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Dugan AG, Decker RE, Austin HL, Namazi S, Bellizzi KM, Blank TO, Shaw WS, Swede H, Cherniack MG, Tannenbaum SH, Cavallari JM. Qualitative Assessment of Perceived Organizational Support for Employed Breast Cancer Survivors. J Occup Environ Med 2023; 65:868-879. [PMID: 37488771 DOI: 10.1097/jom.0000000000002931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE A more detailed understanding of unmet organizational support needs and workplace-based best practices for supporting cancer survivors is needed. METHODS Ninety-four working breast cancer survivors responded to an open-ended survey question regarding the desired types of organizational support that were and were not received during early survivorship. We performed content-analysis of qualitative data. RESULTS Major themes included instrumental support, emotional support, and time-based support. The need for flexible arrangements and reduced workloads was mostly met. Unmet needs included navigation/coordination, understanding/empathy, and time off for treatment and recovery. CONCLUSIONS Organizational support can help cancer survivors manage their health and work roles, diminishing work-health conflict and turnover intent. Study findings can be used to design targeted interventions to fulfill cancer survivors' unmet organizational support needs, which may also apply to workers with other chronic health conditions.
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Affiliation(s)
- Alicia G Dugan
- From the Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, Farmington, Connecticut (A.G.D., W.S.S., M.G.C., J.M.C.); Society for Human Resource Management, Alexandria, Virginia (R.E.D.); Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut (H.L.A.); Department of Health Sciences, Johnson & Wales University, Providence, Rhode Island (S.N.); Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut (K.M.B., T.O.B.); Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut (H.S., J.M.C.); and Neag Comprehensive Cancer Center, UConn Health, Farmington, Connecticut (S.H.T.)
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Shaw WS, Dugan AG, McGonagle AK, Nicholas MK, Tveito TH. The Job Leeway Scale: Initial Evaluation of a Self-report Measure of Health-Related Flexibility and Latitude at Work. J Occup Rehabil 2023; 33:581-591. [PMID: 36971990 PMCID: PMC10040912 DOI: 10.1007/s10926-023-10095-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Purpose Evidence suggests that workers manage health-related challenges at work, in part, by using available leeway to perform work differently. The purpose of this study was to evaluate the reliability and validity of the Job Leeway Scale (JLS), a new 18-item self-report questionnaire designed to assess worker perceptions of available flexibility and latitude to manage health-related challenges at work. Methods Workers seeking assistance for workplace difficulties due to chronic medical conditions (n = 119, 83% female, median age = 49) completed the JLS along with other workplace and health measures. Construct validity was assessed using exploratory factor analysis (EFA), and concurrent validity was assessed by associations with related measures. Results Mean item scores ranged from 2.13 to 4.16 within a possible range of 0-6. The EFA supported three underlying factors: organizational leeway (9 items), task leeway (6 items), and staffing leeway (3 items). Internal consistency (alpha) ranged from 0.78 to 0.91 for subscale scores and 0.94 for the total score. The JLS showed moderate correlations with other work outcome measures including work fatigue, self-efficacy, engagement, and productivity. Conclusion The JLS is a promising new measure with initial support for its reliability and validity to assess worker beliefs of available flexibility to manage health symptoms at work, and this construct may have organizational implications for worker support and accommodation.
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Affiliation(s)
- William S Shaw
- University of Connecticut School of Medicine, Farmington, CT, USA
| | - Alicia G Dugan
- University of Connecticut School of Medicine, Farmington, CT, USA.
