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Documents accompanying this brief
Title Report number
Conceptual models to guide psychosocial
interventions in workplaces (Research Brief)
1010-012-R1B
Conceptualmodelstoguidepsychosocialinterventionsinworkplaces
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Acknowledgements
Theauthorsacknowledgeallwhocontributedtothisproject:
TheWorkSafe Victoria personnelwho participated in theworkshops,
especiallyMrGlennOckerby and Ms Robin Trotter for their input and
assistance throughout the
project.ProfessorCaryCooper,ChairofAcademyof Social
SciencesandDistinguishedProfessorofOrganizationalPsychologyandHealthatLancasterUniversity,England,provided
insightandinput to the conceptual models and the final report.
Assoc Prof Anthony LaMontagne,Principal Research Fellow at the
Melbourne School of Population Heath, University
ofMelbourne,providedinputregardingnewandemergingconceptualmodels.
Thisproject is fundedbyWorkSafeVictoria, through the Institute
forSafety,CompensationandRecoveryResearch(ISCRR).
Citation
Keleher H, Ayton D, Barker S, Ellis N 2010. Conceptual models to
guide psychosocialinterventions in workplaces. Department of Health
Social Science Monash University
andInstituteforSafety,CompensationandRecoveryResearch,Melbourne.
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Contents
Acknowledgements..............................................................................................................2Citation.................................................................................................................................2Contents...............................................................................................................................3Introduction.........................................................................................................................61
Psychosocialhealth........................................................................................................72
Psychosocialfactorsinworkplaces................................................................................94
Healthyworkplaces.....................................................................................................154.1
Mentalhealthatwork.............................................................................................................18
5
Interventionmodelsinhealthpromotion....................................................................206
ConceptualModelsforHealthProgramPlanning.........................................................226.1
PrecedeProceedModel...........................................................................................................226.2
VicHealthFrameworkforthePromotionofMentalHealthandWellbeing............................246.3
PRIMAEFpolicymodelfortheEuropeanUnion.....................................................................27
7
Conceptualmodelsforworkplacehealth.....................................................................307.1
TheJobStressProcess:modifyingvariablesandinterventionspoints....................................317.2
GlaxoSmithKlineResilienceStrategyforoccupationalstress.................................................32
8
Integratedapproachestoworkplacehealthandsafety...............................................338.1
CDCWorkplaceHealthModel.................................................................................................338.2
RobertWoodJohnsonFoundationmodel...............................................................................368.3
EllisIntegratedmodelofworkplacehealthandsafety...........................................................388.4
WorkplaceMentalHealthPromotion.....................................................................................40
9Consultations...................................................................................................................419.1ReportofWorkshop1...................................................................................................419.2ReportofWorkshop2...................................................................................................4510
NextSteps................................................................................................................45
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RiskManagementWorksheet.............................................................................................46STEP1
Identifypotentialworkrelatedstresshazards...................................................................46STEP2
Assessworkrelatedstressrisks..........................................................................................46STEP3
Controlworkrelatedstressrisks.........................................................................................46Taskdesign..........................................................................................................................................47Workload/workpace...........................................................................................................................47Roleintheorganisation......................................................................................................................47
RISKMANAGEMENTWORKSHEET......................................................................................48STEP1
Identifypotentialworkrelatedstress.................................................................................48STEP2
Assessworkrelatedstressrisks..........................................................................................48STEP3
Controlworkrelatedstressrisks.........................................................................................48Workcontext.......................................................................................................................................48Physicalworkenvironmentandequipment........................................................................................48Degreeofcontrol.................................................................................................................................48Organisationalfunctionandculture....................................................................................................48Workschedule.....................................................................................................................................49Managementofwork..........................................................................................................................49Employmentstatus..............................................................................................................................49other(describe):..................................................................................................................................49Relationshipsatwork..........................................................................................................................49
Agenda(COPY)...................................................................................................................51Psychosocial
Conceptual Model Review Workshop Tuesday 27th July 1.00
3.00pmWorkSafeHO222ExhibitionStMelbourneChairperson:ProfessorNikiEllis..................51Agenda(COPY)...................................................................................................................52Psychosocial
Conceptual Model Review Workshop 2 Wednesday 1st September 10am
12pmWorkSafe,222ExhibitionStMelbourneChair:ProfessorNikiEllis..........................52
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TablesandfiguresFigure1:Benefitsofsupportingpeopletobehealthierandinwork(DepartmentofWorkandPensions.&DepartmentofHealth.,2008)................................................................................17Figure2:FrameworkforHealthPromotionInterventions(Murphy&Keleher,2004,p.160).21Figure3:PrecedeProceedHealthPromotionPlanningModel(Green&Kreuter,1999).........23Figure4:VicHealthFrameworkforthePromotionofMentalHealthandWellbeing(Keleher&Armstrong,2006).......................................................................................................................25Figure5:PRIMAEFmodelforpsychosocialriskmanagement(LekaandCox2010)................29Figure6:TheJobStressProcess:ModifyingVariablesandInterventionsPoints(LaMontagne,Keegeletal.,2007).....................................................................................................................31Figure7:GSKResilienceStrategy
forOccupationalStress (RobertsonCooper
Ltd.&UMIST,2003)...........................................................................................................................................33Figure8:WorkplaceHealthModel(CentersforDiseaseControlandPrevention)...................34Figure9:WorkBasedStrategiestoImproveHealth(RobertWoodJohnsonFoundation,2008)....................................................................................................................................................37Figure10:IntegratedModelofWorkplaceHealthandSafety(Ellis,2001)..............................39Figure11:ComprehensiveWorkplaceHealthPromotionModel..............................................41
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Introduction
ThisprojectoriginatedfromarequestbyWorkSafeVictoriatoprovidetimelyinformationonemergingconceptualthinkingaboutworkplacebased
interventionsforpsychosocialfactors.WorkSafe had noted that
different approaches to understanding psychosocial factors hadbeen
developed in different locations across their organisations and
that a number ofdifferentbut relatedconceptswerebeingdiscussed.
WorkSafeVictoria recognised thatanagreed conceptual
frameworkwouldallow them to takeamore coordinatedapproach tothis
area of work that is becoming increasingly important. The Institute
for Safety,Compensation and Recovery Research (ISCRR) advised that
new approaches were beingdeveloped internationally andproposed that
theyundertake,within a short time frame,
arapidappraisalprocessbasedonascanof literature,advice froman
internationalpanelofexpertsandtwoconsultativeworkshopswithWorkSafestaffinJulyandSeptember2010.
Thisprojectaimwastoidentifyconceptualmodelsthatinformandguideinterventionswhichaddress
psychosocial factors in workplaces relevant to work health and
WorkSafe morebroadly.Theobjectivesoftheprojectareto:
1. Undertake a review of existing and emerging conceptual models
that describeinterventions addressing psychosocial determinants of
health in workplaces, ofrelevancetoanOHSregulator;2. AssistWorkSafe
to interpretand thenadoptoradapt thesemodels tosuit theirneeds.
This final report is theoutputof the rapidappraisaland
summarises the thinking
thathasemergedduringtheconsultationsinresponsetotheliterature.
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1 Psychosocialhealth
Psychosocial health is a generic term that is used broadly when
connections are
soughtbetweenmentalhealthandphysicalhealth.Indeed,conceptsrelatingtophysicalandmentalhealth
are deeply intertwined, and are crucial to the overall wellbeing of
individuals,societies and countries (World Health Organization.,
2001). Health startslong beforeillnessin our homes, schools and
jobs and begins where we live, learn, work and play.Health
canbeviewedasapositive (qualityof life)ornegative (risk factor)
construct. Thepromotion of health (health promotion) is about
efforts to create and support healthyenvironments while
simultaneously creating opportunities for people to learn about
thethings that affect their health andwellbeing andwhat they can do
about them (Keleher,MacDougall,Murphy2007).Goodmentalhealth
isaprerequisite forgoodphysicalhealthandbothare interdependentwith
social conditions to the point that without good mental health, it
is difficult for anindividual to feel healthy (Keleher & Round,
2005). The mental health of
individualsaggregatestowardspopulationhealth:
Forall
individuals,mental,physicalandsocialhealtharevitalstrandsof
lifethatareclosely interwovenanddeeply
interdependent.Asunderstandingof this
relationshipgrows,itbecomesevermoreapparentthatmentalhealthiscrucialtotheoverallwellbeingofindividuals,societiesandcountries(WorldHealthOrganization.,2001).
Itfollowsthen,thatorganisationsandgovernmentshavecriticalrolesandresponsibilities
inthecreationandprovisionofsupportiveenvironments
forgoodphysicalhealthandmentalhealthandwellbeing.Thescopeofmentalhealthand
itspromotion ranges from
individualapproachestomuchbroaderconceptualizationsofhowthecreationofgoodmentalhealthoccurs
aswell as the economic and social impacts of poormental health
(Department ofHuman Services., 2009). It follows then, that
organisations and governments have critical
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rolesandresponsibilities
inthecreationandprovisionofsupportiveenvironmentsforgoodphysicalhealthandmentalhealthandwellbeing.
Thepromotionofmentalhealthisabouttakingactiontoensuresocialconditionsandfactorscreate
positive environments for the good mental health and wellbeing of
populations,communities and individuals. Mental health promotion
requires action to influence
thedeterminantsofmentalhealthusingmultilevelinterventionsacrossawiderangeofsectors,policies,
programs, settings and environments (Keleher & Round, 2005).
The scope
ofinvolvementoftheworkplacesectorinthepromotionofthementalhealthandwellbeingofemployeesisanemergingfieldofdebateanddiscussion.
