The Experts below are selected from a list of 30978 Experts worldwide ranked by ideXlab platform
Johannes R Anema - One of the best experts on this subject based on the ideXlab platform.
-
Process Evaluation of a Participatory Supportive Return to Work Program for Workers Without a Permanent Employment Contract, Sick-Listed Due to a Common Mental Disorder
2017Co-Authors: Lieke Lammerts, Frederieke G Schaafsma, Willem Mechelen, Johannes R AnemaAbstract:Purpose This study aimed to perform a process evaluation of a participatory supportive return to work program for workers without a (permanent) employment contract, sick-listed due to a Common Mental Disorder. The program consisted of a participatory approach, integrated care and direct placement in a competitive job. Our main questions were: were these components realized in practice and in accordance with the protocol? The evaluation took place alongside a randomized controlled trial. Methods The study population consisted of workers who filed a sickness benefit claim at the Dutch Social Security Agency, professionals of this agency and of vocational rehabilitation agencies. We focused on sick-listed workers and professionals who had actually participated in the intervention. Data was collected mainly by questionnaires. Results Only 36 out of 94 intervention group participants started with the program. In half of these cases application of integrated care was reported. Most other steps in the program were completed. However, fidelity to the protocol was low to reasonable. Much delay was observed in the execution of the program and only two sick-listed workers were placed in a competitive job. Still, satisfaction with the participatory approach was good. Conclusions Despite the positive evaluation of the participatory approach, the full program was executed less successfully compared to similar programs evaluated in earlier studies. This will probably affect the outcomes of our trial. Findings from this study will help to interpret these outcomes. Nevertheless, more knowledge is needed about experiences of stakeholders who participated in the program. Trial Registration NTR3563.
-
a participatory supportive return to work program for workers without an employment contract sick listed due to a Common Mental Disorder an economic evaluation alongside a randomized controlled trial
2017Co-Authors: Johannes R Anema, Lieke Lammerts, Frederieke G Schaafsma, Willem Van Mechelen, Johanna M Van DongenAbstract:Abstract Background Mental Disorders are associated with high costs for productivity loss, sickness absence and unemployment. A participatory supportive return to work (RTW) program was developed in order to improve RTW among workers without an employment contract, sick-listed due to a Common Mental Disorder. The program contained a participatory approach, integrated care and direct placement in a competitive job. The aim of this study was to evaluate the cost-effectiveness and cost-utility of this new program, compared to usual care. In addition, its return on investment was evaluated. Methods An economic evaluation was conducted alongside a 12-month randomized controlled trial. A total of 186 participants was randomly allocated to the new program ( n = 94) or to usual care ( n = 92). Effect measures were the duration until sustainable RTW in competitive employment and quality-adjusted life years (QALYs) gained. Costs included intervention costs, medical costs and absenteeism costs. Registered data of the Dutch Social Security Agency were used to assess the duration until sustainable RTW, intervention costs and absenteeism costs. QALYs and medical costs were assessed using three- or six-monthly questionnaires. Missing data were imputed using multiple imputations. Cost-effectiveness analysis and cost-utility analysis were conducted from the societal perspective. A return on investment analysis was conducted from the social insurer’s perspective. Various sensitivity analyses were performed to assess the robustness of the results. Results The new program had no significant effect on the duration until sustainable RTW and QALYs gained. Intervention costs and medical costs were significantly higher in the intervention group. From the societal perspective, the maximum probability of cost-effectiveness for duration until sustainable RTW was 0.64 at a willingness to pay of about €10 000/day, and 0.27 for QALYs gained, regardless of the willingness to pay. From the social insurer’s perspective, the probability of financial return was 0.18. Conclusions From the societal perspective, the new program was neither cost-effective in improving sustainable RTW nor in gaining QALYs. From the social insurer’s perspective, the program did not result in a positive financial return. Therefore, the present study provided no evidence to support its implementation. Trial registration The trial was listed at the Dutch Trial Register (NTR) under NTR3563 on August 7, 2012.
