title: A model for occupational safety and health intervention diffusion to small businesses.
abstract: BACKGROUND
  Smaller businesses differ from their larger counterparts in having higher rates of occupational injuries and illnesses and fewer resources for preventing those losses. Intervention models developed outside the United States have addressed the resource deficiency issue by incorporating intermediary organizations such as trade associations.
  
  
  METHODS
  This paper extends previous models by using exchange theory and by borrowing from the diffusion of innovations model. It emphasizes that occupational safety and health (OSH) organizations must understand as much about intermediary organizations as they do about small businesses. OSH organizations ("initiators") must understand how to position interventions and information to intermediaries as added value to their relationships with small businesses. Examples from experiences in two midwestern states are used to illustrate relationships and types of analyses implied by the extended model.
  
  
  RESULTS
  The study found that intermediary organizations were highly attuned to providing smaller businesses with what they want, including OSH services. The study also found that there are opinion leader organizations and individual champions within intermediaries who are key to decisions and actions about OSH programming.
  
  
  CONCLUSIONS
  The model places more responsibility on both initiators and intermediaries to develop and market interventions that will be valued in the competitive small business environment where the resources required to adopt each new business activity could always be used in other ways. The model is a candidate for empirical validation, and it offers some encouragement that the issue of sustainable OSH assistance to small businesses might be addressed. Am. J. Ind. Med. 56:1442-1451, 2013. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.
authors.affiliation: Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Education and Information Division, Cincinnati, Ohio.
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Sinclair
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Cunningham
authors.forename: Paul A
authors.initials: PA
authors.lastname: Schulte
mesh_terms: D006801:Humans; D017146:Models, Organizational; D016272:Occupational Health; D009936:Organizational Innovation; D058012:Small Business / Q000458:organization & administration*
keywords: intervention model; occupational health; occupational safety; small business