Skip to main content
Top
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Study protocol

The effectiveness of the “Brainwork Intervention” in reducing sick leave for unemployed workers with psychological problems: design of a controlled clinical trial

Authors: Selwin S Audhoe, Karen Nieuwenhuijsen, Jan L Hoving, Judith K Sluiter, Monique HW Frings-Dresen

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

Among the working population, unemployed, temporary agency and expired fixed-term contract workers having psychological problems are a particularly vulnerable group, at risk for sickness absence and prolonged work disability. Studies investigating the effectiveness of return-to-work (RTW) interventions on these workers, who are without an employment contract, are scarce. Therefore, a RTW intervention called ‘Brainwork’ was developed. The objective of this paper is to describe the ‘Brainwork Intervention’ and the trial design evaluating its effectiveness in reducing the duration of sick leave compared to usual care.

Methods/Design

The ‘Brainwork Intervention’ is designed to assist unemployed, temporary agency and expired fixed-term contract workers who are sick-listed due to psychological problems, with their return to work. The ‘Brainwork Intervention’ uses an activating approach: in the early stage of sick leave, workers are encouraged to exercise and undertake activities aimed at regaining control and functional recovery while job coaches actively support their search for (temporary) jobs. The content of the intervention is tailored to the severity of the psychological problems and functional impairments, as well as the specific psychosocial problems encountered by the sick-listed worker.
The intervention study is designed as a quasi-randomized controlled clinical trial with a one-year follow-up and is being conducted in the Netherlands. The control group receives care as usual with minimal involvement of occupational health professionals. Outcomes are measured at baseline, and 4, 8 and 12 months after initiation of the program. The primary outcome measure is the duration of sick leave. Secondary outcome measures are: the proportion of subjects who returned to work at 8 and 12 months; the number of days 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. The cost-benefit analysis will be evaluated from an insurer’s perspective.

Discussion

The methodological considerations of the study design are discussed. In this trial we evaluate the effectiveness of an intervention in real occupational health practice, rather than under highly controlled circumstances. The results will be published in 2015.

