The Effectiveness of Health Advice and Occupational Health Intervention on Work Ability
Condition: Signs and Symptoms
Study type: Interventional

Summary: 
      Study hypotheses were 1) Classification of the risk of sickness absence can be made with
      questionnaires addressing self-rated health problems; 2) Occupational health intervention of
      the employees at 'High Risk´ of sickness absence is more effective than usual care in
      controlling sickness absence; 3) Health advice intervention of the employees at 'Increased
      Risk´ of sickness absence is more effective than usual care in controlling sickness absence;
      4) The interventions are cost-effective use of resources from the societal perspective.
    

Detailed description: 
      The study design is a longitudinal cohort study with two embedded randomised trials. The risk
      of sickness absence is classified on the basis of self-administered questionnaires, on the
      basis of a priori defined cut-off limits. Two randomised trials are performed in the
      subgroups of 'High Risk´ and 'Increased Risk´ of sickness absence. The study is performed
      within one corporation in Finland. All employees with permanent job and age between 18 and 60
      years are invited to participate.

      The worker's own occupational nurses and physicians execute the occupational health program
      for workers at 'High Risk´ for sickness absence. The employees in the "High Risk"
      intervention group receive a personal feedback of their health survey results in a letter, in
      which they are also invited to a consultation at the OHS. The main purpose of the
      consultation, during which the individual findings of the health survey are available for the
      OHS professionals, is the construction of an action plan, and if appropriate, referral to a
      medical specialist, or psychologist. The employees in the 'High Risk´ control group receive
      care as usual.

      The intervention for workers at 'Increased Risk´ for sickness absence is executed as medical
      counselling over the telephone. The employees in the 'Increased Risk´ intervention group
      receive a personal feedback of their questionnaire results in a letter, in which they were
      also invited to call the phone advice centre in order to receive medical advice. The
      employees in the 'Increased Risk´ control group receive care as usual.

      Sickness absence data is obtained from the employer's records, the baseline covering the
      one-year period before the intervention and the follow-up covering the one-year period after
      the intervention. Sickness absences are obtained without medical diagnoses. The study
      participants also fill in a health questionnaire including, among other questions, healthcare
      utilization variables at the one-year follow-up.

      We will carry out an intention to treat analysis. We will use analysis of covariance (ANCOVA)
      to analyse sickness absence outcomes at 12 months, with corresponding baseline values and
      risk / treatment group as covariates. Economic evaluation will be performed alongside the
      randomised controlled trial within the 'High Risk´ group.
    

Intervention name(s): Consultation at the occupational health services
Intervention type(s): Behavioral
Intervention description(s): Consultation at the occupational health services
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention