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首页> 美国卫生研究院文献>Annals of Work Exposures and Health >Defining ‘Integration’ for Total Worker Health®: A New Proposal
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Defining ‘Integration’ for Total Worker Health®: A New Proposal

机译：为职工健康®定义整合：一项新建议

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The effects of work and the conditions of employment on health behaviors and intermediate health conditions have been demonstrated, to the extent that these relationships should be addressed in efforts to prevent chronic disease. However, conventional health promotion practice generally focuses on personal risk factors and individual behavior change. In an effort to find solutions to the myriad of health challenges faced by the American workforce, the U.S. National Institute for Occupational Safety and Health (NIOSH) established the (TWH) program. Originally organized around the paradigm of integrating traditional occupational safety and health protections with workplace health promotion, TWH has evolved to a broader emphasis on workplace programs for enhancing worker safety, health, and well-being. Among the research programs and approaches developed by investigators at NIOSH Centers of Excellence for TWH and elsewhere, definitions of ‘integration’ in workplace interventions vary widely. There is no consensus about which organizational or individual outcomes are the most salient, how much to emphasize organizational contexts of work, or which program elements are necessary in order to qualify as ‘Total Worker Health’. Agreement about the dimensions of integration would facilitate comparison of programs and interventions which are self-defined as TWH, although diverse in content. The specific criteria needed to define integration should be unique to that concept—i.e. distinct from and additive to conventional criteria for predicting or evaluating the success of a workplace health program. We propose a set of four TWH-specific metrics for integrated interventions that address both program content and process: (i) coordination and interaction of workplace programs across domains; (ii) assessment of both work and non-work exposures; (iii) emphasis on interventions to make the workplace more health-promoting; and (iv) participatory engagement of workers in pivotal ways during intervention prioritization and planning to develop self-efficacy in addressing root causes, skill transfer, building program ownership, empowerment, and continuous improvement. Thus we find that integration requires organizational change, both to engage two managerial functions with different goals, legal responsibilities, and (often) internal incentives & resources, and also to orient the organization toward salutogenesis. Examples from research activity within the Center for the Promotion of Health in the New England Workplace illustrate how these criteria have been applied in practice.
机译：已经证明了工作和就业条件对健康行为和中等健康状况的影响，在一定程度上应解决这些关系以预防慢性病。然而，常规的健康促进实践通常集中于个人危险因素和个人行为改变。为了找到解决美国劳动力所面临的众多健康挑战的解决方案，美国国家职业安全与健康研究所（NIOSH）制定了（TWH）计划。 TWH最初是围绕将传统的职业安全和健康保护与工作场所健康促进相结合的范例而组织的，现在已经发展成为更加强调工作场所计划以增强工人安全，健康和福祉的范例。 NIOSH TWH卓越中心和其他机构的研究人员开发的研究计划和方法中，“整合”在工作场所干预中的定义差异很大。对于哪种组织或个人成果最为显着，对于强调工作的组织背景有多重视，或哪些计划要素才有资格成为“全体员工健康”，尚无共识。关于整合规模的共识将有助于比较自定义为TWH的计划和干预措施，尽管内容多样。定义集成所需的特定标准对于该概念应该是唯一的。与预测或评估工作场所健康计划成功的常规标准不同并相加。我们针对针对计划内容和过程的综合干预措施提出了一套针对TWH的四个指标：（i）跨领域的工作场所计划的协调和交互； （ii）评估工作和非工作风险； （iii）强调采取干预措施，使工作场所更加健康； （iv）在优先干预措施和计划中提高工作效率以解决根本原因，技能转让，建立计划所有权，授权和持续改进时，工人以关键方式参与式参与。因此，我们发现整合需要组织变革，既要参与具有不同目标，法律责任和（通常）内部激励与资源的两个管理职能，又要使组织朝着良性发展的方向发展。来自新英格兰工作场所健康促进中心内研究活动的示例说明了如何在实践中应用这些标准。

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