Re-Employment for Cancer Patients and survivors.

As unemployed cancer patients and survivors experience severe challenges regarding return-to-work when compared to employed patients and survivors, it is considered worthwhile to study the effects of a return-to-work intervention program, tailored to the specific needs regarding return-to-work for this group.



Objective:

To evaluate the effectiveness of a tailored intervention program for unemployed sick-listed cancer patients and survivors on return-to-work, compared to care as usual.



Study design:

This study will employ a two-armed RCT with a follow-up period of 12 months.



Study population:

“Study population: Unemployed workers who have been sick-listed due to cancer for 12-36 months
and who have applied for sickness or disability benefits at SSA.”



Intervention:

The participants the intervention group of this study receive a tailored intervention program coordinated by a specialized re-integration agency, including a placement at work, coordinated by a job hunting coach. The intervention will target physical, mental, and rehabilitation problems. The program consists of general components (e.g., coaching) and specialist components (e.g., physical therapy) if necessary. The combination of these components will differ per participant and will be adjusted to the individual needs, capabilities and personal situation of the participant. The program will be offered on a national level in the Netherlands.



Main study parameters/endpoints:

The primary outcome measure of this study is duration until sustainable RTW after sick
leave, calculated as the number of days between the day of randomisation and the first day of
sustainable RTW. Sustainable RTW is defined as a period of minimum 28 calendar days,
during which the cancer survivor is working according to schedule. Work can be either paid
work or work resumption with ongoing benefits, e.g., work with therapeutic conditions.

Unemployed cancer patients and survivors face severe challenges regarding return-to-work compared to employed cancer patients and survivors. To accommodate for their specific needs regarding return-to-work, a tailored intervention program was designed, which specifically aims to enhance return-to-work in unemployed cancer patients and survivors. The (cost-) effectiveness of this program will be tested in a randomized controlled trial. We hypothesize that persons in the intervention group of the trial will demonstrate earlier and sustainable return-to-work, compared to the persons in the control group.

Baseline (T0), 3 months (T1), 6 months (T2), 12 months (T3).

The tailored intervention program starts with an introductory interview, during which the tailored intervention program will be explained and obstacles for return-to-work and other forms of activities will be identified. This will also include an assessment of the participants’ cognition regarding return-to-work, needs for additional therapy (e.g., physical and/or psycho-educational), and the skills and knowledge of the participant regarding work and job application processes (e.g., the skill to write letters of application). At the end of this meeting, a personalized intervention plan will be composed. The plan will consist of three main components:

1. Coaching: A maximum of 8 sessions during which cancer-related and return-to-work-related problems are addressed (e.g., fatigue);

2. Recovery: Optionally, mental and/or physical components are offered through professional primary and secondary care.

3. Job application: Maximum of 8 sessions during which rehabilitation skills, job application skills are improved and a work profile and a “route to work” are created. When the first part of the intervention is finished, the participant has a conclusive meeting during which his/her own “action to work-plan” is completed, which consists of several components (i.e., curriculum vitae. Next, the participant will be assigned to a job coach at an independent job hunting agency. The job coach will take into account the work(place)profile that was created by the reintegration agency, to determine the suitable type of work, work content, and necessary preconditions for work resumption. To create an actual return-to-work perspective, the participant will be offered the possibility of placement in a temporary (therapeutic) workplace or paid employment for a period of three months minimum.



The control group will receive usual care.