Workplace Violence Prevention Strategies and Research Needs

Report from the Conference

Partnering in Workplace Violence Prevention: Translating Research to Practice November 17–19, 2004, Baltimore, Maryland

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health This document is in the public domain and may be freely copied or reprinted.

Disclaimer Mention of a company or product does not constitute endorsement by the National Institute for Occupational Safety and Health (NIOSH). In addition, citations to Web sites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or products. Furthermore, NIOSH is not responsible for the content of these Web sites. The recommendations and opinions expressed in this document are those of individual partici­ pants in the conference and may not represent the opinions and recommendations of all members, or of the organizations they represent.

Ordering Information To receive documents or other information about occupational safety and health topics, contact NIOSH at NIOSH Publications Dissemination 4676 Columbia Parkway Cincinnati, OH 45226–1998 Telephone: 1–800–35–NIOSH (1–800–356–4674) Fax: 513–533–8573 E-mail: [email protected] or visit the NIOSH Web site at www.cdc.gov/niosh DHHS (NIOSH) Publication No. 2006–144 September 2006

Safer • Healthier • People™

ii Workplace Violence Foreword

Since the 1980s, violence has been recognized as a leading cause of occupational mortality and mor­ bidity. On average, 1.7 million workers are injured each year, and more than 800 die as a result of workplace violence (WPV) [Bureau of Justice Statistics 2001; BLS 2005]. These tragic deaths and injuries stress the need for a proactive and collaborative WPV prevention effort at the national level.

As part of its WPV Research and Prevention Initiative during 2003, the National Institute for Oc­ cupational Safety and Health (NIOSH) convened a series of stakeholder meetings that focused on various types of WPV and the industries and occupations at risk. For example, separate meetings addressed domestic violence in the workplace, violence in heath care facilities, violence in retail settings, and violence against law enforcement and security professionals. The purpose of these meetings was to bring together subject matter experts from business, academia, government, and labor organizations to discuss current progress, research gaps, and collaborative efforts in address­ ing WPV. One of the recurring discussion points that emerged from the meetings was the need for a national conference on WPV prevention.

In November 2004, NIOSH assembled a diverse group with representatives from various disci­ plines and organizations that have a stake in reducing the toll of WPV. This landmark confer­ ence—Partnering in Workplace Violence Prevention: Translating Research to Practice—was held in Baltimore, Maryland, on November 15–17, 2004. The sessions were structured to give participants an opportunity to discuss the current state of national research and prevention efforts. The intent was to draw out their best professional judgments on (1) identification and implementation of ef­ fective prevention programs and strategies, (2) identification of barriers to prevention and steps for overcoming them, (3) current research and communication needs, and (4) the advancement of research and prevention through effective partnerships.

This report summarizes discussions that took place during the conference. The report does not include a documented review of either the literature on WPV in general or intervention effective­ ness research in particular. In addition, the authors have consciously avoided adding the NIOSH perspective to this report or otherwise augmenting its content. We have preferred to represent as accurately as possible the information, ideas, and professional judgments that emerged from the discussions that took place at the Baltimore workshop.

In my view, the November conference was very successful. This report provides the following:

1. A useful direction for overcoming current barriers and gaps that impede collaborative research, prevention, and communication work

2. An emerging collective vision (based on input from participants) of effective WPV pre­ vention programs that employers and practitioners can consider now

3. A discussion of the research and partnerships needed to advance WPV prevention

Workplace Violence iii I believe that this report will further raise awareness of this national problem and point the way to increased knowledge about the risks, causes, and prevention of WPV. In addition, this report will help companies initiate, improve, and evaluate their WPV prevention efforts. Ultimately, the document will help to accelerate the current downward trends in injuries and deaths from on-the-job as­ saults.

John Howard, M.D. Director, National Institute for Occupational Safety and Health Centers for Disease Control and Prevention

iv Workplace Violence Contents

Foreword ...... iii Abbreviations ...... vii Acknowledgments ...... viii Conference Planning Committee Members ...... ix 1 Introduction ...... 1 1.1 Scope of Workplace Violence (WPV) ...... 1 1.2 Background: surveillance, research, and prevention ...... 3 1.3 Methods and objectives ...... 7 2 Barriers and Gaps that Impede WPV Prevention and Strategies to Overcome Them ...... 8 2.1 Barriers to WPV prevention practice ...... 8 2.2 Gaps in WPV prevention research ...... 11 3 WPV Prevention Programs and Strategies ...... 14 3.1 Strategies or approaches that may apply to more than one type of WPV . . . . . 14 3.2 Strategies specific to Type I (criminal intent) prevention ...... 16 3.3 Strategies specific to Type II (customer/client violence) prevention ...... 17 3.4 Strategies specific to Type III (worker-on-worker) prevention ...... 17 3.5 Strategies specific to Type IV (personal relationship violence) prevention ...... 18 4 Research Needs for WPV Prevention ...... 19 5 Linking Research to Practice ...... 21 6 Partners and their Roles ...... 23 6.1 NIOSH ...... 23 6.2 Other Federal partners ...... 24 6.3 State agencies ...... 24 6.4 Private-sector companies, corporations, and alliances ...... 24 6.5 Business and community organizations ...... 24 6.6 Insurers ...... 25 6.7 Law enforcement ...... 25 6.8 The legal profession ...... 25 6.9 Academic research institutions ...... 25 6.10 The media ...... 25 6.11 The medical community ...... 25

Workplace Violence v 6.12 Worker assistance programs ...... 25 6.13 Social advocacy organizations ...... 26 6.14 Other national organizations ...... 26 7 Conclusions ...... 27 References ...... 28 Appendix ...... 29

vi Workplace Violence Abbreviations

ASIS American Society for Industrial Security BLS Bureau of Labor Statistics CAL/OSHA California/Occupational Safety and Health Administration CFOI Census of Fatal Occupational Injuries IPV intimate partner violence MADD Mothers Against Drunk Driving NIOSH National Institute for Occupational Safety and Health NTOF National Traumatic Occupational Fatalities OSHA Occupational Safety and Health Administration PSA public service announcement WPV workplace violence

Workplace Violence vii Acknowledgments

The National Institute for Occupational Safety and Health (NIOSH) recognizes the cosponsoring organizations that provided financial support for various aspects of the conference: Corporate Alli­ ance to End Partner Violence, Verizon Wireless, State Farm Insurance Company, American Society for Industrial Security (ASIS) International, American Association of Occupational Health Nurses, Liz Claiborne, the Occupational Safety and Health Administration (OSHA) and Injury Prevention Research Center—University of Iowa. The conference and this summary report would not have been possible without the enthusiastic efforts of the conference planning committee (see the list that follows). Members worked diligently to structure the conference, and NIOSH thanks them for their time, energy, and insight. Corinne Peek-Asa, Jonathan Rosen, Kim Wells, and Carol Wilkinson presented plenary session overviews and facilitated breakout sessions on each type of workplace violence (WPV). Meg Boendier, Ste­ phen Doherty, Kathleen McPhaul, and Corinne Peek-Asa provided the working group session sum­ maries that formed the basis for this report. NIOSH appreciates the technical contributions of all these persons and their dedication to the understanding and prevention of WPV. Nancy Stout, Director, NIOSH Division of Safety Research, and Tim Pizatella, Deputy Director, Division of Safety Research, provided guidance and support. Lynn Jenkins, NIOSH, prepared and presented a summary of the conference themes and issues for use in preparing this report. The following NIOSH staff members prepared, organized, and reviewed conference material: Lynn Jenkins, Matt Bowyer, Dan Hartley, Kristi Anderson, Barbara Phillips, and Brooke Doman. Matt Bowyer and Herb Linn summarized conference notes and summary reports, drafted the text, and revised the report. Jane Weber and Gino Fazio provided editorial and production services.

viii Workplace Violence Conference Planning Committee Members

Matt E. Bowyer, Chair Kathleen McPhaul Division of Safety Research American Association of Health Nurses National Institute for Occupational Safety and University of Maryland School of Nursing Health Susan Melnicove Gregory T. Barber, Sr. Director of Education Occupational Safety and Health Administration ASIS International Directorate of Enforcement Programs Corinne Peek-Asa Patricia D. Biles Associate Director Workplace Violence Program Consultant College of Public Health Bill Borwegen University of Iowa Director Robyn Robbins Occupational Health and Safety Service Employees International Union Assistant Director Occupational Safety and Health Office Ann Brockhaus United Food and Commercial Workers ORC Worldwide International Union Occupational Safety and Health Rashuan Roberts Pamela Cox National Institute for Occupational Safety and Division of Violence Prevention Health National Center for Injury Prevention and Control Gene Rugala Butch de Castro Supervisory Special Agent American Nurses Association National Center for Analysis of Violent Crime Center for Occupational Health and Safety Federal Bureau of Investigations

Stephen Doherty Robin Runge Doherty Partners LLC Director Mary Doyle American Bar Association John Hopkins School of Public Health Commission on Domestic Violence

Paula Grubb Linda M. Tapp National Institute for Occupational Safety and Administrator of Consultants Practice Specialty Health American Society of Safety Engineers

Michael Hodgson Mary Tyler Veterans Affairs/ Veterans Health Administration U.S. Office of Personnel Management

E. Lynn Jenkins Kim Wells National Institute for Occupational Safety and Executive Director Health Corporate Alliance to End Partner Violence

Workplace Violence ix

Introduction 1 These tragic examples of violence in U.S. work­ In North Carolina, two masked men places represent a small sample of the many walked into a food mart, killed the violent assaults that occur in U.S. workplaces 44-year-old male co-owner by shooting him annually.* several times with a handgun, ripped away the cash drawer, and fled from the scene. 1.1 Scope of Workplace In Massachusetts, a 27-year-old mechanic Violence (WPV) in an autobody shop was fatally shot in the chest by a customer after they argued According to the Bureau of Justice Statistics, about repairs. an estimated 1.7 million workers are injured each year during workplace assaults; in addi­ In Virginia, an ongoing argument between tion, violent workplace incidents account for two delivery truck loaders at a furniture 18% of all violent crime in the United States company distribution warehouse ended [Bureau of Justice Statistics 2001].Liberty Mu­ abruptly as one pulled a gun and shot the tual, in its annual Workplace Safety Index, cites other to death. “assaults and violent acts” as the 10th leading cause of nonfatal occupational injury in 2002, In South Carolina, a 24-year-old woman representing about 1% of all workplace inju­ who worked in a grocery store was tak­ ries and a cost of $400 million [Liberty Mutual en hostage at gunpoint and then shot to 2004]. During the 13-year period from 1992 death with multiple shotgun blasts by her to 2004, an average of 807 workplace homi­ 20-year-old ex-boyfriend. cides occurred annually in the United States,

*These fatal, gun-related cases do not represent the huge num­ ber of violent incidents that result in nonfatal injuries or no injuries, or that involve other types of weapons. Also, these cases do not adequately represent the many industry sectors and worker populations that face the risk of violent assault at work.

