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Background: Employers express a need for support during sickness absence and return to work (RTW) of cancer survivors. Therefore, a web-based intervention (MiLES) targeted at employers with the objective of enhancing cancer survivors' successful RTW has been developed. This study aimed to assess feasibility of a future definitive randomised controlled trial (RCT) on the effectiveness of the MiLES intervention. Also preliminary results on the effectiveness of the MiLES intervention were obtained.Methods: A randomised feasibility trial of 6 months was undertaken with cancer survivors aged 18-63 years, diagnosed with cancer < 2 years earlier, currently in paid employment, and sick-listed < 1 year. Participants were randomised to an intervention group, with their employer receiving the MiLES intervention, or to a waiting-list control group (2:1). Feasibility of a future definitive RCT was determined on the basis of predefined criteria related to method and protocol-related uncertainties (e.g. reach, retention, appropriateness). The primary effect measure (i.e. successful RTW) and secondary effect measures (e.g. quality of working life) were assessed at baseline and 3 and 6 months thereafter.Results: Thirty-five cancer survivors were included via medical specialists (4% of the initially invited group) and open invitations, and thereafter randomised to the intervention (n = 24) or control group (n = 11). Most participants were female (97%) with breast cancer (80%) and a permanent employment contract (94%). All predefined criteria for feasibility of a future definitive RCT were achieved, except that concerning the study's reach (90 participants). After 6 months, 92% of the intervention group and 100% of the control group returned to work (RR: 0.92, 95% CI: 0.81-1.03); no difference were found with regard to secondary effect measures.Conclusions: With the current design a future definitive RCT on the effectiveness of the MiLES intervention on successful RTW of cancer survivors is not feasible, since recruitment of survivors fell short of the predefined minimum for feasibility. There was selection bias towards survivors at low risk of adverse work outcomes, which reduced generalisability of the outcomes. An alternative study design is needed to study effectiveness of the MiLES intervention.Trial Registration: The study has been registered in the Dutch Trial Register ( NL6758/NTR7627 ). [ABSTRACT FROM AUTHOR]

Background: Employers express a need for support to facilitate the return to work (RTW) process of employees with cancer. We have developed the MiLES intervention, an online toolbox targeting employers during the RTW of employees with cancer. To evaluate the MiLES intervention, we propose the design of a pilot randomised controlled trial (RCT). The aim of this pilot is to determine whether a future RCT to study the effectiveness of this intervention on successful RTW of employees with cancer is feasible. Secondary aims are to obtain preliminary results on the effectiveness of the intervention and to determine the sample size needed in a future definitive RCT.Methods: A pilot RCT with a 6-month follow-up will be conducted. Using medical specialists at Dutch hospitals, we aim to enrol 90 participants diagnosed with cancer (<2 years earlier) aged 18-63 years who are in paid employment with an employer and who are currently sick-listed or partly sick-listed for <1 year. Participants randomised to the intervention group will be asked to inform their employer about the online toolbox supporting employers during the RTW process of employees with cancer. Participants in the control group will receive 'care as usual' from their employer. All measures will be assessed at the level of the employee using questionnaires at baseline and after 3 and 6 months of follow-up. The feasibility of a future RCT will be determined using criteria concerning method-related uncertainties and acceptability of the study protocol. The primary effect measure will be successful RTW (that is, RTW perceived as being successful by the cancer survivor themselves). This effect measure will be used to perform the sample size calculation for a future definitive RCT.Discussion: The design is proposed to determine the feasibility to study the effectiveness of the MiLES intervention targeting employers on the successful RTW of employees diagnosed with cancer. This pilot RCT can increase the probability of a successful future definitive RCT on the effectiveness of the intervention and potentially obviate the need to carry out an unfeasible and resource-intensive study.Trial Registration: Dutch Trial Register (NTR): NL6758, NTR7627. Registered on 30 October 2018. [ABSTRACT FROM AUTHOR]