Trial registration

Trial registration number: NTR4190
Date of registration: September 27th 2013
Literature
2.
go back to reference Marnetoft S, Selander J, Bergroth A, Ekholm J. Factors associated with successful vocational rehabilitation in a Swedish rural area. J Rehab Med. 2001;33:71–8.CrossRef Marnetoft S, Selander J, Bergroth A, Ekholm J. Factors associated with successful vocational rehabilitation in a Swedish rural area. J Rehab Med. 2001;33:71–8.CrossRef
3.
go back to reference Cornelius LR, van der Klink JJL, Groothof JW, Brouwer S. Prognostic factors of long term disability due to mental disorders: a systematic review. J Occup Rehabil. 2011;21:259–74.CrossRefPubMed Cornelius LR, van der Klink JJL, Groothof JW, Brouwer S. Prognostic factors of long term disability due to mental disorders: a systematic review. J Occup Rehabil. 2011;21:259–74.CrossRefPubMed
4.
go back to reference Benach J, Amable M, Muntander C, Benavides FG. The consequences of flexible work for health: are we looking at the right place? J Epidemiol Community Health. 2002;56:405–6.CrossRefPubMedPubMedCentral Benach J, Amable M, Muntander C, Benavides FG. The consequences of flexible work for health: are we looking at the right place? J Epidemiol Community Health. 2002;56:405–6.CrossRefPubMedPubMedCentral
6.
go back to reference Quinlan M, Mayhew C, Bohle P. The global expansion of precarious employment, work disorganization, and consequences for occupational health: a review of recent research. Int J Health Serv. 2001;31(2):335–414.CrossRefPubMed Quinlan M, Mayhew C, Bohle P. The global expansion of precarious employment, work disorganization, and consequences for occupational health: a review of recent research. Int J Health Serv. 2001;31(2):335–414.CrossRefPubMed
7.
go back to reference 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 [in Dutch]. 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 [in Dutch].
8.
go back to reference Confédération Internationale des Entreprises de Travail Temporaire (CIETT). The agency work industry around the world. In: Economic Report 2010 Edition. Brussels: International Confederation of Private Employment Agencies CIETT; 2010. Confédération Internationale des Entreprises de Travail Temporaire (CIETT). The agency work industry around the world. In: Economic Report 2010 Edition. Brussels: International Confederation of Private Employment Agencies CIETT; 2010.
9.
go back to reference Benavides FG, Benach J, Diez-Roux AV, Roman C. How do types of employment relate to health indicators? Findings from the Second European Survey on Working Conditions. J Epidemiol Community Health. 2000;54:494–501.CrossRefPubMedPubMedCentral Benavides FG, Benach J, Diez-Roux AV, Roman C. How do types of employment relate to health indicators? Findings from the Second European Survey on Working Conditions. J Epidemiol Community Health. 2000;54:494–501.CrossRefPubMedPubMedCentral
10.
go back to reference Benach J, Gimeno D, Benavides FG, Martínez JM, Del Mar Torné M. Types of employment and health in the European Union:changes from 1995 to 2000. Eur J Public Health. 2004;14:314–21.CrossRefPubMed Benach J, Gimeno D, Benavides FG, Martínez JM, Del Mar Torné M. Types of employment and health in the European Union:changes from 1995 to 2000. Eur J Public Health. 2004;14:314–21.CrossRefPubMed
11.
go back to reference Ensminger ME, Celentano DD. Unemployment and psychiatric distress: social resources and coping. Soc Sci Med. 1988;27(3):239–47.CrossRefPubMed Ensminger ME, Celentano DD. Unemployment and psychiatric distress: social resources and coping. Soc Sci Med. 1988;27(3):239–47.CrossRefPubMed
12.
go back to reference Lindström M. Psychosocial work conditions, unemployment and self-reported psychological health: a population-based study. Occup Med. 2005;55:568–71.CrossRef Lindström M. Psychosocial work conditions, unemployment and self-reported psychological health: a population-based study. Occup Med. 2005;55:568–71.CrossRef
13.
go back to reference Brown DW, Balluz LS, Ford ES, Giles WH, Strine TW, Moriarty DG, et al. Associations between short- and long term unemployment and frequent mental distress among a national sample of men and women. J Occup Environ Med. 2003;45(11):1159–66.CrossRefPubMed Brown DW, Balluz LS, Ford ES, Giles WH, Strine TW, Moriarty DG, et al. Associations between short- and long term unemployment and frequent mental distress among a national sample of men and women. J Occup Environ Med. 2003;45(11):1159–66.CrossRefPubMed
14.
go back to reference Theodossiou I. The effects of low-pay and unemployment on psychological well-being: a logistic regression approach. J Health Econ. 1998;17(1):85–104.CrossRefPubMed Theodossiou I. The effects of low-pay and unemployment on psychological well-being: a logistic regression approach. J Health Econ. 1998;17(1):85–104.CrossRefPubMed
15.
