Social context for workplace health promotion: feasibility considerations in Costa Rica, Finland, Germany, Spain and Sweden.
We constructed a simple, flexible procedure that facilitates the pre-assessment of feasibility of workplace health promotion (WHP) programmes. It evaluates cancer hazards, workers' need for hazard reduction, acceptability of WHP, and social context. It was tested and applied in 16 workplace communities and among 1085 employees in industry, construction, transport, services, teaching and municipal works in Costa Rica, Finland, Germany, Spain and Sweden. Social context is inseparable from WHP. It covers workers' organizations and representatives, management, safety committees, occupational health services, health and safety enforcement agencies, general health services, non-government organizations, insurance systems, academic and other institutions, regulatory stipulations pertaining WHP, and material resources. Priorities, risk definitions, attitudes, hazard profiles, motivations and assessment methods were highly contextual. Management preferred passive interventions, helping cover expert costs, participating in planning and granting time. Trade unions, workers' representatives, safety committees and occupational health services appeared to be important operational partners. Occupational health services may however be loaded with curative and screening functions or be non-existent. We advocate participatory, multifaceted WHP based on the needs and empowerment of the workers themselves, integrating occupational and lifestyle hazards. Workforce in irregular and shift work, in agriculture, in small enterprises, in the informal sector, and immigrant, seasonal and temporary workers represent groups in need of particular strategies such as community health promotion. In a more general framework, social context itself may become a target for intervention.
Finnish Institute of Occupational Health, Department of Epidemiology and Biostatistics, Helsinki, Finland. paivi.peltomaki@ttl.fi
Päivi
P
Peltomäki
Mauri
M
Johansson
Wolfgang
W
Ahrens
Maria
M
Sala
Catharina
C
Wesseling
Freddy
F
Brenes
Carme
C
Font
Kaj
K
Husman
Gemma
G
Janer
Tarja
T
Kallas-Tarpila
Manolis
M
Kogevinas
Minna
M
Loponen
Maria Dolors
MD
Solé
Jürgen
J
Tempel
Kaisa
K
Vasama-Neuvonen
Timo
T
Partanen
D001294:Attitude to Health; D003364:Costa Rica; D005240:Feasibility Studies; D005387:Finland; D005858:Germany; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D020380:Needs Assessment; D009784:Occupational Diseases / Q000517:prevention & control*; D009786:Occupational Health Services / Q000458:organization & administration*; D011322:Primary Prevention / Q000379:methods; D012931:Social Environment; D013030:Spain; D011795:Surveys and Questionnaires; D013548:Sweden