TheCanadianMentalHealthAssociationdefineaworkplacehealthpromotionprogramasaseriesofactivities,
initiativesandpoliciesdevelopedforthecontinuousenhancementofthequality
of working life, health and the wellbeing of all working
populations. Theseinterventions are developed to improve the
environment (physical, psychosocial,organizational, economic), to
increase personal empowerment and for personal growthdevelopment
(CMHA 2010:webpage).Multiple categories ofworkplace health
promotioninclude occupational health and safety, health and
lifestyle practices and
organizationalculture(CMHA2010).Theextenttowhichworkplacesandtheworksectoridentifyasdriversfor
the promotion ofmental health andwellbeing is a key point of
discussion.Of course,health is created through the influence of
multiple sectors of which work is one.
Otherinfluentialsectorsonthecreationofhealthandwellbeing
includeeducation,environments,theartsandculturaldevelopment,foodandagriculture,transport,andjustice.
This review is intended to assist WorkSafe in decisionmaking
about the extent of
itsengagementinpsychosocialinterventionstopromotementalwellbeingthroughworkhealthprograms.
The review works through contemporary understandings of
psychosocial
riskfactorsandhazards,theconceptofahealthyworkplace,traditionalmodelsofoccupationalhealthandsafety,modelsthatrepresentthetrajectoriesofpsychosocialfactorsandhazardsinworkplacehealthprograms,andthenmodelsthatrepresentintegratedplanning.
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2 Psychosocialfactorsinworkplaces
TheInternationalLabourOffice(ILO)recognisesthattheconceptofpsychosocialfactors
isadifficultterrainasitunderstooddifferentlybydifferentstakeholders.Psychosocialfactorsarefrequentlyrepresentedastheperceptionsandexperiencesoftheemployeeinrelationtotheworkplace.
The terrain includes the concepts of psychosocial risk factors and
psychosocialhazards.
The CMHA define psychosocial risk factors as organizational
factors that impact
thepsychologicalsafetyandhealthofemployees.These factors include
thewaywork iscarriedoutandthecontext
inwhichworkoccurs.Psychosocialriskfactorshavetheabilitytoaffectemployeemental
responses towork and to causemental health problems (CMHA
2010).Natali,Deitingeretal(2008)fortheEuropeanFrameworkforPsychosocialRiskManagement(PRIMAEF)(Section6.3)regardtheconceptofpsychosocialriskfactorstobethesameastheconceptoforganisationalfactors.Indeed,Psychosocialriskfactorsarealsoreferredtointheliterature,associoorganisationalfactors(Natali,Deitingeretal2008).
Psychosocial hazards are defined broadly to include those
aspects of the design andmanagementofwork,and
itssocialandorganisationalcontexts,thathavethepotentialforcausingpsychologicalorphysicalharm(InstituteofWorkHealthandOrganisations,2008,p.14).
Psychosocial hazards in the workplace are associated with poor
physical and mentalwellbeing stemming from physical, psychological
and social effects of the work andorganisational factors (Institute
of Work Health and Organisations, 2008).
Psychosocialhazardsareuniqueandspecifictoeach
job.Thephysicaleffectsofpsychosocialhazardsonphysical health
include hypertension, heart disease, musculoskeletal disorders,
gastrointestinaldisorderand impaired
immunocompetenceandwoundhealing(InstituteofWorkHealthandOrganisations,2008).The
socialandbehaviouraleffects related
topsychosocialhazardsincludephysicalinactivity,excessivedrinking,smoking,poordietandsleep(InstituteofWorkHealthandOrganisations,2008).Researchhasalsoshownanassociationbetweenworkplace
psychosocial hazards and mental health including poor affective and
cognitive
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healthoutcomesincludinganxiety,depression,distress,burnout,decreaseddecisionmakingand
attention. TheWhitehall Studyhasestimated that around twothirdsof
the increasedhealthburden
(inthisstudytheoutcomebeingmeasuredwascardiovasculardisease)
fromoccupationalstress
isduetoadirecteffectoftheneuroendocrinesystemandonethirdanindirecteffectviaunhealthybehaviours(Chandola,Brittonetal.,2008).
Therearealmostasmanyclassificationsofoccupationalstressorsasthereareorganisationalpsychologyresearchers.However,closerinspectionrevealsconsiderablesimilaritiesbetweenthem.Threeauthoritativedescriptionsofpsychosocialriskfactors/occupationalstressorsareshown
below (Tables 1, 2, 3): theUS Institute ofWork, theUKHSE
StressManagementStandardsandtheCanadianMentalHealthAssociation.AusefulconceptproposedintheUKHealthandSafetyExecutiveStressManagementStandardsisthatstressorscanarisefromjobcontentandjobcontextandagain,thesearedescribedintheUKintermsoforganizationalfactors.Jobcontentisessentiallythedesignofjobswhichinturn,aredeterminedbythewayworkisorganized.Jobcontextistheenvironmentinwhichthejobisperformed,arisingfromthewaypeoplearemanaged.
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Table1:Psychosocialhazards(InstituteofWorkHealthandOrganisations,2008)PSYCHOSOCIALHAZARDSJobContent
Lackofvarietyor shortwork cycles, fragmentedormeaninglesswork,
under use of skills, high uncertainty, continuous exposure to
peoplethroughwork
Workload&workplace Work overload or under load, machine
pacing, high levels of
timepressure,continuallysubjecttodeadlines
Workschedule
Shiftworking,nightshifts,inflexibleworkschedule,unpredictablehours,longorunsociablehours
Control Low participation in decision making, lack of control
over workload,pacing,shiftworkingetc
Environment&Equipment Inadequate equipment availability,
suitability or maintenance, poorenvironmentalconditionssuchas
lackofspace,poor lighting,excessivenoise
Organisationalculture&function Poor communication, low
levels of support for problem solving andpersonal development, lack
of definition of, or agreement on,organisationalobjectives
Interpersonalrelationshipsatwork Social or physical isolation,
poor relationships with
supervisors,interpersonalconflict,lackofsocialsupport
RoleinOrganisation
Roleambiguity,roleconflict,andresponsibilityforpeopleCareerdevelopment
Careerstagnationanduncertainty,underpromotionoroverpromotion,
poorpay,jobinsecurity,lowsocialvaluetoworkHomeworkinterface
Conflicting demands of work and home, low support at home, dual
careerproblems.
Table2:Psychosocialhazards(Health&SafetyExecutive,2005)MANAGEMENTSTANDARDS
DESCRIPTIONJobContent Demands
Includesissuessuchasworkload,workpatternsandworkenvironment
Control HowmuchsaythepersonhasinthewaytheydotheirworkSupport
Includes the encouragement, sponsorship and resources provided by
the
organisation,linemanagementandcolleaguesJobcontext Relationships
Includes promoting positive working to avoid conflict and dealing
with
unacceptablebehaviourRole
Whetherpeopleunderstandtheirrolewithintheorganisationandwhether
theorganisationensuresthattheydonotconflictingrolesChange
Howorganisationalchange(largeorsmall) ismanagedandcommunicated
intheorganisation
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Table3:12psychosocialriskfactors(CMHA.,2010)PSYCHOSOCIALRISKFACTORSPsychologicalSupport
A work environment where coworkers and supervisors are supportive
of
employees psychological and mental health concerns, and
respondappropriatelyasneeded
OrganizationalCulture
Aworkenvironmentcharacterizedbytrust,honestyandfairness
ClearLeadership&Expectations
Aworkenvironmentwherethereiseffectiveleadershipandsupportthathelpsemployees
know what they need to do, how their work contributes to
theorganizationandwhetherthereareimpendingchanges
Civility&Respect
Aworkenvironmentwhereemployeesarerespectfulandconsiderate
intheirinteractionswithoneanother,aswellaswithcustomers,clientsandthepublic
PsychologicalJobFit A work environment where there is a good fit
between
employeesinterpersonalandemotionalcompetencies,theirjobskillsandthepositiontheyhold
Growth&Development
Aworkenvironmentwhereemployeesreceiveencouragementandsupport
inthedevelopmentoftheirinterpersonal,emotionalandjobskills
Recognition&Reward A work environment where there is
appropriate acknowledgement
andappreciationofemployeeseffortsinafairandtimelymanner
Involvement&Influence Aworkenvironmentwhereemployeesare
included
indiscussionsabouthowtheirworkisdoneandhowimportantdecisionsaremade
WorkloadManagement A work environment where tasks and
responsibilities can be
accomplishedsuccessfullywithinthetimeavailable
Engagement
Aworkenvironmentwhereemployeesenjoyandfeelconnectedtotheirworkandwheretheyfeelmotivatedtodotheirjobwell
Balance A work environment where there is recognition of the
need for balancebetweenthedemandsofwork,familyandpersonallife
PsychologicalProtection
Aworkenvironmentwhereemployeepsychologicalsafetyisensured
WenotethattheRiskManagementWorksheetatAppendix1fromWorkSafeVictoriareflectsthecategoriesidentifiedabove.
UnderstandingsofthemeaningofoccupationalstresshaveemergedinEuropeoverthepasttwodecades,particularly
from thework in theUK. This is reflected in
theHSEdefinitionwhereoccupationalstressistheadversereactionpeoplehavetoexcessivepressuresorothertypesofdemandplacedonthem(Health&SafetyExecutive,2007,p.7).Implicitinthisisthe
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recognitionthatpeoplewillvaryintheirresponsestopsychosocialhazards(asindeedtheydoto
physical hazards). Therefore the concept of resilience is relevant
to understandings ofpsychosocialhealth.
Resilienceistheabilitytoresistbeingovertakenbynegativeexperienceswhentheyseemtobeoverwhelming(ArizonaHealthFutures,2003),ortheabilitytocreateapositiveworldforourselves.
