Exploring expected and perceived facilitators and barriers of an indicated prevention strategy to prevent future long-term sickness absence; a qualitative study among employers and employees

Abstract

Background An indicated prevention strategy (IPS), consisting of a screening questionnaire and early treatment, was found to be effective for the prevention of future long-term sickness absence (LTSA) in two large Dutch RCT’s. This IPS aims to detect employees who have a high risk to become absent, and subsequently offer them early treatment. Despite the overall effectiveness, only a few companies have implemented this strategy so far. This suggests that companies may not be convinced of the (cost) effectiveness of this strategy yet. In companies where IPS has been implemented, screenings uptake and adherence to early treatment appeared to be moderate, indicating that both employees and employers might perceive barriers. Methods The aim of this qualitative study was to explore the expected and perceived facilitators and barriers for the implementation of the IPS. Semi-structured interviews were conducted with 9 employers and 11 employees (acquainted and unacquainted with IPS) from large companies. Purposive sampling was used to recruit participants. All interviews were transcribed and analyzed thematically. Results The employers believed they were primarily responsible for psychological and work-related health complaints and SA, while the employees felt responsible for health complaints related to their lifestyle. According to the employees, the responsibility of the employer was solely related to work-related health. This finding exposed a relation with the health culture, which was solely based on creating a safe work environment, omitting psychological health issues. The efficacy of this IPS regarding reducing SA was estimated positive, however, the efficacy regarding LTSA was questioned. Fear of a privacy breach was often mentioned by the respondents as an important barrier. Conclusions This study showed that the health culture within a company may be important for the perceived responsibility towards SA and health. A health culture which primarily focuses on physical complaints may raise barriers for the adoption and implementation of this preventive strategy. Participant’ perceptions of the nature of LTSA and the fact that not all participants were familiar with the exact content and phasing of IPS may have doubted the efficacy regarding LTSA. This study provides important clues for future and improved implementation of IPS.

Semmelweis Caring University Model Program Based on the Development of a Center of Preventive Services: Health for All Employees at a University Occupational Setting

“…It has been well-established that health and well-being of the population, especially of working people, are crucial prerequisites for productivity and are of utmost importance for overall socioeconomic and sustainable development ( 26 ). Health promotion and disease prevention programs at occupational settings have a direct effect on the health of employees and by this way strongly contribute to the prosperity of institutions serving as their workplace ( 27 , 28 ). Morbidity and mortality caused by non-communicable diseases are traditionally very unfavorable in Hungary which can be largely attributed to non-existent national public health program and primary care provision with no financial incentives to deliver preventive services ( 29 ).…”

Investigación formativa para el diseño e implementación de una estrategia para aumentar el rastreo de cáncer colorrectal en el ámbito laboral en Argentina

“…En Argentina, algunos estudios muestran el bajo conocimiento de la población general sobre el cáncer de colon y recto y los estudios de tamizaje 24 y falencias en las campañas de comunicación 25 como barreras para el tamizaje. El temor a la pérdida de la confidencialidad de los estudios diagnósticos, si bien minoritaria en este estudio, fue reportado como barrera en otras intervenciones en ámbitos laborales 26 , por lo que es importante llevar garantías a los destinatarios sobre este punto.…”

Opportunities, barriers and facilitators of an indicated prevention strategy to prevent future long-term sickness absence in SMEs: A qualitative study

“…This externalization of organizational responsibility may therefore be considered a specific barrier for the implementation of the indicated prevention strategy earlier introduced, as the preventive strategy also implies the shared responsibility of the employee and the employer. Also, barriers and facilitators in a multinational setting, such as having a culture of health and conceptions about the responsibilities of both employers and employees [23], may not be generalizable to the setting of SMEs. Barriers in SMEs may have to do with issues like defensiveness because of the strong identification of employers with their business.…”

“…Compared to multinational companies, SMEs often lack a "culture of health" (characterized by values and activities directed to employee health) [23]. Yet, important drivers enabling the success of initiatives like the preventive strategy are, according to respondents, primarily based on shared responsibility and trust.…”

“…As multiple stakeholders like employers, employees, and occupational health professionals are involved and need to align their interests and collaborate, recent research has been concerned with identifying the factors for successful adoption and implementation of this preventive strategy [22,23], but only for multinational companies.…”