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01-06-2015

Implementing a Self-Management Intervention for People with a Chronic Compensable Musculoskeletal Injury in a Workers Compensation Context: A Process Evaluation

Authors: Dianne M. Sheppard, Susan Gargett, Alison MacKenzie, Gwendolen Jull, Venerina Johnston, Jennifer Strong, Malcolm Battersby, Niki Ellis

Published in: Journal of Occupational Rehabilitation | Issue 2/2015

Abstract

Purpose Determining factors critical for an intervention’s success, specifically for whom and under what circumstances, is necessary if interventions are to be effectively targeted and efficiently implemented. This paper describes a process evaluation undertaken to assess the implementation of a novel self-management (SM) intervention developed for those with a chronic compensable work-related musculoskeletal disorder seeking to return to work. Methods The process evaluation, assessing the ‘Self-Management for Return to Work’ intervention, examined data from program leader evaluations, telephone interviews with stakeholders (injured worker participants, vocational rehabilitation consultant program leaders and compensation insurance regulators), post-intervention focus group session feedback, attendance lists and researcher notes. Results The evaluation identified several challenges and barriers associated with conducting research within the VR environment and with the characteristics of those targeted i.e., injured workers with a chronic compensable condition. These issues were primary contributing factors to the modifications to the randomised controlled trial methodology and the trial’s premature cessation. Conclusions Despite the difficulties encountered, high stakeholder acceptability suggests that the concept and theory underlying the targeted SM intervention were not flawed, though there is room for further tailoring to both the program method and its timing. The results of this process evaluation provide a useful platform for others considering the implementation of interventions within the vocational rehabilitation context or with individuals with chronic, compensated injuries.

This distribution was calculated using an ex-post method whereby the workers’ compensation premiums paid by employers are considered a transfer cost to society rather than a cost to employers. Using an ex-ante approach it was estimated employers would have borne 16 % and the community 10 % of the total cost.

Phase II clinical research may be defined as “exploring the dimensions of the therapeutic effect and making the necessary preparations for conducting a clinical trial... eventually [including] small-group cohort-control studies” [43].

An active WC claim is defined as currently receiving some form of financial benefit from the Worker’s Compensation Scheme, regardless of return to work status. Participants may be back at work part-time and still receiving benefits.

The RCT, including its evaluation, was approved by Monash University Human Research Ethics Committee (CF11/2335-2011001328).

VR consultants were trained to deliver the standard CDSMP program by licensed trainers, and the two additional modules by members of the research team.

Missing data for date of injury for n = 1 intervention group participant.

N = 1 usual care participant outlier for time since injury was brought back to 2.5 SDs above the mean.

Safe Work Australia. Compendium of Workers Compensation Statistics Australia 2010–11. Canberra: Safe Work Australia; 2013.

Safe Work Australia. The cost of work-related injury and illness for Australian employers, workers and the community 2008–09. Canberra: Safe Work Australia; 2012.

Cameron M. Occupational Rehabilitation. In: Cameron M, Selig S, Hemphill D, editors. Clinical exercise: a case-based approach. Sydney: Elsevier; 2011. p. 124–34.

Eggert S. Psychosocial factors affecting employees’ abilities to return to work. AAOHN J. 2010;58(2):51–5.CrossRefPubMed

Watson PJ, Booker CK, Moores L, Main CJ. Returning the chronically unemployed with low back pain to employment. Eur J Pain. 2004;8:359–69.CrossRefPubMed

Ellis N, Johnston V, Gargett S, MacKenzie A, Strong J, Battersby M et al. Does self-management for return to work increase the effectiveness of vocational rehabilitation for chronic compensated musculoskeletal disorders? Protocol for a randomised controlled trial. BMC Musculoskelet Disord. 2010;11(1):115.

Johnston V, Strong J, Gargett S, Jull G, Ellis N. Enhancing the vocational outcomes of people with chronic disabilities caused by a musculoskeletal condition: development and evaluation of content of self-management training modules. Work. 2013. doi:10.3233/WOR-131722.

Stanford School of Medicine Patient Education Department of Medicine. Chronic Disease Self-Management Program. 2013. http://patienteducation.stanford.edu/programs/cdsmp.html. Accessed 21 Nov 2013.

Linnan L, Steckler A. An overview. In: Steckler A, Linnan L, editors. Process evaluation for public health interventions and research. San Francisco: Jossey-Bass; 2002. p. 1–23.

10.

