that the activity of collaboration shapes prevention as a socio-political activity/practice.