Total Worker Health in Young Workers

A photo of two young workers from Portland Parks and Recreation Aquatics Department discussing safety and health from the PUSH study

Young workers between the ages of 14 and 24 are at an increased risk for occupational injuries to a lack of job experience, an inability to recognize hazards, the ongoing cognitive and physical development of youth, and a reluctance to speak up.

Training has been shown to effectively reduce the number of workplace injuries. The overall goal of PUSH (Promoting U through Safety & Health) is to reduce the incidence of workplace injury among young workers by way of tools specifically designed to address the distinctive needs of this population. Evaluated with City of Portland seasonal park and recreation workers, PUSH showed significant improvements in safety and health knowledge and was well liked by the young workers. 

PUSH builds useful skills in young workers, thereby addressing the long-term goals of reducing injuries and improving health with the added benefit of creating a more productive workforce. PUSH is funded through a grant from the National Institute of Occupation Safety and Health (NIOSH) and is an Oregon Healthy Workforce Center, a NIOSH Total Worker Health Center of Excellence project.

PUSH was funded through a grant from the National Institute of Occupation Safety and Health (NIOSH) and is an Oregon Healthy Workforce Center, a NIOSH Total Worker Health Center of Excellence project.

Visit our newest tools and toolkits website at to access the PUSH toolkit.

Program success: results from the randomized control trial

1. Participants enjoyed the training and reported it being effective.

  • Enjoyed the training (59%)
  • Reported learning new information (95%)
  • Reported changing behaviors as a result of the training (67%)

2. Durable increases in safety and health knowledge were achieved by intervention workers (p less than 0.001, effect size (Cohen's d) 0.4).

Information on the development and evaluation of the PUSH training can be found in our publications below.

Our PUSH toolkit includes 3 components

Promoting U through Safety and Health (PUSH) combines the NIOSH Talking Safety-Youth @Work training with wellness and communication topics in an online training curriculum for young workers, ages 14-24. This curriculum is meant to act in tandem with valuable organization-specific training that all workers are entitled to receive when they start a new job.

1. The PUSH online training is a 50-minute, self-paced program that uses videos and real life examples to teach young workers about safety, communication, and health. 

2. The supervisor-led, "Start the Conversation Activities" reinforce concepts learned in the PUSH online training. Their purpose is to engage supervisors and young workers in two-way conversation about safety and health in the workplace. 

3. Social media prompts are videos, images, and other social media that can be used creatively by your organization to emphasize principles included in the online training or the supervisor-led, "Start the Conversation Activities." Visit the PUSH Tumblr page that showcases examples of social media prompts. 

PUSH Promoting U through Safety & Health Young Workers Study Partners include Portland Parks and Recreation, Oregon Young Employee Safety (OYES), Portland Youth Builders, Oregon Bureau of Labor and Industry and The University of Iowa. Photograph of each of the partner's logos.
PUSH partners include: Portland Parks and Recreation, Oregon Young Employee Safety (OYES), Portland Youth Builders, Oregon Bureau of Labor and Industries, The University of Iowa

Aryal, A., Parish, M., Rohlman, D.S. (2019) Generalizability of the Total Worker Health® online training for young Workers. International Journal of Environmental Research and Public Health, 16 (4). 

Rohlman, D.S., Parish, M., Elliot, D.L., Hanson, G., Perrin, N. (2016). Addressing young workers' needs: the Promoting U through Safety and Health (PUSH) trial outcomes. Healthcare: Special Issue Occupational Health Issues in the New Millennium. 4(3), 55.

Parish, M., Rohlman, D.S., Elliot, D.L., Lasarev, M. (2016). Factors associated with occupational injuries in seasonal young workers. Occupational Medicine. 66(2),166-167.

Elliot, D., Rohlman, D., Parish, M. (2015). Focus groups move online: Feasibility of Tumblr use of e-health curriculum development. Journal of Medical Internet –Research Protocols, 4(1), 1-6. 

Rohlman, D., Parish, M., Elliot, D., Montgomery, D., & Hanson, G. (2013). Characterizing the needs of a young working population: Making the case for total worker health in an emerging workforce. Journal of Occupational & Environmental Medicine, 55, S69-S72.

To learn more about the PUSH toolkit components, such as the online training, Start the Conversation activities and social media prompts or implementing the PUSH toolkit in your organization, visit our tools and toolkit website,

Larissa Doty, Aquatics Coordinator, Portland Parks and Recreation 
"The content in the PUSH training helps us ensure that our staff is prepared to work safely and provides information about their rights as workers and encourages them to speak up when they have questions. We also value the health promotion focus of the training, because we are aware that on the job, healthy workers are safe workers."

  • 73% of young workers that took the PUSH training agreed that they would recommend the training to a coworker
  • 68% really enjoyed taking the PUSH training
  • 69% said the PUSH training was useful in improving health and safety on the worksite
  • 63% reported changing one or more behaviors because of the PUSH training (at 10-week follow up) 

Barbara Aguon, Safety Manager, Portland Parks and Recreation
"Based on the results from the study conducted during the summer of 2013, we believe that using PUSH as a standard training for new hires is a wise investment in our employees. Not only does it enhance the training that we require for all workers, but the online format allows us to save time and money that we would otherwise need to spend on in-person training."

PUSH Video Evaluation Focus Group Participants, Real Young Workers
"The video was short but gave an empowering feeling to its audience. I believe every worker, young and old, should see this video"

"The video was memorable due to the use of humor in many of the sections…"

"I thought this video was actually pretty entertaining for being a training video…"