Participatory Action-oriented Training Research Articles

Enhancing Workplace Safety for Disabled Farmers in Thailand: A Quasi-Experimental Study of Ergonomic Interventions in Vermicompost Production

The aim of this study was to improve the working environment for disabled farmers in vermicompost production using participatory action-oriented training (PAOT). Potential hazards were identified through Job Safety Analysis (JSA), and improvements were implemented based on the analysis. The winnowing step was found to have the highest risk, as farmers had to manually separate vermicompost and earthworms by shaking the mixture through a filter. To address this, a vermicompost winnowing machine was developed specifically for disabled farmers, reducing their working time and the risk of muscle injuries. Ergonomic assessments were conducted using Rapid Entire Body Assessment (REBA). The assessments compared the risks associated with the manual process to those when using the newly developed winnowing machine. The results indicated a reduction in musculoskeletal disorder (MSD) risk for all disabled groups. The findings of this study emphasize the importance of considering occupational health and safety for disabled individuals in agriculture. By implementing ergonomic improvements such as redesigned tools and adjusted workstations, the safety and well-being of disabled farmers can be enhanced. This contributes to creating inclusive and productive work environments. In conclusion, through the application of PAOT and ergonomic assessments, this study successfully identified potential hazards and implemented improvements in vermicompost production for disabled farmers. The development of a specialized winnowing machine reduced the risk of musculoskeletal disorders. Promoting occupational health and safety measures is crucial for supporting the participation and well-being of disabled individuals in agricultural work.

Effects of participatory action-oriented training (PAOT) intervention for hypertension management among intercity van drivers.

This study aims to evaluated the effectiveness of participatory action-oriented training (PAOT) intervention for hypertension management among intercity van drivers. This quasi-experimental study applied concept and process of participatory actionoriented training and self-management to guide the development of the intervention addressing improvement in hypertension management behaviors. A total of 104 intercity van drivers with uncontrolled hypertension in Thailand were recruited to participate in this program. The intervention group (N = 52) received PAOT program, while the control group (N = 52) received conventional program. Data on hypertension management behaviors, and blood pressure were measured at baseline, 1 month and 3 months after intervention. At 3 months after intervention, hypertension management behavior, and systolic blood pressure were significantly different between 2 groups (p < 0.05). This PAOT was found to be feasible and could potentially improve hypertension management, and blood pressure level of intercity van drivers. The program should be applied in further studies with other workplaces in both formal and informal sectors with different characteristics and other health issues. Int J Occup Med Environ Health. 2024;37(2):194-204.

제조업 남자 근로자의 대사증후군 관리를 위한 참여형 개선기법(PAOT) 프로그램을 적용한 3년간의 효과분석

제조업 남자 근로자의 대사증후군 관리를 위한 참여형 개선기법(PAOT) 프로그램을 적용한 3년간의 효과분석

Findings of the Work Improvement on Board (WIB) programme by the Fishery Agency in Japan

Concerns are growing about the safety and health of seamen exposed to high risks while working on vessels. Their accident rate in 2013 was 9.9 per 1000 workers, 5 times higher than that in industry. In order to mitigate the risks of seamen, we developed the Work Improvement on Board (WIB) programme by applying participatory action-oriented training (PAOT) methods that have proven effective for reducing work-related risks in small enterprises, construction sites, and agriculture. We analysed which features of the WIB programme would be most effective for facilitating the planning and implementation of practical improvements on vessels. We examined action -oriented tools used, including a WIB action checklist and good examples, and practical improvements proposed by the participants in 1-day or half-day WIB workshops. To study the effectiveness of the WIB programme, we analysed 1121 replies of a questionnaire distributed to 1459 participants of the programme. We compared the types of improvements achieved and the improvement costs in the WIB programme with those in other PAOT programmes. The impact of the WIB programme on promoting primary prevention by seamen and fishermen was discussed. The action checklist listing practical improvements on board and good example photos apparently facilitated the planning and implementation of improvements feasible on board. The participating crews could propose readily applicable improvements of their vessels within short time. In the case of workshops held in 10 harbours between August and October 2014, participants coming from 110 vessels presented 228 improvement proposals which were mostly feasible at low cost. Among the 1121 questionnaire replies from participants of the WIB programme, over 75% evaluated the programme as necessary, practical and easy-to-understand. These positive results led to the adoption of the WIB programme for training fishermen and seamen on commercial vessels by the Fishery Agency and the Ministry of Land, Infrastructure, Transport and Tourism. The Fishery Agency adopted plans to improve the working environment on fishing vessels by training 500 fishermen per year in the WIB programme from 2013 to 2018. The participatory work improvement programme can work in vessels when it utilises in a flexible manner local good practices and low-cost improvements as guides. The use of action-oriented tools such as a WIB action checklist and good examples seems important. We recommend the wide use of WIB methods in occupational safety and health management systems on board vessels in Japan and other countries.

