Reduction in sick leave by a workplace educational low back pain intervention: A cluster randomized controlled trial.
OBJECTIVE
The aim of this study was to investigate whether a workplace educational low back pain intervention had an effect on sick leave at the individual level and to identify possible predictors of the effect of intervention.


METHODS
Work units in two municipalities were cluster randomized to (a) educational meetings and peer support (45 units), (b) educational meetings, peer support and access to an outpatient clinic if needed (48 units) or (c) a control group (42 units). Both intervention groups attended educational meetings with information about back pain based on a non-injury model. A peer adviser was selected from among their colleagues. The outcome was days of sick leave at the individual level at 3, 6, 9 and 12 months, adjusting for previous sick leave at the unit level. As a result of similar effects on sick leave, the two intervention groups were merged (n=646) and compared with the control group (n=211). The predictors were different levels of belief in back pain myths, pain-related fear, helplessness/hopelessness and low back pain.


RESULTS
The intervention group had significantly less days of sick leave at the three month (4.9 days, p=0.001) and six month (4.4 days, p=0.016) follow ups compared with the control group. At three months, a low level of pain-related fear was the only predictor for the intervention effect (8.0 less days of sick leave, p<0.001). CONCLUSIONS A WORKPLACE EDUCATIONAL BACK PAIN INTERVENTION HAD AN EFFECT ON SICK LEAVE FOR UP TO SIX MONTHS A LOW SCORE ON PAIN-RELATED FEAR WAS A PREDICTOR OF THE INTERVENTION EFFECT.
Uni Research Health, Uni Research, Norway Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Norway eline.ree@uni.no.
Eline
E
Ree
Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway.
Stein Atle
SA
Lie
Uni Research Health, Uni Research, Norway Department of Sport and Physical Activity, Bergen University College, Norway.
Hege R
HR
Eriksen
Uni Research Health, Uni Research, Norway Department of Global Public Health and Primary Care, University of Bergen, Norway The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark.
Kirsti
K
Malterud
Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Norway.
Aage
A
Indahl
Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Norway.
Oddrun
O
Samdal
Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Norway Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway.
Anette
A
Harris
D000223:Adaptation, Psychological; D000328:Adult; D016000:Cluster Analysis; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017116:Low Back Pain / Q000517:prevention & control* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000517:prevention & control*; D009786:Occupational Health Services; D010379:Peer Group; D015397:Program Evaluation; D018582:Sick Leave / Q000706:statistics & numerical data*; D012944:Social Support
Work intervention; health communication; health education; helplessness; hopelessness; low back pain; psychological adaption; sick leave