Work is a key contributor to quality of life and an important aspect of cancer survivorship. We call attention to current topics in cancer survivorship and work with 12 articles on cancer survivorship and work in this special section. The focus is on less studied diagnostic groups such as gastrointestinal cancer and prostate cancer, and on long-term effects of cancer diagnosis and treatment on work. Furthermore, studies are included on topics not generally studied including cognitive limitations and pain, the role of the employer on work outcomes among different types of cancer survivors and some countries not typically covered in the existing literature on work and cancer survivorship. We conclude that to improve sustainable work participation in cancer survivors, personalised, tailored interventions should be provided. A prerequisite for this is the identification of groups and individuals at high risk for adverse work outcomes. In order to develop such interventions, research involving new approaches such as matching data registries, participatory approaches and the involvement of many stakeholders and survivors with these different types of cancer diagnoses is necessary. IMPLICATIONS FOR CANCER SURVIVORS: The goal of sustainable work participation in cancer survivors can be improved by the delivery of a personalised or risk-based tailored intervention. Furthermore, successful work outcomes often involve many stakeholders who should all be included Implications for Cancer Survivors. The goal of sustainable work participation in cancer survivors can be improved by the delivery of a personalised or risk-based tailored intervention. Furthermore, successful work outcomes often involve many stakeholders who should all be included. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: This study explored employer's perspectives on (1) their experience of good practice related to workers diagnosed with cancer and their return to work (RTW), and (2) their perceived needs necessary to achieve good practice as reported by employers from nine separate countries.Methods: Twenty-five semi-structured interviews were held in eight European countries and Israel with two to three employers typically including HR managers or line managers from both profit and non-profit organisations of different sizes and sectors. Interviews were recorded and transcribed verbatim. A grounded theory/thematic analysis approach was completed.Results: Employers' experience with RTW assistance for workers with cancer appears to be a dynamic process. Results indicate that good practice includes six phases: (1) reacting to disclosure, (2) collecting information, (3) decision-making related to initial actions, (4) remaining in touch, (5) decision-making on RTW, and (6) follow-up. The exact details of the process are shaped by country, employer type, and worker characteristics; however, there was consistency related to the need for (1) structured procedures, (2) collaboration, (3) communication skills training, (4) information on cancer, and (5) financial resources for realizing RTW support measures.Conclusions: Notwithstanding variations at country, employer, and worker levels, the employers from all nine countries reported that good practice regarding RTW assistance in workers with a history of cancer consists of the six phases above. Employers indicate that they would benefit from shared collaboration and resources that support good practice for this human resource matter.Implications For Cancer Survivors: Further research and development based on the six phases of employer support as a framework for a tool or strategy to support workers with a history of cancer across countries and organisations is warranted. [ABSTRACT FROM AUTHOR]

Purpose Evidence shows that employers play a key role in facilitating the return to work of employees with cancer, yet little is known about the employers' experiences in settings where no policies or regulations are available to guide this process. Against this background, we aimed (1) to understand how employers experience and manage the process of having employees with cancer and (2) to explore their reflections regarding their role in returning to work. Methods Twenty employers from various types of organisations and sectors were interviewed. Inductive thematic analysis was performed using NVivo 11. Results Employers experienced having employees with cancer as a process with three distinct phases reflected in three emerging themes: disclosure of the diagnosis and absence from work; returning to work; post-returning to work. A fourth theme emphasizes the employers' reflections on how they conceive their own role. In the absence of a normative framework for dealing with employees with cancer, employers used commonsensical rules of thumb and immediate solutions based on ad-hoc decisions and were often compelled to innovate. They offered accommodations only if requested by the employee after returning to work. The return to work process was neither planned nor phased. Conclusion Employers need information and guidelines for effectively assisting employees with cancer. Better channels of communication and collaboration with health professionals are essential for more adequate support for the long-term consequences of cancer. A detailed return to work policy is required to tackle the inconsistencies in the support offered and this policy must also rethink how diagnosis disclosure takes place in Romanian organisations. [ABSTRACT FROM AUTHOR]

Major knowledge gaps limit the development and implementation of interventions to improve employment outcomes among people with cancer. To identify research priorities to improve employment outcomes after cancer, the National Cancer Institute sponsored the meeting "Evidence-Based Approaches for Optimizing Employment Outcomes among Cancer Survivors." This article describes research recommendations stemming from the meeting. At the patient level, longitudinal studies are needed to better understand how patient sociodemographic and clinical characteristics and their experiences at work shape employment outcomes. Interventions that mitigate the impact of cancer and its treatment on employment are critical. At the provider-level, future research is needed to characterize the extent to which physicians and other healthcare providers talk to their patients about employment concerns and how that information is used to inform care. Additionally, there is a need to test models of care delivery that support routine screening of employment concerns, the capture of employment outcomes in electronic health records, and the effective use of this information to improve care. At the employer level, evidence-based training programs are needed to prepare supervisors, managers, human resources staff, and occupational health professionals to address health issues in the workplace; and future interventions are needed to improve patient -employer communication and facilitate workplace accommodations. Importantly, research is needed that reflects the perspectives and priorities of patients and their families, providers and healthcare systems, and employers. Transdisciplinary partnerships and stakeholder engagement are essential to ensure that employment-focused interventions and policies are developed, implemented, and sustained in real-world healthcare delivery and workplace settings. [ABSTRACT FROM AUTHOR]

Purpose and methods Cancer survivors have a higher risk of adverse work outcomes such as not being able to return to work (RTW). The process of returning to work is complex as a result of the diverse stakeholders and numerous factors involved related to the employee diagnosed with cancer, the work environment, health care system, and the legal system. One of the key stakeholders is the employer, as the employer is in the position to facilitate work accommodations. Therefore, the purpose of this brief review is to consider opportunities regarding the role of the employer to enhance the work participation of employees with cancer. Results and conclusions We currently know little about which aspects of employer support have a positive impact on the ability of employees diagnosed with cancer to retain at work or RTW. In addition, there is a lack of interventions and tools which support employers in their management of employees diagnosed with cancer. The inclusion of employer support into the workplace can help employees diagnosed with cancer with their work retention and RTW, which is an important aspect of their quality of life and benefits the society at large. [ABSTRACT FROM AUTHOR]

Background: Managers are considered to be main stakeholders in the return to work (RTW) of cancer survivors. However, the perspectives of cancer survivors and managers differ on what managerial actions should be taken during the RTW of cancer survivors. This difference might put effective collaboration and successful RTW at risk. Therefore, this study aims to reach consensus among managers and cancer survivors on the managerial actions to be taken during the four different RTW phases of cancer survivors (i.e., Disclosure, Treatment, RTW plan, Actual RTW).Methods: The Technique for Research of Information by Animation of a Group of Experts (TRIAGE) was implemented with managers and cancer survivors (hereafter referred to as "experts"). An initial list of 24 actions was derived from a previous study. Firstly, for each action, fifteen experts were asked to indicate individually how important this action is per RTW phase (Likert scale from 1 - "Not important at all" to 6 - "Very important"). Consensus was reached when ≥ 80% (i.e., ≥ twelve experts) of the experts rated that action ≥5. Secondly, for each phase of the RTW process, the 15 actions with the highest percentage were discussed with eight experts during the collective consultation, except for the actions that already reached consensus. After discussion, the experts voted whether each action was important ("yes" / "no") and consensus required ≥ 87.5% (i.e., ≥ seven experts) of the experts to consider an action as important.Results: Twenty-five managerial actions were finally retained for at least one of the RTW phases, e.g., Disclosure: "respect privacy" and "radiate a positive attitude", Treatment: "show appreciation" and "allow sufficient sick leave", RTW Plan: "tailor" and "communicate", and Actual RTW: "support practically" and "balance interest".Conclusion: Cancer survivors and managers reached consensus on the importance of 25 managerial actions, distributed into each phase of the RTW process. These actions should be considered an interplay of managerial actions by different stakeholders on the part of the employer (e.g., direct supervisor, HR-manager), and should be a responsibility that is shared by these stakeholders. The collective implementation of these actions within the company will help cancer survivors feel fully supported. [ABSTRACT FROM AUTHOR]