Clinical trials

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.

This study aims to establish the test-retest reliability of the WB6Dim digital self-assessment tool across its eight well-being dimensions, using a 3-day interval protocol designed to minimize the probability of genuine well-being changes between assessments. Participants complete the 28-item WB6Dim questionnaire at baseline (T1) and again 3 days later (T2). A single contamination control question at T2 identifies participants who experienced a significant life event during the interval; these pairs are excluded from primary ICC analyses and retained for exploratory analyses. An optional third assessment at 9 weeks (T3) provides preliminary exploratory data on sensitivity to change following access to a well-being program. T3 is not part of the primary design.