Training for occupational health physicians to involve significant others in the return-to-work process of workers with chronic diseases: a randomized controlled trial

Nicole C. Snippen, Haitze J. de Vries, Mariët Hagedoorn, Sandra Brouwer

Research output: Contribution to JournalArticleAcademicpeer-review


Purpose: To determine the efficacy of the “Training for Occupational health physicians To Involve Significant others” (TOTIS) e-learning module for improving occupational health physicians’ (OHPs) knowledge, attitudes, and self-efficacy regarding involving significant others in the return-to-work process. Materials and methods: A randomized controlled trial with 87 OHPs, involving an intervention group and a wait-listed control group. Between-group differences in knowledge, attitude, and self-efficacy outcomes, and retention of effects were assessed using ANOVA and paired t-tests. Reactions to the e-learning module were analyzed with descriptive statistics and thematic analysis. Results: We found moderate to large effects on OHPs’ knowledge (p < 0.001, η p2 = 0.202), attitudes (p = 0.003, η p2 = 0.098), and self-efficacy (p < 0.001, η p2 = 0.237), with retention of all changes at 10-week follow-up. OHPs graded the e-learning module with a mean score of 7.9 out of 10 (SD = 1.11) and indicated that the module increased their awareness of the role of significant others and encouraged them to address this more often. Conclusions: The TOTIS e-learning module and accompanying materials are valuable resources for OHPs to learn how significant others influence work outcomes of workers with chronic diseases and to manage their involvement in the re-integration process. Trial registration: This study is registered in the Netherlands Trial Register under trial number NL8744; for rehabilitation The TOTIS e-learning module is the first evidence-based training to improve the knowledge, attitudes, and self-efficacy of occupational health physicians with regard to involving significant others in the re-integration process of workers with chronic diseases. The e-learning module and accompanying tools can increase the awareness of occupational health physicians about the role of significant others and encourage them to address the role of significant others in the re-integration process of sick-listed workers. It could be beneficial to expand on the e-learning module with a face-to-face training program involving group interaction, peer discussion, and skills development.

Original languageEnglish
JournalDisability and rehabilitation
Early online date2022
Publication statusE-pub ahead of print - 2022


  • Occupational health physicians
  • chronic disease
  • continuing medical education
  • randomized controlled trial
  • return to work

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