A Participatory Return-to-Work Program for Temporary Agency Workers and Unemployed Workers Sick-Listed Due to Musculoskeletal Disorders: a Process Evaluation Alongside a Randomized Controlled Trial |
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Authors: | Karlijn M van Beurden Sylvia J Vermeulen Johannes R Anema Allard J van der Beek |
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Institution: | (1) Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands;(2) Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands |
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Abstract: | Introduction Beside (cost-)effectiveness, the feasibility of an intervention is important for successful implementation in daily practice.
This study concerns the process evaluation of a newly developed participatory return-to-work (RTW) program for workers without
an employment contract, sick-listed due to musculoskeletal disorders. The program consisted of a stepwise process, guided
by an independent RTW coordinator, aimed at making a consensus-based RTW plan with the possibility of a temporary (therapeutic)
workplace. The aims of this study were to describe the reach and extent of implementation of the new program, the satisfaction
and experiences of all stakeholders, and the perceived barriers and facilitators for implementation of the program in daily
practice. Methods Temporary agency workers and unemployed workers, sick-listed for 2–8 weeks due to musculoskeletal disorders were eligible
for this study. Data were collected from the workers; their insurance physicians and labour experts at the Dutch Social Security
Agency; RTW coordinators; and case managers from participating vocational rehabilitation agencies. Data collection took place
using professionals’ reports, standardized matrices, questionnaires at baseline and at 3-month follow-up, and group interviews
with the professionals. Results Of the 79 workers who were allocated to the participatory RTW program group, 72 workers actually started with the intervention.
Overall, implementation of the program was performed according to protocol. However, offering of suitable temporary workplaces
was delayed with 44.5 days. Results showed satisfaction with the RTW coordinator among the workers and three quarters of the
labour experts experienced a minor or major contribution of the presence of the RTW coordinator. Several barriers for implementation
were identified, such as the administrative time-investment, unclear information about the program, no timely offering of
temporary (therapeutic) workplaces, and the need for additional support in case of complex health problems. Conclusions This study indicates overall feasibility for implementation of the participatory RTW program in daily practice. However,
to overcome important barriers, more attention should be paid to improve timely offering of suitable temporary workplaces,
to describe more clearly the program goals and the professional’s roles, and to offer additional support for workers suffering
from complex multi-causal health problems. Trial registration NTR1047. |
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