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JOB COMPETENCY MODEL OF WORKPLACE HEALTH EDUCATION OF OCCUPATIONAL HEALTH PROFESSIONALS IN KOREA

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JOB COMPETENCY MODEL OF WORKPLACE HEALTH

EDUCA-TION OF OCCUPAEDUCA-TIONAL HEALTH PROFESSIONALS IN KOREA

YEON-HAKIM

College of Nursing, Sungshin University, Woonjung Green Campus, 55 Dobong-ro 76ga-gil, Gangbuk-gu, Seoul, 142-732, Korea

Email: tiffany7@sungshin.ac.kr

ABSTRACT

The purpose of this study was to develop a job competency model of workplace health education in order to provide standardized and unified tools for occupational health professionals. The study was conducted by using methodological study design. Literature review, job analysis, and job validity verification were conducted. A convenience sample of 485 occupational health pro-fessionals participated in the study. Through a literature review and job analysis, job competency of workplace health education was structured. Verification of validity was achieved among uni-versity-research industries with various professionals affiliated with occupational health profes-sionals. Verified job competency model of workplace health education for occupational health professionals consisted of eight duties and 40 tasks. The tasks given high performance and im-portance by occupational health professionals were included in the ‘planning’ and ‘implemen-tation’ factors. The tasks which were considered important but were not performed relatively well were included in the ‘evaluation and improvement’ factor. The results indicated that the job competency model of workplace health education for occupational health professionals is a val-idated tool. Further studies are needed to explore the performance levels based on the job com-petency model of this study.

Key words: Occupational health service; competency; workplace; health education INTRODUCTION

According to the International Labor Organization, workplace education in occupational health is a basic and essential job of occupational health professionals (OHPs), in which individual workers are em-powered in order to promote their health and increase labour productivity (Baker and Wallstein, 2011; Jung et al., 2007; Gilmore and Campbell, 2005). Such education encourages workers to improve personal health management, actively fulfill their occupational health responsibilities, lead to proactive risk assessment at work sites and satisfy their right to know about their occupational health (Kogi, 2006; Thomas, 2000; Knowles, 1980).

Workplace health education can be performed either actively or passively depending on the back-ground of OHPs. Differences can exist in job performance based on health educator awareness (e.g., per-formance, importance, difficulty) within the specific professional area. This may influence the competency of OHPs in key areas of workplace education and increase the lack of understanding of duties. For these reasons, a standardized and unified job competency model for OHPs is needed in order to promote, initiate and maintain workplace health education.

Received 16 February 2017; accepted 1 January 2018

*New affiliation of author: College of Nursing, Korea National University of Transportation. 61, Daehak-ro, Yonggang-ri, Jeungpyeong-eup, Jeungpyeong-gun, Chungcheongbuk-do, Republic of Korea.

Email: tiffany-kim@hanmail.net

Originals

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According to the Korea Occupational Safety Health Act (2011), OHPs are individuals who perform the overall job of occupational health management including the maintenance and promotion of occupa-tional health. Occupaoccupa-tional environment physicians (OEPs), occupaoccupa-tional health nurses (OHNs), industrial hygienists (IHs), and air pollution environmental engineers (APEEs) are all considered to be OHPs in Korea. Currently, there are a total of 13,500 OHPs in Korea, and the assignment statuses are 3.8%, 64.5%, 7.2% and 23.4%, respectively, in the above positions (Ministry of Employment and Labor: MOEL, 2010). Because multiple professions fall into the title of OHPs, a job competency model of workplace health ed-ucation is needed in order to ensure desirable job performance outcomes under realistic circumstances.

Workplace health education competency might not be able to be evaluated independently of its work-site context. A reliable and valid measurement of competency in health education should reflect the reality of the workplace health situation and incorporate the education processes (Kawakami et al., 2004; Watson, 1981). Therefore, it would be more appropriate to develop a job competency model by using methodological design. Various job competency guidance models have been developed (International Organization for Standardization: ISO, 2015) to provide practical tools that can reduce errors and increase efficacy in job performance; however, job competency models of OHPs regarding workplace health education are rare. Some efforts have been made by professionals providing health education but these were limited to specific jobs (Cooper et al., 2010; De Onna, 2002). Although workplace health education provided by OHPs has been described in previous studies performed in various countries, the main method utilized to evaluate the effectiveness of a model or program intervention was questionnaire surveys (Robson et al., 2012; Burke et al., 2006; Lee et al., 2006).

Therefore, the purpose of this study was to methodologically develop a job competency model of workplace health education so as to provide a standardized and unified tool for OHPs. The author also evaluated the performance, importance and difficulty level of job competency of workplace health educa-tion. This should contribute to the improvement of the efficiency and convenience in the guidance of work-place health education and help prevent confusion and conflict in roles of OHPs. Moreover, the findings will provide basic evidence for developing relevant job standards and training curriculums.

