Participatory interventions for return-to-work for temporary agency workers and unemployed workers sicklisted due to musculoskeletal disorders.
A randomised controlled trial and cost-effectiveness evaluation.

Musculoskeletal disorders are next to mental disorders, the most common cause
for sickness absence and workdisability in the working population of the
Netherlands and other countries. The same applies to the vulnerable working
population, i.e. temporary agency workers and unemployed workers.
The number of applications for and awarded disability benefits is significantly
higher among this group, than for sicklisted employees.
For the vunerable working population there is a need for new return-to-work
methods, which aim at activating concrete return-to-work and which are
evidence-based.
Recently a protocol for participatory ergonomics as a return-to-work
intervention was developed for employees sicklisted 2 to 6 weeks due to
nonspecific low back pain.
This workplace intervention accelerated return-to-work with an average of 27
days and evaluation by the employees and professionals was positive.
A comparable method for temporary agency workers and unemployed workers,
sicklisted due to muscoloskeletal disorders, is not available at present and
cost-effectiveness is unknown.

For this study the aim was first to adjust the parcipatory return-to-work
method for employees with nonspecific LBP to the working methods and procedures
of the national organisation, responsible for counseling, disability management
and activating return-to-work of sicklisted temporary agency workers and
unemployed workers. For this adaptation 'Intervention Mapping' was used, a
structured method for development of interventions.
Based on a needs assessment and contextanalysis a concept protocol was
developed. Important stakeholders were involved in this proces, i.e. insurance
physicians, workexperts, staff and management of the national organisation,
temporary agency workers and temporary agencies.
Next further 'fine-tuning' of the protocol took place after focusgroup
interviews with the insurance physians, workexperts, staff and management of
the national organisation.
The cost-effectiveness and applicability of this return-to-work method for
sicklisted temporary agency workers and unemployed workers with musculoskeletal
disorders will be evaluated.

Randomized Controlled Trial (n= 2 x 80)

The participants will be randomized for the participatory return-to-work method
and usual care (= treatment and counseling according to the operative
guidelines) or only usual care.
The participatory protocol for temporary adapted work is guided by a specially
trained procescoach. The aim of the protocol is reaching consensus, after
inventarisation of the obstacles for return-to-work, between the sicklisted
temporary agency worker or unemployed worker, the occupational professional and
other possible stakeholders, about suitable temporary adapted work to promote
lasting return-to-work. The interventiongroup will also receive the usual care.

For the participants there are no or only slight risks connected to this study.
The participatory return-to-work method will cost about 5 1/2 to 6 hours for a
participant. This consists of an half hour consult with an insurance physician,
an hour consult with a workexpert and two times two hours for the participatory
protocol.
Participants will be asked four times to fill in a questionnaire. Each
questionnaire takes about 30 minutes.