-
a participatory supportive return to work program for workers without an employment contract sick listed due to a Common Mental Disorder an economic evaluation alongside a randomized controlled trial
2017Co-Authors: Johannes R Anema, Lieke Lammerts, Frederieke G Schaafsma, Willem Van Mechelen, Johanna M Van DongenAbstract:Mental Disorders are associated with high costs for productivity loss, sickness absence and unemployment. A participatory supportive return to work (RTW) program was developed in order to improve RTW among workers without an employment contract, sick-listed due to a Common Mental Disorder. The program contained a participatory approach, integrated care and direct placement in a competitive job. The aim of this study was to evaluate the cost-effectiveness and cost-utility of this new program, compared to usual care. In addition, its return on investment was evaluated. An economic evaluation was conducted alongside a 12-month randomized controlled trial. A total of 186 participants was randomly allocated to the new program (n = 94) or to usual care (n = 92). Effect measures were the duration until sustainable RTW in competitive employment and quality-adjusted life years (QALYs) gained. Costs included intervention costs, medical costs and absenteeism costs. Registered data of the Dutch Social Security Agency were used to assess the duration until sustainable RTW, intervention costs and absenteeism costs. QALYs and medical costs were assessed using three- or six-monthly questionnaires. Missing data were imputed using multiple imputations. Cost-effectiveness analysis and cost-utility analysis were conducted from the societal perspective. A return on investment analysis was conducted from the social insurer’s perspective. Various sensitivity analyses were performed to assess the robustness of the results. The new program had no significant effect on the duration until sustainable RTW and QALYs gained. Intervention costs and medical costs were significantly higher in the intervention group. From the societal perspective, the maximum probability of cost-effectiveness for duration until sustainable RTW was 0.64 at a willingness to pay of about €10 000/day, and 0.27 for QALYs gained, regardless of the willingness to pay. From the social insurer’s perspective, the probability of financial return was 0.18. From the societal perspective, the new program was neither cost-effective in improving sustainable RTW nor in gaining QALYs. From the social insurer’s perspective, the program did not result in a positive financial return. Therefore, the present study provided no evidence to support its implementation. The trial was listed at the Dutch Trial Register (NTR) under NTR3563 on August 7, 2012.
Lieke Lammerts - One of the best experts on this subject based on the ideXlab platform.
-
Process Evaluation of a Participatory Supportive Return to Work Program for Workers Without a Permanent Employment Contract, Sick-Listed Due to a Common Mental Disorder
2017Co-Authors: Lieke Lammerts, Frederieke G Schaafsma, Willem Mechelen, Johannes R AnemaAbstract:Purpose This study aimed to perform a process evaluation of a participatory supportive return to work program for workers without a (permanent) employment contract, sick-listed due to a Common Mental Disorder. The program consisted of a participatory approach, integrated care and direct placement in a competitive job. Our main questions were: were these components realized in practice and in accordance with the protocol? The evaluation took place alongside a randomized controlled trial. Methods The study population consisted of workers who filed a sickness benefit claim at the Dutch Social Security Agency, professionals of this agency and of vocational rehabilitation agencies. We focused on sick-listed workers and professionals who had actually participated in the intervention. Data was collected mainly by questionnaires. Results Only 36 out of 94 intervention group participants started with the program. In half of these cases application of integrated care was reported. Most other steps in the program were completed. However, fidelity to the protocol was low to reasonable. Much delay was observed in the execution of the program and only two sick-listed workers were placed in a competitive job. Still, satisfaction with the participatory approach was good. Conclusions Despite the positive evaluation of the participatory approach, the full program was executed less successfully compared to similar programs evaluated in earlier studies. This will probably affect the outcomes of our trial. Findings from this study will help to interpret these outcomes. Nevertheless, more knowledge is needed about experiences of stakeholders who participated in the program. Trial Registration NTR3563.
