title: Execution of a participatory supportive return to work program within the Dutch social security sector: a qualitative evaluation of stakeholders' perceptions.
abstract: BACKGROUND
  A process evaluation of a participatory supportive return to work program, aimed at workers without a (permanent) employment contract who are sick-listed due to a common mental disorder, revealed that this program was executed less successfully than similar programs evaluated in earlier studies. The program consisted of a participatory approach, integrated care and direct placement in competitive employment. Aim of this study was to get a better understanding of the execution of the program by evaluating stakeholders' perceptions. In the absence of an employer, the program was applied by the Dutch Social Security Agency, in collaboration with vocational rehabilitation agencies. Together with the sick-listed workers, these were the main stakeholders. Our research questions involved stakeholders' perceptions of the function(s) of the program, and their perceptions of barriers and facilitators for a successful execution of the program within the Dutch social security sector.
  
  
  METHODS
  Semi-structured interviews were held with five sick-listed workers, eight professionals of the Social Security Agency, and two case managers of vocational rehabilitation agencies. Interview topics were related to experiences with different components of the program. Selection of respondents was based on purposive sampling and continued until data saturation was reached. Content analysis was applied to identify patterns in the data. Two researchers developed a coding system, based on predefined topics and themes emerging from the data.
  
  
  RESULTS
  Although perceived functions of some components of the program were as intended, all stakeholders stressed that the program often had not resulted in return to work. Perceived barriers for a successful execution were related to a poor collaboration between the Dutch Social Security Agency, vocational rehabilitation agencies and healthcare providers, the type of experienced (health) problems, time constraints, and limited job opportunities.
  
  
  CONCLUSIONS
  For future implementation of the program, it will be important to consider how a better integration of services by the Dutch Social Security Agency, vocational rehabilitation agencies and the mental healthcare sector can be improved in order to address treatment and vocational needs simultaneously, and to better match the sick-listed worker with the limited opportunities in the Dutch labor market.
  
  
  BACKGROUND
  NTR3563.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, Amsterdam, MB, 1007, Netherlands.|Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, Netherlands.
authors.forename: Lieke
authors.initials: L
authors.lastname: Lammerts
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, Amsterdam, MB, 1007, Netherlands. f.schaafsma@vumc.nl.|Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, Netherlands. f.schaafsma@vumc.nl.
authors.forename: Frederieke G
authors.initials: FG
authors.lastname: Schaafsma
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, Amsterdam, MB, 1007, Netherlands.
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, Amsterdam, MB, 1007, Netherlands.|Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, Netherlands.
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Anema
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008875:Middle Aged; D009426:Netherlands; D015397:Program Evaluation; D036301:Qualitative Research; D012050:Rehabilitation, Vocational; D062707:Return to Work / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data; D012943:Social Security
keywords: Common mental disorders; Complex intervention; Context; Qualitative study; Return to work; Setting; Social security; Stakeholders’ perceptions; Temporary workers; Unemployed workers