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

Abstract

BackgroundIn 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.MethodsSix 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.Results85 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.ConclusionsParticipants, 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 registrationDutch Trial Register, registration number NTR3562, registered 07-08-2012.

Barriers to and Facilitators of Implementing Programs for Return to Work (RTW) of Cancer Survivors in Four European Countries: A Qualitative Study

“…In light of this complexity, the implementation of individual RTW programs for cancer survivors has proved to be challenging [15, 16]. Implementation includes the process of putting programs to use or the process of integrating new programs within a setting [17–19].…”

“…Therefore, in attempting to better understand what hinders and, more importantly, may help better implement RTW programs, it is important to not limit consideration to a single country with its specific legislation and healthcare system but also include a diverse set of countries in terms of legislation and healthcare system to be able to complement findings. Additionally, to the best of our knowledge, previous research has focussed solely on the implementation success of individual RTW programs for cancer survivors [15, 16]. It would be of added value to study the barriers to and facilitators of a large and diverse set of RTW programs for cancer survivors to see whether overarching themes can be identified.…”

Evaluation of Usability and Satisfaction of Two Online Tools to Guide Return to Work for Cancer Survivors on the Cancer and Work Website

“…However, cancer survivors face challenges when returning to work compared to individuals without cancer, including higher risks of unemployment, workplace stigma [5], and employer misperceptions of cancer survivors' work abilities, productivity, and reliability [6]. Between 26%-53% of cancer survivors will experience job loss or will resign during or after treatment [4,7,8]. Higher risks of unemployment among cancer survivors have also been associated with the increasing presence of late and long-term effects of cancer and its treatment [3,9,10] such as cancer-related fatigue [11], cancer distress, and cognitive impairment [12].…”

Process evaluation of a tailored work-related support intervention for patients diagnosed with gastrointestinal cancer

“…To structure and describe those, we used the model of Linnan and Steckler [21] for structuring the process evaluation. Other RTW studies [23][24][25] also evaluated their intervention process with this model, allowing us to relate and learn from their intervention process. Furthermore, results of the effectiveness of an intervention can be put into perspective by performing a process evaluation with the individual components of the intervention process and the relation between these components [20,26].…”