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Clarke DJ, Powers K, Trusson D, Craven K, Phillips J, Holmes J, McKevitt C, Bowen A, Watkins CL, Farrin AJ, Wright-Hughes A, Sach T, Chambers R, Radford K. The RETurn to work After stroKE (RETAKE) trial: Findings from a mixed-methods process evaluation of the Early Stroke Specialist Vocational Rehabilitation (ESSVR) intervention. PLoS One 2024; 19:e0311101. [PMID: 39383146 PMCID: PMC11463838 DOI: 10.1371/journal.pone.0311101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 09/12/2024] [Indexed: 10/11/2024] Open
Abstract
INTRODUCTION A key goal for working age stroke survivors is to return to work, yet only around 50% achieve this at 12 months. Currently, there is limited evidence of effectiveness of early stroke-specialist vocational rehabilitation (ESSVR) interventions from randomised controlled trials. This study examined fidelity to ESSVR and explored social and structural factors which may have influenced implementation in the RETurn to work After stroKE (RETAKE) randomised controlled trial. METHODS Mixed-methods process evaluation assessing intervention fidelity and incorporating longitudinal case-studies exploring stroke survivors' experiences of support to return to work. Normalisation Process Theory, and the Conceptual Model for Implementation Fidelity, informed data collection and analysis. RESULTS Sixteen sites across England and Wales participated in RETAKE. Forty-eight occupational therapists (OTs), supported by 6 mentors experienced in vocational rehabilitation (VR), delivered the intervention (duration 12 months) between February 2018 and April 2022. Twenty-six participants (15 ESSVR, 11 usual care (UC)) were included in longitudinal case-studies. An additional 18 participants (8 ESSVR and 10 UC) were interviewed once. Nineteen OTs, 6 mentors and 19 service managers were interviewed. Fidelity was measured for 39 ESSVR participants; mean fidelity score was 78.8% (SD:19.2%, range 31-100%). Comparison of the experiences of ESSVR and UC participants indicated duration and type of support to return to work were perceived to be better for ESSVR participants. They received early, co-ordinated support including employer liaison and workplace adjustments where appropriate. In contrast, UC participants reported limited or no VR or return to work support from health professionals. Typically, UC support lasted 2-8 weeks, with poor communication and co-ordination between rehabilitation providers. Mentor support for OTs appeared to increase fidelity. Service managers indicated ESSVR would enhance post-stroke services. CONCLUSIONS ESSVR was valued by participants and was delivered with fidelity; implementation appeared to be facilitated by mentor support for OTs.
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Affiliation(s)
- David James Clarke
- Academic Unit for Ageing and Stroke Research, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Katie Powers
- Centre for Rehabilitation & Ageing Research Medicine/ Injury, Inflammation and Recovery Sciences, School of Medicine, Medical School Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Diane Trusson
- Centre for Rehabilitation & Ageing Research Medicine/ Injury, Inflammation and Recovery Sciences, School of Medicine, Medical School Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Kristelle Craven
- Centre for Rehabilitation & Ageing Research Medicine/ Injury, Inflammation and Recovery Sciences, School of Medicine, Medical School Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Julie Phillips
- Centre for Rehabilitation & Ageing Research Medicine/ Injury, Inflammation and Recovery Sciences, School of Medicine, Medical School Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Jain Holmes
- Centre for Rehabilitation & Ageing Research Medicine/ Injury, Inflammation and Recovery Sciences, School of Medicine, Medical School Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Christopher McKevitt
- Department of Population Health Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Audrey Bowen
- Manchester Centre for Health Psychology & the Geoffrey Jefferson Brain Research Centre MAHSC, University of Manchester, Manchester, United Kingdom
| | - Caroline Leigh Watkins
- Applied Health Research Hub, Stroke Research Team, School of Nursing and Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Amanda J. Farrin
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom
| | - Alexandra Wright-Hughes
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom
| | - Tracey Sach
- Health Economics Group, Norwich Medical School, Norwich Research Park, University of East Anglia, Norwich, United Kingdom
| | - Rachel Chambers
- Department of Population Health Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Kate Radford
- Centre for Rehabilitation & Ageing Research Medicine/ Injury, Inflammation and Recovery Sciences, School of Medicine, Medical School Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom
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Karcz K, Schwegler U, Schiffmann B, Finger ME. Risk factors and service gaps affecting a sustainable work: a qualitative multi-stakeholder analysis in the context of persons with acquired brain injury living in Switzerland. BMC Health Serv Res 2024; 24:753. [PMID: 38902701 PMCID: PMC11188514 DOI: 10.1186/s12913-024-11128-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/21/2024] [Indexed: 06/22/2024] Open
