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7The next three sections describe the literature review, includ- ing a description of BBS, BBS observation techniques, and spe- cific behavioral safety-management techniques. The behavioral approach to safety is directly influenced by the research and legacy of B. F. Skinner (1938, 1953). Skinner believed behaviors were ideal for scientific study because they could be opera- tionally defined and influenced based on the merit of being observable and thus reliably trackable. BBS approaches to safety focus on systematically studying the effects of various inter- ventions on safety-related target behaviors. The DO IT process (described below) describes how most BBS programs work (Geller, 2001). BBS interventions modify either events before the behavior (antecedents or prompts) or the events that occur after behavior (consequences). For example, being late for work may prime a person to speed. The consequences of speed- ing may be desirable (get to work on time) or undesirable (receive a speeding ticket). Behaviors followed by desirable consequences are more likely to be repeated in the future and those followed by undesirable consequences are less likely to be repeated in the future (Daniels, 1999; Geller, 2001). Research has shown BBS to be cost-effective, primarily because behavior-change techniques are straightforward and relatively easy to administer, and because intervention progress can be readily assessed by company personnel monitoring tar- get behaviors (Daniels, 1999; Sulzer-Azaroff and de Santamaria, 1980). Geller (2001) developed a simple, easy-to-use BBS process for continuous behavioral improvement. Figure 1 provides a visual illustration of the DO IT process. Gellerâs (2001) DO IT process comprises four steps: 1. Define target behaviors. Identify safe and/or at-risk behav- iors to be increased or reduced. Usually a review of safety records, job hazardsâ analyses, near-miss/crash reporting, audit findings, or interviews with employees will identify behaviors to be targeted. After selecting target behaviors, define them in a way that is easy for everyone to understand. After selecting and defining target behaviors, a behavioral checklist that includes the targeted behaviors can be devel- oped. See Appendix C for examples of checklists used in CMV settings. 2. Observe behavior. Observe and record the target behaviors using a behavioral checklist or other observation technique (e.g., OBSM device). Observations continue until a stable baseline of the target behaviors is achieved. 3. Intervene to influence target behaviors. By studying the baseline rate of target behaviors, an intervention can be developed to increase and/or decrease target behaviors. Specific behavioral management techniques are described below. Geller (2001) recommends asking the following questions when determining how to intervene on a tar- get behaviors(s): (a) How does the frequency of the target behavior vary among different individuals? (b) In what situations and at what times does the target behavior occur most often? (c) When and where does the behav- ior occur least often? (d) How often does a person have an opportunity to perform the appropriate safe behavior but does not make it? (e) What specific environmental changes occur before and after the target behavior occurs? and (f) What environmental factors are supporting a particular at-risk behavior and/or inhibiting a particular safe behavior? 4. Test to measure effectiveness of the intervention. Continue observations after implementing the intervention(s) to assess the success of the intervention. If goals have been achieved, set progressively higher goals or select new target behaviors and start the DO IT process over again. If goals have not been achieved, select a more achievable goal or implement a different intervention(s). Behavioral Checklist The first step in creating a behavioral checklist is determin- ing which target behaviors should be included in the behav- ioral checklist. Target behaviors should not only include those Behavior-Based Safety Principles
8behaviors identified through crash, incident, and injury reports, but also behaviors drivers would like to address. The second step is determining how many behaviors to include on the behavioral checklist. Both Geller (2001) and Krause (1997) recommend starting small in the beginning and progressively adding more behaviors as employees become more experi- enced in the observation techniques. Finally, determine the anonymity of the observer and the observee (the person being observed). Again, both Geller (2001) and Krause (1997) rec- ommend the observee should remain anonymous. This will increase participation and employees will see the process is not a âgotcha program,â but rather an objective way to assess problem areas and increase safety. At first, it may be best to keep both the observer and observee anonymous. However, as the process continues and employees begin to trust that the information on the behavioral checklists is used to improve safety and not to identify problem workers, the observer may be noted on the checklist to assess participation in the process. See Appendix C for examples of behavioral