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Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Offering a tailored return to work program to cancer survivors with job loss: a process evaluation

Authors: M. P. van Egmond, S. F. A. Duijts, A. P. J. Scholten, A. J. van der Beek, J. R. Anema

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

In Europe, 1.7 million persons of working age are diagnosed with cancer each year. During or after treatment, cancer survivors (CSs) are vulnerable for job loss, and many CSs struggle with return to work (RTW). When offering RTW interventions to CSs, it is important to conduct a process evaluation to assess such factors as the population reached and implementation problems. Recently, we developed an innovative RTW program, tailored specifically to the needs of CSs with job loss in the Netherlands. The aim of this study was to evaluate the likelihood of theory and implementation failure, as well as to evaluate procedures for recruitment, execution and implementation of the tailored RTW program for CSs with job loss.

Methods

Six components were evaluated in the RTW program: Recruitment, Reach, Dosage, Implementation, Satisfaction, and Experienced Barriers. Data were provided by logbooks and questionnaires from participating CSs, occupational health care (OHC) professionals, and re-integration coaches and job hunting officers who delivered the RTW program. SPSS and Excel were used to conduct the analyses.

Results

85 CSs received the tailored RTW program. Their mean age was 47.9 years (SD 8.5). The majority were female (72 %), married (52 %), and of Dutch nationality (91 %). The program reached 88.2 % of the target population and 52 % of participants who started the program received the adequate dosage. The program implementation score was 45.9 %. Participants’ mean overall program duration remained within the protocol boundaries. Re-integration coaches were more satisfied with the program than job hunting officers or OHC professionals. Likewise, participants were more satisfied with the program delivery by the re-integration coaches than with the delivery by the job hunting officers. Reported barriers within the RTW program were a lack of communication, high program intensity and short program duration, and, with regard to the job hunting officers, a lack of experience with cancer-related RTW problems.

Conclusions

Participants, OHC professionals, re-integration coaches and job hunting officers generally had positive experiences with the innovative tailored RTW program. Facilitating communication between the delivering parties, and engaging usual care during program delivery, could be key elements to improved program implementation.

