The stage of change approach for implementing ergonomics advice e Translating research into practice Paul Rothmore a, * , Paul Aylward b , Jodi Oakman c , David Tappin d , Jodi Gray a , Jonathan Karnon a a School of Public Health, University of Adelaide, Australia b Discipline of Public Health, School of Health Sciences, Flinders University, Australia c Centre for Ergonomics and Human Factors, School of Psychology and Public Health, La Trobe University, Australia d Healthy Work Group, School of Management, Massey University, New Zealand article info Article history: Received 10 December 2015 Received in revised form 4 July 2016 Accepted 29 August 2016 Keywords: Stage of change Implementation Ergonomics interventions Translation abstract The Stage of Change (SOC) approach has been proposed as a method to improve the implementation of ergonomics advice. However, despite evidence for its efficacy there is little evidence to suggest it has been adopted by ergonomics consultants. This paper investigates barriers and facilitators to the imple- mentation, monitoring and effectiveness of ergonomics advice and the adoption of the SOC approach in a series of focus groups and a subsequent survey of members of the Human Factors Societies of Australia and New Zealand. A proposed SOC assessment tool developed for use by ergonomics practitioners is presented. Findings from this study suggest the limited application of a SOC based approach to work-related musculoskeletal injury prevention by ergonomics practitioners is due to the absence of a suitable tool in the ergonomists' repertoire, the need for training in this approach, and their limited access to relevant research findings. The final translation of the SOC assessment tool into professional ergonomics practice will require accessible demonstration of its real-world usability to practitioners and the training of er- gonomics practitioners in its application. © 2016 Elsevier Ltd. All rights reserved. 1. Introduction Work-related musculoskeletal disorders (MSDs) are a major cost burden to individuals, businesses and society (National Research Council and the Institute of Medicine, 2001; Woolf and Pfleger, 2003). In the European Union MSDs are the most frequently re- ported health problem among workers (Eurofound, 2012). In the USA, over the preceding decade, they have accounted for more than one-third of all work-related injuries resulting in work absence (National Insitute for Occupational Safety and Health, 2004). While in Australia they are one of eight nationally recognised priority occupational diseases, accounting for total costs of more than $61.8 billion each year (Safe Work Australia, 2015). The contribution of physical and psychosocial risk factors to the development of MSDs and the importance of implementing multi- factorial interventions in their prevention is widely acknowledged (Silverstein and Clark, 2004; Westgaard and Winkel, 2011; Macdonald and Oakman, 2015). Although some successes in the implementation of MSD prevention strategies have been reported (Silverstein and Clark, 2004; Denis et al., 2008; Palmer et al., 2012) MSDs remain a significant workplace issue (Wells, 2009). Wells (2009) proposed that this limited success may be associated with low rates of implementation. In other words, there is a gap between the proposed interventions designed by ergonomists and those which are implemented by organisations (Rothmore et al., 2013; Oakman et al., 2016). Issues related to implementation include the level of awareness of ergonomics issues (Whysall et al., 2004), organisational attitudes (Perrow, 1983), and political, social and contextual issues (Theberge and Neumann, 2010). While several authors have proposed methods to improve the effectiveness of ergonomics interventions in organisational settings these have been primarily researcher- driven with little consideration for the transferability of their findings into daily professional practice (Theberge and Neumann, 2010). As an example, while Broberg and Hermund (2004) * Corresponding author. Level 7,178 North Terrace, Adelaide, SA 5005, Australia. E-mail address: paul.rothmore@adelaide.edu.au (P. Rothmore). Contents lists available at ScienceDirect Applied Ergonomics journal homepage: www.elsevier.com/locate/apergo http://dx.doi.org/10.1016/j.apergo.2016.08.033 0003-6870/© 2016 Elsevier Ltd. All rights reserved. Applied Ergonomics 59 (2017) 225e233