-
a participatory supportive return to work program for workers without an employment contract sick listed due to a Common Mental Disorder an economic evaluation alongside a randomized controlled trial
2017Co-Authors: Johannes R Anema, Lieke Lammerts, Frederieke G Schaafsma, Willem Van Mechelen, Johanna M Van DongenAbstract:Abstract Background Mental Disorders are associated with high costs for productivity loss, sickness absence and unemployment. A participatory supportive return to work (RTW) program was developed in order to improve RTW among workers without an employment contract, sick-listed due to a Common Mental Disorder. The program contained a participatory approach, integrated care and direct placement in a competitive job. The aim of this study was to evaluate the cost-effectiveness and cost-utility of this new program, compared to usual care. In addition, its return on investment was evaluated. Methods An economic evaluation was conducted alongside a 12-month randomized controlled trial. A total of 186 participants was randomly allocated to the new program ( n = 94) or to usual care ( n = 92). Effect measures were the duration until sustainable RTW in competitive employment and quality-adjusted life years (QALYs) gained. Costs included intervention costs, medical costs and absenteeism costs. Registered data of the Dutch Social Security Agency were used to assess the duration until sustainable RTW, intervention costs and absenteeism costs. QALYs and medical costs were assessed using three- or six-monthly questionnaires. Missing data were imputed using multiple imputations. Cost-effectiveness analysis and cost-utility analysis were conducted from the societal perspective. A return on investment analysis was conducted from the social insurer’s perspective. Various sensitivity analyses were performed to assess the robustness of the results. Results The new program had no significant effect on the duration until sustainable RTW and QALYs gained. Intervention costs and medical costs were significantly higher in the intervention group. From the societal perspective, the maximum probability of cost-effectiveness for duration until sustainable RTW was 0.64 at a willingness to pay of about €10 000/day, and 0.27 for QALYs gained, regardless of the willingness to pay. From the social insurer’s perspective, the probability of financial return was 0.18. Conclusions From the societal perspective, the new program was neither cost-effective in improving sustainable RTW nor in gaining QALYs. From the social insurer’s perspective, the program did not result in a positive financial return. Therefore, the present study provided no evidence to support its implementation. Trial registration The trial was listed at the Dutch Trial Register (NTR) under NTR3563 on August 7, 2012.
-
a participatory supportive return to work program for workers without an employment contract sick listed due to a Common Mental Disorder an economic evaluation alongside a randomized controlled trial
2017Co-Authors: Johannes R Anema, Lieke Lammerts, Frederieke G Schaafsma, Willem Van Mechelen, Johanna M Van DongenAbstract:Mental Disorders are associated with high costs for productivity loss, sickness absence and unemployment. A participatory supportive return to work (RTW) program was developed in order to improve RTW among workers without an employment contract, sick-listed due to a Common Mental Disorder. The program contained a participatory approach, integrated care and direct placement in a competitive job. The aim of this study was to evaluate the cost-effectiveness and cost-utility of this new program, compared to usual care. In addition, its return on investment was evaluated. An economic evaluation was conducted alongside a 12-month randomized controlled trial. A total of 186 participants was randomly allocated to the new program (n = 94) or to usual care (n = 92). Effect measures were the duration until sustainable RTW in competitive employment and quality-adjusted life years (QALYs) gained. Costs included intervention costs, medical costs and absenteeism costs. Registered data of the Dutch Social Security Agency were used to assess the duration until sustainable RTW, intervention costs and absenteeism costs. QALYs and medical costs were assessed using three- or six-monthly questionnaires. Missing data were imputed using multiple imputations. Cost-effectiveness analysis and cost-utility analysis were conducted from the societal perspective. A return on investment analysis was conducted from the social insurer’s perspective. Various sensitivity analyses were performed to assess the robustness of the results. The new program had no significant effect on the duration until sustainable RTW and QALYs gained. Intervention costs and medical costs were significantly higher in the intervention group. From the societal perspective, the maximum probability of cost-effectiveness for duration until sustainable RTW was 0.64 at a willingness to pay of about €10 000/day, and 0.27 for QALYs gained, regardless of the willingness to pay. From the social insurer’s perspective, the probability of financial return was 0.18. From the societal perspective, the new program was neither cost-effective in improving sustainable RTW nor in gaining QALYs. From the social insurer’s perspective, the program did not result in a positive financial return. Therefore, the present study provided no evidence to support its implementation. The trial was listed at the Dutch Trial Register (NTR) under NTR3563 on August 7, 2012.