Abstract
INTRODUCTION Along with the social and economic challenges posed by an aging society, creating work conditions that allow persons to stay healthy and work into old age has become a major task of Western societies. Retaining employment after returning to work is particularly difficult for individuals with a disability, as evidenced by the high rate of premature labor market dropout. Individuals with acquired brain injury (ABI) exemplify this challenge, as it often impairs cognitive, technical, and interpersonal abilities that are crucial in today's labor market. To effectively support these individuals, vocational integration practitioners require comprehensive knowledge of risk factors for premature labor market dropout and effective strategies for sustainable work. OBJECTIVE This study aimed to identify perceived risk factors and related service gaps regarding sustainable work for people with ABI, as reported by affected individuals, employers, vocational integration professionals, and health professionals. METHODS Secondary data analysis. Data that was originally collected through seven focus groups and two interviews with persons with ABI, 15 interviews with employers, and 13 interviews with vocational integration and health professionals in the context of the project 'Sustainable employment' was re-analysed thematically. RESULTS Two major themes of risk factors were identified: (1) person-related factors (including the subthemes: post-ABI impairments; lack of understanding of post-ABI impairments; poor health management) and (2) environment-related factors (including the subthemes: challenges related to the service structure; insufficient knowledge and education about ABI; challenges at the workplace; difficulties in private life). While stakeholders noted the variety of the currently available services, they particularly pointed to the missing long-term monitoring and counseling services for persons with ABI following the initial return-to-work, reflecting a major challenge for sustainable work. An overarching gap related to the fragmentation of the service structure and the lack of case coordination along the working life. CONCLUSIONS Multiple stakeholders emphasized the importance of empowering individuals, ensuring easy access to professional support, and providing a suitable work environment to address key risk factors and facilitate sustainable work for individuals with ABI. Continuous coaching, long-term monitoring and counseling following return-to-work, were identified as potential strategies to achieve these goals.
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Affiliation(s)
- Katarzyna Karcz
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland.
| | - Urban Schwegler
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Barbara Schiffmann
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland
| | - Monika E Finger
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, 6207, Switzerland
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Mohamad NBZ, Ng YS, Asano M. Experiences of participating in a vocational rehabilitation program in Singapore. Disabil Rehabil 2024; 46:139-149. [PMID: 36564959 DOI: 10.1080/09638288.2022.2159076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/11/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE The purposes of this study were to (i) describe the lived experiences of participating in a Singaporean vocational rehabilitation (VR) program among individuals with stroke and spinal cord injury and (ii) identify salient features of the program that facilitated their return-to-work process. MATERIALS AND METHODS This was a qualitative phenomenological study. Participants were invited to complete an interview about their return-to-work process after acquiring a disability vis-à-vis their participation in a local VR program. The qualitative data were analyzed inductively. RESULTS Twenty-four middle-aged participants with a stroke or spinal cord injury completed the interviews. The participants' experiences with the local VR program were largely positive. Several key features of the VR program were identified. These were: (i) providing a multi-disciplinary and individualized program; (ii) building positive collaborations between service providers and participants; and (iii) supporting personal growth among participants. CONCLUSION The Singaporean VR program demonstrated internationally recommended best practices. These best practices were beneficial for the participants' return-to-work process, as reflected by their positive feedback about the program. Our study emphasizes the need for comprehensive and evidence-based VR programs to meet the complex needs of individuals with disabilities who want to return to work.Implications for rehabilitationMulti- or inter-disciplinary care services are needed in vocational rehabilitation (VR) programs to support the complex return-to-work process of clients.VR programs should have the capacity to provide client-centered care as their clients may experience diverse, yet unique challenges during their return-to-work processVR service providers play a crucial role in engaging and motivating their clients throughout the program to achieve their return-to-work goalsVR service providers should address concurrent or future concerns that could impact on their clients' ability to return to or remain at work.
