Date of Award

8-2026

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Heather McGee, Ph.D.

Second Advisor

Samantha Lynn Hardesty, Ph.D.

Third Advisor

Jennifer Bott, Ph.D.

Fourth Advisor

Jonathon C. Baker, Ph.D.

Keywords

Autism, human services, intellectual disabilities, personal protective equipment, safety, staff injuries

Abstract

Staff who provide care for individuals with autism spectrum disorder and intellectual disability experience high workplace injury rates, particularly in applied behavior analysis settings (Hardesty 2020; Hardesty et al., 2025; Romani et al., 2020). Despite these elevated risks, organizations lack evidence-based criteria for determining what protection to recommend to staff based on documented injury outcomes (Irwin Helvey et al. 2024). This study examined how staff injury characteristics are associated with staff-worn personal protective equipment (PPE) use in an inpatient neurobehavioral unit. A retrospective analysis of 1,998 staff injury incidents from 105 patients (2020-2024) tested whether injury severity, injury type relevance, and patient-level staff injury history predicted PPE use and intensity. Staff incidents were rated using the Severity- Informed Rating Scale (Hardesty, 2020) and were classified by injury type relevance to available protective equipment. Logistic regression analyses indicated high-severity incidents had 39% higher odds of PPE use compared with low-severity incidents (OR = 1.39, p = .001). Highrelevance injuries (bites, scratches, head strikes) were associated with twice the odds of PPE use compared with no-relevance injuries (OR = 2.03, p < .001). Ordered logistic regression demonstrated severity predicted PPE intensity (OR = 1.14, p = .001), with this relationship varying by injury type relevance. Patient-level analyses indicated maximum severity strongly predicted head protection use (OR = 7.54, p < .001). These findings could enable organizations to develop severity-informed PPE frameworks that match protection levels to documented injury characteristics, improving staff safety in ABA settings.

Comments

Fifth Advisor: Ron Van Houten, Ph.D.

Access Setting

Dissertation-Open Access

Download

Share

COinS