Improving school teacher?s psychological wellbeing and work ability by a workplace-based intervention ? The BALANCE project

• Register: ISRCTN
• Last refreshed on: 13 January 2015
• Main ID: ISRCTN70177564
• Date of registration: 02/07/2014
• Prospective Registration: No
• Primary sponsor: The National Research Center For The Working Environment (NRCWE) (Denmark)
• Public title: Improving school teacher?s psychological wellbeing and work ability by a workplace-based intervention ? The BALANCE project
• Scientific title: The BALANCE project - A cluster-randomized trial of a complex workplace based intervention to maintain or improve work ability among school teachers at risk for being at reduced psychological wellbeing.
• Date of first enrolment: 01/04/2013
• Target sample size: 1000
• Recruitment status: Completed
• URL: http://isrctn.com/ISRCTN70177564
• Study type: Interventional
• Study design: A cluster randomized controlled trial comparing an intervention group with an assessment only control group. (Quality of life)

Countries of recruitment

Denmark

Contacts

• Name: Jesper Kristiansen

Key inclusion & exclusion criteria

Inclusion criteria: All public schools in the municipal of Copenhagen got the possibility to seek for participation in the project - both school teachers (children age: 7-15 years) and preschool teachers (children age: 6 years) from the participating schools will be part of the study population.
Exclusion criteria: Exclusion criteria for participating in the project:
Special schools (as for example schools for deaf students) are not invited to participate in the project

Exclusion criteria for participation in the scientific evaluation of the study:
The school management and school employees who have other functions than teaching are not part of the study population

Exclusion criteria for participation in the scientific evaluation of the study:
The school management and school employees who have other functions than teaching are not part of the study population

Age minimum:
Age maximum:
Gender: Both

Health Condition(s) or Problem(s) studied

School teachers with or without mental health problems working at the participating schools.
Not Applicable

Intervention(s)

The individual focused interventions include four components:
1. A screening to identify individuals with reduced psychological wellbeing
2. A case manager is appointed to contact the individuals with reduced psychological wellbeing identified in the screening. The case manager will through personal conversations clarify the needs and give support and motivation to participate in other parts of the individual intervention.
3. A course in stress management is one of the options offered
4. Job task modification, a time-limited adjustment of job demands and the current level of resources, is another option offered to the teachers with reduced psychological wellbeing.

The organization focused intervention includes three components:
1. Education of the ?Triad? (that is, representatives from the school management, the local shop steward and the local health and safety representative). The Triad receives training to improve their ability to support teachers with reduced psychological well-being, especially regarding those participating in the individual focused intervention. Furthermore the triad is trained to cooperate about improving the psychosocial working environment for all teachers of the school.
2. A seminar is organized at each school for all teachers. The purpose of the seminar is to increase focus at the school on an inclusive and supporting culture and reduce stigmatization of employees with mental health problems.
3. The seminar is the starting point for the final organizational intervention component which is activities centered around a theme selected by each school - a theme that has been found relevant for improving the psychosocial working environment of the specific workplace, for example improvement of support from colleagues.

The duration of the intervention is 12 months.

Primary Outcome(s)

The primary outcomes are:
1. The change from baseline (before the intervention) to the first follow-up (post-intervention) in psychological wellbeing assessed by WHO-5
2. The change from baseline to the first follow-up in work ability measured by the Work-Role Functioning Questionnaire (WRFQ)
3. The change from baseline to the first follow-up in work-related fatigue measured by Need for Recovery Questionnaire (NFR)
The change from baseline will be analyzed in a mixed effects model including the intervention as a categorical variable defined according to the intention-to-treat principle, and with the baseline value of the specific outcome as a covariate. The correlation between persons from the same school will be modelled using a compound symmetry covariance structure.

Additional primary outcomes are:
1. Sickness absence
2. Employment status
These are assessed from the employer?s records for the 12 months periods starting January 2014 (follow-up period). The influence of the intervention on sickness absence will be analyzed in a Cox proportional hazard regression model for interval-censored data using duration of the absence period as the time scale. The correlation between measurements within the individual and within the school will be modelled by including a random effect of individual and a random effect of school. The observation will be censored in case of termination of employment, death, or end of follow-up. The target event when analyzing employment status will be termination of employment at the school, while censoring at termination due to death, at age 65 years (standard age for old-age pension in Denmark), or at end of follow-up, whichever comes first. In these analyses, age will be used as the time scale.

Secondary Outcome(s)

The first group of secondary outcomes consists of changes from baseline to follow-up in psychological wellbeing measures complementary to the primary outcomes:
1. Mental health assessed with the Mental Health Inventory-5 (MHI-5)
2. Work ability (WAI)
3. Symptoms of depression and anxiety (SCL-90)
4. Sleep problems (KSS)

The second group of secondary outcomes consists of changes from baseline to follow-up of measures assessing the perceived psychosocial working environment:
1. Social support from colleagues (COPSOQ)
2. Social support from the manager (COPSOQ)
3. Social community at work (COPSOQ)
4. Quality of the management (COPSOQ)
5. Social capital among colleagues and between the teachers and the management
6. Expectations with regard to continue to work at the current school

Finally, a third group of secondary outcomes will be the change from baseline to 1 year after completion of the interventions (second follow-up) in all the variables mentioned above for:
1. Psychological wellbeing
2. Work ability
3. Work-related fatigue
4. Perceived working environment etc.

Secondary ID(s)

N/A

Source(s) of Monetary Support

Danish Government (Grant from the Social Reserve Program 2012) Grant number 17.21.02.60 (Denmark)