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Gignac MAM, Bowring J, Tonima S, Franche RL, Thompson A, Jetha A, Smith PM, Macdermid JC, Shaw WS, Van Eerd D, Beaton DE, Irvin E, Tompa E, Saunders R. A Sensibility Assessment of the Job Demands and Accommodation Planning Tool (JDAPT): A Tool to Help Workers with an Episodic Disability Plan Workplace Support. J Occup Rehabil 2023; 33:145-159. [PMID: 35835885 PMCID: PMC9282615 DOI: 10.1007/s10926-022-10057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Purpose Sensibility refers to a tool's comprehensiveness, understandability, relevance, feasibility, and length. It is used in the early development phase to begin assessing a new tool or intervention. This study examined the sensibility of the job demands and accommodation planning tool (JDAPT). The JDAPT identifies job demands related to physical, cognitive, interpersonal, and working conditions to better target strategies for workplace supports and accommodations aimed at assisting individuals with chronic health conditions. Methods Workers with a chronic health condition and workplace representatives were recruited from health charities, workplaces, and newsletters using convenience sampling. Cognitive interviews assessed the JDAPT's sensibility. A 70% endorsement rate was the minimum level of acceptability for sensibility concepts. A short screening tool also was administered, and answers compared to the complete JDAPT. Results Participants were 46 workers and 23 organizational representatives (n = 69). Endorsements highly exceeded the 70% cut-off for understandability, relevance, and length. Congruence between screening questions and the complete JDAPT suggested both workers and organizational representatives overlooked job demands when completing the screener. Participants provided additional examples and three new items to improve comprehensiveness. The JDAPT was rated highly relevant and useful, although not always easy to complete for someone with an episodic condition. Conclusions This study highlights the need for tools that facilitate accommodations for workers with episodic disabilities and provides early evidence for the sensibility of the JDAPT.
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Affiliation(s)
- Monique A M Gignac
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Julie Bowring
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Sabrina Tonima
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
| | | | - Aaron Thompson
- Workplace Safety and Insurance Board (WSIB), Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Arif Jetha
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Peter M Smith
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Joy C Macdermid
- School of Physical Therapy, Western University, London, ON, Canada
| | - William S Shaw
- Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Dwayne Van Eerd
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Dorcas E Beaton
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Emma Irvin
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Emile Tompa
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ron Saunders
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
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Sullivan V, Wilson MN, Gross DP, Jensen OK, Shaw WS, Steenstra IA, Hayden JA. Expectations for Return to Work Predict Return to Work in Workers with Low Back Pain: An Individual Participant Data (IPD) Meta-Analysis. J Occup Rehabil 2022; 32:575-590. [PMID: 35152369 DOI: 10.1007/s10926-022-10027-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Purpose Low back pain is associated with disability and lost productivity due to inability of workers to return to work. Personal recovery expectation beliefs may be associated with return to work outcomes in those with low back pain at high risk for chronic disability. We aimed to (1) assess whether workers' expectations for return to work, following a low back pain episode, are associated with subsequent return to work; and (2) explore the relationships between return to work expectations and other prognostic factors in their association with work outcomes.Methods We conducted an Individual Participant Data (IPD) meta-analysis using data from five prospective cohort studies identified by a Cochrane prognostic factor review. A one-stage IPD meta-analysis approach was applied. Multi-level mixed effects models were used to determine the unadjusted and adjusted associations between expectations and return to work (logistic regression) and time to return to work (parametric survival models with Weibull distribution).Results The final dataset included 2302 participants. Positive expectations for return to work were associated with return to work at follow-up in both unadjusted (Odds Ratio (OR) 2.95; 95% Confidence Interval (CI) 2.21, 3.95) (n = 2071) and comprehensively adjusted (OR 2.01; 95% CI 1.46, 2.77) (n = 1109) models. Similar findings were identified for shorter length of time to return to work in both unadjusted (HR 2.40; 95% CI 2.09, 2.75) (n = 1156) and minimally adjusted (HR 2.43; 95% CI 2.12, 2.79) (n = 1154) models.Conclusions Results suggest workers with low expectations for return to work are at increased risk for long-term work disability.