Occupational Safety and Health Activities Conducted across Countries in Asia.

Three occupational safety and health (OSH) activities, one international and two national workshops, were documented as part of OSH activities conducted under the International Labor Organization/Korea Partnership Program in the year 2011–2012. This study aimed to provide information on what the three OSH activities were implemented and how they contributed to the improvement of OSH in Asian countries. The international workshop was useful for the participants to understand a variety of information on OSH as well as participatory action-oriented training (PAOT) approaches at the regional and global levels. The two national workshops were practical for participants to strengthen their knowledge and skills on the PAOT at the enterprise and national levels. The study shows that the three OSH activities contributed to the understanding of the participants on OSH and PAOT, and that the activities promoted the improvement of OSH across countries in Asia.

참여형 개선기법(PAOT)의 원리를 적용한 대사증후군 관리 프로그램 효과분석

Objectives: The purpose of this study was to apply participatory action-oriented training (PAOT) principle for the management of metabolic syndrome and to assess its effectiveness in the workplace. Methods: The metabolic syndrome management program applying participatory action-oriented training (PAOT) principle is constructed action checklist, Group discussion, self-creation of an action plan, after 3 months, 6 months, 1 year, the practice carried out check up and encourage practice activity. Results: The seventy-seven workers who participated in the metabolic syndrome management program made a total of 246 action plans, 3.8 action plans per person and 234 action plans were achieved after one year, so that 81.0% of action plans have been achieved. After 1 year, in the intervention group, systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), the risk factors score decreased statistically significant, and metabolic syndrome prevalence decreased 54.8%. whereas the control group also showed a significant decreased in the mean systolic and diastolic blood pressure, the risk factors score. but, low-density lipoprotein (LDL) was significantly increased. Conclusions: To improve the effectiveness of metabolic syndrome management program applying participatory action-oriented training (PAOT) principle, the need to continues implementing programs and analysis of the long-term effects are required. Participatory action-oriented training (PAOT) principle can applying without cost and time, the human burden for the prevention and management of chronic diseases such as metabolic syndrome.

Utility of action checklists as a consensus building tool

The present study’s objective was to determine the mechanisms for enhancing the utility of action checklists applied in participatory approach programs for workplace improvements, to identify the benefits of building consensus and to compare their applicability in Asian countries to find the most appropriate configuration for action checklists. Data were collected from eight trainees and 43 trainers with experience in Participatory Action-Oriented Training. Statistical analysis was performed in SPSS using the package PASW, version 19.0. The difference in the mean score for the degree of the utility of action checklists between countries was analyzed using ANOVA methods. Factor analysis was performed to validate the action checklists’ utility. Pearson Correlation Coefficients were then calculated to determine the direction and strength of the relationship between these factors. Using responses obtained from trainees’ in-depth interviews, we identified 33 key statements that were then classified into 11 thematic clusters. Five factors were extracted, namely “ease of application”, “practical solutions”, “group interaction”, “multifaceted perspective” and “active involvement”. The action checklist was useful for facilitating a participatory process among trainees and trainers for improving working conditions. Action checklists showed similar patterns of utility in various Asian countries; particularly when adjusted to local conditions.

EFFECTIVENESS OF A PARTICIPATORY ACTION ORIENTED TRAINING INTERVENTION APPROACH AMONG HARVESTERS IN OIL PALM PLANTATION

Consistent with the global demand for palm oil, the intensified upstream harvesting activities of oil palms’ fresh fruit bunches, despite the harvesters evidences of various ergonomics risk factors leading to musculoskeletal disorders should be a cause for concern. Thus, this study describes the effectiveness of a modified and locally adapted Participatory Action-Oriented Training intervention program in improving the working environment of the harvesters. A training program modified and customized to the harvesters’ working in oil palm plantation consist of 3 primary instrument (awareness video, interactive lecture and action checklist) with 3 reinforcing activities (to increase knowledge, enhance understanding and practical application). Based on the result of post-intervention assessment, the self-reported prevalence of MSD and KAP score among Intervention Group (IG) did not significantly differ from Control Group (CG). Instead of decreasing, the prevalence of MSD in the past 12 months and 7 days increased within IG. Qualitative findings in this research show that the negative psychosocial and organizational climate has severely affected the implementation of PAOT rendering the effect of the intervention approach. The interventions were ineffective on the IG as this study suffers from various situational barriers as obstacles to benefit the full extent of PAOT advantages. Keywords: Participatory Action-Oriented Approach, Intervention, Ergonomics, Harvester, Oil Palm Plantation

