Organisational Policies and Practices for the Inclusion of Vulnerable Workers: A Scoping Review of the Employer's Perspective.

Purpose Current models of inclusive workplaces are primarily based on the perceptions of vulnerable workers, whereas attention for employer's perceptions is lacking. This scoping review addresses this issue by mapping the literature that covers employer's perceptions on the application and importance of organisational policies and practices aimed at the inclusion of vulnerable workers. Methods A literature search for qualitative and quantitative research articles was conducted in MEDLINE, Scopus, ProQuest, PsychInfo, Google Scholar and Web of Science. Studies were included when (a) they reported on practices aimed at the inclusion, participation, or rehabilitation of (b) workers with disabilities, a low education or migration background, or who were long-term unemployed, and (c) were based on samples of employers or their representatives. Results The search resulted in 3,134 articles. In total, 38 articles met the inclusion criteria of this study. We identified seven types of inclusive practices to stimulate the inclusion of vulnerable workers that employers applied and/or perceived as valuable: senior management commitment, recruitment and selection, performance management and development practices, job accommodations and redesign of work, supportive culture, external collaborations with other employers, and monitoring. Conclusions Our review identified seven categories of inclusive practices that pertain to all stages of the employee journey of vulnerable workers. These categories move beyond those reported in studies based on employee samples, for instance by highlighting the importance of monitoring and collaborations with other employers. Hence, our findings stress that insight into employers' perceptions about effective measures is crucial to increase labour market participation of vulnerable groups.

Employers' attitude, intention, skills and barriers in relation to employment of vulnerable workers.

BACKGROUND: Little is known why some organizations employ vulnerable workers and others do not. OBJECTIVE: To explore the relationships between the attitude, intention, skills and barriers of employers and employment of vulnerable workers. METHODS: We included 5,601 inclusive organizations (≥1% of employees had a disability, was long-term unemployed or a school dropout) and 6,236 non-inclusive organizations of the Netherlands Employers Work Survey 2014-2019. We operationalized employer factors based on the Integrative Model of Behavioral Prediction as attitude (negative impact), intention (mission statement regarding social inclusion), skills (human resources policies and practices), and barriers (economic conditions and type of work). We used multivariate-adjusted logistic regression models. RESULTS: Compared to non-inclusive organizations, inclusive organizations had a more negative attitude (OR:0.81) and a stronger intention to employ vulnerable workers (OR:6.09). Regarding skills, inclusive organizations had more inclusive human resources practices (OR:4.83) and initiated more supporting human resources actions (OR:4.45). Also, they adapted more work conditions towards the needs of employees (OR:1.52), negotiated about work times and absenteeism (OR:1.49), and had general human resources practices on, for example, employability (OR:1.78). Inclusive organizations had less barriers reflected by better financial results (OR:1.32), more employment opportunities (OR:1.33) and more appropriate work tasks (OR:1.40). CONCLUSIONS: Overall, inclusive organizations reported more positive results on the employer factors of the Integrative Model of Behavioral Prediction, except for a more negative attitude. The more negative attitude might reflect a more realistic view on the efforts to employ vulnerable groups, and suggests that other unmeasured emotions and beliefs are more positive.

Factors associated with work participation and work functioning in depressed workers: a systematic review.

BACKGROUND: Depression is associated with negative work outcomes such as reduced work participation (WP) (e.g., sick leave duration, work status) and work functioning (WF) (e.g., loss of productivity, work limitations). For the development of evidence-based interventions to improve these work outcomes, factors predicting WP and WF have to be identified. METHODS: This paper presents a systematic literature review of studies identifying factors associated with WP and WF of currently depressed workers. RESULTS: A total of 30 studies were found that addressed factors associated with WP (N = 19) or WF (N = 11). For both outcomes, studies reported most often on the relationship with disorder-related factors, whereas personal factors and work-related factors were less frequently addressed. For WP, the following relationships were supported: strong evidence was found for the association between a long duration of the depressive episode and work disability. Moderate evidence was found for the associations between more severe types of depressive disorder, presence of co-morbid mental or physical disorders, older age, a history of previous sick leave, and work disability. For WF, severe depressive symptoms were associated with work limitations, and clinical improvement was related to work productivity (moderate evidence). Due to the cross-sectional nature of about half of the studies, only few true prospective associations could be identified. CONCLUSION: Our study identifies gaps in knowledge regarding factors predictive of WP and WF in depressed workers and can be used for the design of future research and evidence-based interventions. We recommend undertaking more longitudinal studies to identify modifiable factors predictive of WP and WF, especially work-related and personal factors.

Supervisory behaviour as a predictor of return to work in employees absent from work due to mental health problems.