Stephen Stansfeld - One of the best experts on this subject based on the ideXlab platform.
-
stressors and Common Mental Disorder in informal carers an analysis of the english adult psychiatric morbidity survey 2007
2014Co-Authors: Stephen Stansfeld, Sally Mcmanus, Melanie Smuk, Juliana Onwumere, Charlotte Clark, Cleo Pike, Jenny Harris, Paul BebbingtonAbstract:This study investigates potential explanations of the association between caring and Common Mental Disorder, using the English Adult Psychiatric Morbidity Survey 2007. We examined whether carers are more exposed to other stressors additional to caring – such as domestic violence and debt – and if so whether this explains their elevated rates of Mental Disorder. We analysed differences between carers and non-carers in Common Mental Disorders (CMD), suicidal thoughts, suicidal attempts, recent stressors, social support, and social participation. We used multivariate models to investigate whether differences between carers and non-carers in identifiable stressors and supports explained the association between caring and CMD, as measured by the revised Clinical Interview Schedule.
-
stressors and Common Mental Disorder in informal carers an analysis of the english adult psychiatric morbidity survey 2007
2014Co-Authors: Stephen Stansfeld, Sally Mcmanus, Melanie Smuk, Juliana Onwumere, Charlotte Clark, Cleo Pike, Jenny Harris, Paul BebbingtonAbstract:This study investigates potential explanations of the association between caring and Common Mental Disorder, using the English Adult Psychiatric Morbidity Survey 2007. We examined whether carers are more exposed to other stressors additional to caring--such as domestic violence and debt--and if so whether this explains their elevated rates of Mental Disorder. We analysed differences between carers and non-carers in Common Mental Disorders (CMD), suicidal thoughts, suicidal attempts, recent stressors, social support, and social participation. We used multivariate models to investigate whether differences between carers and non-carers in identifiable stressors and supports explained the association between caring and CMD, as measured by the revised Clinical Interview Schedule. The prevalence of CMD (OR=1.64 95% CI 1.37-1.97), suicidal thoughts in the last week (OR=2.71 95% CI 1.31-5.62) and fatigue (OR=1.33 95% CI 1.14-1.54) was increased in carers. However, caring remained independently associated with CMD (OR=1.58 1.30-1.91) after adjustment for other stressors and social support. Thus caring itself is associated with increased risk of CMD that is not explained by other identified social stressors. Carers should be recognized as being at increased risk of CMD independent of the other life stressors they have to deal with. Interventions aimed at a direct reduction of the stressfulness of caring are indicated. However, carers also reported higher rates of debt problems and domestic violence and perceived social support was slightly lower in carers than in non-carers. So carers are also more likely to experience stressors other than caring and it is likely that they will need support not only aimed at their caring role, but also at other aspects of their lives.
-
occupations work characteristics and Common Mental Disorder
2013Co-Authors: Stephen Stansfeld, Paul Bebbington, Sally Mcmanus, Rachel Jenkins, Jenny Harris, C Pike, T Brugha, Angela Hassiotis, Howard MeltzerAbstract:Background. The present study aimed to assess the prevalence of Common Mental Disorders (CMDs) by occupation in a representative sample of the English adult population. Another aim was to examine whether the increased risk of CMD in some occupations could be explained by adverse work characteristics. Method. We derived a sample of 3425 working-age respondents from the Adult Psychiatric Morbidity Survey 2007. Occupations were classified by Standard Occupational Classification group, and CMD measured by the Revised Clinical Interview Schedule. Job characteristics were measured by questionnaire, and tested as explanatory factors in associations of occupation and CMD. Results. After adjusting for age, gender, housing tenure and marital status, caring personal service occupations had the greatest risk of CMD compared with all occupations (odds ratio 1.73, 95% confidence interval 1.16–2.58). The prevalence of adverse psychosocial work characteristics did not follow the pattern of CMD by occupation. Work characteristics did not explain the increased risk of CMDs associated with working in personal service occupations. Contrary to our hypotheses, adding work characteristics individually to the association of occupation and CMD tended to increase rather than decrease the odds for CMD. Conclusions. As has been found by others, psychosocial work characteristics were associated with CMD. However, we found that in our English national dataset they could not explain the high rates of CMD in particular occupations. We suggest that selection into occupations may partly explain high CMD rates in certain occupations. Also, we did not measure emotional demands, and these may be important mediators of the relationship between occupation type and CMDs.
