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Norito Kawakami - One of the best experts on this subject based on the ideXlab platform.
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effects of a multi component Workplace Intervention program with environmental changes on physical activity among japanese white collar employees a cluster randomized controlled trial
International Journal of Behavioral Medicine, 2018Co-Authors: Kazuhiro Watanabe, Norito KawakamiAbstract:This study aimed to investigate effects of a flexible multi-component Workplace Intervention program for improving physical activity among Japanese white-collar employees in a cluster randomized controlled trial design. A total of 208 worksites and nested employees were approached. Any worksite interested in a 3-month physical activity promotion Intervention and white-collar workers aged 18 years or older were eligible. The worksites were randomly assigned to an Intervention or a control, stratified by worksite size. The Intervention worksites were offered an Intervention program that allows these worksites to select Intervention components from a set of options, including environmental changes. The control worksites were offered feedback and basic occupational health services. Physical activity level was measured using a self-reported questionnaire at baseline and at 3 and 6 months of follow-up. Three worksites (92 employees) were allocated to the Intervention and five worksites (98 employees) to the control worksites. The overall physical activity level in the Intervention worksites significantly increased compared with the control worksites (Coeff = 0.45, SE = 0.19, p = 0.018). For subgroup analyses, the Intervention effect on the overall physical activity level was significant among medium- and large-sized worksites but not among small-sized worksites. This trial showed a significant and positive effect of the Intervention program on physical activity. The program is unique because of its flexibility and feasibility. However, small worksites might receive less benefit from the program, indicating a need for further support and/or new technologies. UMIN Clinical Trials Registry (ID=UMIN000024069).
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effects of a multi component Workplace Intervention program with environmental changes on physical activity among japanese white collar employees a cluster randomized controlled trial
International Journal of Behavioral Medicine, 2018Co-Authors: Kazuhiro Watanabe, Norito KawakamiAbstract:Purpose This study aimed to investigate effects of a flexible multi-component Workplace Intervention program for improving physical activity among Japanese white-collar employees in a cluster randomized controlled trial design. Methods A total of 208 worksites and nested employees were approached. Any worksite interested in a 3-month physical activity promotion Intervention and white-collar workers aged 18 years or older were eligible. The worksites were randomly assigned to an Intervention or a control, stratified by worksite size. The Intervention worksites were offered an Intervention program that allows these worksites to select Intervention components from a set of options, including environmental changes. The control worksites were offered feedback and basic occupational health services. Physical activity level was measured using a self-reported questionnaire at baseline and at 3 and 6 months of follow-up. Results Three worksites (92 employees) were allocated to the Intervention and five worksites (98 employees) to the control worksites. The overall physical activity level in the Intervention worksites significantly increased compared with the control worksites (Coeff = 0.45, SE = 0.19, p = 0.018). For subgroup analyses, the Intervention effect on the overall physical activity level was significant among medium- and large-sized worksites but not among small-sized worksites. Conclusion This trial showed a significant and positive effect of the Intervention program on physical activity. The program is unique because of its flexibility and feasibility. However, small worksites might receive less benefit from the program, indicating a need for further support and/or new technologies. Trial registration UMIN Clinical Trials Registry (ID=UMIN000024069).
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effects of a multicomponent Workplace Intervention programme with environmental changes on physical activity among japanese white collar employees a protocol for a cluster randomised controlled trial
BMJ Open, 2017Co-Authors: Kazuhiro Watanabe, Norito KawakamiAbstract:Introduction Physical activity is one of the most important health behaviours as a determinant of physical and mental health. Although Intervention strategies for promoting physical activity among workers are needed, evidence for the effectiveness of multilevel Workplace Interventions with environmental changes on the promotion of physical activity are still limited due to lack of cluster randomised controlled trials (RCTs). The aim of this study is to investigate effects of a 3-month Workplace Intervention programme with environmental changes on the improvement in physical activity among Japanese white collar employees. Methods and analysis This study will be a two-arm and parallel-group cluster (worksite) RCT. Japanese worksites and employees who are employed by the worksites will be recruited through health insurance associations and chambers of commerce. Worksites that meet the inclusion criteria will be randomly allocated to Intervention or control groups. The Intervention worksites will be offered the original Intervention programme that consists of 13 contents with environmental changes. The control worksites will be able to get three times feedback of the assessment of the amount of physical activity and basic occupational health service in each worksite. The primary outcome will be the total amount of physical activity measured by the Global Physical Activity Questionnaire at baseline, 3 months and 6 months. Multilevel latent growth modelling will be conducted to examine the effectiveness of the Intervention programme. Ethics and dissemination This study was ethically approved by the research ethics committee of the Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Japan (No. 11230). Results will be submitted and published in a scientific peer-reviewed journal. Trial registration number UMIN000024069; Pre-results.
