Interventions for return to work following work-related injuries among young adults: A systematic literature review
Abstract: OBJECTIVE: To provide a review of current knowledge about interventions aimed to facilitate young adults to return to work following work-related injuries. METHODS: A systematic review of published literature from the year 2010 and onwards was conducted to identify studies examining return to work interventions for young adults (aged 19–29) following work-related injuries using PubMed and Web of Science. Two reviewers conducted the screening process and assessed the study quality using the National Heart, Lung… Show more
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Cited by 5 publications
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What is the volume, quality and characteristics of evidence relating to the effectiveness and cost‐effectiveness of multi‐disciplinary occupational health interventions aiming to improve work‐related outcomes for employed adults? An evidence and gap map of systematic reviews
BackgroundIn the UK, tens of millions of working days are lost due to work‐related ill health every year, costing billions of pounds. The role of Occupational Health (OH) services is vital in helping workers to maintain employment when they encounter injury or illness. OH providers traditionally rely on a clinical workforce to deliver these services, particularly doctors and nurses with OH qualifications. However, the increasing demand for OH services is unlikely to be met in the future using this traditional model, due to the declining number of OH‐trained doctors and nurses in the UK. Multi‐disciplinary models of OH delivery, including a more varied range of healthcare and non‐healthcare professionals, could provide a way to meet this new demand for OH services. There is a need to identify collaborative models of OH service delivery and review their effectiveness on return‐to work outcomes. There is an existing pool of systematic review evidence evaluating workplace based, multi‐disciplinary OH interventions, but it is difficult to identify which aspects of the content and/or delivery of these interventions may be associated with improved work‐related outcomes.ObjectivesThe aim of this evidence and gap map (EGM) was to provide an overview of the systematic review evidence that evaluates the effectiveness and cost‐effectiveness of multi‐disciplinary OH interventions intending to improve work‐related outcomes.Search MethodsIn June 2021 we searched a selection of bibliographic databases and other academic literature resources covering a range of relevant disciplines, including health care and business studies, to identify systematic review evidence from a variety of sectors of employment. We also searched Google Search and a selection of topically relevant websites and consulted with stakeholders to identify reports already known to them. Searches were updated in February 2023.Selection CriteriaSystematic reviews needed to be about adults (16 years or over) in employment, who have had absence from work for any medical reason. Interventions needed to be multi‐disciplinary (including professionals from different backgrounds in clinical and non‐clinical professions) and designed to support employees and employers to manage health conditions in the workplace and/or to help employees with health conditions retain and/or return to work following medical absence. Effectiveness needed to be measured in terms of return to work, work retention or measures of absence, or economic evaluation outcomes. These criteria were applied to the title and abstract and full text of each systematic review independently by two reviewers, with disagreements resolved through discussion. We awarded each systematic review a rating of ‘High’, ‘Medium’ or ‘Low’ relevance to indicate the extent to which the populations, interventions and their contexts synthesised within the review were consistent with our research question. We also recorded the number of primary studies included within each of the ‘High’ and ‘Medium’ reviews that were relevant to research question using the same screening process applied at review level.Data Collection and AnalysisSummary data for each eligible review was extracted. The quality of the systematic reviews, rated as ‘High’ or ‘Medium’ relevance following full text screening, was appraised using the AMSTAR‐2 quality appraisal tool. All data were extracted by one reviewer and checked by a second, with disagreements being settled through discussion. Summary data for all eligible systematic reviews were tabulated and described narratively. The data extracted from reviews of ‘High’ and ‘Medium’ relevance was imported into EPPI‐Mapper software to create an EGM.Stakeholder InvolvementWe worked alongside commissioners and policy makers from the Department of Health and Social Care (DHSC) and Department of Work and Pensions (DWP), OH personnel, and people with lived experience of accessing OH services themselves and/or supporting employees to access OH services. Individuals contributed to decision making at all stages of the project. This ensured our EGM reflects the needs of individuals who will use it.Main ResultsWe identified 98 systematic reviews that contained relevant interventions, which involved a variety of professionals and workplaces, and which measured effectiveness in terms of return to work (RTW). Of these, we focused on the 30 reviews where the population and intervention characteristics within the systematic reviews were considered to be of high or medium relevance to our research questions. The 30 reviews were of varying quality, split evenly between High/Moderate quality and Low/Critically‐Low quality ratings. We did not identify any relevant systematic review evidence on any other work‐related outcome of interest. Interventions were heterogenous, both within and across included systematic reviews. The EGM is structured according to the health condition experienced by participants, and the effectiveness of the interventions being evaluated, as reported within the included systematic reviews. It is possible to view (i) the quality and quantity of systematic review evidence for a given health condition, (ii) how review authors assessed the effectiveness or cost‐effectiveness of the interventions evaluated. The EGM also details the primary studies relevant to our research aim included within each review.Authors’ ConclusionsThis EGM map highlights the array of systematic review evidence that exists in relation to the effectiveness or cost‐effectiveness of multi‐disciplinary, workplace‐based OH interventions in supporting RTW. This evidence will allow policy makers and commissioners of services to determine which OH interventions may be most useful for supporting different population groups in different contexts. OH professionals may find the content of the EGM useful in identifying systematic review evidence to support their practice. The EGM also identifies where systematic review evidence in this area is lacking, or where existing evidence is of poor quality. These may represent areas where it may be particularly useful to conduct further systematic reviews.
