Impact of a Work-Focused Intervention on the Productivity and Symptoms of Employees With Depression

Program on Health, Work and Productivity, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine (Impact Factor: 1.63). 02/2012; 54(2):128-35. DOI: 10.1097/JOM.0b013e31824409d8
Source: PubMed


To test a new program's effectiveness in reducing depression's work burden.
A brief telephonic program to improve work functioning was tested in an early-stage randomized controlled trial involving 79 Maine State Government employees who were screened in for depression and at-work limitations (treatment group = 59; usual care group = 27). Group differences in baseline to follow-up change scores on the Work Limitations Questionnaire (WLQ), WLQ Absence Module, and Patient Health Questionnaire (PHQ)-9 depression severity scale were tested with analysis of covariance.
Although there were no baseline group differences (P ≥ 0.05), by follow-up, the treatment group had significantly better scores on every outcome and differences in the longitudinal changes were all statistically significant (P = 0.0.27 to 0.0001).
The new program was superior to usual care. The estimated productivity cost savings is $6041.70 per participant annually.

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Available from: Debra Lerner, Oct 04, 2015
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    • "Most importantly for the current study, the WLQ has been correlated with objectively-measured employee-level work productivity, and scores on the WLQ can be translated into a single Productivity Index score that indicates the percentage difference in output from a healthy (not limited) benchmark population [37]. Recently, the WLQ has also been shown sensitive to the effects of intervention [38]. "
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    ABSTRACT: Background The percentage of older and chronically ill workers is increasing rapidly in the US and in many other countries, but few interventions are available to help employees overcome the workplace challenges of chronic pain and other physical health conditions. While most workers are eligible for job accommodation and disability compensation benefits, other workplace strategies might improve individual-level coping and problem solving to prevent work disability. In this study, we hypothesize that an employer-sponsored group intervention program employing self-management principles may improve worker engagement and reduce functional limitation associated with chronic disorders. Methods In a randomized controlled trial (RCT), workers participating in an employer-sponsored self-management group intervention will be compared with a no-treatment (wait list) control condition. Volunteer employees (n = 300) will be recruited from five participating employers and randomly assigned to intervention or control. Participants in the intervention arm will attend facilitated group workshop sessions at work (10 hours total) to explore methods for improving comfort, adjusting work habits, communicating needs effectively, applying systematic problem solving, and dealing with negative thoughts and emotions about work. Work engagement and work limitation are the principal outcomes. Secondary outcomes include fatigue, job satisfaction, self-efficacy, turnover intention, sickness absence, and health care utilization. Measurements will be taken at baseline, 6-, and 12-month follow-up. A process evaluation will be performed alongside the randomized trial. Discussion This study will be most relevant for organizations and occupational settings where some degree of job flexibility, leeway, and decision-making autonomy can be afforded to affected workers. The study design will provide initial assessment of a novel workplace approach and to understand factors affecting its feasibility and effectiveness. Trial registration NCT01978392 (Issued November 6, 2013)
    BMC Public Health 05/2014; 14(1):515. DOI:10.1186/1471-2458-14-515 · 2.26 Impact Factor
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    • "Even though information on productivity loss at work was only collected for 51% of the study sample, the CBA including this information gives a clear indication of the underestimation of productivity loss costs when only using sickness absence data and assuming that participants are 100% productive when at work. As presenteeism seems to be an important contributor to productivity loss among workers with mental health problems, this is an important variable to include in economic evaluations [6,29,30]. However, previous studies on the economic benefit of occupational health care interventions for workers with mental health problems often missed information on presenteeism [26–28]. "
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    ABSTRACT: Workers with common mental disorders (CMDs) frequently experience recurrent sickness absence but scientifically evaluated interventions to prevent recurrences are lacking. The objectives of this study are to evaluate the cost-effectiveness and cost-benefit of a problem solving intervention aimed at preventing recurrent sickness absence in workers with CMDs compared to care as usual. An economic evaluation was conducted alongside a cluster-randomised controlled trial with 12 months follow-up. Treatment providers were randomised to either a 2-day training in the SHARP-at work intervention, i.e. a problem solving intervention, or care as usual. Effect outcomes were the incidence of recurrent sickness absence and time to recurrent sickness absence. Self-reported health care utilisation was measured by questionnaires. A cost-effectiveness analysis (CEA) from the societal perspective and a cost-benefit analysis (CBA) from the employer's perspective were conducted. The CEA showed that the SHARP-at work intervention was more effective but also more expensive than care as usual. The CBA revealed that employer's occupational health care costs were significantly higher in the intervention group compared to care as usual. Overall, the SHARP-at work intervention showed no economic benefit compared to care as usual. As implementation of the SHARP-at work intervention might require additional investments, health care policy makers need to decide if these investments are worthwhile considering the results that can be accomplished in reducing recurrent sickness absence.
    PLoS ONE 08/2013; 8(8):e71937. DOI:10.1371/journal.pone.0071937 · 3.23 Impact Factor
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    ABSTRACT: OBJECTIVE: We examined how change in work time control was associated with sleep and health 1 year later. METHODS: Work time control, sleep, fatigue, recovery, and depression were assessed at baseline (T1) and at follow-up (T2) for 2382 daytime workers. The change in work time control from T1 to T2 was classified into four groups: low to low, low to high, high to low, and high to high. RESULTS: A repeated-measures analysis of covariance showed significant decreases in the frequency of insomnia symptoms and depressive symptoms from T1 to T2 for the low to high group, which were similar to the high to high group. Significantly lower fatigue was found for these two groups at T2. CONCLUSION: An increase in work time control, in addition to its stable high level, may produce beneficial effects upon sleep and health.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 08/2012; 54(9):1078-85. DOI:10.1097/JOM.0b013e31826230b7 · 1.63 Impact Factor
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