go back to reference Shiels C, Gabbay MB, Ford FM. Patient factors associated with duration of certified sickness absence and transition to long-term incapacity. Br J Gen Pract. 2004;54:86–91.PubMedPubMedCentral Shiels C, Gabbay MB, Ford FM. Patient factors associated with duration of certified sickness absence and transition to long-term incapacity. Br J Gen Pract. 2004;54:86–91.PubMedPubMedCentral
16.
go back to reference Brown J, Hanlon P, Turok I, Webster D, Arnott J, Macdonald EB. Mental health as a reason for claiming incapacity benefit-a comparison of national and local trends. J Public Health. 2009;31:74–80.CrossRef Brown J, Hanlon P, Turok I, Webster D, Arnott J, Macdonald EB. Mental health as a reason for claiming incapacity benefit-a comparison of national and local trends. J Public Health. 2009;31:74–80.CrossRef
17.
go back to reference Knowledge Center Dutch Institute for Employee Benefit Schemes [Kenniscentrum UWV], Dutch Institute for Employee Benefit Schemes Knowledge Report 2011–III [UWV Kennisverslag 2013–III]. Amsterdam, The Netherlands; 2011. [in Dutch] Knowledge Center Dutch Institute for Employee Benefit Schemes [Kenniscentrum UWV], Dutch Institute for Employee Benefit Schemes Knowledge Report 2011–III [UWV Kennisverslag 2013–III]. Amsterdam, The Netherlands; 2011. [in Dutch]
18.
go back to reference Watson PJ, Booker CK, Moores L, Main CJ. Returning the chronically unemployed with low back pain to employment. Eur J Pain. 2004;8(4):359–69.CrossRefPubMed Watson PJ, Booker CK, Moores L, Main CJ. Returning the chronically unemployed with low back pain to employment. Eur J Pain. 2004;8(4):359–69.CrossRefPubMed
19.
go back to reference Audhoe SS, Hoving JL, Sluiter JK, Frings-Dresen MHW. Vocational interventions for unemployed: effects on work participation and mental distress. A systematic review. J Occup Rehabil. 2010;20(1):1–13.CrossRefPubMed Audhoe SS, Hoving JL, Sluiter JK, Frings-Dresen MHW. Vocational interventions for unemployed: effects on work participation and mental distress. A systematic review. J Occup Rehabil. 2010;20(1):1–13.CrossRefPubMed
20.
go back to reference 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;22:437–46.CrossRefPubMedPubMedCentral 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;22:437–46.CrossRefPubMedPubMedCentral
21.
go back to reference Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996;276:637–9.CrossRefPubMed Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996;276:637–9.CrossRefPubMed
22.
go back to reference Altman DG, Shulz KF, Moher D, Egger M, Davidhoff F, Elbourne D, et al. The revised CONSORT statement for reporting randomized controlled trials: explanation and elaboration. Ann Intern Med. 2001;134:663–94.CrossRefPubMed Altman DG, Shulz KF, Moher D, Egger M, Davidhoff F, Elbourne D, et al. The revised CONSORT statement for reporting randomized controlled trials: explanation and elaboration. Ann Intern Med. 2001;134:663–94.CrossRefPubMed
23.
go back to reference Nieuwenhuijsen K, Verbeek JHAM, de Boer AGEM, Blonk RW, van Dijk FJ. Predicting the duration of sickness absence for patients with common mental disorders in occupational health care. Scand J Work Environ Health. 2006;32:67–74.CrossRefPubMed Nieuwenhuijsen K, Verbeek JHAM, de Boer AGEM, Blonk RW, van Dijk FJ. Predicting the duration of sickness absence for patients with common mental disorders in occupational health care. Scand J Work Environ Health. 2006;32:67–74.CrossRefPubMed
24.
go back to reference NVAB. In: van der Klink J, editor. Guideline for Mental Health Problems. Eindhoven: NVAB [Dutch Association of Occupational Physicians]; 2000 [in Dutch]. NVAB. In: van der Klink J, editor. Guideline for Mental Health Problems. Eindhoven: NVAB [Dutch Association of Occupational Physicians]; 2000 [in Dutch].
25.
go back to reference van der Klink JJL, Ausems CMM, 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]. van der Klink JJL, Ausems CMM, 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].
26.
go back to reference Wollburg E, Braukhaus C. Goal setting in psychotherapy: the relevance of approach and avoidance goals for treatment outcome. Psychother Res. 2010;20(4):488–94.CrossRefPubMed Wollburg E, Braukhaus C. Goal setting in psychotherapy: the relevance of approach and avoidance goals for treatment outcome. Psychother Res. 2010;20(4):488–94.CrossRefPubMed
27.
go back to reference Holliday RC, Antoun M, Playford ED. A survey of goal-setting methods used in rehabilitation. Neurorehabil Neural Repair. 2005;19(3):227–31.CrossRefPubMed Holliday RC, Antoun M, Playford ED. A survey of goal-setting methods used in rehabilitation. Neurorehabil Neural Repair. 2005;19(3):227–31.CrossRefPubMed
28.
go back to reference Levack WM, Taylor K, Siegert RJ, Dean SG, McPherson KM, Weatherall M. Is goal planning in rehabilitation effective? A systematic review. Clin Rehabil. 2006;20(9):739–55.CrossRefPubMed Levack WM, Taylor K, Siegert RJ, Dean SG, McPherson KM, Weatherall M. Is goal planning in rehabilitation effective? A systematic review. Clin Rehabil. 2006;20(9):739–55.CrossRefPubMed
