Implementation of a Participatory Ergonomics Intervention to Reduce Musculoskeletal and Stress-Related Mental Health Risks in Australian Retail Workers: Protocol for a Randomized Controlled Trial.

backgroundWorker participation has been identified as important for managing the risks of work-related musculoskeletal disorders (WMSDs) and stress-related mental health problems (MHPs). Previously identified barriers include securing long-term management support to implement risk reduction measures. Few studies evaluate how a manager or decision maker's readiness to act influences the outcomes of a participatory ergonomics program. The Stages of Change (SoC) framework has been suggested for tailoring ergonomics interventions to managers' receptiveness in a workplace setting.

objectiveThe main aim is to evaluate the implementation of the "A Participatory Hazard Identification and Risk Management" (APHIRM) toolkit in the online order fulfillment department for a sample of stores in a large retail organization, compared to usual risk management practice.

methodsThis study is a cluster quasi-randomized controlled trial, comparing implementation of the APHIRM toolkit with usual safety risk management practice. As is typical for workplaces, the intervention is facilitated by the organization's safety team. We recruited 9 control and 9 intervention stores to the study through random selection of eligible stores. Quantitative data are collected at baseline and 12-month follow-up. Qualitative data to enable a process evaluation are collected over the duration of the study. Primary outcome measures are physical and psychosocial hazard severity scores. Secondary outcomes are self-rated pain and discomfort scores and action plan implementation measures. Managers' progression through SoC is an additional outcome measure. The primary outcome measures (physical and psychosocial hazard severity ratings) will be analyzed by variance-weighted cluster-level ANCOVA. Ethics approval was granted by the La Trobe University Human Research Ethics Committee (HEC25088).

resultsFunding was provided in June 2025. Recruitment and randomization concluded in early August 2025. The intervention, including data collection, commenced in late August 2025 and is expected to conclude in September 2026. A total of 332 participants have been recruited to the study. Response rates have averaged 46% across control and intervention groups. As of January 2026, no data analyses have been conducted. Primary findings are anticipated to be published in Spring 2028.

conclusionsThis study evaluates the implementation of the APHIRM toolkit survey in a multisite, large retail organization in Australia and describes the use of toolkit resources. It evaluates managers' SoC regarding WMSD and MHP prevention and how this may influence outcomes. Findings from this study should provide additional insight on how to implement the toolkit in large organizations to reduce WMSD and stress-related MHP risk and inform future development of the content of the APHIRM toolkit. This study is anticipated to further inform tailoring of interventions to managers' and decision-makers' SoC.

trial registrationOSF Registries 10.17605/OSF.IO/82R9G; https://osf.io/82r9g. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/84864.