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Affiliation(s)
- Victoria Sullivan
- Department of Community Health & Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Maria N Wilson
- Department of Community Health & Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - Ole Kudsk Jensen
- Spine Center, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - William S Shaw
- Division of Occupational and Environmental Medicine, Departments of Medicine and Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Ivan A Steenstra
- Epidemiologist, Director Program Evaluation & Research Outcomes, LifeWorks, Toronto, ON, Canada
| | - Jill A Hayden
- Department of Community Health & Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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Main CJ, Shaw WS, Nicholas MK, Linton SJ. System-level efforts to address pain-related workplace challenges. Pain 2022; 163:1425-1431. [PMID: 35195550 PMCID: PMC9341230 DOI: 10.1097/j.pain.0000000000002548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/01/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Chris J. Main
- Primary Care and Health Sciences, Keele University, Keele, Staffordshire, United Kingdom
| | - William S. Shaw
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, United States
| | - Michael K. Nicholas
- Pain Management Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Steven J. Linton
- Department of Law, Psychology, and Social Work, Orebro University, Orebro, Sweden
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Shaw WS, McLellan RK, Besen E, Namazi S, Nicholas MK, Dugan AG, Tveito TH. A Worksite Self-management Program for Workers with Chronic Health Conditions Improves Worker Engagement and Retention, but not Workplace Function. J Occup Rehabil 2022; 32:77-86. [PMID: 33983524 PMCID: PMC8858918 DOI: 10.1007/s10926-021-09983-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 05/26/2023]
Abstract
Purpose An increasing number of workers in the US have chronic health conditions that limit their ability to work, and few worksite interventions have been tested to improve worker coping and problem solving at work. The purpose of this study was to evaluate a worksite-based health self-management program designed to improve workplace function among workers with chronic health conditions. Methods We conducted a randomized, controlled trial of a worksite self-management program ("Manage at Work") (clinicaltrials.gov #NCT01978392) for workers with chronic health conditions (N = 119; 82% female, ages 20-69). Most workers were recruited from the health care or light manufacturing industry sectors. Workers attended a 5-session, facilitated psychoeducational program using concepts of health self-management, self-efficacy, ergonomics, and communication. Changes on outcomes of work engagement, work limitation, job satisfaction, work fatigue, work self-efficacy, days absent, and turnover intention at 6-month follow-up were compared to wait-list controls. Results The most prevalent chronic health conditions were musculoskeletal pain, headaches, vision problems, gastrointestinal disorders, respiratory disorders, and mental health disorders. The self-management program showed greater improvement in work engagement and turnover intent at 6-month follow-up, but there was no evidence of a parallel reduction in perceived work limitation. Trends for improved outcomes of work self-efficacy, job satisfaction, and work fatigue in the intervention group did not reach statistical significance in a group x time interaction test. Conclusions Offering a worksite self-management program to workers with chronic health conditions may be a feasible and beneficial strategy to engage and retain skilled workers who are risking disability.Clinical trial registration: Clinicaltrials.gov #NCT01978392.
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Affiliation(s)
- William S. Shaw
- University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT 06030 USA
| | - Robert K. McLellan
- Geisel School of Medicine at Dartmouth, 1 Rope Ferry Drive, Hanover, NH 03755 USA
| | - Elyssa Besen
- Liberty Mutual Insurance, 175 Berkeley Street, Boston, MA 02116 USA
| | - Sara Namazi
- University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT 06030 USA
| | - Michael K. Nicholas
- University of Sydney at North Shore Hospital, St. Leonards, NSW 2065 Australia
| | - Alicia G. Dugan
- University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT 06030 USA
| | - Torill H. Tveito
- University of South-Eastern Norway, Raveien 215, 3184 Borre, Norway
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Gignac MAM, Bowring J, Jetha A, Beaton DE, Breslin FC, Franche RL, Irvin E, Macdermid JC, Shaw WS, Smith PM, Thompson A, Tompa E, Van Eerd D, Saunders R. Disclosure, Privacy and Workplace Accommodation of Episodic Disabilities: Organizational Perspectives on Disability Communication-Support Processes to Sustain Employment. J Occup Rehabil 2021; 31:153-165. [PMID: 32410153 PMCID: PMC7954721 DOI: 10.1007/s10926-020-09901-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Purpose Employers increasingly are asked to accommodate workers living with physical and mental health conditions that cause episodic disability, where periods of wellness are punctuated by intermittent and often unpredictable activity limitations (e.g., depression, anxiety, arthritis, colitis). Episodic disabilities may be challenging for workplaces which must comply with legislation protecting the privacy of health information while believing they would benefit from personal health details to meet a worker's accommodation needs. This research aimed to understand organizational perspectives on disability communication-support processes. Methods Twenty-seven participants from diverse employment sectors and who had responsibilities for supporting workers living with episodic disabilities (e.g., supervisors, disability managers, union representatives, occupational health representatives, labour lawyers) were interviewed. Five participants also had lived experience of a physical or mental health episodic disability. Participants were recruited through organizational associations, community networks and advertising. Semi-structured interviews and qualitative content analysis framed data collection and analyses, and mapped communication-support processes. Results Seven themes underpinned communication-support process: (1) similarities and differences among physical and mental health episodic disabilities; (2) cultures of workplace support, including contrasting medical and biopsychosocial perspectives; (3) misgivings about others and their role in communication-support processes; (4) that subjective perceptions matter; (5) the inherent complexity of the response process; (6) challenges arising when a worker denies a disability; and (7) casting disability as a performance problem. Conclusions This study identifies a conceptual framework and areas where workplace disability support processes could be enhanced to improve inclusion and the sustainability of employment among workers living with episodic disabilities.
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Affiliation(s)
- Monique A M Gignac
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Julie Bowring
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada
| | - Arif Jetha
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Dorcas E Beaton
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada
| | - F Curtis Breslin
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada
| | | | - Emma Irvin
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada
| | - Joy C Macdermid
- School of Physical Therapy, Western University, London, ON, Canada
| | | | - Peter M Smith
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Aaron Thompson
- Workplace Safety and Insurance Board (WSIB), Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Emile Tompa
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Dwayne Van Eerd
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada
| | - Ron Saunders
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada
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Dugan AG, Decker RE, Namazi S, Cavallari JM, Bellizzi KM, Blank TO, Dornelas EA, Tannenbaum SH, Shaw WS, Swede H, Salner AL. Perceptions of clinical support for employed breast cancer survivors managing work and health challenges. J Cancer Surviv 2021; 15:890-905. [PMID: 33405056 DOI: 10.1007/s11764-020-00982-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/12/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE A substantial portion of breast cancer survivors are active in the workforce, yet factors that allow survivors to balance work with cancer management and to return to work are poorly understood. We examined breast cancer survivors' most valued/desired types of support in early survivorship. METHODS Seventy-six employed breast cancer survivors answered an open-ended survey question assessing the most valued/desired support to receive from healthcare providers during early survivorship to manage work and health. Cutrona's (Journal of Social and Clinical Psychology 9:3-14, 1990) optimal matching theory and House's (1981) conceptualization of social support types informed our analyses. Data were content-analyzed to identify themes related to support, whether needed support was received or not, and the types of healthcare providers who provided support. RESULTS We identified six themes related to types of support. Informational support was valued and mostly received by survivors, but they expected more guidance related to work. Emotional support was valued but lacking, attributed mainly to providers' lack of personal connection and mental health support. Instrumental (practical) support was valued but received by a small number of participants. Quality of life support to promote well-being and functionality was valued and often received. Other themes included non-specific support and non-support. CONCLUSIONS This study expands our understanding of how breast cancer survivors perceive work-related support from healthcare professionals. Findings will inform targeted interventions designed to improve the support provided by healthcare professionals. IMPLICATIONS FOR CANCER SURVIVORS Breast cancer survivors managing work and health challenges may benefit by having their unmet support needs fulfilled.
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Affiliation(s)
- Alicia G Dugan
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06030, USA.