-
occupation and Mental health in a national uk survey
2011Co-Authors: Stephen Stansfeld, F Rasul, Jenny Head, N SingletonAbstract:Objectives To measure the prevalence of Common Mental Disorder (CMD) by occupation in a representative sample of Great Britain and to identify occupations with increased and decreased risk of CMD.
-
neighbourhood social capital and Common Mental Disorder testing the link in a general population sample
2008Co-Authors: Mai Stafford, Mary De Silva, Stephen Stansfeld, Michael MarmotAbstract:General population multilevel studies of social capital and Mental health are few in number. This multilevel study examined external measures of neighbourhood social capital and Common Mental Disorders (CMD). Main effects and stress buffering models were tested. Based on data from over 9000 residents in 239 neighbourhoods in England and Scotland, there was no evidence of a main effect of social capital. For people living in deprived circumstances only, associations between neighbourhood social capital and CMD were seen. Elements of bridging social capital (contact amongst local friends) were associated with lower reporting of CMD. Elements of bonding social capital (attachment to neighbourhood) were associated with higher reporting of CMD. Findings provide some support for the hypothesis that social capital may protect against CMD, but indicate that initiatives should be targeted to deprived groups, focus on specific elements of social capital and not neglect the important relationship between personal socioeconomic disadvantage and CMD.
Martin Prince - One of the best experts on this subject based on the ideXlab platform.
-
determinants of Common Mental Disorder alcohol use Disorder and cognitive morbidity among people coming for hiv testing in goa india
2015Co-Authors: Rosie Mayston, Melanie Abas, Vikram Patel, Priya Korgaonkar, Ramesh S Paranjape, Savio Rodrigues, Martin PrinceAbstract:objective To investigate associations between background characteristics (psychosocial adversity, risk behaviours/perception of risk and HIV-related knowledge, perceptions and beliefs) and psychological and cognitive morbidity among people coming for testing for HIV/AIDS in Goa, India. methods Analysis of cross-sectional baseline data (plus HIV status) from a prospective cohort study. Participants were recruited at the time of coming for HIV testing. results Consistent with associations found among general population samples, among our sample of 1934 participants, we found that indicators of psychosocial adversity were associated with CMD (Common Mental Disorder – major depression, generalised anxiety and panic Disorder) among people coming for testing for HIV. Similarly, perpetration of intimate partner violence was associated with AUD (alcohol use Disorder). Two STI symptoms were associated with CMD, and sex with a non-primary partner was associated with AUD. Suboptimal knowledge about HIV transmission and prevention was associated with low cognitive test scores. In contrast with other studies, we found no evidence of any association between stigma and CMD. There was no evidence of modification of associations by HIV status. conclusions Among people coming for testing for HIV/AIDS in Goa, India, we found that CMD occurred in the context of social and economic stressors (violence, symptoms of STI, poor education and food insecurity) and AUD was associated with violence and risky sexual behaviour. Further research is necessary to understand the role of gender, stigma and social norms in determining the relationship between sexual and Mental health. Understanding associations between these background characteristics and psychological morbidity may help inform the design of appropriate early interventions for depression among people newly diagnosed HIV/AIDS.