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Development of a multi-component Workplace Intervention program with environmental changes on physical activity among Japanese white-collar employees: a cluster randomized controlled trial
2017Co-Authors: Kazuhiro Watanabe, Norito KawakamiAbstract:Objective: Physical activity among white-collar workers is one of the most important health behaviors in occupational health. Although many Workplace Intervention strategies with environmental changes to promote physical activity were reported, evidence is still insufficient due to lack of cluster randomized controlled trials (cRCTs). In this study, we aimed to develop a new 3-month Workplace Intervention program with environmental changes for a cRCT among Japanese white-collar employees. Methods: We developed an original program that consists of multi-component environmental changes based on a literature review and hearing good practices among Japanese worksites. Workplace environment that we target to change was operationally defined as scores of the Environmental Assessment Tool (EAT, DeJoy et al., 2008; Watanabe et al., 2016). This scale can quantitatively assess promotion and programs, organizational policies and practice, and internal physical environment to promote physical activity. Results: From the literature review, three possible functions of Workplace environment were assumed: (a) building awareness and social norms for physical activity, (b) enhancing accessibility for physical activity, and (c) enhancing individual cognitive-behavioral skills. In addition, some environmental changes were reported that Japanese worksites already conducted from the qualitative interviews, including policy making, informational messages, and exercise programs. Based on the results, 8 items of the EAT were referred and finally the 13 contents based on the 7 items of the EAT were considered to be included into the program and feasible to conduct at Japanese Workplace: (1) policy making and declaration, (2) posters for the program contents and recommendation for physical activity, (3) notification on intra-website/electronic bulletin board system, (4) prompts for stair-use, (5) exercise programs, (6) an individual competition program, (7) psychological education to increase self-regulation, (8) subsidization of a membership to an offsite exercise facilities, (9) providing onsite fitness facilities, (10) facilitating bike rack spaces, (11) changing facilities, and (12) shower facilities, and (13) contract for sponsorship with sports teams. Conclusion: This 3-month Intervention program for the cRCT is feasible and possiblly effective on promoting physical activity among Japanese white-collar employees. The findings from the cRCT will be useful for both of researchers and employers to improve occupational health among workers. Trial registration: The study protocol was registered at the UMIN Clinical Trials Registry (UMIN-CTR, ID=UMIN000024069).
Kazuhiro Watanabe - One of the best experts on this subject based on the ideXlab platform.
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effects of a multi component Workplace Intervention program with environmental changes on physical activity among japanese white collar employees a cluster randomized controlled trial
International Journal of Behavioral Medicine, 2018Co-Authors: Kazuhiro Watanabe, Norito KawakamiAbstract:This study aimed to investigate effects of a flexible multi-component Workplace Intervention program for improving physical activity among Japanese white-collar employees in a cluster randomized controlled trial design. A total of 208 worksites and nested employees were approached. Any worksite interested in a 3-month physical activity promotion Intervention and white-collar workers aged 18 years or older were eligible. The worksites were randomly assigned to an Intervention or a control, stratified by worksite size. The Intervention worksites were offered an Intervention program that allows these worksites to select Intervention components from a set of options, including environmental changes. The control worksites were offered feedback and basic occupational health services. Physical activity level was measured using a self-reported questionnaire at baseline and at 3 and 6 months of follow-up. Three worksites (92 employees) were allocated to the Intervention and five worksites (98 employees) to the control worksites. The overall physical activity level in the Intervention worksites significantly increased compared with the control worksites (Coeff = 0.45, SE = 0.19, p = 0.018). For subgroup analyses, the Intervention effect on the overall physical activity level was significant among medium- and large-sized worksites but not among small-sized worksites. This trial showed a significant and positive effect of the Intervention program on physical activity. The program is unique because of its flexibility and feasibility. However, small worksites might receive less benefit from the program, indicating a need for further support and/or new technologies. UMIN Clinical Trials Registry (ID=UMIN000024069).