Workplace Violence 1 1 • Introduction 1 • Introduction

according to the Bureau of Labor Statistics through 2003. In 2004, homicides dropped be­ (BLS) Census of Fatal Occupational Injuries low struck-by-object incidents to become the (CFOI) [BLS 2005]. The number of deaths fourth leading cause of fatal workplace injury ranged from a high of 1,080 in 1994 to a low of (see Figure 1) [BLS 2005]. 551 workplace homicides in 2004, the lowest number since CFOI began in 1992. Although It is not altogether clear what factors may the number of deaths increased slightly over have influenced the overall decreasing trend the previous year in both 2000 (677) and 2003 in occupational homicides for the period 1992 (631), the overall trend shows a marked de­ through 2004, and whether the decreasing cline [BLS 2005]. From 1992 through 1998, numbers will be sustained in subsequent years. homicides comprised the second leading cause Since robbery-related violence results in a large of traumatic occupational injury death, be­ proportion of occupational homicides, certain hind motor-vehicle-related deaths. In 1999, trends (e.g., economic fluctuations) are likely the number of workplace homicides dropped to have contributed to the decreasing toll. The below the number of occupational fall-related reduction may partially stem from the efforts deaths, and remained the third leading cause of researchers and practitioners to address

1,600

1,400

1,200 1,074 1,080 1,044 1,036 1,000 927 860 800 714 651 677 Number of fatalities 600 643 609 632 551 400

200

0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 Year Highway incidents Homicides Falls Struck by object

Figure 1. The four most frequent fatal work-related events, 1992–2004. NOTE: Data from 2001 exclude fatalities resulting from the September 2001 terrorist attacks. (SOURCE: U.S. Department of Labor, Bureau of Labor Statistics, Census of Fatal Occupational injuries, 2004.)

2 Workplace Violence 1 • Introduction 1 • Introduction

robbery-related WPV especially through inter­ come into focus—largely resulting from im­ vention evaluation research and dissemination provements in occupational safety and health and implementation of evidence-based strate­ surveillance—as a leading cause of workplace gies. The reduction may be partially explained fatality and injury in many industry sectors in by the efforts of Federal,State,and local agencies the United States. and other policy-makers to develop statutes, administrative regulations, and/or technical information for WPV prevention as a result of 1.2 Background: Surveillance, improved recognition and understanding of Research, and Prevention the risks for WPV. Whatever the reasons be­ hind the trend, future research and prevention When the National Traumatic Occupational efforts should focus on identifying, verifying, Fatalities (NTOF) surveillance system was de­ and replicating successes—such as reductions veloped by the National Institute for Occupa­ in robbery-related (Type I) violence—and tional Safety and Health (NIOSH) in the 1980s, identifying and addressing those types of WPV an accurate count of workplace traumatic inju­ where little or no change has occurred. The ry deaths in the United States was available for fact that violence-related deaths increased over the first time [NIOSH 1989]. In 1988, NIOSH previous years’ totals in both 2000 and 2003 published its first article disseminating data raises questions about the sustainability of the on the magnitude of the national workplace overall downward trend and whether the oc­ homicide problem [Hales et al. 1988]. This ar­ cupational homicide experience in the United ticle presented results indicating that worker States may in fact be leveling. against worker violence, which continues to be emphasized by the media, is only a small por­ A few of the violent incidents that occur in tion of the WPV that occurs daily in the United workplaces and result in deaths or serious inju­ States. ries to workers are reported widely and promi­ nently on TV and radio broadcasts, newspaper The U.S. Department of Labor, through its Oc­ pages, and media Web sites. As indicated, WPV cupational Safety and Health Administration incidents arise out of a variety of circumstances: (OSHA) and the BLS, brought increased focus some involve criminals robbing taxicab driv­ on occupational violence through compliance, ers, convenience stores, or other retail opera­ surveillance, analysis, and information dissemi­ tions; clients or patients attacking providers in nation efforts.Although no specific Federal reg­ health care or social service offices; disgruntled ulations then (or now) addressed WPV, OSHA workers seeking revenge; or domestic abuse began to cite employers where violent incidents that spills over to the workplace (see Table 1). occurred under the General Duty Clause [29 * More recently, the threat of another form of USC 654 5(a)(1)], which requires employers to criminal violence—terrorism—hangs over the provide safe and healthful work environments nation’s workplaces.Yet many employers, man­ for workers. OSHA also provided and dissemi­ agers, and workers are not particularly aware nated, through reports and the OSHA Web site, that the potential for violence is a risk facing violence prevention guidance for high risk sec­ them in their own workplaces. The public is tors and populations such as health care, social generally not aware of either the scope or the services, late-night retail establishments, and prevalent types of violence at work. In fact, it taxi and livery drivers. The BLS has clarified the has been only within the last two decades that the problem of violent workplace behavior has *United States Code.

Workplace Violence 3 1 • Introduction 1 • Introduction

injury and fatality risks to workers from violent creating the system that remains in wide use incidents through its nonfatal and fatal injury today [IPRC 2001]. (See Table 1.) This ty­ surveillance and special analyses of characteris­ pology has proven useful not only in study­ tics of occupational violence. ing and communicating about WPV but also in developing prevention strategies. In the mid 1990s, as more researchers were Certain occupations, such as taxicab drivers becoming engaged in the study of occupa­ and convenience store clerks, face a higher risk tional violence, the California Occupational of being murdered at work [IPRC 2001], while Safety and Health Administration (Cal/OSHA) health care workers are more likely to become developed a model that described three distinct victims of nonfatal assaults [NIOSH 2002]. types of WPV based on the perpetrator’s re­ lationship to the victim(s) and/or the place of Since nearly all of the U.S. workforce (more employment [Cal/OSHA 1995, Howard 1996]. than 140 million) can potentially be exposed Later, the Cal/OSHA typology was modified to or affected by one of the four types of WPV, to break Type III into Type III and Type IV, occupational safety and health practitioners

Table 1. Typology of workplace violence

Type Description

I: Criminal intent The perpetrator has no legitimate relationship to the business or its em­ ployee, and is usually committing a crime in conjunction with the violence. These crimes can include robbery, shoplifting, trespassing, and terrorism. The vast majority of workplace homicides (85%) fall into this category. II: Customer/client The perpetrator has a legitimate relationship with the business and be­ comes violent while being served by the business. This category includes customers, clients, patients, students, inmates, and any other group for which the business provides services. It is believed that a large portion of customer/client incidents occur in the health care industry, in settings such as nursing homes or psychiatric facilities; the victims are often pa­ tient caregivers. Police officers, prison staff, flight attendants, and teachers are some other examples of workers who may be exposed to this kind of WPV, which accounts for approximately 3% of all workplace homicides. III: Worker-on-worker The perpetrator is an employee or past employee of the business who at­ tacks or threatens another employee(s) or past employee(s) in the work­ place. Worker-on-worker fatalities account for approximately 7% of all workplace homicides. IV: Personal relationship The perpetrator usually does not have a relationship with the business but has a personal relationship with the intended victim. This category in­ cludes victims of domestic violence assaulted or threatened while at work, and accounts for about 5% of all workplace homicides.

Sources: CAL/OSHA 1995; Howard 1996; IPRC 2001.

4 Workplace Violence 1 • Introduction 1 • Introduction

and advocates should be concerned. Exam­ particularly since most violent or threatening be­ ples of high-risk industries include the retail havior—including verbal violence (e.g., threats, trade industry, whose workers are most often verbal abuse, hostility, harassment) and other affected by Type I (criminal intent violence), forms, such as stalking—may not be reported and the health care industry, whose workers until it reaches the point of actual physical as­ may generally be affected most by Type II (cli­ sault or other disruptive workplace behavior. ent, customer, or patient violence). Although all four types of WPV can potentially occur Most of the research that was conducted over the in any workplace, Type III (worker-on-work­ last half of the decade of the 90s was published in er violence) and Type IV (personal relation­ scientific and professional journal articles. Fig­ ship violence, also known as intimate partner ure 2 shows the dramatic increase in the num­ violence), are more likely to occur across all in­ ber of research articles published in the medical dustry sectors. literature that dealt with WPV from the 1980s, WPV includes a much wider range of behav­ when the occupational fatality surveillance data iors than just overt physical assaults that result first showed that occupational homicide was in injury or death. Thus, WPV has been defined the second leading cause of traumatic occupa­ as “violent acts, including physical assaults and tional death, through 2004 [National Library of threats of assault, directed toward persons at Medicine 2005].Similar results were obtained in work or on duty” [NIOSH 1996]. It is widely searches of the occupational safety and health, agreed that violence at work is underreported, business, and social science literature.

250

193 200

ns 150 tio 150

ofcita

100 mber Nu 41 50 13 0 3 3 0 1970–1974 1975–1979 1980–1984 1985–1989 1990–1994 1995–1999 2000–2004 5-year period

Figure 2. Medline entries for WPV for 5-year periods from 1970 to 2004.

