Documents Aust, Birgit 5 results

"Objectives The aim of this study was to evaluate the effect of the Danish return-to-work (RTW) program on long-term sickness absence in a randomized controlled trial in three municipalities. Methods The intervention group comprised 1948 participants while the control group comprised 1157 participant receiving ordinary sickness benefit management (OSM). Study participants were working-age adults receiving long-term (?8 weeks or more) benefits, included regardless of reason for sickness absence or employment status. Each beneficiary was followed-up for a maximum period of 52 weeks. Cox proportional hazards model was used to estimate hazard ratios (HR) for return to work (RTW) with 95% confidence intervals (95% CI). Results The intervention effect differed significantly between the municipalities (P=0.00005). In one municipality (M2) the intervention resulted in a statistically significant increased rate of recovery from long-term sickness absence (HR 1.51, 95% CI 1.31–1.74). In the other two municipalities, the intervention did not show a statistically significant effect (HRM1 1.12, 95% CI 0.97–1.29, and HRM3 0.80, 95% CI 0.63–1.03, respectively). Adjustment for a series of possible confounders only marginally altered the estimated HR. Conclusion The effect of the intervention differed substantially between the three municipalities, indicating that that contextual factors are of major importance for success or failure of this complex intervention."

"The Danish national return-to-work (RTW) program aims to improve the management of municipal sickness benefit in Denmark. A study is currently ongoing to evaluate the RTW program. The purpose of this article is to describe the study protocol. The program includes 21 municipalities encompassing approximately 19 500 working-age adults on long-term sickness absence, regardless of reason for sickness absence or employment status. It consists of three core elements: (i) establishment of multidisciplinary RTW teams, (ii) introduction of standardized workability assessments and sickness absence management procedures, and (iii) a comprehensive training course for the RTW teams. The effect evaluation is based on a parallel group randomized trial and a stratified cluster controlled trial and focuses on register-based primary outcomes - duration of sickness absence and RTW - and questionnaire-based secondary outcomes such as health and workability. The process evaluation utilizes questionnaires, interviews, and municipal data. The effect evaluation tests whether participants in the intervention have a (i) shorter duration of full-time sickness absence, (ii) longer time until recurrent long-term sickness absence, (iii) faster full RTW, (iv) more positive development in health, workability, pain, and sleep; it also tests whether the program is cost-effective. The process evaluation investigates: (i) whether the expected target population is reached; (ii) if the program is implemented as intended; (iii) how the beneficiaries, the RTW teams, and the external stakeholders experience the program; and (iv) whether contextual factors influenced the implementation. The program has the potential to contribute markedly to lowering human and economic costs and increasing labor force supply. First results will be available in 2013."

"The aim of the present intervention study was to examine if increased influence on working hours among shift workers led to better sleep quality.391 employees were categorized into groups based on the performed activities: High (self-rostering), moderate (education and/or policy for working hours), and low intensity intervention (meetings and discussions) and reference. Sleep quality was assessed by Karolinska Sleep Questionnaire (KSQ) at baseline and follow-up (12 months). To elucidate the process of the intervention interviews were conducted.Influence on one's own working hours increased only in the high intensity group (p < 0.001). No effects of interventions on sleep quality were observed. Thus, sleep quality was not improved by increasing work time influence in the present group of Danish elder care workers. This was partly due to program failure (failed intervention), but may also be due to other factors such as few participants working night and few working full time."

"Objective
This review aimed to examine systematically the epidemiological evidence linking work-related exposure to violence and threats thereof with risk of mental disorders and mental ill-health symptoms.
Methods
We searched PubMed, EMBASE, PsycINFO and Web of Science to identify original studies that provide quantitative risk estimates. The evidence was weighted according to completeness of reporting, potential common method bias, and bias due to differential selection and drop out, selective reporting, and misclassification of exposure and outcome.
Results
We identified 14 cross-sectional and 10 cohort studies with eligible risk estimates, of which 4 examined depressive disorder and reported an elevated risk among the exposed [pooled relative risk (RR) 1.42, 95% confidence interval (CI) 1.31-1.54, I 2=0%]. The occurrence of depressive and anxiety symptoms, burnout and psychological distress was examined in 17 studies (pooled RR 2.33, 95% CI 3.17, I 2=42%), and 3 studies examined risk of sleep disturbance (pooled RR 1.22, 95% CI 1.09-1.37, I2=0%). In most studies, common method bias and confounding could not be ruled out with confidence and strong heterogeneity in most outcome definitions invalidate the strict interpretation of most pooled risk estimates.
Conclusion
The reviewed studies consistently indicate associations between workplace violence and mental health problems. However, due to methodological limitations the causal associations (if any) may be stronger or weaker than the ones reported in this study. Prospective studies with independent and validated reporting of exposure and outcome and repeated follow-up with relevant intervals are highly warranted."

"Objective
This study aimed to systematically review the effectiveness of organizational-level interventions in improving the psychosocial work environment and workers' health and retention.
Methods
We conducted an overview of systematic reviews on organizational-level interventions published between 2000 and 2020. We systematically searched academic databases, screened reference lists, and contacted experts, yielding 27 736 records. Of the 76 eligible reviews, 24 of weak quality were excluded, yielding 52 reviews of moderate (N=32) or strong (N=20) quality, covering 957 primary studies. We assessed quality of evidence based on quality of review, consistency of results, and proportion of controlled studies.
Results
Of the 52 reviews, 30 studied a specific intervention approach and 22 specific outcomes. Regarding intervention approaches, we found strong quality of evidence for interventions focusing on “changes in working time arrangements” and moderate quality of evidence for “influence on work tasks or work organization”, “health care approach changes”, and “improvements of the psychosocial work environment”. Regarding outcomes, we found strong quality of evidence for interventions about “burnout” and moderate quality evidence for “various health and wellbeing outcomes”. For all other types of interventions, quality of evidence was either low or inconclusive, including interventions on retention.
Conclusions
This overview of reviews identified strong or moderate quality of evidence for the effectiveness of organizational-level interventions for four specific intervention approaches and two health outcomes. This suggests that the work environment and the health of employees can be improved by certain organizational-level interventions. We need more research, especially about implementation and context, to improve the evidence."