Intervenções em saúde do trabalhador - contexto, desafios e possibilidades de desenvolvimento: uma revisão de escopo / Occupational health interventions - context, challenges and possibilities for development: a scoping review

Resumo Objetivo: analisar a estrutura, o funcionamento das intervenções para prevenção de agravos e a promoção da saúde do trabalhador no Brasil, segundo os critérios de sistematicidade, agência transformativa e transformação. Métodos: foi realizada uma revisão de escopo de estudos empíricos publicados entre 2010 e 2019. Para avaliar e interpretar os achados e discutir suas possibilidades e tendências de desenvolvimento, utilizaram-se os três critérios mencionados. Resultados: foram incluídos 147 estudos; observou-se que o objeto da intervenção é mais comum em elementos isolados do sistema de atividade produtiva do que sobre o conjunto completo; a agência transformativa dos atores envolvidos é pouco estimulada; a transformação efetiva das condições que deram origem às intervenções aparece com mais frequência nas situações em que se pretendia mudar apenas aspectos proximais aos agravos de saúde. Conclusão: embora parte dos estudos reporte mudanças implementadas, a maioria deles não refere intervenções sobre os determinantes de saúde e não envolve os trabalhadores como protagonistas das mudanças. Os achados permitiram discutir possibilidades de desenvolvimento e desafios para intervenções.

Abstract Objective: to analyze the structure and functioning of interventions for diseases prevention and workers' health promotion in Brazil according to the criteria of systematicity, transformative agency and transformation. Methods: we carried out a scope review of empirical studies published between 2010 and 2019. To evaluate and interpret the findings and discuss their possibilities and development trends, the three mentioned criteria were used. Results: 147 articles were included. Isolated elements of the productive system are more often subject to intervention than the entire system. Workers' transformative agency is little stimulated, and the effective transformation of the conditions targeted appears more frequently in situations focused on changing only proximal aspects to health issues. Conclusion: although some studies report implemented changes, most of them do not refer to interventions on health determinants and do not involve the workers as protagonists of changes. The findings allowed to discuss development possibilities and challenges for interventions.

Learning Platforms for Implementing Formative Interventions to Promote the Health and Safety of Workers in Brazil.

Formative intervention methodologies, such as the Change Laboratory (CL), are increasingly being used in work environments. However, the learning process entailed in the application of these methodologies has received insufficient attention and may be facilitated through the use of learning platforms. We examined the development of learning and training strategies for implementing formative interventions, drawing on the experiences of a research group focusing on workers' health. Information obtained from individuals involved in CL formative activities was analyzed and interpreted using Cultural-Historical Activity Theory and the theory of expansive learning. The process of learning to implement formative interventions unfolded gradually, beginning with the interventionists' initial exposure to abstract concepts that they subsequently internalized via various mediations and applied in concrete situations. Four key interventionist training strategies used to foster collective learning were identified: (1) promoting dialogues and exchange of experiences, (2) creating environments for continuous learning and permanent discussion (seminars and post-graduate courses and the use of communication technologies), (3) creating spaces for experimentation and the practical application of concepts (case studies and participation in interventions), and (4) the use of the double stimulation method during training programs.