METHODS Research design and ethical considerations

This study was a methodological study designed with literature review, job analysis and validity ver-ification. The study was performed with informed consent after obtaining approval of the Institutional Re-view Board at the College of Medicine, Hanyang University (No:HY-13-093-2). Participating subjects were informed of the purpose of this study and completed the questionnaires anonymously. All respondents were informed that they could withdraw from the survey at any time.

Study population and data collection

A total of 485 subjects were involved in this study. Data was collected from November 10, 2013 to April 30, 2014.

First, six panel members were organized for the job analysis committee to determine job items based on a literature review. The panel members in the job analysis committee consisted of two university pro-fessors (faculty of medicine, faculty of nursing), two trainers of OHPs (OEP, OHN), and two OHPs (OHN, IH). The members were invited based on their job skills, ability to describe their work, and knowledge of how to precisely define standard terms or apply competency (Norton and Moser, 2008). All the members had at least 20 years of experience in their respective fields.

Second, 479 OHPs nationwide participated to verify job items. This included 91 occupational health experts (for adequacy and construct validity of duty items) and 388 occupational health practitioners (155 for content validity and 233 for construct validity of task items). Occupational health experts are specialized in workplace health and work for government, agencies, universities or senior OHPs. Occupational health practitioners were those who actually handle occupational health at worksites. Samples were collected by convenience sampling. The sample size was determined based on factor analysis (Tabachnick and Fidell,

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2007; Nunnaly, 1978) and correlation analysis (Cohen, 1988) with the following criteria: at least five to ten times greater than the number of variables to be analyzed, a 0.2 small effect size, 80% statistical power, a 0.05 significance level using a G-Power program and an anticipated dropout rate of 20%.

The questionnaires were emailed nationwide to a hundred occupational health experts, and the author contacted the subjects by telephone to encourage them to respond to the survey. The final sample of occu-pational health experts included 91 subjects with the response rate of 91%. They were 14 professors in the field of occupational health, 30 trainers from occupational education institutions and 47 senior OHPs.

The author visited six industrial health centres nationwide twice to collect data from occupational health practitioners when the Korea Industrial Health Association was delivering continuing training pro-grams to OHPs. The aim of these visits was to ensure that all occupational health practitioners were cor-rectly represented by the assignment status that the Ministry of Employment and Labor (MOEL, 2010) reported. On the first visit, the author collected 155 questionnaires in order to verify content validity. The subjects all handed in complete responses. On the second visit, 238 subjects answered the questionnaire in order to verify construct validity. Five subjects did not complete their questionnaire yielding a response rate of 97.8%. The final samples of occupational health practitioners were 155 and 233 subjects.

Procedures and data analysis

This study was designed in a three-phase approach: literature review, job analysis, and validity veri-fication (Fig. 1).

Phase 1: The literature review analyzed publications of occupational health, including reports of the American Association of Occupational Health Nurses (AAOHN, 2012), the Council of Group Occupational Health Service (KCGOHS, 2013) and the Korea Association Occupational Health Nursing (KAOHN, 2007). The author also examined relevant articles published between January 1, 1995 (i.e. subsequent to the passage of the Korea National Health Promotion Act) and December 31, 2013 by searching the Korea Citation Index using keywords of “OHPs (OEP/OHN/IH/APEE)” and “workplace health education/train-ing.” The studies had to meet the following inclusion criteria:

(1) A focus on health education to workers.

(2) A clear presentation of the education performed by OHPs.

Of the originally identified 194 articles, 25 met the inclusion criteria. This phase aimed to determine the conceptual framework of reference guides for extracting competencies of OHPs in workplace health education at various workplaces. It was focused on the analysis, design, development, implementation and application of an evaluation model (ADDIE model), a theoretical model related to the education process (Watson, 1981).

Phase 2: To clarify the state of effective competencies of OHPs, a job analysis method was applied to establish group consensus via group discussion. This method is based on a systematic, evidence-based ap-proach implemented in order to develop competency-based job items (De Onna, 2002; Nunnaly, 1978). The job analysis committee met over a 3-day period with each session lasting at least two hours to determine job items extracted from the literature. The workshop was facilitated by a nursing college professor who was specialized in job analysis. The job analysis committee, including the facilitator, consisted of six panel members who were representatives from universities, industry and research related to workplace health education. They were to define key words and judge what requirements should be included in job items of OHPs. Throughout this process, the panel members confirmed job items, classified them as either duties or tasks and made modifications. They took note that tasks were minimum active units, while duties were bundles of tasks performed within the responsibilities of one’s job (Norton and Moser, 2008). They also referred Norton and Moser (2008) who reported that this method enabled them to build consensus in prop-erties of duties and tasks for building solid foundation of job competency.