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effects of a multi component Workplace Intervention program with environmental changes on physical activity among japanese white collar employees a cluster randomized controlled trial
International Journal of Behavioral Medicine, 2018Co-Authors: Kazuhiro Watanabe, Norito KawakamiAbstract:Purpose This study aimed to investigate effects of a flexible multi-component Workplace Intervention program for improving physical activity among Japanese white-collar employees in a cluster randomized controlled trial design. Methods A total of 208 worksites and nested employees were approached. Any worksite interested in a 3-month physical activity promotion Intervention and white-collar workers aged 18 years or older were eligible. The worksites were randomly assigned to an Intervention or a control, stratified by worksite size. The Intervention worksites were offered an Intervention program that allows these worksites to select Intervention components from a set of options, including environmental changes. The control worksites were offered feedback and basic occupational health services. Physical activity level was measured using a self-reported questionnaire at baseline and at 3 and 6 months of follow-up. Results Three worksites (92 employees) were allocated to the Intervention and five worksites (98 employees) to the control worksites. The overall physical activity level in the Intervention worksites significantly increased compared with the control worksites (Coeff = 0.45, SE = 0.19, p = 0.018). For subgroup analyses, the Intervention effect on the overall physical activity level was significant among medium- and large-sized worksites but not among small-sized worksites. Conclusion This trial showed a significant and positive effect of the Intervention program on physical activity. The program is unique because of its flexibility and feasibility. However, small worksites might receive less benefit from the program, indicating a need for further support and/or new technologies. Trial registration UMIN Clinical Trials Registry (ID=UMIN000024069).
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effects of a multicomponent Workplace Intervention programme with environmental changes on physical activity among japanese white collar employees a protocol for a cluster randomised controlled trial
BMJ Open, 2017Co-Authors: Kazuhiro Watanabe, Norito KawakamiAbstract:Introduction Physical activity is one of the most important health behaviours as a determinant of physical and mental health. Although Intervention strategies for promoting physical activity among workers are needed, evidence for the effectiveness of multilevel Workplace Interventions with environmental changes on the promotion of physical activity are still limited due to lack of cluster randomised controlled trials (RCTs). The aim of this study is to investigate effects of a 3-month Workplace Intervention programme with environmental changes on the improvement in physical activity among Japanese white collar employees. Methods and analysis This study will be a two-arm and parallel-group cluster (worksite) RCT. Japanese worksites and employees who are employed by the worksites will be recruited through health insurance associations and chambers of commerce. Worksites that meet the inclusion criteria will be randomly allocated to Intervention or control groups. The Intervention worksites will be offered the original Intervention programme that consists of 13 contents with environmental changes. The control worksites will be able to get three times feedback of the assessment of the amount of physical activity and basic occupational health service in each worksite. The primary outcome will be the total amount of physical activity measured by the Global Physical Activity Questionnaire at baseline, 3 months and 6 months. Multilevel latent growth modelling will be conducted to examine the effectiveness of the Intervention programme. Ethics and dissemination This study was ethically approved by the research ethics committee of the Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Japan (No. 11230). Results will be submitted and published in a scientific peer-reviewed journal. Trial registration number UMIN000024069; Pre-results.
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Development of a multi-component Workplace Intervention program with environmental changes on physical activity among Japanese white-collar employees: a cluster randomized controlled trial
2017Co-Authors: Kazuhiro Watanabe, Norito KawakamiAbstract:Objective: Physical activity among white-collar workers is one of the most important health behaviors in occupational health. Although many Workplace Intervention strategies with environmental changes to promote physical activity were reported, evidence is still insufficient due to lack of cluster randomized controlled trials (cRCTs). In this study, we aimed to develop a new 3-month Workplace Intervention program with environmental changes for a cRCT among Japanese white-collar employees. Methods: We developed an original program that consists of multi-component environmental changes based on a literature review and hearing good practices among Japanese worksites. Workplace environment that we target to change was operationally defined as scores of the Environmental Assessment Tool (EAT, DeJoy et al., 2008; Watanabe et al., 2016). This scale can quantitatively assess promotion and programs, organizational policies and practice, and internal physical environment to promote physical activity. Results: From the literature review, three possible functions of Workplace environment were assumed: (a) building awareness and social norms for physical activity, (b) enhancing accessibility for physical activity, and (c) enhancing individual cognitive-behavioral skills. In addition, some environmental changes were reported that Japanese worksites already conducted from the qualitative interviews, including policy making, informational messages, and exercise programs. Based on the results, 8 items of the EAT were referred and finally the 13 contents based on the 7 items of the EAT were considered to be included into the program and feasible to conduct at Japanese Workplace: (1) policy making and declaration, (2) posters for the program contents and recommendation for physical activity, (3) notification on intra-website/electronic bulletin board system, (4) prompts for stair-use, (5) exercise programs, (6) an individual competition program, (7) psychological education to increase self-regulation, (8) subsidization of a membership to an offsite exercise facilities, (9) providing onsite fitness facilities, (10) facilitating bike rack spaces, (11) changing facilities, and (12) shower facilities, and (13) contract for sponsorship with sports teams. Conclusion: This 3-month Intervention program for the cRCT is feasible and possiblly effective on promoting physical activity among Japanese white-collar employees. The findings from the cRCT will be useful for both of researchers and employers to improve occupational health among workers. Trial registration: The study protocol was registered at the UMIN Clinical Trials Registry (UMIN-CTR, ID=UMIN000024069).