Trial registration

Dutch Trial Register, registration number NTR3562, registered 07-08-2012.
Literature
1.
go back to reference Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JWW, Comber H, Forman D, Bray F. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49:1374–403.CrossRefPubMed Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JWW, Comber H, Forman D, Bray F. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49:1374–403.CrossRefPubMed
2.
3.
go back to reference Feuerstein M, Todd BL, Moskowitz MC, Bruns GL, Stoler MR, Nassif T, Yu X. Work in cancer survivors: a model for practice and research. J Cancer Surviv. 2010;4:415–37.CrossRefPubMed Feuerstein M, Todd BL, Moskowitz MC, Bruns GL, Stoler MR, Nassif T, Yu X. Work in cancer survivors: a model for practice and research. J Cancer Surviv. 2010;4:415–37.CrossRefPubMed
4.
go back to reference Hoving JL, Broekhuizen MLA, Frings-Dresen MHW. Return to work of breast cancer survivors: a systematic review of intervention studies. BMC Cancer. 2009;9:117.CrossRefPubMedPubMedCentral Hoving JL, Broekhuizen MLA, Frings-Dresen MHW. Return to work of breast cancer survivors: a systematic review of intervention studies. BMC Cancer. 2009;9:117.CrossRefPubMedPubMedCentral
5.
go back to reference Kennedy F, Haslam C, Munir F, Pryce J. Returning to work following cancer: a qualitative exploratory study into the experience of returning to work following cancer. Eur J Cancer Care (Engl). 2007;16:17–25.CrossRef Kennedy F, Haslam C, Munir F, Pryce J. Returning to work following cancer: a qualitative exploratory study into the experience of returning to work following cancer. Eur J Cancer Care (Engl). 2007;16:17–25.CrossRef
6.
go back to reference Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol. 2011;77:109–30.CrossRefPubMed Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol. 2011;77:109–30.CrossRefPubMed
7.
go back to reference Park JH, Park JH, Kim SG. Effect of cancer diagnosis on patient employment status: a nationwide longitudinal study in Korea. Psychooncology. 2009;18:691–9.CrossRefPubMed Park JH, Park JH, Kim SG. Effect of cancer diagnosis on patient employment status: a nationwide longitudinal study in Korea. Psychooncology. 2009;18:691–9.CrossRefPubMed
8.
go back to reference de Boer AGEM, Taskila T, Ojajarvi A, van Dijk FJH, Verbeek JHAM. Cancer survivors and unemployment: a meta-analysis and meta-regression. JAMA. 2009;301:753–62.CrossRefPubMed de Boer AGEM, Taskila T, Ojajarvi A, van Dijk FJH, Verbeek JHAM. Cancer survivors and unemployment: a meta-analysis and meta-regression. JAMA. 2009;301:753–62.CrossRefPubMed
9.
go back to reference Noeres D, Park-Simon TW, Grabow J, Sperlich S, Koch-Giesselmann H, Jaunzeme J, Geyer S. Return to work after treatment for primary breast cancer over a 6-year period: results from a prospective study comparing patients with the general population. Support Care Cancer. 2013;21:1901–9.CrossRefPubMed Noeres D, Park-Simon TW, Grabow J, Sperlich S, Koch-Giesselmann H, Jaunzeme J, Geyer S. Return to work after treatment for primary breast cancer over a 6-year period: results from a prospective study comparing patients with the general population. Support Care Cancer. 2013;21:1901–9.CrossRefPubMed
10.
go back to reference Tamminga SJ, Verbeek JHAM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Frings-Dresen MHW, de Boer AGEM. Effectiveness of a hospital-based work support intervention for female cancer patients - a multi-centre randomised controlled trial. PLoS One. 2013;8:e63271.CrossRefPubMedPubMedCentral Tamminga SJ, Verbeek JHAM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Frings-Dresen MHW, de Boer AGEM. Effectiveness of a hospital-based work support intervention for female cancer patients - a multi-centre randomised controlled trial. PLoS One. 2013;8:e63271.CrossRefPubMedPubMedCentral
11.
go back to reference Thijs KM, de Boer AGEM, Vreugdenhil G, van de Wouw AJ, Houterman S, Schep G. Rehabilitation using high-intensity physical training and long-term return-to-work in cancer survivors. J Occup Rehabil. 2012;22:220–9.CrossRefPubMed Thijs KM, de Boer AGEM, Vreugdenhil G, van de Wouw AJ, Houterman S, Schep G. Rehabilitation using high-intensity physical training and long-term return-to-work in cancer survivors. J Occup Rehabil. 2012;22:220–9.CrossRefPubMed
12.