29.
go back to reference World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef
30.
go back to reference 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;10:191–7.CrossRef 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;10:191–7.CrossRef
31.
go back to reference Lagerveld SE, Blonk RWB, Brennikmeijer V, Schaufeli WB. Return to work among employees with mental health problems: Development and validation of a self-efficacy questionnaire. Work Stress. 2010;4:359–75.CrossRef Lagerveld SE, Blonk RWB, Brennikmeijer V, Schaufeli WB. Return to work among employees with mental health problems: Development and validation of a self-efficacy questionnaire. Work Stress. 2010;4:359–75.CrossRef
32.
go back to reference Dressler WW. Unemployment and depressive symptoms in a southern black community. J Nerv Ment Dis. 1986;174:639–45.CrossRefPubMed Dressler WW. Unemployment and depressive symptoms in a southern black community. J Nerv Ment Dis. 1986;174:639–45.CrossRefPubMed
33.
go back to reference Iversen L, Sabroe S. Psychological well-being among unemployed and employed people after a company closedown: a longitudinal study. J Soc Issues. 1988;44:141–52.CrossRef Iversen L, Sabroe S. Psychological well-being among unemployed and employed people after a company closedown: a longitudinal study. J Soc Issues. 1988;44:141–52.CrossRef
34.
go back to reference Claussen B. Health and re-employment in a five-year follow-up of long-term unemployed. Scan J Public Health. 1999;2:94–100. Claussen B. Health and re-employment in a five-year follow-up of long-term unemployed. Scan J Public Health. 1999;2:94–100.
35.
go back to reference van der Lem R, van der Wee NJA, 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.CrossRefPubMed van der Lem R, van der Wee NJA, 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.CrossRefPubMed
36.
go back to reference Sackett DL. Explanatory vs. management trials. In: Haynes RB, Sackett DL, Guyatt GH, editors. Clinical epidemiology: how to do clinical practice research. Tugwell. Philadelphia: Lippincott, Williams and Wilkins; 2006. Sackett DL. Explanatory vs. management trials. In: Haynes RB, Sackett DL, Guyatt GH, editors. Clinical epidemiology: how to do clinical practice research. Tugwell. Philadelphia: Lippincott, Williams and Wilkins; 2006.
37.
go back to reference Rothwell PM. External validity of randomized controlled trials: ‘to whom do the results of this trial apply?’. Lancet. 2005;365:82–93.CrossRefPubMed Rothwell PM. External validity of randomized controlled trials: ‘to whom do the results of this trial apply?’. Lancet. 2005;365:82–93.CrossRefPubMed
39.
go back to reference Burdorf A, Post W, Bruggeling T. Reliability of a questionnaire on sickness absence with specific attention to absence due to back pain and respiratory complaints. Occup Environ Med. 1996;53(1):58–62.CrossRefPubMedPubMedCentral Burdorf A, Post W, Bruggeling T. Reliability of a questionnaire on sickness absence with specific attention to absence due to back pain and respiratory complaints. Occup Environ Med. 1996;53(1):58–62.CrossRefPubMedPubMedCentral
40.
go back to reference Severens JL, Mulder J, Laheij RJF, Verbeek ALM. Precision and accuracy in measuring absence from work as a bias for calculating productivity costs in The Netherlands. Soc Sci Med. 2000;51:243–9.CrossRefPubMed Severens JL, Mulder J, Laheij RJF, Verbeek ALM. Precision and accuracy in measuring absence from work as a bias for calculating productivity costs in The Netherlands. Soc Sci Med. 2000;51:243–9.CrossRefPubMed
41.
go back to reference Hensing G. Swedish Council on Technology Assessment in Health Care (SBU). Chapter 4. Methodological aspects in sickness-absence research. Scand J Public Health Suppl. 2004;63:44–8.CrossRefPubMed Hensing G. Swedish Council on Technology Assessment in Health Care (SBU). Chapter 4. Methodological aspects in sickness-absence research. Scand J Public Health Suppl. 2004;63:44–8.CrossRefPubMed
42.
go back to reference Ferrie JE, Kivimaki M, Head J, Shipley MJ, Vahtera J, Marmot MG. A comparison of self-reported sickness absence with absences recorded in employers’ registers: evidence from the Whitehall II study. Occup Environ Med. 2005;62(2):74–9.CrossRefPubMedPubMedCentral Ferrie JE, Kivimaki M, Head J, Shipley MJ, Vahtera J, Marmot MG. A comparison of self-reported sickness absence with absences recorded in employers’ registers: evidence from the Whitehall II study. Occup Environ Med. 2005;62(2):74–9.CrossRefPubMedPubMedCentral
Metadata
Title
The effectiveness of the “Brainwork Intervention” in reducing sick leave for unemployed workers with psychological problems: design of a controlled clinical trial
Authors
Selwin S Audhoe
Karen Nieuwenhuijsen
Jan L Hoving
Judith K Sluiter
Monique HW Frings-Dresen
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1728-z

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue