TY - JOUR

T1 - Implementation of the Danish return-to-work program

T2 - process evaluation of a trial in 21 Danish municipalities

AU - Aust, Birgit

AU - D. Nielsen, Maj Britt

AU - Grundtvig, Gry

AU - Buchardt, Helle L.

AU - Ferm, Linnea

AU - Andersen, Irene

AU - Lund, Trine L.

AU - Jelle, Martin Ohmann Claudio

AU - F. Andersen, Malene

AU - Hansen, Jørgen V.

AU - Tverborgvik, Torill

AU - Helverskov, Trine

AU - Bjorner, Jakob Bue

AU - Rugulies, Reiner

AU - Ørbæk, Palle

AU - Winzor, Glen

AU - Bültmann, Ute

AU - Poulsen, Otto M.

PY - 2015/11

Y1 - 2015/11

N2 - OBJECTIVES: The aim of this study was to evaluate the implementation of the Danish national return-to-work (RTW) program in 21 Danish municipalities.METHODS: We conducted a structured process evaluation on (i) reach and recruitment, (ii) fidelity, (iii) dose-delivered, (iv) dose-received, and (v) context by formulating 29 implementation criteria and analyzing qualitative and quantitative data from administrative records, interviews, field notes, and questionnaires.RESULTS: All municipalities integrated the basic features of the RTW program into the existing framework of the sickness benefit management system to an acceptable degree, ie, establishment of RTW teams, participation of RTW team members in the training courses, and following the general procedures of the program. However, the level of implementation varied considerably between the municipalities, particularly with respect to fidelity (defined as implementation consistent with the principles of the interdisciplinary RTW process). Five municipalities had high and eight had low fidelity scores. Similar large differences were found with regard to dose-delivered, particularly in the quality of cooperation with beneficiaries, employers, and general practitioners. Only 50% of the first consultations with the RTW coordinator were conducted in time. Among participants who were employed when their sickness absence period started, only 9% had at least one meeting with their workplace.CONCLUSION: It was feasible to implement the basic features of the Danish RTW program, however, large variations existed between municipalities. Establishment of well-functioning interdisciplinary RTW teams might require more time and resources, while ensuring early assessment and more frequent cooperation with employers might need more general adjustments in the Danish sickness benefit system.

AB - OBJECTIVES: The aim of this study was to evaluate the implementation of the Danish national return-to-work (RTW) program in 21 Danish municipalities.METHODS: We conducted a structured process evaluation on (i) reach and recruitment, (ii) fidelity, (iii) dose-delivered, (iv) dose-received, and (v) context by formulating 29 implementation criteria and analyzing qualitative and quantitative data from administrative records, interviews, field notes, and questionnaires.RESULTS: All municipalities integrated the basic features of the RTW program into the existing framework of the sickness benefit management system to an acceptable degree, ie, establishment of RTW teams, participation of RTW team members in the training courses, and following the general procedures of the program. However, the level of implementation varied considerably between the municipalities, particularly with respect to fidelity (defined as implementation consistent with the principles of the interdisciplinary RTW process). Five municipalities had high and eight had low fidelity scores. Similar large differences were found with regard to dose-delivered, particularly in the quality of cooperation with beneficiaries, employers, and general practitioners. Only 50% of the first consultations with the RTW coordinator were conducted in time. Among participants who were employed when their sickness absence period started, only 9% had at least one meeting with their workplace.CONCLUSION: It was feasible to implement the basic features of the Danish RTW program, however, large variations existed between municipalities. Establishment of well-functioning interdisciplinary RTW teams might require more time and resources, while ensuring early assessment and more frequent cooperation with employers might need more general adjustments in the Danish sickness benefit system.

U2 - 10.5271/sjweh.3528

DO - 10.5271/sjweh.3528

M3 - Journal article

C2 - 26445011

VL - 41

SP - 529

EP - 541

JO - Scandinavian Journal of Work, Environment & Health

JF - Scandinavian Journal of Work, Environment & Health

SN - 0355-3140

IS - 6

ER -