Shaping a positive occupational safety climate in general practice teams -findings of the baseline survey of the cluster randomized IMPROVEjob trial

Anke Wagner ^1* Esther Rind ¹ Stefanie Burgess ¹ Irina Böckelmann ² Beatrice Thielmann ^1,2 Helen Heinz ³ Achim Siegel ¹ Verena Schröder ³ Karl-Heinz Jöckel ^3,4 Anika Hüsing ³ Claudia Pieper ⁴ Anna-Lisa Eilerts ⁴ Tanja Seifried-Dübon ⁵ Florian Junne ⁵ Brigitte Werners ⁶ Annegret Dreher ⁷ Lukas Degen ⁸ Birgitta M. Weltermann ⁷ Monika A. Rieger ¹

• ¹ Institute for Occupational Medicine, Social Medicine and Health Services Research, University Hospital and Faculty of Medicine, University of Tübingen, Tübingen, Germany
• ² Institute of Occupational Medicine, Faculty of Medicine, Otto von Guericke University Magdeburg, Madgeburg, Saxony-Anhalt, Germany
• ³ Center for Clinical Trials, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
• ⁴ Institute for Medical Informatics, Biometry and Epidemiology, Essen University Hospital, Essen, North Rhine-Westphalia, Germany
• ⁵ Department of Psychosomatic Medicine and Psychotherapy, Tübingen University Hospital, Tübingen, Baden-Württemberg, Germany
• ⁶ Operations Research, Institute of Management, Ruhr-University Bochum, Bochum, Germany
• ⁷ Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, North Rhine-Westphalia, Germany
• ⁸ Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany

Introduction: The consideration of occupational health and safety can support the creation of good sustainable working conditions in general practices and help in retaining staff and support their workability. This study aimed to assess attitudes of primary care physicians and practice assistants towards occupational safety climate, and to identify what factors are associated with a perceived positive occupational safety climate in this setting. The identification of such factors in general practice settings can serve as a basis for further developments of specific tailored interventions and offers to promote workplace safety for GPs and practice assistants.Methods: This study is based on baseline data of a cluster randomized controlled trial (IMPROVEjob study): 84 practice owners, 28 employed physicians, and 254 practice assistants from 60 German general practices took part in a standardized survey. Occupational safety climate was measured with items from previous studies. Standardized and validated items regarding working conditions, work behavior, general health, burnout and chronic stress were also included. All statistical analyses were performed with IBM SPSS version 28, and comprised descriptive analyses, Mann–Whitney-U-test and Kruskal-Wallis test, as well as a stepwise multiple regression analysis considering cluster effects.Results: We found a positive perception of occupational safety climate across all occupational groups, for example regarding the role of the direct supervisor in occupational safety at work or the occupational safety commitment of the practice. Bivariate analysis mainly revealed associations between occupational safety climate and several aspects of working conditions. The regression model revealed the following important factors for perceived positive occupational safety climate (assessed by the scale company standards): supervisor support for occupational safety (β=0.43) and job satisfaction (β=0.22).Discussion: Leadership and job satisfaction were identified as main factors shaping a positive occupational safety climate (scale company standards) in our regression model built on data from German general practices and their practice teams. The findings are consistent with a previous study conducted in the German healthcare setting. The promotion of these factors should be supported further and can probably contribute to improving the occupational safety climate in general practices in Germany.