Integrative Prevention at Work: A Concept Analysis and Meta-Narrative Review.

Purpose The purpose of this study was to conceptualize integrative prevention at work and to identify its operational variables to support its application in occupational rehabilitation. Methods Based on Walker and Avant's specifications for concept analysis, we conducted a systematic five-step procedure (i.e., 1-identification of research question, 2-literature search through meta-narrative review, 3-manuscript selection, 4-extraction, 5-analysis). Results Analysis of information extracted from 20 manuscripts across diverse literature fields allowed to identify that the shared attributes of integrative prevention at work are: (a) coordination of the three levels of prevention, (b) integration of health promotion with prevention, (c) shared understanding of the goal, (d) engagement of stakeholders, and (e) variety of actions. The analysis also identified three antecedents and five consequences, situating the concept within the context of a change process. The results include recommendations for promoting the practical application of the concept. Conclusion The results of this study offer an informative, non-prescriptive, and operational definition of integrative prevention at work that all the stakeholders involved, including occupational rehabilitation professionals, can use.

Integrated Prevention at Work: Protocol for a Concept Analysis.

BACKGROUND: Integrated prevention at work promises to eliminate the boundaries between primary, secondary, and tertiary prevention actions taken by stakeholders in the world of work. It is receiving increasing attention from the scientific community because of its concerted and harmonized approach, which promotes employment access, return, and healthy long-term continuation. Although promising, integrated prevention is not yet well-defined, which makes it difficult to operationalize. OBJECTIVE: This manuscript exposes the protocol of a study aiming to conceptualize integrated prevention at work on the basis of scientific and experiential knowledge. METHODS: Using a concept analysis research design, data collection has been planned in 2 parts. A meta-narrative literature review will first be conducted to document how integrated prevention has been defined in the literature. Then, phone interviews will be conducted with key informers (ie, managers, workers, ergonomists, occupational therapists, psychologists, physiotherapists, union and insurance representatives) to document their viewpoints and understanding of integrated prevention at work. Qualitative data gathered during these 2 parts of research will be analyzed using template analysis, which allows data from literature and empirical collection to be analyzed simultaneously. The analysis will bring out the points of convergence, divergence, and complementarity between the information gleaned from literature and key informers' experiences to arrive at a conceptualization of integrated prevention at work by identifying its uses, attributes, antecedents, and consequences. As a final step, validation and interpretation with a TRIAGE (Technique for Research of Information by Animation of a Group of Experts) group will be carried out in collaboration with the key informers to identify the tools for the implementation of integrated prevention at work and promote workers' health and safety. RESULTS: This study is expected to offer a contemporary conceptualization of integrated prevention at work that clearly lays out the variables of this concept and elicits the viewpoints of the different stakeholders. CONCLUSIONS: This study will contribute to the advancement of knowledge about the professional injury prevention continuum. The clear identification of the uses, attributes, antecedents, and consequences of integrated prevention at work will offer concrete tools to stakeholders to implement innovative and promising approaches to integrated prevention at work. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/29869.

Interventions for the prevention of musculoskeletal disorders in a seasonal work context: A scoping review.

Seasonal work is characterized by difficult working conditions further influenced by organizational, physical, and time constraints which expose seasonal workers to high risks of MSDs. Our aim was to provide an overview of the recommendations and interventions carried out in a seasonal work context to prevent MSDs. To do this, we conducted a scoping review through a systematic electronic search of seven scientific databases and the websites of ergonomics and occupational health and safety organizations. After screening by independent reviewers according to specific criteria sets, we performed qualitative analyses on the 16 studies retained. Findings revealed six categories of transformation targets sought by the interventions/recommendations with the technical devices/physical work environment category being the most reported. We also found it was quite rare for studies to consider the seasonal work context in and of itself when developing and implementing interventions. Our review thus highlights the need to pay attention to intervention processes in order to better understand the influence of seasonality on the measures taken to prevent MSDs in working environments.

Return to work following total knee arthroplasty: A multiple case study of stakeholder perspectives.

