RT Journal Article
SR Electronic
T1 Mechanisms of vocational interventions for return to work from musculoskeletal conditions: a mediation analysis of the MI-NAV trial
JF Occupational and Environmental Medicine
JO Occup Environ Med
FD BMJ Publishing Group Ltd
SP 246
OP 253
DO 10.1136/oemed-2022-108716
VO 80
IS 5
A1 Aidan G Cashin
A1 Britt Elin Øiestad
A1 Fiona Aanesen
A1 Kjersti Storheim
A1 Alexander Tingulstad
A1 Tarjei Langseth Rysstad
A1 Hopin Lee
A1 James H McAuley
A1 Gail Sowden
A1 Gwenllian Wynne-Jones
A1 Anne Therese Tveter
A1 Margreth Grotle
YR 2023
UL http://oem.bmj.com/content/80/5/246.abstract
AB Objectives To investigate whether and to what extent, return to work (RTW) expectancy and workability mediate the effect of two vocational interventions on reducing sickness absence in workers on sick leave from a musculoskeletal condition.Methods This is a preplanned mediation analysis of a three-arm parallel randomised controlled trial which included 514 employed working adults with musculoskeletal conditions on sick leave for at least 50% of their contracted work hours for ≥7 weeks. Participants were randomly allocated (1:1:1) to one of three treatment arms; usual case management (UC) (n=174), UC plus motivational interviewing (MI) (n=170) and UC plus a stratified vocational advice intervention (SVAI) (n=170). The primary outcome was the number of sickness absence days over 6 months from randomisation. Hypothesised mediators included RTW expectancy and workability assessed 12 weeks after randomisation.Results The mediated effect of the MI arm compared with UC on sickness absence days through RTW expectancy was −4.98 days (−8.89 to −1.04), and workability was −3.17 days (−8.55 to 2.32). The mediated effect of the SVAI arm compared with UC on sickness absence days through RTW expectancy was −4.39 days (−7.60 to −1.47), and workability was −3.21 days (−7.90 to 1.50). The mediated effects for workability were not statistically significant.Conclusions Our study provides new evidence for the mechanisms of vocational interventions to reduce sickness absence related to sick leave due to musculoskeletal conditions. Changing an individual’s expectation that RTW is likely may result in meaningful reductions in sickness absence days.Trial registration number NCT03871712.Data are available on reasonable request. Anonymised individual participant data (including data dictionary) will be available on reasonable request from January 2023 to December 2028 to researchers who provide a methodologically sound scientific proposal that has been approved by an ethics committee and by the scientific board of the MI-NAV study. Requests to access data should be addressed to brielo@oslomet.no.