Resilience is a key to individual and population levels of mental
health andwellbeing and to inequalities (Friedli, 2009). The
concept of resilience includes positiveadaptation, protective
factors, and consideration of assets that moderate risk
factors.Resilience is influenced by both psychological and
socioecological factors at individual,organisationalandcommunity
levels.Oftenresilience, indiscussion
inthecontextofmentalhealthatwork,isusedonlyinthesenseofindividualcapability,howeverthegoodaspectsofworkaswellasotherfeaturesofcommunitylifearethoughttocreatethegoodsthatbuildresilience.
For example theGlaxoSmithKlinemodel of resilience (Figure 7 in
Section 7.2)operatesatanindividual,teamandorganisationallevel.
Some specific psychosocial hazards have gained prominence in
Australia and elsewhere.Thesecanbe fitted
intobroadersocioorganisational factor
frameworks,examplesofwhichareprovided above. Bullying, violence
andharassment all relate to relationships atwork.Violence at work,
including customer violence, is implicated in unsafe physical
workenvironments.
Worklifebalancehashadconsiderablerecognition(Natali,Deitingeretal.,2008,p.90)andisespeciallyan
issueforwomen;this isusuallypickedup inworkscheduling,but
isrelatedtootherstressorsaswell. Bullyingatwork
isamultiformphenomenonfromthepsychosocialriskmanagement
perspective. To become bullied is a psychosocial stress situation
causingpsychologicalharm(Einarsen,Matthiesenetal.,1998;Vartia,2001;Zapf,Knorzetal.,1996).Ontheotherhand,bullyingatworkshouldberegardedanddiscussedasaconsequenceofapoorpsychosocialworkenvironment(Hauge,Skogstadetal.,2007;Salin,2003;Vartia,1996).Harassmentatworkandworkplacemobbingareconstructsofbullying.
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Therehasbeen,andstill is,considerable resistance to theconcept
that thedesignofgoodwork is an important determinant of population
health and wellbeing, although recentrecognition by
theWorldHealthOrganisations SocialDeterminants
ofHealthCommissionand the response to the Black Report in theUK
should help. That dealingwith selectedpsychosocial hazards,
especially those which can be understood in terms of
individualbehaviours,hasbeenpossiblecouldbeconsideredtobeareflectionoftheongoingtensionbetweenthecompetingtheoriesofaccidentcausationtheexternalworkingenvironmentvstheaccidentproneindividual(Swuste,vanGulijketal.,2010).Anothercommenton
theconceptofpsychosocialhazards is that it ispossible
toconstructwork in
thisareausingapositiveconstructofhealth,e.g.qualityofworking life.
Thus thesame psychosocial factors are used to appraise aworking
environment but the aim is tomaximise the quality of thatworking
environment, rather thanminimising the harm
frompsychosocialhazards.
WhentheUKStressManagementStandardswerereleasedanentireissue of the
journalWork and Stresswas devoted to peer review of thiswork.
TheNewZealand reviewersmade thepoint that itmaybepreferable
tousesuchaconstruct ratherthanstressmanagement(Ellis,2007).
Further to thedescriptionofpsychosocial risk factorsas
socioorganizational factors (pp8,11), the termpsychosocial risk
factors isoftenused inworkplacehealth in the
contextofdelayedrecoveryfromillnessandinjuryaswell,particularlycompensableinjuryandillness.Itisnowwellrecognisedthatpeoplewithcompensatedillnessorinjuryhaveslowerrecoveriesthanpeoplewhose
illnessesand
injuriesarenotcompensated(Harris,Mulfordetal.,2005).Themechanismofthiseffectisnotknownyet,butitishypothesisedthatpsychosocialfactorsin
the workplace, e.g. relationships with supervisors, and outside the
workplace e.g. theextentofsocialsupportareimportant(RACP,2001).
Theemergenceofpsychosocialfactorsasaworkplaceresponsibilityandthehazardsthatleadtopsychosocial
risksareof increasing concern in theworkplacehealth literature,with
theimpactlargelyfoundtobeonstressandthebroaderconceptofmentalhealth.Thisleadsto
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the roleofpsychosocial riskmanagement inworkplacehealth.
LekaandCox (2008) in thePsychosocial RIsk Management Excellence
Framework (PRIMAEF) make the case thatpsychosocial riskmanagement
is synonymous to best business practice: best practice inrelation
to psychosocial risk management essentially reflects best practice
in terms oforganisational management, learning and development,
social responsibility and thepromotionofqualityofworking
lifeandgoodwork (p175).Psychosocial riskmanagementgoes beyond
occupational health and safety policy and practice to contribute to
broaderagendas about the promotion of workers health, the quality
of working life as well
asinnovationandcompetitiveness.LekaandCox(2008)seethatpsychosocialriskmanagementhasaneconomicdimension,becausegood
riskmanagementcontributes to
thecreationofpositiveworkenvironments.Theconceptofapositiveworkenvironment
inthePRIMAEF istaken further in other literature, into the concept
of healthy workplaces, based on workcoming out of
theWorldHealthOrganizationwhere the concepts of both protection
andpromotionareemphasized.
4 Healthyworkplaces
TheWorldHealthOrganization(WHO)regardstheworkplaceasasettingforprotectingandpromotingthehealthofworkers,theirfamiliesandthecommunity.InMay2007,theWorldHealthAssemblyendorsedtheGlobalPlanofActiononWorkersHealthfortheperiod20082017whichhasbeenadoptedunanimouslyby193WHOMemberStates.WithintheGlobalPlan,
countries and international stakeholders expressed a need for a
globally coherentframework for planning, delivery and evaluation of
essential interventions for workplacehealth protection and
promotion (WHO 2010). The WHO states that A healthy
workingenvironment is one in which there is not only an absence of
harmful conditions but
anabundanceofHealthPromotingones(WorldHealthOrganization.,2010b).Thisframeworkisincreasingly
used in the literature to support the development of frameworks to
promotehealthyworkplaces because of their positive impact on
anworkers health
andwellbeing(Black,2008;CSDH.,2008).Ofcourse,notallworkisgoodforoneshealthitisgoodwork
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that isbeneficial tohealthandwellbeing.Goodwork is
interdependentwith thenotionofhealthyworkplaceswhich is
concernedwith the protection ofworkers from physical
andpsychosocialhazards (CSDH.,2008).
Justasneighborhoodsshouldnotbehazardoustoourhealth,norshouldourjobsorworkplaces.
Benefitsofgoodworkareusuallyconceptualisedatthelevelofindividualssuchasfinancialsecurity,
social status, personal development, social connections, and
selfesteem
andbusinessesintermsofproductivitygains.However,thereisincreasinginterestinthebroaderbenefitsofhealthyworkplacesattheleveloffamilies,communitiesandpopulations,andtheeconomy.
Black (2008) argues that there are health benefits ofwork to
individuals andfamilies but there are also benefits to business
from productivity gains and benefits
tocommunitiesasworkisacontributortosocialcapital1.Figure1fromBlack(2008),illustratestheUK
conceptualisation of the benefits of goodwork. The figure
highlights the need forsustained programs to support people to be
in longterm work, and demonstrates
themultipleoutcomesthatflowfromwork.
1Socialcapital
isamultidimensionalconceptthatemphasizesboththequalityandstructureofsocialrelationshipsornetworksofsocialrelationswhicharecharacterisedbynormsoftrustandreciprocityandwhichleadtooutcomesofmutualbenefit(Stone,Grayetal.,2003).
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Figure1:Benefitsof supportingpeople tobehealthierand inwork
(DepartmentofWorkandPensions.&DepartmentofHealth.,2008)
The conceptualisation in Figure 1 suggests that a broad range of
stakeholders should beconsidered in the development of healthy
workplaces including employers and
employerorganisations,workers,tradeunions,governmentbodies,families,communitiesandbroadersocietyconcernsabouttheconditionsthatpromotehealthandwellbeingforindividualsandpopulations.IntheWorkersHealth:GlobalPlanforAction,theWorldHealthOrganization(2010)definesahealthyworkplaceasonethatconsidersthefollowing:
Healthandsafetyconcernsinthephysicalworkenvironment;
Fortheindividual Empowerment,increasedself
confidence,greaterdignity Bettergeneralhealth(mental&
physical) Financialsecurity Betterlivingconditions
Opportunitiesfordevelopment Moreproductive
Forfamiliesandchildren Betterlivingconditions
Bettergeneralhealth
(mental&physical) Lesslikelihoodof
experiencingdisadvantageineducation
Greaterpotentialforsocialmobility
Fortheregions&communities Moresocialmobility
Lesssocialexclusion Reductioninsocialdeprivation&
childpoverty Increasedproductivity Higheremployment
Lessburdenonpublicservices
Forbusinesses Moremotivatedand
productiveworkers Lessworkingtimelostto
illhealth Betterstaffretention Greatercompetitiveness
Higherprofits
Fortheeconomy Assistingtheconditionsof
businesssuccess Higherproductivity Supportingeconomic
performance
BENEFITSOFSUPPORTINGPEOPLETOBEHEALTHIER&IN
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Health,safetyandwellbeingconcernsinthepsychosocialworkenvironment,includingorganisationofworkandworkplaceculture;
Personalhealthresourcesintheworkplace;and Ways of participating
in the community to improve the health of workers, their
familiesandothermembersofthecommunity(WorldHealthOrganization.,2010a,p.6).
4.1
MentalhealthatworkAstheideasabouthealthyworkplaceshavedevelopedandtheconceptualunderstandingsofpsychosocial
factors, risks,hazardsandmanagementhaveemerged,
theconceptofmentalhealthatwork isbeinggiven
increasingattention.This
iswhattheCanadianMentalHealthAssociationreferstoasworkmentalhealthpromotion.TheUKNationalInstituteforHealthandClinicalExcellence(NICE)hasreleasedareport(NICE2009)onthePromotionofMentalWellbeingintheWorkplace.