-
Common Mental Disorder symptoms among patients with malaria attending primary care in ethiopia a cross sectional survey
2014Co-Authors: Markos Tesfaye, Charlotte Hanlon, Martin Prince, Fasil Tessema, Atalay AlemAbstract:Background Common Mental Disorders (CMDs) are frequent among patients attending primary care. In Africa, CMDs are often misdiagnosed as physical illnesses because many of the patients complain of somatic symptoms of Mental distress. We explored whether there was difference in the levels of CMD symptoms between patients with thick film confirmed and clinical cases of malaria with negative thick film in primary care. Methods A cross-sectional comparative study was conducted on 300 adults with a clinical diagnosis of malaria in primary care centres in Jimma, Ethiopia. Patients were recruited consecutively until 100 cases of ‘malaria’ with a negative thick film and 200 cases of malaria with a positive thick film consented to participate. The 20-item Self-Reporting Questionnaire (SRQ-20) was used to measure CMD. The non-parametric Wilcoxon rank-sum test was used to explore the association between thick film result and CMD. Results Participants had a mean age of 28.2 (S.D = 10.9) years and the majority (57.3%) were women. The prevalence of high CMD symptoms (six or more symptoms on the SRQ-20) was 24.5%. Suicidal ideation was reported by 13.8% of the participants. CMD symptoms were significantly higher in patients who had taken medication prior to visiting the primary care (p = 0.012) and in those whose symptoms had been present for seven days or more (p = 0.041). There was no statistically significant association between level of CMD symptoms and having a negative thick film result (OR 0.98; 95%CI 0.92, 1.04) or objective presence of fever (OR 1.04; 95%CI 0.93, 1.15). Conclusions CMD symptoms among cases of malaria did not appear to be associated with a negative thick film result. The high levels of CMD symptoms, including suicidal ideation, calls for further studies to investigate the persistence and progression of these symptoms following resolution of the acute malarial episode.
-
symptoms of Common Mental Disorder and cognitive associations with seropositivity among a cohort of people coming for testing for hiv aids in goa india a cross sectional survey
2013Co-Authors: Rosie Mayston, Melanie Abas, Vikram Patel, Priya Korgaonkar, Ramesh S Paranjape, Savio Rodrigues, Martin PrinceAbstract:Background: The majority of research on HIV/AIDS and Mental health has been carried out among clinical populations: the time of onset of comorbid depression and the mechanisms for this are therefore unclear. Although there is evidence to suggest that asymptomatic people living with HIV/AIDS exhibit some cognitive deficits, the prevalence of poor cognitive functioning among people in low income settings at an early, pre-clinical stage has not yet been investigated. Methods: We used a cross-sectional survey design to test the hypotheses that symptoms of Common Mental Disorder (CMD) and low scores on cognitive tests would be associated with seropositivity among participants coming for testing for HIV/AIDS. Participants were recruited at the time of coming for testing for HIV/AIDS; voluntary informed consent was sought for participation in research interviews and data linkage with HIV test results. Baseline questionnaires including sociodemographic variables and measures of Mental health (PHQ-9, GAD-7, panic Disorder questions, AUDIT and delayed word list learning and recall and animal naming test of verbal fluency) were administered by trained interviews. HIV status data was extracted from clinical records. Results: CMD and scoring below the educational norm on the test of verbal fluency were associated with testing positive for HIV/AIDS in bivariate analysis (OR = 2.26, 1.31-3.93; OR = 1.77, 1.26-2.48, respectively). After controlling for the effects of confounders, the association between CMD and seropositivity was no longer statistically significant (AOR = 1.56, 0.86-2.85). After adjusting for the effects of confounders, the association between low scores on the test of verbal fluency and seropositivity was retained (AOR = 1.77, 1.27-2.48). Conclusions: Our findings provide tentative evidence to suggest that low cognitive test scores (and possibly depressive symptoms) may be associated with HIV status among people who have yet to receive their HIV test results. Impaired cognitive functioning and depression-like symptoms may be the result of the same underlying neurological damage. CMD and cognitive impairment may overlap to a greater extent than previously assumed. If replicated, this may have implications for the way in which we measure and treat CMD and cognitive functioning among people living with HIV/AIDS.
-
impact of perinatal somatic and Common Mental Disorder symptoms on functioning in ethiopian women the p mamie population based cohort study
2012Co-Authors: Vesile Senturk, Charlotte Hanlon, Girmay Medhin, Michael Dewey, Mesfin Araya, Atalay Alem, Martin Prince, Robert StewartAbstract:Background Little is known of the relationship between perinatal somatic and Common Mental Disorder (CMD) symptoms and impaired functioning in women from settings where the burden of undernutrition and infectious disease morbidity is high.