Ellard D, Parsons S. Process evaluation: Understanding how and why interventions work. In: Thorogood M, Coombes Y, editors. Evaluating Health Promotion: Practice and Methods. 3rd ed. Oxford: Oxford University Press; 2010.

11.

Nutbeam D, Bauman A. Evaluation in a Nutshell: a practical guide to the evaluation of health promotion programs. Sydney: McGraw-Hill; 2006.

12.

Nytrø K, Saksvik PØ, Mikkelsen A, Bohle P, Quinlan M. An appraisal of key factors in the implementation of occupational stress interventions. Work & Stress. 2000;14(3):213–25.CrossRef

13.

Oakley A, Strange V, Bonell C, Allen E, Stephenson J, Team RS. Process evaluations in randomised controlled trials of complex interventions. BMJ. 2006;332:413–6.CrossRefPubMedCentralPubMed

14.

Rychetnik L, Frommer M, Hawe P, Shiell A. Criteria for evaluating evidence on public health interventions. J Epidemiol Community Health. 2002;56(2):119–27.CrossRefPubMedCentralPubMed

15.

Tamminga SJ, de Boer AGEM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, et al. A hospital-based work support intervention to enhance the return to work of cancer. J Occup Rehabil. 2012;22:565–78.CrossRefPubMedCentralPubMed

16.

Steckler A, Linnan L, editors. Process evaluation for public health interventions and research. San Francisco: Jossey-Bass; 2002.

17.

Cadilhac DA, Hoffmann S, Kilkenny M, Lindley R, Lalor E, Osborne RH, et al. A phase II multicentered, single-blind, randomized, controlled trial of the stroke self-management program. Stroke. 2011;42:1673–9.CrossRefPubMed

18.

Osborne RH, Elsworth GR, Whitfield K. The Health Education Impact Questionnaire (heiQ): an outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions. Patient Educ Couns. 2007;66:192–201.CrossRefPubMed

19.

Bouwsma EVA, Vonk Noordegraaf A, Szlávik Z, Brölmann HAM, Emanuel MH, Lips JP et al. Process evaluation of a multidisciplinary care program for patients undergoing gynaecological surgery. J Occup Rehabil. 2014;24(3):425–38.

20.

Martin MHT, Nielsen MBD, Petersen SMA, Jakobsen LM, Rugulies R. Implementation of a coordinated and tailored return-to-work intervention for employees with mental health problems. J Occup Rehabil. 2012;22:427–36.CrossRefPubMed

21.

van Beurden K, Vermeulen SJ, Anema JR, van der Beek AJ. A participatory return-to-work program for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders: a process evaluation alongside a randomized controlled trial. J Occup Rehabil. 2012;22:127–40.CrossRefPubMedCentralPubMed

22.

Buijs PC, Lambeek LC, Koppenrade V, Hooftman WE, Anema JR. Can workers with chronic back pain shift from pain elimination to function restore at work? J Back Musculoskelet. 2009;22:65–73.

23.

Lambeek LC, van Mechelen W, Buijs PC, Loisel P, Anema JR. An integrated care program to prevent work disability due to chronic low back pain: a process evaluation within a randomized controlled trial. BMC Musculoskelet Disord. 2009;10:147. doi:10.1186/1471-2474-10-147.

24.

Shevil E, Finlayson M. Process evaluation of a self-management cognitive program for persons with multiple sclerosis. Patient Educ Couns. 2009;76:77–83.CrossRefPubMed

25.

Cimprich B, Janz NK, Northhouse L, Wren PA, Given B, Given CW. Taking charge: a self-management program for women following breast cancer treatment. Psycho-Oncol. 2005;14:704–17.CrossRef

26.

Schreurs KMG, Colland VT, Kuijer RG, de Ridder DTD, van Elderen T. Development, content, and process evaluation of a short self-management intervention in patients with chronic diseases requiring self-care behaviours. Patient Educ Couns. 2003;51:133–41.CrossRefPubMed

27.

Maskell J, Newcombe P, Martin G, Kimble R. Conducting a paediatric multi-centre RCT with an industry partner: challenges and lessons learned. J Paediatr Child Health. 2012;48:974–7.CrossRefPubMed

28.

Robinson RC, Garofalo JP, Behnk P. Program evaluation of prevention and intervention methods. In: Gatchel RJ, Schultz IZ, editors. Handbook of occupational health and wellness. New York: Springer; 2012. p. 495–511.CrossRef

29.