| | - Ragan E Decker
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
| | - Sara Namazi
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06030, USA
| | - Jennifer M Cavallari
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06030, USA
- Department of Public Health Sciences, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06030, USA
| | - Keith M Bellizzi
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269, USA
| | - Thomas O Blank
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269, USA
| | - Ellen A Dornelas
- Hartford Hospital, Hartford HealthCare Cancer Institute, 80 Seymour St, Hartford, CT, 06102, USA
| | - Susan H Tannenbaum
- Neag Comprehensive Cancer Center, UConn Health, 263 Farmington Ave, Farmington, CT, 06030, USA
| | - William S Shaw
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06030, USA
| | - Helen Swede
- Department of Public Health Sciences, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06030, USA
| | - Andrew L Salner
- Hartford Hospital, Hartford HealthCare Cancer Institute, 80 Seymour St, Hartford, CT, 06102, USA
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Shaw WS, Main CJ, Findley PA, Collie A, Kristman VL, Gross DP. Opening the Workplace After COVID-19: What Lessons Can be Learned from Return-to-Work Research? J Occup Rehabil 2020; 30:299-302. [PMID: 32562129 PMCID: PMC7303572 DOI: 10.1007/s10926-020-09908-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
- William S. Shaw
- University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Chris J. Main
- Keele University, Keele, North Staffordshire ST5 5BG UK
| | - Patricia A. Findley
- Rutgers, the State University of New Jersey, 120 Albany Street, New Brunswick, NJ USA
| | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004 Australia
| | - Vicki L. Kristman
- EPID@Work Research Institute and Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1 Canada
| | - Douglas P. Gross
- University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4 Canada
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Abstract
Opioid use disorder (OUD) and opioid overdose deaths (OODs) are prevalent among US workers, but work-related factors have not received adequate attention as either risk factors or opportunities for OOD prevention. Higher prevalence of OOD in those with heavy physical jobs, more precarious work, and limited health care benefits suggest work environment and organizational factors may predispose workers to the development of OUD.Organizational policies that reduce ergonomic risk factors, respond effectively to employee health and safety concerns, provide access to nonpharmacologic pain management, and encourage early substance use treatment are important opportunities to improve outcomes. Organizational barriers can limit disclosure of pain and help-seeking behavior, and opioid education is not effectively integrated with workplace safety training and health promotion programs.Policy development at the employer, government, and association levels could improve the workplace response to workers with OUD and reduce occupational risks that may be contributing factors.
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Affiliation(s)
- William S Shaw
- William S. Shaw is with the Division of Occupational and Environmental Medicine, Department of Medicine, University of Connecticut School of Medicine, Farmington. Cora Roelofs and Laura Punnett are with the Department of Biomedical Engineering, Francis College of Engineering, University of Massachusetts Lowell
| | - Cora Roelofs
- William S. Shaw is with the Division of Occupational and Environmental Medicine, Department of Medicine, University of Connecticut School of Medicine, Farmington. Cora Roelofs and Laura Punnett are with the Department of Biomedical Engineering, Francis College of Engineering, University of Massachusetts Lowell
| | - Laura Punnett
- William S. Shaw is with the Division of Occupational and Environmental Medicine, Department of Medicine, University of Connecticut School of Medicine, Farmington. Cora Roelofs and Laura Punnett are with the Department of Biomedical Engineering, Francis College of Engineering, University of Massachusetts Lowell
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Nicholas MK, Costa DSJ, Linton SJ, Main CJ, Shaw WS, Pearce G, Gleeson M, Pinto RZ, Blyth FM, McAuley JH, Smeets RJEM, McGarity A. Implementation of Early Intervention Protocol in Australia for 'High Risk' Injured Workers is Associated with Fewer Lost Work Days Over 2 Years Than Usual (Stepped) Care. J Occup Rehabil 2020; 30:93-104. [PMID: 31346923 DOI: 10.1007/s10926-019-09849-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Purpose To evaluate whether a protocol for early intervention addressing the psychosocial risk factors for delayed return to work in workers with soft tissue injuries would achieve better long-term outcomes than usual (stepped) care. Methods The study used a controlled, non-randomised prospective design to compare two case management approaches. For the intervention condition, workers screened within 1-3 weeks of injury as being at high risk of delayed returned to work by the Örebro Musculoskeletal Pain Screening Questionnaire-short version (ÖMPSQ-SF) were offered psychological assessment and a comprehensive protocol to address the identified obstacles for return to work. Similarly identified injured workers in the control condition were managed under usual (stepped) care arrangements. Results At 2-year follow-up, the mean lost work days for the Intervention group was less than half that of the usual care group, their claim costs were 30% lower, as was the growth trajectory of their costs after 11 months. Conclusions The findings supported the hypothesis that brief psychological risk factor screening, combined with a protocol for active collaboration between key stakeholders to address identified psychological and workplace factors for delayed return to work, can achieve better return on investment than usual (stepped) care.
