exposure, future ITS designs in the construction industry,
as noted by Spangenberg et al,28 should also take
into account the variability of the construction process
in order to increase the internal validity.
Ideally, the development of an intervention is based
on theories and models that illuminate the pathway of
how the work-related injuries can be reduced or prevented.
The definition and measurement of process
indicators, designed for evaluating the implementation
of the intervention, are necessary to determine to what
extent the proposed interventions have actually been
applied.38 Testing the association of determinants
from underlying theories or models with intervention
outcomes increases the insight into the potentially
effective elements of the intervention. Measuring
the behavioral change of workers as a direct
effect of the intervention process, along with the
surveillance of injury rates and frequencies, provides
a better insight into how the intervention works and
also strengthens the evidence of a causative effect on
the injury outcome.39
Future research in this area should focus on
(1) defining indicators for evaluating the implementation
of the intervention, (2) implementing the interventions
in the best possible way, (3) measuring the
behavioral change of workers as a direct result of the
intervention process, (4) measuring fatal and nonfatal
injuries as main outcome variables for evaluating the
effectiveness of the intervention, and (5) testing the
association of behavioral changes with the main outcome
measures.