Top

BMC Public Health

Published in:

01-12-2021 | Research article

Is the “Brainwork Intervention” effective in reducing sick leave for non-permanent workers with psychological problems? Results of a controlled clinical trial

Authors: Selwin S. Audhoe, Jan L. Hoving, Bonne J. H. Zijlstra, Monique H. W. Frings-Dresen, Karen Nieuwenhuijsen

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

Both the presence of psychological problems and the absence of an employment contract are related to long-term sickness absence, prolonged work disability and unemployment. Studies researching the effectiveness of return-to-work interventions on these non-permanent workers, including unemployed and temporary agency workers and workers with an expired fixed-term contract, are lagging behind. Therefore, a return-to-work intervention called “Brainwork” was developed. The aim of this study was to assess the effectiveness of the ‘Brainwork Intervention’ in reducing the duration of sick leave compared to usual care over a 12-month follow-up.

Methods

In a multicenter controlled clinical trial, using a quasi-randomization procedure, we compared the Brainwork Intervention (n = 164) to usual care (n = 156). The primary outcome was the duration of sick leave. Secondary outcomes were the duration of sick leave starting from Social Security Agency transfer; the proportion of workers returned to work; the number of hours of paid employment during the follow-up period; the degree of worker participation; the level of psychological complaints; and the self-efficacy for return to work. Protocol adherence (Brainwork Intervention) was considered sufficient when at least three of the five protocol steps were followed. Cox regressions, linear and ordinal regression, and Mixed Model analyses were performed.

Results

All 320 participants were analyzed. The Brainwork Intervention resulted in a non-significant reduction of the duration of sick leave compared to usual care (269 days versus 296 days; HR = 1.29; 95% CI 0.94–1.76; p = 0.11). For those working (46%) during the 12-month follow-up, the mean number of hours of paid employment was non-significantly higher in the usual care group (682 h versus 493 h; p = 0.053). No significant differences were found for other secondary outcomes. Protocol adherence was 10%.

Conclusions

The Brainwork Intervention as performed with a low protocol adherence did not result in a significant reduction of the duration of sick leave compared to usual care. It remains unclear what the results would have been if the Brainwork Intervention had been executed according to protocol.

Trial registration

The Netherlands Trial Register (NTR); NTR3976 (old registration number NTR4190). Registered September 27th 2013.

Available only for authorised users

Ferrari AJ, Charlson FJ, Norman RE, Flaxman AD, Patten SB, Vos T, et al. The epidemiological modelling of major depressive disorder: application for the global burden of disease study 2010. PLoS One. 2013;8(7):e69637. https://doi.org/10.1371/journal.pone.0069637 PMID: 23922765.CrossRefPubMedPubMedCentral

Sanderson K, Andrews G. Common mental disorders in the workforce: recent findings from descriptive and social epidemiology. Can J Psychiatr. 2006;51(2):63–75. PMID: 16989105. https://doi.org/10.1177/070674370605100202.CrossRef

Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617–27. https://doi.org/10.1001/archpsyc.62.6.617 PMID: 15939839.CrossRefPubMedPubMedCentral

Kessler RC. The global burden of anxiety and mood disorders: putting the European study of the epidemiology of mental disorders (ESEMeD) findings into perspective. J Clin Psychiatry. 2007;68(Suppl 2):10–9 PMID: 17288502.PubMedPubMedCentral

OECD. Sickness, disability and work: breaking the barriers. Paris: OECD Publishing; 2010. Available: http://www.oecd.org/publications/sickness-disability-and-work-breaking-the-barriers-9789264088856-en.htm. https://doi.org/10.1787/9789264088856-en.CrossRef

OECD. Sick on the Job? Paris: OECD Publishing; 2012. Available: http://www.oecd.org/els/mental-health-and-work-9789264124523-en.htmCrossRef

Lepine JP, Briley M. The increasing burden of depression. Neuropsychiatr Dis Treat. 2011;7(Suppl 1):3–7. https://doi.org/10.2147/NDT.S19617 PMID: 21750622.CrossRefPubMedPubMedCentral

Blank L, Peters J, Pickvance S, Wilford J, Macdonald E. A systematic review of the factors which predict return to work for people suffering episodes of poor mental health. J Occup Rehabil. 2008;18(1):27–34. https://doi.org/10.1007/s10926-008-9121-8 PMID: 18213510.CrossRefPubMed

Cornelius LR, van der Klink JJ, Groothoff JW, Brouwer S. Prognostic factors of long term disability due to mental disorders: a systematic review. J Occup Rehabil. 2011;21(2):259–74. https://doi.org/10.1007/s10926-010-9261-5 PMID: 21057974.CrossRefPubMed

10.

