Preventing Mid- and Later-Life Work Limitations

Study Overview
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Brief Summary
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The Work and Health Initiative (WHI) trial is testing an innovative, community-based program that provides mental health and vocational services to workers 50 years or older to improve functioning and reduce productivity loss. The purpose of this study is to test the hypothesis that relative to usual care, the WHI improves the work outcomes of depression and reduces depression-related productivity loss.

Detailed Description
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National demographic, economic and cultural trends are creating a need for hiring and retaining older workers. However, while many older people will prefer and/or need to work, chronic health problems occurring in mid-life or later can severely disrupt employment. This study will conduct a randomized controlled trial (RCT) of the Work and Health Initiative (WHI). The WHI is an innovative community-based program that provides mental health and vocational services to workers with depression to improve functioning and reduce productivity loss. This study will focus on workers 50 years of age and older. This study will test the hypothesis that relative to usual care, the WHI improves the work outcomes of depression. Study results potentially will result in a new multi-disciplinary method for addressing a serious public health and employment issue.

Official Title
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Preventing Mid- and Later-Life Work Limitations: Community-Based Depression Care

Conditions
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Depression

Intervention / Treatment
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* Behavioral: Work and Health Initiative
* Behavioral: Usual Medical or Behavioral Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age ≥ 45 years working ≥ 15 hours/week DSM-IV current major depression and/or dysthymia Work limitations: at-work productivity loss score ≥ 5% Exclusion Criteria: severe physical health deficits non-English speaking or reading positive current alcoholism screening psychosis mania

Ages Eligible for Study
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Minimum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: WHI<br> | Behavioral: Work and Health Initiative<br>* Telephone-based multi-modal intervention, consisting of: vocational coaching, cognitive-behavioral therapy strategies and care coordination strategies provided by specially-trained EAP counselors<br>|
| Active Comparator: Usual Care<br> | Behavioral: Usual Medical or Behavioral Intervention<br>* Referral to treatment as usual through personal physician, mental health professional, behavioral health program, and/or Employee Assistance Program<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| At-work performance deficits and productivity loss as measured by the Work Limitations Questionnaire |  | 4 months post-randomization | 
| Absenteeism and productivity loss as measured by the Work Limitations Questionnaire Absence Module |  | 4 months post-randomization | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depression symptom severity as measured by the Patient Health Questionnaire (PHQ-9) |  | 4 months post-randomization | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Depression, Work Performance and Productivity, Worksite Intervention