Assessing the return-to-work mode of precarious workers with mental health issues: reliability, validity, and usability of the REMODE-tool

Mental health issues are highly prevalent among precarious workers, often leading to prolonged sickness absence and unemployment. A worker's perceptions and attitudes about return-to-work are important determinants of work resumption and can be categorized into three modes: an expectant, an ambivalent-uncertain, and an active return-to-work mode. To support professionals in identifying these modes, we developed the REturn-to-work MODe Evaluation (REMODE) tool. This study evaluated REMODE's inter-rater agreement, inter-item consistency, content validity, and usability. In a vignette study, 71 occupational health professionals from a Dutch social security institute viewed six videos of consultations between insurance physicians and precarious workers. They then used REMODE to assess the worker's return-to-work mode and need for occupational support. Participants also rated REMODE's validity and usability with 5-point Likert scale questions based on the Content Validity Index and System Usability Scale. We used a generalized linear mixed model to analyse inter-rater agreement and inter-item consistency. The professionals highly agreed on the REMODE-score [ICC 0.87 (95% CI 0.63-0.97)] and corresponding return-to-work mode [ICC 0.83 (0.54-0.95), Κω 0.75 (0.74-0.75)]. Their agreement on need for occupational support was moderate [ICC 0.65 (0.30-0.89), Κω 0.57 (0.56-0.57)]. REMODE's internal consistency demonstrated excellence (Cronbach's alpha 0.92), and the content validity index (0.83) and system usability scale (76) were acceptable. REMODE is a promising tool for occupational health professionals as it supports identification of the return-to-work mode of precarious workers with mental health issues. We propose a refined version of RE-MODE for use in occupational healthcare and research.