• Etiological research
Health
• Hill's criteria for causation • WHC4001 : evidence
Chemical factors
Biological factors
for determinants
Work schedules
Work home
Job demands
Job control
• Consider strength of the association
• Consider side effects
• WHC4002: evidence
Physical factors
for interventions
interference
Work physical Social support
activity
Risk factors Ergonomic factors Health behaviour Educational level
Personality
WHC4002 - Strategies for health
• Module 1: protection,
Knowledgedisease
on determinants of
Coping style
prevention
HC4001 prevention and re- integration into work Health
C4002 health and labor participation.
Lecture 1 (Opening) • ReadyChemical
to solve all issues
Physical
concerning
Biological
work
and participation?
g the best strategy Risk factors →
ain Health
tion Psychosocial Health
behaviour
module
Personal
•WHC4003:
Social
Implementation (occupational he
Functioning
characteristics management)
environment
From risk to prevention
1. Intended Other factors
outcome
a. Which outcome as target?
4. Prevalence/extend
i. Exposure: Reduce of risk factors
stress or chemical exposition
(broad or within specific subgroup)
ii. Effect: Reduce long term sickness absence or cancer WHC4002
b. 5. Effectivenessinterest?
Stakeholder(s) of the intervention MODULE AIMS & HOW TO REACH
i. Compliance
6. Cost/efforts with legislation/sectoral
in relation to effect agreements
ii. 1Health
Intended protection
outcomeor promotion
prevention 7. Implementation
iii. Career/labour
Goal of market prospects
intervention
risk factors into preventive strategies WHC 4003! costs
iv. • Saving
ome Which outcome as target?
c. All comes• effect
Intended with
Exposure:the
size AIM/goal
Reduce stress orset for health
chemical exposition
or outcome? protection •
i. Legal Effect:
and Reduce
disease
compliance, long term sickness
expected absence
prevention healthorrisk
cancer
reduction
• Stakeholder(s) interest?
ii. Cost/benefit ratio
end of risk factors 2. Causal(and by whom, stakeholder perspective)
• Compliance with legislation/sectoral agreements
factor for• outcome?
Health protection or promotion
2 Causal factor • Career/labor market prospects
f the intervention a. for outcome
Search for bestcosts
• Saving evidence: 3 Modifiable? -Knowledge
n to effect (training causal inference) i. • Preferably
Intended effectrandomized
size trial (CAT / EBOH training)
-Engineering
-Costs
n Search for b. best evidence:
Etiological • Legal compliance, expected health risk reduction High modifiability Intermediate
research Low modifiability
• Preferably randomized • Cost/benefit
trial (CAT ratio
/ EBOH training) modifiability
i. Bradford Hill's criteria for causation
• Etiological research
c. Consider strength of the association Chemical factors Work schedules Job demands
• Hill'sd.
criteria for causation
Consider side effects Biological factors Work home Job control
•3.Consider strength
Modifiable → of the association interference
•4.Consider side effects of risk factors
Prevalence/extend Physical factors Work physical Social support
activity
5. Effectiveness of the intervention Definition
Ergonomic factors
strategyEducational level
Health behaviour
Aim (1)
6. Cost in relation to effect Personality
7. Implementation
1. Teach you how to select and develop strategies to Coping style
• Protect health Health
• Prevent disease
Strategy = a plan of re-integration
• Foster action designed
into work to achieve a particular goal 1
A strategy can be an intervention
2. Diversity of disciplines or a policy
- Intervention = 1. an act of intervening; 2. any interference in the affairs
3. ICF trajectory
of others
4. EBOH trajectory
- Intervening = 1. to take a decisive or intrusive role in order to determine
events
5. Communication & Intervention skills trajectory
(Collins Concise Dictionary, 1989)
- “An intervention can be designed to change environmental or
behavioural factors related to health, but the most immediate impact of an intervention
is usually on a set of well-defined determinants of behaviour and environmental
conditions”
Other factors Parcel, Kok, Gottlieb & Fernandez, 2011, in: Planning Health Promotion
(Bartholomew,
Programs, 3rd ed., p.3)
- Policy = a plan ofofaction
4. Prevalence/extend adopted or pursued by an individual, government, party,
risk factors
business (Collins Concise Dictionary, 1989)
(broad or within specific subgroup) WHC4002
5. Effectiveness of the intervention MODULE AIMS & HOW TO REACH THE
Randomized control
6. Cost/efforts trials preferred
in relation to investigate →
to effect
7. Implementation
WHC 4003! 1
All comes with the AIM/goal set for health
protection and disease prevention
,Strategies can be:
- To protect health
- To prevent disease
- To foster re-integration into work
Stages of prevention:
- Universal prevention
o Prevention / health promotion offered to all members of a population
irrespective of risk level
- Selective prevention
o Prevention of ill-health for those who are at risk for ill-health, e.g., because of
harmful exposure
o Requires monitoring
Strategies
- Indicated prevention and early intervention (2nd previously)
o Prevention of further deterioration for those who have early signs of ill-health.
