RETAIN Program for Work-related Injuries

(MN RETAIN Trial)

Overseen By Samantha Westphal, RN, BSN, PHN, CLMS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mayo Clinic

Disqualifiers: Legal issues, Informed consent, RETAIN employees, Workers' comp, SSDI/SSI, Self-employed

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate how the RETAIN program (Minnesota Retaining Employment and Talent After Injury/Illness Network) can assist individuals in staying at work or returning to work after an injury or illness. Participants will either work with a dedicated case manager and access career resources or receive a job services handout. The trial is open to Minnesota residents who have been unable to work for at least four weeks due to a work-related or personal injury or illness. It is particularly suitable for those recently out of work and in need of job-related support. As an unphased trial, this study provides a unique opportunity for participants to access valuable support and resources to aid their return to work.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your healthcare provider.

What prior data suggests that the RETAIN program is safe for workforce retention and reduction of workplace disability?

Research shows that the RETAIN Program helps workers stay at or return to work after an injury or illness. It emphasizes early intervention, assisting people in returning to work as soon as it is safe. Studies have shown that these strategies improve outcomes for workers, enabling them to continue their jobs or find new ones if necessary.

As the program focuses on support and guidance rather than medical treatment, reports of physical side effects or negative reactions, common in drug trials, are absent. Instead, the program provides resources and case managers to assist workers in their return to work. This indicates the program is well-tolerated, offering support rather than medical interventions. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the RETAIN Program because it offers a personalized approach to helping individuals return to work after an injury. Unlike traditional methods that might only provide generic resources, this program assigns each participant a dedicated Return-to-Work Case Manager from Minnesota. This personalized support is supplemented with referrals to additional career and workforce development resources when needed, ensuring a comprehensive and tailored recovery pathway. This individualized attention could lead to more effective and faster reintegration into the workforce, which is why it holds promise compared to standard options.

What evidence suggests that the RETAIN Program is effective for improving workforce retention and reducing workplace disability?

Research has shown that the RETAIN Program helps workers return to their jobs or stay employed after an injury or illness. In this trial, participants in the Intervention Group will receive a dedicated Minnesota RETAIN Return-to-Work Case Manager and access to additional career and workforce development resources. Studies have found that the program's early support strategies can help keep people in their jobs and reduce future work-related disabilities. Early data suggests that people in the program use more services and have better job outcomes compared to those in the Control Group, who receive a handout with additional job-related services. Overall, the evidence supports the program's success in helping workers return to work sooner and remain employed. ^{1 4 5 6 7}

Who Is on the Research Team?

Laura Breeher, MD, MPH

Principal Investigator

Mayo Clinic

Clayton Cowl, MD,MS

Principal Investigator

Mayo Clinic

Are You a Good Fit for This Trial?

The Minnesota RETAIN Phase 2 trial is for Minnesota residents who have had or will have surgery affecting their work within the last 12 weeks or next 8 weeks. Participants must have worked in MN at least one day in the past 3 months, be over 18, and employed or active in the labor force. It's not for those with worker's comp having a QRC/DCM, involved in related litigation, unable to consent, employed by certain organizations with return-to-work programs, or on SSDI/SSI.

Inclusion Criteria

Employed or currently in the labor force

Has worked at least one day within the last 3 months (80% or more of participants)

Has worked at least one day greater than 3 months but less than 6 months prior (up to 20% of participants)

Exclusion Criteria

Legal representation/litigation at the time of enrollment related to the medical condition

I am unable to understand and give consent for treatment.

I work for a RETAIN healthcare recipient with a return-to-work program.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants are assigned a dedicated Minnesota RETAIN Return-to-Work Case Manager and referred for additional career and workforce development resources as needed

12 months

Follow-up

Participants are monitored for workforce retention and reduction of workplace disability

12 months

Long-term Follow-up

Participants are monitored for long-term work disability reduction

5 years

What Are the Treatments Tested in This Trial?

Interventions

• RETAIN Program

Trial Overview This study tests the RETAIN program aimed at helping employees stay at work or return after an injury or illness. It's a randomized control trial assessing if this program can reduce workplace disability and improve workforce retention through early intervention practices implemented by various partners including Mayo Clinic and state departments.

