Survey participants

Prior to the educational program, 60 questionnaires were collected from doctors and 340 from medical staff. Following the program, 48 questionnaires were collected from doctors and 226 from medical staff. The demographic details of the survey participants are summarized in Table 2. No significant differences were observed in gender, age, years of experience, occupation, or specialty among the doctors and medical staff before and after the educational program. Among the doctors, 25 participants (52.1%) attended the lecture-based course, while 23 (47.9%) completed the self-training course. Among medical staff, 90 participants (40.4%) attended the lecture-based course, and 133 (59.6%) participated in the self-training course.

Table 2 Demographic details of the survey participantsChanges in awareness of SBWT

The recognition survey was evaluated using a yes/no format, and the results are displayed in Fig. 1A. Before the educational program, awareness of SBWT was low, at 36.7% among doctors and 28.2% among medical staff. Awareness of the guidelines issued by Japan’s Ministry of Health, Labour and Welfare was even lower, at 10% among doctors and 7.4% among medical staff. After completing the educational program, awareness of SBWT increased significantly, rising to 81.3% among doctors and 58.3% among medical staff (p < 0.01 for both). Similarly, awareness of the guidelines increased significantly, to 52.1% among doctors and 25.6% among medical staff (p < 0.01 for both).

Fig. 1

Changes in awareness rate of support for balancing work-treatment (SBWT) and guideline. A Before and after the educational program. B Between the lecture-based and self-training methods

Changes in interest in SBWT

Participants were asked to rate their level of interest and concern regarding SBWT on a 5-point Likert scale. The results are presented in Fig. 2A, B. Both doctors and medical staff demonstrated increases across all six evaluated categories after completing the educational program. Among doctors, significant improvements were observed in the categories of “necessity” (4.15–4.5, p = 0.01), “interest” (3.87–4.19, p = 0.02), and “clinical practice” (3.75–4.17, p < 0.01). However, no significant changes were observed in the categories of “improvement in patients’ QOL” (4.28–4.52, p = 0.06), “increase in patient motivation” (3.93–4.13, p = 0.17), or “improving patient outcomes” (3.87–4, p = 0.40), which are directly relevant to IBD patients. In contrast, medical staff demonstrated significant increases across all six categories: “necessity” (4.01–4.3, p < 0.01), “interest” (3.54–3.97, p < 0.01), “clinical practice” (3.39–3.74, p < 0.01), “improvement in patients’ QOL” (4.22–4.47, p < 0.01), “increase in patient motivation” (3.9–4.18, p < 0.01), and “improving patient outcomes” (3.62–3.98, p < 0.01). Compared to doctors, medical staff perceived a greater impact of SBWT on factors directly related to IBD patients.

Fig. 2

Changes in interest and concern about support for balancing work-treatment (SBWT). A Before and after the educational program among doctors. B Before and after the educational program among medical staff. C Between the lecture-based and self-training methods among doctors. D Between the lecture-based and self-training methods among medical staff

Behavioral changes

Behavioral changes resulting from the educational program were assessed in three areas: experience with consultations about employment for IBD patients, difficulty responding to such consultations, and experience providing SBWT for other illnesses. Responses were recorded using yes/no or multiple-choice formats, with results summarized in Fig. 3A–C. Before the educational program, 45% of doctors and 12.1% of medical staff had prior experience with consultations about employment for IBD patients. These findings indicate that doctors are the primary point of contact for employment-related consultations. After the program, the rate of such consultations increased slightly to 50% for doctors and 14.3% for medical staff, with no statistically significant difference compared to baseline (p = 0.61, p = 0.43, respectively). The percentage of respondents who reported difficulty in responding to consultations was high among both groups before the program, at 59.3% for doctors and 56.1% for medical staff. This proportion remained similarly high after the program, at 56.1% for doctors and 71.9% for medical staff, with no statistically significant decline (p = 0.34, p = 0.11, respectively). Experience in providing SBWT for illnesses other than IBD was limited before the program, at 13.3% for doctors and 8.5% for medical staff. These rates showed no significant increase after the program, rising to 16.7% for doctors and 11.7% for medical staff (p = 0.63, p = 0.22, respectively).

