title: Municipal return to work management in cancer survivors undergoing cancer treatment: a protocol on a controlled intervention study.
abstract: BACKGROUND
  Cancer survivors are often left on their own to deal with the challenges of resuming work during or after cancer treatment, mainly due to unclear agreements between stakeholders responsible for occupational rehabilitation. Social inequality exists in cancer risk, survival probability and continues with regard to the chance of being able to return to work. The aim is to apply an early, individually tailored occupational rehabilitation intervention to cancer survivors in two municipalities parallel with cancer treatment focusing on enhancing readiness for return to work.
  
  
  METHODS
  In a controlled trial municipal job consultants use acceptance and commitment therapy dialogue and individual-placement-and-support-inspired tools with cancer survivors to engage them in behaviour changes toward readiness for return to work. The workplace is involved in the return to work process. Patients referred to surgery, radiotherapy or chemotherapy at the Oncology Department, Aarhus University Hospital, Denmark for the diagnoses; breast, colon-rectal, head and neck, thyroid gland, testicular, ovarian or cervix cancer are eligible for the study. Patients must be residents in the municipalities of Silkeborg or Randers, 18-60 years of age and have a permanent or temporary employment (with at least 6 months left of their contract) at inclusion. Patients, for whom the treating physician considers occupational rehabilitation to be unethical, or who are not reading or talking Danish are excluded. The control group has identical inclusion and exclusion criteria except for municipality of residence. Return to work is the primary outcome and is indentified in a social transfer payment register. Effect is assessed as relative cumulative incidences within 52 weeks and will be analysed in generalised linear regression models using the pseudo values method. As a secondary outcome; co-morbidity and socio-economic status is analysed as effect modifiers of the intervention effect on return to work.
  
  
  CONCLUSIONS
  The innovative element of this intervention is the timing of the occupational rehabilitation which is much earlier initiated than usual and the active involvement of the workplace. We anticipate that vulnerable cancer survivors will benefit from this approach and reduce the effects of social inequality on workability.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN50753764 . Registered August 21(st), 2014.
authors.affiliation: Public Health and Quality Improvement - CFK, Central Denmark Region, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark. ChristinaMalmose.Stapelfeldt@stab.rm.dk.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Stapelfeldt
authors.affiliation: Public Health and Quality Improvement - CFK, Central Denmark Region, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark.
authors.forename: Merete
authors.initials: M
authors.lastname: Labriola
authors.affiliation: Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Anders Bonde
authors.initials: AB
authors.lastname: Jensen
authors.affiliation: Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Niels Trolle
authors.initials: NT
authors.lastname: Andersen
authors.affiliation: Public Health and Quality Improvement - CFK, Central Denmark Region, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark.
authors.forename: Anne-Mette H
authors.initials: AM
authors.lastname: Momsen
authors.affiliation: Public Health and Quality Improvement - CFK, Central Denmark Region, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark.|Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Claus Vinther
authors.initials: CV
authors.lastname: Nielsen
mesh_terms: D000328:Adult; D003718:Denmark / Q000453:epidemiology; D019468:Disease Management; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D012050:Rehabilitation, Vocational / Q000706:statistics & numerical data*; D012107:Research Design; D062707:Return to Work / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data*; D017741:Survivors / Q000706:statistics & numerical data*; D014942:Workers' Compensation