Oct 1, 2014 - Université de Sherbrooke, Longueuil, Canada. CONCLUSION. Findings suggests that the isolated approach to the three levels of prevention ...
Integrated Prevention in the Workplace : Developing a Concept to Better Develop Practices Calvet B (1), Vézina N (1), Nastasia I (2), Laberge M (3), Rubiano P (1), Sultan-Taïeb H (1), Toulouse G (2), Durand MJ (4) 1. Université du Québec à Montréal, Montréal, 2. Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Montréal 3. Université de Montréal, Montréal, 4. Université de Sherbrooke, Longueuil, Canada
CONTEXT
METHODS
Traditionally, levels of prevention are divided into three categories: primary, secondary and tertiary. However, management at all three levels of prevention are often isolated in workplaces. This is especially true in larger companies where human resources personnel may be minimally involved in the prevention aspect and focus their efforts mainly on rehabilitation, return-to-work and compensation. In light of this fact, one may wonder how a systemic understanding of health at work is possible for those in prevention with only partial access to the other elements. Indeed, firms implement many programs - whether in prevention or in managing remainat-work and return-to-work programs. Workplaces could benefit from implementing more effective prevention programs : coordinating actions and efforts from all three levels into better prevention practices.
Scoping review PUBMED, SCOPUS, GOOGLE SCHOLAR 20 semi-structured interviews and content analysis with N-VIVO Occupational Therapists, Ergonomists, Occupational H&S Managers, CSST compensation and rehabilitation staff, workers in the “return-towork” process and an association mandated to assist injured workers. One-on-one and group meetings with researchers and experts
The objectives of this study are to better understand the concept known as “integrated prevention”, as well as the stakeholders’ perspectives, and to identify barriers and opportunities for workplace implementation.
RESULTS According to the International Encyclopedia of the Social Sciences, prevention ”focuses on changing naturally occurring disease-producing conditions by administering interventions early in the RESULTS disease process to reduce, eliminate, or alter the events that produce diseases.” Also, primary prevention deals with “preventing problems before they exist”; secondary prevention deals with the “early detection of disease and initiation of early treatment programs”; tertiary prevention deals with the “correction of disease and/or prevention of further health deterioration as a result of disease such as rehabilitation and restoration with chronic diseases and conditions” (Dick and Borner, 2009) Several findings emerge from the scoping review : • Some researchers speak only of primary and secondary prevention (Frank and Cullen, 2003; Yassi et al., 2003) • The concept of “integrated prevention" is discussed in the literature from different perspectives (Cole et al, 2006) • Integrated prevention is rarely referred to as covering primary, secondary and tertiary prevention • Tremblay-Boudreault et al. (2011) show, from an ergonomic intervention, that efficient integrated prevention changes workplace culture in terms of occupational health and safety as well as collaboration among stakeholders
Figure 1
The interviews show that : • The people we met do not currently use the concept of integrated prevention • Even if practitioners and experts do not use the concept of integrated prevention, they all distinguish between the different levels and targeted actions • In practice, few bridges are established to link the various levels of prevention • Interventions at the tertiary level do not necessarily lead to a primary level intervention and vice versa
DISCUSSION The results of the scoping review and interviews converge and lead us to our first reflection on integrated prevention (Figure 1). The lack of clear prevention definitions leads to confusion in workplace practice. It is important to differentiate and maintain the three levels of prevention to illustrate the continuum in the individual’s health status and the relationship between the various prevention practices within the company.
Thus, our definition of integrated prevention (illustrated by the large gray circular arrows) involves a considerations of many aspects : the continuum between the three levels of prevention, the gateway to intervention (stemming from individual or company needs, the types of actions from micro (workstation) to macro levels (work organization), etc.
CONCLUSION Findings suggests that the isolated approach to the three levels of prevention does not facilitate the development of integrated prevention in workplaces. However, many gateways could be used to bridge the gaps between primary, secondary and tertiary prevention. Testing the model in an actual workplace will bring new elements to light to help build effective practices.
REFERENCES Cole, D. C., Van Eerd, D., Bigelow, P., & Rivilis, I. (2006). Integrative interventions for MSDs: nature, evidence, challenges & directions. Journal of occupational rehabilitation, 16(3), 351-366. Darity, W. A. (2008). International encyclopedia of the social sciences. Detroit: Macmillan Reference USA. Dyck, D. E., & Borner, H. (2006). Disability management: Theory, strategy & industry practice. LexisNexis/Butterworths. Frank, J., & Cullen, K. (2006). Preventing injury, illness and disability at work.Scandinavian journal of work, environment & health, 160-167. Tremblay-Boudreault, V, Vézina,N., Denis, D., Tousignant-Laflamme, Y. (2011). La formation visant une prise en charge globale des troubles musculo-squelettiques par l’entreprise : une étude exploratoire. PISTES, 13 (1), 18 p. Yassi, A., Ostry, A., & Spiegel, J. (2003). Injury prevention and return to work: breaking down the solitudes. New views on preventing work-related disability. Taylor & Francis Books Ltd, 75-86. 3rd WDPI Conference: Implementing Work Disability Prevention Knowledge September 29th – October 1st, 2014
