Occupational Physicians’ Perspectives on Determinants of Employee Participation in a Randomized Controlled Musculoskeletal Health Promotion Measure: A Qualitative Study

Self Cite

Musculoskeletal disorders (MSDs) are among the most common cause for reduced work capacity and sick leave. Workplace health promotion programs are often neither tailored to the workplace nor the individual needs of the employees. To counteract lacking intersectional care, this four-year randomized controlled trial (RCT) aimed to investigate the effects of modular coordinating case management (treatment group) compared to supported self-management (control group) on MSD specific sick leave days (routine data), workability (WAI), self-efficacy (self-efficacy scale), and pain (German pain questionnaire, GPQ). The study network comprised 22 companies, 15 company health insurance funds, and 12 pension funds in Germany. Overall, 852 participants (Module A/early intervention: n = 651, Module B/rehabilitation: n = 190, Module C/reintegration: n = 10) participated. Both groups achieved fewer sick leave days, higher workability, and less pain (p < 0.0001) at follow-up compared to baseline. At follow-up, the coordinating case management group showed fewer disability days (GPQ), lower disability scores (GPQ), and lower pain intensities (GPQ) than the supported self-management group (p < 0.05), but no superiority regarding MSD specific sick leave days, workability, nor self-efficacy. Module A showed more comprehensive differences. The accompanying process evaluation shows barriers and facilitators for the implementation of the program, especially in a RCT setting.

Section: Summative/results Evaluationmentioning

confidence: 99%

“…The main implemenentation facilitators and barriers are listed in Figure 3. Please see other publications for deeper sub-analyses [7,8]. A central component of the coordinating case management treatment group is the case manager.…”

Section: Formative/process Evaluationmentioning

confidence: 99%

A Cross-Provider Healthcare Management Program for Musculoskeletal Disorders: Results of a Randomized Controlled Trial in 22 German Companies

Choi

Lindert

Schlomann

et al. 2021

Self Cite

“…The analysis of the uptake of health care and preventive health care measures has long been an important pillar of health care research in population-based studies in the secondary and tertiary prevention sector [ 15 , 16 , 17 , 18 , 19 ] as well as in the operational setting analyzing the uptake of occupational health services [ 20 , 21 ] or workplace health promotion [ 22 , 23 , 24 ]. In this context of health care research, we do not know enough about the extent to which employees take up (voluntary) occupational health care in Germany when it is offered.…”

Section: Introductionmentioning

confidence: 99%

Uptake of Voluntary Occupational Health Care—Assessments of German Occupational Health Physicians and Employees

Michaelis

Preiser

Voelter-Mahlknecht

et al. 2022

Workers’ health surveillance is considered essential for employees’ health and protection against hazardous working conditions. It is one part of occupational health care and thus one of four pillars of holistic workplace health management. In Germany, employers are obliged to provide mandatory and voluntary occupational health care (OHC) to employees, dependent on the defined occupational hazards. However, employees are not obliged to make use of voluntary OHC. No empirical information is available about the uptake of voluntary OHC by employees and the influencing factors in Germany. Thus, we carried out an explorative multi-perspective study with qualitative and quantitative elements to get insights from the view of occupational health physicians (OHPs) and employees. We conducted a survey among OHPs based on prior statements from two focus group discussions. A multivariate logistic regression analysis was performed to detect enablers and barriers regarding employee uptake of the offered voluntary OHC. We used extended qualitative methods among employees instead of an analogous survey. In total, 460 OHPs participated in the survey (response rate 29.1%), and 25 employees took part in interviews. Most of the employees had not heard the term voluntary OHC before, and only a few remembered respective occupational health care after explanatory request. In total, 78% of the OHPs assessed that employees always/mostly take up voluntary OHC. The most important attributed reason for non-uptake was that employees see no need for occupational health care when they feel healthy. The most important enabler for the perceived high uptake of voluntary OHC in the regression analysis was a positive attitude of the OHP toward voluntary OHC. While OHPs perceived that voluntary OHC was accepted by a majority of employees, this was not confirmed by the interviews with selected employees. This could indicate that the OHP respondents overestimated the amount of uptake. Since it became clear that employees are often unfamiliar with the terminology itself, we see a need for more and better information regarding the objectives and content of occupational health care to improve this important pillar of workplace health management.

“…Ensuring a holistic approach in addition to WHP as a part of OSH, models should be developed in which the occupational physician (in some European Countries even mandatory by law for every company size [55]) can be involved more regularly and intensively in the whole process of WHP without having to devote additional resources. Future research could focus on analyzing the role of the occupational physician at the enterprise level [56] and at the same time whether this is desired by the companies or would be feasible.…”

Section: Recommendations For Research and Practicementioning

confidence: 99%

A German Model Project for Workplace Health Promotion—Flow of Communication, Information, and Reasons for Non-Participation in the Offered Measures

Lutz

Fischmann

Drexler

et al. 2022

Background: Workplace health promotion (WHP) as a part of workplace health management (WHM) was strengthened in German legislature with the Prevention Act of 2015. However, smaller enterprises often do not offer WHM or WHP. Accordingly, a model-project for improving the uptake and implementation, particularly in micro-, small, and medium-sized enterprises (MSMEs) was carried out. The aim of the study was to determine reasons for non-participation in WHP offers and analyze communication issues, both from the employee’s and employer’s perspective. Methods: In total, 21 managers or persons responsible for WHP participated in the first online survey between March and April 2020, and 156 employees responded to the second online survey between June and October 2021. The importance of barriers and communication issues was investigated. Based on a principal component analysis on non-participation, differences regarding sociodemographic variables were analyzed. Results: Most employees knew about the offered measures and that the measures were cost free. There was no significant association between having communicated the offers to the employees and considering them suitable for their needs. Most of the managers or persons responsible for WHP rated the measures as sufficiently varied and allowed staff to take part during working-time. Reasons for non-participation from the managers’ point of view were travel time to the location of the offers, lack of time, and a missing fit between offers and employees’ needs. From the employees’ point of view, workload (including working time) was the main barrier to participation. Conclusions: For the practical implementation of model projects in MSMEs, special attention should be paid to ensuring opportunity to participate, which may be easier with in-house offers.