What is the volume, quality and characteristics of evidence relating to the effectiveness and cost‐effectiveness of multi‐disciplinary occupational health interventions aiming to improve work‐related outcomes for employed adults? An evidence and gap map of systematic reviews
BackgroundIn the UK, tens of millions of working days are lost due to work‐related ill health every year, costing billions of pounds. The role of Occupational Health (OH) services is vital in helping workers to maintain employment when they encounter injury or illness. OH providers traditionally rely on a clinical workforce to deliver these services, particularly doctors and nurses with OH qualifications. However, the increasing demand for OH services is unlikely to be met in the future using this traditional model, due to the declining number of OH‐trained doctors and nurses in the UK. Multi‐disciplinary models of OH delivery, including a more varied range of healthcare and non‐healthcare professionals, could provide a way to meet this new demand for OH services. There is a need to identify collaborative models of OH service delivery and review their effectiveness on return‐to work outcomes. There is an existing pool of systematic review evidence evaluating workplace based, multi‐disciplinary OH interventions, but it is difficult to identify which aspects of the content and/or delivery of these interventions may be associated with improved work‐related outcomes.ObjectivesThe aim of this evidence and gap map (EGM) was to provide an overview of the systematic review evidence that evaluates the effectiveness and cost‐effectiveness of multi‐disciplinary OH interventions intending to improve work‐related outcomes.Search MethodsIn June 2021 we searched a selection of bibliographic databases and other academic literature resources covering a range of relevant disciplines, including health care and business studies, to identify systematic review evidence from a variety of sectors of employment. We also searched Google Search and a selection of topically relevant websites and consulted with stakeholders to identify reports already known to them. Searches were updated in February 2023.Selection CriteriaSystematic reviews needed to be about adults (16 years or over) in employment, who have had absence from work for any medical reason. Interventions needed to be multi‐disciplinary (including professionals from different backgrounds in clinical and non‐clinical professions) and designed to support employees and employers to manage health conditions in the workplace and/or to help employees with health conditions retain and/or return to work following medical absence. Effectiveness needed to be measured in terms of return to work, work retention or measures of absence, or economic evaluation outcomes. These criteria were applied to the title and abstract and full text of each systematic review independently by two reviewers, with disagreements resolved through discussion. We awarded each systematic review a rating of ‘High’, ‘Medium’ or ‘Low’ relevance to indicate the extent to which the populations, interventions and their contexts synthesised within the review were consistent with our research question. We also recorded the number of primary studies included within each of the ‘High’ and ‘Medium’ reviews that were relevant to research question using the same screening process applied at review level.Data Collection and AnalysisSummary data for each eligible review was extracted. The quality of the systematic reviews, rated as ‘High’ or ‘Medium’ relevance following full text screening, was appraised using the AMSTAR‐2 quality appraisal tool. All data were extracted by one reviewer and checked by a second, with disagreements being settled through discussion. Summary data for all eligible systematic reviews were tabulated and described narratively. The data extracted from reviews of ‘High’ and ‘Medium’ relevance was imported into EPPI‐Mapper software to create an EGM.Stakeholder InvolvementWe worked alongside commissioners and policy makers from the Department of Health and Social Care (DHSC) and Department of Work and Pensions (DWP), OH personnel, and people with lived experience of accessing OH services themselves and/or supporting employees to access OH services. Individuals contributed to decision making at all stages of the project. This ensured our EGM reflects the needs of individuals who will use it.Main ResultsWe identified 98 systematic reviews that contained relevant interventions, which involved a variety of professionals and workplaces, and which measured effectiveness in terms of return to work (RTW). Of these, we focused on the 30 reviews where the population and intervention characteristics within the systematic reviews were considered to be of high or medium relevance to our research questions. The 30 reviews were of varying quality, split