Ståhl Christian, Costa-Black Katia, Loisel Patrick
a Department of Medical and Health Sciences, Division of Community Medicine , Linköping University , Linköping , Sweden.
b HELIX Competence Centre, Linköping University , Linköping , Sweden.
Disabil Rehabil. 2018 Apr;40(8):952-959. doi: 10.1080/09638288.2016.1277399. Epub 2017 Jan 17.
This article explores and applies theories for analyzing socio-political aspects of implementation of work disability prevention (WDP) strategies.
For the analysis, theories from political science are explained and discussed in relation to case examples from three jurisdictions (Sweden, Brazil and Québec).
Implementation of WDP strategies may be studied through a conceptual framework that targets: (1) the institutional system in which policy-makers and other stakeholders reside; (2) the ambiguity and conflicts regarding what to do and how to do it; (3) the bounded rationality, path dependency and social systems of different stakeholders; and (4) coalitions formed by different stakeholders and power relations between them. In the case examples, the design of social insurance systems, the access to and infrastructure of healthcare systems, labor market policies, employers' level of responsibility, the regulatory environment, and the general knowledge of WDP issues among stakeholders played different roles in the implementation of policies based on scientific evidence.
Future research may involve participatory approaches focusing on building coalitions and communities of practice with policy-makers and stakeholders, in order to build trust, facilitate cooperation, and to better promote evidence utilization. Implications for Rehabilitation Implementation of work disability prevention policies are subject to contextual influences from the socio-political setting and from relationships between stakeholders Stakeholders involved in implementing strategies are bound to act based on their interests and previous courses of action To promote research uptake on the policy level, stakeholders and researchers need to engage in collaboration and translational activities Political stakeholders at the government and community levels need to be more directly involved as partners in the production and utilization of evidence.
本文探讨并应用相关理论来分析工作残疾预防（WDP）策略实施过程中的社会政治层面。
在分析过程中，结合瑞典、巴西和魁北克三个司法管辖区的案例，对政治学理论进行解释和讨论。
WDP策略的实施可通过一个概念框架进行研究，该框架关注：（1）政策制定者和其他利益相关者所处的制度体系；（2）在做什么以及如何做方面存在的模糊性和冲突；（3）不同利益相关者的有限理性、路径依赖和社会系统；（4）不同利益相关者形成的联盟及其之间的权力关系。在这些案例中，社会保险制度的设计、医疗保健系统的可及性和基础设施、劳动力市场政策、雇主的责任水平、监管环境以及利益相关者对WDP问题的一般认知，在基于科学证据的政策实施中发挥了不同作用。
未来的研究可能涉及参与式方法，重点是与政策制定者和利益相关者建立联盟和实践社区，以建立信任、促进合作并更好地推动证据的利用。对康复的启示工作残疾预防政策的实施受到社会政治背景以及利益相关者之间关系的背景影响。参与实施策略的利益相关者必然会基于自身利益和以往行动方针采取行动。为了在政策层面促进研究成果的应用，利益相关者和研究人员需要开展合作与转化活动。政府和社区层面的政治利益相关者需要更直接地作为伙伴参与证据的产生和利用。
