## 3 Results and Discussion
### Topic 2: Healthcare Delivery
#### 3.3.3 Preventative Healthcare: Organisation-Led Initiatives  
Given the increased likelihood that workers in the resource sector have poor health behaviours, both employees and employers may benefit from the implementation of behaviour-change interventions for workers, such as interventions targeting healthy eating, physical activity, and alcohol consumption [29]. While this does not strictly fall within the scope of primary care, a number of studies have reported that organisation-led interventions and changes to workplace culture have resulted in favourable outcomes for health and well-being in oil and gas and mine workers [16; 30; 31]. In this regard, organisations such as the National Institute for Occupational Safety and Health (NIOSH), a research agency under the Centre for Disease Control and Prevention (CDC), have developed a strategy for a more holistic and preventative healthcare, called Total Worker Health (TWH), which can be implemented by organisations to support the health of their employees [32]. The development of this strategy stems from the assumption that preventative healthcare can lead to reduced healthcare costs as well as increased productivity [27]. A systematic review of TWH-related interventions found that health behaviours such as diet, physical activity, and tobacco use can be improved, based on data drawn from related industries, including manufacturing and construction [33]. In addition, the IOGP health-management framework [34], which is specific to the oil and gas industry, outlines that risk management strategies should encompass a range of factors including fitness for work, health surveillance, worker well-being, occupational health, fatigue management, management of drug and alcohol misuse, and planning for infectious disease controls. In the mining industry, a number of health promotion interventions have been trialled which primarily relate to improved dietary and physical activity behaviours of employees. [PERSON] et al. [28] described a statewide (NSW, Australia) 'Get Healthy at Work' program whereby resources and support can be accessed via an online portal as part of the behaviour-change intervention. The study reflected on initial implementation, but changes in employee health and health behaviours were not assessed. [PERSON] et al. [35] also reported on a health and wellness intervention in the mining industry which was an eight-step framework based on a model by the World Health Organisation, though outcomes of the intervention are not yet available. The available evidence suggests that organisations see the value of these programs, and are supportive of implementing more preventative healthcare within the services they offer and, as such, the interventions should be further explored and evaluated. In contrast, organisation-led interventions focusing on supporting better mental-health-related outcomes have been widely evaluated and endorsed within the resource sector. The interventions which appear to be most successful are those which are driven by the employer, but which create/facilitate peer networks and aim to strengthen non-professional supports for employees [36]. The success of organisation-led mental health interventions likely relates to demonstrated associations between a workplace commitment to mental health and improved employee well-being [37], along with workers in the resource sector preferring to seek mental health support from non-professional (i.e., peers, colleagues, friends, or family) rather than professional supports (i.e., an employee assistance program [EAP] or a general practitioner [GP]) [12; 38; 39]. A recent systematic review of mental health interventions in the mining industry found consistent associations between employee perceptions that their organisation was committed to good mental health or had organisational support available and improved mental health, well-being, and perceived quality and efficiency of work [16].