Effectiveness of a Comprehensive Stress Management Program to Reduce Work-Related Stress in a Medium-Sized Enterprise

ObjectivesTo assess the effectiveness of a comprehensive workplace stress management program consisting of participatory action-oriented training (PAOT) and individual management.MethodsA comprehensive workplace stress management program was conducted in a medium-sized enterprise. The baseline survey was conducted in September 2011, using the Korean Occupational Stress Scale (KOSS) and Worker’s Stress Response Inventory (WSRI). After implementing both organizational and individual level interventions, the follow up evaluation was conducted in November 2011.ResultsMost of the workers participated in the organizational level PAOT and made Team-based improvement plans. Based on the stress survey, 24 workers were interviewed by a researcher. After the organizational and individual level interventions, there was a reduction of several adverse psychosocial factors and stress responses. In the case of blue-collar workers, psychosocial factors such as the physical environment, job demands, organizational system, lack of rewards, and occupational climate were significantly improved; in the case of white-collar workers, the occupational climate was improved.ConclusionsIn light of these results, we concluded that the comprehensive stress management program was effective in reducing work-related stress in a short-term period. A persistent long-term follow up is necessary to determine whether the observed effects are maintained over time. Both team-based improvement activities and individual interviews have to be sustainable and complementary to each other under the long-term plan.

The Effect of Participatory Approach Program for Cardiovascular Disease Prevention in the Workplace

Objectives: The purpose of this study was to develop a program applying participatory action-oriented training (PAOT) methods for the management of cardiovascular disease risk factors and to assess its effectiveness in the workplace. Methods: The cardiovascular disease risk factors of 817 workers in the workplace were assessed, and periodic health examination was conducted. Sixty-four workers (7.8%) were selected as a moderate-risk group and high risk group, and performed the participatory approach program for cardiovascular disease preventive management. Results: The sixty-four workers who participated in the participatory approach program made a total of 246 action plans, 3.8 action plans per person and 115 action plans were achieved after three months, so that 46.7% of action plans have been achieved. In the intervention group that participated in the program, the rate of smoking decreased from 36.2% to 8.6% and systolic and diastolic blood pressure significantly decreased from 140.0±9.4 ㎜Hg to 134.2±12.3 ㎜Hg and from 92.6±7.1 ㎜Hg to 80.0±9.8 ㎜Hg respectfully. In addition, risk factor score also decreased by 0.3, whereas the control group who did not participate in the program also showed a significant reduction in the mean systolic and diastolic blood pressure. Regular exercise increased from 8.5% to 16.0%. Conclusions: To improve the effectiveness of the participatory approach program for the management of cardiovascular disease risk factors, the need to continues implementing programs and analysis of the long-term effects are required.

&lt;사례보고&gt; 농작업 환경개선을 위한 한국형 참여형 개선활동 교육(PAOT)의 개발과 실제 적용 사례

Objectives: This study was conducted to develop a Korean version of the Participatory Action Oriented Training (PAOT) program and training materials for improvement of agricultural working environments. Methods: The PAOT manual and checklist were developed on the basis of the original English version of the training materials, a questionnaire survey of agricultural health and safety professionals, and a brainstorming conference. Good example pictures were collected through visits to agricultural workers' houses, and an easily understandable picture was drawn by an animation specialist. A PAOT action manual and five types of action checklists were developed for use in different agricultural environments. Each action checklist contained six categories and 38 items of agricultural health and safety principles; the six categories were material storage and handling, work stations and tools, machine safety, physical environment, working schedule and organization, and basic health and safety management. Incorporating these training materials, a one-day Korean PAOT program was developed. Results: Among 307 candidate agricultural workers from four rural Korean villages, 94 workers (59 males, 35 females) participated in a PAOT from July 2007 to Oct 2008. The PAOT program was successful and the mean self-estimated satisfaction score of the participants was greater than 90%. Conclusions: A Korean PAOT program and training materials were successfully developed and applied to Korean agricultural workers. Although more studies are needed, it is expected that PAOT will greatly contribute to the improvement of agricultural working conditions and health and safety through the use of agricultural workers' self initiatives.

