Presentation M O35

M O35 (Oral Presentation):
Effect of Peer-Based Low Back Pain Information and Reassurance at the Workplace on Sick Leave: A Cluster Randomized Trial

Presented by: Torill Helene Tveito


Odeen M1, Ihlebæk C5, Indahl A1,2,3, Wormgoor MEA2, Lie SA1,4, Eriksen HR1,3

  1. Uni Research Health, Bergen, Norway
  2. Clinic of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway
  3. Department of Health Promotion and Development, University of Bergen, Norway
  4. Department of Public Health and Primary Health Care, University of Bergen, Norway
  5. Department of Landscape Arch. and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway



High levels of sick leave and disability benefits are costly for the individual, the organization, and society. Musculoskeletal pain is one of the most common causes of sick leave and disability, and low back pain the most common single diagnosis within this group. A workplace intervention aimed at reduction of sick leave and disability from low back pain (LBP) was developed from a clinical intervention previously shown to be effective in reducing sick leave in LBP patients; and was based on the Cognitive Activation Theory of Stress, a non-injury model of LBP, and a non-directive social support model for transfer of knowledge. The intervention focused on conveying evidence based up-to-date information on LBP, aiming to prevent negative consequences rather than preventing the LBP in itself. The aim of the study was to evaluate if information and reassurance about LBP presented at the workplace could reduce sick leave.


A cluster randomized controlled trial with 135 work units of about 3,500 employees in two Norwegian municipalities, randomized into two intervention groups; Education and peer support (EPS) (n = 45 units), education and ‘‘peer support plus access to an outpatient clinic’’ (EPSOC) (n = 48 units), and a control group (n = 42 units). Both interventions consisted of educational meetings and a ‘‘peer adviser’’ appointed by colleagues. Employees in the EPSOC group had access to an outpatient clinic for medical examination and further education. The control group received no intervention. Main outcome was sick leave from municipal records. Secondary outcomes were pain, pain related fear of movement, coping, and beliefs about LBP from 1,746 employees (response rate about 50 %).


EPS reduced sick leave by 7 % and EPSOC reduced sick leave by 4 % during the intervention year, while sick leave in the control group was increased by 7 % during the same period. Overall, Rate Ratios (RR) were statistically significant for EPSOC (RR = .84 (C.I = 0.71–.99) but not EPS (RR = .92 (C.I = 0.78–1.09)) in a mixed Poisson regression analysis. Faulty beliefs about LBP were reduced in both intervention groups.


Educational meetings, combined with peer support and access to an outpatient clinic, were effective in reducing sick leave in public sector employees.

Schedule Details

Monday September 29
15:45 - 17:15 Afternoon Concurrent Sessions (M O25 - M O37 and Seminar 3)
Session: Return to work process
Room B