Mentalwellbeing isadynamic state inwhich the individual isable
todevelop
theirpotential,workproductivelyandcreatively,buildstrongandpositiverelationshipswithothersandcontributetotheircommunity.Itisenhancedwhenanindividualisabletofulfil
their personal and social goals and achieve a sense of purpose in
society(NationalInstituteforHealthandClinicalExcellence,2009,p.6).
Mentalhealthatworkisalsobeingcastinrelationtotheconceptofmentalcapital:[Mental
capital] encompasses a persons cognitive and emotional resources.
Itincludestheircognitiveability,howflexibleandefficienttheyareatlearning,andtheiremotionalintelligence,suchastheirsocialskillsandresilienceinthefaceofstress.Itthereforeconditionshowwellan
individual isabletocontributeeffectivelytosociety,andalso
toexperienceahighpersonalqualityof life
(ForesightMentalCapitalandWellbeingProject,2008,p.10)
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Theideaofcapitalsparksassociationwithnotionsofsocial,culturalandfinancialcapitaltheForesightreportsuggestthatitisbothchallengingandnaturaltothinkofthemindinthisway.Thereportidentifiesfiveevidencebasedstrategies(Box1)thatpeoplecanusetofostertheir
own mental wellbeing, which can be seen as the mental wellbeing
equivalent of
5servicesoffruit/vegetablesperdayandcouldbeusefulcontentforworkhealthprograms:Box1:Individualactionsforwellbeing
Theseactionsareclearlylinkedtonotionsofbenefitsfromsocialcapital.Theimplicationsofhowtobuildmentalhealthcapitalthroughworkplacehealthpromotionarequiteprofound,andyetarereliantonthewaysthathealth,mentalhealth,andrisksandhazardstophysicalandmentalhealth,areconceptualisedandunderstood.Mentalcapitalofindividualsisinterdependentwithbroadersocietallevelsofsocialandotherformsofcapital.Thewaysinwhichsome
industries promote giving and volunteer programs and engage in
corporate
socialresponsibilityprogramsresonatewithconceptsofmentalcapitalandwellbeing.
1.
Connect...Withthepeoplearoundyou.Withfamily,friends,colleaguesandneighbours.Athome,work,schoolorinyourlocalcommunity.Thinkoftheseasthecornerstonesofyourlifeandinvesttimeindevelopingthem.Buildingtheseconnectionswillsupportandenrichyoueveryday.
2.
Beactive...Goforawalkorrun.Stepoutside.Cycle.Playagame.Garden.Dance.Exercisingmakesyoufeelgood.Most
importantly,discoveraphysicalactivityyouenjoyandthatsuitsyour
levelofmobilityandfitness.
3.
Takenotice...Becurious.Catchsightofthebeautiful.Remarkontheunusual.Noticethechangingseasons.Savourthemoment,whetheryouarewalkingtowork,eatinglunchortalkingtofriends.Beawareoftheworldaroundyouandwhatyouarefeeling.Reflectingonyourexperienceswillhelpyouappreciatewhatmatterstoyou.
4. Keep learning...Trysomethingnew.Rediscoveranold
interest.Signup
forthatcourse.Takeonadifferentresponsibilityatwork.Fixabike.Learntoplayaninstrumentorhowtocookyourfavouritefood.Setachallengeyouenjoyachieving.Learningnewthingswillmakeyoumoreconfidentaswellasbeingfun.
5. Give
...Dosomethingniceforafriend,orastranger.Thanksomeone.Smile.Volunteeryourtime.Joinacommunitygroup.Lookout,aswellasin.Seeingyourself,andyourhappiness,aslinkedtothewidercommunitycanbeincrediblyrewardingandcreatesconnectionswiththepeoplearoundyou.
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5 Interventionmodelsinhealthpromotion
Therearemanywaystoclassifyormodelinterventionstrategiesforthepromotionofhealth.Inworkplacehealth,a
scheme thatdistinguishesbetweenprimary, secondary,and
tertiaryinterventionsiscommonlyuseandtheseareoutlinedfurtheron.
Inhealthpromotion,amuchbroaderconceptualizationof interventions
isunderstoodonacontinuumfromdownstreamtoupstream.TheWHOOttawaCharterforHealthPromotionhighlights
fivekeyactionareas forthepromotionofhealthandwellbeing
includinghealthypublic policy; creating supportive environments;
develop the personal skills of people
andsupportparticipationandengagementofcommunities(howeverdefined)sothatareinvolvedinactionsthatsupporthealth(WorldHealthOrganization,1986).
The Framework forHealth Promotion Interventions (Figure 2)
illustrates and classifies
therangeofinterventionsthatcanbeusedandthelevelatwhichtheyarelikelytohaveeffect.Thelandscapeofhealthpromotionbothgloballyandnationally,ismovingupstreambecausedownstream
approaches in isolation of upstream changes, do little to change
healthoutcomes(Keleher,MacDougalletal.,2007).
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DiseasePrevention Communication
strategiesHealtheducationandempowerment
CommunityandHealthdevelopment
Infrastructure &SystemsChange
PrimarySecondaryTertiary
HealthInformationBehaviour ChangeCampaigns
Knowledge
UnderstandingSkillDevelopment
Engagement
CommunityActionProgrampartnerships
PolicyLegislationOrganisationalChangeIntersectoralpartnerships
PrimarycareapproachesLifestylebehaviouristapproaches
Socioecologicalapproaches
Figure2:FrameworkforHealthPromotionInterventions(Murphy&Keleher,2004,p.160)
The Framework for Health Promotion Interventions (Figure 2) sets
out range of
possibleinterventionsonanupstreamdownstreamcontinuumwhere
thedownstreamprimarycareapproachincludesprimarycareapproachaimedatimprovingphysiologicalrisk.Thisapproachisabouttreatmentanddiagnosis/preventionandmanagementofconditions.
The midstream lifestyle/behaviourist approach recognises that
lifestyles, behaviours, andpersonalchoices
influencehealthoutcomes.Midstream factors includepsychosocial
factorssuch as social support and health related behaviours. At the
midstream level, healthpromotion isabouthealtheducationto
informpeopleabouttherisksandconsequencesoflifestyle/behavioursincludingtargetedbehaviourchangecampaigns.
Theupstreamsocioecologicalapproachacknowledgestheinfluencesthatinfrastructureandsystems
can exert on the interactions between people and their social and
physicalenvironments. Health promotion strategies include community
engagement and
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development and infrastructure and systems change. These are key
interventions thatsupportasocioecologicalapproach
Health promotion is most effective when it involves multilevel,
integrated andcomplementary interventions that are supported by
health and other sectors working incollaborative partnerships with
the community. There is considerable evidence thatorganisations can
influence the health and wellbeing of employees (World
HealthOrganization.,2010a).Asocioecologicalapproachtotheorganisationworkerinterfaceseeksto
create organisational structures and systems that are health
promoting, while alsoempowering individuals to exercise greater
control over their own health and
wellbeingwithintheirowncontexts.
6 ConceptualModelsforHealthProgramPlanning
Thissectionoutlinestwoofthemoredetailedplanningmodelsthathavebeendevelopedtocapturethecomplexitiesofprogramplanningforhealthoutcomes.Theyhaveincommon,alevelofconceptual
thinkingabout the levelsofaction,populationsof
interest,anddesiredoutcomes.The goalsof aplanningmodel shouldbe
toexplainhealthrelatedbehaviors
aswellasenvironments,andtodesignandevaluatetheinterventionsneededtoinfluenceboththebehaviorsandtheconditionsthatinfluencethemleadingtothedesiredoutcomesoftheinterventions.
ThefirstmodelisfromGreenandKreuter(1999)fromtheUSAandthesecondisAustralian,fromtheVictorianHealthPromotionFoundation.
6.1 PrecedeProceedModelThe PrecedeProceed model (Green &
Kreuter, 1999) recognises that there are multipledeterminants of
health and therefore interventions/programs to improve health
requiremultidimensionalandmultisectoralaction.
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Figure3:PrecedeProceedHealthPromotionPlanningModel(Green&Kreuter,1999)
The model starts with an assessment of the quality of life and
any social problemsexperiencedby thepopulation
(Green&Kreuter,1999).The second step is to identifyanyspecific
health problems that contribute to quality of life and determine
which of
theseproblemsshouldbeprioritized(Green&Kreuter,1999).Thehealthproblemsareanalysedtodetermine
the environmental and behavioural risk factors. These are grouped
into thefollowing(Green&Kreuter,1999):
Predisposingfactors:personalfactorsthatinfluencemotivationtochange,suchasknowledge,beliefs,attitudes,values
Enabling factors:supportchange
inbehaviourorenvironment,suchasresourcesandskills,andalsoanybarriers
Reinforcingfactors:feedbackreceivedfromadoptingthebehaviour
HealthPromotion
Healtheducation
Policyregulationorganization
Predisposingfactors
Reinforcingfactors
Enablingfactors
Behaviour&lifestyle
Environment
Health Qualityoflife
Phase5Administration&PolicyAssessment
PRECEDEPhase4
Educational&OrganizationalAssessment
Phase3Behavioural&EnvironmentalAssessment
Phase1SocialAssessment
Phase2EpidemiologicalAssessment
Phase6Implementation Phase7ProcessEvaluation
Phase9OutcomeEvaluation
Phase8ImpactEvaluation
PROCEED
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Itisimportanttoconsidertheextenttowhichthesefactorscontributetothehealthproblemandalso
theresourcesavailableand theorganisationscapacity
todeliverhealthpromotionprograms.Onceanintervention/programhasbeendevelopedandimplementedevaluationis
conducted process, impact and outcome measures. The evaluation
process
providesfeedbacktotheearlierstagesofthemodeltocreateacyclicalprocess.
6.2
VicHealthFrameworkforthePromotionofMentalHealthandWellbeingThismodel
alsomoves from individual to population level approaches including
a level toidentify thedeterminantsof the issues. Bydifferentiating
the levelsofplanning, it allowsorganisations to assess the range of
interventions they have in place and what
elsecould/shouldbedeveloped.
