Goal-focused group intervention; sustainable health improvement but no effect on work participation

• Published in: European Journal of Public Health
• Main Authors: Fleten, N, Fyhn, T, Tveito, T H
• Format: Article in Journal/Newspaper
• Language: English
• Published: Oxford University Press (OUP) 2019
• Subjects: Public Health, Environmental and Occupational Health; Norway; Northern Norway; Troms
• Online Access: http://dx.doi.org/10.1093/eurpub/ckz185.332; http://academic.oup.com/eurpub/article-pdf/29/Supplement_4/ckz185.332/32631238/ckz185.332.pdf

Abstract Background Sick leave in Norway is high relative to other OECD-countries, but few of numerous work rehabilitation efforts are evaluated adequately. Financed by research and development grants from the Norwegian Work- and Welfare Directorate we explored the effect of goal-focused group intervention in the Norwegian Welfare organisation in Troms, Northern-Norway. Methods In a randomised controlled trial, we compared a goal-focused group intervention to receiving a 3-month membership card at a local gym. Main outcomes were work participation, self-rated health (0-100), functioning EQ-5D, and subjective health complaints, (29 items, 0-3). Most participants were long time sick-listed, and recruited from welfare service caseworkers. We collected surveys at baseline, 3 and 15 months, and corresponding register data on work participation. Results Participating persons, 89 in the group intervention and 63 in the gyms, were comparable in age and gender, 85% women. Self-rated health scores improved in both groups at 3 months. At 15 months, the control group were back at basis while improvement sustained in intervention group, Initial scores 50.9 (95% CI 47.4-54.4), 3 months 58.1 (52.4-63.8) and 15 months 58.6 (51.8-65.4). In favour of intervention the difference in difference of scores on subjective health complaints was 2.34, p=.056 at 3 months, and 4.01, p=.035 at 15 months. Mean total score on EQ-5D and daily living function improved significantly in the intervention group 8.09 - 7.67 (95% CI7.26-8.07), and 1.91-1.70 (1.53-1.86) respectively in 15 months. Work participation did not reflect these improvements. Both groups reached mean 98 workdays within 15 months follow-up. Conclusions Goal-focused group intervention has the potential to improve self-rated health and functioning, but gives no immediate effect on work participation. Key messages Goal-focused group intervention among sick-listed is cost effective focusing health related quality of live. Improving health and function is important but not sufficient to speed up return to work.