title: A participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders: results of a randomized controlled trial.
abstract: BACKGROUND
  Within the labour force workers without an employment contract represent a vulnerable group. In most cases, when sick-listed, these workers have no workplace/employer to return to. Therefore, the aim of this study was to evaluate the effectiveness on return-to-work of a participatory return-to-work program compared to usual care for unemployed workers and temporary agency workers, sick-listed due to musculoskeletal disorders.
  
  
  METHODS
  The workers, sick-listed for 2-8 weeks due to musculoskeletal disorders, were randomly allocated to the participatory return-to-work program (n = 79) or to usual care (n = 84). The new program is a stepwise procedure aimed at making a consensus-based return-to-work plan, with the possibility of a temporary (therapeutic) workplace. Outcomes were measured at baseline, 3, 6, 9 and 12 months. The primary outcome measure was time to sustainable first return-to-work. Secondary outcome measures were duration of sickness benefit, functional status, pain intensity, and perceived health.
  
  
  RESULTS
  The median duration until sustainable first return-to-work was 161 days in the intervention group, compared to 299 days in the usual care group. The new return-to-work program resulted in a non-significant delay in RTW during the first 90 days, followed by a significant advantage in RTW rate after 90 days (hazard ratio of 2.24 [95% confidence interval 1.28-3.94] P = 0.005). No significant differences were found for the measured secondary outcomes.
  
  
  CONCLUSIONS
  The newly developed participatory return-to-work program seems to be a promising intervention to facilitate work resumption and reduce work disability among temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. s.vermeulen@vumc.nl
authors.forename: Sylvia J
authors.initials: SJ
authors.lastname: Vermeulen
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Anema
authors.forename: Antonius J M
authors.initials: AJ
authors.lastname: Schellart
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Knol
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
authors.forename: Allard J
authors.initials: AJ
authors.lastname: van der Beek
mesh_terms: D000328:Adult; D004651:Employment; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D009426:Netherlands; D009786:Occupational Health Services; D010358:Patient Participation; D015397:Program Evaluation; D016016:Proportional Hazards Models; D012017:Referral and Consultation; D018582:Sick Leave; D013997:Time Factors; D016896:Treatment Outcome; D014938:Work Capacity Evaluation