go back to reference de Boer AG, Taskila T, Tamminga SJ, Frings-Dresen MH, Feuerstein M, Verbeek JH. Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst Rev. 2011;CD007569. doi: 10.1002/14651858.CD007569. de Boer AG, Taskila T, Tamminga SJ, Frings-Dresen MH, Feuerstein M, Verbeek JH. Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst Rev. 2011;CD007569. doi: 10.​1002/​14651858.​CD007569.
13.
go back to reference Bakker FC, Persoon A, Schoon Y, Olde Rikkert MGM. Uniform presentation of process evaluation results facilitates the evaluation of complex interventions: development of a graph. J Eval Clin Pract. 2015;21:97–102.CrossRefPubMed Bakker FC, Persoon A, Schoon Y, Olde Rikkert MGM. Uniform presentation of process evaluation results facilitates the evaluation of complex interventions: development of a graph. J Eval Clin Pract. 2015;21:97–102.CrossRefPubMed
14.
go back to reference Oakley A, Strange V, Bonell C, Allen E, Stephenson J. RIPPLE Study Team: process evaluation in randomised controlled trials of complex interventions. BMJ. 2006;332:413–6.CrossRefPubMedPubMedCentral Oakley A, Strange V, Bonell C, Allen E, Stephenson J. RIPPLE Study Team: process evaluation in randomised controlled trials of complex interventions. BMJ. 2006;332:413–6.CrossRefPubMedPubMedCentral
15.
go back to reference Steckler A, Linnan L. Process evaluation for Public Health Interventions and Research. An Overview. 1st ed. San Francisco: Jossey-Bass Publishers; 2002. Steckler A, Linnan L. Process evaluation for Public Health Interventions and Research. An Overview. 1st ed. San Francisco: Jossey-Bass Publishers; 2002.
16.
go back to reference Goldenhar LM, LaMontagne AD, Katz T, Heaney C, Landsbergis P. The intervention research process in occupational safety and health: an overview from the National Occupational Research Agenda Intervention Effectiveness Research team. J Occup Environ Med. 2001;43:616–22.CrossRefPubMed Goldenhar LM, LaMontagne AD, Katz T, Heaney C, Landsbergis P. The intervention research process in occupational safety and health: an overview from the National Occupational Research Agenda Intervention Effectiveness Research team. J Occup Environ Med. 2001;43:616–22.CrossRefPubMed
17.
go back to reference Wierenga D, Engbers LH, Van Empelen P, Duijts S, Hildebrandt VH, van Mechelen W. What is actually measured in process evaluations for worksite health promotion programs: a systematic review. BMC Public Health. 2013;13:1190.CrossRefPubMedPubMedCentral Wierenga D, Engbers LH, Van Empelen P, Duijts S, Hildebrandt VH, van Mechelen W. What is actually measured in process evaluations for worksite health promotion programs: a systematic review. BMC Public Health. 2013;13:1190.CrossRefPubMedPubMedCentral
18.
go back to reference van Egmond MP, Duijts SF, Vermeulen SJ, van der Beek AJ, Anema JR. Return to work in sick-listed cancer survivors with job loss: design of a randomised controlled trial. BMC Cancer. 2015;15:63.CrossRefPubMedPubMedCentral van Egmond MP, Duijts SF, Vermeulen SJ, van der Beek AJ, Anema JR. Return to work in sick-listed cancer survivors with job loss: design of a randomised controlled trial. BMC Cancer. 2015;15:63.CrossRefPubMedPubMedCentral
19.
go back to reference van Egmond M, Duijts S, Loyen A, Vermeulen S, van der Beek A, Anema J: Barriers and facilitators for return to work in cancer survivors with job loss experience: a focus group study. Eur J Cancer Care (Engl). 2015. doi: 10.1111/ecc.12420. van Egmond M, Duijts S, Loyen A, Vermeulen S, van der Beek A, Anema J: Barriers and facilitators for return to work in cancer survivors with job loss experience: a focus group study. Eur J Cancer Care (Engl). 2015. doi: 10.​1111/​ecc.​12420.
20.
go back to reference Vermeulen SJ, Tamminga SJ, Schellart AJ, Ybema JF, Anema JR. Return-to-work of sick-listed workers without an employment contract--what works? BMC Public Health. 2009;9:232.CrossRefPubMedPubMedCentral Vermeulen SJ, Tamminga SJ, Schellart AJ, Ybema JF, Anema JR. Return-to-work of sick-listed workers without an employment contract--what works? BMC Public Health. 2009;9:232.CrossRefPubMedPubMedCentral
21.
go back to reference Hulshof CT, Verbeek JH, van Dijk FJ, van der Weide WE, Braam IT. Evaluation research in occupational health services: general principles and a systematic review of empirical studies. Occup Environ Med. 1999;56:361–77.CrossRefPubMedPubMedCentral Hulshof CT, Verbeek JH, van Dijk FJ, van der Weide WE, Braam IT. Evaluation research in occupational health services: general principles and a systematic review of empirical studies. Occup Environ Med. 1999;56:361–77.CrossRefPubMedPubMedCentral
22.