AIMS: To study supervisory behaviour as a predictive factor for return to work of employees absent due to mental health problems; and to explore the association between conditional factors and supervisory behaviour. METHODS: Eighty five supervisors of employees were interviewed by telephone. Questionnaires providing information on person related factors, depressive symptoms, and sickness absence were sent to the employees at baseline, three months, six months, and after one year. Three aspects of supervisory behaviour during the period of absence were measured: communication with the employee, promoting gradual return to work, and consulting of other professionals. RESULTS: Better communication between supervisor and employee was associated with time to full return to work in non-depressed employees. For employees with a high level of depressive symptoms, this association could not be established. Consulting other professionals more often was associated with a longer duration of the sickness absence for both full and partial return to work. If sickness absence had financial consequences for the department, the supervisor was more likely to communicate frequently with the employee. Supervisors who were responsible for return to work in their organisation were more likely to communicate better and to consult more often with other professionals. CONCLUSION: Supervisors should communicate more frequently with employees during sickness absence as well as hold follow up meetings more often as this is associated with a faster return to work in those employees.

The Depression Anxiety Stress Scales (DASS): detecting anxiety disorder and depression in employees absent from work because of mental health problems.

AIMS: To (1) evaluate the psychometric properties and (2) examine the ability to detect cases with anxiety disorder and depression in a population of employees absent from work because of mental health problems. METHODS: Internal consistency, construct validity, and criterion validity of the Depression Anxiety Stress Scales (DASS) were assessed. Furthermore, the ability to identify anxiety disorders or depression was evaluated by calculating posterior probabilities of these disorders following positive and negative test results for different cut off scores of the DASS-Depression and DASS-Anxiety subscales. RESULTS: Internal consistency of the DASS subscales was high, with Cronbach's alphas of 0.94, 0.88, and 0.93 for depression, anxiety, and stress respectively. Factor analysis revealed a three factor solution, which corresponded well with the three subscales of the DASS. Construct validity was further supported by moderately high correlations of the DASS with indices of convergent validity (0.65 and 0.75), and lower correlations of the DASS with indices of divergent validity (range -0.22 to 0.07). Support for criterion validity was provided by a statistically significant difference in DASS scores between two diagnostic groups. A cut off score of 5 for anxiety and 12 for depression is recommended. The DASS showed probabilities of anxiety and depression after a negative test result of 0.05 and 0.06 respectively. Probabilities of 0.29 for anxiety disorder and 0.33 for depression after a positive test result reflect relatively low specificity of the DASS. CONCLUSION: The psychometric properties of the DASS are suitable for use in an occupational health care setting. The DASS can be helpful in ruling out anxiety disorder and depression in employees with mental health problems.

Reducing long term sickness absence by an activating intervention in adjustment disorders: a cluster randomised controlled design.

AIMS: To compare an innovative activating intervention with "care as usual" (control group) for the guidance of employees on sickness leave because of an adjustment disorder. It was hypothesised that the intervention would be more effective than care as usual in lowering the intensity of symptoms, increasing psychological resources, and decreasing sickness leave duration. METHODS: A prospective, cluster randomised controlled trial was carried out with 192 patients on first sickness leave for an adjustment disorder. Symptom intensity, sickness duration, and return to work rates were measured at 3 months and 12 months. Analyses were performed on an intention to treat basis. RESULTS: At 3 months, significantly more patients in the intervention group had returned to work compared with the control group. At 12 months all patients had returned to work, but sickness leave was shorter in the intervention group than in the control group. The recurrence rate was lower in the intervention group. There were no differences between the two study groups with regard to the decrease of symptoms. At baseline, symptom intensity was higher in the patients than in a normal reference population, but decreased over time in a similar manner in both groups to approximately normal levels. CONCLUSION: The experimental intervention for adjustment disorders was successful in shortening sick leave duration, mainly by decreasing long term absenteeism.

Job stress, fatigue, and job dissatisfaction in Dutch lorry drivers: towards an occupation specific model of job demands and control.

OBJECTIVES: Building on Karasek's model of job demands and control (JD-C model), this study examined the effects of job control, quantitative workload, and two occupation specific job demands (physical demands and supervisor demands) on fatigue and job dissatisfaction in Dutch lorry drivers. METHODS: From 1181 lorry drivers (adjusted response 63%) self reported information was gathered by questionnaire on the independent variables (job control, quantitative workload, physical demands, and supervisor demands) and the dependent variables (fatigue and job dissatisfaction). Stepwise multiple regression analyses were performed to examine the main effects of job demands and job control and the interaction effect between job control and job demands on fatigue and job dissatisfaction. RESULTS: The inclusion of physical and supervisor demands in the JD-C model explained a significant amount of variance in fatigue (3%) and job dissatisfaction (7%) over and above job control and quantitative workload. Moreover, in accordance with Karasek's interaction hypothesis, job control buffered the positive relation between quantitative workload and job dissatisfaction. CONCLUSIONS: Despite methodological limitations, the results suggest that the inclusion of (occupation) specific job control and job demand measures is a fruitful elaboration of the JD-C model. The occupation specific JD-C model gives occupational stress researchers better insight into the relation between the psychosocial work environment and wellbeing. Moreover, the occupation specific JD-C model may give practitioners more concrete and useful information about risk factors in the psychosocial work environment. Therefore, this model may provide points of departure for effective stress reducing interventions at work.