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WB6Dim-LTSA: Can Workplace Well-Being Scores Predict Collective Absenteeism? (WB6Dim-LTSA)

17 maggio 2026 aggiornato da: Clover Link

Predictive Value of the Adaptive Load Index (ICA) Derived From the WB6Dim Instrument on Collective Absenteeism Rates at a 6-Month Horizon: A Prospective Multicenter Cohort Study

This prospective multicenter cohort study evaluates the predictive value of the Adaptive Load Index (ICA), a composite indicator derived from the WB6Dim well-being instrument, on long-duration sick leave (≥ 30 days) in French companies at a 6-month horizon. In France, 7% of sick leave episodes (those exceeding 6 months) account for 45% of total sickness benefit expenditure (Cour des Comptes 2024). Group disability insurance charges rose +24.4% in 2024 (France Assureurs 2025). Critically, a substantial proportion of long-duration sick leave occurs without prior escalation in administrative absence data - the 'cliff effect' - where presenteeism masks progressive deterioration (Gustafsson & Marklund 2011). Prediction models based solely on absence history plateau at AUC 0.65 for cumulative days (Roelen 2013), while composite psychometric instruments reach C-index 0.73-0.74 (Airaksinen et al. 2018, SJWEH). The WB6Dim is a validated 28-item psychometric tool measuring 9 dimensions of workplace well-being (NCT07301879, NCT07433764; test-retest ICA .904). The ICA classifies respondents into 4 adaptive load levels. Aggregated at the company level, the ICA distribution may detect deterioration during the presenteeism window, before costly sick leave materializes. The study collects 4 WB6Dim assessments over 6 months alongside company-level absence data stratified by duration (2024-2026) and individual self-reported absence data (duration and episode count). Six pre-registered hypotheses test whether ICA predicts long-duration leave, including an exploratory hypothesis targeting companies with no prior absence signal but degraded well-being scores.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Descrizione dettagliata

BACKGROUND: In France, sickness benefit expenditure reached 10.2 billion euros in 2023, up 28% since 2019 (DREES/CNAM, Études & Résultats n°1321, 2024). The cost distribution follows a Pareto pattern: 7% of sick leave episodes (those exceeding 6 months) generate 45% of total expenditure (Cour des Comptes, RALFSS 2024). For group disability insurers (prévoyance collective), the pressure is acute: charges for incapacity-disability-dependence rose +24.4% in 2024, long-duration indemnified days increased +31% since 2020, and the claims-to-premiums ratio deteriorated to 56.9% (France Assureurs 2025). These 7% of episodes are the primary cost driver, yet current identification relies on retrospective administrative data - the signal arrives after the damage is done. The literature identifies two pathways to long-duration sick leave: (1) escalation from repeated short absences (≥3 episodes/year, RR 1.5-2.5; Koopmans 2008, Hultin 2012, Roelen 2018, Sørensen et al. 2025), where administrative data detect the pattern but often too late for effective prevention; and (2) the 'cliff effect' - sudden onset without prior absence signal, driven by prolonged presenteeism masking progressive deterioration (Gustafsson & Marklund 2011, Ahola 2009, López-Bueno & Clausen 2021). Administrative data are entirely blind to the second pathway. Composite psychometric instruments can detect risk during the presenteeism window: they reach C-index 0.73-0.74 vs 0.65 for absence-only models (Airaksinen et al. 2018; Roelen 2013), and combining questionnaire + administrative data reaches C-index 0.79 (Nyberg et al. 2023).

The WB6Dim (Well-Being 6 Dimensions) is a 28-item digital psychometric instrument assessing 9 well-being dimensions, validated on 808 participants across 4 cohorts with 2 pre-registered protocols (NCT07301879, NCT07433764). All 19 convergent validity hypotheses were confirmed against 10 international gold-standard scales (PSS-10, WHO-5, CBI, ISI-7, RSES, SAS-SV, MSPSS, UCLA-3, CFQ-13, BPNS). The test-retest reliability (ICA) reached .904 (excellent). The Adaptive Load Index (ICA) classifies each respondent into 4 levels: low-to-moderate load, high load, very high load, and critical load. The Environmental Attentional Dysregulation (DAE) further characterizes the dominant source of strain (internal, digital, relational, or mixed). No published study has tested the predictive value of a composite well-being index, measured at the collective level, on sick leave ≥30 days - the threshold triggering group disability insurance benefits.

DESIGN: Prospective multicenter cohort study with 4 measurement waves over 6 months (June-November 2026). The unit of analysis is the company (collective level). No individual diagnosis or prognosis is delivered. Data sources include: (1) company-level HR data on absenteeism stratified by duration (aggregated, anonymized) for 2024, 2025, and 2026; (2) individual self-reported absence integrated into the WB6Dim at T0, T2, and T3. The study includes two analytical components: a retrospective analysis correlating T0 WB6Dim scores with 2024-2025 absenteeism, and a concurrent analysis testing whether T0-T2 trajectories predict T2-T3 absenteeism. Six pre-registered hypotheses are tested, including an exploratory hypothesis (H6) targeting the added value of ICA for companies with no elevated absence history but degraded well-being scores - directly testing whether the WB6Dim can identify the costly 7% before administrative data show any signal.

