Presentation at the 2nd International Symposium: ICF Education. 30 June 2017 (Cape Town). http://www.icfeducation.org

1. Positioning of presentation
PhD project at Maastricht University
Towards a paradigm shift in occupational health;
The potential of the International Classification of Functioning,
Disability and Health (ICF) for preventive practice, research &
education

2. The effect of two ICF-training programs on
knowledge, skills and attitude among (future)
occupational health professionals
Carin de Brouwer, Ludovic van Amelsvoort, Yvonne
Heerkens, Guy Widdershoven, IJmert Kant
ICF Education, Kaapstad 2017
Date: 30-06-17

3. Content
- Developments and challenges regarding occupational
health
- Relevance of ICF framework
- Aims of ICF training
- Measurement characteristics
- Content of training
- Results
- Conclusion
- Key messages
- Discussion

4. Societal Developments challenging Occupational Health
Developments western society:
• Aging of the population
• Working age people
• Pension funding
• Workers need to stay in
workforce longer
• Changing nature of work
• Changing riskfactors & related
health issues
• More precarious work (latest
crisis)
Challenges for OH professionals:
• Tertiary prevention of work
related problems is difficult
• Proactive approach in OH for
fostering health is warranted
• Biopsychosocial perspective is
needed as a mental model in
use
How to catalyse this
paradigm shift?

5. Relevance of ICF framework for Occupational Health
• Biopsychosocial paradigm
• Language for describing work related functioning; Heerkens et
al. Elaboration of the contextual factors of the ICF for
Occupational Health Care. Work . 2017;57(2)
• Scheme for visualising interplay of components; research level
and individual level
• Facilitating tertiary as well as other ways of prevention and
health promotion
• Facilitating monitoring of health (instead of return to work
guidance and disease prevention only)

6. Aims ICF training
Students in OH curriculum:
Enhancing students in
scientific reasoning from a
biopsychosocial perspective
through integrating
the knowledge and skills
acquired in the longitudinal
ICF-training trajectory with
knowledge and skills acquired
in an Evidence Based Practice
(EBP) training trajectoryc
cBrouwer et al. Work . 2017;57(2)
OH care Professionals:
Enhancing implementation
of a preventive strategyb
aiming for reducing
sickness absence in their
target companies, through
screening and early
intervention of employees
at high risk for future sick
leave
bBrouwer et al. Work . 2017;57(2)

7. Measurement characteristics
Measurement Instrument*:
- Background characteristics participants
- 15 closed questions investigating prior exposure to ICF
- 15 knowledge items
- 38 skills items
- 12 attitude statements (2 usfulness, 10 mastery)
*Adapted instrument of Reed et al. Disability and rehabilitation. 2008;30(12-13):927-41
Measurement moments:
- t0: just before ICF training
- T1: last day of ICF training
Participants: 26 students, 18 professionals

8. Content of training
Knowledge &
Skills
Attitude
Mastery
Usefulness
Use of ICF Core Sets (e.g. VR)

9. Increase in knowledge
0
3
6
9
12
15
T0 T1
Knowledge
Students Professionals
Both groups statistically significant increase over time
At T1 between group difference p<0.05 in favor of
students

10. Increase in skills
0
4
8
12
16
20
24
28
32
36
T0 T1
Skills
Students Professionals
Only students showed a significant increase over time
(P<0,05)

11. Increase in usefulness
2
3
4
5
6
7
8
9
10
T0 T1
Usefulness
Students Professionals
No statistical significant increases over time
At T0 and T1 students perceived usefulness higher
(p<0.05)

12. Increase in mastery
10
15
20
25
30
35
40
45
50
Categorie 1 Categorie 2
Mastery
Students Professionals
Both groups increase mastery over time (p<0.05)
At T1 between group difference in favor of students
(p<0.05)

13. Conclusion
- Knowledge increased significant in students and OH professionals
- Mastery increased significant in students and OH professionals
- Skills increased for students only, seems much more depending on
intensity of training
- Mastery is most important predictor of actual behaviour change in Social
Cognitive Theories (Godin et al. Implementation science : 2008 Jul
16;3:36)
- Behaviour change in this context would be the actual use of ICF in
occupational healthcare to enhance more proactive approaches.

14. Key messages
- ICF can be trained to students and professionals
- Effects of training more pronounced in students
- Paradigmshift in (occupational) healthcare should start in
healthcare curricula, agree with Bornbaum et al.(Disability and
rehabilitation. 2015;37(2):179-86)

15. Questions?
Thank you for your attention
carin.debrouwer@maastrichtuniversity.nl

16. Discussion
- Inventorying the needs of the training participants versus How to raise awareness
for the potential of the ICF framework
- Aims of training important for tailoring content and motivation participants
- The intensity of the training (how much is enough?)
- Importance of capability belief based on increased knowledge versus skills lagging
behind
- The level aimed for in teaching ICF (4th level in master program, but for example
2th level is enough for healthcare professionals or medicine students??) versus
the acceptability of the training (target overshoot when the bar is set to high)

17. Effects of training on knowledge, skills, and attitude
Scale
(Score Min; Max)
T0 Mean score
(SD; N)
T1 Mean score
(SD; N)
Δ T1-T0 Mean score*
(SD;N)
Student Proff. Student Proff. Student Proff.
Knowledge
(0; 15)
3.8W
(3.1; 26)
4.8W
(3.6; 17)
11.7B, W
(1.5; 24)
10.5B, W
(2.5; 18)
7.8**
(3.7; 24)
5.4**
(3.4; 16)
Skills
Functions
(0; 8)
4.4W
(0.9; 25)
4.7
(1.7; 15)
4.9W
(1.5; 24)
4.8
(1.2; 18)
0.6
(1.6; 23)
-0.1
(1.9; 14)
Activities/Participatio
n
(0; 21)
15.4
(2.4; 26)
15.7
(3.2; 15)
16.4
(2.4; 24)
15.2
(4.1; 18)
0.9
(3.4; 24)
-0.8
(4.6; 14)
Environmental
Factors
(0; 9)
3.4
(1.2; 26)
3.1
(2.0; 15)
4.0
(1.2; 23)
3.7
(1.5; 18)
0.4
(1.6; 23)
0.7
(2.1; 14)
Skills total
(0; 38)
23.1W
(3.1; 25)
23.6
(4.8; 15)
25.6W
(3.3; 23)
23.7
(5.5; 18)
2.2
(4.8; 22)
-0.8
(5.9; 14)
Attitude
Usefulness
(2; 10)
8.0B
(0.9; 26)
7.2B
(1.3; 17)
8.2B
(1.0; 24)
7.4B
(1.4; 18)
0.2
(1.1; 24)
0.3
(1.1; 16)
Mastery
(10; 50)
23.9W
(7.2; 26)
23.8W
(6.9; 17)
39.6B, W
(4.1; 24)
32.0B, W
(5.1; 18)
15.4**
(7.4; 24)
8.6**
(4.5; 16)
Attitude total
(12; 60)
31.9W
(7.8; 26)
31.0W
(7.7; 17)
47.8B, W
(4.8; 24)
39.4B, W
(6.0; 18)
15.6**
(7.7; 24)
8.9**
(5.2; 16)