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Affiliation(s)
- M K Nicholas
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia.
| | - D S J Costa
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - S J Linton
- Center for Health And Medical Psychology, Department of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden
| | - C J Main
- Arthritis Care UK Primary Care Centre, Keele University, Keele, North Staffordshire, UK
| | - W S Shaw
- University of Massachusetts Medical School, Worcester, MA, USA
| | - G Pearce
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - M Gleeson
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - R Z Pinto
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - F M Blyth
- School of Public Health, Concord Clinical School, University of Sydney, Sydney, NSW, Australia
| | - J H McAuley
- Neuroscience Research Australia and School of Medical Sciences, University of NSW, Sydney, NSW, Australia
| | - R J E M Smeets
- Department of Rehabilitation Medicine, Caphri, Maastricht University, Maastricht, The Netherlands
- CIR Revalidatie, Eindhoven, The Netherlands
| | - A McGarity
- Injury Management Health & Safety Branch, NSW Fire and Safety, Sydney, Australia
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Nicholas MK, Costa DSJ, Linton SJ, Main CJ, Shaw WS, Pearce G, Gleeson M, Pinto RZ, Blyth FM, McAuley JH, Smeets RJEM, McGarity A. Correction to: Implementation of Early Intervention Protocol in Australia for 'High Risk' Injured Workers is Associated with Fewer Lost Work Days Over 2 Years Than Usual (Stepped) Care. J Occup Rehabil 2019; 29:671. [PMID: 31414346 DOI: 10.1007/s10926-019-09855-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The original version of this article unfortunately contained a spelling error in one of the co-authors's names. The family name of the co-author was incorrectly displayed as "James McCauley" instead of "James McAuley. The original article has been corrected.
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Affiliation(s)
- M K Nicholas
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia.
| | - D S J Costa
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - S J Linton
- Center for Health And Medical Psychology, Department of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden
| | - C J Main
- Arthritis Care UK Primary Care Centre, Keele University, Keele, North Staffordshire, UK
| | - W S Shaw
- University of Massachusetts Medical School, Worcester, MA, USA
| | - G Pearce
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - M Gleeson
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - R Z Pinto
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - F M Blyth
- School of Public Health, Concord Clinical School, University of Sydney, Sydney, NSW, Australia
| | - J H McAuley
- Neuroscience Research Australia and School of Medical Sciences, University of NSW, Sydney, NSW, Australia
| | - R J E M Smeets
- Department of Rehabilitation Medicine, Caphri, Maastricht University, Maastricht, The Netherlands
- CIR Revalidatie, Eindhoven, The Netherlands
| | - A McGarity
- Injury Management Health & Safety Branch, NSW Fire and Safety, Sydney, Australia
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Skarpaas LS, Haveraaen LA, Småstuen MC, Shaw WS, Aas RW. Horizontal return to work coordination was more common in RTW programs than the recommended vertical coordination. The Rapid-RTW cohort study. BMC Health Serv Res 2019; 19:759. [PMID: 31655594 PMCID: PMC6815375 DOI: 10.1186/s12913-019-4607-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 10/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In return-to-work (RTW) programs, coordinators are often provided in order to integrate services. However, models of coordinating services vary widely internationally, and across different programs, where one distinction is between vertical and horizontal integration (i.e. between levels/institutions, or within one service/level). The aim of this study was therefore to explore and describe if and how a coordinator was provided in RTW-programs, and whether the provision of a coordinator was associated with certain personal or intervention characteristics. METHODS The study was designed as a cohort study following employees participating in a variety of Rapid-RTW-programs in Norway (n = 39). Employees (n = 494) answered a self-administered questionnaire, which was linked to register-data on diagnoses and sickness-absence. Employees who replied yes/no to the question "Did the program provide a person who tailored or coordinated your services?" were included in this analysis. Associations for being provided with a coordinator were tested in adjusted logistic regression models. RESULTS Sixty-nine percent of the employees reported having a coordinator. These coordinators were mainly responsible for coordinating treatment within own programs (i.e. horizontal coordination, 68%). As expected, rehabilitation programs more often provided a coordinator compared to treatment programs (OR 3.87 95% CI 2.42-6.24). The odds for being provided with a coordinator were reduced for each additional year of age of the employee (OR 0.97, 95% CI 0.96-0.99). More professions were involved in programs that provided coordinators, also more contact with other stakeholders like leaders and social insurance services (NAV), but only contact with supervisor remained statistically significant in adjusted analysis (OR 1.69 95% CI 0.31-9.27). The programs with a coordinator more often provided adaptations at the workplace for the individual employee (OR 0.08 95% CI 0.01-0.60). However, these signs of vertical integration were only evident for a limited number of employees. CONCLUSION In this study, seven of ten employees reported to have a coordinator, which was associated with more professions and stakeholder involvement in the RTW-process. Most of these coordinators did not coordinate vertically between the service levels and types of intervention arenas for sick listed employees (i.e. workplace, social security, and health care services), as recommended in earlier research.