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Figure 4:VicHealth Framework for the Promotion ofMentalHealth
andWellbeing (Keleher&Armstrong,2006)
TheVicHealthmodelbeginswith identificationof thedeterminantsof
the issueandworksthrough clear understanding of the population
groups and settings for health promotion
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action.Keysectorsthatneedtoacttopromotementalhealthandwellbeinginclude(Keleher&Armstrong,2006):
Employment and workplace: the availability of work, the
conditions of
work.Unemploymentandunderemploymentareconsiderableinfluencesonmentalhealth
Education:Prerequisiteforgoodmental&physicalhealth.Keytopeoplescapacitytofind
satisfyingwork, participate in other aspects of social life and
undertake socialroles
Housing:adequateshelterisaprerequisiteforhealth.
Local government: built, social, economic and natural
environments have a
strongimpactonmentalandphysicalhealthandwellbeing.
Justice: Statutory regulations and policy are necessary to
prohibit and
reducediscriminationbasedonsex,race,colour,ethnicorsocialorigin,language,religionorbelief,geneticfeatures.Equalityandnondiscriminationarecriticalformentalhealth
Transport: lack of affordable transport is related to social
isolation and
diminishedopportunityforemployment,education,andaccesstohealthservices
Thearts:communityartsprecinctshavepositivementalhealthimpactsthroughtheirimpactonsocialfactors
Sport and recreation: physical activity improves health.
Emphasis is placed onparticipation and increasing access in sport
and recreation, and not just oncompetition.
Thisrangeofsectorsandsettingswhich influencementalhealth,
indicatethe importanceofpartnerships between and across those
sectors. Another key feature of the VIcHealthFramework is that it
identifies both Intermediate and longerterm outcome levels.
Atintermediateoutcomes, four levels for interventionsare
importantand foreffectiveness,at
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leasttwooftheseshouldsimultaneouslybethefocusofanyprogram(Keleher&Armstrong,2006):
Strengthening individuals increasing social connection through
sustained involvement ingroup activities, access to supportive
relationships, mental health literacy (includingemotional
literacy),andresilience, including interventionsdesigned
topromoteselfesteemand selfefficacy, selfdetermination and control
and life skills such as
communicating,negotiatingandrelationshipandparentingskills
Strengthening communities providing environments that are safe,
supportive andsustainable.Communitiesalsoneedtobeableto
increasesocial
inclusionandparticipation;improveneighbourhoodenvironments;enhance
social cohesion;develophealth and socialservices that support
mental health such as antibullying strategies at school,
workplacehealth, community safety, child care and self help
networks; increase citizenship and civicengagement (which affects
how people relate to and deal with, their social world);
andincreaseawarenessacrosssectorsandcommunitiesofmentalhealthandwellbeingissues.
Strengtheningwholesocieties,
includingreducingstructuralbarrierstogoodmentalhealthundertaking
integrated, sustained and supported initiatives to build the
healthy structuresand socialenvironmentsneeded toaddress
structuralbarriers togoodmentalhealth.Thiswork needs to happen
across sectors, including education, employment,
housing,environmentand justice. Itmusthavea strong
legislativeplatformandadequate
resourceallocationtoreduceracism,discriminationandviolence,toaddressinequitiesandtopromoteaccess
toeducation,meaningfulemployment,housing, servicesand support for
thosewhoarevulnerable.
6.3
PRIMAEFpolicymodelfortheEuropeanUnionThepurposeofthePRIMAEFprojectwastodefineaEuropeanframeworkforpsychosocialriskmanagementwithamodelthatwasaimedatbeingrelevanttoboththeenterpriseleveland
wider macro policy level. The report (Leka and Cox 2010) sets out
the process,methodologyandbackground literature that informs
themodel,making thecase formuch
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strongermanagementofpsychosocialriskfactorsatthelevelofpolicylevel.Theysetoutthecasethisway:Psychosocial
riskmanagement is relevantnotonly
tooccupationalhealthandsafetypolicyand practice but also to broader
agendas that aim to promoteworkers health, quality
ofworkinglifeandinnovationandcompetitivenessacrosstheEU.Inparticular,psychosocialriskmanagementclearlymapsontheWorldHealthOrganization(WHO)globalplanofactiononworkershealthand
itsobjectives to:protectandpromotehealthat theworkplace
throughintegratedmeasurestomanagepsychosocialrisks;adoptclearoccupationalhealthstandardstointroducehealthyworkpractices,workorganisationandahealthpromotingcultureattheworkplace;and
createpractical tools for
theassessmentandmanagementofoccupationalrisks.Inaddition,psychosocialriskmanagementisrelevanttotheLisbonagendathataimstopromote
quality of work and innovation and enhance economic performance
andcompetitiveness of EU enterprises. Psychosocial risk management
can contribute to thecreation of positive work environments where
commitment, motivation, learning
anddevelopmentplayanimportantroleandsustainorganisationaldevelopment(Leka,Coxetal2010,p6).Thisisamodelthatprivilegesupstreampolicyapproacheswhileincorporatingworkplaceriskassessment
approaches. Key to the macro level is the range of partnerships
that arenecessaryforamacropolicyapproachtobeeffective.
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Figure5:PRIMAEFmodelforpsychosocialriskmanagement(LekaandCox2010)
As with the PrecedeProceed Program Planning Model and the
VicHealth Framework forplanning, the PRIMAEF model is underpinned
by a set of principles and concepts
whichinformtheframework.Thepolicylevelinterventionsrecommendedareclassifiedas:I.
Legislation/policydevelopmentII.
Standardsatnational/stakeholderlevelsIII.
Stakeholder/collectiveagreementsIV. DeclarationsigningV.
InternationalorganisationactionVI. SocialdialogueinitiativesVII.
NationalstrategydevelopmentVIII. DevelopmentofguidelinesIX.
Economicincentives/programmesX.
Establishingnetworks/partnerships.
Outcomes
Innovation
EconomicPerformance
QualityofWork
Public&Occupational
Health
LabourMarketImpacts
Themacrolevelriskmanagementpolicyprocess
POLICIESAFFECTINGTHECHANGINGWORLDOFWORK(economic,publichealth,labourmarket,tradepoliciesetc)
RiskManagementPolicy
Risk&HealthMonitoring
TranslationPolicyPlans
InterventionProgrammes
PolicyEvaluation
SocietalLearning
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The reportoutlines thehighlevel frameworkagreements
thatarebeingused
togetbuyinfromstakeholdersacrosstheEU.Theseframeworkagreementsareoutlinedinthefullreport(LekaandCox2010).KeyissuesofrelevancetothePRIMAEFapproachtothemanagementof
psychosocial risks at work include policies, stakeholder
perceptions, social dialogue,corporate social responsibility,
monitoring and indicators, standards and best
practiceinterventionsatdifferentlevels(LekaandCox2010,p14).
The full report (LekaandCox2010) comprisesnine chapterswhich
includeanoverviewofbestpracticeinterventionsinworkplacestressandpsychosocialriskfactormanagement,withtaxonomies
of interventions, a review of the effectiveness of various
interventions, adiscussion of evaluations and outcome measures. The
online book can be found athttp://primaef.org/book.aspx.
7 Conceptualmodelsforworkplacehealth
Thissectionprovidesanoverviewofexamplesofworkplacehealthmodels,drawingouttheirfeatures.The
Job Stress Process model (Figure 7.1) was developed by Australian
researchers,specificallyasamodelforthepreventionofoccupationalstress.Itisbuiltaroundaprimarysecondarytertiaryinventionframework.
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7.1 TheJobStressProcess:modifyingvariablesandinterventionspoints
Figure6:The Job StressProcess:ModifyingVariablesand
InterventionsPoints (LaMontagne,Keegeletal.,2007)
In thismodel, the primarysecondarytertiary prevention approach
iswhere (LaMontagne,Keegeletal.,2007):
ThePrimarylevelisaboutcontrollingstressorsthroughworkredesign(environmentallevelintervention)
The Secondary level is about assisting individuals to copewith
stressors (individuallevelintervention),and
The Tertiary level is about rehabilitation of people with
stressrelated illness(individuallevelintervention).
Thismodelemphasisespsychosocialenvironmentalstressorsthatarisefromtheworkplaceincluding(LaMontagne,Keegeletal.,2007):
majorlifeevents(deathofacoworkeronthejob)
PrimaryInterventionToeliminateorreducejob
stressorsSecondary InterventionToalterthewayindividuals
perceiveorrespondtojobstressTertiaryIntervention
Totreat,compensate,andrehabilitateworkerswithjobstressrelatedillness
Workingconditions Distress Shorttermresponse
Enduringhealthoutcomes
Modifyingvariables:IndividualorSituationalCharacteristics
Social Nonwork
relatedstressors
Socioeconomicstatus
Biophysical Age Sex Health
status
Psychological Personality Coping
abilities
Behavioural Exercise Recreational
activities Nutrition
Genetic Inherited
predispositiontomentalillness,heartdisease
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dailyhassles(meetingdeadlines)
chronicstrains(ongoingworkoverload,bullying,sexdiscrimination)
ambientenvironment(exposuretonoise,hazardousmaterials,ergonomicexposures)
cataclysmicevents(toxicspill)
This model recognises that socioorganisational working
conditions are importantdeterminants of adverse health outcomes,
and that a combination of environmental
andindividualinterventionsaremosteffectiveinachievinggoodoutcomes.
7.2
GlaxoSmithKlineResilienceStrategyforoccupationalstressTheGSKmodelwasalsodeveloped
specifically for thepreventionofoccupational stress inthe early
2000s (Robertson Cooper Ltd. & UMIST, 2003). At that time, it
was the mostcomprehensive model. It took resilience as a focus and
defined it broadly in terms ofindividuals, teams andorganizations.
