Article Text

Original research
Effects of a participatory organisational, core work task focused workplace intervention on employees’ primary healthcare consultations: secondary analysis of a cluster RCT
  1. Elisabeth Framke1,
  2. Ole Henning Sørensen1,
  3. Line R M Pedersen1,
  4. Jacob Pedersen1,
  5. Ida E H Madsen1,
  6. Jakob B Bjorner1,2,3,
  7. Reiner Rugulies1,2,4
  1. 1National Research Centre for the Working Environment, Copenhagen, Denmark
  2. 2Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  3. 3QualityMetric, Johnston, Ri USA
  4. 4Department of Psychology, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to Dr Elisabeth Framke, National Research Centre for the Working Environment, Copenhagen 2100, Denmark; elf{at}


Objectives We aimed to examine whether a participatory organisational workplace intervention focusing on core tasks at work resulted in lower primary healthcare utilisation of employees.

Methods The cluster randomised controlled trial included 78 preschools, 44 allocated to the intervention group (1745 employees) and 34 allocated to the control group (1267 employees). The intervention aimed to involve employees in improving the psychosocial work environment while focusing on core tasks at work. Using Poisson regression, we tested the rate ratios (RRs) of consultations in the intervention compared with the control group in terms of all consultations in primary healthcare and general practitioner (GP) consultations, respectively, per person-year during 31 months of follow-up. The fully adjusted model included adjustment for sex, age, job group, workplace type and size, and previous primary healthcare utilisation.

Results During the follow-up, intervention group employees had 11.0 consultations/person-year, while control group employees had 11.6 consultations/person-year (RR 0.97, 95% CI 0.92 to 1.01). Employees in the intervention group had 7.5 GP consultations/person-year, while control group employees had 8.2 GP consultations/person-year (RR 0.95, 95% CI 0.90 to 0.99). Post hoc analyses indicated that the effect of the intervention was particularly strong in employees in preschools with a moderate or high level of implementation.

Conclusions The participatory organisational workplace intervention focusing on core tasks at work among preschool employees had a small, statistically non-significant effect on overall primary healthcare utilisation and a small, statistically significant effect on GP consultations. These results suggest a beneficial effect of the participatory organisational intervention on employees’ health.

Trial registration number ISRCTN16271504

  • primary health care

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  • Contributors EF and RR formulated the hypothesis. OHS conceived and coordinated the Pioneer intervention study. OHS and EF collected the questionnaire data. EF retrieved data from Statistics Denmark. EF, LRMP, JP and RR designed the data analysis. LRMP conducted the data analysis in collaboration with JP and EF. All authors contributed to the interpretation of results. EF wrote the first draft of the manuscript, and all authors revised the manuscript critically. All authors read and approved the final version of manuscript.

  • Funding The intervention was funded by a grant from the Danish Prevention Fund (grant number: 09-1-1a-096) and the evaluation of the intervention was funded by a grant from the Danish Working Environment Research Fund (grant number: 28-2010-03).

  • Disclaimer The two funding sources had no further role in the study design, the collection, analyses and interpretation of data; the writing of the manuscript; or the decision to submit the manuscript for publication.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval According to Danish law, studies using solely questionnaire and register data do not need approval from the National Committee on Health Research Ethics (National Videnskabsetisk Komité).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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