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Affiliation(s)
- Lisebet Skeie Skarpaas
- Presenter - Making Sense of Science, Stavanger, Norway. .,Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway.
| | | | | | - William S Shaw
- Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Randi Wågø Aas
- Presenter - Making Sense of Science, Stavanger, Norway.,Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Nicholas MK, Costa DSJ, Linton SJ, Main CJ, Shaw WS, Pearce R, Gleeson M, Pinto RZ, Blyth FM, McCauley JH, Maher CG, Smeets RJEM, McGarity A. Predicting Return to Work in a Heterogeneous Sample of Recently Injured Workers Using the Brief ÖMPSQ-SF. J Occup Rehabil 2019; 29:295-302. [PMID: 29796980 DOI: 10.1007/s10926-018-9784-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose (1) to examine the ability of the Örebro Musculoskeletal Pain Screening Questionnaire-short version (ÖMPSQ-SF) to predict time to return to pre-injury work duties (PID) following a work-related soft tissue injury (regardless of body location); and (2) to examine the appropriateness of 50/100 as a suitable cut-off score for case identification. Methods Injured workers (IW) from six public hospitals in Sydney, Australia, who had taken medically-sanctioned time off work due to their injury, were recruited by insurance case managers within 5-15 days of their injury. Eligible participants (N = 213 in total) were administered the ÖMPSQ-SF over the telephone by the case manager. For objective (1) Cox proportional hazards regression analysis was used to predict days to return to PID using the ÖMPSQ-SF. For objective (2) receiver operator characteristic (ROC) analysis was used to determine the ÖMPSQ-SF total score that optimises sensitivity and specificity in detecting whether or not participants had returned to PID within 2-7 weeks. Results The total ÖMPSQ-SF score significantly predicted number of days to return to PID, such that for every 1-point increase in the total ÖMPSQ-SF score the predicted chance of returning to work reduced by 4% (i.e., hazard ratio = 0.96), p < 0.001. Sensitivity and specificity for the ROC analysis comparing ÖMPSQ-SF total score to return to PID within 2-7 weeks suggested 48 as the optimal cut off (sensitivity = 0.65, specificity = 0.79). Conclusion The results provide strong support for the use of the ÖMPSQ-SF in an applied setting for identifying those IW likely to have delayed RTW when administered within 15 days of the injury. While a score of 48/100 was the optimal cut point for sensitivity and specificity, pragmatically, 50/100 should be acceptable as a cut-off in future studies of this type.
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Affiliation(s)
- M K Nicholas
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia.