Phase 3: To establish consensus among universities, researchers and industry, the various professionals affiliated with OHPs and their duties and tasks were statistically validated. This was analyzed using SPSS Win 20.0 (SPSS, Inc., Chicago, IL, USA) as follows:

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question as a valid measure of the construct based on a 5-point Likert scale (1: strongly disagree, 5: strongly agree). The adequacy was calculated in percentages, with an overall rating average of 78.2%, which met the suggested requirement of 75.0% (Yaghmaie, 2003). Factor analysis was performed with varimax rota-tion on duty items to verify construct validity. Data related to duties was appropriate for factor analysis (KMO measurements were 0.86 and Bartlett's sphericity test was Chi-square=394.500, p<.001) to determine underlying structures.

2) Occupational health practitioners verified content and construct validity of task items. First, the task items were validated to 155 OHPs using the content validity index (CVI; 0.87). One task could not meet the standard of CVI (0.65) and was deleted. It was ‘Implement workplace health education by mobile app’. Once again, the remaining task items were rated by the 233 OHPs using a 5-point Likert scale to verify construct validity. The questionnaire evaluated the performance, importance and difficulty level ranging from 5 (high frequently performed, very important, very difficult) to 1 (never performed, not im-portant, very easy). Importance level data collected on tasks were analyzed by using factor analysis. Data related to tasks was appropriate for factor analysis (KMO measurements were 0.95 and Bartlett's sphericity test was Chi-square=8723.113, p<.001) to determine underlying structures.

RESULTS Characteristics of subjects

Characteristics of 485 subjects in this study are reported in Table 1. The average age of panel members was 48.50±8.59 and their average career duration was 24.50±5.61. The average career length of

occupa-Fig. 1. The flow of this study.

Phase 1

Literature review from 3 manuals for OHPs and Build the reference guide 25 KCI articles

Phase 3 Validity verification

Define and classify job competency into duties and

tasks of workplace health education for OHPs through 6

panel members Phase 2

Job analysis

Verify adequacy and construct validity of duty items from 91 occupational Verify content validity of task

items from 155 occupational health practitioners Verify construct validity of

task items from 233 occupational health

practitioners health experts

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Table 1. Characteristics of the subjects (N=485).

Panels (6) health expertsOccupational (91)

Occupational health practitioners(388) Content validity

(155) Construct validity(233) Variables Mean±SDn (%), Mean±SDn (%), Mean±SDn (%), Mean±SDn (%),

Gender Male 41 (45.1) 43 (27.7) 85 (36.5) Female 50 (54.9) 112 (72.3) 148 (63.5) Age (yr.) ≤29 0 (0.0) 0 (0.0) 0 (0.0) 34 (14.6) 30-39 0 (0.0) 40 (44.0) 68 (43.9) 82 (35.2) 40-49 3 (50.0) 26 (28.6) 59 (34.2) 77 (33.0) ≥50 3 (50.0) 25 (27.5) 28 (21.9) 40 (17.2) 48.50±8.59 40.46±12.72 41.06±9.08 39.94±9.14 Career duration as an OHP (yr.) <22-4 0 (0.0)0 (0.0) 0 (0.0)0 (0.0) 98 (63.2)39 (25.2) 99 (42.5)73 (31.3) 5≤ 6 (100.0) 91 (100.0) 18 (11.7) 61 (26.2) 24.50±5.61 14.26±11.51 2.33±4.16 3.61±4.61 Professional area OHN 3 (50.0) 33 (36.3) 106 68.4) 130 (55.9) OEP 2 (33.4) 13 (14.3) 4 (2.5) 4 (1.7) IH 1 (16.6) 42 (46.2) 15 (9.7) 46 (19.7) APEE 0 (0.0) 3 (3.2) 30 (19.4) 53 (22.7) Job type Full time 51 (32.9) 66 (28.3) Part time 104 (67.1) 167 (71.7) Size of enterprise SME 120 (77.4) 155 (66.5) LE 35 (22.6) 78 (33.5) type of enterprise MI 46 (29.7) 104 (44.6) NMI 109 (70.3) 129 (55.4) Working region Seoul·Kyongin 32 (20.6) 70 (30.0)

Middle-eastern·Central 3 (1.9) 33 (14.2) South-eastern 65 (41.9) 112 (48.1) South-western 55 (35.5) 18 (7.7)

OHP=Occupational Health Professional; OHN=Occupational Health Nurse; OEP=Occupational Environment Physician, IH=Industrial Hygiene; APEE=Air Pollution EnvironmentalEngineer; SME=Small-medium enterprise (≤300 workers); LE=Large-scale enterprise (300 worker≤);MI=Manufacturing Industry; NMI=Non-Manufacturing Industry.

tional health experts was 14.26±11.51 years, and 33 experts were OHNs (36.3%), 13 were OEPs (14.3%) and 45 were HIs and APEEs (49.4%). Occupational health practitioners who verified the content validity had average age of 41.06±9.08 years and an average career duration as an OHP of 2.33±4.16 years. This group included 106 OHNs (68.4%), 4 OEPs (2.5%), 15 HIs (9.7%), and 30 APEEs (19.4%). Among oc-cupational health practitioners who verified the construct validity,148 (63.5%) were female subjects. Their average age was 39.94±9.14 years old, and their average career duration as OHPs was 3.61±4.61 years. This group included 130 OHNs (55.9%), 4 OEPs (1.7%), 46 His (19.7%) and 53 APEEs (22.7%).

