title: Strategies to reduce safety violations for working from heights in construction companies: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Safety measures should be applied to reduce work-related fatal and non-fatal fall injuries. However, according to the labor inspectorate, more than 80% of Dutch construction sites violate safety regulations for working from heights. To increase compliance with safety regulations, employers and workers have to select, implement and monitor safety measures. To facilitate this behavioral change, stimulating knowledge awareness and personalized feedback are frequently advocated behavior change techniques. For this study, two behavior change strategies have been developed in addition to the announcement of safety inspections by the labor inspectorate. These strategies consist of 1) face-to-face contacts with safety consultants and 2) direct mail with access to internet facilities. The objective of this study is to evaluate the effectiveness of these two strategies on the safety violations for working from heights, the process and the cost measures.
  
  
  METHODS
  This study is a block randomized intervention trial in 27 cities to establish the effects of the face-to-face guidance strategy (N = 9), a direct mailing strategy (N = 9) and a control condition of no guidance (N = 9) on safety violations to record by labor inspectors after three months. A process evaluation for both strategies will be performed to determine program implementation (reach, dose delivered and dose received), satisfaction, knowledge and perceived safety behavior. A cost analysis will be performed to establish the financial costs for both strategies. The present study is in accordance with the CONSORT statement.
  
  
  CONCLUSIONS
  This study increases insight into performing practice-based randomized controlled trials. The outcome will help to evaluate the effect of two guidance strategies on safety violations. If these strategies are effective, implementation of these strategies through the national institute of safety and health or labor inspectorate can take place to guide construction companies in complying with safety regulations.
  
  
  BACKGROUND
  NTR 4298 on 29-nov-2013.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, P,O, Box 22660, Amsterdam 1100 DD, the Netherlands. h.f.vandermolen@amc.nl.
authors.forename: Henk F
authors.initials: HF
authors.lastname: van der Molen
authors.forename: Monique H W
authors.initials: MH
authors.lastname: Frings-Dresen
mesh_terms: D002947:Cities; D060389:Construction Industry / Q000592:standards*; D006801:Humans; D009426:Netherlands; D009786:Occupational Health Services; D060051:Occupational Injuries / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012449:Safety; D017132:Workplace