The conceptof resilience therefore,wasbuilt into
avarietyoforganisationalinitiativesthatweredevelopedfromthismodel.
Resilience underpins GSK approach to mental wellbeing and is
prominent in the GSKsleadershipessentials.
Performanceismeasuredandprofessionaldevelopment isplanned
inresponsetothestrategyandisacentralelementoftheGSKhealthandsafetyriskassessmentandmanagementstandard(RobertsonCooperLtd.&UMIST,2003).
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Figure7:GSKResilienceStrategyforOccupationalStress(RobertsonCooperLtd.&UMIST,2003)
8 Integratedapproachestoworkplacehealthandsafety
8.1
CDCWorkplaceHealthModelTheCDCWorkplacehealthPlace(Figure8)wasdevelopedforanAmericanworkplacehealthpromotion
context. It represents a coordinated approach toworkplace health
promotion,which is intended to result in a planned, organized, and
comprehensive set of
programs,policies,benefits,andenvironmentalsupportsdesignedtomeetthehealthandsafetyneedsofallemployees.
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Figure8:WorkplaceHealthModel(CentersforDiseaseControlandPrevention)
This is a comprehensivemodel that shows a relationship between
interventions and theirintentions to achieve outcomes. It does this
by showing that for
effectiveness,workplacehealthpromotionneedstoaddressmultiplerisk
factorsandhealthconditionsconcurrently.Themodelrecognizesthattheinterventionsandstrategieschoseninfluencemultiplelevelsofthe
organization including the individual employee and the organization
as a whole. It
isintegratedintomanagementandillustratesadesiredsetofoutcomes.
Step 1 is Assessment, which is about defining employee health
risks and concerns
anddescribecurrenthealthpromotionactivities,capacityandneeds.Aimstocaptureapictureofthemany
factors that influenceemployeehealth including: individual level
factors such
aslifestylechoices,theworkenvironment(e.g,physicalworkingconditionsandsocialsupport),and
theorganizational level
(e.g.,culture,policies,andpractices).Thisassessmentcan takeplace
informally through conversations, a call for input/opinions (such
as abulletinboard,opinion box, email requesting ideas), or more
formally by using instruments such as
anemployeehealthsurveyorenvironmentalaudit.Involvingemployeesfromthebeginningwill
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reinforcethesharedresponsibilityandcommitmenttheemployeeandtheorganizationhavetoemployeehealth,andtheoverallsuccessoftheworkplacehealthprogram.
Step2 isaboutPlanning/WorkplaceGovernance.Thisprocess
istodevelopthecomponentsofaworkplacehealthprogramsincludinggoaldetermination;selectingpriorityinterventions;and
building an organizational infrastructure. Organisational
strategies provide theinfrastructure to ensure program objectives
are achieved, employee health risks areappropriatelymanaged, and
the companys resources are used responsibility. Examples
oforganizational strategies include: Dedicating senior leadership
support to serve as a rolemodel and champion; Identifying
aworkplacehealth coordinator, councilor committee tooversee the
program; Developing a workplace health improvement plan with
sufficientresources to articulate and execute goals and strategies;
Communicating clearly
andconsistentlywithallemployees;Establishingworkplacehealth
informaticstocollectandusedataforplanningandevaluation.
Step 3 is Implementation which involves all the steps needed to
put health promotionstrategiesand interventions
intoplaceandmakingthemavailabletoemployees.Apersonshealth is a
result of both individual actions and the context or
environmentwithinwhichthoseactionsaretaken.Employersandemployeeshavemanyopportunitiestoinfluencetheworkenvironmenttopromotehealthandpreventdisease.Changingtheenvironmentaffectslargegroupsofworkerssimultaneouslyandmakesadoptinghealthybehaviorsmucheasieriftherearesupportiveworkplacenormsandpolicies.Therefore,
it is importantfortheoverallworkplace health program to contain a
combination of individual and organizational
levelstrategiesandinterventionstoinfluencehealth.Thestrategiesandinterventionsavailablefallintofourmajorcategories:HealthrelatedProgramsopportunitiesavailabletoemployeesatthe
workplace or through outside organizations to begin, change or
maintain
healthbehaviours;HealthrelatedPoliciesformal/informalwrittenstatementthataredesignedtoprotectorpromoteemployeehealth.Theyaffectlargegroupsofemployeessimultaneously;Health
Benefits part of an overall compensation package including health
insurancecoverageandotherservicesordiscountsregardinghealth;
EnvironmentalSupportsrefers
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tothephysicalfactorsatandnearbytheworkplacethathelpprotectandenhanceemployeehealth
Step4 isaboutEvaluationtosystematically investigatethemerit
(e.g.,quality),worth (e.g.,effectiveness), and significance (e.g.,
importance) of an organized health promotionaction/activity. It is
important to assess how well the workplace health program can
besustainedover time,how it is receivedbyemployees andmanagement,
and its returnoninvestment (ROI). The evaluation should focus on
questions that are relevant, salient, anduseful to those who will
use the findings and that the evaluation process feeds into
acontinuousquality improvement loop to
improveandstrengthenexistingactivities; identifypotential gaps in
current offerings; and describe the efficiency and effectiveness of
theresourcesinvested.
Thefullreport,WorkMattersforHealth,providesexamplesofpromisingprogramstomakeworkhealthier,andmakes
thecase that Agrowingbodyofevidence indicates thathealthpromotion
programs are cost effective (2008 p 10). The CDCmodel is a fully
integratedmodelthattacklesphysicalandpsychosocialandenvironmentalfactorsaswellas
individualhealth factors. It couldbe readasgivinggreateremphasis
tonegative constructs than theRobertWoodJohnsonmodelinFigure9.
8.2
RobertWoodJohnsonFoundationmodelFigure9fromtheRobertWoodJohnsonFoundation,
illustratesaclassificationofworkplacepreventionandhealthpromotion
strategies. Thismodel illustratesapathwayofstrategiesfromprevention
through tobehaviourchangeand then tomore upstream strategies
thatsupportbehaviourchangebycreatingsupportiveenvironmentsforhealth.Thisisconsistentwithhealthpromotionprinciplesoutlinedabove.
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Figure9:WorkBasedStrategiestoImproveHealth(RobertWoodJohnsonFoundation,2008)
Thepathway inthemodelbeginswiththepreventionofworkrelated
illnessand injuryandincludesmodifying theworkplace environment to
decreaseworkers exposure to risk andunsafe physical conditions and
educatingworkers about safeworkplace practices such
assmokefreeworkplacespolicies.
Moving along the pathway, the next level of action is to
reduceworkrelated stress. Thisincludes
improvingpsychosocialaspectsoftheworkingenvironmentandpromotingbalancebetweenworkandfamilyresponsibilitiessuchastheResultsOnlyWorkEnvironment(ROWE)aworkplace
initiativewhichfocusesonproductivityandresultsofemployeesworkeffortsratherthantimeatwork.Individualworkerandhis/herteamsetsworkhoursandschedulesrather
than supervisors. Employees report significant positive change in
their control
overtheirworktime,senseofworkfamilybalanceandhealthandhealthbehaviours.
Workbasedhealthprotectionand
promotionstrategies
Preventingworkrelatedillness&injury
Reducingworkrelatedstress
Supportinghealthierbehavioursthroughworkplace
environments&servicesofferedat work
Expandingworkrelatedresources&
opportunities
Workplacesafetymeasures
Controlofworkplacehazards
Improvedergonomics
Healthandsafetytraining
Decreasingjobstrain
Fosteringsocialsupportamongworkers
Stressmanagement Supportingwork
familybalance(e.g.throughflexibleschedules)
Healthscreeningandservices Promotinghealthybehaviours
Creatingahealthpromoting
environment
Medicalcarebenefits
Paidsick&personalleave
Child&eldercareservices
Jobtraining&education
Adequatewages&salaries
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Thenextlevelisaboutsupportinghealthierbehavioursthroughworkplaceenvironmentsandservicesofferedatworkincludesapproachessuchaseducation,healthriskassessments,onand
offsite services and fitness programs; incentives for employees to
participate incomprehensivehealthprograms.
Themore upstream end of the RobertWood Johnsonmodel identifies
the importance
ofworkrelatedresourcesandopportunities.Thisincludesstrategiessuchasexpansionofworkrelatedcompensationandbenefitstoenableworkerstotakebettercareofthemselvesandtheir
families; providingworker education training to increase access to
higherstatus andhigherwage jobs; addressing issues affecting
working families such as early childhoodeducation,after schoolcare,
lowerwagework,worker flexibility,youth transitionsand thefutureof
thematureworkforce;and facilitating researchand innovativepolicy
solutions toimprove the lives of working families through
partnerships linking the private
sector,governmentandotherstakeholders.
8.3
EllisIntegratedmodelofworkplacehealthandsafetyTheEllis(2008)model(Figure10)showshowanintegratedmodelcangivegreateremphasisto
positive constructs that recognises levels of action across the
downstream upstreamcontinuum.This
issimilartotheapproachtakenbyDameCarolBlack
inher2008reportfortheUKgovernmentwherethereisemphasisonthebenefitsforindividualworkers,aswellasemployersandultimatelyforbroadersociety,notjustaminimisationoflosses.
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Figure10:IntegratedModelofWorkplaceHealthandSafety(Ellis,2001)
The model moves from individual approaches/interventions into an
integrated systemapproach. Such an integrated model indicates that
interventions must recognise
howindividualsbehaveinresponseto,andcopewith,thepsychosocialandphysicalenvironment.An
integratedmodelof interventionsunderstandsthatsymptomsofstress in
individualsareoften due to organisational level problems rather
than personal coping deficiencies.Comprehensive worksite health
promotion programs therefore incorporate principles
ofhealthpromotionandpublichealth,withdownstreamtoupstreamstrategiestoaddressthesocial,economicandenvironmentaldeterminantsofhealth.Themodelalsoextendsbeyondtheboundaryofworkplaces
toconsider thebenefitsandcostsofworkingenvironments
tosocietymorebroadly.