go back to reference 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;22:127–40.CrossRefPubMed 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;22:127–40.CrossRefPubMed
23.
go back to reference Lammerts L, Vermeulen SJ, Schaafsma FG, van Mechelen W, Anema JR. Return to work of workers without a permanent employment contract, sick-listed due to a common mental disorder: design of a randomised controlled trial. BMC Public Health. 2014;14:594.CrossRefPubMedPubMedCentral Lammerts L, Vermeulen SJ, Schaafsma FG, van Mechelen W, Anema JR. Return to work of workers without a permanent employment contract, sick-listed due to a common mental disorder: design of a randomised controlled trial. BMC Public Health. 2014;14:594.CrossRefPubMedPubMedCentral
24.
go back to reference Glasgow RE, McKay HG, Piette JD, Reynolds KD. The RE-AIM framework for evaluating interventions: what can it tell us about approaches to chronic illness management? Patient Educ Couns. 2001;44:119–27.CrossRefPubMed Glasgow RE, McKay HG, Piette JD, Reynolds KD. The RE-AIM framework for evaluating interventions: what can it tell us about approaches to chronic illness management? Patient Educ Couns. 2001;44:119–27.CrossRefPubMed
27.
go back to reference van Oostrom SH, van Mechelen W, Terluin B, de Vet HCW, Anema JR. A participatory workplace intervention for employees with distress and lost time: a feasibility evaluation within a randomized controlled trial. J Occup Rehabil. 2009;19:212–22.CrossRefPubMed van Oostrom SH, van Mechelen W, Terluin B, de Vet HCW, Anema JR. A participatory workplace intervention for employees with distress and lost time: a feasibility evaluation within a randomized controlled trial. J Occup Rehabil. 2009;19:212–22.CrossRefPubMed
28.
go back to reference Lambeek LC, van Mechelen W, Buijs PC, Loisel P, Anema JR. An integrated care program to prevent work disability due to chronic low back pain: a process evaluation within a randomized controlled trial. BMC Musculoskelet Disord. 2009;10:147.CrossRefPubMedPubMedCentral Lambeek LC, van Mechelen W, Buijs PC, Loisel P, Anema JR. An integrated care program to prevent work disability due to chronic low back pain: a process evaluation within a randomized controlled trial. BMC Musculoskelet Disord. 2009;10:147.CrossRefPubMedPubMedCentral
29.
go back to reference Anema JR, Steenstra IA, Urlings IJM, Bongers PM, de Vroome EMM, van Mechelen W. Participatory ergonomics as a return-to-work intervention: a future challenge? Am J Ind Med. 2003;44:273–81.CrossRefPubMed Anema JR, Steenstra IA, Urlings IJM, Bongers PM, de Vroome EMM, van Mechelen W. Participatory ergonomics as a return-to-work intervention: a future challenge? Am J Ind Med. 2003;44:273–81.CrossRefPubMed
30.
go back to reference Lammerts L, Schaafsma F, van Mechelen W, Anema J. 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. J Occup Rehabil. 2016. Epub ahead of print Lammerts L, Schaafsma F, van Mechelen W, Anema J. 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. J Occup Rehabil. 2016. Epub ahead of print
31.
go back to reference Siegel R, DeSantis C, Virgo K, Stein K, Mariotto A, Smith T, Cooper D, Gansler T, Lerro C, Fedewa S, Lin C, Leach C, Cannady RS, Cho H, Scoppa S, Hachey M, Kirch R, Jemal A, Ward E. Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin. 2012;62:220–41.CrossRefPubMed Siegel R, DeSantis C, Virgo K, Stein K, Mariotto A, Smith T, Cooper D, Gansler T, Lerro C, Fedewa S, Lin C, Leach C, Cannady RS, Cho H, Scoppa S, Hachey M, Kirch R, Jemal A, Ward E. Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin. 2012;62:220–41.CrossRefPubMed
32.
go back to reference Guassora AD, Jarlbaek L, Thorsen T. Preparing general practitioners to receive cancer patients following treatment in secondary care: a qualitative study. BMC Health Serv Res. 2015;15:202.CrossRefPubMedPubMedCentral Guassora AD, Jarlbaek L, Thorsen T. Preparing general practitioners to receive cancer patients following treatment in secondary care: a qualitative study. BMC Health Serv Res. 2015;15:202.CrossRefPubMedPubMedCentral
33.
34.
go back to reference Stapelfeldt CM, Labriola M, Jensen AB, Andersen NT, Momsen AM, Nielsen CV. Municipal return to work management in cancer survivors undergoing cancer treatment: a protocol on a controlled intervention study. BMC Public Health. 2015;15:720.CrossRefPubMedPubMedCentral Stapelfeldt CM, Labriola M, Jensen AB, Andersen NT, Momsen AM, Nielsen CV. Municipal return to work management in cancer survivors undergoing cancer treatment: a protocol on a controlled intervention study. BMC Public Health. 2015;15:720.CrossRefPubMedPubMedCentral