A job chart of workplace health education for OHPs obtained by literature analysis and job analysis Items of duty and task of workplace health education for OHPs, which were extracted and confirmed by literature review and job analysis, are shown in Fig. 2.

The job items obtained by literature review were 10 duties and 37 tasks. These were modified through job analysis. ‘Assure guideline and standards’, ‘investigate hazardous risk factors complied with the guide-line’, ‘establish learning objectives on each content plans’ and ‘confirm participants by classified health education’ were displayed. ‘Analyze general characteristics and organization structure’, ‘check health ed-ucation place, equipment, advertisement materials etc.’ and ‘contact outside lecturers’ were eliminated. ‘Check that the training course is reimbursed through MOEL refund’, ‘assess available resources’, ‘review validity of workplace health education’, ‘prepare proposal’, ‘implement workplace health education by mobile app’ and ‘investigate satisfaction measurement’ were inserted.

A job chart of workplace health education for OHPs obtained by literature review and job analysis were 8 duties contained a total of 41 tasks. The definition of workplace health education in OHPs was “ability to guide workers to improve work-related health management abilities in order to prevent and man-age occupational accidents by providing knowledge, while supporting a profitable attitude that encourman-ages

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A5. Confirm participants by classified health

education B1. Select topics

and make a list C1. Construct workplace

health education yearly schedule D1. Discuss workplace health education program

E1. Develop or request materials F1. Distribute yearly plan

F5. Conduct offline workplace health

education

A6. Assure guideline and standards for workplace

health education B2. Comprise multiple

increased risk factors C2. Establish learning objectives on each content

plans D2. Plan advertisement E2. Combine recreation,

experiences etc. in F2. Inform workplace health education by e-mail or intranet F6. Contact workplace health education by intranet online

A7. Check that the training course is reimbursed through MOEL

B3. Search recent noticeable issues and

interests C3. Select workplace health education methods

for planning contents D3. Discuss with related

agency to acquire resources E3. Establish evaluation

plan F3. Gain support from advocacy group (cafeteria,

store)

B4. Assess available resources C4. Negotiate needed

resources D4. Form labor union/ management team for

budget support E4. Get draft document

approval F4. CEO participation in

workplace health education F8. Check safety health manager and supervisor complete health education

F9. Discuss further workplace health

education A1. Survey need

assessment and preference

A2. Check supervisor, labor committee request

issues

A3. Investigate hazardous risk factors complied with

the guideline

A4. Interpreting health checkup results and health

counseling records B. Identify High-priority problems A. Assess Needs C. Plan Schedule and Contents D. Plan Administration and Budget E. Develop Health Education F. Conduct Health Education Definition  F7. Implement workplace health education by

Ability to guide workers to improve work-related health management abilities in order to prevent and manage occupational accidents by providing knowledge, while supporting a profitable attitude that encourages workers to perform desirable behaviours

B5. Review validity of workplace health

education C5. Prepare proposal

D5. Place necessary resources for workplace

health education

G1. Evaluate input G2. Evaluate process G3. Evaluate results satisfaction measurementG4. Investigate

G2. Document result

paper H2. Preserve and manage documents

G. Evaluate H. Document DDuuttyy 77DDVVNN with supervisor developing content mabile app

Fig. 2. A job chart of workplace health education for occupational health health professionals. workers to perform desirable behaviors.” The duty items were ‘assess needs’, ‘identify high-priority prob-lems’, ‘plan schedule and contents’, ‘plan administration and budget’, ‘develop health education’, ‘conduct health education’, ‘evaluate’ and ‘document’.

Validity of items for the duty and task of workplace health education for OHPs

Validity of items for duty and task of workplace health education for OHPs are shown in Table 2. Construct validity of duty items were achieved by factor loading of .50. There were no items excluded. With the Eigen value of 1.0 and the cumulative percentage of 70.1, two sub-factors were extracted. Factor 1 included the duty items of ‘plan schedule and contents,’ ‘plan administration and budget,’ ‘develop health education,’ and ‘document’. Factor 2 was a combination of the duties ‘assess needs,’ ‘identify high-priority problems,’ ‘conduct health education’ and ‘evaluate’. Sub-factors were extracted and were formulated into new meanings: Factor 1: ‘workplace health education administration’ and Factor 2: ‘workplace health ed-ucation processes’. The internal validity showed Cronbach's alpha of .898.

Construct validity of task items were achieved by factor loading of .50. The KMO measurements were 0.95 and Bartlett's sphericity test was Chi-square=8723.113 (p<.001). Three sub-factors were formu-lated and had accounted for 63.6% of the variance and represented Eigen values greater than 1. The factors contained 20, 12, and eight tasks, respectively. Sub-factors were formulated into new meanings: Factor 1: planning, Factor 2: implementation, and Factor 3: evaluation and improvement. Internal validity showed a Cronbach’s alpha of .974.

