Informal Caregivers at Work - Phase 2 (PPJob-II)

Mental Health and Occupational Outcomes Among Informal Caregivers at Work - a Danish Nationwide Register-based Cohort Study

Mental health problems are rising among children and adolescents. This may not only impact the child's level of daily functioning but also close family members. Informal caregiving is defined as unpaid care for a sick, disabled, or other closely related person. Providing long-term informal care has been associated with detrimental stress-related outcomes, and being simultaneously active in the labor market has been highlighted as an increased burden for the caregiver. Workplaces are poorly suited for dealing with private stressors despite their potential negative consequences for the caregiver's job status and health. There is a need for improving understanding of how long-term informal caregiving impacts job and health outcomes, as well as for measures minimizing potential negative consequences among at-risk occupational groups.

Study Overview

• Status: Active, not recruiting
• Conditions: Work-Related Stress
• Intervention / Treatment: Other: Primary informal caregiver at work.

Detailed Description

This Danish nationwide observational cohort study examines the associations between employees being a primary informal caregiver for a child or adolescent with mental health problems and the employees' occupational and health outcomes. In addition, we seek to identify modifying psychosocial risk factors at work as well as at-risk occupational groups. The study relies on pre-existing longitudinal data extracted from Danish national registers, including highly reliable information on occupational status, birth information, residence, public transfer payments, income, psychiatric treatment and services, treatment for substance abuse, psychotropic prescription drugs redeemed, as well as background information. In Denmark, all citizens are assigned with a unique identification number enabling merging of national register data included. Caregiver-child relationships are established based on merging of data from birth and household registers. In this study, register data are further merged with information on psychosocial work environment based on national survey data. All data are located at Statistics Denmark, and accessed and analyzed via a logged, secured platform, The Danish Occupational Cohort (DOC*X) (www.DOC-X.dk). Exposed employees are compared to a reference group of employees without mental health problems at the familiy level matched according to age group, gender (female/male), and socio-occupational status.

• Study Type: Observational
• Enrollment (Actual): 4386647

Contacts and Locations

Study Locations

• Denmark
  • Valby, Denmark, 2500
    • Team Working Life Denmark

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

This is a nationalwide register-based study of occupational and mental health outcomes of all adult caregivers to children with and without mental health problems.

Description

Inclusion Criteria:

• Children/adolescents: Citizens aged 0-25 years in the period between 2000 and 2018. Mental disorder is indicated by redeeming of psychotropic medication, treatment for substance abuse, and psychiatric services. Children of reference adult caregivers is defined by having no personal history of a mental disorder. We exclude children born outside of Denmark.
• Adults: Citizens aged 18-67 years residing in Denmark, partaking in the work force in the period between 2000-2008, and living with a child in the household at any time until the child's 18th year or being a parent to a child at its birth.

Exclusion Criteria:

• We exclude all citizens born in the Faroe Islands and in Greenland. We exclude all citizens residing in the Faroe Islands and in Greenland in the period between 2000 and 2018.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Danish citizens; All citizens aged 0-25 years and all adults aged 18-67 years residing in Denmark in the period from 2000 to 2008.	Other: Primary informal caregiver at work.; Employees becoming a primary informal caregiver for a child or an adolescent with mental health problems in the period from 2000 to 2018.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Personal gross income (Level of analysis: primary informal caregiver)	Personal gross income is analyzed as series of annual statuses.	Up to 10 years of follow-up.
Employment (Level of analysis: primary informal caregiver).	Employment is analyzed as series of annual statuses (i.e., number of weeks employed within each year during follow-up).	Up to 10 years of follow-up.
Long-term sickness absence (Level of analysis: primary informal caregiver).	Long-term sickness absence is analyzed as time-to-event from baseline on the week scale.	Up to 10 years of follow-up.
Mental health (Level of analysis: primary informal caregiver).	Mental health is analyzed as time-to-event from baseline on the week scale whichever comes first: redeemed psychotropic drug prescriptions, treatment for substance abuse or psychiatric hospital services.	Up to 10 years of follow-up.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Moderation of potential associations by psychosocial work environment (Level of analysis: primary informal caregiver)	Moderation of potential association by psychosocial work environment is based on age- and sex-specific job-exposure matrices (JEM).	JEMs were composed of national survey data collected in 2000 and 2005.
Moderation of potential associations by occupational group (Level of analysis: primary informal caregiver).	Moderation by occupational group is based on DISCO-88 codes (International Standard Classification of Occupation, Danish version 1988).	Annual data in the period between 2000 and 2018.

Collaborators and Investigators

• Sponsor: Team Working Life Denmark
• Collaborators: National Research Centre for the Working Environment, Denmark; Bispebjerg Hospital; Herlev and Gentofte Hospital; HMW Health and Communication
• Investigators: Principal Investigator: Johan H Jensen, PhD, Team Working Life Denmark; Principal Investigator: Johan H Jensen, PhD, Occupational and Environmental Medicine, Copenhagen University Hospital - Bispebjerg & Frederiksberg

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2023
• Primary Completion (Estimated): December 31, 2024
• Study Completion (Estimated): December 31, 2025

Study Registration Dates

• First Submitted: May 21, 2024
• First Submitted That Met QC Criteria: May 28, 2024
• First Posted (Estimated): June 4, 2024

Study Record Updates

• Last Update Posted (Estimated): June 4, 2024
• Last Update Submitted That Met QC Criteria: May 28, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Keywords: Mental health issue; Work-related illness; Loss of career progression
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Occupational Diseases; Occupational Stress
• Other Study ID Numbers: TeamWorkingLifeDenmark

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

IPD Plan Description

Statistics Denmark's extensive collections of registers contain a significant potential for research and analysis.

In order to use this research and analysis potential in accordance with the current register legislation and Statistics Denmark's data confidentiality principles, Statistics Denmark has established special micro-data schemes (Research Scheme, Authority Scheme and Legislative Model).

Through the micro-data schemes, microdata (i.e. individual/single company data) is made available for specific research, investigation and analysis tasks for authorised research/analysis environments. Foreign research/analysis environments cannot be authorised for the scheme, but under certain conditions, foreign users can access data.

Further information: https://www.dst.dk/en/TilSalg/Forskningsservice/Dataadgang

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No