title: Effectiveness of return-to-work interventions for disabled people: a systematic review of government initiatives focused on changing the behaviour of employers.
abstract: BACKGROUND
  OECD countries over the past two decades have implemented a range of labour market integration initiatives to improve the employment chances of disabled and chronically ill individuals. This article presents a systematic review and evidence synthesis on effectiveness of government interventions to influence employers' employment practices concerning disabled and chronically ill individuals in five OECD countries. A separate paper reports on interventions to influence the behaviour of employees.
  
  
  METHODS
  Electronic and grey literature searches to identify all empirical studies reporting employment effects and/or process evaluations of government policies aimed at changing the behaviour of employers conducted between 1990 and 2008 from Canada, Denmark, Norway, Sweden and the UK.
  
  
  RESULTS
  Few studies provided robust evaluations of the programmes or their differential effects and selection of participants into programmes may distort the findings of even controlled studies. A population-level effect of legislation to combat discrimination by employers could not be detected. Workplace adjustments had positive impacts on employment, but low uptake. Financial incentives such as wage subsidies can work if they are sufficiently generous. Involving employers in return-to-work planning can reduce subsequent sick leave and be appreciated by employees, but this policy has not been taken up with the level of intensity that is likely to make a difference. Some interventions favour the more advantaged disabled people and those closer to the labour market.
  
  
  CONCLUSIONS
  Future evaluations need to pay more attention to differential impact of interventions, degree of take-up, non-stigmatizing implementation and wider policy context in each country.
authors.affiliation: Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Clayton
authors.forename: Ben
authors.initials: B
authors.lastname: Barr
authors.forename: Lotta
authors.initials: L
authors.lastname: Nylen
authors.forename: Bo
authors.initials: B
authors.lastname: Burström
authors.forename: Karsten
authors.initials: K
authors.lastname: Thielen
authors.forename: Finn
authors.initials: F
authors.lastname: Diderichsen
authors.forename: Espen
authors.initials: E
authors.lastname: Dahl
authors.forename: Margaret
authors.initials: M
authors.lastname: Whitehead
mesh_terms: D002170:Canada; D002908:Chronic Disease; D019049:Developed Countries; D006233:Persons with Disabilities / Q000331:legislation & jurisprudence* / Q000534:rehabilitation; D004651:Employment / Q000331:legislation & jurisprudence* / Q000523:psychology; D005060:Europe; D006801:Humans; D011287:Prejudice; D012050:Rehabilitation, Vocational; D012456:Salaries and Fringe Benefits / Q000331:legislation & jurisprudence; D018582:Sick Leave / Q000331:legislation & jurisprudence*; D017132:Workplace / Q000331:legislation & jurisprudence