Workplace Violence 5 1 • Introduction 1 • Introduction

In April 2000, the University of Iowa Injury discuss WPV in terms of current progress, re­ Prevention Research Center sponsored a meet­ search gaps, and potential collaborative efforts. ing entitled Workplace Violence Intervention Stakeholders with interest in the following topic Research Workshop in Washington, D.C. The areas met during the timeframes noted: workshop brought together invited partici­ pants to discuss WPV and recommend strate­ ■ May 2003—Violence in Health Care gies for addressing this national problem. The Settings workshop recommendations were published ■ June 2003—Domestic Violence in the as Workplace Violence: Report to the Nation in Workplace February 2001 [IPRC 2001]. This report iden­ tified key research issues and called for funding ■ August 2003—Violence in Retail Settings to address these research needs. ■ November 2003—Violence Against Law In December 2000, Congress appropriated $2 Enforcement and Security Professionals million to NIOSH to develop a WPV Research One of the recurring themes that emerged and Prevention Initiative consisting of intra­ from the stakeholder discussions was the need mural and extramural research programs tar­ for a national conference on WPV prevention. geting all aspects of WPV. Most of the money In January 2004, NIOSH assembled a diverse was used to fund new research grants under­ planning committee to begin developing this taken by extramural researchers. Intramural forum. On November 15–17, 2004, NIOSH research efforts focused on collaborating with held, for the first time, a national conference on other agencies to collect improved data on WPV prevention, entitled Partnering in Work­ WPV from workers and employers, convening place Violence Prevention: Translating Research a Federal interagency task force to coordinate to Practice [NIOSH 2004]. Federal research activities, and collaborat­ ing with other groups to raise awareness of This document is the final product resulting WPV and disseminate information developed from the November 2004 conference. It sum­ through the Initiative. marizes what conference participants think are key strategies required for successful WPV In June 2002, the Federal Bureau of Investi­ prevention, further research and communica­ gation’s National Center for the Analysis of tion needs, barriers and gaps that impede pre­ Violent Crime hosted a symposium on WPV vention, and strategies for addressing them. bringing together a multidisciplinary group The document also summarizes participants’ to look at the latest thinking in prevention, thoughts about potential partners among intervention, threat assessment and manage­ Federal, State, and private agencies with the ment, crisis management, and critical incident response. The results were published in March resources and skills necessary to collaborate 2004 in Workplace Violence: Issues in Response in prevention efforts, conduct further re­ [Rugala and Isaacs 2004]. search, and facilitate appropriate regulations. It is hoped that this report will serve several As part of the WPV Research and Prevention important purposes—to raise awareness of Initiative, NIOSH convened a series of stake­ employers, workers, policy makers, and the holder meetings on WPV during 2003. The public in general to the fact that WPV con­ purpose of these meetings was to allow subject tinues to be a major public health issue; to matter experts from business, academia, gov­ assist business and labor leaders in adopting ernment, and labor organizations to collectively effective prevention programs and strategies;

6 Workplace Violence 1 • Introduction 1 • Introduction

to aid researchers in identifying future projects; ■ An evening group event featuring a series and to prompt government officials to consider of one-act plays reflecting the human im­ more comprehensive national programs. pact of violence in the workplace and cul­ tural issues concerning violence

1.3 Methods and Objectives ■ Breakout sessions that addressed the During the conference, NIOSH assembled a four discussion points among each of diverse group of experts representing the four the four WPV types WPV typologies and the various disciplines en­ gaged in WPV research and prevention efforts ■ Introductory and summary presenta­ (see Appendix for a full list of participants).The tions of the discussions of each break­ conference was structured to give participants out session, by session moderators in an opportunity to discuss successful WPV pre­ plenary sessions vention strategies, barriers and challenges to WPV prevention, major research and informa­ ■ A closing summary session tion dissemination gaps, and potential roles for various organizations in WPV prevention over This report should provide a useful frame­ the next decade. In order to address the objec­ work for thinking about the current state of tives in an effective manner, discussion points WPV research, prevention, and communica­ were posed to participants in breakout sessions tion activities in the United States. Chapter 2 that were divided into four WPV typologies: presents a discussion of barriers and gaps that Criminal Intent (Type I), Customer/Client impede the development and implementa­ (Type II), Worker-on-Worker (Type III), and tion of WPV prevention programs. Chapter 3 Personal Relationship (Type IV). summarizes the best WPV strategy/program practices presented by conference participants. The objectives of the conference are reflected in the following instructions given to discus­ This summary represents an implicit template sion participants: for addressing WPV prevention on a compa­ ny, corporate, agency, and national level and ■ Identify successful WPV prevention includes strategies both general and specific strategies. to the four types of WPV. Chapter 4 presents a discussion of general research needs; Chap­ ■ Identify barriers and challenges to and strategies for implementing WPV pre­ ter 5 addresses the importance of linking re­ vention. search findings to practical prevention efforts. One of two important themes of the confer­ ■ Identify major research and infor­ ence—partnership—is the focus of discussion mation dissemination gaps in WPV in Chapter 6. Included are some ideas about prevention efforts. partners who should be involved in national, ■ Identify existing and potential part­ community, and company collaborations, and ners and their roles in advancing WPV what they could be doing to address WPV. prevention. Chapter 7 provides some concluding thoughts and a call to action for potential collaborators The conference included the following: in a national WPV prevention effort. The Ap­ ■ State-of-the-art presentations from a pendix provides a full list of conference par­ panel of experts in each WPV type ticipants.

Workplace Violence 7 2 • Barriers and Gaps that Impede WPV Prevention, and Strategies to Overcome Them

Barriers and Gaps that Impede WPV Prevention and Strategies to Overcome Them 2 Conference participants identified and dis­ usually depend on the particular organization in cussed numerous barriers and gaps facing question, and sometimes the type of WPV. These those working to implement existing strategies issues are also discussed in Chapter 3. and programs addressing WPV prevention or those seeking to study and fill knowledge gaps Barriers impeding research efforts include lack related to WPV risks and prevention. In many of access to company and workplace informa­ cases, strategies for addressing and overcoming tion, and inadequate data to define the scope these barriers and gaps were proposed and dis­ of WPV. Knowledge of intervention effective­ cussed. Employers, managers and supervisors, ness is sparse, and information about the costs safety practitioners, workers, members of the of both WPV incidents and prevention efforts public safety and legal professions, research­ versus benefits of specific prevention strategies ers, designers and manufacturers of protec­ and programs is lacking. Too little is known tive technologies and products, educators and regarding specific characteristics of perpetra­ communicators, and others—all face difficul­ tors, victims, companies, and circumstances ties in the process of identifying, document­ surrounding violent events. These issues are ing, assessing, preventing, and communicating discussed in Chapter 4. about violent workplace events. This report essentially addresses two key au­ 2.1 Barriers to WPV diences—those who are responsible for Prevention Practice implementing WPV prevention programs in communities, companies, or workplaces (policy 2.1.1 Corporate Attitude, Denial makers, employers, managers, safety and health practitioners, members of teams who come from For some companies, a prevailing corporate at­ multiple disciplines and perspectives, workers, titude or denial of the potential for WPV, may etc.) and those who face challenges related to be strong enough that employers and manag­ exploring and filling the gaps in our knowledge ers remain unconvinced that they need to ad­ of WPV and WPV prevention (researchers). dress it. In some, violence is not recognized The most important barriers and gaps that im­ as a high priority among competing threats pede the implementation of effective WPV pre­ until a tragic, violent event occurs. In many or­ vention programs, strategies, and interventions ganizations, the value of WPV prevention in

8 Workplace Violence 2 • Barriers and Gaps that Impede WPV Prevention, and Strategies to Overcome Them

reducing liability and turnover and increasing 2.1.4 Lack of Incentives, productivity is not well understood. Employ­ Disincentives ers may also hesitate to explore WPV risks and issues because they are wary about nega­ Conference participants believe that there are tive company image, legal liability, assuming too few incentives for companies to imple­ responsibility for workers’ private lives, and ment WPV prevention programs. Few regu­ worker enlightenment and empowerment. One latory requirements address violence, many line of thinking is that workers who become guidelines addressing violence are outdated, aware of these issues will certainly file complaints and the many legal issues prompted by Fed­ and claims. All of these factors are barriers to eral, State and local statutes, ordinances, and developing policies, providing training, recog­ regulations present challenges to WPV pre­ nizing and reporting violence, and developing vention and can seem an impenetrable thicket. and implementing WPV prevention programs. Current laws are often ineffective, unenforced, Workers readily perceive the lack of manage­ and inconsistent from State to State. Employ­ ment acknowledgment of WPV and support for ers who might consider WPV prevention pro­ WPV prevention. On the other hand, corporate grams may feel at a competitive disadvantage leaders who set out to raise awareness of WPV if no mandatory, enforced regulations exist and improve workplace communication, dem­ that cover the entire industry sector. If more onstrate their acknowledgement of WPV and compelling data on costs of violence and provide a foundation for improved reporting costs/benefits of prevention programs and and risk assessment and program development strategies were available, companies would and implementation. likely have more incentive to invest resources in WPV prevention programs. In addition, 2.1.2 The Culture of Violence; the positive effects of knowledgeable workers De-humanization of empowered to provide input and participate Workplaces in planning and decision making, which can include improved safety and health, morale, A profound barrier to WPV prevention is re­ efficiency, and productivity, provide an im­ lated to the culture of violence that permeates portant incentive to management. U.S. society, including workplaces. 2.1.5 Lack of Awareness 2.1.3 Lack of Worker Empowerment For some, the most substantial barrier is Violent events (especially Type 1 violence) simply a lack of awareness of the scope and are prevalent in small businesses where importance of the problem on the part of workers may lack a voice. Workers without a employers and workers alike. This lack of voice—that is, without a personal opportuni­ awareness extends beyond company walls to ty to provide their concerns or participate in all levels of the public and private sector and leadership decisions—or without an advocate the general public. to speak for them,have great difficulty influenc­ ing the adoption or even the consideration of 2.1.6 Lack of Information, Access to prevention programs. In many businesses, large Available Information and small, disconnects exist between manage­ ment and workers that impede communica­ For other knowledgeable employers, a lack of tion of concerns and collaboration. access to risk information or evidence-based