Tipo di studio

Osservativo

Iscrizione (Stimato)

2000

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Luoghi di studio

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto
  • Adulto più anziano

Accetta volontari sani

Sì

Metodo di campionamento

Campione non probabilistico

Popolazione di studio

Employees of French companies with 50 or more employees, recruited through employer participation agreements. Companies are sourced through occupational health networks and direct outreach. All employees meeting inclusion criteria within participating companies are eligible regardless of job type, contract status, or health condition.

Descrizione

Inclusion Criteria:

  • Employee of a participating French company (≥ 50 employees)
  • Age 18 years or older
  • Access to a smartphone or computer to complete the digital questionnaire
  • Electronic informed consent provided at baseline

Exclusion Criteria:

  • Refusal to participate or withdrawal of consent
  • Inability to complete the questionnaire in French

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

Coorti e interventi

Gruppo / Coorte
Multi-company workforce cohort
Single-cohort design. All participants receive the same observational protocol: 4 WB6Dim assessments over 6 months. The predictive analysis is conducted at the company level, comparing companies above versus below the sample median of collective critical ICA proportion at T0. No group assignment is made at the individual level. Stratification is performed post-hoc based on observed ICA distributions.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Company-level incidence rate of sick leave episodes ≥ 30 days over 6 months, as measured from aggregated HR records
Lasso di tempo: 6 months post-enrollment
Company-level incidence of sick leave episodes lasting 30 days or more, measured from aggregated HR data provided by each participating company for the period June-November 2026. This threshold marks the transition from short-term to long-term sickness absence in the French social security system and is associated with sharply reduced return-to-work probability.
6 months post-enrollment

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Company-level incidence rate of sick leave episodes ≥ 90 days over 6 months, as measured from aggregated HR records
Lasso di tempo: 6 months post-enrollment
Company-level incidence of sick leave episodes lasting 90 days or more, corresponding to long-term illness (affection de longue durée) classification and elevated risk of permanent disability transition.
6 months post-enrollment
Number of employees with ≥ 3 distinct absence episodes within 6 months per company, as measured from aggregated HR records
Lasso di tempo: 6 months post-enrollment
Company-level count of employees with 3 or more distinct absence episodes within a 6-month period. Repeated short absences are an established early marker of subsequent long-duration leave (Koopmans 2008, RR=1.9; Hultin 2012, OR=2.0).
6 months post-enrollment
Self-reported cumulative absence duration and episode count, as measured by WB6Dim questionnaire items
Lasso di tempo: Baseline, 3 months, and 6 months post-enrollment
Self-reported work absence collected via two items in the WB6Dim questionnaire. Item 1: cumulative duration (0 / 1-7 days / 8-30 days / 31-90 days / >90 days). Item 2: number of separate episodes (0 / 1 / 2 / 3+). Each assessment covers the period since the previous measurement.
Baseline, 3 months, and 6 months post-enrollment
Change in collective ICA distribution from baseline to 3 months as a predictor of sick leave ≥ 30 days between 3 and 6 months
Lasso di tempo: Baseline and 3 months (predictor); 3 to 6 months post-enrollment (outcome)
Change in collective ICA distribution between baseline and 3 months (slope of degradation) as a predictor of sick leave ≥ 30 days observed between 3 and 6 months post-enrollment. Tests whether longitudinal worsening of collective well-being adds predictive value beyond static baseline measurement.
Baseline and 3 months (predictor); 3 to 6 months post-enrollment (outcome)
Change in predictive model AUC when adding DAE profile distribution to the ICA-based model for sick leave ≥ 30 days
Lasso di tempo: 6 months post-enrollment
Improvement in predictive model discrimination (AUC) when adding DAE profile distribution (internal, digital, relational, mixed) to the ICA-based model. Tests whether characterizing the dominant source of strain improves identification of at-risk companies beyond overall load level.
6 months post-enrollment
Agreement (Cohen's kappa) between aggregated self-reported absence and company-level HR absence data, stratified by duration class
Lasso di tempo: 6 months post-enrollment
Agreement between aggregated individual self-reports and company-level HR data, assessed using Cohen's kappa at the company level. Stratified by duration class. Validates the use of self-reported absence as a complementary data source when HR records are unavailable.
6 months post-enrollment

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Clover Link

Investigatori

  • Cattedra di studio: Frédérique RETORNAZ, MD, PhD, European Hospital, Unit of Care and Research in Internal Medicine and Infectious Diseases.

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Collegamenti utili

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 giugno 2026

Completamento primario (Stimato)

15 novembre 2026

Completamento dello studio (Stimato)

30 novembre 2026

Date di iscrizione allo studio

Primo inviato

17 maggio 2026

Primo inviato che soddisfa i criteri di controllo qualità

17 maggio 2026

Primo Inserito (Effettivo)

26 maggio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

26 maggio 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

17 maggio 2026

Ultimo verificato

1 maggio 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • WB6DIM-LTSA-2026-01

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Descrizione del piano IPD

Individual participant data will not be shared. The study analyzes company-level aggregated indicators only. No individual diagnosis or prognosis is delivered. Sharing individual-level data would conflict with GDPR requirements and the anonymization commitments made to participants and employers in the informed consent. De-identified, aggregated company-level datasets may be made available to qualified researchers upon reasonable request and approval by the data protection officer.

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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