In discussion of the health benefits ofwork, as per Dame Carol
Blacks report forexample, it is
importanttorememberthathealthbenefitsdoarise
fromgoodwork.CorebusinessforworkhealthprogramsisnowextendingthetraditionalOHSmodeltopickupandaddresspsychosocialrisksandhazards.However,thereremainsisaneedtodefinethevaluepropositionofthegoodandclarifyandquantifythelinkbetweeneconomicdimensionsandthebenefitsofgoodworktopeopleshealth.
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AmajorissueforWorkSafeindevelopingabroadermodel,willbetheimplicationsforcompensation.
A major pressure on workers compensation is broadening of
thedefinition of what is compensable. Governments constantly seek
to manage
thedemandonschemesbynarrowingdefinitions.Thereforewhatisbeingconsideredwillhave
its difficulties. Essentially an integrated model broadens the
scope
forpreventionbutwillneedtoconsidertheimplicationsforcompensation.
8.4 WorkplaceMentalHealthPromotion
TheCanadianMentalHealthAssociationinassociationwiththeUniversityofTorontosTHCA(The
Health Communication Unit) have developed a Workplace Mental Health
Promotionwebsite resource.This site listedbelow,provides
informationon creatingmentallyhealthyworkplacesby
takingacomprehensiveapproach toworkplacehealthpromotion
inotherwords, theymake thecase
thateffectiveworkplacehealthpromotionprogramsaddressallthreecategoriesofworkplacehealth:occupationalhealthandsafety,organisationalculture,and
voluntary health practices. Mental health is integrally associated
with each of
thecategoriesofeffectiveworkplacehealthpromotioninitiatives.ThemodelatFigure11shouldbereadinconjunctionwiththefollowingeightworkplacestrategieswhichCMHAputforwardisnecessarytosupportworkplacehealth:
1. Encouragingactiveemployeeparticipationanddecisionmaking2.
Clearlydefiningemployeesdutiesandresponsibilities3.
Promotingworklifebalance4.
Encouragingrespectfulandnonderogatorybehaviours5.
Managingworkloads6. Allowingcontinuouslearning7.
Havingconflictresolutionpracticesinplace8.
Recognizingemployeescontributionseffectively
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Figure11:ComprehensiveWorkplaceHealthPromotionModel
Theprogrammanagementmodel
forcomprehensiveworkplacementalhealthpromotion
isathttp://wmhp.cmhaontario.ca.Inaddition,thewebsiteprovidesatableofhealthpromotionapproaches
toworkplacehealthpromotionwhich isconsistentwithFigure2 in this
report;casestudiesandarangeofexplanationsandinformationtosupportprogramdevelopment.
9Consultations
Thissection
includessummaryreportsofthetwoworkshopsconductedaspartofthisrapidappraisalandfeedbackreceivedfromthe
thoughtpanelonthedraftreport. Theagendasfor the workshops are
available in Appendix 2 and the thought panel respondent
(CaryCooper)feedbackisatAppendix3.
9.1ReportofWorkshop1
The firstworkshopwas held in late July 2010with seniorWorkSafe
personnel to
exploremodelsofworkplacehealthandsafety,considertheregulatorscurrentapproaches/modelsandhow
they relate to the literature,andpotential forexpansionof
theWorkSafemodel.The following is a summary of points from the
workshop discussion which followedpresentations.
The breadth of psychosocial factors is likely to take WorkSafe
beyond its currentsphereofthinkinganditscomfortzone.
Workplace
VoluntaryhealthpracticesOccupationalHealth
andSafety
OrganisationalCulture
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Questionsaroseabout theextent towhichWorkSafe is
lookingatabroadermentalhealth strategy, a psychosocial strategy, or
a more narrow bullying/workplacerelationsstrategy.
The workshop discussions showed a readiness for a broader model
of
workplacehealthandsafetytodealwith'psychosocialfactors',whichmaystretchtheboundariesoftheWorkSafestatute.Tosomeextentworkhealthhasbeensuccessfulinthinkingandworkingbroadly,
extending the traditionalboundariesofOHS,being careful toensure the
expected outcomes of their extended activities can be related
toWorkSafe'sstatuteandspecificallythatworkplacehealthpromotioncanbeexpectedtoreduceworkrelatedinjuryandillness.
Staffwerepositiveabout integratedmodels, ie those that
integrateOHSandWHP.TheEllismodel,andtheCDCmodelwhich
isessentiallyan
integratedmodelforthespecificissueofstress,werewellreceived.
Whentalkingaboutbroaderoutcomesmostlytalkedaboutcontributingto
improvedproductivity(and
improvedperformancesameoutcomereally),butalsomentionedqualityoflifeafewtimes.
Therewasagreement that the issue isnotconfined
tomentalhealthoutcomesandrecognition thatpsychosocial factors are
significantdeterminantsofphysicalhealthoutcomesaswell.
TherewasrecognitionthatonewayinwhichWorkSafecouldusefullymoveaheadonworkplace
health promotion is to consider the nature of partnership with
otheragencies and a scopingof the their contribution towards common
goals. The
TAC,VicRoadsandVictoriaPolicehavesuchapartnership,whichnowhas
longhistoryofeffectivenessinachievingoutcomes.Themappingofrolesofwhatcrossgovernmentpartnerships
could be brought into influence, would be a valuable exercise.
BydelineatingthatWorkSafeisresponsiblefor,andstrategicthinkingabouthowbesttoengagethosepartners.
Indiscussionofthehealthbenefitsofwork,alaDameCarolBlack, it is
importanttoremember that health benefits do arise from goodwork.
This is core business, ie
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43Report:1010012R1
extendingtraditionalOHSmodeltopickuppsychosocialhazards. There
isaneedtodefine thevaluepropositionof thegoodand the link
toeconomicdimensionsandbenefits.
A major issue in developing a broader model, will be the
implications forcompensation. A major pressure on workers
compensation is broadening of thedefinition of what is compensable.
Governments constantly seek to manage
thedemandonschemesbynarrowingdefinitions.Thereforewhatisbeingconsideredwillhave
its difficulties. Essentially an integrated model broadens the
scope
forprevention.Theproposedwillneedtoconsidertheimplicationsforcompensation.
Commentsonourdescriptionofworkshop1givemoreemphasistotheriskassociatedwithbroadening
the scope of prevention, in that may put pressure on compensation.
Discussion
WorkSafe probably does have the legislative power to broaden
scope to includementalwellbeing
WorkSafe needs to decide whether it wants to be a leader in
workplace
healthpromotionorwhetheritwantstosupportworkinthisarea
ReasonsWorkSafe shouldbeplaying amajor role WorkSafe (andOHS in
general)gives priority to prevention health has a poor track record
of giving priority
topreventionovertreatment;WorkSafehastherelationships,bothwithworkplacesandwithrelevantstakeholders;workonmentalwellbeingwillrequireafocusoncultureand
line management, this is a direction that WorkSafe is trying to
move
intogenerally,egEPMprogram,thereforementalwellbeingworkislikelytoreinforcethenewdirectionsofOHS
Issuesresourcing(WorkSafewouldhavetoprioritiseinfavourofthisnewdirection);alsothepressureoncompensationargument
Terminology Mental wellbeing for work on prevention/promotion,
psychologicalinjury forclaims. Issues ifuse terms thatsound
likementalhealthwillcommunity
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expect that WorkSafe is going fill void re mental health
services; capacity of
ourcurrentproviders(forrecoverythisis)hasastrongmedicalmodelfocus(psychiatristsand
psychologists), capacity needs to be strengthened re building
resilience in
thecontextofrecovery.AdvantageofmentalwellbeingisthoughtitmightfitwithOHS,WorkHealthandrecovery
(claimsmanagement). Issue identifiedbeforereiterated need to make
sure we keep link between physical and mental processes,
termpsychologicalinjurydoesnotimplythis.
Canadianmodelconsideredtobeuseful IndiscussionofGSKmodel strong
feeling thatmodelusedbyWorkSafeneeds to
havestrongemphasisonorganisationallevel interventions.
TheenforcementsideofthebusinesstakesaviewthatweshouldbeimprovingsystemsinworkplaceforH&S.This
led to a discussionwhich resulted in agreement that anymodel
chosenmusthave include organisational level and individual level;
enforcement and voluntaryinterventions; primary, secondary and
tertiary prevention (and/or otherpromotion/preventionspectrums)
Needs of enforcement clarity, themore grey, the harder to use
the
enforcementtools,alsosocialjusticeinordertodealwithcomplaints(gettingalotofcomplaintsrebullying)
Needtotakecommunitywithus overall term resilience not liked
community perceives it to be an individual level
intervention WorkSafe requires a strong commitment to
organisational levelinterventions
PartnershipmaybeusefultothinkaboutpartnershipsWorkSafecouldbring
inthatarenotalreadyengagedegbusinessschools,SkillsVic.Needtolookathowexistingpartnershipscouldbeused.Needtomapallthsi
ModelEllis,GSK,CDCcouldallbecombined.AlsolikedCanadian. Some
discussion on moving onto interventions/implementation Keleher
model
useful,needtobuildknowledge.
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9.2ReportofWorkshop2
The second workshop was held in early September 2010. The
Workshop began with anopportunity for participants to provide
comments on the draft report and review
anycommentsfromthethoughtpanel.Theworkshopthenfocusedonkeydiscussionpoints:
WhatarethetensionsbetweenbroadeningthescopeofWorkSafe'sroleinpreventionand
WorkSafe's statutory obligations (across both health & safety
andClaims/Compensation)?
What userfriendly language might be considered by WorkSafe to
describe mentalhealthandpsychosocialfactors?