Workplace Violence 9 2 • Barriers and Gaps that Impede WPV Prevention, and Strategies to Overcome Them 2 • Barriers and Gaps that Impede WPV Prevention, and Strategies to Overcome Them

prevention programs or strategies may form who are involved in and affected by them, and a difficult barrier to action. Those programs potential preventive approaches and their ef­ and interventions that have been evaluated fectiveness. OSHA has guidelines for late night and shown effective in specific settings—for retail [OSHA 2004], but companies not under instance the interventions addressing violence OSHA jurisdiction may not be aware of this resulting from convenience store robber­ information. Potential sources of information ies—have not been adopted in all workplac­ useful to businesses include police department es where similar risks and circumstances are crime prevention units, Web-based violence present. Further, they have not been evaluated prevention and security sites, and insurance for other workplaces and industry sectors fac­ companies. ing similar risks. Many other programs and interventions that have been adopted or sug­ gested for different types of WPV and differ­ 2.1.7 Lack of Communication/ ent workplace settings and circumstances have Training not been rigorously evaluated, if evaluated at A major barrier to awareness and prevention all. If evidence-based prevention programs of WPV is an overall lack of adequate and ef­ and strategies are available, the information fective communication and training about mostly resides in academia or government what constitutes violence (definition); when agencies. Researchers in academia and gov­ violence has occurred (incident reporting); ernment are often satisfied with publication of what the company does about violence (policy, their findings in the peer-reviewed literature, procedures, disposition); and what peers and or lack the knowledge and means to further partners have learned and are doing (research, disseminate or translate their results for use in prevention, collaboration). In the pursuit of in­ at-risk companies. As a result, employers may dividual responsibilities and tasks, the impor­ not be fully cognizant of the risks they and tance of communication may be overlooked their workers face. Or, an employer or practi­ entirely or given a low priority among compet­ tioner who is aware of the risks and who has ing demands. the desire to establish and implement a pre­ vention program may not be able to find or access evidence-based programs and interven­ 2.1.8 Lack of Resources tions to use or choose from. Many of the companies facing high risks of Among companies with WPV programs, some WPV are small companies with limited re­ are reluctant to share WPV information (e.g., sources for research, prevention, and evalua­ statistics, program information, effectiveness tion. In an increasingly pressurized economy data), even among other departments in the and in the absence of sufficient cost-benefit same company. Privacy issues and proprie­ data, prevention may be seen as an unwar­ tary and competitive attitudes may influence ranted expenditure rather than an invest­ companies and agencies to guard their data, ment with a return. Employers may address thus hindering data sharing. Compounding competing demands first unless a tragic vio­ the effect of this barrier, researchers may fall lent event has already occurred to gain their short of the efforts needed to engage and part­ attention and prompt action. Small com­ ner with employers. This in turn limits the panies often have neither the resources nor ability of researchers to determine character­ the staffs to address problems from a multi­ istics of violent events, characteristics of those disciplinary perspective.

10 Workplace Violence 2 • Barriers and Gaps that Impede WPV Prevention, and Strategies to Overcome Them 2 • Barriers and Gaps that Impede WPV Prevention, and Strategies to Overcome Them

2.1.9 Lack of Reporting 2.1.11 Lack of Written WPV Policy, Definitions, and Consequences Violent events, wherever they occur, may not (See Chapter 3.) be reported for various reasons. When WPV occurs in companies that lack an enlight­ A company or corporation without a written ened, prevention-oriented culture, victim­ WPV prevention program or policy may fail ized workers may be inhibited from reporting to provide critical information necessary to single incidents or patterns of abusive behav­ protect workers. Prevention efforts may not ior that would be reported and addressed in succeed without written documentation that other companies. In such companies, victims includes company policy on WPV, definitions or witnesses of violence may feel that noth­ that clearly indicate what specific behaviors ing will be done if they do report. Otherwise constitute WPV and are therefore prohibited well meaning employers or managers in com­ actions, the specific consequences of those ac­ panies that do not communicate to workers tions, who is accountable for the program and the behaviors that are considered to be vio­ specific elements, and the roles and responsi­ lent, the mechanisms for reporting them, and bilities of all workers. assurances of security, confidentiality, and prompt response, may be unwittingly foster­ ing a violent work environment that could 2.1.12 Lack of Teamwork, ultimately experience a tragic, violent event. Partnerships Too often, in the aftermath of such a tragedy, Interdisciplinary and interdepartmental work is people remember precursor events or behav­ very difficult to initiate and maintain, even with­ iors that should have prompted reporting, in the walls of one company. Effective programs response, and intervention at the time they require the combined efforts of employers, work­ occurred. Sadly, failures to report verbal or ers, law enforcement, and, for larger companies, physical abuse represent lost opportunities the multiple departments with a stake in violence for prevention. Lack of reporting is also a fun­ prevention and worker safety and health. damental barrier to effective surveillance, a critical component of WPV prevention at all levels, from company-level to national-level 2.2 Gaps in WPV Prevention prevention. Research

2.1.10 Lack of Effective Followup 2.2.1 Lack of WPV Intervention to Reported WPV Events Evaluation Research Victims and recipients of threats or harass­ The ideal situation is for employers and ment expect a firm response. When manage­ practitioners planning and implementing ment fails to respond promptly and firmly to WPV prevention programs to have credible, reported WPV incidents, or does not follow evidence-based interventions, strategies, cur­ through according to company policies and pro- ricula, and programs available. A primary re­ cedures,workers will perceive the lack of manage­ search need in WPV prevention is to obtain ment commitment.Workers will then be hesitant evaluation data on strategies and interventions to report future violent events and behaviors. for a variety of workplace applications.

Workplace Violence 11 2 • Barriers and Gaps that Impede WPV Prevention, and Strategies to Overcome Them 2 • Barriers and Gaps that Impede WPV Prevention, and Strategies to Overcome Them

2.2.2 Lack of Best Practices for ■ Addition of key pieces of data to exist­ Implementation ing data sets

The need for practical and proven guidance for ■ Researcher access to data from compa­ program implementation goes hand-in-hand nies and insurers, as well as workplaces with the need for evidence-based prevention programs and strategies. Critical informa­ 2.2.4 Lack of Information about the tion about best practices for WPV programs is Costs of WPV; the Cost- needed by employers and practitioners. Effectiveness of Prevention The economics of WPV represents a substan­ 2.2.3 Lack of (or Inadequacy of) tial gap in knowledge. Understandably, em­ Data ployers desire and respond to solid, empirical Currently available data—based largely on po­ cost data on actual and potential losses from lice responses, emergency room admissions, WPV and benefits of prevention programs and workers’ compensation claims, insurance interventions. They are interested in under­ payments to victims, and death certificates— standing costs relative to benefits and return do not reflect the scope of WPV, especially on investment when it comes to development considering the incidence of noninjury and and implementation of programs. Employers nonphysical events (e.g., threats, bullying, may not expect each and every intervention harassment, stalking). Reluctance on the part to pay for itself, but they do seek a general of corporations and companies to release idea of what to expect as a result of investing data and to admit researchers into their en­ in prevention. A difficult concept to calculate vironments for the purpose of collecting in­ and convey is the cost of a non-event—that is, cidence data or evaluating interventions and one that is prevented through programmatic programs impedes description of the WPV investment. Other important cost consider­ experience, as well as further investigations of ations include the loss of experienced work­ causation and prevention. In addition, the vic­ ers and the resultant new personnel hiring tims and witnesses of WPV may be reluctant and training costs. to report incidents for a variety of reasons. (See Section 2.1.9.) Aside from cultural and 2.2.5 Research and Communication behavioral impediments to the acquisition of Needs Specific to ypeT I better data, technical issues exist that must be (Criminal Intent) Prevention overcome. For example, a commonly accept­ ed, operational definition of what constitutes Research is needed to provide evidence about WPV, while not perfectly fitting every scenario effectiveness of specific environmental, be­ imaginable, will be necessary to the uniform havioral, and administrative interventions in collection of data. Standardized data collec­ non-convenience-store settings. Also uncer­ tion using common definitions is essential tainties about effectiveness of other suggested to draw reasonable conclusions on effective interventions require additional research to prevention. Standardization may require the enable the attainment of consensus in contro­ following: versial topics such as effectiveness of on-site guards, bullet-resistant barriers, certain train­ ■ Better categorization of data ing elements, and multiple clerks.

