SusTained Employability in cancer Patients and their partnerS: Results of a Randomized Controlled Trial into the Effectiveness of the STEPS Program.

PURPOSE: Cancer survivors experience challenges in establishing sustained employability, i.e., return to work and work retention. We evaluated the effectiveness of a stages-of-change-based work participation program (STEPS) to support sustained employability in cancer survivors.

METHODS

A two-armed randomized controlled trial was conducted among employees diagnosed with cancer 3-18 months earlier. Participants completed questionnaires pre-randomization, and at 6- and 12-month of follow-up (T1 and T2). Mixed-effects modeling compared STEPS with usual care on working hours (sustained employability) and secondary outcomes.

RESULTS

Of 239 included participants, 123 were randomly assigned to STEPS and 116 to usual care. There were no meaningful differences in weekly working hours between the STEPS and control groups during follow-up. However, strict STEPS protocol adherence was related to working fewer hours per week across T1 and T2 (- 3.6, 95%CI [- 6.90, - 0.36]) and at T1 specifically (- 3.9, 95%CI [- 7.47, - 0.28]). Participants in STEPS who had returned to work to some extent at baseline worked fewer hours at T1 (- 3.7, 95%CI [- 7.16, -0.22]). Finally, participants in STEPS had 0.7-point higher best-ever work ability at T2 (95%CI [0.04, 1.31]). All other outcomes did not differ meaningfully between groups.

CONCLUSION

In its current form, STEPS does not improve sustained employability in cancer survivors. While STEPS may improve self-perceived work ability, this is unlikely to improve objective work-related outcomes. Work participation support should extend beyond initial return to work and engage employees and employers to address workplace barriers and facilitators.