Willem Van Mechelen - One of the best experts on this subject based on the ideXlab platform.
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cost effectiveness of a Workplace Intervention for sick listed employees with common mental disorders design of a randomized controlled trial
BMC Public Health, 2008Co-Authors: Johannes R Anema, Henrica C W De Vet, Dirk L Knol, Sandra H Van Oostrom, Berend Terluin, Willem Van MechelenAbstract:Considering the high costs of sick leave and the consequences of sick leave for employees, an early return-to-work of employees with mental disorders is very important. Therefore, a Workplace Intervention is developed based on a successful return-to-work Intervention for employees with low back pain. The objective of this paper is to present the design of a randomized controlled trial evaluating the cost-effectiveness of the Workplace Intervention compared with usual care for sick-listed employees with common mental disorders. The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are on sick leave for 2 to 8 weeks with common mental disorders. The Workplace Intervention will be compared with usual care. The Workplace Intervention is a stepwise approach that aims to reach consensus about a return-to-work plan by active participation and strong commitment of both the sick-listed employee and the supervisor. Outcomes will be assessed at baseline, 3, 6, 9 and 12 months. The primary outcome of this study is lasting return-to-work, which will be acquired from continuous registration systems of the companies after the follow-up. Secondary outcomes are total number of days of sick leave during the follow-up, severity of common mental disorders, coping style, job content, and attitude, social influence, and self-efficacy determinants. Cost-effectiveness will be evaluated from the societal perspective. A process evaluation will also be conducted. Return-to-work is difficult to discuss in the Workplace for sick-listed employees with mental disorders and their supervisors. Therefore, this Intervention offers a unique opportunity for the sick-listed employee and the supervisor to discuss barriers for return-to-work. Results of this study will possibly contribute to improvement of disability management for sick-listed employees with common mental disorders. Results will become available in 2009. ISRCTN92307123
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development of a Workplace Intervention for sick listed employees with stress related mental disorders Intervention mapping as a useful tool
BMC Health Services Research, 2007Co-Authors: Johannes R Anema, Henrica C W De Vet, Sandra H Van Oostrom, Berend Terluin, Anita Venema, Willem Van MechelenAbstract:To date, mental health problems and mental workload have been increasingly related to long-term sick leave and disability. However, there is, as yet, no structured protocol available for the identification and application of an Intervention for stress-related mental health problems at the Workplace. This paper describes the structured development, implementation and planning for the evaluation of a return-to-work Intervention for sick-listed employees with stress-related mental disorders (SMDs). The Intervention is based on an existing successful return-to-work Intervention for sick-listed employees with low back pain. The principles of Intervention Mapping were applied to combine theory and evidence in the development, implementation and planning for the evaluation of a participatory Workplace Intervention, aimed at an early return-to-work for sick-listed employees with SMDs. All stakeholders were involved in focus group interviews: i.e. employees recently sick-listed with SMDs, supervisors and occupational health professionals. The development of the participatory Workplace Intervention according to the Intervention Mapping principles resulted in a structured return-to-work Intervention, specifically tailored to the needs of sick-listed employees with SMDs. Return-to-work was proposed as a behavioural change, and the Attitude – Social influence – self-Efficacy model was identified as a theoretical framework. Stakeholder involvement in focus group interviews served to enhance the implementation. The cost-effectiveness of the Intervention will be evaluated in a randomised controlled trial. Intervention Mapping was found to be a promising method to develop Interventions tailored to a specific target group in the field of occupational health. ISRCTN92307123
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multidisciplinary rehabilitation for subacute low back pain graded activity or Workplace Intervention or both a randomized controlled trial