12 Workplace Violence 2 • Barriers and Gaps that Impede WPV Prevention, and Strategies to Overcome Them 2 • Barriers and Gaps that Impede WPV Prevention, and Strategies to Overcome Them

2.2.6 Research and Communication 2.2.9 Other General Research Needs Needs Specific to Type II Conference participants also offered a substan­ (Client on Worker Violence) tial list of research gaps, most of which were Prevention not discussed in detail. Currently, not enough is known about what According to Conference participants, research produces violence in social service, health care, is needed to better understand the following: and other settings for worker-client interac­ tion. What is known has not always been wide­ ■ Variations in what is being done in indi­ ly reported in the scientific literature or by the vidual businesses, industry sectors, law national media. Risk estimates are not available enforcement, and State and local gov­ that clarify the influence of various situational ernments and environmental factors. ■ What motivates businesses to take ac­ tion in addressing WPV 2.2.7 Research and Communication Needs Specific to ypeT III ■ What types of regulation are effective

(Worker on Worker) Prevention ■ Work organization and how it affects Type III WPV is somewhat unique among the WPV prevention program implementa­ tion and impact types in that most of the losses incurred as a result of a violent incident (e.g., losses related ■ Characteristics of both perpetrators and to the victim, the perpetrator, the damages, the victims of each type of WPV productivity, etc.) are usually borne solely by one employer. More solid information about ■ Successful management systems for the direct relationship between the availability tracking WPV and followup activities of reliable data and the opportunity for preven­ ■ What makes training effective—that is, tion, and the resultant potential for controlling what content, teaching methods, inter­ costs through intervention, may be effective vals, etc. in persuading employers to share information and provide access needed by researchers. ■ How to disseminate information about effective violence prevention strategies and programs more widely and/or more 2.2.8 Research and Communication appropriately Needs Specific to ypeT IV (Interpersonal Violence) ■ How to effectively communicate Prevention — What WPV is More rigorous, science-based efforts are need­ — Protection and prevention as posi­ ed in characterizing risk factors, costs, and tive issues effectiveness of WPV prevention programs and — The importance of scientific re­ strategies addressing Type IV violence. search in addressing WPV

Workplace Violence 13 3 • WPV Prevention Programs and Strategies

WPV Prevention Programs and Strategies 3

This chapter is tailored for use by employers, accepted throughout the organization and sus­ managers, and safety and health practitioners tained. Worker participation in planning, de­ who desire to develop and implement or evalu­ velopment, and implementation of programs ate company WPV prevention programs. Con­ and strategies is also important. The concept ference participants were asked to identify and of dynamic commitment (i.e., involving both discuss WPV prevention strategies, which may management and workers) in WPV prevention range from comprehensive, overarching compa­ was discussed as a fundamental necessity un­ ny policies and programs to individual interven­ derlying the allocation of adequate prevention tion strategies that seek to modify environment program resources and the development of a or behavior. Prevention programs and strategies violence prevention culture within an organi­ that might offer increased protection against zation. WPV in general are discussed first, followed by program and strategy elements that are unique to specific WPV typologies. 3.1.2 Multidisciplinary Team Approach to WPV Prevention Another common theme voiced often dur­ 3.1 Strategies or Approaches ing the conference was the need for collabo­ That May Apply to More ration of people from different disciplines, Than One Type of WPV company units or departments, and levels of the organization. The involvement of persons 3.1.1 Management and Worker with diverse expertise and experience is espe­ Commitment cially critical due to the depth and complexity of WPV prevention. Such teamwork is crucial The importance of management commitment for planning, developing, and implementing to WPV prevention policies and programs programs, as well as serving discrete functions, cannot be overemphasized. Top management such as threat assessment teams formed to re­ support helps ensure that adequate resources view and respond to reported physical, verbal, (including staffing) will be applied to the pro­ or threatened violence. Some of the key levels, gram, that the program will be launched from disciplines, and departments mentioned in­ the top down, and that the effort will likely be cluded management, union, human resources,

14 Workplace Violence 3 • WPV Prevention Programs and Strategies

safety and health, security, medical/psychology, program. These elements will also provide a legal, communications, and worker assistance. basis for program evaluation. Programs that discourage reporting or blame the victim The pre-arranged use of outside expertise and will not likely be successful. At a minimum, collaboration with local law enforcement and the WPV policy/program should be reviewed local service providers was also offered as a way annually but optimally can be easily tweaked for companies to ensure effective programs, as necessary. Good communication, confi­ particularly in smaller companies with fewer dentiality, teamwork, and accountability are workers, departments, and resources. Proac­ musts. Communication must flow vertically tive planning/collaboration with local law en­ (management to staff and vice-versa) and forcement may be helpful should an incident horizontally (i.e., across organizational divi­ requiring police response occur. sions or departments). Communication can take many forms, and organizations should think outside the box when communicating 3.1.3 Written WPV Policy/Program information about WPV policies/programs. Tailored to Organization’s Needs For example, information about company A documented company policy/program must policy/programs can be communicated as include definitions that clearly indicate what inserts with pay stubs or on stickers for tele­ behaviors constitute WPV, including threat­ phones. A WPV prevention program should ening or abusive physical and verbal behavior. be well integrated with other company pro­ Prohibited actions must be specified, and the grams. specific consequences of those actions spelled out. A review and response system for all re­ 3.1.4 Training ported violent incidents must be in place, along with guidelines to assist those with the Training for both managers and workers is responsibility to review and respond. Specific a key element in any WPV prevention pro­ procedures are needed for reviewing each re­ gram. The presence of management at train­ ported incident, and mechanisms are needed ing sessions can increase the visibility of the to support and protect all affected persons. organization’s top-level commitment to pre­ Ineffective followup undermines worker per­ vention. Training content may differ by type ception of management commitment and ne­ of WPV (see Sections 3.2 through 3.5), but gates incentives to report incidents. Victims in general, training (initially and on a recur­ and recipients of threats or harassment expect ring basis) should be provided on the haz­ a firm response. Review and response to re­ ards found in the organization’s workplaces ported violence might best be accomplished and in the organization’s prevention policies via a team approach (e.g., a threat assessment and procedures, with emphasis on report­ team). ing requirements and the companies’ review, response, and evaluation procedures. Train­ Clear, precise definitions; mandatory com­ ing can be implemented from the top down, prehensive (all incidents) reporting; a struc­ with managers and supervisors trained first. ture and process in place for reporting; and A train-the-trainer approach can be used, timely and reliable review and response will with supervisors responsible for training and all contribute to accurate reporting, which evaluating training for their own staffs. Spe­ in turn enables precise risk assessment and cialized training on creating a positive work dedication of appropriate resources to the environment and developing effective teams

Workplace Violence 15 3 • WPV Prevention Programs and Strategies 3 • WPV Prevention Programs and Strategies could be useful, as well as training to improve 3.2 Strategies Specific to awareness of cultural differences (diversity) and to enable the development of workers’ Type I (Criminal Intent) cultural competence. Prevention The potential for Type I WPV exists across all 3.1.5 Culture Change industries but is prevalent in certain industries characterized by interaction with the public, Employers should examine the workplace to the handling of cash, etc. Certain industries in determine if there are cultural barriers to WPV the retail trade sector (convenience and liquor awareness and prevention. If needed, the work­ stores, for example) face higher than average place culture should be modified to foster in­ creased awareness of WPV and prevention, the risks. Specific environmental, behavioral, and clarification and enumeration of acceptable and administrative strategies have been imple­ unacceptable behavior,WPV reporting, availabil­ mented and evaluated as a result, particularly ity of support for victims, and availability of help in convenience stores. A core group of inter­ for perpetrators (if employed by the company, as ventions has been determined to be effective in in Type III and sometimes Type IV WPV). convenience stores [Hendricks et al. 1999, Loo­ mis et al. 2002], including the following:

3.1.6 Evaluation 1. Environmental interventions Prevention programs and strategies should be — Cash control evidence-based to the extent that evidence is available. However, often action must be taken — Lighting control (indoor and outdoor) before data can be collected and evidence of ef­ — Entry and exit control fectiveness obtained. It is crucial that companies — Surveillance (e.g., mirrors and make the effort to evaluate programs and strate­ cameras, particularly closed-circuit gies and cooperate with researchers in interven­ cameras) tion effectiveness evaluation research. Employers may waste valuable resources on hazard control — Signage and training if evaluation procedures are not integrated into programs to measure impact. 2. Behavioral interventions Information about successful programs and — Training on appropriate robbery strategies must be effectively shared and commu­ response nicated within companies and industry sectors — Training on use of safety equipment and, where applicable, across sectors. While it is true that rigorous evaluation is challenging and — Training on dealing with aggressive, often involves substantial cost, employers and re­ drunk, or otherwise problem persons searchers may, through collaboration, find ways to leverage their combined resources to selective­ 3. Administrative interventions ly assess strategy and program effectiveness. In — Hours of operation addition, such partnerships may provide a vehicle for sharing evaluation methods and — Precautions during opening and results across many companies in an industry closing sector. — Good relationship with police

16 Workplace Violence 3 • WPV Prevention Programs and Strategies 3 • WPV Prevention Programs and Strategies

— Implementing safety and security could include recognition of behavioral cues policies for all workers preceding violence, violence de-escalation techniques and other related interpersonal Some interventions for convenience stores and communication skills, new requirements and other workplaces are controversial or not (in health care) for patient seclusion and re­ universally agreed upon by researchers. These straint, and proper restraint and take-down instructions will require additional study, in­ techniques. cluding the following:

■ Having multiple clerks on duty 3.3.3 Accreditation Criteria Tied to WPV Prevention ■ Using taxicab partitions Another strategy would have accreditation ■ Having security guards present bodies specify WPV program and training re­ ■ Providing bullet-resistant barriers quirements as criteria for successfully meeting accreditation standards for social service and health care organizations and facilities. Spe­ 3.3 Strategies Specific to cific programming and training in response to the demands of meeting such criteria should Type II (Customer/Client improve workplace protection from client/pa­ Violence) Prevention tient-based violence.

