Unifying and diversifying workplace-based efforts for promoting health and preventing disability.

In the last decades, the workplace has gradually been more acknowledged as a core arena for interventions aiming at promoting health and preventing disability [1–3]. A first example of this acknowledgement is the frequent use of Workplace or Worksite Health Promotion Programs (WHPP), built on a Public Health tradition, aiming at improving employees’ health and lifestyle (i.e., physical activity, healthy eating, weight loss, relaxation, smoking, and drug/alcohol use). The body of knowledge assessing WHPP’s effectiveness is increasing [4–6]. A systematic review found more than 300 trials of WHPP published between 2000 and 2012 [5]. Still, the effectiveness of such interventions is for several of the targeted lifestyle changes inconclusive or non-consistent [5–8]. One review even found that high-quality trials tended to report smaller effects than low-quality trials [8]. A second example is Individual Placement Support (IPS), aiming at increasing participation in work, among groups with larger work disability challenges [9]. Inspired by the recovery ideology, the paradigm ∗Address for correspondence: Randi W. Aas, Presenter, Stavanger Innovation Park, Prof. Olav Hanssens v. 7a, Stavanger 4021, Norway. Tel.: +4791182266; E-mail: [email protected]. shift in the 80’s in psychiatric vocational rehabilitation from “train then place” to “place then train” changed the field, and IPS became the new paradigm [9, 10]. Competitive employment became the goal, and lengthy pre-employment training was replaced with rapid job search. This made us design “placement interventions” at real workplaces, where the efficient Supported Employment [11, 12] is a great example. To train first and most at workplaces, not in clinics is therefore common today in psychiatric rehabilitation. A third example is treatment of musculoskeletal disorders (MSD). “Disease prevention” in the mid-1990’s suggested to be replaced with “disability prevention”, by which workplace foci were strengthened [13–15]. Ten years ago, we were still asking if workplace interventions were an effective means for secondary prevention of low back pain [16]. Today, we know more and judge workplace-based efforts as main solutions for reducing sick leave and return to work for sick-listed employees with MSD and common mental disorders [17–21]. The Workplace Disability Prevention and Integration (WDPI) community of researchers is these days building a strong body of knowledge about workplacebased efforts worldwide, as still much is unknown. For example, we do not know why workplace interventions seem to reduce sick leave and promote return to work, but not affect health outcomes [3, 19].