The final model of job competency of workplace health education for OHPs consisted of eight duties and 40 tasks (Fig. 3).

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Duties Factor 1 Factor 2 H. Document 0.841 0.186 C. Plan schedule and contents 0.778 0.246 E. Develop health education 0.714 0.369 D. Plan administration and budget 0.668 0.32 A. Assess needs 0.173 0.846 G. Evaluate 0.353 0.829 B. Identify high-priority problems 0.363 0.809 F. Conduct health education 0.565 0.584 Eigen values 4.694 1 % of Variance 58.678 11.427 Cumulative(%) 58.678 70.105 Cronbach’s α 0.819 0.876 Cronbach’s α of all duties 0.898

Table 2-1. Factor analysis of workplace health education duties for occupational health professionals.

Tasks Factor1 Factor 2 Factor 3

A-5.Confirm participants by classified health education 0.799 0.283 0.067

A-3. Investigate hazardousrisk factors complied withthe guideline 0.774 0.296 0.033

B-5. Review validity of workplace health education 0.751 0.195 0.229

B-2. Comprise multiple increased risk factors 0.719 0.188 0.273

A-6. Assure guidelines and standards for workplace healtheducation 0.717 0.327 -0.014

B-1. Select topics and make a list 0.716 0.271 0.118

B-3. Search recent noticeable issues and interests 0.704 0.2 0.27

B-4. Assess available resources 0.695 0.206 0.257

C-5. Prepare proposal 0.689 0.235 0.408

A-2. Check supervisor, labor committee request issues 0.683 0.346 0.055

A-4. Interpreting health checkup results and health counseling records 0.683 0.429 0.065

D-1. Discuss workplace health education program with supervisor 0.679 0.146 0.456

A-1.Survey need assessment and preference 0.672 0.128 0.205

C-4. Negotiate needed resources 0.665 0.164 0.468

C-3. Select workplace health education methods for planning contents 0.651 0.102 0.476

D-3. Discuss with related agency to acquire resources 0.638 0.135 0.44

C-2. Establish learning objectives on each content plans 0.631 0.227 0.372

D-2. Plan advertisement 0.623 0.091 0.418

C-1. Construct workplace health education yearly schedule 0.623 0.287 0.241

A-7. Check that the training course is reimbursed through MOEL refund 0.569 0.242 0.125

E-1. Develop or request materials 0.23 0.8 0.228

D-5. Place necessary resources for workplace health education 0.291 0.752 0.253

F-5. Conduct offline workplace health education 0.262 0.722 0.109

E-2. Combine recreation, experiences, etc. in developingcontents 0.289 0.716 0.34

D-4. Form labor union/management team for budget support 0.28 0.709 0.286

H-2. Preserve and manage documents 0.209 0.688 0.316

E-4. Get draft document approval 0.19 0.659 0.402

E-3. Establish evaluation plan 0.309 0.651 0.369

F-1. Distribute yearly plan 0.204 0.63 0.366

F-8. Check safety health manager and supervisor complete health education 0.252 0.595 0.099

F-4. CEO participation in workplace health education 0.275 0.545 0.479

F-2. Inform workplace health education by e-mail or intranet 0.249 0.518 0.508

G-1. Evaluate input 0.263 0.404 0.762

G-2. Evaluate process 0.305 0.414 0.733

G-3. Evaluate results 0.282 0.448 0.729

G-4. Investigate satisfaction measurement 0.161 0.433 0.662

F-9. Discuss further workplace health education 0.261 0.488 0.621

F-3. Gain support from advocacy group (cafeteria, store, etc.) 0.318 0.369 0.601

F-6. Conduct workplace health education by intranet online 0.253 0.518 0.545

H-1. Document result paper 0.224 0.538 0.545

Eigen values 20.254 3.61 1.609

% of Variance 50.635 9.025 4.023

Cumulative(%) 50.635 59.66 63.683

Cronbach’s α 0.974 0.942 0.943

Cronbach’s α of all tasks 0.974

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Performance, importance, difficulty levels of job competency according to tasks

The levels of performance, importance, and difficulty of the tasks are presented in Table 3. Tasks with high performance level were ‘preserve and manage documents’ (3.67±1.14), ‘construct yearly workplace health education schedule’ (3.57±1.04) and ‘interpret health checkup results and health counseling records’ (3.55±1.04), in descending order of performance. High-importance tasks were ‘interpret health checkup results and health counseling records’ (4.01±0.87), ‘preserve and manage documents’ (3.97±0.83) and ‘construct yearly workplace health education schedule’ (3.95±0.86). Tasks with the highest difficulty levels were ‘form labor union/management team for budget support,’ with a score of 3.48±1.02, and ‘chief exec-utive officer participation in workplace health education,’ with a score of 3.48±1.08.