evenly between High/Moderate quality and Low/Critically‐Low quality ratings. We did not identify any relevant systematic review evidence on any other work‐related outcome of interest. Interventions were heterogenous, both within and across included systematic reviews. The EGM is structured according to the health condition experienced by participants, and the effectiveness of the interventions being evaluated, as reported within the included systematic reviews. It is possible to view (i) the quality and quantity of systematic review evidence for a given health condition, (ii) how review authors assessed the effectiveness or cost‐effectiveness of the interventions evaluated. The EGM also details the primary studies relevant to our research aim included within each review.Authors’ ConclusionsThis EGM map highlights the array of systematic review evidence that exists in relation to the effectiveness or cost‐effectiveness of multi‐disciplinary, workplace‐based OH interventions in supporting RTW. This evidence will allow policy makers and commissioners of services to determine which OH interventions may be most useful for supporting different population groups in different contexts. OH professionals may find the content of the EGM useful in identifying systematic review evidence to support their practice. The EGM also identifies where systematic review evidence in this area is lacking, or where existing evidence is of poor quality. These may represent areas where it may be particularly useful to conduct further systematic reviews.
IntroductionThere is a lack of studies that focus exclusively on return to work (RTW) and sick leave patterns following a work injury among young adults. This study aims to close the gap by contributing with knowledge regarding young adults’ sick leave pattern after a work injury and their experience of RTW after a work injury in Sweden.Methods and analysisThe present study is a multimodal study, which will use Swedish national register data and qualitative data collection by photovoice. Injuries classified as work injuries according to the Swedish injury classification were included. Registry data will be retrieved from the Swedish National-based registers of Swedish Information System on Occupational Accidents and Work-related diseases, the Swedish Social Insurance Agency’s database MicroData for Analysis of Social Insurance and the Swedish Longitudinal Integration Database for Health Insurance and Labour Market Studies. Persons who have registered a work injury at the Swedish Work Environment Authority in 2012 will be included. Sick leave patterns will be analysed using group-based trajectory models and multivariate analyses to explore how sick leave patterns have developed over 5 years. Subsequently, a participatory approach using photovoice method will be conducted to explore young adults’ perceptions of barriers and facilitators in RTW after a work injury. Results from the photovoice group sessions will be analysed using a grounded theoretical approach.Ethics and disseminationThe study has been reviewed and approved by the Ethical Review Board (case number 2019/028-6) in Sweden. Results of the study will be disseminated through peer-reviewed journals, print and media presentation, conferences and via reports to the funding agency.
BACKGROUND: To achieve adequate return to work (RTW) after sickness absence, Dutch legislation prescribes cooperation between absent employees and employers. Yet, we lack insight into how employees with low levels of education exercise influence over (i.e. self-direct) RTW. OBJECTIVE: This study aimed to enhance our understanding of: A) the role that employers play in the self-direction of employees with low levels of education over their RTW, B) how employers perceive these employees’ efforts (or lack thereof) to self-direct their own RTW, and how employers understand and interpret the behaviours of these employees. Social cognitive theory served as a framework. METHODS: A qualitative study was conducted with 13 employer representatives using semi-structured interviews. Data were analysed in NVivo12 using a template approach. RESULTS: Employers tend to play a guiding, directive role in employees’ RTW. According to employers, employees generally comply with the employers’ decisions and suggestions, whether or not they have tried to realise their own preferences regarding mode and timing of RTW. Employers interpret such employee behaviours from the perspective of environmental (e.g. financial pressures to RTW) and person-related factors (e.g. sickness and RTW perceptions). CONCLUSIONS: Employers, rather than employees direct the employees’ RTW. Employers should give voice to employees and enable them to have more control over their RTW. Future research should acquire more insight in the employees’ perspective.
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