OBJECTIVE: The study's aim was to gain insights into factors influencing sustainable return to work following total knee arthroplasty (TKA). DESIGN: A descriptive multiple-case design was used. A case was defined as a worker's following TKA work disability situation. SETTINGS: The cases came from public hospitals in urban and semi-urban areas in Quebec (Canada) and involved mostly non-work-related TKAs. SUBJECTS: Workers had to be between 6 and 12 months post-TKA, have physical/manual jobs and currently employed. Their rehabilitation professionals and workplace representatives (employer and/or union) were also recruited, based on the work disability paradigm. MAIN MEASURES: Semi-structured interviews, questionnaires on pain, physical work demands (workers only), and observation of the work activities of those workers back at work were used. Cases were compared and categorized for worker-perceived levels of difficulty in returning to or staying at work: little or no difficulty (n = 8); some difficulty (n = 5); not back at work due to excessive difficulty with their knee (n = 4). RESULTS: A total of 17 cases were constituted. In only one case, the worker benefitted from an interdisciplinary work rehabilitation approach. Results highlight the interplay among these factors: (1) the workers' perceptions of their residual symptoms and ability to manage them, (2) the interaction between work adjustments and tools offered by the employers and the workers' own strategies, and (3) perceptions of the workers' physical capacities. CONCLUSION: Workers' who face high levels of work demands/difficulties and who have limited access to work adjustments and tools should be referred for work rehabilitation.

Impacts of considering sex and gender during intervention studies in occupational health: Researchers' perspectives.

The aim of this article is to examine the impacts of incorporating sex and gender (s/g) analysis in integrated knowledge translation (iKT) initiatives in the field of ergonomics and occupational health. The article presents findings based on a retrospective analysis of twelve intervention-research (IR) studies, including a thematic content analysis of in-depth interviews conducted with 15 researchers involved in these IRs. The findings offer an overview of various categories of impacts, such as changes in partners' views, in workplace settings and conditions, in practices and policies, and in economic outcomes. In these types of IR, health effects measurement is not the main objective, and direct health outcomes are difficult to assess. Explicitly talking about sex/gender led more often to system-level changes but less often to workplace-level changes, compared to interventions where sex/gender was not identified as a specific object of the intervention.

The Organization of Working Time: Developing an Understanding and Action Plan to Promote Workers' Health in a Seasonal Work Context: L'organisation temporelle du travail: la comprendre pour développer des actions favorisant la santé des travailleuses en contexte de travail saisonnier.

Despite the health problems associated with irregular schedules and long working hours, few studies have focused on the temporal dimension of work in seasonal working contexts. Through the monitoring of sixteen seasonal workers in the crab-processing industry over a two-year period, this study aimed to better understand their working reality and to provide a detailed picture of the temporal dimension of seasonal work as experienced by these workers. Observations of the work activity, interviews, and analysis of official documents were carried out. The findings reveal that the organization of working time and working conditions are very restrictive. These constraints are linked not only to the work environment and management but also to various public policies and ministerial directives. Methodological elements essential for the study of the organization of working time have been identified and could contribute to a better understanding of temporal constraints experienced by seasonal workers. Résumé Malgré les problèmes de santé associés aux horaires non standards et aux longues heures de travail, peu d'études se sont attardées à dégager un portrait de la dimension temporelle du travail en contexte de travail saisonnier. Par le suivi de 16 travailleuses saisonnières de l'industrie de la transformation du crabe pendant deux années, cette étude visait à mieux comprendre leur réalité de travail et à dresser un portrait détaillé de la dimension temporelle du travail saisonnier tel que vécu par ces travailleuses. Des observations du travail, des entretiens et l'analyse de documents ont été réalisés. Les résultats révèlent une organisation temporelle et des conditions de travail fort contraignantes pour ces travailleuses liées, entre autres, à l'environnement et à la gestion du travail, mais également à diverses politiques publiques et consignes ministérielles. Des éléments méthodologiques essentiels pour l'étude des temps de travail ont également été identifiés et contribueront à mieux cerner les contraintes temporelles des situations de travail vécues par les travailleuses saisonnières.

The Challenges of Mobilizing Workers on Gender Issues: Lessons from Two Studies on the Occupational Health of Teachers in Québec: Les défis de mobiliser les travailleur.ses sur la question du genre: Constats issus de deux recherches portant sur la santé au travail d'enseignant.es du Québec.

In partnership with the largest teachers' union confederation in Québec ( Centrale des syndicats du Québec), two qualitative research studies that integrate gender were conducted in the teaching community. These ergonomic studies advocated a participatory approach involving interviews and observations with high school teachers (thirty-five) and female teachers responsible for vocational training in trades with predominantly male clientele (twelve). The results revealed that gender influences work success by reducing the operational leeway available for female teachers to carry out their work and protect their health. In both studies, it was difficult to discuss these results with the teachers, especially with female teachers. Resistance, even denial, was present among high school teachers, while, in vocational training, resignation and a feeling of helplessness were observed. These reactions demonstrate that taking gender into account in prevention poses particular challenges that need to be addressed in order to promote equality between women and men in workplaces.