members of the working group headed by I. Udris (Switzerland) are proponents of a sa- lutogenic approach in industrial psychological research (see, for example, Udris, Kraft & Mussmann, 1991; Udris, Kraft, Muheim, Mussmann & Rimann, 1992). In the research project “Personnel and Organisational Resources of Salutogenesis” (SALUTE), they ex- amined the influence that personnel and organisational factors have on the maintenance of health in the context of employment. Their research is based on system theory and ac- tion theory models in which health or illness result from exchange and coping processes between internal and external resources and demands, similar to those of Antonovsky and Becker. Based on their research results, the working group formulated consequences for the design of working structures and for industrial preventive measures. Industrial health promotion should not only influence individual health behaviour, but also contain thorough and holistic measures for the design of work and organisational structures (Udris et al., 1992).
Concrete applications of the salutogenic approach in the form of specific health-promot- ing programmes or measures in an industrial context are not known to us.
4.1.
Health Promotion and Prevention
The following section discusses the importance of the salutogenic model for the develop- ment, conception and design of preventive measures. This is based on the following ma- terial:
– Implications that can be drawn directly from Antonovsky’s theories or that he formulated himself,
– Contributions that contain the fundamental elaborations on the necessity of the integration of salutogenic approaches in prevention, as well as those that contain the key word “salutogenesis“,
– Literature on health promotion as conceived by the WHO.
Antonovsky’s principal thesis is that a strong sense of coherence is the decisive factor for successful coping with omnipresent stressors and thus for the maintenance of health (Antonovsky, 1987a). He regarded the SOC as a stable characteristic which is not only formed by individual factors, but also by historical, social and cultural conditions. The development of the SOC is completed by adulthood and can only be slightly or tem- porarily modified by critical events. However, the stability of the SOC has not been suffi- ciently clarified. Antonovsky himself said little about ways to change the SOC through planned, targeted measures and interventions. He pointed out that, in many situations,
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Research and Pr actice of Health Promotion, Volume 4 slight and temporary changes may be significant, and that it could be important to assist people in critical life situations so that their SOC does not start to decline temporarily. Antonovsky considered structural and social measures that enable the individual to in- fluence and participate in socially recognised decision processes to be the most promising way to positively influence the SOC. According to Antonovsky, it becomes more stable and thus more difficult to change as one gets older. The conclusion to be drawn from this is that it is important to create a world in which children and adolescents experience con- sistency, can recover from stress, and can participate in decision-making processes. All in all, the implications and consequences that can be drawn from Antonovsky’s theoretical elaborations on the practice of prevention tend to be rather sobering. Once adulthood is reached, the SOC can be changed only slightly or temporarily. If at all, changes can only be made by long-term assistance or intervention which results in “psycho- therapying” preventive measures. Measures aimed at individuals can achieve only little if the structural and societal conditions are unfavourable. Therefore, health promotion and preventive measures must be geared to changing a broad spectrum of individual, social and cultural factors.Antonovsky himself stressed again and again that a strong SOC does not always result in socially acceptable behaviour and can be developed in contexts that are destructive to our Western democratic ideals: “I would like to say that the rigidity of an SOC that emerges
in such a context inevitably makes it fragile, inauthentic, and doomed to shattering. But we must grant that the evidence is not at all clear” (Antonovsky, 1987a, p. 106).
Despite Antonovsky’s pessimistic elaborations, the salutogenesis model has become important to the field of prevention. It serves as a meta-theory for the working field, as legitimation for conceptual ideas and for the planning of concrete measures. It provides a framework for preventive activities that often lack a clear theoretical foundation and are undertaken in an activistic, uncoordinated manner. This theoretical framework supports resource-oriented, competence-raising and non-specific preventive measures. The model also supports a critical view of the previous preventive measures taken in health educa- tion and confronts the risk factor model. In this context, the low success rate regarding the change in risk factors should be mentioned. It is also important that the model parries the puritanical aspects of “warnings”, “alarms” and “austerity” belonging to the risk factor model with a positive concept. The shift in perspective from risk factors to preven- tive factors is compatible with a modern concept of health which ranks the psychological and social dimensions on the same level as the physical dimension.
The inception of the salutogenesis model occurred at about the same time as the com- munity psychology movements that formulated the concept of empowerment and social- ecological approaches. All these approaches stand for or have enabled a shift in perspective in prevention, which has had an impact on the Ottawa Charter of the WHO and the approach of health promotion. Even though the terms “salutogenesis” or “SOC” are not mentioned in the Ottawa Charter of the WHO of 1986, it subsequently placed the main