ReviewoftheGlaxoSmithKlinemodelofresilienceasabroaderconceptualisationofworkplace
health? Is the GSK model what most people understand resilience
tomean?
WhatothergovernmentdepartmentsarerelevanttoWorksafeforpartnershipsforabroader
vision of work health? And what is/might be the role of these
othergovernmentdepartmentsinahealthyworkforce?
10 NextSteps
ThenextstepsarebothforWorkSafeandISCRR:1.
WorkSafetoputmoretimeintothedevelopmentoftheirmodel.Mappingofcurrent
workplacehealthpromotionprogramsontoaninterventionsmodel(egKelehermodelFigure
2) to better understand the range of program strategies already
funded byWorkSafe.CorporateStrategywilltakethisforward.
2.
ISCRRandMonashUniversitytofinalisethereportbyendofOctober.
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APPENDIX1:WorkSafeRiskManagementtemplate
Date:
Section/workarea: Managementrepresentative:
Healthandsafetyrepresentative:
RiskManagementWorksheet
STEP1 Identifypotentialworkrelatedstresshazards STEP2
Assessworkrelatedstressrisks STEP3
Controlworkrelatedstressrisks
Markpotentialstresshazardsintheworkplacecomplete
duringdiscussions/consultationprocessFormarksinSTEP1,gotoSTEP2
Record:when,howoftenandoverwhatperiodoftimework
relatedstressrisksoccur
Assesswhetherthereareanyinterimmeasurescanbe
implementedimmediately
Prioritiserisksintheorderthattheywillbedealtwith:inthe
shortterm,mediumtermandlongterm.ProceedtoSTEP3
ConsultemployeesandtheirHSRstodecideonmeasuresto
eliminateorreduceworkrelatedstressrisks.
Developanactionplanwithtargetstoshow:
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howriskcontrolmeasureswillbeimplemented,resourcedandmonitored.
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include:datesonwhichactionswillbeimplementedandwhoisresponsibleforallactions.
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Taskdesignamismatchbetweenqualifications/experienceandthedemandsofthejob
fragmentedormeaninglesswork lackofvarietyother(describe):
Typehere Typehere
Workload/workpace
lackofcontroloverworkmethods,paceand/orrateworkoverloadorunderloadhighworkrateortimepressuresother(describe):
Roleintheorganisation roleortaskuncertainty roleconflict
responsibilitybeyondtheindividualscapacitytocopeother(describe):
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RISKMANAGEMENTWORKSHEETSTEP1 Identifypotentialworkrelatedstress
STEP2 Assessworkrelatedstressrisks. STEP3
ControlworkrelatedstressrisksWorkcontext
hazardousworkpoorcommunicationonworkplaceissuesdealingwithdifficultclients/customersviolenceandthreatsofviolenceother(describe):
Physicalworkenvironmentandequipment
poorworkplacelayout
lackofspaceexcessivenoiseand/orotherenvironmentalstressors(eg:vibration,extremeheat/cold)
inadequateequipmentother(describe):
Degreeofcontrol
lowparticipationindecisionmakinglackofcontroloverworkmethodsandschedulingofworkother(describe):
Organisationalfunctionandculture
poormanagementoforganisationalchangepoorcommunicationwithintheworkplace
rigidworkpracticespeopleunabletoworkouttheirownsolutionstothedaytodayproblemstheyencounterintheworkplace
anonsupportiveworkculturewhereconcernsandrequestsaredismissed
other(describe):
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Workscheduleshiftworkingdisruptiontobodyprocessesinflexibleworkschedulesunpredictableworkinghours
longorunsocialhoursother(describe):
Managementofworkpoorleadershipsupervisionarrangementsperformancemanagementarrangementsinadequateinformation,instructionand/ortrainingother(describe):
Employmentstatus jobinsecuritycareeruncertaintyorstagnation
lackofreward,recognition,statuslowsocialvalueofthework
other(describe):
Relationshipsatworkbullyingandharassmentpoorrelationshipwithcoworkersandsuperiors
interpersonalconflictphysicalorsocialisolation
lackofopportunitytobeconsulted
lackofsocialsupportother(describe):
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APPENDIX2:WorkshopAgendas
Agenda(COPY)PsychosocialConceptualModelReviewWorkshop
Tuesday27thJuly1.003.00pmWorkSafeHO222ExhibitionStMelbourne
Chairperson:ProfessorNikiEllis1.00pm1.10pm Welcome
ProfessorNikiEllis
1.10pm1.30pm Presentationofconceptualmodelsandframeworks
forworkplacepsychosocialinterventions ProfessorHelenKeleher
1.30pm2.00pm
FeedbackbyWorksafeontheusefulnessoftheinitialsetofconceptualframeworks/models
Worksafe
2.00pm2.30pm Discussionregardingfurtherresearchdirections
ProfessorNikiEllistofacilitate
2.30pm2.45pm Discussionregardingoutlineoffinalreport
ProfessorNikiEllistofacilitate
2.45pm3.00pm Conclusion All
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Agenda(COPY)
PsychosocialConceptualModelReviewWorkshop2Wednesday1stSeptember10am12pmWorkSafe,222ExhibitionStMelbourne
Chair:ProfessorNikiEllis
10.00am10.10am 1.Welcome&sessionoverview ProfNikiEllis
10.10am10.25am 2.Reviewofworkshop1Attachment1Workshop1Report
ProfHelenKeleher
10.25am10:50am 3.Reviewdraftreport:a) FeedbackfromWorkSafeb)
ReviewcommentsfromInternationalPanel
Attachment2DraftreportAttachment3Panelcomments(ProfCooper)
(a)WorkSafe(b)ProfHelenKeleher
10:50am11:20am 4.Discussionofkeyquestions:a)
Exploretheissueraisedatthelastmeetingabouttension
betweenbroadeningthescopeofWorkSafe'sroleinpreventionandtheneedtocontaincompensationcostswhilstworkingwithinWorkSafesstatutoryobligations.Howmightthatbetackled?
b)
Atthelastworkshopweagreedthatthetermpsychosocialisnotuserfriendly.Howeverpsychologicalinjurymaynotcapturesufficientlytheinterrelatednessofphysical,mentalandsocialdeterminantsofphysicalandmentalhealthoutcomes.Whatareothertermswhichmightwork?
c)
ReviewtheGlaxoSmithKlinemodelofresilience.Whatdoyouthinkofthatbroaderconceptualisation?Isthatwhatmostpeopleunderstandresiliencetomean?
d)
WhatothergovernmentdepartmentsarerelevanttoWorkSafeforpartnershipsforabroadervisionofworkhealth?
e)
Whatis/mightbetheroleoftheseothergovernmentdepartmentsinahealthyworkforce?
Prof Niki Ellis tofacilitate
11.20am11.40am 5.Exerciseapplyingconceptualmodels
ProfHelenKeleher
11.40am11.55am 6.NextstepshowwillWorkSafeusethisinformation?
WorkSafe
11:55am12pm 7.Conclusion ProfNikiEllis
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Appendix3:FeedbackfromThoughtPanelmember17August2010ImustcongratulateyouonanoutstandingjobonyourReport.Itdoescovermostoftheconceptualframeworksandmodelsinthefield.ItalsoaccuratelyhighlightswhatisavailablefromWHO,HSE,theBlackReportandtheForesight
report on Mental Capital and Wellbeing (Cooper, et al. Mental
Capital and Wellbeing,
Oxford:WileyBlackwells,2009).TheonlygapIcansee,butthatmightbethenextstageafterthisreport
ispresentedand internalized, is in the specific policies and
interventions needed. Inmy role as lead scientist in
theUKgovernments Foresightwork,wehadover400 scientists involved
andover85 science reviews, then
turnedtheseintointerventionsandpoliciesandthengotateamofhighlevelgovernmentandacademiceconomiststocost
most of them. So, for example, the scientific evidence indicated
that flexible working had
enormousindividualandorganizationalbenefitsbutthecostbenefitanalysissuggestedthattherighttorequestflexibleworkingshouldbeforallemployeesandthat
justthosewithchildrenwitha3:1ratioasopposedtoa2:1
ifonlypermittedforthosewithchildren.Inaddition,itwasfoundthatcarryingoutanorganizationalstressauditproducedmajor
cost beneficial effects if the organization developed action plans
based on the audit, eventhough the audit itself,without action,
stillhad somepositive effects throughorganizationalosmosis.
Thereweremanymorepoliciesand interventionsconsidered,supported
inanumberofcases,wherepossible,withcostbenefit ratios, which most
governments need when they are planning policy. Another
importantconsiderationhadtodowithmanagerialstyle,wheretheevidenceisthatitcanbeharmfultopeopleshealth!Thesuggestionherewastoincentivizeorganizationstobettertrainmanagers,atalllevels,onhoningtheirsocialand
interpersonalskillsbygovernmentandemployereachpayingpartofthecosts.
Ifyou lookatthemodels,the issuesofcontrol, longhours,
lackofroleclarity,etc.,fallwithinthecompetencyofthe
linemanagerbutourbusinessschoolsdontactuallyteachpeoplehowtomanageothers,mostlyonlythetheorybehindit!Whatmightbeusefulforyournextphase,wouldbetotranslatesomeofthesepsychosocialinterventionsintospecificinterventionsandpolicies,costthemorgetthedatafromtheForesightreportwhereavailable,andthenpilotsomeoftheseinVictoriaState.Ihopethathelps.ProfessorCaryL.Cooper,CBEChairoftheAcademyofSocialSciences,DistinguishedProfessorofOrganizationalPsychologyandHealthLancasterUniversityManagementSchoolLancasterUniversity
012 R1_Conceptual models to guide psychosocial determinants_full
report_18102010012 R1B_Conceptual models to guide psychosocial
determinants_Research Brief_19102010
