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Ill health has a large impact on wellbeing, functioning and work disability of workers with over 10% of the potential working population on long-term sickness absence or receiving a work disability benefit. An innovative preventive strategy, based on early detection of high risk workers and subsequent early intervention, was proven effective in significantly reducing future long-term sickness absence risk over 1 year. The early detection of vulnerable workers is based on the validated screening instrument, the Balansmeter, which detects workers who, due to a combination of ill health, personal and work characteristics, are at high risk for future sickness absence. Based on its established efficacy the strategy has been implemented in several (multinational) companies. Considering the effectiveness on sickness absence, it can be expected that the preventive strategy will also favorably impact labor participation by reducing the work disability risk and it can improve health and wellbeing and reduce health care resource use of vulnerable employees and as such will show high cost benefit as well as effectiveness on the long run.

Until now however, widespread implementation of this strategy may be hampered by the fact that the need and necessity for this strategy, as well as its benefits, are not sufficiently known and/or recognized by the stakeholders involved (employees, employers, occupational health professionals, insurance companies and government) yet. It is assumed that to support widespread implementation of this effective strategy, insight in and evidence of the anticipated benefits, cost-effectiveness and long-term effects is of paramount importance. To assess stakeholders’ needs and evaluate overall cost-effectiveness of the preventive strategy, the aims of this project are:

1: To gain insight in the stakeholders’ needs, necessities and anticipated barriers with regards to a preventive strategy, based on early detection and subsequent intervention of the high risk workers.

2: To examine the long term costs, effects/benefits, cost-effectiveness of the preventive strategy, separate for the different stakeholders (employees, employers, occupational health professionals, insurance companies and government).

The research aims will be addressed by analyzing data from three different study populations, consisting of an extended follow up of two prospective randomized controlled trials on the efficacy of early intervention to reduce future sick leave supplemented with data of the long running Maastricht Cohort Study (MCS). Data from the trials will be extended and expanded over time by data linking with company data. Data from the MCS will be used to describe health care resource use and sickness absence in a non-screened working population and to compare these reference data with the screened populations from the two RCTs. Furthermore, an assessment covering the needs and necessities of a preventive strategy to reduce long term sickness absence and work disability will be held among the primary stakeholders (employees, employers and occupational health professionals). In focus groups and a stakeholder conference, both the results of the needs assessment and the results of the costs effects and benefits analysis will be discussed, aiming at identifying and tackling potential barriers and stimulating factors in the widespread implementation of the preventive strategy. This study will address these questions thereby uncovering the needs and necessities with regards to the implementation of a strategy proven effective to reduce long term sickness absence. Furthermore this study will establish the cost-effectiveness of the preventive strategy by studying benefits, costs and long-term effects (sickness absence, work disability, health care resource use, well-being) for all workers and for specific subgroups (e.g. SES). Moreover, costs and benefits will be assessed for and discussed with the stakeholders involved.

By integrating the research findings and communicate and discuss the results, including their financial, legal and ethical aspects, with all relevant stakeholders (employees, employers, occupational health professionals, insurance companies and government) potential barriers and facilitating factors for widespread implementation can be identified and collaborative strategies to foster widespread implementation developed. As the screening facilities, education of personnel and practical issues with regards to the screening program have already been addressed, removing these barriers and communicating the results to all relevant stakeholders, will open the way towards broad implementation. As such, widespread implementation will contribute to the health and well being of vulnerable workers, and will promote more equity in the access to an effective strategy. Simultaneously, the project contributes to further knowledge on this preventive strategy to increase participation of workers.


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