Feasibility study of a revised intervention for addressing student sickness absence: a qualitative evaluation

In the Netherlands, Youth Health Care (YHC) physicians expanded upon the implementation of the Medical Advice for Sick-reported Students (MASS) intervention by introducing a MASS YHC procedure involving a multidisciplinary team. This study examines the feasibility of the revised intervention.

The study was conducted between September 2023 and June 2024. Qualitative data were gathered using 10 homogeneous focus groups with 42 key users (25 YHC and 17 school professionals). The study was guided by the Measurement Instrument for Determinants of Innovations framework using deductive thematic analysis in Atlas.ti.

The revised MASS YHC procedure was well understood once its changes were clarified. School and YHC professionals reported that allocating care and requesting absence consultations following a school's Care Advisory Team meeting had become more streamlined. New information materials supported the communication with parents and colleagues. School professionals generally accepted the procedural adjustments but questioned the added value of jointly assigning care with parents and involving non-physician YHC disciplines in absence consultations; they felt capable of selecting YHC disciplines themselves. According to YHC professionals, calling parents to assign care and schedule consultations reduced no-shows and made absence consultations smoother and more effective. When absence consultations involved students who were not enrolled at the YHC professional's affiliated school, communication within the YHC and with school professionals became more challenging. Most YHC professionals valued the multidisciplinary case discussions for enhancing advisory plans through diverse insights and shared experiences, which also fostered job satisfaction and a sense of shared responsibility. However, some YHC physicians viewed team meetings as a means of oversight rather than support. All professionals considered the focus group sessions to be helpful for staying informed about the implementation progress, exchanging barriers and success factors, and clarifying the reasoning behind adjustments.

The MASS YHC procedure was well-equipped for implementation following process refinement and the development of support materials. Parental involvement in care allocation was perceived to reduce no-shows and smoothen absence consultations. Multidisciplinary case discussions were perceived to enhance knowledge and job satisfaction. Ongoing, guided implementation with evaluation is crucial to prevent implementation failure due to local adaptations or misinterpretations.