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

17 mei 2026 bijgewerkt door: 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.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Gedetailleerde beschrijving

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.

Studietype

Observationeel

Inschrijving (Geschat)

2000

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Ja

Bemonsteringsmethode

Niet-waarschijnlijkheidssteekproef

Studie Bevolking

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.

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

Cohorten en interventies

Groep / Cohort
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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Company-level incidence rate of sick leave episodes ≥ 30 days over 6 months, as measured from aggregated HR records
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Company-level incidence rate of sick leave episodes ≥ 90 days over 6 months, as measured from aggregated HR records
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Clover Link

Onderzoekers

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

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Nuttige links

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 juni 2026

Primaire voltooiing (Geschat)

15 november 2026

Studie voltooiing (Geschat)

30 november 2026

Studieregistratiedata

Eerst ingediend

17 mei 2026

Eerst ingediend dat voldeed aan de QC-criteria

17 mei 2026

Eerst geplaatst (Werkelijk)

26 mei 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

26 mei 2026

Laatste update ingediend die voldeed aan QC-criteria

17 mei 2026

Laatst geverifieerd

1 mei 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • WB6DIM-LTSA-2026-01

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Beschrijving IPD-plan

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.

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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