Schouw Darcelle, Mash Robert, Kolbe-Alexander Tracy
a Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa.
b School of Health and Wellbeing , University of Southern Queensland , Ipswich , Australia.
Glob Health Action. 2018;11(1):1544336. doi: 10.1080/16549716.2018.1544336.
The workplace is an important setting for the prevention of non-communicable diseases (NCDs). Policies for transformation of the workplace environment for occupational health and safety in South Africa have focused more on what to do and less on how to do it. There are no guidelines and little evidence on workplace-based interventions for NCDs.
The aim of this study was to learn how to transform the workplace environment in order to prevent and control cardio-metabolic risk factors for NCDs amongst the workforce at a commercial power plant in Cape Town, South Africa.
The study design utilized participatory action research in the format of a cooperative inquiry group (CIG). The researcher and participants engaged in a cyclical process of planning, action, observation and reflection over a two-year period. The group used outcome mapping to define the vision, mission, boundary partners, outcomes and strategies required. At the end of the inquiry the CIG reached a consensus on their key learning.
Substantial change was observed in the boundary partners: catering services (78% of progress markers achieved), sport and physical activities (75%), health and wellness services (66%) and managerial support (65%). Highlights from a 10-point consensus on key learning included the need for: authentic leadership; diverse composition and functioning of the CIG; value of outcome mapping; importance of managerial engagement in personal and organizational change; and making healthy lifestyle an easy choice.
Transformation included a multifaceted approach and an engagement with the organization as a living system. Future studies will evaluate changes in the risk profile of the workforce, as well as the costs and consequences for the organization.
工作场所是预防非传染性疾病（NCDs）的重要场所。南非关于转变工作场所环境以促进职业健康与安全的政策更多地侧重于做什么，而较少关注如何去做。目前尚无关于基于工作场所的非传染性疾病干预措施的指南，相关证据也很少。
本研究的目的是了解如何转变工作场所环境，以预防和控制南非开普敦一家商业发电厂员工的非传染性疾病的心血管代谢风险因素。
本研究设计采用合作探究小组（CIG）形式的参与式行动研究。研究人员和参与者在两年时间内参与了一个规划、行动、观察和反思的循环过程。该小组使用成果映射来确定所需的愿景、使命、边界伙伴、成果和策略。在探究结束时，合作探究小组就其关键学习内容达成了共识。
在边界伙伴方面观察到了实质性变化：餐饮服务（实现了78%的进展指标）、体育和身体活动（75%）、健康与保健服务（66%）以及管理支持（65%）。关于关键学习内容的十点共识中的要点包括需要：真实的领导力；合作探究小组的多元化组成和运作；成果映射的价值；管理参与个人和组织变革的重要性；以及使健康的生活方式成为容易的选择。
转变包括多方面的方法以及将组织作为一个活系统来参与。未来的研究将评估员工风险状况的变化，以及对组织的成本和影响。