How Is the Trial Designed?

Group I: Sub Study Group Experimental Treatment 1 Intervention

Individuals will be assigned a dedicated Minnesota RETAIN Return-to-Work Case Manager. Intervention group participants will be referred for additional career and workforce development resources when needed.

Group II: Intervention Group Experimental Treatment 1 Intervention

Individuals will be assigned a dedicated Minnesota RETAIN Return-to-Work Case Manager. Intervention group participants will be referred for additional career and workforce development resources when needed.

Group III: Control Group Active Control 1 Intervention

Individuals will receive a handout with additional job related services; e.g. Job Accommodation Network.

Who Is Running the Clinical Trial?

Mayo Clinic

Lead Sponsor

Trials

3,427

Recruited

3,221,000+

Minnesota Department of Employment and Economic Development

Collaborator

Trials

1

Recruited

5,200+

Minnesota Department of Health

Collaborator

Trials

9

Recruited

179,000+

Mathematica Policy Research

Collaborator

Trials

1

Recruited

5,200+

United States Department of Labor

Collaborator

Trials

1

Recruited

5,200+

Minnesota Department of Labor and Industry

Collaborator

Trials

1

Recruited

5,200+

United States Social Security Administration

Collaborator

Trials

2

Recruited

8,200+

Workforce Development, Inc.

Collaborator

Trials

2

Recruited

8,400+

Published Research Related to This Trial

In the Ontario Life After Workplace Injury Study, 40% of eligible workers with work-related injuries participated in an 18-month follow-up, revealing that 61% were still employed by their original employer, while 23% were not working at all.

Preliminary data showed that longer durations of disability claims were associated with poorer health outcomes and function, highlighting the need for targeted interventions to support these workers' recovery and return to work.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cohort profile: the Ontario Life After Workplace Injury Study (OLAWIS). Mustard, C., Nadalin, V., Carnide, N., et al.[2021]

The Vocational Improvement Project, a 5.5-year pilot program in Washington State, successfully reduced repeat referrals and delays in vocational rehabilitation for injured workers, while also increasing worker choice and establishing partnerships to enhance outcomes.

Despite these improvements, challenges remain, as retraining plan completion rates are below 60% and only half of the workers earned wages within two years after completing their plans, indicating a need for further enhancements in the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving vocational rehabilitation services for injured workers in Washington State. Sears, JM., Wickizer, TM., Schulman, BA.[2022]

The articles highlight the potential for early intervention strategies to help workers with medical conditions avoid prolonged work disability, based on analyses of disability claims data and case studies from 50 employers.

By improving systems to identify and support these workers promptly, stakeholders can significantly influence their job retention and overall outcomes, suggesting a need for evidence-based interventions in the workplace.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Opportunities for Early Intervention to Avoid Prolonged Work Disability: Introduction to the Special Section. Ben-Shalom, Y., Schimmel Hyde, J.[2019]

A study of 1850 patients with chronic disabling occupational musculoskeletal disorders found that older age, female sex, and extreme disability at admission were significant predictors of failing to retain work one year after treatment.

Other notable risk factors included nonworking status at discharge, antisocial personality disorder, receiving government disability benefits, and dependence on opiate pain medications, which can help tailor individualized treatment plans for better outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prediction of failure to retain work 1 year after interdisciplinary functional restoration in occupational injuries. Brede, E., Mayer, TG., Gatchel, RJ.[2012]

A ten-year study in a public utility company with over 5300 employees showed that implementing quality-based diagnostic and treatment protocols led to a 55% reduction in days lost from work and a 51% decrease in new injuries reported.

The program also resulted in a 67% decrease in surgeries performed, a significant increase in surgical success rates, and a cumulative savings of over 4.1 million dollars in lost time and replacement wages, highlighting the effectiveness of quality care in reducing costs and improving outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A quality-based protocol for management of musculoskeletal injuries. A ten-year prospective outcome study. Wiesel, SW., Boden, SD., Feffer, HL.[2005]

The RETAIN Kentucky program, funded by the U.S. Department of Labor, aims to help individuals with non-work-related injuries and illnesses return to work or stay employed, utilizing RTW Coordinators for support.