Weinberger M, Murray MD, Marrero DG, Brewer N, Lykens M, Harris LE, et al. Issues in conducting randomized controlled trials of health services research interventions in nonacademic practice settings: the case of retail pharmacies. Health Serv Res. 2002;37(4):1067–77.CrossRefPubMedCentralPubMed

30.

Gaskill D, Morrison P, Sanders F, Forster E, Edwards H, Fleming R, et al. University and industry partnership: Lessons from collaborative research. Int J Nurs Pract. 2003;9:347–55.CrossRefPubMed

31.

MacEachen E, Kosny A, Ferrier S, Chambers L. The, “toxic dose” of system problems: why some injured workers don’t return to work as expected. J Occup Rehabil. 2010;20:349–66.CrossRefPubMed

32.

Detaille SI, Heerkens YF, Engels JA, van der Guilden JWJ, van Dijk FJH. Effect evaluation of a self-management program for Dutch workers with a chronic somatic disease: a randomized controlled trial. J Occup Rehabil. 2013;23(2):189–99.CrossRefPubMed

33.

Foster G, Taylor SJC, Eldridge S, Ramsay J, Griffiths CJ. Self-management education programmes by lay leaders for people with chronic conditions. Cochrane Database Syst Rev. 2007; 4. Art. No.: CD005108. doi:10.1002/14651858.CD005108.pub2.

34.

Varekamp I, Krol B, van Dijk FJH. Empowering employees with chronic diseases: process evaluation of an intervention aimed at job retention. Int Arch Occup Environ Health. 2011;84:35–43.CrossRefPubMedCentralPubMed

35.

Bültmann U, Sherson D, Olsen J, Hansen CL, Lund T, Kilsgaard J. Coordinated and tailored work rehabilitation: a randomized controlled trial with economic evaluation undertaken with workers on sick leave due to musculoskeletal disorders. J Occup Rehabil. 2009;19:81–93.CrossRefPubMed

36.

Harrison M, Fullwood C, Bower P, Kennedy A, Rogers A, Reeves D. Exploring the mechanisms of change in the chronic disease self-management program: secondary analysis of data from a randomized controlled trial. Patient Educ Couns. 2011;85(2):e39–47.CrossRefPubMed

37.

Ruehlman LS, Karoly P, Enders C. A randomized controlled evaluation of an online chronic pain self management program. Pain. 2012;153(2):319–30.CrossRefPubMedCentralPubMed

38.

Chiauzzi E, Pujol LA, Wood M, Bond K, Black R, Yiu E, et al. painACTION-back pain: a self-management website for people with chronic back pain. Pain Med. 2010;11(7):1044–58.CrossRefPubMed

39.

Solomon M, Wagner SL, Goes J. Effects of a web-based intervention for adults with chronic conditions on patient activation: online randomized controlled trial. J Med Internet Res. 2012;14(1):e32.CrossRefPubMedCentralPubMed

40.

Battersby MW, Von Korff M, Schaefer J, Davis C, Ludman E, Greene SM, et al. Twelve evidence-based principles for implementing self-management support in primary care. Jt Comm J Qual Patient Saf. 2010;36(12):561–70.PubMed

41.

Krause N, Frank JW, Dasinger LK, Sullivan TJ, Sinclair SJ. Determinants of duration of disability and return-to-work after work-related injury and illness: challenges for future research. Am J Ind Med. 2001;40:464–84.CrossRefPubMed

42.

Lipsey MW, Cordray DS. Evaluation methods for social intervention. Annu Rev Psychol. 2000;51:345–75.CrossRefPubMed

43.

Robey RR. A five-phase model for clinical outcomes research. J Commun Disord. 2004;37:404.

Title: Implementing a Self-Management Intervention for People with a Chronic Compensable Musculoskeletal Injury in a Workers Compensation Context: A Process Evaluation
Authors: Dianne M. Sheppard
Susan Gargett
Alison MacKenzie
Gwendolen Jull
Venerina Johnston
Jennifer Strong
Malcolm Battersby
Niki Ellis
Publication date: 01-06-2015
Publisher: Springer US
Published in: Journal of Occupational Rehabilitation / Issue 2/2015
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-014-9551-4

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Implementing a Self-Management Intervention for People with a Chronic Compensable Musculoskeletal Injury in a Workers Compensation Context: A Process Evaluation

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Does the Economy Affect Functional Restoration Outcomes for Patients with Chronic Disabling Occupational Musculoskeletal Disorders?

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Importance of Participation in Major Life Areas Matters for Return to Work

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