Tasks with a low performance level were ‘investigate satisfaction measurement’ with a score of 2.82±1.08, ‘evaluate process’ with a score of 2.83±0.98 and ‘evaluate input’ at 2.85±0.95. Tasks of rela-tively low importance compared with the others were ‘Gain support from advocacy group (cafeteria, store, etc.)’ with an average score of 3.51±0.92, ‘evaluate input’ with a score of 3.54±0.89, and ‘evaluate process’ with a score of 3.59±0.91. All of these were categorized into the ‘evaluation and improvement’ factor.

Fig. 3. Job competency model of workplace health education for occupational health professionals. Implementation

(Factor 2)

MOEL=The Ministry of Employment and Labor; CEO=Chief Executive Officer

Assess

Needs High-priority ProblemsIdentify Schedule and Plan

Contents

Plan Administration

and Budget

Develop Health

Education Conduct Health Education Evaluate

TASKS Confirm participants by classified health

education

Select topics and make a list

Construct workplace health education

yearly schedule

Discuss workplace health education

program with

Combine recreation, experiences, etc. in

developing contents Evaluate input

Assure guidelines and standards for workplace health education Comprise multiple increased risk factors Establish learning objectives on each

content plan Plan advertisement

Develop or request materials

Conduct workplace

health education by intranet online

Evaluate process Search recent

noticeable issues and interests

Select workplace health education

methods for planning

Discuss with the related agency to acquire resources

Establish an evaluation plan

Gain support from the advocacy group (cafeteria,

Evaluate results Assess available

resources Negotiate needed resources

Get draft document approval Investigate satisfaction measurement Review validity of workplace health education Prepare proposal Discuss further workplace health education Survey need assessment and preference Investigate hazardous risk factors complied with the guideline Interpreting health

checkup results and health counseling

records

Document result papers Form labor union/

management team for budget support

Definition: Ability to guide workers to improve work-related health management abilities in order to prevent and manage occupational accidents by providing knowledge, while supporting a profitable attitude that encourages workers to perform desirable behaviors.

Planning (Factor 1) Check supervisor, labour committee request issues DUTIES Distribute a yearly plan Conduct offline workplace health education Inform workplace health education by e-mails or the intranet

Check that the training course

reimbursed through MOEL refund

CEO participation in workplace health education

Check safety health manager and

supervisor complete health education

Place necessary resources for workplace health education Preserve and manage documents Evaluation & improvements (Factor 3) Document contents supervisors

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Table 3. Performance, importance and difficulty levels of workplace health education tasks (N=233).

Tasks MeanPerformanceSD MeanImportanceSD MeanDifficultySD

Planning (Factor 1) 3.25 0.77 3.77 0.63 3.31 0.65

1-A-1. Survey need assessment and preference 2.94 1.11 3.82 0.8 3.25 0.87 1-A-2. Check supervisor, labor committee request issues 3.28 0.07 3.8 0.86 3.34 0.87 1-A-3. Investigate hazardousrisk factors complied withthe

guideline 3.39 1.07 3.92 0.82 3.47 0.87 1-A-4. Interpretinghealth checkup results and health counselingrecords 3.55 1.04 4.01 0.87 3.33 0.91 1-A-5. Confirm participants by classified health education 3.34 1.05 3.83 0.86 3.24 0.92 1-A-6. Assure guidelines and standards for work place health

education 3.36 1.1 3.79 0.87 3.32 0.92 1-A-7. Check that the training course is reimbursed

through MOEL refund 3.28 1.09 3.6 0.9 3.09 0.92 1-B-1. Select topics and make a list 3.19 1.01 3.66 0.79 3.27 0.86 1-B-2. Comprise multiple increased risk factors 3.18 1.03 3.82 0.86 3.42 0.91 1-B-3. Search recent noticeable issues and interests 3.11 1.02 3.7 0.85 3.19 0.97 1-B-4. Assess available resources 3.25 0.9 3.74 0.76 3.38 0.83 1-B-5. Review validity of workplace health education 3.21 1 3.75 0.85 3.33 0.86 1-C-1. Construct workplace health education yearly schedule 3.57 1.04 3.95 0.86 3.28 0.98 1-C-2. Establish learning objectives on each content plans 3.46 1.03 3.82 0.81 3.25 0.98 1-C-3. Select workplace health education methods for planning contents 3.35 0.99 3.71 0.88 3.27 0.84 1-C-4. Negotiate needed resources 3.22 0.99 3.73 0.85 3.39 0.89 1-C-5. Prepare proposal 3.16 0.98 3.67 0.9 3.34 0.93 1-D-1.Discuss workplace health education program with supervisor 2.98 1.05 3.7 0.9 3.39 0.92 1-D-2. Plan advertisement 3.07 1.11 3.64 0.9 3.3 0.91 1-D-3. Discuss with related agency to acquire resources 3.09 1.09 3.65 0.96 3.45 0.92