-
the comparative validity of screening scales for postnatal Common Mental Disorder in kintampo ghana
2009Co-Authors: Benedict Weobong, Bright Akpalu, V Doku, Seth Owusuagyei, Lisa Hurt, Betty R Kirkwood, Martin PrinceAbstract:Abstract Background There have been few attempts formally to validate screening measures for postnatal Common Mental Disorder in low income country settings. We have investigated the comparative validity of three different screening approaches in a community-based study in Kintampo, Ghana. Method 160 women aged 15–45 years, and 5–11 weeks postpartum were first screened using the Self-Report Questionnaire (SRQ-20), with oversampling of higher scorers. The other test assessments were the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9). Criterion validity was measured against the Comprehensive Psychopathological Rating Scale (CPRS), and concurrent validity against the WHO Disability Assessment Schedule. A sub-sample ( n = 40) was re-interviewed 2 weeks later for test–retest reliability. Results Internal consistency (Cronbach's Alpha) was equivalent across all three test scales; EPDS (0.79), SRQ-20 (0.78) and PHQ-9 (0.79). Test–retest reliability was better for PHQ-9 (ICC 0.75) than for the EPDS (0.51). For criterion validity the PHQ-9 (AUROC 0.90 (0.81–0.98)), was superior to the SRQ-20 (0.74 (0.62–0.86)) and the EPDS ((0.84 (0.76–0.92). Youden's Index was also superior for PHQ-9. Item analysis revealed that a mixture of somatic and cognitive symptoms best discriminated between cases and non-cases for all three scales. Limitations Inability to ascertain inter-rater reliability, order effects and possible loss of technical equivalence due to item modifications. Conclusions The evidence for the validity, reliability, and superiority of the PHQ-9 over other screening assessments has been extended. The PHQ-9 is short, easy to administer and acceptable to a largely illiterate population of Ghanaian women, 5 to 11 weeks post partum.
Frederieke G Schaafsma - One of the best experts on this subject based on the ideXlab platform.
-
Process Evaluation of a Participatory Supportive Return to Work Program for Workers Without a Permanent Employment Contract, Sick-Listed Due to a Common Mental Disorder
2017Co-Authors: Lieke Lammerts, Frederieke G Schaafsma, Willem Mechelen, Johannes R AnemaAbstract:Purpose This study aimed to perform a process evaluation of a participatory supportive return to work program for workers without a (permanent) employment contract, sick-listed due to a Common Mental Disorder. The program consisted of a participatory approach, integrated care and direct placement in a competitive job. Our main questions were: were these components realized in practice and in accordance with the protocol? The evaluation took place alongside a randomized controlled trial. Methods The study population consisted of workers who filed a sickness benefit claim at the Dutch Social Security Agency, professionals of this agency and of vocational rehabilitation agencies. We focused on sick-listed workers and professionals who had actually participated in the intervention. Data was collected mainly by questionnaires. Results Only 36 out of 94 intervention group participants started with the program. In half of these cases application of integrated care was reported. Most other steps in the program were completed. However, fidelity to the protocol was low to reasonable. Much delay was observed in the execution of the program and only two sick-listed workers were placed in a competitive job. Still, satisfaction with the participatory approach was good. Conclusions Despite the positive evaluation of the participatory approach, the full program was executed less successfully compared to similar programs evaluated in earlier studies. This will probably affect the outcomes of our trial. Findings from this study will help to interpret these outcomes. Nevertheless, more knowledge is needed about experiences of stakeholders who participated in the program. Trial Registration NTR3563.
