Total Worker Health® and Small Business Employee Perceptions of Health Climate, Safety Climate, and Well-Being during COVID-19

Int J Environ Res Public Health. 2021 Sep 15;18(18):9702. doi: 10.3390/ijerph18189702.


The COVID-19 pandemic created workplace challenges for employee safety and health, especially in small enterprises. We used linear mixed-effects regression to examine changes in health climate, safety climate, and worker well-being, prior to the pandemic and at two timepoints during it. We also examined whether employees at organizations that had received a TWH leadership development intervention prior to COVID-19 would better maintain pre-pandemic perceptions of climates and well-being. The final study cohort consisted of 261 employees from 31 organizations. No differences were observed in mean outcome scores between the leadership intervention groups at any of the survey timepoints. We combined intervention groups to examine the difference across timepoints. Perceptions of health and safety climates remained stable across all timepoints. However, employee well-being scores declined between the pre-pandemic period and subsequent COVID-19 timepoints. These findings suggest that while small organizations continued to be viewed as supporting employees' health and safety over the course of the pandemic, well-being scores declined, indicating that other factors contributed to decreased well-being. The findings from this study have implications for small business leaders as they navigate the impact of the COVID-19 pandemic on the health, safety, and well-being on their organizations and employees.

Keywords: COVID-19; Total Worker Health; health climate; leadership; safety climate; well-being.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • COVID-19*
  • Humans
  • Organizational Culture
  • Pandemics
  • Perception
  • SARS-CoV-2
  • Safety Management
  • Small Business*
  • Workplace