Tools for Two: The SHARP-at work study. Effectiveness of an intervention Stimulating Healthy participation And Relapse Prevention. A cluster randomised controlled trial.

Common mental disorders, such as depression, anxiety disorder, and adjustment
disorder, have emerged as a major public and occupational health problem in
many countries. These disorders can have severe consequences such as
absenteeism and work disability. Different interventions have been developed to
improve the return to work of these employees, but still a large proportion of
employees experiences health and work problems after their return to work. For
this reason, an intervention will be developed to prevent recurrent sickness
absence in employees who have returned to work after a period of sickness
absence because of common mental disorders. This protocol describes the
intervention and the effectiveness evaluation.

First, to determine the effectiveness of the intervention in preventing
recurrent sickness absence in employees who have returned to work after a
period of sickness absence because of a common mental disorder. Second, to
determine the effectiveness of the intervention in improving mental health and
work functioning, and facilitating an adequate coping style. Next to the effect
evaluation, the cost-effectiveness and the process of the intervention will be
evaluated.

A cluster randomised controlled trial with randomisation at the level of the
occupational physician. Occupational physicians will be randomly assigned to
the intervention condition or the control condition. Occupational physicians in
the intervention condition will receive a training in the intervention.
Occupational physicians in the control condition will deliver care as usual.

Employees in the intervention condition will be supported during their first
weeks after return to work by their occupational physician. This intervention
is an extension of the guideline of the Dutch Association for Occupational
Physicians on treating sickness absence because of mental health problems.
Employees in the control group will receive care as usual.

The burden of the intervention is acceptable. It comprises four to five
consultations with the occupational physician and (if approved by the employee)
at least one of these consultations will be attended by the supervisor. Not all
these consultations are additional because in the control condition the
occupational physicians will also have consultations (according to the
guideline). Questionnaires on work and health will be collected at baseline, 3,
6, and 12 months follow-up. Moreover, the employee will be asked to complete a
diary over a period of four weeks at 2, 5 and 11 months follow-up.
So far no adverse side effects have been reported of interventions related to
the present intervention. No major risks are anticipated for the intervention.