3.3.1 Adequate Staffing, Skill Mix One strategy that emerged from discussions of 3.4 Strategies Specific to the Type II panel is that of ensuring adequate Type III Violence (Worker­ staffing and mix of skills to effectively serve cli­ on-Worker) Prevention ent, customer, or patient needs. Low respon­ siveness and quality of service, which can result 3.4.1 Evaluating Prospective from inadequate staffing and skills of personnel, Workers can produce frustration and agitation in clients or patients. For clients and patients, acute needs Preventing worker-on-worker violence begins and accompanying real or perceived urgency during the hiring process by employers who combined with a history of violence, can place ensure that job applicants are properly and both staff and other clients/patients at risk. In thoroughly evaluated by means of background addition, social services or health care workers checks and reference verification. who work alone may be vulnerable to assault, especially in worker-client relationships where 3.4.2 Training in Policies/Reporting the client has a criminal background or is men­ tally ill or emotionally disturbed. A key in worker-on-worker violence preven­ tion is the comprehensive reporting of all pro­ 3.3.2 Training hibited behaviors among workers, including threatening, harassing, bullying, stalking, etc. In addition to general training on WPV haz­ Therefore, training during new worker orienta­ ards and organizational policies and proce­ tion and subsequent refresher training should dures, training specific to Type II violence focus on company WPV definitions, policies,

Workplace Violence 17 3 • WPV Prevention Programs and Strategies

and procedures. Also, reporting should be with clear-cut information about the nature strongly encouraged and supported. of personal relationship or intimate partner violence (IPV), its observable traits and cues, and methods for discerning it in coworkers. 3.4.3 Focus on Observable Employers must train workers in what to do if Behaviors they should suspect that a coworker is involved The perpetrators are present or former work­ in interpersonal violence, either as a victim or ers who usually have substantial knowledge perpetrator. Training should emphasize the of coworkers, physical surroundings, and of­ relevant company policies and procedures. ten security and violence prevention mea­ sures. Observation and reporting of changes 3.5.2 A Culture of Support in behavior that become a concern are critical. Therefore, a successful prevention strategy will A company should strive to create a culture of provide procedures for reporting and addressing support for victims that includes assurances no observable behaviors that elevate to concerns. A penalties exist for coming forward, complete strong company focus and emphasis on the ob­ confidentiality will be observed, safety and se­ servation and reporting of behaviors that gener­ curity protocols will be implemented, and re­ ate concern, coupled with timely and consistent ferrals to appropriate community services will response (see Section 3.1.3), may help create a be provided as options to workers. A company climate that deters violent behavior. should also inform all workers about the con­ sequences of being a perpetrator of IPV or any other form of WPV. The company should com­ 3.5 Strategies Specific to Type municate clearly through policies and training IV (Personal Relationship that IPV behavior is inappropriate and will be Violence) Prevention dealt with. Furthermore, the company should attempt to create a culture that both supports 3.5.1 Training in Policies and victims and enables perpetrators to seek help. Reporting Providing referrals to appropriate community services and implementing long-term pro­ To prevent Type IV violence, company poli­ grams that address battering and bullying be­ cies and procedures must provide workers havior are reasonable approaches.

18 Workplace Violence 3 • WPV Prevention Programs and Strategies

Research Needs for WPV Prevention 4

This chapter presents WPV research needs, as is the evaluation of prevention strate­ identified by conference participants. It is tai­ gies and programs. The need is broad, lored for use by researchers and research agen­ spanning the wide range of prevention cies and institutes engaged in, or interested in options, the types of violence, and the the study of WPV risk and prevention. Con­ variety of industry sectors and indi­ ference participants were asked to identify and vidual workplaces. Evaluation research discuss research and information dissemina­ is also expensive and time consuming. tion gaps and offer strategies for filling those Therefore, a strategic approach is need­ gaps. The overarching research needs identi­ ed in which priorities are carefully con­ fied by participants are presented below. It is sidered, costs are shared and resources hoped that this chapter can be used to inform leveraged, and results are widely dis­ the development of WPV research strategies seminated especially to at-risk employ­ and agendas. Further, it should be useful as ers and workers and the associations a basis for formulating new research projects and unions that represent them. and for forging partnerships. ■ Develop consistent WPV definitions. ■ Establish national strategy/agenda. Employers, workers, and everyone else Under the leadership of NIOSH, re­ with a stake in occupational violence searchers from government, academic must have a clear, shared conception of and private research institutes, busi­ what constitutes WPV. In addition to nesses and associations, worker ad­ a shared conceptual definition, a con­ vocacy groups and unions, and other sistent operational definition is needed organizations, should collaborate with for comparability in reporting and data business leaders, safety and health collection. practitioners and advocates, and other interested stakeholders to establish a ■ Ensure consistent and universal re­ national research agenda for WPV. porting. Reporting is an issue at the company level, at the industry level, ■ Conduct evaluation research. A critical en­ and at the national level. Accurate and deavor for research-business collaboration consistent reporting will enable both

Workplace Violence 19 4 • Research Needs for WPV Prevention

t argeting of prevention research and ■ Conduct economics research. Deci­ assessment of trends and effectiveness. sion makers in the private sector are accustomed to analyzing costs, ben- ■ Share data among partners. Both busi­ efits, return on investments—in short, nesses and agencies possess data on examining the bottom line issues that reported WPV incidents, which if col- impact their businesses. Realistic as­ lected, combined, and analyzed, would sessments of the costs of WPV to busi­ shed light on the broader WPV expe­ nesses and society in general, and the rience in the United States, and could cost-benefit of prevention, including potentially enable more focused and cost-effectiveness comparisons of ef­ thereby cost-efficient prevention ef­ fective, focused prevention options are forts in companies or sectors. needed.

20 Workplace Violence 4 • Research Needs for WPV Prevention

Linking Research to Practice 5

Research that has been conducted to date measures throughout workplaces, com­ must be translated into practical preventive panies, and industries at risk. workplace action. It is clear that Conference participants see a gap in the availability of ■ Identify and use existing data, find­ evidence-based prevention options for indus­ ings, and knowledge that have yet to be try—that is, between what is known and what translated and transferred to practical is applied in the workplace. As additional eval­ prevention technologies, products, in­ uation studies and demonstration projects terventions, strategies, programs, cur­ are concluded, research findings of effective ricula, and recommendations. preventive interventions must be proactively ■ Collaborate and cooperate fully with translated into prevention products and tech­ potential partners to plan new research nologies and transferred to and implemented with implications for practical preven­ in workplaces. The translation, transfer, and tion. wider implementation of prevention strate­ gies and programs may be as or more time ■ To help ensure such research, engage consuming, costly, and challenging as their partners (particularly business and in­ initial development and validation. However, dustry partners) earlier in the process the substantial input provided by participants of identifying problem areas and con­ in the conference suggests that an excellent ceptualizing research projects and ap­ opportunity exists for a broad, collaborative proaches. effort to do the following: Conference participants identified the follow­ ■ Take stock of the knowledge base for ing overarching needs in linking research to WPV prevention. practice:

■ ■ Explore the gaps in that knowledge. Establish and maintain a clearinghouse of WPV-related information, particularly ■ Prioritize needed research and infor­ evidence-based programs and strategies. mation efforts. As in many domains, the volume of ■ Identify opportunities for wider imple­ information related to WPV risks and mentation of known effective prevention prevention is growing. A daunting

Workplace Violence 21 5 • Linking Research to Practice

challenge looms in the organization, and workers, policy makers, media, and validation (assessment of reliability), the general public. Federal government tailoring, and distribution of informa­ partners should help communicate ex­ tion about WPV risks, prevention strat­ isting knowledge, including what con­ egies and options, research findings, stitutes WPV, the types of WPV, the cost data, and other pertinent knowl­ sectors and occupations at risk, and the edge components. A key design objec­ critical roles of research, evaluation, and tive should be easy access for employers company policies and programs in the and all other partners. prevention effort. Information about availability of support services for or­ ■ Sponsor national, public information/ ganizations and individuals should be education campaigns to raise awareness included. Such information might be of WPV, emphasize the importance of particularly useful to companies seek­ prevention programs, and provide con­ ing to develop and implement WPV tact information for support services. programs, and individuals seeking help Wider awareness of the prevalence of who may be either victims or perpetra­ WPV is needed among at-risk employers tors of WPV.

22 Workplace Violence 5 • Linking Research to Practice

Partners and Their Roles 6

Participants in conference discussions repeat­ center, as a voice for objectivity in research and edly emphasized the importance of collaborat­ dissemination, as a strong advocate for iden­ ing and partnering in WPV prevention—from tifying and improving effective research and the interdisciplinary and interdepartmental prevention approaches, and as an organization collaboration (so crucial to developing and im­ that leverages resources, engages stakeholders, plementing prevention programs) to national and prepares and disseminates information for interorganizational partnerships (essential for the business community. advancing WPV research, implementing find­ ings, and evaluating efforts). Partners need to be In addition to the NIOSH role in conducting, identified and engaged; roles need to be deter­ collaborating in, and coordinating WPV re­ mined; agendas, strategies, and plans need to be search, the following principal roles were sug­ developed; and programs need to be established, gested for NIOSH: implemented, and evaluated. ■ Developing and keeping a clearinghouse This section identifies some of the partners of information about violent workplace (or types of partners) that participants sug­ events, model programs, data collection gested were necessary to the WPV research and instruments, implementation practices, prevention effort, as well as some of the roles and other pertinent information po­ and responsibilities that participants thought tentially useful to employers and other fit well with each based on their missions and stakeholders activities. ■ Developing (1) data-gathering standards for compiling data from disparate sourc­ es and (2) a reporting system that cap­ 6.1 NIOSH tures all WPV events—verbal abuse and other threatening behaviors as well as in­ NIOSH was recognized as a key organization, jury outcomes both in assuming specific roles and responsi­ bilities suggested during the discussions and in ■ Leading an effort to make the issue of facilitating the collective efforts of a wide range WPV more visible (through public in­ of partners. NIOSH was recognized for its cur­ formation and education campaigns, rent roles and activities as a leading research for example)

Workplace Violence 23 6 • Partners and their Roles 6 • Partners and their Roles

6.2 Other Federal Partners 6.4 Private-Sector Suggested roles for other relevant Federal part­ Companies, Corporations, ners (such as OSHA, BLS, the Department of and Alliances Justice, the National Center for Injury Preven­ tion and Control, the Veteran’s Administra­ Roles suggested for private-sector companies, tion, and other agencies that collect relevant corporations, and alliances are the following: data or regulate industry) in collaboration ■ Contributing to the effort to forge with NIOSH include the following: common WPV definitions along with

■ Coordinating the national WPV pre­ government agencies and worker advo­ vention effort over the next decade cacy groups

