title: How Do Organizational Policies and Practices Affect Return to Work and Work Role Functioning Following a Musculoskeletal Injury?
abstract: Purpose Organizational-level policies and practices that promote safety leadership and practices, disability management and ergonomic policies and practices are considered key contextual determinants of return to work. Our objective was to examine the role of worker-reported organizational policies and practices (OPPs) in return to work (RTW) and work role functioning (WRF) and the mediating role of pain self-efficacy and work accommodation. Methods A worker cohort (n = 577) in Ontario, Canada was followed at 1, 6 and 12 months post injury. Both RTW (yes/no) and WRF (WLQ-16) status (3 levels) were measured. OPPs were measured (high vs. low) at 1 month post-injury. Pain self-efficacy (PSE) and work accommodation (WA) were included in mediation analyses. Results OPPs predicted RTW at 6 months (adjusted OR 1.77; 95 % CI 1.07-2.93) and 12 months (adjusted OR 2.07; 95 % CI 1.18-3.62). OPPs predicted WRF at 6 months, but only the transition from working with limitations to working without limitations (adjusted OR 3.21; 95 % CI 1.92-5.39). At 12 months, OPPs predicted both the transition from not working to working with and without limitations and from not working or working with limitations to working without limitations (adjusted OR 2.13; 95 % CI 1.37-3.30). Offers of WA mediated the relationship between OPPs and both RTW and WRF at 6 months follow-up. PSE mediated the relationship between OPPs and RTW and WRF at 6 months. At 12 months neither mediated the relationship. Conclusions The findings support worker-reported OPPs as key determinants of both RTW and WRF. These results point to the importance of WA and PSE in both RTW and WRF at 6 months.
authors.affiliation: Institute for Work and Health, Toronto, ON, Canada. bamickii@fiu.edu.|Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., AHC-5-453, Miami, FL, 33199, USA. bamickii@fiu.edu.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Amick
authors.affiliation: Institute for Work and Health, Toronto, ON, Canada.
authors.forename: Hyunmi
authors.initials: H
authors.lastname: Lee
authors.affiliation: Institute for Work and Health, Toronto, ON, Canada.|Dalla Lana School of Public Health, Toronto, ON, Canada.
authors.forename: Sheilah
authors.initials: S
authors.lastname: Hogg-Johnson
authors.affiliation: Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Katz
authors.affiliation: Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Sandra
authors.initials: S
authors.lastname: Brouwer
authors.affiliation: Institute for Work and Health, Toronto, ON, Canada.|WorkSafeBC, Vancouver, BC, Canada.
authors.forename: Renée-Louise
authors.initials: RL
authors.lastname: Franche
authors.affiliation: Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Ute
authors.initials: U
authors.lastname: Bültmann
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000523:psychology / Q000534:rehabilitation*; D060051:Occupational Injuries / Q000523:psychology / Q000534:rehabilitation*; D016017:Odds Ratio; D009864:Ontario; D016134:Organizational Policy; D011446:Prospective Studies; D062707:Return to Work / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
keywords: Organizational policies and practices; Return-to-work; Self-efficacy; Work accommodation; Work role functioning