Integrated Health Promotion Programme
Author(s): Hege R. Eriksen.,C. Ihlebæk, A. Mikkelsen, H. Grønningsæter, G. M. Sandal and H. Ursin Country: Norway
Is the intervention sector specific?	No
Is the intervention usable with different enterprise sizes?	Yes
Is the intervention equally applicable to both genders?	Yes
Is the intervention based on theory?	Yes
Can the intervention approach be adapted/ tailored?	Yes
Does the intervention promote CSR and how?	The intervention was not explicitly linked to responsible business practices although it does promote employee well-being
Does the intervention promote social dialogue and how?	Social dialogue was not a key component of this intervention
Overview (including risk assessment and law – legal requirements etc.): One of the main causes of sick leave is subjective health problems; defined as conditions with few or not objective findings. In Norway, more than half of the total sick leaves are based on such subjective statements and conditions; making managing and, moreover, reducing sick leave a national priority. In response to this national concern, Eriksen and colleagues have developed a worksite intervention aimed at decreasing subjective health complaints and reducing sick leave. This worksite intervention is a combined integrated health programme, which contains three main components: (a) physical exercise; (b) information regarding stress, coping, health and nutrition; and (c) a practical examination of the worksite.
Implementation: The integrated health programme was conducted two hours once a week for 12 weeks. Each session consisted of two subsections, the first hour is dedicated to theoretical exercises (topics included the relationship between demands and exercise, anatomy, information about low back pain, stress theory, ergonomics, exercise physiology, pain and behaviour, musculoskeletal pain, nutrition, etc.) and the second part comprised of physical exercise. The physical exercise component of the integrated health programme consisted of: warm-up/aerobic, alternative working positions and strength training, stretching and relaxation. The level and intensity of the exercise programme were individually tailored to meet the capabilities of the individual. Two instructors, both physiotherapists, were present at each session. The worksite was visited twice (during the second and eighth week), where degree of static work, heavy lifts, repetitive motion, and so on were analyzed. On the second practical examination the focus was on identifying possible new ways of doing the job and job tasks.
Practical applications: The intervention is standardized and based on detailed protocols, manuals and prepared teaching material (e.g., slides and transparencies). Professional instructions underwent training to hone skills and respective methods required for successful implementation. The integrated health programme has been successfully implemented in a variety of occupational sectors (specifically the public and healthcare sectors); and in medium to large-sized organisations.
Innovative aspects: The integrated health programme uses a combination of education and physical exercise to promote and strengthen stress management within individuals; whilst, examining and addressing the larger working environment and design of work.
Evaluation (including process issues, outcomes and sustainability): The integrated health programmes’ effectiveness has been assessed by randomly allocating participants to one of three interventions: physical exercise, a traditional stress management training approach, and the newly developed integrated health promotion programme. Measurements were taken at three time points: prior to intervention; directly following the intervention; and at a one year follow up. Several outcome variables were used to assess the intervention: namely, job stress, subjective health complaints, and sick leave. Additionally, a subjective evaluation of improvement after the intervention was measured by asking participants if the intervention had had any influence on their perceived health, work environment, work situation, physical fitness, muscle pain, ability to deal with stress, and knowledge of how to maintain good health.
Benefits (including cost effectiveness): Based on the evaluation of the integrated health programme intervention, the following were the benefits observed. The integrated health programme had the best overall effect as compared to the stress management intervention and physical exercise. Individuals participating in the integrated health programme reported increased levels of physical fitness and health. The integrated health programme was found to improve the work situation and increase participants’ knowledge and capacity for dealing with stress; and decrease muscle pain and increase knowledge about how to maintain optimal health. All observed improvements were maintained at the one year follow up.
References: Eriksen, H.R., Ihlebaek, C., Mikkelsen, A., Gronninsaeter, H., Sandal, G.M., & Ursin, H., (2002). Improving subjective health at the worksite: A randomized controlled trail of stress management training, physical exercise, and an integrated health programme. Occupational Medicine, 52,383-391.
Comments: While the intervention examines aspects of the work environment as well, it focuses on work and task design only (e.g. static work, heavy lifts, repetitive motion) and not on the full range of psychosocial hazards.