Intervention mapping for development of a participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders

BACKGROUND: In the past decade in activities aiming at return-to-work (RTW), there has been a growing awareness to change the focus from sickness and work disability to recovery and work ability. To date, this process in occupational health care (OHC) has mainly been directed towards employees. However, within the working population there are two vulnerable groups: temporary agency workers and unemployed workers, since they have no workplace/employer to return to, when sick-listed. For this group there is a need for tailored RTW strategies and interventions. Therefore, this paper aims to describe the structured and stepwise process of development, implementation and evaluation of a theory- and practise-based participatory RTW program for temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders (MSD). This program is based on the already developed and cost-effective RTW program for employees, sick-listed due to low back pain. METHODS: The Intervention Mapping (IM) protocol was used to develop a tailor-made RTW program for temporary agency workers and unemployed workers, sick-listed due to MSD. The Attitude-Social influence-self-Efficacy (ASE) model was used as a theoretical framework for determinants of behaviour regarding RTW of the sick-listed worker and development of the intervention. To ensure participation and facilitate successful adoption and implementation, important stakeholders were involved in all steps of program development and implementation. Results of semi-structured interviews and 'fine-tuning' meetings were used to design the final participatory RTW program. RESULTS: A structured stepwise RTW program was developed, aimed at making a consensus-based RTW implementation plan. The new program starts with identifying obstacles for RTW, followed by a brainstorm session in which the sick-listed worker and the labour expert of the Social Security Agency (SSA) formulate solutions/possibilities for suitable (therapeutic) work. This process is guided by an independent RTW coordinator to achieve consensus. Based on the resulting RTW implementation plan, to create an actual RTW perspective, a vocational rehabilitation agency is assigned to find a matching (therapeutic) workplace. The cost-effectiveness of this participatory RTW program will be evaluated in a randomised controlled trial. CONCLUSION: IM is a promising tool for the development of tailor-made OHC interventions for the vulnerable working populatio

Return-to-work of sick-listed workers without an employment contract – what works?

BACKGROUND: In the past decade flexible labour market arrangements have emerged as a significant change in the European Union labour market. Studies suggest that these new types of labour arrangements may be linked to ill health, an increased risk for work disability, and inadequate vocational rehabilitation. Therefore, the objectives of this study were: 1. to examine demographic characteristics of workers without an employment contract sick-listed for at least 13 weeks, 2. to describe the content and frequency of occupational health care (OHC) interventions for these sick-listed workers, and 3. to examine OHC interventions as possible determinants for return-to-work (RTW) of these workers. METHODS: A cohort of 1077 sick-listed workers without an employment contract were included at baseline, i.e. 13 weeks after reporting sick. Demographic variables were available at baseline. Measurement of cross-sectional data took place 4-6 months after inclusion. Primary outcome measures were: frequency of OHC interventions and RTW-rates. Measured confounding variables were: gender, age, type of worker (temporary agency worker, unemployed worker, or remaining worker without employment contract), level of education, reason for absenteeism (diagnosis), and perceived health. The association between OHC interventions and RTW was analysed with a logistic multiple regression analysis. RESULTS: At 7-9 months after the first day of reporting sick only 19% of the workers had (partially or completely) returned to work, and most workers perceived their health as fairly poor or poor. The most frequently reported (49%) intervention was 'the OHC professional discussed RTW'. However, the intervention 'OHC professional made and discussed a RTW action plan' was reported by only 19% of the respondents. The logistic multiple regression analysis showed a significant positive association between RTW and the interventions: 'OHC professional discussed RTW'; and 'OHC professional made and discussed a RTW action plan'. The intervention 'OHC professional referred sick-listed worker to a vocational rehabilitation agency' was significantly associated with no RTW. CONCLUSION: This is the first time that characteristics of a large cohort of sick-listed workers without an employment contract were examined. An experimental or prospective study is needed to explore the causal nature of the associations found between OHC interventions and RT

Boundary work: An interpretive ethnographic perspective on negotiating and leveraging cross-cultural identity

The complexity of global organizations highlights the importance of members’ ability to span diverse boundaries that may be defined by organization structures, national borders, and/or a variety of cultures associated with organization, nation-based societal and work cultures, industries, and/or professions. Based on ethnographic research in a Japan–US binational firm, the paper describes and analyzes the boundary role performance of the firm\u27s Japanese members. It contributes toward theory on boundary spanning by introducing a “cultural identity negotiation” conceptual framework. We show boundary spanning as a process shaped through the interplay of the contextual issues that make a boundary problematic; an individual\u27s multiple repertoires of cultural knowledge; and the individual boundary spanner\u27s “negotiation”, through interaction with others, of his/her cultural identities – the sense of “who I am” as a cultural being that is fundamental to an individual\u27s self-concept. At the same time, we make transparent the epistemological and methodological foundations of an interpretive ethnographic approach, demonstrating its value for understanding complex organizational processes. Research findings have practical implications for the selection and training of an organization\u27s employees, particularly of persons who may be considered “bicultural”

Reference projections for greenhouse gases: emission projections for 2001 - 2010

Results are presented of the project 'reference projection for energy and greenhouse gases' carried out by RIVM and ECN for the Ministries of Housing, Spatial Planning and the Environment, and of Economic Affairs. The reference projection considers emission of greenhouse gases in the Netherlands in 2010. Emission sources and trends up to 2000 were analysed, and expected developments with respect to economic growth and energy supply for the period 2001-2010 updated. This led to new estimates for the greenhouse gas emissions in 2010. Differences with previous scenario studies were analysed, and the effects of both announced and implemented policy measures assessed. Emissions of CO2 were analysed separately from other greenhouse gases. The total expected greenhouse gas emissions for the Netherlands in 2010 are concluded to be 225 Mton CO2 equivalent, which represents a near stabilisation for 2000 as the net result of a 12 Mton increase in CO2 emissions and a 9 Mton decrease in other greenhouse gases. The expected development of domestic emissions appears favourable with respect to the current policy goal: an emission target stated in the Kyoto agreement of -6 % in relation to the 1990/1995 level and the realisation of half the emission reductions through domestic (inland) measures. The uncertainty in total annual CO2 -equivalent emissions in 2010 is estimated at 14 Mton (95% confidence interval) due to identified uncertain future societal developments and possible future improvements in greenhouse gas emission inventories. These results will be used to evaluate the current progress with respect to the national climate change policy in the Netherlands, described in "The Netherlands' Climate Policy Implementation Plan, Part I: inland measures"(June 1999).Het rapport presenteert de resultaten van het project 'Referentieraming energie en broeikasgassen' dat door RIVM en ECN is uitgevoerd in opdracht van de ministeries van Economische Zaken en Volkshuisvesting, Ruimtelijke Ordening en Milieubeheer. De Referentieraming schat de emissie van broeikasgassen in Nederland in 2010. Emissie bronnen en trends tot 2000 zijn geanalyseerd, en toekomstige ontwikkelingen van de economie en energievoorziening zijn opnieuw ingeschat. De nieuwe raming van de emissie van de broeikasgassen is vergeleken met eerdere ramingen die zijn gebruikt voor het nationale klimaatbeleid. Tevens zijn de emissiereductie effecten van het voor 1 juli vastgestelde klimaatbeleid ingeschat. Bij de analyse is onderscheid gemaakt tussen de CO2 en niet - CO2 broeikasgassen. De resultaten dienen ter ondersteuning van de tussentijdse evaluatie in 2002 van het klimaatbeleid zoals aangekondigd in de Uitvoeringsnota Klimaatsbeleid (1999)