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Affiliation(s)
- Nizar Bin Zainal Mohamad
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Yee Sien Ng
- Department of Rehabilitation Medicine, Singapore General Hospital, Singapore
| | - Miho Asano
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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Coutts E, Cooper K. Return to work for adults following stroke: a scoping review of interventions, factors, barriers, and facilitators. JBI Evid Synth 2023; 21:1794-1837. [PMID: 37255032 DOI: 10.11124/jbies-22-00174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This scoping review aimed to map the literature on interventions, factors, barriers, and facilitators for return to work for adults post-stroke with or without communication disorders. INTRODUCTION Difficulties in returning to work can significantly impact individuals following a stroke (eg, their sense of purpose and self-esteem), not only financially, but also as they adjust to the change in their situation. Such difficulties may arise from communication disorders as well as physical impairments. Previous reviews on return to work post-stroke have focused on specific aspects, such as interventions, or barriers and facilitators, but have not provided a comprehensive map of the field. Further, no systematic or scoping reviews to date have focused on literature addressing return to work for people with communication disorders post-stroke. INCLUSION CRITERIA This review considered literature that reported on interventions, barriers, and facilitators for return to work for adults (aged 16 years or older) following an ischemic or hemorrhagic stroke. Records focusing on transient ischemic attacks or acquired brain injury were excluded, as were those in which a comorbidity or disability (eg, learning disability, dementia, respiratory disorder) had a significant impact on the individual's ability to work. METHODS This review followed the JBI scoping review methodology. Primary research of any type, systematic and non-systematic reviews, and gray literature from developed countries written in English from 2010 to the present day were identified from 7 databases, 2 gray literature repositories, JBI Evidence Synthesis , and an internet search. Records were screened for relevance to the review topic by 2 independent reviewers, and data relevant to the review questions were extracted. Findings were presented as narrative supported by tables. RESULTS Of the 106 sources included, 61 addressed demographic-based, socioeconomic-based, impairment-based, or recovery-based factors related to return to work. One of these 61 sources, a narrative review, focused on communication disorders. Thirty-eight sources explored barriers and facilitators for return to work from different stakeholders' perspectives; 3 of these 38 sources, including 2 qualitative studies and 1 narrative review, focused on post-stroke communication disorders. Eleven sources focused on interventions, including 7 studies (reported across 9 sources) that developed or tested return-to-work interventions. Of these primary studies, 1 randomized controlled trial and 1 retrospective cohort study were identified. The remaining intervention studies were case studies or case series. None of these intervention studies addressed communication disorders. CONCLUSIONS While there has been extensive research on factors, barriers, and facilitators for return to work post-stroke, there is a lack of research on interventions supporting return to work. There is also a significant gap in the evidence base on returning to work with a post-stroke communication disorder, highlighting the need for further research in this important area.
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Affiliation(s)
- Emma Coutts
- Speech and Language Therapy, NHS Grampian, Fraserburgh UK
| | - Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
- The Scottish Centre for Evidence-based, Multi-professional Practice: A JBI Centre of Excellence, Robert Gordon University, Aberdeen, UK
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Mohamad NBZ, Koh NZM, Yeo JPT, Ng MG, Turpin M, Asano M. A qualitative study of Singaporean perspectives on returning to work after stroke. Work 2023:WOR211170. [PMID: 36641709 DOI: 10.3233/wor-211170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Post-stroke return-to-work (RTW) rates reported in Singapore ranged between 38% and 55%, indicating challenges in the RTW process among individuals with stroke. OBJECTIVE We sought to understand the lived experience of returning to work among individuals with stroke in Singapore. METHODS This was a qualitative study using a phenomenological approach. We recruited individuals with stroke who were citizens or permanent residents of Singapore. We conducted semi-structured interviews to collect data on their lived experience of returning to work and analyzed the interview data inductively. RESULTS Twenty-seven participants completed the interviews. Their median age was 61 years (interquartile range = 54 - 64). They were mostly male (n = 19, 70.4%) and married (n = 21, 78%). Twenty participants (74%) returned to work after their stroke. Three major themes emerged from the interviews that underpinned the participants' RTW experience. They were i) direct impact of stroke, ii) realignment of life priorities, and iii) engagement with support and resources. CONCLUSION RTW after stroke is complex and influenced by personal and environmental factors. Our findings suggest that individuals with stroke need continuing support to overcome stigma and discrimination, to manage expectations of their recovery process, and to better navigate resources during their RTW process in Singapore. We recommend future studies to design and test the feasibility of appropriate interventions based on our proposed strategies to better support individuals with stroke to return to work.