After nearly 3 years of Phase 1, the program is transitioning to Phase 2, which will last 30 months and build on the insights gained to improve employment retention strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

RETAIN Kentucky: A return-to-work and stay-at-work program for people with disabilities grounded in the conservation of resources theory. Rumrill, P., Sheppard-Jones, K., Collett, JW., et al.[2022]

The study presents a new framework for analyzing how health service spending and utilization in work disability management varies across different regions and settings, emphasizing the importance of high-quality healthcare access for effective disability management.

By identifying predisposing, enabling, workplace environment, and need-based factors, the framework aims to help researchers and policymakers understand and improve health care delivery within work disability management systems, particularly in Canada.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Framework for Understanding How Variation in Health Care Service Delivery Affects Work Disability Management. Sharpe, K., McGrail, K., Mustard, C., et al.[2022]

A survey of 1833 workers with soft-tissue injuries in Ontario revealed that while 66% were contacted by their workplace, only 36% were offered modified work arrangements to aid their return after injury.

The most common modifications included reduced hours (24%), flexible hours (25%), and lighter duties (57%), but these temporary changes did not significantly impact the duration of compensation benefits, although offers of arrangements did correlate with shorter benefit durations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Modified work: prevalence and characteristics in a sample of workers with soft-tissue injuries. Brooker, AS., Cole, DC., Hogg-Johnson, S., et al.[2019]

Returning to work after an injury generally leads to better health outcomes, while unnecessary time off can worsen overall health, benefiting employers, employees, and insurers alike.

Disability duration guidelines, such as those outlined in 'The medical disability advisor--Workplace guidelines for disability duration,' are essential for facilitating a fair and evidence-based return to work process among all stakeholders involved.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Return to work management of people with temporary disability]. Okreglicka, M.[2011]

Patients in a hospital-based pain treatment program showed significant improvements, including reduced use of analgesics and fewer hospitalizations and surgeries, compared to those denied treatment by their workers' compensation insurance.

The study, which followed 63 treated patients and 37 untreated patients over 18 months, found that those who received pain treatment were more likely to return to work, highlighting the clinical and cost-effectiveness of such programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pain clinic #13. Comprehensive pain center treatment of low back workers' compensation injuries. An industrial medicine clinical outcome follow-up comparison. Tollison, CD., Kriegel, ML., Satterthwaite, JR., et al.[2011]

Citations

1. mnretain.com mnretain.com/

Home - MN RETAIN The Retaining Employment and Talent after Injury/Illness Network (RETAIN) helps workers stay at or return to work when an injury or illness impacts employment.

2. mathematica.org mathematica.org/publications/retain-demonstration-impacts-two-months-after-enrollment

The Retaining Employment and Talent After Injury/Illness ... This report presents the five RETAIN programs' early impacts on enrollee service use, employment, and health; it is the first of two reports on ...

3. mnphy.com mnphy.com/1223-cover-one-deb-zurcher

The MN Retain Study - Minnesota Physician April 2025 Issue The Minnesota RETAIN program's primary goal is to provide early intervention strategies for workers to stay at work or return to work as soon as medically ...

4. journals.sagepub.com journals.sagepub.com/doi/10.1177/10519815241290331

Mn RETAIN: An early intervention model to identify and ... MN RETAIN collects numerous data points to help evaluate the effectiveness of the intervention. Included among these data are demographic ...

5. clinicaltrials.gov clinicaltrials.gov/study/NCT05146349?term=retain&viewType=Table&rank=1

NCT05146349 | Minnesota RETAIN Impact Evaluation This study is a randomized control trial (RCT) to evaluate the impact of RETAIN program expansion and services on workforce retention and reduction of future ...

6. mn.gov mn.gov/deed/programs-services/dislocated-worker/mn-retain/

Minnesota RETAIN Minnesota RETAIN aims to help workers return to work after injury/illness, and assists those who cannot be accommodated in their regular job.

7. dol.gov dol.gov/agencies/odep/initiatives/saw-rtw/retain

Retaining Employment and Talent After Injury/Illness ... RETAIN programs implement early intervention strategies to improve stay-at-work/return-to-work (SAW/RTW) outcomes of individuals who experience a work ...