■ Forging a common definition with em­ ■ Sharing data on WPV events as well ployer alliances and worker advocacy as successes, problems, and methods groups to identify the range of behav­ to overcome barriers in implementing iors that constitute WPV WPV prevention programs and strate­ gies. ■ Gathering data on the Federal workforce (the Nation’s largest worker group) ■ Adopting WPV prevention strategies that have been recommended and veri­ ■ Implementing WPV prevention pro­ fied by Federal agencies grams in Federal workplaces

■ Ensuring and maintaining up-to-date statistics on WPV 6.5 Business and Community

■ Adopting a partnership model to devel­ Organizations op regulations addressing WPV Suggested roles for business and community organizations are as follows:

6.3 State Agencies ■ Serving as conveners, bringing together These roles were suggested for State agencies: factions of the community to engage in dialog, striving to comprehend the is­ ■ Collaborating with Federal partners sue, and forging a coordinated response to embrace common definition(s) of to WPV prevention WPV ■ Sharing prevention programs and strat­ ■ Quantifying victimizations among State egies: a businesses-helping-businesses workers and thereby adding to the avail­ approach able data ■ Assisting government, media, and edu­ ■ Determining specific and relevant strate­ cational institutions in increasing public gies for prevention in State government awareness of WPV risks and prevention

24 Workplace Violence 6 • Partners and their Roles 6 • Partners and their Roles

6.6 Insurers ■ Training attorneys to be sensitive and provide outreach to affected clients The following roles were suggested for insurers: ■ Providing incentives, primarily by re­ 6.9 Academic Research ducing workers’ compensation premi­ ums for employers who implement WPV Institutions prevention programs that demonstrably The following roles were suggested for aca­ lower workers’ compensation costs demic research institutions: ■ Supporting research that seeks eco­ nomic evidence that violence preven­ ■ Training new researchers entering the tion provides a return on investment to field employers or other entities investing in WPV prevention ■ Raising the research bar by setting the ex­ ample in research and crafting violence 6.7 Law Enforcement prevention strategies based on findings ■ Playing a proactive role in accessing pri­ Roles suggested for law enforcement agencies include the following: vate industry data

■ Collecting more detailed data and stan­ ■ Emphasizing in its law, business, and dardizing definitions management curricula the dynamics of WPV and its impact on workers, fami­ ■ Disseminating evidence-based preven­ tion information lies, and corporate health

■ Providing assistance to businesses in taking prevention steps 6.10 The Media ■ Participating in research efforts to address the prevention of workplace The role suggested for the media was providing crime and violence public service announcements (PSAs) in sup­ port of public information campaigns. ■ Focusing on community-oriented policing

6.8 The Legal Profession 6.11 The Medical Community These roles were suggested for the legal profes­ The medical community’s suggested role was sion: to improve recognition and reporting of po­ tential cases of injury or stress from WPV. ■ Appropriately balancing the need for collecting accurate WPV victimization data with the tangle of overlapping pri­ 6.12 Worker Assistance vacy interest laws Programs ■ Securing exemptions or waivers from existing privacy restraints in order to Suggested roles for worker assistance programs collect data were the following:

Workplace Violence 25 6 • Partners and their Roles

■ Improving screening and recognition of 6.14 Other National potential WPV issues Organizations ■ Being involved in response to WPV in­ The following roles were suggested for other cidents to serve victim, witness, and co­ national organizations: worker needs ■ Having safety and security specialists and 6.13 Social Advocacy organizations interact with research and regulatorycommunitiestoenableresearch­ Organizations to-practice linkage (incorporate findings in their programs and procedures) and to Roles suggested for social advocacy organiza­ provide expert input to researchers and tions were the following: regulators

■ Contributing to the effort to forge com­ ■ Having academic schools of architec­ mon WPV definitions with Federal, ture, urban planning, and civil engi­ State, business, and labor partners neering to interact with violence prevention partners to provide expert ■ Developing media campaigns following input to research and regulatory efforts the model provided by Mothers Against and to incorporate safety and security Drunk Driving (MADD) considerations into their designs

26 Workplace Violence 6 • Partners and their Roles

Conclusions 7

This report summarizes the discussions that Great strides have been made over the past occurred during the conference Partnering two decades. Likewise, opportunities exist to in Workplace Violence Prevention: Translating address the barriers and gaps outlined in this Research to Practice in Baltimore, Maryland, report and to achieve a more coordinated, ef­ in November 2004. Many ideas are presented ficient, and cost-effective national effort to about what is missing from the national ef­ understand, control, and prevent violent inci­ fort to study and prevent WPV. Some gaps dents at work. These violent incidents damage could be addressed by increasing intervention or destroy the victims’ sense of security, dig­ evaluation research; improving reporting, data nity, and (too often) their well-being and their collection, and data sharing; facilitating and lives. They represent a large toll to our society. enabling organizations to foster the dynamic commitment and cooperation of employers The key to the utility and impact of a report and workers; analyzing costs and cost-benefits; such as this is the extent to which people and and improving organization and delivery of organizations can visualize and initiate the ef­ risk and prevention information. Other gaps forts and partnerships needed to understand are more specific to the types of violence, the and reduce the risks of WPV within their various roles and relations among partnering spheres of influence. We encourage your in­ organizations, or the industries and occupa­ terest, involvement, and collaboration in this tions involved. effort.

Workplace Violence 27 References

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28 Workplace Violence Appendix Conference Participants Participants in Partnering in Workplace Violence Prevention: Translating Research to Practice, Baltimore, Maryland, November 15–17, 2004 Jorge Acuna Charlene Baker Crisis Prevention Institute Centers for Disease Control and Prevention [email protected] [email protected] 262–317–3445 770–488–1737 Steve Albrecht Marianne Balin Albrecht Training & Development Blue Shield of California Foundation [email protected] [email protected] 619–445–4735 415–229–5215 Sania Amr Angela Banks University of Maryland, School of Medicine Centers for Disease Control and Prevention [email protected] [email protected] 410–706–1466 770–488–4273 Kristi Anderson Gregory T. Barber Sr. National Institute for Occupational Safety and Occupational Safety and Health Health Administration [email protected] [email protected] 304–285–6362 202–693–2473 Debra Anderson Cathleen Batton University of Kentucky Baltimore County Police Department [email protected] [email protected] 859–257–3410 410–931–2145 Susie Ashby DeAnna Beckman U.S. Army University of Cincinnati [email protected] [email protected] 410–306–1057 513–558–3951 Jim Azekely Javier Berezdivin International Taxi Drivers Safety Council AngerExperts.com [email protected] [email protected] 304–525–0902 305–757–2161 Karen Baker David Bernstein National Sexual Violence Resource Center Forensic Consultants, PC [email protected] [email protected] 717–909–0710, Ext. 101 860–833–7732

Workplace Violence 29 Jean Berrier Ann Brockhaus Convenience Store Safety Committee ORC Worldwide [email protected] [email protected] 757–425–2396 202–293–2980

Patricia Biles Jean–Pierre Brun Biles and Associates Laval University [email protected] 202–484–8226 jean–[email protected] 418–656–2405 Vicki Black U.S. Army Tanya Burrwell [email protected] American Psychological Association 410–278–7155 [email protected] 202–336–6049 Heather Blackiston DAOHN John Byrnes [email protected] AON Aggression Management 302–458–0586 [email protected] Barbara Blakeney 407–804–2434 American Nurses Association [email protected] Nancy Carothers Convenience Store Safety Committee James Blando [email protected] New Jersey Department of Health 650–867–8349 [email protected] 609–777–3039 Norman Caulfield Commission for Labor Cooperation Chris Blodgett Washington State University [email protected] [email protected] 202–464–1107 509–358–7679 Rebecca Cline Meg Boendier Ohio Domestic Violence Network Workplace Violence Advocate [email protected] [email protected] 330–725–8405

Matt Bowyer James Coleman National Institute for Occupational Safety and National Council of Chain Restaurants Health [email protected] [email protected] 304–285–5991 571–522–6100 Mark Braverman Joanne Colucci Marsh USA American Express Company [email protected] [email protected] 202–263–7938 877–208–7492

30 Workplace Violence Phaedra Corso Frank Denny Centers for Disease Control and Prevention Department of Veterans Affairs [email protected] [email protected] 770–488–1734 202–273–9743

Francis D’Addario Bob DeSiervo Starbucks Coffee Company American Society of Safety Engineers [email protected] [email protected] 847–768–3402 206–318–8736 Carmen Dieguez Linda Dahlberg Miami–Dade County Government Centers for Disease Control and Prevention [email protected] [email protected] 305–375–2682 770–488–4496 Edward DiSabatino Lucia Davis–Raiford MBNA Bank Miami–Dade County Government [email protected] [email protected] 302–457–2167 305–375–2685 Francis Dixon David Dawson MBNA Bank Empowerlink Threat Management [email protected] [email protected] 302–457–2179 905–945–0101 Stephen Doherty Butch de Castro Doherty Partners LLC American Nurses Association [email protected] [email protected] 617–393–9928

Katherine Deitcher Brooke Doman National Institute for Occupational Safety and DAOHN Health [email protected] [email protected] 302–432–0025 Robert Dorsey Richard V. Denenberg Santa Clara County Domestic Violence Workplace Solutions, Inc. Council [email protected] [email protected] 518–398–5111 408–525–0107

Tia Schneider Denenberg Terrie Dort Workplace Solutions, Inc. National Council of Chain Restaurants [email protected] [email protected] 518–398–5111 202–626–8183