Implementation (Factor 2) 3.24 0.84 3.73 0.64 3.22 0.7

2-D-4. Form labor union/management team for budget support 2.97 1.12 3.66 0.91 3.48 1.02 2-D-5. Place necessary resources for workplace health education 3.24 1.05 3.7 0.9 3.37 1.03 2-E-1. Develop or request materials 3.36 1.15 3.68 0.86 3.18 0.98 2-E-2. Combine recreation, experiences, etc. in developing

contents 3.18 1.09 3.69 0.86 3.24 0.96 2-E-3. Establish evaluation plan 3.02 1.03 3.68 0.85 3.2 0.9 2-E-4. Get draft document approval 3.31 1.16 3.73 0.88 3.16 0.94 2-F-1. Distribute yearly plan 3.3 1.1 3.82 0.84 3.12 0.97 2-F-2. Inform workplace health education by e-mail or intranet 3.07 1.21 3.59 0.86 3.06 0.98 2-F-4. CEO participation in workplace health education 2.87 1.16 3.69 0.99 3.48 1.08 2-F-5. Conduct offline workplace health education 3.4 1.08 3.74 0.86 3.28 1.01 2-F-8. Check safety health manager and supervisor completehealth education 3.49 1.24 3.84 0.94 3.09 1.1 2-H-2. Preserve and manage documents 3.67 1.14 3.97 0.83 3.01 1.11

Evaluation and Improvement (Factor 3) 2.97 0.84 3.62 0.7 3.24 0.73

3-F-3. Gain support from advocacy group (cafeteria, store, etc.) 2.87 1.08 3.51 0.92 3.31 0.98 3-F-6. Conduct workplace health education by intranet online 3.15 1.24 3.6 0.89 3.21 0.98 3-F-9. Discuss further workplace health education 3.17 1.05 3.77 0.85 3.17 0.98 3-G-1. Evaluate input 2.85 0.95 3.54 0.89 3.26 0.88 3-G-2. Evaluate process 2.83 0.98 3.59 0.91 3.26 0.88 3-G-3. Evaluate results 2.91 0.99 3.62 0.88 3.27 0.88 3-G-4. Investigate satisfaction measurement 2.82 1.08 3.6 0.89 3.24 0.91 3-H-1. Document result paper 3.15 1.09 3.75 0.84 3.17 0.96 Total 3.19 0.75 3.73 0.59 3.27 0.6

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DISCUSSION

Workplace health education delivered by OHPs was defined by literature review and our focus group study as the “ability to guide workers to improve work-related health management abilities in order to prevent and manage occupational accidents by providing knowledge, while supporting a profitable attitude that encourages workers to perform desirable behaviors.” This definition was similar to the findings of re-cent publications and articles. Previous studies suggested workplace health education is known to provide knowledge of potential occupational environmental hazards to improve worker ability to manage personal health (KCGOHS, 2013; AAOHN, 2012; KAOHN, 2007). Recent studies have supported the value of ac-tion-based health education. These studies also emphasize systematic health education with experience-based learning to support desirable behaviors (Watson, 1981; Knowles, 1980).

Job items for workplace health education were initially extracted from a literature review and were then confirmed by job analysis. Panel members decided upon 8 duties and 41 tasks. The duties were ‘assess needs,’ ‘identify high-priority problems,’ ‘plan schedule and contents,’ ‘plan administration and budget,’ ‘develop health education,’ ‘conduct health education,’ ‘Evaluate’ and ‘Document,’ which reflected analy-sis, design, development, implication, and the evaluation process using Watson’s ADDIE model (1981).

The statistically verified job competency of workplace health education for OHPs consisted of eight duties and 40 tasks. The occupational health practitioners perceived workplace health education tasks as ‘planning,’ ‘implementation,’ and ‘evaluation and improvements’ factors. The task factors were proposed based on the ADDIE model (De Onna, 2002; Watson, 1981) and previous studies (KCGOHS, 2013; AAOHN, 2012; KAOHN, 2007; Kogi, 2006).

In contrast, occupational health experts perceived workplace health education duties as factors of ‘workplace health education administration’ and ‘workplace health education processes.’ This indicated that occupational health experts might perceive workplace health education as a two-way process. Although the occupational health experts had an average career duration of 14.26±11.51 years and had equally dis-tributed professional areas, the structures for their duties and tasks did not agree. On the other hand, the majority of occupational health practitioners who evaluated construct validity had career less than 5 years (73.8%) and OHNs occupied 55.9%. Despite a mean subject age of 39.94±9.14 years, the mean career du-ration of the subjects was only 3.61±4.61 years. A reasonable explanation might be that OHNs often worked previously as hospital nurses and, as a consequence, had only short working careers as OHPs. Thus, further research is also recommended to explore the job competency of workplace health education according to OHPs’ professional area based on the author’s job competency model. Further studies according to job type, size of enterprise and type of enterprise are also recommended. Even so, due to various positions of the chosen occupational health experts, differences in perception between administrators and educators could have existed. ‘Workplace health education processes’ are applied and managed by the ‘workplace health education administration’ (AAOHN, 2012). Many studies have obtained good results focusing on the ‘workplace health education process’ (Lee et al., 2006; Yoon et al., 2012). Meanwhile, the ‘workplace health education administration’ dealt with job structure as a role of an administrator and emphasized a strategy of making participation of workers or of educating methods (Kogi, 2006). Therefore, when occu-pational health experts train or make policy for occuoccu-pational health practitioners, it should be important to reflect the workplace health situation and incorporate the education processes (Kawakami et al., 2004; Watson, 1981). It is suggested to develop a training curriculum based on this study’s model.

