The Use and Perceived Usefulness of an Online Toolbox Targeted at Employers (MiLES Intervention) for Enhancing Successful Return to Work of Cancer Survivors.

PURPOSE: The MiLES intervention is a web-based intervention targeted at employers with the objective of enhancing successful return to work (RTW) of cancer survivors. The aim of this study is to gain insight into the employers' use and perceived usefulness of the MiLES intervention. METHODS: Employer representatives (e.g. Human Resource managers and supervisors) were given access to the MiLES intervention, which contains, among others, interactive videos, conversation checklists and tailored tips. After six weeks, an online questionnaire gathered data on employers' use and the perceived usefulness of the intervention. In-depth qualitative data on these topics were gathered during semi-structured interviews, which were analyzed using a content analysis. RESULTS: Thirty-one eligible employers were included. Twenty-two of them filled out the questionnaire and twenty were interviewed. Typically, employers used the intervention 2-3 times, for 26 min per visit. The usefulness of the intervention scored 7.6 out of 10 points, and all employers would recommend it to colleagues. Employers' use decreased when support needs were low and when the intervention did not correspond with their specific situation (e.g. complex reintegration trajectories). Employers perceived the intervention to be supporting and practically oriented. They appreciated the fact that the intervention was web-based and combined visual and textual content. The possibility of consulting specialized services for complex situations would further enhance its usefulness. CONCLUSION: The MiLES intervention provides employers with a useful tool in their daily practice. Its effectiveness for enhancing employers' managerial skills and cancer survivors' successful RTW is subject for further research.

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

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 web-based 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.

Perceived employer-related barriers and facilitators for work participation of cancer survivors: A systematic review of employers' and survivors' perspectives.

OBJECTIVE: To identify employer-related barriers and facilitators for work participation of cancer survivors from the perspective of both employers and cancer survivors, and to synthesise these perceived barriers and facilitators to understand their perceived consequences. METHODS: A systematic review of qualitative studies focusing on employers' and cancer survivors' perspectives on the work participation of cancer survivors was performed. Four databases (MEDLINE, EMBASE, PsycINFO, and Business Source Premier) were systematically searched, and the quality of studies included was assessed using the CASP checklist. Perceived barriers and facilitators were extracted and synthesised to conduct a content analysis. RESULTS: Five studies representing the employers' perspectives and 47 studies representing the cancer survivors' perspectives were included. Employers perceived barriers and facilitators related to support, communication, RTW policies, knowledge about cancer, balancing interests and roles, and attitude. Survivors perceived barriers and facilitators related to support, communication, work environment, discrimination, and perception of work ability. The synthesis found that the employers' willingness to support can be understood by perceptions they have of the survivor, goals of the employer, and national or organisational policies. Employers require knowledge about cancer and RTW policies to be able to support survivors. CONCLUSIONS: This review identified a plurality of and a large variety in perceived employer-related barriers and facilitators for work participation of cancer survivors, which can be understood to be related to both employers' willingness and ability to support. There is a need for interventions targeting employers, with the aim of enhancing the sustainable work participation of cancer survivors.

Employers' experience of employees with cancer: trajectories of complex communication.

PURPOSE: Remaining in paid work is of great importance for cancer survivors, and employers play a crucial role in achieving this. Return to work (RTW) is best seen as a process. This study aims to provide insight into (1) Dutch employers' experiences with RTW of employees with cancer and (2) the employers' needs for support regarding this process. METHODS: Thirty employer representatives of medium and large for-profit and non-profit organizations were interviewed to investigate their experiences and needs in relation to employees with cancer. A Grounded Theory approach was used. RESULTS: We revealed a trajectory of complex communication and decision-making during different stages, from the moment the employee disclosed that they had been diagnosed to the period after RTW, permanent disability, or the employee's passing away. Employers found this process demanding due to various dilemmas. Dealing with an unfavorable diagnosis and balancing both the employer's and the employee's interests were found to be challenging. Two types of approach to support RTW of employees with cancer were distinguished: (1) a business-oriented approach and (2) a care-oriented approach. Differences in approach were related to differences in organizational structure and employer and employee characteristics. Employers expressed a need for communication skills, information, and decision-making skills to support employees with cancer. CONCLUSIONS: The employers interviewed stated that dealing with an employee with cancer is demanding and that the extensive Dutch legislation on RTW did not offer all the support needed. We recommend providing them with easily accessible information on communication and leadership training to better support employees with cancer. IMPLICATIONS FOR CANCER SURVIVORS: • Supporting employers by training communication and decision-making skills and providing information on cancer will contribute to improving RTW support for employees with cancer. • Knowing that the employer will usually be empathic when an employee reveals that they have been diagnosed with cancer, and that the employer also experiences difficulties and dilemmas, might lower the threshold to discuss wishes regarding disclosure, communication, and work issues. • The interests of employer and employee in relation to RTW are interrelated; both have responsibility and a role to play, and are in need of support.