Barriers and facilitators for implementation of a return-to-work intervention for sickness absence beneficiaries with mental health problems: Results from three Danish municipalities

TY - JOUR

T1 - Barriers and facilitators for implementation of a return-to-work intervention for sickness absence beneficiaries with mental health problems

T2 - Results from three Danish municipalities

AU - Martin, Marie H. T.

AU - Moefelt, Louise

AU - Dahl Nielsen, Maj Britt

AU - Rugulies, Reiner

N1 - © 2015 the Nordic Societies of Public Health.

PY - 2015/6

Y1 - 2015/6

N2 - AIMS: Evidence for the effectiveness of return-to-work (RTW) interventions aimed at sickness absence beneficiaries with mental health problems (MHPs) is still relatively sparse and mostly inconclusive. This may in part reflect the varying settings and inconsistent implementations associated with the interventions. The aim of this paper is to identify barriers and facilitators for the implementation of a coordinated and tailored RTW-intervention implemented at three different sites.METHODS: We used qualitative and quantitative data to assess the implementation according to process evaluation guidelines. Data sources were individual and group interviews, observations, national registers, and documents used in the intervention.RESULTS: The quality of the implementation varied greatly across the three settings. Barriers included lack of skills to assess MHPs according to the inclusion criteria, different interpretations of sickness absence legislation among stakeholders, competing rehabilitation alternatives, and lack of managerial support for the intervention. An important facilitator was the motivation and availability of resources to solve disagreements through extensive communication.CONCLUSIONS: The different settings presented various barriers and facilitators, which resulted in different versions of the intervention. A higher degree of user involvement in the design and development phase is likely to improve the implementation quality of future interventions.

AB - AIMS: Evidence for the effectiveness of return-to-work (RTW) interventions aimed at sickness absence beneficiaries with mental health problems (MHPs) is still relatively sparse and mostly inconclusive. This may in part reflect the varying settings and inconsistent implementations associated with the interventions. The aim of this paper is to identify barriers and facilitators for the implementation of a coordinated and tailored RTW-intervention implemented at three different sites.METHODS: We used qualitative and quantitative data to assess the implementation according to process evaluation guidelines. Data sources were individual and group interviews, observations, national registers, and documents used in the intervention.RESULTS: The quality of the implementation varied greatly across the three settings. Barriers included lack of skills to assess MHPs according to the inclusion criteria, different interpretations of sickness absence legislation among stakeholders, competing rehabilitation alternatives, and lack of managerial support for the intervention. An important facilitator was the motivation and availability of resources to solve disagreements through extensive communication.CONCLUSIONS: The different settings presented various barriers and facilitators, which resulted in different versions of the intervention. A higher degree of user involvement in the design and development phase is likely to improve the implementation quality of future interventions.

KW - Adult

KW - Cities

KW - Denmark

KW - Female

KW - Health Services Accessibility

KW - Humans

KW - Male

KW - Mental Disorders

KW - Middle Aged

KW - Qualitative Research

KW - Return to Work

KW - Sick Leave

U2 - 10.1177/1403494814568484

DO - 10.1177/1403494814568484

M3 - Journal article

C2 - 25816862

SN - 1403-4948

VL - 43

SP - 423

EP - 431

JO - Acta socio-medica Scandinavica

JF - Acta socio-medica Scandinavica

IS - 4

ER -