The content validity of tasks was relatively high except for ‘implement health education to workers using a mobile app,’ which fell short of the standard and was deleted from further analyses. Even though the job analysis committee made a consensus via group discussion, the occupational health practitioners did not agree with this education method. A series of safety health guidelines using a mobile app has been developed and provided to shipbuilding and repair, building control, machinery manufacturing and other industrial sectors in Korea (KOSHA, 2014). Many studies have reported the effect of health education through a mobile phone upon cardiopulmonary resuscitation training, obesity prevention, diabetes control, etc. (Arnhold et al., 2014; Kalz et al., 2014; Nollen et al., 2014). However, studies of health education

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tar-geting workplaces using mobile apps are rare, especially in Korea. Application of mobile apps to workplace health education is not yet common. Nevertheless, health education utilizing mobile apps is highlighted for the future and is definitely necessary for workplace health education.

The result of construct validity showed that the OHPs perceived ‘gain support from advocacy group (cafeteria, store, etc.)’, ‘conduct workplace health education using the intranet,’ and ‘discuss further place health education’ tasks as parts of the ‘evaluation and improvement’ factor. This indicated that work-place education is more efficient when support and follow-up are stressed to maintain improvements (Kogi, 2006). Moreover, post-education management is necessary for further education since follow-up for more than two to five months is recommended in order to positively change worker behaviour (Kirkpatrick and Kirkpatrick, 2006).

This study also evaluated performance, importance and difficulty levels of job competency according to tasks. According to the results, all the task items showed high importance and difficulty compared to the performance level. Tasks that OHPs perceived as having importance and difficulty but not actually car-ried out were included in the ‘evaluation and improvement’ factor which they seemed to judge this area as a low priority (Kim and Jung, 2016). Conversely, the three best-performed tasks which belonged to the ‘planning’ and ‘implementation’ factors (i.e. ‘preserve and manage documents,’ ‘construct yearly work-place health education schedule’ and ‘interpret health checkup results and health counseling records’) were all perceived by OHPs as having high importance. OHPs seemed to place high performance levels on tasks that they thought were important. The most difficult tasks perceived by workplace OHPs were ‘form labor union/management team for budget support’ and ‘chief executive officer participation in workplace health education.’ These tasks showed relatively low performance levels compared with the others. Among pre-vious results, chief executive officers’ perception of health was the key factor in successful workplace health education (Lee et al., 2006). Director participation in implementation of workplace education drew support in gaining resources and budget allocations. Thus, the above tasks should be considered when de-veloping training curriculum for OHPs (Kim and Jung, 2016).

This study has several strengths. Firstly, it was based on consensus among university-research indus-tries. Second, and more importantly, this study considered these differences in its presentations of a job competency model of workplace health education. Third, unlike other job analysis research, this study val-idated duties and tasks methodologically, and it therefore anticipates practical and theoretical usage. Finally, this study is the first to perform an analysis of the workplace health education job area.

However, this study has some limitations. This study is only a guide for workplace health education. It should be supported with detailed descriptions of the skills and attitudes toward current job standards of OHPs.

CONCLUSIONS

This study was performed to develop a job competency model of workplace health education for use as a standardized and unified tool for OHPs. By using methodological steps, the study revealed that the job competency model of workplace health education consisted of eight duties and 40 tasks. All the task items showed high importance and difficulty levels than performance levels. Tasks that OHPs performed well and perceived important were in ‘planning’ and ‘implementation’. On the other hand, tasks having importance but not actually carried out were included in the ‘evaluation and improvement’ factor. Thus, it is suggested that this job competency model be used as a guideline for workplace health education. Further research is needed to explore the performance levels according to OHPs’ professional area, job type, size of enterprise and type of enterprise based on the author’s job competency model. The model could also be the basis for developing job standards or training curriculums of workplace health education for OHPs.

CONFLICT OF INTERESTS The author declares that there is no conflict of interest.

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Fig. 1. The flow of this study.
Table 1. Characteristics of the subjects (N=485).
Fig. 2. A job chart of workplace health education for occupational health health professionals.
Table 2-2. Factor analysis of workplace health education duties for occupational health professionals.
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