-
a participatory supportive return to work program for workers without an employment contract sick listed due to a Common Mental Disorder an economic evaluation alongside a randomized controlled trial
2017Co-Authors: Johannes R Anema, Lieke Lammerts, Frederieke G Schaafsma, Willem Van Mechelen, Johanna M Van DongenAbstract:Abstract Background Mental Disorders are associated with high costs for productivity loss, sickness absence and unemployment. A participatory supportive return to work (RTW) program was developed in order to improve RTW among workers without an employment contract, sick-listed due to a Common Mental Disorder. The program contained a participatory approach, integrated care and direct placement in a competitive job. The aim of this study was to evaluate the cost-effectiveness and cost-utility of this new program, compared to usual care. In addition, its return on investment was evaluated. Methods An economic evaluation was conducted alongside a 12-month randomized controlled trial. A total of 186 participants was randomly allocated to the new program ( n = 94) or to usual care ( n = 92). Effect measures were the duration until sustainable RTW in competitive employment and quality-adjusted life years (QALYs) gained. Costs included intervention costs, medical costs and absenteeism costs. Registered data of the Dutch Social Security Agency were used to assess the duration until sustainable RTW, intervention costs and absenteeism costs. QALYs and medical costs were assessed using three- or six-monthly questionnaires. Missing data were imputed using multiple imputations. Cost-effectiveness analysis and cost-utility analysis were conducted from the societal perspective. A return on investment analysis was conducted from the social insurer’s perspective. Various sensitivity analyses were performed to assess the robustness of the results. Results The new program had no significant effect on the duration until sustainable RTW and QALYs gained. Intervention costs and medical costs were significantly higher in the intervention group. From the societal perspective, the maximum probability of cost-effectiveness for duration until sustainable RTW was 0.64 at a willingness to pay of about €10 000/day, and 0.27 for QALYs gained, regardless of the willingness to pay. From the social insurer’s perspective, the probability of financial return was 0.18. Conclusions From the societal perspective, the new program was neither cost-effective in improving sustainable RTW nor in gaining QALYs. From the social insurer’s perspective, the program did not result in a positive financial return. Therefore, the present study provided no evidence to support its implementation. Trial registration The trial was listed at the Dutch Trial Register (NTR) under NTR3563 on August 7, 2012.
-
a participatory supportive return to work program for workers without an employment contract sick listed due to a Common Mental Disorder an economic evaluation alongside a randomized controlled trial
2017Co-Authors: Johannes R Anema, Lieke Lammerts, Frederieke G Schaafsma, Willem Van Mechelen, Johanna M Van DongenAbstract:Mental Disorders are associated with high costs for productivity loss, sickness absence and unemployment. A participatory supportive return to work (RTW) program was developed in order to improve RTW among workers without an employment contract, sick-listed due to a Common Mental Disorder. The program contained a participatory approach, integrated care and direct placement in a competitive job. The aim of this study was to evaluate the cost-effectiveness and cost-utility of this new program, compared to usual care. In addition, its return on investment was evaluated. An economic evaluation was conducted alongside a 12-month randomized controlled trial. A total of 186 participants was randomly allocated to the new program (n = 94) or to usual care (n = 92). Effect measures were the duration until sustainable RTW in competitive employment and quality-adjusted life years (QALYs) gained. Costs included intervention costs, medical costs and absenteeism costs. Registered data of the Dutch Social Security Agency were used to assess the duration until sustainable RTW, intervention costs and absenteeism costs. QALYs and medical costs were assessed using three- or six-monthly questionnaires. Missing data were imputed using multiple imputations. Cost-effectiveness analysis and cost-utility analysis were conducted from the societal perspective. A return on investment analysis was conducted from the social insurer’s perspective. Various sensitivity analyses were performed to assess the robustness of the results. The new program had no significant effect on the duration until sustainable RTW and QALYs gained. Intervention costs and medical costs were significantly higher in the intervention group. From the societal perspective, the maximum probability of cost-effectiveness for duration until sustainable RTW was 0.64 at a willingness to pay of about €10 000/day, and 0.27 for QALYs gained, regardless of the willingness to pay. From the social insurer’s perspective, the probability of financial return was 0.18. From the societal perspective, the new program was neither cost-effective in improving sustainable RTW nor in gaining QALYs. From the social insurer’s perspective, the program did not result in a positive financial return. Therefore, the present study provided no evidence to support its implementation. The trial was listed at the Dutch Trial Register (NTR) under NTR3563 on August 7, 2012.