Workplace Violence 31 Rosanne Dufour Giuseppe Fichera Commission des normes du travail Department Occupational Health Clinica Del [email protected] Lavoro Luigi Devoto 418–380–8521 [email protected] 0039/02/5454091 Carole Dupere Commission des normes du travail Dawn Fischer [email protected] U.S. Army 514–873–4947 [email protected] 410–278–3609 Jennifer Edens John Flood Federal Bureau of Prisons U.S. Air Force [email protected] [email protected] 202–514–4492 405–234–2262 Gerhard Eisele Pamela Foreman Oak Ridge Associated Universities University of California San Francisco [email protected] [email protected] 865–576–2208 707–292–1886 Rosemary Erickson James Fox Athena Research Corporation Northeastern University [email protected] [email protected] 605–275–6028 617–373–3296 Shelley Erickson Kelley Frampton U.S. Department of Agriculture, Food Safety U.S. Bureau of Labor and Inspection Service [email protected] [email protected] 202–691–6189 515–727–8981 Roland (Ron) Fravel III Don Faggiani U.S. Department of Agriculture, Food Safety Police Executive Research Forum and Inspection Service [email protected] [email protected] 202–690–1999 202–321–9354 Eric Frazer Gary Farkas Forensic Consultants, PC Psychologist/HR Consultant Yale University School of Medicine [email protected] [email protected] 808–521–2433 203–624–0111 Richard Fazzio Tom Galassi Occupational Safety and Health Occupational Safety and Health Administration Administration [email protected] [email protected] 617–565–8110 202–693–2100

32 Workplace Violence Linda Garber Jim Hardeman State Farm Insurance WPV Prevention, Inc. [email protected] [email protected] 434–872–5958 508–746–6021

Chantenia Gay Randy Harper HCR Manor Care U.S. Department of Labor [email protected] [email protected] 410–480–2333 202–693–4906 Daniel Hartley Dorothy Goff National Institute for Occupational Safety and Consultant Health 651–777–0311 [email protected] 304–285–5812 Teague Griffith National WPV Prevention Partnership/SCDVC Gail Heller [email protected] [email protected] 509–487–6783 614–258–6080

Paula Grubb Jennifer Hilliard National Institute for Occupational Safety and American Association of Homes and Services for the Aging Health [email protected] [email protected] 202–508–9444 513–533–8179 Michael Hodgson Jeffrey Hagen Veterans Health Administration The Community College of Baltimore County [email protected] [email protected] 202–273–8353 410–780–6955 John Howard Mary Jane Haggitt Director, National Institute for Occupational University of Washington Safety and Health [email protected] [email protected] 770–712–8113 202–401–6997

Patrick Hancock Terri Howard Target Corporation Baltimore County Public Schools [email protected] [email protected] 612–761–4214 410–887–4133 Lee Husting Sarah Hansel National Institute for Occupational Safety and VA Maryland Health Care System Health [email protected] [email protected] 410–642–2411, Ext. 5499 404–498–2506

Workplace Violence 33 Lisalyn R. Jacobs Nicholas Lamis III Legal Momentum Miami–Dade County Government [email protected] [email protected] 202–326–0040 305–375–2680

Lynn Jenkins John Lane National Institute for Occupational Safety and The Omega Threat Management Group, Inc. Health [email protected] [email protected] 310–551–2063 304–285–5822 Douglas Leach Barbara Kabrick Blue Shield of CA Foundation International Taxi Drivers Safety Council [email protected] [email protected] 415–229–5462 509–475–3842 Rocky Leavitt Ann Kaminstein Ken Bu Kai, Inc., Martial Arts [email protected] DV Initiative 270–982–3548 [email protected] 617–306–6969 Theresa Leavitt Business Leaders National, Inc. Michelle Keeney [email protected] U.S. Secret Service 270–723–7463 [email protected] 202–406–5205 Cheri Lee Texas Health Resources Gwendolyn Keita [email protected] American Psychological Association 817–462–7073 [email protected] 202–336–6044 Johnny Lee Peace at Work Susan Kindred [email protected] CCBC-Catonsville 919–719–7203 [email protected] 410–455–5133 Hank Linden Longview Associates, Inc. Trina King [email protected] U.S. Postal Service 914–946–0525 [email protected] 202–268–3981 Herbert Linn National Institute for Occupational Safety and Carrie Kirasic Health Weber Aircraft [email protected] [email protected] 304–285–5947

34 Workplace Violence Jane Lipscomb Randall Miller University of Maryland Baltimore County Police Department [email protected] [email protected] 410–931–2165 Rich Lombard Unity Health System Sarah Miller U.S. Department of Labor, Women’s Bureau [email protected] [email protected] 585–589–0662 202–693–6716 Thomas Lowe Leah Morfin New York State Nurses Association Ms. Foundation for Women [email protected] [email protected] 212–785–0157, Ext. 200 212–709–4405

Wayne Lundstrom Nancy Munro WV Fatality Assessment and Control American Association of Critical Care Nurses Evaluation (WVFACE) [email protected] 703–450–7911 [email protected] 304–293–1529 Christine Neubauer State Farm Insurance Jay Malcan Virginia Union University Barry Nixon [email protected] National Institute for the Prevention of WPV, 804–646–6119 Inc. [email protected] Daniel McDonald 949–770–5264 Veterans Health Affairs Ellen Nolan [email protected] Prince William County Government 205–731–1812 [email protected] 703–792–7967 David McKay Ohio Domestic Violence Network Denise Null [email protected] General Motors 937–492–9995 [email protected] 410–631–2103 Kate McPhaul University of Maryland Baltimore John O’Brien Veteran’s Medical Center of Baltimore [email protected] [email protected] 410–706–4907 410–605–7012 Dan Michael Emily O’Hagan Target Corporation New Jersey Department of Health [email protected] [email protected] 612–696–4133 609–292–9553

Workplace Violence 35 Anne O’Leary-Kelly Deborah Reed University of Arkansas Illinois Nurses Association [email protected] [email protected] 479–575–4566 217–523–0783 Marc Oliver Carol Reeves University of Maryland University of Arkansas [email protected] [email protected] 479–575–6220 Richard Ottenstein The Workplace Trauma Center Chiara Rengo [email protected] Department Occupational Health Clinica Del 410–363–4432 Lavoro Luigi Devoto Paul Papp [email protected] U.S. Army 0039/02/5454091 [email protected] Joyce Renner 410–306–1079 State Farm Insurance George W. Pearson [email protected] TritonPCS/SunCom 301–620–6130 [email protected] William Rhoads 804–364–7381 Centers for Disease Control and Prevention Corinne Peek–Asa [email protected] University of Iowa Injury Prevention Research 770–488–1284 Center Robyn Robbins [email protected] 319–335–4895 United Food and Commercial Workers Union [email protected] Timothy Pizatella 202–466–1505 National Institute for Occupational Safety and Health Roger Rosa [email protected] National Institute for Occupational Safety and 304–285–5894 Health [email protected] Roderick Pullen 202–205–7856 Community College of Baltimore County System Jonathan Rosen [email protected] New York State Public Employees Federation 410–455–4455 [email protected] 518–785–1900, Ext. 385 Susan Randolph University of North Carolina School of Benjamin Ross Public Health Occupational Safety and Health Administration [email protected] [email protected] 919–966–0979 404–562–2284

36 Workplace Violence Emily Rothman Mark Scovill Boston University School of Public Health, Texas Health Resources Department of Social and Behavioral [email protected] Sciences 817–462–7665 [email protected] 617–414–1385 Rick Seta New York Police Department Art Rudat [email protected] America Online, Inc. [email protected] 302–457–3242 703–265–5733 Barbara Silverstein Eugene Rugala Washington State Dept Labor and Industries [email protected] [email protected] 703–632–4321 360–902–5668 Robin Runge Rita Smith American Bar Association Commission on National Coalition Against Domestic Violence Domestic Violence [email protected] [email protected] 303–839–1852, Ext. 105 202–662–8637 Kate Snyder Georgia Sabatini DAOHN MBNA America [email protected] [email protected] 410–229–6572 302–432–0024 Vikki Sanders Rebecca Speer OSHA Consultation, Minnesota Speer Associates [email protected] [email protected] 651–284–5274 415–283–4888

Mario Scalora Robert Stabler University of Nebraska, Lincoln Cape Canaveral Hospital [email protected] [email protected] 402–472–3126 321–868–7235

James Scaringi Jennifer Stapleton Department of Veterans Affairs Corporate Alliance to End Partner Violence [email protected] [email protected] 202–273–7381 509–487–6783 Ronald Schouten Massachusetts General Hospital/Harvard Arnie Stenseth Medical School Athena Research Corp. [email protected] [email protected] 617–726–5195 605–275–6028

Workplace Violence 37 Nancy Harvey Phil Travers Steorts International Consumer Product Safety Commission [email protected] [email protected] 703–790–5116 303–504–7447 Kiersten Stewart Glenn Valis Family Violence Prevention Fund MBNA America [email protected] [email protected] 410–229–6678 202–682–1212 Dana Vogelsang Harley Stock Florida Department of Health Incident Management Group [email protected] [email protected] 561–662–5647 954–452–0434 KC Wagner Nancy Stout Cornell University–ILR National Institute for Occupational Safety and [email protected] Health 212–340–2826 [email protected] Jane Walstedt 304–285–5894 U.S. Department of Labor, Women’s Bureau Craig Swallow [email protected] 202–693–6781 [email protected] +44 7968726891 Dutchin Webster CWA Local 2107 Reena Tandon [email protected] Johns Hopkins School of Public Health 410–768–0611 [email protected] Kim Wells Linda Tapp Corporate Alliance to End Partner Violence American Society of Safety Engineers [email protected] [email protected] 309–664–0667 856–489–6510 Deborah Widiss Robin Thompson Legal Momentum Robin H. Thompson & Associates [email protected] [email protected] 212–925–6635 Carol Wilkinson Corey Thompson IBM American Postal Workers Union, AFL-CIO [email protected] [email protected] 914–499–5555 202–842–4273 William Zimmerman Craig Thorne United States Capitol Police Threat Assessment University of Maryland School of Medicine Section [email protected] [email protected] 410–706–7464 202–224–1495

38 Workplace Violence