Anna Finnes

Research problem and specific aims Despite mounting research on work-directed interventions aimed at reducing sickness absence or increasing RTW among employees with common mental disorders (CMDs) incorporating depression, anxiety, or stress-related disorders, their effectiveness is incongruent. Hence, the specific aims are:to explore how coordinators and general practitioners perceive contextual factors, based on the Consolidated Framework of Implementation Research, influencing their use of work-directed interventions in primary care,to explore how coordinators, general practitioners and employer representatives perceive the design, accessibility, usability, and acceptability of a ‘prototype’ problem-solving intervention with workplace involvement aimed at reducing sickness absence.Based on the findings from aim 1 and 2, the problem-solving intervention will be further developed, and the third aim is:to evaluate the feasibility of the problem-solving intervention with workplace involvement, and its preliminary effects on RTW and symptoms among employees on sickness absence due to CMDs in the primary care setting. Data and method Feasibility design.  Study participants: Aim 1 and 2: coordinators, general practitioners and employer representatives. Aim 3: employees on sickness absence due to CMDs, coordinators and/or general practitioners, employer representatives. Data collection with focus group interviews with approx. 5 – 7 participants/group (in total 60-84 study participants) (aim 1, 2). A pre-post evaluation of a problem-solving intervention with 40 employees on sickness absence (aim 3). Data analysis: thematic analysis, descriptive statistics, linear mixed models. Societal relevance and utilisation CMDs are today the most common reasons for sickness absence causing suffering, risk of social isolation, and long-term sick leave. The economic burden is considerable. Therefore, having employees on sickness absence returning to their work is a key priority. The project will provide insights into the primary care settings´ challenges in providing interventions aimed at reducing sickness absence. Plan for project realisation Letter of intent are provided as additional files and by co-applicants/contact persons Anna Finnes and Therese Hellman. Main costs: salaries. Additional costs: ethical review, transcription services, language editing, statistical support.

Research problem and specific questionsChronic stress-related disorders are common reasons for sick leave in Sweden. To date, there is no established evidence-based treatment for these disorders, and overall, few treatment models have succeeded in successfully addressing both symptoms and work ability. The overall purpose of this project is to evaluate such integrated interventions by comparing the effects of work-focused cognitive behavior therapy (WCBT) to usual treatment for patients on sick leave for chronic stress disorders in a randomized controlled multicenter trial. Specifically, we aim to investigate whether WCBT is more effective in increasing self-assessed work ability and treating symptoms, and is cost-effective, compared to treatment as usual (TAU). Further, we aim to investigate potential moderators and mediators of change in WCBT for chronic stress disorders. Data and methodThe study is designed as a randomized controlled (RCT) multicenter study carried out at 3-4 primary care centers in the Stockholm region. The study design will follow participants with questionnaires before, during, and until the post-treatment measurement. Outcome measures are self-assessed work ability, symptoms of physical and mental fatigue and cognitive weariness and days on sick leave. Weekly measures during treatmetn will include measures of potential mechanism variables. Societal relevance and utilizationStress-related health problems do not only cause a great deal of personal suffering but also incur a sizable social cost. The project is expected to generate valuable information related to the effects and cost-effectiveness of guideline-based care as well as care enhanced with WCBT as well as general knowledge about treatment components, implementation strategies, and the influence of individual and contextual factors in work-life rehabilitation. The results can be used in health care and as a basis for companies and organizations that want to improve their routines around employees on sick leave for mental illness.Plan for project realizationA pilot study has already been conducted at a large primary care center in Stockholm. At least two more primary care centers will be involved with a study coordinator located at each center to ensure the inclusion of patients and measurement procedures. The project group consists of experts in intervention research, health economics, and statistical modeling which ensures the methodological quality of the project.