Benach J, Muntaner C. Precarious employment and health: developing a research agenda. J Epidemiol Community Health. 2007;61(4):276–7. https://doi.org/10.1136/jech.2005.045237 PMID: 17372284.CrossRefPubMedPubMedCentral

11.

de Jong P, Schrijvershof C, Veerman T. Unemployed and flex workers in profile. Comparison between nine months sick-listed unemployed and flex workers and employees [Vangnetters en profil. Vergelijking tussen negen maanden zieke vangnetters en werknemers]. The Netherlands: APE/AStri; 2008.

12.

Knowledge Center Dutch Institute for Employee Benefit Scheme Kenniscentrum UWV. Dutch Institute for Employee Benefit Schemes Knowledge Report 2014–2 [UWV Kennisverslag 2014–2]. Amsterdam: Knowledge Center Dutch Institute for Employee Benefit Schemes [Kenniscentrum UWV]; 2014.

13.

Audhoe SS. Promoting work participation of non-permanent workers with psychological problems: an evidence-based approach to occupational health care (doctoral dissertation). Amsterdam: University of Amsterdam; 2016. p. 2016.

14.

de Jong P, Veerman T, van der Burg C, Schrijvershof C. The Netherlands is no longer sick. From disability insurance act debacle to work and income act miracle [Nederland is niet ziek meer. Van WAO-debakel naar WIA-mirakel]. Amsterdam/Leiden: APE/AStri; 2010.

15.

Versantvoort M, van Echtelt P. Hindered at work. Trend report sickness absence, work disability and employment of persons with health restrictions [Belemmerd aan het werk. Trendrapportage ziekteverzuim, arbeidsongeschiktheid en arbeidsdeelname personen met gezondheidsbeperkingen]. The Hague: Social and Cultural Planning Office Knowledge Center [SCP/CBS/TNO/UWV Kenniscentrum]; 2012.

16.

Wanberg CR. The individual experience of unemployment. Annu Rev Psychol. 2012;63(1):369–96. https://doi.org/10.1146/annurev-psych-120710-100500. PMID: 21721936.CrossRefPubMed

17.

Confédération Internationale des Enterprise de Travail Temporaire (CIETT). The agency work industry around the world. Economic Report 2010. Brussels: International Confederation of Private Employment Agencies CIETT; 2010.

18.

Knowledge Center Dutch Institute for Employee Benefit Schemes [Kenniscentrum UWV]. Dutch Institute for Employee Benefit Schemes Knowledge Report 2013–1 [UWV Kennisverslag 2013–1]. Amsterdam: Knowledge Center Dutch Institute for Employee Benefit Schemes; 2013.

19.

Benach J, Gimeno D, Benavides FG, Martinez JM, Torne MM. Types of employment and health in the European union: changes from 1995 to 2000. Eur J Pub Health. 2004;14(3):314–21. PMID: 15369041. https://doi.org/10.1093/eurpub/14.3.314.CrossRef

20.

Centraal Bureau voor de Statistiek [Statistics Netherlands]. Beroepsbevolking; internationale definitie 2000–2013 [Labor force; international definition 2000–2013]. Den Haag/Heerlen: CBS; 2014. Available from: http://statline.cbs.nl/StatWeb/publication/?DM=SLNL&PA=71855ned&D1=9-10&D2=0&D3=0&D4=a&HDR=T&STB=G1,G2,G3&CHARTTYPE=1&VW=T. Accessed May 2020

21.

Audhoe SS, Hoving JL, Sluiter JK, Frings-Dresen MH. Vocational interventions for unemployed: effects on work participation and mental distress. A systematic review. J Occup Rehabil. 2010;20(1):1–13. https://doi.org/10.1007/s10926-009-9223-y PMID: 20039106.CrossRefPubMed

22.

Lammerts L, Schaafsma FG, Bonefaas-Groenewoud K, van Mechelen W, Anema JR. Effectiveness of a return-to-work program for workers without an employment contract, sick-listed due to common mentl disorders. Scand J Work Environ Health. 2016;42(6):469–80. https://doi.org/10.5271/sjweh.3588 PMID: 27571387.CrossRefPubMed

23.

