Supporting employers to enhance the return to work of cancer survivors: development of a web-based intervention (MiLES intervention)

Abstract

Purpose The purpose of this study was to develop an intervention targeting employers, with the aim of enhancing cancer survivors' return to work (RTW). Methods Intervention Mapping was used to combine information gathered from several procedures involving numerous stakeholders, for example, employers, cancer survivors, oncological occupational physicians, and e-health experts. Results Employers indicated that they require tailored support during four RTW phases: (1) disclosure, (2) treatment, (3) RTW planning, and (4) actual RTW. The most important employer actions were identified for each RTW phase, for instance, "communicate," "support practically," and "assess work ability," and thereafter formulated as the performance objectives of the intervention. The trans-theoretical model of change was used as a theoretical framework, and several methodologies were employed to induce the desired behavior change, for example modeling, tailoring, and active learning. Subsequently, a webbased intervention with interactive videos, conversation checklists, links to reliable external sources, and succinct, tailored tips and information was developed and adjusted on the basis of pre-tests with different stakeholders. Conclusions The intervention was developed with input from employers and all relevant stakeholders in the RTW of cancer survivors. The systematic, step-wise development resulted in a succinct and easily accessible intervention targeting the most important employer actions during all RTW phases. As such, the intervention corresponds with employers' needs and preferences in practice. Implications for cancer survivors By providing employers with support, the intervention could well be the missing link in efforts to optimize the work participation of cancer survivors.

The MiLES intervention targeting employers to promote successful return to work of employees with cancer: design of a pilot randomised controlled trial

“…We used the intervention mapping approach to develop the MiLES intervention, to support employers during the RTW of employees with cancer ('MiLES is an abbreviation for 'the Missing Link: optimising return to work of Employees diagnosed with cancer, by Supporting employers') [23,24]. This web-based intervention, which is an 'online toolbox', aims to amend the behaviour of the employer during the various RTW phases of an employee with cancer: 1) the period between disclosure of the employee's illness to the employer and the first treatment; 2) the period of sick leave during the employee's treatment; 3) the period in which the concrete planning and preparation of the employee's RTW take place; and 4) the period after RTW [24].…”

Introduction to special section on: current topics in cancer survivorship and work

“…The article by Greidanus et al [22] describes, to the best of our knowledge, the first intervention that solely targets employers in relation to cancer survivorship, i.e. the MiLES intervention.…”

“…the MiLES intervention. This web-based intervention was developed in close collaboration with several employers and other stakeholders, in order to meet employers' needs and increase it feasibly in actual practice [22]. Although its effectiveness on various work outcomes in several types of cancer survivors remains to be empirically determined, the MiLES intervention does provide the description of a potentially useful approach based on the employer's perspective.…”

“…For example, a cancer survivor at high risk of adverse work outcomes due to cognitive problems might receive a personalised intervention including cognitive training delivered by a (neuro-) psychologist or professional in a healthcare setting, as suggested by Ehrenstein et al [18] and Klaver et al [19]. While another cancer survivor at high risk because of a lack of employer support might benefit from an intervention that would involve the employer using a web-based intervention or communication skills training approach, as suggested by Greidanus et al [22] and de Rijk et al [21]. Lastly, a third cancer survivor who needs to work to support her family, experiencing pain and number of health complications, might benefit from a multidisciplinary team as proposed by Zaman et al [11].…”

The Successful Return-To-Work Questionnaire for Cancer Survivors (I-RTW_CS): Development, Validity and Reproducibility

“…Research shows that the employer is an important stakeholder in the RTW of employed cancer survivors, but also that employers need interventions that support them in their role [14,15]. Such interventions have lately been developed [16], but their effectiveness for successful RTW of employed cancer survivors is to be studied [17]. In order to study this effect, it is essential to use an outcome measure with items that could be influenced by an employer.…”