Title: Sustainable return to work: A pilot cluster randomised controlled trial of amulticomponent workplace ‘IGLOO’ intervention compared with usual return-to-worksupport
Funder: Department of Health and Social Care

Abstract: Research Question: Can the IGLOo sustainable return-to-work intervention be successfully delivered in employer organisations to reduce long-term sick leave and support staying in work after returning? Background: Systematic reviews on mental health and long-term sick leave suggest that multi-component return-to-work interventions targeting the individual worker and the workplace show definitive improvements in return-to-work outcomes. However, sustainable return-to-work interventions are in their infancy and workplace return-to-work research is needed on multi-component interventions, their effectiveness, and the mechanism by which they work. The lead investigator (FM) and JY are currently conducting a return-to-work pilot study in the Midlands (ends June 2022). The pilot study delivers an online intervention aimed at workers on long-term sick leave and their line managers. However, the pilot is not a multi-level intervention and excludes components for employers and components to address sustainable return-to-work. Our process evaluation shows that line managers and workers are keen for interventions that help workers stay in work after returning. We therefore propose an intervention study that addresses the gaps in our current pilot study and the existing evidence reviews. Aims/Objectives: Undertake a two-arm pilot cluster RCT of the IGLOo sustainable return-to-work intervention to inform a future fully-powered definitive trial. Methods: A two-arm pilot cluster RCT will be conducted in eight organisations (four intervention, four control), with 100 participants on long-term sick leave (defined as >14 days) due to a common mental health problem as a primary reason or where it is known as an associated comorbidity. The IGLOo intervention is multi-levelled and delivers 1) return-to-work support whilst a worker is on long-term sick leave and 2) workplace support that promotes good work after the worker returns from long-term sick leave. Phase 1: employers will be encouraged to complete online training on mental health and long-term sick leave best-practice management. Phase 2: workers on long-term sick leave and their line managers will be asked to use an online toolkit that promotes early communication and provides strategies to reduce the number of days on long term sick. Phase 3: within 1-month of returning to work, online training is offered to the worker and to their line manager on how to modify job tasks to suit the worker s needs. Measurements will be taken at baseline, at 3, 6, 9 and 12 months. The primary outcomes of interest will be employer and participant recruitment and attrition, intervention fidelity and acceptability, learning transfer, and completion of proposed outcome measures (including the primary return-to-work outcome: days until first day of return, secondary outcomes: the number of days a participant has stayed in work from their first day of return to six months, self-report mental health, readiness to return and stay at work, self-efficacy, work productivity, communication, job crafting and demographics). A full process evaluation and an exploratory economic evaluation will also be conducted to further inform a definitive trial. Timelines: A 36-months study with employers participating for 30 months. Impact/dissemination: The pilot study will provide evidence for policy guidelines around workplace return-to-work programmes and a dissemination plan.

Lay abstract: This project will pilot test a return-to-work programme designed to support employees mental well-being whilst on long-term sick leave and after returning to work. Long-term sick leave is a national concern, with the most common reasons being mental health issues. Employees on sick leave for reasons such as back pain or stroke, are also likely to experience poor mental health during long-term sick leave. Despite government guidelines for employers on how to support an employee on long-term sick leave and after their return to work, many employers find this difficult. Our research team propose an intervention which consists of an employer educational information pack outlining the scientific evidence on what works best in supporting employees back-to-work and what helps them to stay in work after long-term sick leave. For employees taking long-term sick leave, an online toolkit will be given that outlines step-by-step actions to take to support their mental well-being whilst on sick leave, and actions to take when they are ready to return-to-work. For line managers, training will be given in how to support their employee on long-term sick leave and how to help them return-to-work. Within one month of an employee returning to work, online training will be offered to help them make reasonable changes to their job so that their mental well-being is supported. Online training will be given to line managers so they can support their employee in making reasonable changes. Parts of the return-to-work programme design have been carried out with public involvement (i.e., with employees and employers) who helped shape the programme content and helped with assessing the practicality of the programme content. However, the parts of the return-to-work programme which take place when an employee has returned are not yet tested for their online practicality. We will recruit eight large organisations where four will receive our programme and four will act as a comparison group (carry on as normal). For the first part of the programme (providing employees with support whilst they are on sick leave and training for line managers), we will measure how many days employees are on long-term sick leave until they return to work. For the second part of the programme (employee training on making job changes) we will measure how many days employees stay in work without taking long-term sick leave again or leaving work within six months of returning. We will also ask participants to complete some questions about their mental health and work. These will be asked before the programme and then at 3, 6 and 12 months. We will talk to employees, their line managers and employers about their experiences of the programme and work closely with public members on the next steps.

Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MENTAL HEALTH