Spine, 2007Co-Authors: Johannes R Anema, Ivan A Steenstra, P M Bongers, Henrica C W De Vet, Dirk L Knol, Patrick Loisel, Willem Van MechelenAbstract:Study design. Population-based randomized controlled trial. Objective. To assess the effectiveness of Workplace Intervention and graded activity, separately and combined, for multidisciplinary rehabilitation of low back pain (LBP). Summary of Background Data. Effective components for multidisciplinary rehabilitation of LBP are not yet established. Methods. Participants sick-listed 2 to 6 weeks due to nonspecific LBP were randomized to Workplace Intervention (n = 96) or usual care (n = 100). Workplace Intervention consisted of Workplace assessment, work modifications, and case management involving all stakeholders. Participants still sick-listed at 8 weeks were randomized for graded activity (n = 55) or usual care (n = 57). Graded activity comprised biweekly 1-hour exercise sessions based on operant-conditioning principles. Outcomes were lasting return to work, pain intensity and functional status, assessed at baseline, and at 12, 26, and 52 weeks after the start of sick leave. Results. Time until return to work for workers with Workplace Intervention was 77 versus 104 days (median) for workers without this Intervention (P = 0.02). Workplace Intervention was effective on return to work (hazard ratio = 1.7; 95% CI, 1.2-2.3; P = 0.002). Graded activity had a negative effect on return to work (hazard ratio = 0.4; 95% CI, 0.3-0.6; P < 0.001) and functional status. Combined Intervention had no effect. Conclusion. Workplace Intervention is advised for multidisciplinary rehabilitation of subacute LBP. Graded activity or combined Intervention is not advised.
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multidisciplinary rehabilitation for subacute low back pain graded activity or Workplace Intervention or both a randomized controlled trial
Spine, 2007Co-Authors: Johannes R Anema, Ivan A Steenstra, P M Bongers, Henrica C W De Vet, Dirk L Knol, Patrick Loisel, Willem Van MechelenAbstract:To assess the effectiveness of Workplace Intervention and graded activity, separately and combined, for multidisciplinary rehabilitation of low back pain (LBP). Summary of Background Data. Effective components for multidisciplinary rehabilitation of LBP are not yet established. Methods: Participants sick-listed 2 to 6 weeks due to nonspecific LBP were randomized to Workplace Intervention (n = 96) or usual care (n = 100). Workplace Intervention consisted of Workplace assessment, work modifications, and case management involving all stakeholders. Participants still sick-listed at 8 weeks were randomized for graded activity (n = 55) or usual care (n = 57). Graded activity comprised biweekly 1-hour exercise sessions based on operant-conditioning principles. Outcomes were lasting return to work, pain intensity and functional status, assessed at baseline, and at 12, 26, and 52 weeks after the start of sick leave. Results: Time until return to work for workers with Workplace Intervention was 77 versus 104 days (median) for workers without this Intervention (P = 0.02). Workplace Intervention was effective on return to work (hazard ratio = 1.7; 95% CI, 1.2-2.3; P = 0.002). Graded activity had a negative effect on return to work (hazard ratio = 0.4; 95% CI, 0.3-0.6; P < 0.001) and functional status. Combined Intervention had no effect. Conclusion: Workplace Intervention is advised for multidisciplinary rehabilitation of subacute LBP. Graded activity or combined Intervention is not advised.
Laura A Linnan - One of the best experts on this subject based on the ideXlab platform.
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development of a Workplace Intervention for child care staff caring and reaching for health s care healthy lifestyles Intervention
Health Promotion Practice, 2020Co-Authors: Gabriela Arandia, Dianne S Ward, Amber E Vaughn, Lori A Bateman, Laura A LinnanAbstract:Child care staff are among the lowest wage workers, a group at increased risk for a wide array of chronic diseases. To date, the health of child care staff has been largely ignored, and there have been very few Interventions designed for child care staff. This article describes the development of the Caring and Reaching for Health (CARE) Healthy Lifestyles Intervention, a Workplace Intervention aimed at improving physical activity and health behaviors among child care staff. Theory and evidence-based behavior change techniques informed the development of Intervention components with targets at multiple social ecological levels. Final Intervention components included an educational workshop held at a kick-off event, followed by three 8-week campaigns. Intervention components within each campaign included (1) an informational magazine, (2) goal setting and weekly behavior self-monitoring, (3) weekly tailored feedback, (4) e-mail/text prompts, (5) center-level displays that encouraged team-based goals and activities, and (6) coaching for center directors. This multilevel, theory-driven Intervention is currently being evaluated as part of a larger randomized controlled trial. Process evaluation efforts will assess the extent to which child care staff participated in, engaged with, and were satisfied with the Intervention. Lessons learned will guide future Intervention research engaging child care workers.
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Workplace health and safety Intervention for child care staff rationale design and baseline results from the care cluster randomized control trial
Contemporary Clinical Trials, 2018Co-Authors: Dianne S Ward, Amber E Vaughn, Derek Hales, Anthony J Viera, Ziya Gizlice, Lori A Bateman, Anna H Grummon, Gabriela Arandia, Laura A LinnanAbstract:Abstract Background Low-wage workers suffer disproportionately high rates of chronic disease and are important targets for Workplace health and safety Interventions. Child care centers offer an ideal opportunity to reach some of the lowest paid workers, but these settings have been ignored in Workplace Intervention studies. Methods Caring and Reaching for Health (CARE) is a cluster-randomized controlled trial evaluating efficacy of a multi-level, Workplace-based Intervention set in child care centers that promotes physical activity and other health behaviors among staff. Centers are randomized (1:1) into the Healthy Lifestyles (Intervention) or the Healthy Finances (attention control) program. Healthy Lifestyles is delivered over six months including a kick-off event and three 8-week health campaigns (magazines, goal setting, behavior monitoring, tailored feedback, prompts, center displays, director coaching). The primary outcome is minutes of moderate and vigorous physical activity (MVPA); secondary outcomes are health behaviors (diet, smoking, sleep, stress), physical assessments (body mass index (BMI), waist circumference, blood pressure, fitness), and Workplace supports for health and safety. Results In total, 56 centers and 553 participants have been recruited and randomized. Participants are predominately female (96.7%) and either Non-Hispanic African American (51.6%) or Non-Hispanic White (36.7%). Most participants (63.4%) are obese. They accumulate 17.4 (±14.2) minutes/day of MVPA and consume 1.3 (±1.4) and 1.3 (±0.8) servings/day of fruits and vegetables, respectively. Also, 14.2% are smokers; they report 6.4 (±1.4) hours/night of sleep; and 34.9% are high risk for depression. Conclusions Baseline data demonstrate several serious health risks, confirming the importance of Workplace Interventions in child care.
Johannes R Anema - One of the best experts on this subject based on the ideXlab platform.
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Workplace Interventions to prevent work disability in workers on sick leave
Cochrane Database of Systematic Reviews, 2015Co-Authors: Myrthe Van Vilsteren, Henrica C W De Vet, Sandra H Van Oostrom, Reneelouise Franche, Cecile R L Boot, Johannes R AnemaAbstract:Background Work disability has serious consequences for individuals as well as society. It is possible to facilitate resumption of work by reducing barriers to return to work (RTW) and promoting collaboration with key stakeholders. This review was first published in 2009 and has now been updated to include studies published up to February 2015. Objectives To determine the effectiveness of Workplace Interventions in preventing work disability among sick-listed workers, when compared to usual care or clinical Interventions. Search methods We searched the Cochrane Work Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO databases on 2 February 2015. Selection criteria We included randomised controlled trials (RCTs) of Workplace Interventions that aimed to improve RTW for disabled workers. We only included studies where RTW or conversely sickness absence was reported as a continuous outcome. Data collection and analysis Two review authors independently extracted data and assessed risk of bias of the studies. We performed meta-analysis where possible, and we assessed the quality of evidence according to GRADE criteria. We used standard methodological procedures expected by Cochrane. Main results We included 14 RCTs with 1897 workers. Eight studies included workers with musculoskeletal disorders, five workers with mental health problems, and one workers with cancer. We judged six studies to have low risk of bias for the outcome sickness absence. Workplace Interventions significantly improved time until first RTW compared to usual care, moderate-quality evidence (hazard ratio (HR) 1.55, 95% confidence interval (CI) 1.20 to 2.01). Workplace Interventions did not considerably reduce time to lasting RTW compared to usual care, very low-quality evidence (HR 1.07, 95% CI 0.72 to 1.57). The effect on cumulative duration of sickness absence showed a mean difference of -33.33 (95% CI -49.54 to -17.12), favouring the Workplace Intervention, high-quality evidence. One study assessed recurrences of sick leave, and favoured usual care, moderate-quality evidence (HR 0.42, 95% CI 0.21 to 0.82). Overall, the effectiveness of Workplace Interventions on work disability showed varying results. In subgroup analyses, we found that Workplace Interventions reduced time to first and lasting RTW among workers with musculoskeletal disorders more than usual care (HR 1.44, 95% CI 1.15 to 1.82 and HR 1.77, 95% CI 1.37 to 2.29, respectively; both moderate-quality evidence). In studies of workers with musculoskeletal disorders, pain also improved (standardised mean difference (SMD) -0.26, 95% CI -0.47 to -0.06), as well as functional status (SMD -0.33, 95% CI -0.58 to -0.08). In studies of workers with mental health problems, there was a significant improvement in time until first RTW (HR 2.64, 95% CI 1.41 to 4.95), but no considerable reduction in lasting RTW (HR 0.79, 95% CI 0.54 to 1.17). One study of workers with cancer did not find a considerable reduction in lasting RTW (HR 0.88, 95% CI 0.53 to 1.47). In another subgroup analysis, we did not find evidence that offering a Workplace Intervention in combination with a cognitive behavioural Intervention (HR 1.93, 95% CI 1.27 to 2.93) is considerably more effective than offering a Workplace Intervention alone (HR 1.35, 95% CI 1.01 to 1.82, test for subgroup differences P = 0.17). Workplace Interventions did not considerably reduce time until first RTW compared with a clinical Intervention in workers with mental health problems in one study (HR 2.65, 95% CI 1.42 to 4.95, very low-quality evidence). Authors' conclusions We found moderate-quality evidence that Workplace Interventions reduce time to first RTW, high-quality evidence that Workplace Interventions reduce cumulative duration of sickness absence, very low-quality evidence that Workplace Interventions reduce time to lasting RTW, and moderate-quality evidence that Workplace Interventions increase recurrences of sick leave. Overall, the effectiveness of Workplace Interventions on work disability showed varying results. Workplace Interventions reduce time to RTW and improve pain and functional status in workers with musculoskeletal disorders. We found no evidence of a considerable effect of Workplace Interventions on time to RTW in workers with mental health problems or cancer. We found moderate-quality evidence to support Workplace Interventions for workers with musculoskeletal disorders. The quality of the evidence on the effectiveness of Workplace Interventions for workers with mental health problems and cancer is low, and results do not show an effect of Workplace Interventions for these workers. Future research should expand the range of health conditions evaluated with high-quality studies.
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cost effectiveness of a Workplace Intervention for sick listed employees with common mental disorders design of a randomized controlled trial
BMC Public Health, 2008Co-Authors: Johannes R Anema, Henrica C W De Vet, Dirk L Knol, Sandra H Van Oostrom, Berend Terluin, Willem Van MechelenAbstract:Considering the high costs of sick leave and the consequences of sick leave for employees, an early return-to-work of employees with mental disorders is very important. Therefore, a Workplace Intervention is developed based on a successful return-to-work Intervention for employees with low back pain. The objective of this paper is to present the design of a randomized controlled trial evaluating the cost-effectiveness of the Workplace Intervention compared with usual care for sick-listed employees with common mental disorders. The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are on sick leave for 2 to 8 weeks with common mental disorders. The Workplace Intervention will be compared with usual care. The Workplace Intervention is a stepwise approach that aims to reach consensus about a return-to-work plan by active participation and strong commitment of both the sick-listed employee and the supervisor. Outcomes will be assessed at baseline, 3, 6, 9 and 12 months. The primary outcome of this study is lasting return-to-work, which will be acquired from continuous registration systems of the companies after the follow-up. Secondary outcomes are total number of days of sick leave during the follow-up, severity of common mental disorders, coping style, job content, and attitude, social influence, and self-efficacy determinants. Cost-effectiveness will be evaluated from the societal perspective. A process evaluation will also be conducted. Return-to-work is difficult to discuss in the Workplace for sick-listed employees with mental disorders and their supervisors. Therefore, this Intervention offers a unique opportunity for the sick-listed employee and the supervisor to discuss barriers for return-to-work. Results of this study will possibly contribute to improvement of disability management for sick-listed employees with common mental disorders. Results will become available in 2009. ISRCTN92307123
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development of a Workplace Intervention for sick listed employees with stress related mental disorders Intervention mapping as a useful tool
BMC Health Services Research, 2007Co-Authors: Johannes R Anema, Henrica C W De Vet, Sandra H Van Oostrom, Berend Terluin, Anita Venema, Willem Van MechelenAbstract:To date, mental health problems and mental workload have been increasingly related to long-term sick leave and disability. However, there is, as yet, no structured protocol available for the identification and application of an Intervention for stress-related mental health problems at the Workplace. This paper describes the structured development, implementation and planning for the evaluation of a return-to-work Intervention for sick-listed employees with stress-related mental disorders (SMDs). The Intervention is based on an existing successful return-to-work Intervention for sick-listed employees with low back pain. The principles of Intervention Mapping were applied to combine theory and evidence in the development, implementation and planning for the evaluation of a participatory Workplace Intervention, aimed at an early return-to-work for sick-listed employees with SMDs. All stakeholders were involved in focus group interviews: i.e. employees recently sick-listed with SMDs, supervisors and occupational health professionals. The development of the participatory Workplace Intervention according to the Intervention Mapping principles resulted in a structured return-to-work Intervention, specifically tailored to the needs of sick-listed employees with SMDs. Return-to-work was proposed as a behavioural change, and the Attitude – Social influence – self-Efficacy model was identified as a theoretical framework. Stakeholder involvement in focus group interviews served to enhance the implementation. The cost-effectiveness of the Intervention will be evaluated in a randomised controlled trial. Intervention Mapping was found to be a promising method to develop Interventions tailored to a specific target group in the field of occupational health. ISRCTN92307123
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multidisciplinary rehabilitation for subacute low back pain graded activity or Workplace Intervention or both a randomized controlled trial
Spine, 2007Co-Authors: Johannes R Anema, Ivan A Steenstra, P M Bongers, Henrica C W De Vet, Dirk L Knol, Patrick Loisel, Willem Van MechelenAbstract:Study design. Population-based randomized controlled trial. Objective. To assess the effectiveness of Workplace Intervention and graded activity, separately and combined, for multidisciplinary rehabilitation of low back pain (LBP). Summary of Background Data. Effective components for multidisciplinary rehabilitation of LBP are not yet established. Methods. Participants sick-listed 2 to 6 weeks due to nonspecific LBP were randomized to Workplace Intervention (n = 96) or usual care (n = 100). Workplace Intervention consisted of Workplace assessment, work modifications, and case management involving all stakeholders. Participants still sick-listed at 8 weeks were randomized for graded activity (n = 55) or usual care (n = 57). Graded activity comprised biweekly 1-hour exercise sessions based on operant-conditioning principles. Outcomes were lasting return to work, pain intensity and functional status, assessed at baseline, and at 12, 26, and 52 weeks after the start of sick leave. Results. Time until return to work for workers with Workplace Intervention was 77 versus 104 days (median) for workers without this Intervention (P = 0.02). Workplace Intervention was effective on return to work (hazard ratio = 1.7; 95% CI, 1.2-2.3; P = 0.002). Graded activity had a negative effect on return to work (hazard ratio = 0.4; 95% CI, 0.3-0.6; P < 0.001) and functional status. Combined Intervention had no effect. Conclusion. Workplace Intervention is advised for multidisciplinary rehabilitation of subacute LBP. Graded activity or combined Intervention is not advised.
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multidisciplinary rehabilitation for subacute low back pain graded activity or Workplace Intervention or both a randomized controlled trial
Spine, 2007Co-Authors: Johannes R Anema, Ivan A Steenstra, P M Bongers, Henrica C W De Vet, Dirk L Knol, Patrick Loisel, Willem Van MechelenAbstract:To assess the effectiveness of Workplace Intervention and graded activity, separately and combined, for multidisciplinary rehabilitation of low back pain (LBP). Summary of Background Data. Effective components for multidisciplinary rehabilitation of LBP are not yet established. Methods: Participants sick-listed 2 to 6 weeks due to nonspecific LBP were randomized to Workplace Intervention (n = 96) or usual care (n = 100). Workplace Intervention consisted of Workplace assessment, work modifications, and case management involving all stakeholders. Participants still sick-listed at 8 weeks were randomized for graded activity (n = 55) or usual care (n = 57). Graded activity comprised biweekly 1-hour exercise sessions based on operant-conditioning principles. Outcomes were lasting return to work, pain intensity and functional status, assessed at baseline, and at 12, 26, and 52 weeks after the start of sick leave. Results: Time until return to work for workers with Workplace Intervention was 77 versus 104 days (median) for workers without this Intervention (P = 0.02). Workplace Intervention was effective on return to work (hazard ratio = 1.7; 95% CI, 1.2-2.3; P = 0.002). Graded activity had a negative effect on return to work (hazard ratio = 0.4; 95% CI, 0.3-0.6; P < 0.001) and functional status. Combined Intervention had no effect. Conclusion: Workplace Intervention is advised for multidisciplinary rehabilitation of subacute LBP. Graded activity or combined Intervention is not advised.
