title: Efficacy of temporary work modifications on disability related to musculoskeletal pain or depressive symptoms--study protocol for a controlled trial.
abstract: BACKGROUND
  Previous research suggests that work with a suitable workload may promote health and work retention in people with disability. This study will examine whether temporary work modifications at the early stage of work disability are effective in enhancing return to work (RTW) or staying at work among workers with musculoskeletal or depressive symptoms.
  
  
  METHODS
  A single-centre controlled trial with modified stepped wedge design will be carried out in eight enterprises and their occupational health services (OHSs) in nine cities in Finland. Patients seeking medical advice due to musculoskeletal pain (≥4 on a scale from 0-10) or depressive symptoms (≥1 positive response to 2 screening questions) and fulfilling other inclusion criteria are eligible. The study involves an educational intervention among occupational physicians to enhance the initiation of work modifications. Primary outcomes are sustained RTW (≥4 weeks at work without a new sickness absence (SA)) and the total number of SA days during a 12-month follow-up. Secondary outcomes are intensity of musculoskeletal pain (scale 0-10), pain interference with work or sleep (scale 0-10) and severity of depressive symptoms (Patient Health Questionnaire, PHQ-9), inquired via online questionnaires at baseline and 3, 6, 9 and 12 months after recruitment. Information on SA days will be collected from the medical records of the OHSs over 12 months, before and after recruitment. The findings will give new information about the possibilities of training physicians to initiate work modifications and their effects on RTW in employees with work disability due to musculoskeletal pain or depressive symptoms.
  
  
  BACKGROUND
  The Coordinating Ethics Committee of Hospital District of Helsinki and Uusimaa has granted approval for this study. The results will be published in peer-reviewed journals.
  
  
  BACKGROUND
  ISRCTN74743666.
authors.affiliation: Health and Work Ability, OHS and Work Health, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Eija
authors.initials: E
authors.lastname: Haukka
authors.affiliation: Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland Client Services, Occupational Health Collaboration, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Kari-Pekka
authors.initials: KP
authors.lastname: Martimo
authors.affiliation: Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland Development of Work and Organizations, Mental Health and Cognition, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Teija
authors.initials: T
authors.lastname: Kivekäs
authors.affiliation: Health and Work Ability, OHS and Work Health, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Ritva
authors.initials: R
authors.lastname: Horppu
authors.affiliation: Health and Work Ability, OHS and Work Health, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Tea
authors.initials: T
authors.lastname: Lallukka
authors.affiliation: Health and Work Ability, OHS and Work Health, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Solovieva
authors.affiliation: Health and Work Ability, OHS and Work Health, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Rahman
authors.initials: R
authors.lastname: Shiri
authors.affiliation: Health and Work Ability, OHS and Work Health, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Irmeli
authors.initials: I
authors.lastname: Pehkonen
authors.affiliation: Health and Work Ability, OHS and Work Health, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Esa-Pekka
authors.initials: EP
authors.lastname: Takala
authors.affiliation: University of Waterloo, School of Public Health and Health Systems, Waterloo, Ontario, Canada University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada.
authors.forename: Ellen
authors.initials: E
authors.lastname: MacEachen
authors.affiliation: Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Eira
authors.initials: E
authors.lastname: Viikari-Juntura
mesh_terms: D000328:Adult; D003863:Depression; D006233:Persons with Disabilities; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D059352:Musculoskeletal Pain; D015397:Program Evaluation; D012107:Research Design; D062707:Return to Work; D018582:Sick Leave; D011795:Surveys and Questionnaires; D014478:Unemployment; D014938:Work Capacity Evaluation; D016526:Workload
keywords: EPIDEMIOLOGY; Job accommodation; MENTAL HEALTH; Return to work