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Affiliation(s)
| | - Nicklaus Zhi Ming Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Joanna Peck Tiang Yeo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Min Geng Ng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Merrill Turpin
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Miho Asano
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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De Dios Pérez B, Radford K, das Nair R. Experiences of people with multiple sclerosis at work: Towards the understanding of the needs for a job retention vocational rehabilitation intervention. Work 2022; 72:303-313. [DOI: 10.3233/wor-210012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Supporting people with multiple sclerosis (MS) at work can be challenging due to the unpredictable nature and myriad of disease-related symptoms, and issues related to the work environment. OBJECTIVE: To explore, amongst people with MS in employment, their experiences of and need for vocational rehabilitation (VR), and perceived barriers and facilitators to implementing VR. METHODS: We conducted 20 semi-structured interviews with people with MS, employers, and healthcare professionals. Interviews were audio-recorded, transcribed, and analysed using the framework method. RESULTS: We identified nine themes reflecting the main MS symptoms (e.g. cognition, fatigue), and environmental factors such as support provided at work (e.g. change of working hours) and workplace characteristics. Providing support tailored to the individual’s needs and early intervention were seen as important attributes for the intervention. The barriers identified referred to lack of resources and confidentiality issues; however, having flexibility in the content and delivery of the intervention were seen as facilitators. CONCLUSION: The impact of environmental factors (e.g. attitudes towards disability) on employment difficulties is equal to or greater than disease-related factors. Environmental changes in the attitudes of co-workers and workplace flexibility can enable people with MS to remain in work for longer.
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Affiliation(s)
- Blanca De Dios Pérez
- Centre for Rehabilitation & Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Kate Radford
- Centre for Rehabilitation & Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK
| | - Roshan das Nair
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire NHS Foundation Trust, Nottingham, UK
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Karcz K, Trezzini B, Escorpizo R, Schwegler U, Finger M. Factors associated with sustaining work after an acquired brain injury: a scoping review. Disabil Rehabil 2021; 44:6510-6530. [PMID: 34590966 DOI: 10.1080/09638288.2021.1960439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Maintaining work in the long term represents a major challenge for people with acquired brain injury (ABI) as evidenced by a high rate of premature labour market dropouts. The present study aimed to compile factors associated with working in the long term after sustaining an ABI. MATERIALS AND METHODS We carried out a scoping review synthesizing quantitative and qualitative research conducted between 2000 and 2021. Databases searched comprised PubMed, CINAHL Complete, PsycINFO, Scopus, and Web of Science. RESULTS Ten quantitative and nine qualitative studies were included, all but one from high-resource countries. Quantitative research predominantly comprised longitudinal follow-ups on individuals' work status several years post ABI onset, showing an effect of injury-related and sociodemographic factors. Qualitative studies mostly dealt with work maintenance and revealed a key role of cognitive difficulties, psychological personal factors (e.g., adequate coping strategies) and environmental factors (e.g., flexible work schedules, supportive colleagues). CONCLUSIONS The factors identified in our review should receive particular attention in vocational integration and job retention programs to support work participation of people with ABI in the long term. There is a need for measures that regularly monitor and promote a good match between individuals and their work environment.Implications for RehabilitationPeople with acquired brain injury (ABI) often have long-lasting and invisible injury-related difficulties that hamper their labour market participation.Factors identified as positively associated with working in the long term, such as coping strategies and self-awareness, should be strengthened.Future interventions should educate affected persons, employers and health care professionals about long-lasting injury-related difficulties and promote a supportive work environment for people with ABI.Prolonged availability of vocational services could be beneficial for supporting work maintenance of people with ABI.