o Requires screening • That what can be done to
- Tertiary prevention • protect health,
• prevent disease prevention
o Support functioning and participation of re-integration
• foster those who have intoan illness or disability
work
Levels of strategies (targeting level)
- Macro or structural level
o EU and national
o Legislation, policies & institutes
o Rooted in welfare state
- Meso or Organisational level
o Human Resource Management (HRM): Staffing & Development and motivation
of employees
o Health management (WHC4003)
o Part of HRM?
o Health promotion, prevention, and re-integration (Disability Management)
o In organisational policies, structure, and functions
- Micro or Individual level
o Work-related strategies
o Behavioural strategies
o Clinical strategies
o Strategies aiming at social context
Universal prevention / health promotion → macro level (inter)national policy strategies
Selective prevention (monitoring) → organizational level (managerial and departmental
strategies) Conceptual framework for prevention
Indicated prevention and early intervention Individual
course of ICF
→ individual level disease
Tertiary prevention → individual level Primary Healthy No Universal Population
(clinical strategies; physical, medical) prevention Disorder prevention (healthy
living)
Selective
prevention
Secundary
prevention Risk
factors /
symptoms Disorder
Disorder Indicated
prevention
impairments
impairment
Extra information s
Treatment
Universal interventions target the general Tertiary Disease Impairment
prevention (function)
population and are not directed at a Chronic
disease Limitation
specific risk group. Universal prevention (activity)
Individual
Care related
measures address an entire population Restrictions prevention
(treatment /
counseling)
(participation)
2
,(national, local, community, school, or neighbourhood) with messages and programs aimed
at preventing or delaying the use of alcohol, tobacco, and other drugs. The mission of universal
prevention is to deter the onset of substance abuse by providing all individuals with the
information and skills necessary to prevent the problem. The entire population is considered
at risk and able to benefit from prevention programs.
Selective interventions target those at higher-than-average risk for substance abuse;
individuals are identified by the magnitude and nature of risk factors for substance abuse to
which they are exposed. Selective prevention measures target subsets of the total population
that are considered at risk for substance abuse by virtue of their membership in a particular
segment of the population. Selective prevention targets the entire subgroup, regardless of the
degree of risk of any individual within the group.
Indicated interventions target those already using or engaged in other high-risk behaviors to
prevent heavy or chronic use. Indicated prevention measures are designed to prevent the
onset of substance abuse in individuals who do not meet the medical criteria for addiction, but
who are showing early danger signs. The mission of indicated prevention is to identify
individuals who are exhibiting problem behaviors and to involve them in special programs.
Restrictions Individual
Care related
(participation) (treatment /
prevention counseling)
adox 3
Prevention paradox: a population approach often will yield a larger health benefit (on a
population level) than an intervention that only aims at the high-risk group in the population
ach Small effect in large group > large effect in small group
t (on a
an an
ly aims
p in the
Levels of the strategy (targeting level)
• Macro or structural level (addressing the whole population)
o (EU and national) policies
group > o Rooted in welfare state
• Meso or Organisational level
group o Human Resource Management (HRM): Staffing & Development and motivation
of employees
o Health management (WHC4003)
o Part of HRM?
o Health promotion, prevention, and4 re-integration (Disability Management)
o In organisational policies, structure, and functions
• Micro or Individual level
o Work-related strategies
o Behavioural strategies
o Clinical strategies
o Strategies aiming at social context
4
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