Promoting Evidence-based Practice for improved occupational safety and health at Swedish occupational Health services. A research program.

Despite the rapid growth in research and R&D expenditures, the translation of scientific knowledge into practice is still very limited. There is a need to find effective strategies that can bridge the gap between research and practice.

Background

Building practice-based research networks where end-users are involved have been shown to be effective in health care settings. With the aim of strengthening the research and evidence-based practice in occupational health services in Sweden, a practice-based research network (PBRN-OSH). The main mission of the programme is to develop and promote the use of evidence-based occupational safety and health (OSH) interventions, with the goal of creating healthy productive workplaces with a sustainable workforce. The developed network, which included researchers, practitioners from occupational health services and national representatives from the labour-market parties, provides the overarching infrastructure of the program.

AIM

The aim of the program is to develop and promote the use of evidence-based measures in the everyday work of OH-services in supporting OSH at workplaces.

Method

We developed a knowledge synthesis and translation system and a prevention support system using the Interactive Systems Framework for dissemination and implementation (ISF) as a guiding framework. The rationale for using the Interactive Systems Framework (ISF) as a guiding framework in the development of the PBRN-OSH program is that it describes the contributions that researchers, stakeholders, practitioners and others can make to bring evidence-based methods into practice. The ISF includes three systems that support dissemination and implementation of evidence-based interventions, methods and policies.

Results

During the programme we obtained several important activities to promote the translation of occupational safety and health research into practice. The PBRN-OSH developed in the program resulted in several practice based research projects as well as different measures to ensure evidence based practice in OSH such as national practice guidelines for the OH-services and the inclusion of evidence based practice (EBP) as mandatory in the accreditation of the national OH-services. Moreover, results show that over time the competence in EBP increased among practitioner at the OH-services. In conclusion, from a societal perspective the benefits of PBRN are obvious. It provides increased societal relevance as studies to a higher degree address current societal problems. At user level, it leads to an increased cooperation and understanding of the importance of EBP and thereby more effective measures for OSH at workplaces.

Promoting evidence-based practice within occupational health

Despite the abundance of research knowledge, there is to date still a gap between the research that exists and what is used in practice. This gap is a problem in many areas, including the area of occupational health and work environment. Scientific knowledge is often insufficiently used within the occupational health services or within an organisation’s work environment.

 

Results

Employers and employees are not always given the best possible support when it comes to implementing evidence-based methods within their organisation and practice. To support the use of cost-effective methods within occupational health, researchers at the unit of Intervention- and implementation research for worker health, have for many years worked with promoting evidence-based practice within occupational health. This work has among others included the development of occupational health guidelines, such as the Guideline for the prevention of mental ill health at the workplace and the Guideline for health screenings at the workplace. To ensure that the development of occupational health guidelines in Sweden would become a sustainable practice, researchers at the unit started a collaboration with the government authority MYNAK. This authority is devoted to the dissemination of evidence-based practice within occupational health and safety, and the occupational health services. Since, 2019 the authority has taken the dissemination of occupational health guidelines and the development of new guidelines, with the support of our unit.

Evidence based practice within the Swedish occupational health services

Evidence-based practice (EBP) has been introduced in health care settings as a means of linking research results to clinical practice. Karolinska Institutet and the Royal Institute of Technology have evaluated the development of EBP in occupational health services in 2011 and 2014.

Aim: To investigate whether the development of evidence-based practice (EBP) in the Swedish occupational health services in relation to attitudes, knowledge and use improved during the first 3 years of the government’s initiative.

Method: The study has a mixed methods design combining questionnaires and interviews with data collection at baseline (2011) and at 3-year follow-up (2014).

Results and conclusions

  • The practitioners’ knowledge of, and competence for working with EBP was moderate at baseline and improved at the three-year follow-up

  • The practitioners’ knowledge of critically reviewing scientific literature had increased at follow-up

  • At follow-up, the practitioners experienced lower levels of organizational and managerial support for EBP

  • Managers viewed the responsibility for implementing EBP as a matter for individual practitioners rather than as an organizational issue, which is mainly explained by economic matters

  • Managers and practitioners are generally positive to EBP

    • The findings indicate a need to educate managers in how to support EBP

    • Such education might be supported by an infrastructure for EBP in the occupational health services.

Researchers, project time and funding

Principal Investigator Irene Jensen and Lydia Kwak. This program involves researchers in the Worker Health research team at the unit.

The program started Jan 2011 and are still ongoing

Funded by FORTE, AFA Insurance and Mynak

Publications

Reports in Swedish

Final report AFA

Final report FORTE

Metoder för företagshälsa. Checklista Tidiga indikatorer för mobbning. Nr 9.2, 2015

Metoder för företagshälsa. EBP i FHV en treårsuppföljning Nr 7 .2105

Metoder för företagshälsa. Effekter av hälsoundersökningar. Nr 6, 2014

Metoder för företagshälsa. Evidensbaserad praktik i företagshälsovården. Nr 2, 2012

Metoder för företagshälsa. Forskning och utveckling inom företagshälsovården. Nr 1, 2012

Metoder för företagshälsa. Hierarkier av hälsa 2012. Nr 4, 2012

Metoder för företagshälsa. Hälsofrämjande insatser riktade till arbetsplatsens fysiska miljö och organisationsstruktur effekt på arbetsrelaterade utfall. Nr 12, 2017

Metoder för företagshälsa. Insatser via FHV för att minska psykisk ohälsa Nr 8, 2015

Metoder för företagshälsa. Kostnadsjämförelse mellan tre rehabiliteringsprogram för anställda med alkoholproblem. Nr 11, 2016

Metoder för företagshälsa. Tidiga indikatorer för mobbning. Nr 9.1, 2015

Metoder för företagshälsa. Tidiga insatser för ryggbesvär. Nr 5, 2013

Metoder för företagshälsa. Viktiga incitament för svenska arbetsgivare vid genomförande av arbetsmiljöinsatser. Nr 10, 2016

Metoder för företagshälsovården_Att arbeta med att främja goda matvanor och fysisk aktivitet på arbetsplatser. Nr 3, 2012

 

International publications

Promoting evidence practice   https://www.mdpi.com/1660-4601/17/15/5283?type=check_update&version=1

Developing a practice guideline for the occupational health services by using a community of practice approach: a process evaluation of the development process ht https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387008/tps://www.ncbi.nlm…

Development of evidence-based practice in occupational health services in Sweden: a 3-year follow-up of attitudes, barriers and facilitators. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387008/

Irene Jensen

Professor
C6 Institute of Environmental Medicine

Lydia Kwak

Lecturer senior
C6 Institute of Environmental Medicine
C6 Institute of Environmental Medicine