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Affiliation(s)
- Katarzyna Karcz
- Work and Integration Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Bruno Trezzini
- Work and Integration Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Reuben Escorpizo
- Work and Integration Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Rehabilitation and Movement Science, The University of Vermont, USA
| | - Urban Schwegler
- Work and Integration Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Monika Finger
- Work and Integration Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Radford KA, Craven K, McLellan V, Sach TH, Brindle R, Holloway I, Hartley S, Bowen A, O'Connor R, Stevens J, Philips J, Walker M, Holmes J, McKevitt C, Murray J, Watkins C, Powers K, Shone A, Farrin A. An individually randomised controlled multi-centre pragmatic trial with embedded economic and process evaluations of early vocational rehabilitation compared with usual care for stroke survivors: study protocol for the RETurn to work After stroKE (RETAKE) trial. Trials 2020; 21:1010. [PMID: 33298162 PMCID: PMC7724443 DOI: 10.1186/s13063-020-04883-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Return to work (RTW) is achieved by less than 50% of stroke survivors. The rising incidence of stroke among younger people, the UK economic forecast, and clinical drivers highlight the need for stroke survivors to receive support with RTW. However, evidence for this type of support is lacking. This randomised controlled trial (RCT) will investigate whether Early Stroke Specialist Vocational Rehabilitation (ESSVR) plus usual care (UC) (i.e. usual NHS rehabilitation) is more clinically and cost-effective for supporting post-stroke RTW, than UC alone. METHODS Seven hundred sixty stroke survivors and their carers will be recruited from approximately 20 NHS stroke services. A 5:4 allocation ratio will be employed to randomise participants to receive ESSVR plus UC, or UC alone. The individually tailored ESSVR intervention will commence within 12 weeks of stroke onset and be delivered for up to 12 months as necessary by trained RETAKE occupational therapists in the community, participants' homes or workplaces, and outpatient/inpatient therapy settings, via telephone, email, or SMS text message. Outcome data will be collected via self-report questionnaires administered by post or online at 3, 6, and 12 months follow-up. The primary outcome will be self-reported RTW and job retention at 12 months (minimum 2 h/week). Secondary outcomes will include mood, function, participation, health-related quality of life, confidence, intervention compliance, health and social care resource use, and mortality. An embedded economic evaluation will estimate cost-effectiveness and cost-utility analyses from National Health Service (NHS) and Personal Social Services (PSS) perspectives. An embedded process evaluation will employ a mixed methods approach to explore ESSVR implementation, contextual factors linked to outcome variation, and factors affecting NHS roll-out. DISCUSSION This article describes the protocol for a multi-centre RCT evaluating the clinical- and cost-effectiveness of an early vocational rehabilitation intervention aimed at supporting adults to return to work following a stroke. Evidence favouring the ESSVR intervention would support its roll-out in NHS settings. TRIAL REGISTRATION ISRCTN, ISRCTN12464275 . Registered on 26 February 2018.
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Affiliation(s)
- Kathryn A Radford
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK.
| | - Kristelle Craven
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK
| | - Vicki McLellan
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Level 11 Worsley Building, Leeds, LS2 9JT, UK
| | - Tracey H Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Room 2.37, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Richard Brindle
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Level 11 Worsley Building, Leeds, LS2 9JT, UK
| | - Ivana Holloway
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Level 11 Worsley Building, Leeds, LS2 9JT, UK
| | - Suzanne Hartley
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Level 11 Worsley Building, Leeds, LS2 9JT, UK
| | - Audrey Bowen
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester MAHSC, Manchester, M13 9PL, UK
| | - Rory O'Connor
- Academic Department of Rehabilitation Medicine, Leeds Institute of Molecular Medicine, University of Leeds, Level D, Martin Wing, Leeds General Infirmary, Leeds, LS1 3EX, UK
| | - Judith Stevens
- Patient and Public Involvement Collaborator, Hampshire, UK
| | - Julie Philips
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK
| | - Marion Walker
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK
| | - Jain Holmes
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK
| | - Christopher McKevitt
- Department of Population Health Sciences, Faculty of Life Sciences & Medicine, King's College London, 5th Floor Addison House, Guy's Campus, London, SE1 1UL, UK
| | - John Murray
- Different Strokes, Raphael House, Ilford, London, IG1 1YT, UK
| | - Caroline Watkins
- Lancashire Clinical Trials Unit, School of Health, University of Central Lancashire, Brook Building, Room 217, Preston, PR1 2HE, UK
| | - Katie Powers
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK
| | - Angela Shone
- Research and Innovation, Jubilee Conference Centre, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB, UK
| | - Amanda Farrin
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Level 11 Worsley Building, Leeds, LS2 9JT, UK
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