35.
go back to reference Tamminga SJ, de Boer AGEM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Verbeek JHAM, Frings-Dresen MHW. A hospital-based work support intervention to enhance the return to work of cancer patients: a process evaluation. J Occup Rehabil. 2012;22:565–78.CrossRefPubMedPubMedCentral Tamminga SJ, de Boer AGEM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Verbeek JHAM, Frings-Dresen MHW. A hospital-based work support intervention to enhance the return to work of cancer patients: a process evaluation. J Occup Rehabil. 2012;22:565–78.CrossRefPubMedPubMedCentral
36.
go back to reference Laxminarayan R, Chow J, Shahid-Salles SA. Intervention cost-effectiveness: overview of main messages; disease control priorities in developing countries. Washington, DC: World Bank; 2006. Laxminarayan R, Chow J, Shahid-Salles SA. Intervention cost-effectiveness: overview of main messages; disease control priorities in developing countries. Washington, DC: World Bank; 2006.
37.
go back to reference Anema JR, Jettinghoff K, Houtman I, Schoemaker CG, Buijs PC, van den Berg R. Medical care of employees long-term sick listed due to mental health problems: a cohort study to describe and compare the care of the occupational physician and the general practitioner. J Occup Rehabil. 2006;16:41–52.CrossRefPubMed Anema JR, Jettinghoff K, Houtman I, Schoemaker CG, Buijs PC, van den Berg R. Medical care of employees long-term sick listed due to mental health problems: a cohort study to describe and compare the care of the occupational physician and the general practitioner. J Occup Rehabil. 2006;16:41–52.CrossRefPubMed
38.
go back to reference Eurofound. Eurofound year book 2012: living and working in Europe. Dublin; 2013. Eurofound. Eurofound year book 2012: living and working in Europe. Dublin; 2013.
40.
go back to reference Harrington CB, Hansen JA, Moskowitz M, Todd BL, Feuerstein M. It’s not over when it’s over: long-term symptoms in cancer survivors--a systematic review. Int J Psychiatry Med. 2010;40:163–81.CrossRefPubMed Harrington CB, Hansen JA, Moskowitz M, Todd BL, Feuerstein M. It’s not over when it’s over: long-term symptoms in cancer survivors--a systematic review. Int J Psychiatry Med. 2010;40:163–81.CrossRefPubMed
41.
go back to reference Martin MHT, Moefelt L, Dahl Nielsen MB, Rugulies R. Barriers and facilitators for implementation of a return-to-work intervention for sickness absence beneficiaries with mental health problems: results from three Danish municipalities. Scand J Public Health. 2015;43:423–31.CrossRefPubMed Martin MHT, Moefelt L, Dahl Nielsen MB, Rugulies R. Barriers and facilitators for implementation of a return-to-work intervention for sickness absence beneficiaries with mental health problems: results from three Danish municipalities. Scand J Public Health. 2015;43:423–31.CrossRefPubMed
42.
go back to reference Aust B, Nielsen MB, Grundtvig G, Buchardt HL, Ferm L, Andersen I, Lund TL, Jelle MOC, Andersen MF, Hansen JV, Tverborgvik T, Helverskov T, Bjorner JB, Rugulies R, Orbaek P, Winzor G, Bultmann U, Poulsen OM. Implementation of the Danish return-to-work program: process evaluation of a trial in 21 Danish municipalities. Scand J Work Environ Health. 2015;41:529–41.CrossRefPubMed Aust B, Nielsen MB, Grundtvig G, Buchardt HL, Ferm L, Andersen I, Lund TL, Jelle MOC, Andersen MF, Hansen JV, Tverborgvik T, Helverskov T, Bjorner JB, Rugulies R, Orbaek P, Winzor G, Bultmann U, Poulsen OM. Implementation of the Danish return-to-work program: process evaluation of a trial in 21 Danish municipalities. Scand J Work Environ Health. 2015;41:529–41.CrossRefPubMed
43.
go back to reference Treweek S, Pitkethly M, Cook J, Kjeldstrom M, Taskila T, Johansen M, Sullivan F, Wilson S, Jackson C, Jones R, Mitchell E. Strategies to improve recruitment to randomised controlled trials. Cochrane Database Syst Rev. 2010;MR000013. doi: 10.1002/14651858.MR000013. Treweek S, Pitkethly M, Cook J, Kjeldstrom M, Taskila T, Johansen M, Sullivan F, Wilson S, Jackson C, Jones R, Mitchell E. Strategies to improve recruitment to randomised controlled trials. Cochrane Database Syst Rev. 2010;MR000013. doi: 10.​1002/​14651858.​MR000013.
Metadata
Title
Offering a tailored return to work program to cancer survivors with job loss: a process evaluation
Authors
M. P. van Egmond
S. F. A. Duijts
A. P. J. Scholten
A. J. van der Beek
J. R. Anema
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3592-x

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