Carlier BE, Schuring M, Burdorf A. Influence of an interdisciplinary re-employment programme among unemployed persons with mental health problems on health, social participation and paid employment. J Occup Rehabil. 2018;28(1):147–57. https://doi.org/10.1007/s10926-017-9704-3 PMID: 28397017.CrossRefPubMed

24.

Reme SE, Monstad K, Fyhn T, Sveinsdottir V, Løvvik C, Lie SA, et al. A randomized controlled multicenter trial of individual placement and support for patients with moderate-to-severe mental illness. Scand J Work Environ Health. 2019;45(1):33–41. https://doi.org/10.5271/sjweh.3753 PMID: 30074050.CrossRefPubMed

25.

Audhoe SS, Hoving JL, Nieuwenhuijsen K, Friperson R, de Jong PR, Sluiter JK, et al. Prognostic factors for the work participation of sick-listed unemployed and temporary agency workers with psychological problems. J Occup Rehabil. 2012;22(4):437–46. https://doi.org/10.1007/s10926-012-9358-0 PMID: 22481379.CrossRefPubMedPubMedCentral

26.

Schuring M, Mackenbach J, Voorham T, Burdorf A. The effect of reemployment on perceived health. J Epid Comm Health. 2011;65(7):639–44. https://doi.org/10.1136/jech.2009.103838.CrossRef

27.

Schuring M, Burdorf A. The benefits of paid employment among persons with common mental health problems: evidence for the selection and causation mechanism. Scand J Work Environ Health. 2017. https://doi.org/10.5271/sjweh.3675.

28.

Nieuwenhuijsen K, Faber B, Verbeek JH, Neumeyer-Gromen A, Hees HL, Verhoeven AC, et al. Interventions to improve return to work in depressed people. Cochrane Database Syst Rev. 2014;12:CD006237.

29.

van Vilsteren M, van Oostrom SH, de Vet HC, Franche RL, Boot CR, Anema JR. Workplace interventions to prevent work disability in workers on sick leave. Cochrane Database Syst Rev. 2015;10:CD006955.

30.

Cullen KL, Irvin E, Collie A, Clay F, Gensby U, Jennings PA, et al. Effectiveness of workplace interventions in return-to-work for musculoskeletal, pain-related and mental health conditions: an update of the evidence and messages for practitioners. J Occup Rehabil. 2018;28(1):1–15. https://doi.org/10.1007/s10926-016-9690-x.CrossRefPubMed

31.

Audhoe SS, Nieuwenhuijsen K, Hoving JL, Sluiter JK, Frings-Dresen MH. The effectiveness of the “Brainwork Intervention” in reducing sick leave for unemployed workers with psychological problems: design of a controlled clinical trial. BMC Public Health. 2015;15(1):377. https://doi.org/10.1186/s12889-015-1728-z. PMID: 25887217.

32.

van der Klink JJ, Blonk RW, Schene AH, van Dijk FJ. Reducing long term sickness absence by an activating intervention in adjustment disorders: a cluster randomised controlled design. Occup Environ Med. 2003;60(6):429–37. https://doi.org/10.1136/oem.60.6.429 PMID: 12771395.CrossRefPubMedPubMedCentral

33.

van der Klink JJL, Ausems CM, Beijderwellen BD, Blonk R, Bruinvels DJ, Dogger J, et al. Guideline for Mental Health Problems. Utrecht: NVAB [Dutch Association of Occupational Physicians]; 2007. [in Dutch]

34.

Waddell G, Burton AK. Is work good for your health and well-being? London: The Stationery Office; 2006. (www. tsoshop.co.uk):ISBN:9780117036949

35.

van der Noordt M, IJzelenberg H, Droomers M, Proper KI. Health effects of employment: a systematic review of prospective studies. Occup Environ Med. 2014;71(10):730–6. https://doi.org/10.1136/oemed-2013-101891 PMID: 24556535.CrossRefPubMed

36.

Luciano A, Bond GR, Drake RE. Does employment alter the course and outcome of schizophrenia and other severe mental illnesses? A systematic review of longitudinalresearch. Schizophr Res. 2014;159(2–3):312–21. https://doi.org/10.1016/j.schres.2014.09.010 PMID: 25278105.CrossRefPubMed

37.

van der Hoek W, Baal K, van der Hoek E, van der Lingen W, Meij A, Simons J, et al. Sick-listed workers without a permanent employment contract: characteristics and risk factors for long-term sickness absence [De vangetpopulatie in de Ziektewet: kenmerken en risicofactoren voor langdurig verzuim]. J Occup Insurance Med. 2008;16(6):240–6.

38.

Schulz KF, Altman DG, Moher D. Consort 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Med. 2010;8(1):18. https://doi.org/10.1186/1741-7015-8-18. PMID: 20334633.CrossRefPubMedPubMedCentral

39.

Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27(1):191–7. PMID: 9122299. https://doi.org/10.1017/S0033291796004242.CrossRefPubMed

40.

Lagerveld SE, Blonk RWB, Brenninkmeijer V, Schaufeli WB. Return to work among employees with mental health problems: development and validation of a self-efficacy questionnaire. Work Stress. 2010;24(4):359–75. https://doi.org/10.1080/02678373.2010.532644.CrossRef

41.

Treweek S, Zwarenstein M. Making trials matter: pragmatic and explanatory trials and the problem of applicability. Trials. 2009;10(1):37. 19493350. https://doi.org/10.1186/1745-6215-10-37.CrossRefPubMedPubMedCentral

42.

van der Lem R, van der Wee NJ, van Veen T, Zitman FG. Efficacy versus effectiveness: a direct comparison of the outcome of treatment for mild to moderate depression in randomized controlled trials and daily practice. Psychother Psychosom. 2012;81(4):226–34. https://doi.org/10.1159/000330890 PMID: 22584117.CrossRefPubMed

43.

Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, et al. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282(15):1458–65. PMID: 10535437. https://doi.org/10.1001/jama.282.15.1458.CrossRefPubMed

44.

Martin MH, Nielsen MB, Madsen IE, Petersen SM, Lange T, Rugulies R. Effectiveness of a coordinated and tailored return-to-work intervention for sickness absence beneficiaries with mental health problems. J Occup Rehabil. 2013;23(4):621–30. https://doi.org/10.1007/s10926-013-9421-5 PMID: 23358809.CrossRefPubMed

45.

van Beurden KM, Vermeulen SJ, Anema JR, van der Beek AJ. 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. J Occup Rehabil. 2012;22(1):127–40. https://doi.org/10.1007/s10926-011-9314-4 PMID: 21656252.CrossRefPubMed

46.

Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3–4):327–50. https://doi.org/10.1007/s10464-008-9165-0 PMID: 18322790.CrossRefPubMed

47.

Lammerts L, Schaafsma FG, van Mechelen W, Anema JR. Execution of a participatory supportive return to work program within the Dutch social security sector: a qualitative evaluation of stakeholders’ perceptions. BMC Public Health. 2016;16(1):323. https://doi.org/10.1186/s12889-016-2997-x. PMID: 27074885.CrossRefPubMedPubMedCentral

48.

Nigatu YT, Liu Y, Uppal M, McKinney S, Rao S, Gillis K, et al. Interventions for enhancing return to work in individuals with common mental illness: systematic review and meta-analysis of randomized controlled trails. Psychol Med. 2016;46(16):3263–74. https://doi.org/10.1017/S0033291716002269 PMID: 27609709.CrossRefPubMed

Title: Is the “Brainwork Intervention” effective in reducing sick leave for non-permanent workers with psychological problems? Results of a controlled clinical trial
Authors: Selwin S. Audhoe
Jan L. Hoving
Bonne J. H. Zijlstra
Monique H. W. Frings-Dresen
Karen Nieuwenhuijsen
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-021-10704-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is the “Brainwork Intervention” effective in reducing sick leave for non-permanent workers with psychological problems? Results of a controlled clinical trial

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2021

What do young Australian adults know about modifiable risk factors for dementia?

Correction to: Risk of stress/depression and functional impairment in Denmark immediately following a COVID-19 shutdown

Assessing the feasibility, acceptability and impacts of an education program on hepatitis B testing uptake among ethnic Chinese in Australia: results of a randomised controlled pilot study

Modeling the change trajectory of sleep duration and its associated factors: based on an 11-year longitudinal survey in China

Risk factors for some tropical diseases in an African country

Implementation of an organizational intervention to improve low-wage food service workers’ safety, health and wellbeing: findings from the Workplace Organizational Health Study