Fig. 3

Behavioral change in support for balancing work-treatment (SBWT). A, C, E Before and after the educational program among doctors. B, D, F Before and after the educational program among medical staff

The detailed content of employment-related consultations and the responses taken were further analyzed and are shown in Fig. 4A–D. Consultation content was categorized into six areas: job type, job details, working hours, sick leave, job changes, and job-seeking. Similarly, responses were classified into seven actions: conversation only, preparation of a physician’s written opinion, issuance of a medical certificate, letters to the workplace, direct calling with the workplace, contact with company physicians, and contact with hospital administrators. Among doctors, there was a tendency to more frequently inquire about the details of patients’ work, although no statistically significant increases were observed in specific categories. Among medical staff, the proportion of all consultation areas increased, with a similarly greater focus on job details. Regarding the types of responses provided by doctors, there was a notable trend of reduced reliance on medical certificates and increased use of physician-written opinions in alignment with the guidelines for SBWT. Among medical staff, there was a clear increase in reporting to doctors, reflecting a trend toward standardized responses. Although no significant behavioral changes were observed overall, the results suggest that the educational program initiated a process of unifying responses to employment-related consultations.

Fig. 4

Changes in the detailed content of employment-related consultations and the actual responses taken. A, C Before and after the educational program among doctors. B, D Before and after the educational program among medical staff

Differences in effectiveness between lecture and self-training methods

As part of a sub-analysis, the effectiveness of the lecture-based and self-training methods was compared. The results are shown in Figs. 1B, 2C, D, and 3D–F. For doctors, there were no significant differences in the recognition of SBWT or the guidelines between the lecture-based and self-training methods (88% vs. 73.9%, p = 0.28; 56% vs. 47.8%, p = 0.57, respectively). However, the lecture-based method demonstrated significant improvements in “necessity” (4.72 vs. 4.26, p < 0.01), “interest” (4.36 vs. 4, p = 0.04), and “improvement in patients’ QOL” (4.76 vs. 4.26, p < 0.01). For medical staff, the lecture method was significantly more effective than self-training for both recognition of SBWT (74.4% vs. 47.3%, p < 0.01) and the guidelines (38.9% vs. 16.5%, p < 0.01). In addition, the lecture method resulted in significant improvements in “necessity” (4.5 vs. 4.17, p < 0.01), “interest” (4.12 vs. 3.64, p = 0.02), “clinical practice” (3.92 vs. 3.62, p < 0.01), “improvement in patients’ QOL” (4.61 vs. 4.37, p < 0.01), and “increase in patient motivation” (4.36 vs. 4.07, p < 0.01). In terms of behavioral changes, the experience rate of providing SBWT for other illnesses was significantly higher among medical staff in the lecture-based group compared to the self-training group (18.9% vs. 6.8%, p < 0.01).

These findings suggest that the lecture-based method was more effective overall, particularly for medical staff, in increasing awareness, interest, and engagement with SBWT.

Factors influencing awareness and interest in SBWT

The factors influencing awareness and interest in SBWT were analyzed using multivariate analysis, considering both the overall results (before and after the educational program) and the results after the educational program alone. Interest in SBWT was assessed based on responses to the “2–2, Interest” section of the questionnaire. The overall analysis results are presented in Supplemental Table 3. Independent factors associated with awareness included participation in the educational program, age under 40 years, and more than 9 years of employment, with participation in the educational program exhibiting the highest odds ratio. Factors associated with interest included participation in the educational program, being a physician, and age under 40 years, with participation in the educational program also showing the highest coefficient, similar to awareness. The results of the analysis conducted after the educational program are presented in Supplemental Table 4. Independent factors associated with awareness included the lecture method, age under 40 years, and more than 9 years of employment, with the lecture method demonstrating the highest odds ratio. In addition, factors associated with interest included the lecture method and age under 40 years, with the highest coefficient observed for the lecture method, similar to awareness.