Action-oriented use of ergonomic checkpoints for healthy work design in different settings.

Recent experiences in the action-oriented use of ergonomic checkpoints in different work settings are reviewed. The purpose is to know what features are useful for healthy work design adjusted to each local situation. Based on the review results, common features of ergonomic checkpoints used in participatory training programs for improving workplace conditions in small enterprises, construction sites, home work and agriculture in industrially developing countries in Asia are discussed. These checkpoints generally compile practical improvement options in a broad range of technical areas, such as materials handling, workstation design, physical environment and work organization. Usually, "action checklists" comprising the tiles of the checkpoints are used together. A clear focus is placed on readily applicable low-cost options. Three common features of these various checkpoints appear to be important. First, the checkpoints represent typical good practices in multiple areas. Second, each how-to section of these checkpoints presents simple improvements reflecting basic ergonomic principles. Examples of these principles include easy reach, fewer and faster transport, elbow-level work, coded displays, isolated or screened hazards and shared teamwork. Third, the illustrated checkpoints accompanied by corresponding checklists are used as group work tools in short-term training courses. Many practical improvements achieved are displayed in websites for inter-country work improvement networks. It is suggested to promote the use of locally adjusted checkpoints in various forms of participatory action-oriented training in small-scale workplaces and in agriculture particularly in industrially developing countries.

Development of an intervention to prevent work-related musculoskeletal disorders among hospital nurses based on the participatory approach

The participatory approach has been widely used to improve the work environment. The purpose of this study was to develop an intervention to prevent work-related musculoskeletal disorders in hospital nurses using the participatory approach. Based on the Participatory Action Oriented Training (PAOT) approach, the multidisciplinary team conducted the trainer workshop to develop a comprehensive intervention protocol, which yielded several practical and low-cost solutions to reduce the risk factors for musculoskeletal disorders. Structured tools that were focused on the hospital environment were developed. The developed action checklist consisted of 43 items that were focused on five areas of nursing tasks (i.e., patient care and treatment; safe handling of drugs, medical devices, and equipment; workstation design; physical environment; and welfare facilities and administration). The final intervention protocol consisted of a series of structured participant workshop, follow-up visits, and presentation of achievements.

Application of Participatory Action-Oriented Training (PAOT) to Small and Medium sized Enterprises for Prevention of Work-related Musculoskeletal Disorders

Application of Participatory Action-Oriented Training (PAOT) to Small and Medium sized Enterprises for Prevention of Work-related Musculoskeletal Disorders

Insulin Resistance, Its Consequences, and Coronary Heart Disease

Approximately 25 years ago, our research group1 2 used quantitative methods to show that resistance to insulin-mediated glucose disposal was present in patients with either impaired glucose tolerance or NIDDM. These initial observations have been confirmed on multiple occasions since then, and there is now a large body of evidence that shows that this defect is present in the vast majority of glucose-intolerant individuals.3 4 5 6 7 8 In addition, several reports9 10 11 demonstrated that first-degree relatives of patients with NIDDM are also relatively insulin resistant compared with well-matched volunteers without a family history of NIDDM. Finally, prospective studies12 13 14 15 16 have identified insulin resistance and/or compensatory hyperinsulinemia as the initial defect in the development of NIDDM. Thus, the central role of insulin resistance in the pathogenesis and clinical course of patients with NIDDM has been well established. Of greater relevance to the IRAS study of “Insulin Sensitivity and Atherosclerosis” published in this issue of Circulation 17 is recent awareness that the ability of insulin to mediate glucose disposal can differ by as much as 10-fold in subjects with normal glucose tolerance.18 19 Because the degree of insulin resistance in a substantial portion of these persons approaches that seen in patients with impaired glucose tolerance or NIDDM, it is assumed that they are able to secrete enough insulin to overcome the insulin resistance and maintain normal glucose tolerance. Unfortunately, the philanthropic response on the part of the pancreatic β-cell is not without cost, and in 1988,20 it was emphasized that these individuals were at increased risk to have higher plasma TG and lower HDL cholesterol concentrations and higher blood pressure. More importantly, it was suggested that the cluster of abnormalities associated with insulin resistance, designated as Syndrome X, significantly increased …