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In the first 2 years of this project a participatory-ethnographic approach for work-place health promotion will be developed to stimulate positive health and social resilience among low SEP employees. The study aims to develop, to carry out and to evaluate interventions for work place health promotion in participatory collaboration with employees and to attune the interventions to their perspectives, experiences and capabilities. The participatory refers to the need to engage relevant internal stakeholders (employees, management, occupations physician, HR staff) in health promotion interventions, as this creates ownership and sustainability. The ethnography refers to the need to attune to the life world of employees and to how they give meaning to health, work, change, participation and other health promotion related issues. As ethnography connects to broader meanings of health than epidemiological methods, this approach is very much suited for stimulating positive health, a concept that also stresses the multi-dimensional character of health. The choice for this approach is inspired and guided by scientific studies of participatory approaches in fields like work ergonomics, work related stress, community health promotion and community participation.

The project will be carried out in 2 companies in the southern part of the Netherlands, a factory with a substantial amount of blue collar workers working in shifts, and a company for sheltered labor for people with intellectual, mental or physical disabilities. In both companies a basis for a participatory-ethnographic approach is established before the project starts, as for both companies pilot studies about vitality and health are available. These pilots make clear that employees do value health and are interested to improve their health, but also that participation in the programs is hindered by specific focus, design and timing of the program on the one hand and broader work organization and culture related factors on the other hand.

In these companies in a step-wise process of co-designing, co-executing and co-evaluating health interventions will be organized. In all phases the perspective of employees is leading as it is their health that is the central object of interventions and study: this implies that also the evaluation criteria for success (what works/what does not work) are developed with employees. Through diverse participatory formats, that are suited for low SEP employees as they do not only rely on verbal expressions and argumentative reasoning, health promotion interventions will be designed, carried out and evaluated. When necessary we will provide input to this process by giving examples of possible activities that may fit the life world of employees – e.g. health race and other playful activities, multimedia tools, making a health exhibition together. In this process we draw theoretically from literatures that are sensitive to the non-rationalistic dimensions of human behavior chance: a. philosophy and sociology of the body to be sensitive to the specific way low SEP employees may embody (not speak about) their health, b: visual sociology to be sensitive to other than written tools to express ideas and preferences like for instance photo voice, c. philosophy of play to be sensitive to the engaging capacity of play as a vehicle for change.

These processes will be documented through intensive fieldwork, in depth interviews and feedback meetings. For the systematic analysis of these collected data we will make use of software program for qualitative data analysis Nvivo, to support the coding process we will combine deductive and inductive analysis strategies, in which data and theoretical concepts are compared and contrast in an iterative process to deepen understanding of the findings. Analyses of the data feed into the participatory process as starting point of the next phase.

From the start, the process and the intermediary findings will also be shared with external stakeholders on a national level, to anticipate and prepare the implementation of the project results in the third year. Discussions in these meetings will be translated in an e-manual for HR managers and professionals about participatory health promotion for low SEP employees. In the third year this approach will be implemented and tested in 4 other companies in other regions in the Netherlands while the developments in company A/B will still be followed. On the basis of feedback during this implementation phase, we will adjust and fine tune the e-manual, to ensure that it is useful in different settings with lower SEP employees. The project will result in an ethnographic grounded e-manual for participatory health promotion for low SEP employees and academic and professional publications.


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