Gärtner 2013.

Methods	Cluster‐RCT, Netherlands
Participants	Nurses on wards of an academic hospital were screened for work and health problems: Experimental: 29 wards, 591 participants of which 151 screened positive Control: 28 wards, 561 participants of which 161 screened positive. Experimental: 17% Control 22% men, > 45 years age Experimental 51% Control 46%, > 10 years of experience Experimental 51% Control 41%
Interventions	1) Experimental: All who screened positive were referred to Occupational Health Physician (OHP). Participants who were screened as positive were invited for a face‐to‐face preventive consultation with their occupational physician. The consultation was voluntary, and workers could reschedule or cancel it if they wished. Supervisors were not informed about the screening results or about the invitation for and content of the preventive consultation of any employee. The 7‐step protocol for OHPs closely followed occupational physicians’ care as usual for consultations initiated by the employee in contrast to the compulsory consultation in the context of absenteeism. Occupational physicians received 3 hours of training from the researchers on the use of the protocol. (CBT) 2) Control: Waiting list: In the control arm. Participants filled out the baseline questionnaire; however, results of the screening‐questionnaires were not to be reported back to participants, and no further interventions were advised at baseline. As compensation, participants in the control arm received their personal screening results together with a tailored choice for a self‐help EMH intervention six months after baseline.
Outcomes	The study's primary outcome was help‐seeking behaviour; we used secondary outcomes: distress from the Dutch 4DKL, anxiety and depression from Brief Symptom Inventory
Notes	We got the following data for the distress scale of the 4DKL at 6 months follow‐up for the group who screened positive from author K Nieuwenhuijsen: Experimental: N = 86 6.24 ± 6.52 Control: N = 116 6.82 ± 6.57
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	" Randomization was performed at the ward level (n = 86). Randomization sequences with a block size of three were generated with Nquery Advisor (Statistical Solutions, Ltd, Cork, Ireland) by one researcher (K.N.) who was not involved in the recruitment"
Allocation concealment (selection bias)	Unclear risk	Not blinded
Blinding (performance bias and detection bias) All outcomes	High risk	Providers not blinded, outcome self‐reported measures of stress
Incomplete outcome data (attrition bias) All outcomes	High risk	At 3 months lost to follow‐up: Experimental 37% / Control 30%; at 6 months Experimental 46% / Contr 34%
Selective reporting (reporting bias)	Low risk	All outcomes reported that were announced in protocol
Other bias	High risk	Compliance very low: 34% of those invited visited their OHP