checklists used in CMV setting. Multiple Intervention Level Hierarchy Individual differences in people suggest that some people are likely to benefit from simple interventions, while others may require more complex and intrusive interventions to achieve desired safety goals. Geller (1998) developed the multiple inter- vention level (MIL) hierarchy to summarize the impact, intru- siveness, and cost of various interventions. Interventions at Level 1, such as posters, signs, and other safety messages or slogans, are the least expensive and intrusive. Level 1 inter- ventions are designed to be cost-effective and have large-scale appeal. Individuals unaffected by Level 1 interventions fall through the cracks; these individuals require a more intrusive and expensive intervention. A Level 2 intervention may also involve signs and reminders, but these may be intensive and intrusive, such as signing and displaying a promise card to wear a safety belt. A Level 3 inter- vention might include peer-to-peer coaching or an incentive/ reward program. A Level 4 intervention is the most intrusive and labor-intensive. An example of a Level 4 intervention is one-to-one counseling. Typically, these interventions must be implemented by a professional with extensive training and are reserved for âhard coreâ problem individuals who are at the greatest risk for injury and crashes. Figure 2 displays the MIL hierarchy. The height of each intervention box indicates the financial cost to participate or implement the intervention. The length of each box represents the probability that a per- son will be affected by the intervention (i.e., change in behavior will result). The width of each intervention level (marked A, B, C) indicates repeated applications of the same intervention (Geller, 1998). Effectiveness of BBS Studies showing the injury reduction potential and resultant reduction in workersâ compensation claims were presented previously (BST, 1998; Guastello, 1993; Hantula et al., 2001; Sulzer-Azaroff and Austin, 2000). These tremendous gains in safety are attributed in large part to their ability to engage workers collaboratively in the improvement process. While impressive, almost all of these BBS initiatives have been implemented in manufacturing settings. While several small, well-controlled studies have assessed the efficacy of some behav- ioral management techniques in CMV operations (Hickman and Geller, 2003b; Krause, 1997; Olson and Austin, 2001), there remains a need to assess the effectiveness of a comprehensive BBS program with CMV drivers. A 1999 study conducted for the Office of Motor Carrier and Highway Safety (now the Federal Motor Carrier Safety Administration) addressed the applicability of implementing BBS processes with CMV drivers (Krause, Robin, and Knipling, 1999). The authors reviewed the fundamental assumptions and steps of BBS and successful BBS applications in industry, including applications to driving safety by a Canadian oil and natural gas and a U.S. glass man- ufacturing and distribution company. They concluded that BBS was a promising approach to enhancing CMV operational safety and should be more widely employed in the motor transport industry. While there have been few published studies assessing the effectiveness of BBS with CMV drivers, other transportation modes, such as rail, have recently assessed how a BBS program can be successfully implemented. The Federal Railroad Admin- istration has supported several efforts to assess the efficacy of BBS programs in the rail industry (Ranney et al., 2005). Amtrak has implemented a comprehensive BBS program with its ticket agents, gate agents, baggage handlers, and janitors in Chicagoâs Union Station. Injuries among these sectors over a 3-year span were reviewed to develop a list of safe behaviors. Source: Adapted from Geller (2001). to collect baseline data to influence target behavior(s) to measure effectiveness of the intervention(s) EFINE BSERVEO D I T NTERVENE EST behavior(s) to target Figure 1. The DO IT process.
9The operational definitions for these safe behaviors were defined and a behavioral checklist was created (see Appen- dix C for an example of the checklist). Employees observed co-workers and recorded âsafeâ and âat-riskâ behaviors on the checklist. The results from the checklists were aggregated and shown to employees as feedback. During Phase I, Hall (2006) reported a significant positive correlation between the frequency of observations made by employees and staff-hours between injuries. Further, in Phase II, Hall (2006) reported an 85.7% reduction in injuries. Moreover, Ricci and Hall (2006) report on a similar BBS process with rail employees at a site in the Western United States. They found a 57% reduc- tion in the frequency of accidents, incidents, and injuries from pre-intervention to post-intervention (see Appendix C for an example of the checklist). These rail employees were able to conduct peer-to-peer coaching because none of the employees were solitary workers, which most CMV drivers are. One obvious limitation is the applicability of peer-to-peer coaching to industries and work settings involving solitary workers. Source: Adapted from Geller (1998). Figure 2. MIL hierarchy.