An intervention study for employees who are frequently absent from their work.

Frequent absenteeism is a problem for employers and employees. Frequent
absenteeism poses a problem for employers, e.g. with work planning. Frequently
absent employees can suffer from tensions e.g. with colleagues, apart from
frequently not feeling well. They also more frequently loose their job due to
dismissal (Gustaffson K, Marklund S. Int J Occup Med Environ Health 2011; 24
(2): 153-165). In addition 50% of frequenly absent employees will turn into a
long term absentee within 4 years Koopmans et al.Occup Med. 2008; 58: 268-274).
The background of frequent absenteeism is multifactorial (Beemsterboer et al.
2008).

All is all, frequent absenteeism is an important problem that scarcely has been
researched. Employers and employees want an employee to feel better and to be
less frequently absent. The employee wants to be at the wheel (focus group
study of the researcher, as of yet unpublished).

For this reason the researcher has bundled known instruments into an
internet-intervention, to help employees reach this goal.

Comparable studies have been undertaken in other internet intervention programs
((Bolier et al 2012, JMIR Res Protoc. 2012; 1 (1): e2, Genugten et al 2012, J.
Med. Internet Res. 2012 Mar 14; 14 (2): e44) .).

The objective of the study is to research the effect of the internet
internet-intervention - with and without consultation with the Occupational
Physician- on the frequency of absenteeism.

The study is a prospective intervention study with a maximum follow-up of 2
years after inclusion. The study is a randomized open study. It is an
intervention study.

Participants will be randomized over a control group and two intervention
groups before the study. Both intervention groups will get the internet
intervention. One intervention group additionally gets an advisory consult with
their own occupational physician.

1 The researcher informs employers about the study. 2. Employers distribute
information letters and consent letters to employees who have been absent 3x or
more frequently in the preceding year. 3. Employees who are willing to
participate fill out the consent letter, sign it and return it to the
researcher. 4. Afther this, an employee will receive a unique inlog code which
gets him/her access to the webbased questionnaire, the starting point of the
research. 5 The control group only fills out the questionnaire and furthermore
get "care as usual" from their occupational health provider. One intervention
group fills out the guestionnaire and gets digital advise. The other
intervention group fills out the questionnaire, gets digital advise, and gets
an invitation with their own occupational health physician. 6. Employees of
both intervention groups fill out a short evaluation questionnaire after 3
months. 7. After one year, the employees from the intervention groups get a
questionnaire with only questions on the secundairy outcome parameters
(burn-out, engagement and work ability). After 2 years this process is
repeated. 8. The absenteeism of participants will be followed during 2 years
through the registration system of the occupational health care provider.

Both intervention groups are provided with an webbased questionnaire with
digital advises increases awareness of frequent absenteeism and stimulates them
to improve their health and wellbeing. The questionnaire part of the
intervention is based on validated schales of the Utrecht Burn-out Scale
(UBOS), General Health Questionnaire (GHQ-12), Short-Form 12 (SF-12,
measurement generic health) Work Ability Index (WAI), Work Role Functioning
Questionnaire (WRFQ), Alcohol Use Disorders Identification Test (AUDIT-C),
shoreted scales for the Questionnaire on the Experience and Evaluation of Work
(QEEW).

The interventions are based on validated methods (problem solving strategy and
empowerment) and other regular interventions in the practice of occupational
health physicians, such as 'fretting exercises', and the rationale demands/work
capacity from the NvAB guideline : Management of mental health problems of
workers by occupational health physicians).

Additionally, the employees in one of the intervention groups are invited for
an advisory consultation with their own occupational physician. The starting
point of this consultation will consist of the relationship between
absenteeism, health, well-being , problems and the risk on (long-term)
absenteeism in the future. The first step of this advisory consultation
concerns clarification of problems that had to do with the frequent
absenteeism. Following problem clarification, the next step in the consultation
will be to discuss ways to improve health and wellbeing through concrete
problem solving. The purpose of the advisory consultation is to motivate
employees to set up an action plan.

During the study, 4 questionnaires will be completed. The first questionnaire
(at the start of the study) will take about 20 minutes to complete. Employees
randomised into intervention groups will receive a short questionnaire after 3
months to evaluate the advice and actions taken; this questionnaire will take
5-10 minutes to complete. After 1 year, a third questionnaire will measure
burn-out, vitality and workability; this questionnaire will take about 10
minutes to complete. To measure long-term effects of the intervention, a fourth
questionnaire will also measure burn-out, vitality and workability after 2
years; this questionnaire will take about 10 minutes to complete.
The employees of one intervention group will be invited for an advisory
consultation with the occupational researcher, which will take 15-30 minutens
travelling time and 30 minutes consultation time.

An employee is free to participate in the study. The employer is not informed
whether an employee participates or not in the study. Not participating
therefore cannot harm an employee in any way in their relationship with the
employer. Likewise, their own occupational physician and other occupational
professionals also are not informed whether an employee participates or not in
the study. Not participating therefore has no influence on the regular
occupational health service towards an employee.

The advantage of the intervention for employees will be that they will be more
aware of their health and wellbeing and learn ways to self-manage their health.
Another intended advantage for employees is to function better, have an
increased workability en in some cases are able to keep their job.