To better understand the methodological challenges faced by interventi
on research in health care, workshops reviewed two intervention studie
s to reduce back injuries among nursing home staff and two studies on
the use of precautions to prevent occupational transmission of bloodbo
rne pathogens. These studies adapted rigorous designs to real-world se
ttings and made good use of multiple measures to detect effects and co
mmunicate this information to policy makers. The studies grappled with
issues about implementation integrity and would benefit from better t
heory of administrative practices associated with a safety-conscious w
ork environment. (C) 1996 Wiley-Liss, Inc.