| | - D S J Costa
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - S J Linton
- Department of Law, Psychology, and Social Work, Center for Health and Medical Psychology, Örebro University, Örebro, Sweden
| | - C J Main
- Arthritis Care UK Primary Care Centre, Keele University, North Staffordshire, UK
| | - W S Shaw
- University of Connecticut Health Center, Farmington, CT, USA
| | - R Pearce
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - M Gleeson
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - R Z Pinto
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - F M Blyth
- School of Public Health, Concord Clinical School, University of Sydney, Sydney, NSW, Australia
| | - J H McCauley
- Neuroscience Research Australia and School of Medical Sciences, University of NSW, Sydney, NSW, Australia
| | - C G Maher
- The George Institute, Sydney Medical School, University of Sydney, Sydney, Australia
| | - R J E M Smeets
- Knowledge Centre Rehabilitation Foundation Limburg, Hoensbroek, The Netherlands
- Department of Rehabilitation Medicine, Caphri, Maastricht University, Maastricht, The Netherlands
| | - A McGarity
- Injury Management, Health & Safety Branch, NSW Fire and Safety, Sydney, Australia
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Skarpaas LS, Haveraaen LA, Småstuen MC, Shaw WS, Aas RW. The association between having a coordinator and return to work: the rapid-return-to-work cohort study. BMJ Open 2019; 9:e024597. [PMID: 30782911 PMCID: PMC6398742 DOI: 10.1136/bmjopen-2018-024597] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/29/2018] [Accepted: 12/05/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess if the reported provision of a coordinator was associated with time to first return to work (RTW) and first full RTW among sick-listed employees who participated in different rapid-RTW programmes in Norway. DESIGN The study was designed as a cohort study. SETTING Rapid-RTW programmes financed by the regional health authority in hospitals and Norwegian Labour and Welfare Administration in Norway. PARTICIPANTS The sample included employees on full-time sick leave (n=326) who participated in rapid-RTW programmes (n=43), who provided information about the coordination of the services they received. The median age was 46 years (minimum-maximum 21-67) and 71% were female. The most common reported diagnoses were musculoskeletal (57%) and mental health disorders (14%). INTERVENTIONS The employees received different types of individually tailored RTW programmes all aimed at a rapid RTW; occupational rehabilitation (64%), treatment for medical or psychological issues, including assessment, and surgery (26%), and follow-up and work clarification services (10%). It was common to be provided with a coordinator (73%). PRIMARY AND SECONDARY OUTCOME MEASURES Outcomes were measured as time to first RTW (graded and 100%) and first full RTW (100%). RESULTS Employees provided with a coordinator returned to work later than employees who did not have a coordinator; a median (95% CI) of 128 (80 to 176) days vs 61 (43 to 79) days for first RTW, respectively. This difference did not remain statistically significant in the adjusted regression analysis. For full RTW, there was no statistically significant difference between employees provided with a coordinator versus those who were not. CONCLUSIONS The model of coordination, provided in the Norwegian rapid-RTW programmes was not associated with a more rapid RTW for sick-listed employees. Rethinking how RTW coordination should be organised could be wise in future programme development.
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Affiliation(s)
- Lisebet Skeie Skarpaas
- Presenter - Making Sense of Science, Stavanger, Norway
- Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway
| | | | | | - William S Shaw
- Division of Occupational & Environmental Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Randi Wågø Aas
- Presenter - Making Sense of Science, Stavanger, Norway
- Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Lee J, Huang YH, Cheung JH, Chen Z, Shaw WS. A systematic review of the safety climate intervention literature: Past trends and future directions. J Occup Health Psychol 2018; 24:66-91. [PMID: 29697992 DOI: 10.1037/ocp0000113] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Safety climate represents the meaningfulness of safety and how safety is valued in an organization. The contributions of safety climate to organizational safety have been well documented. There is a dearth of empirical research, however, on specific safety climate interventions and their effectiveness. The present study aims at examining the trend of safety climate interventions and offering compiled information for designing and implementing evidence-based safety climate interventions. Our literature search yielded 384 titles that were inspected by three examiners. Using a stepwise process that allowed for assessment of interobserver agreement, 19 full articles were selected and reviewed. Results showed that 10 out of the 19 articles (52.6%) were based on a quasi-experimental pre- and postintervention design, whereas 42.1% (n = 8) studies were based on a mixed-design approach (including both between- and within-subject design). All interventions in these 19 studies involved either safety-/health-related communication or education/training. Improvement of safety leadership was also a common component of safety climate interventions. According to the socio-technical systems classification of intervention strategies, all studies were categorized as interventions focusing on improving organizational and managerial structure as well as the personnel subsystem; four of them also aimed at improving technological aspects of work, and five of them aimed at improving the physical work subsystem. In general, a vast majority of the studies (89.5%, n = 17) showed a statistically significant improvement in safety climate across their organizations postintervention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Jin Lee
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety
| | - Yueng-Hsiang Huang
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety
| | - Janelle H Cheung
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety
| | - Zhuo Chen
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety
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Shaw WS, Feuerstein M, Miller VI, Wood PM. Identifying Barriers to Recovery from Work Related Upper Extremity Disorders: Use of a Collaborative Problem Solving Technique. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/216507990305100806] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Improving health and work outcomes for individuals with work related upper extremity disorders (WRUEDs) may require a broad assessment of potential return to work barriers by engaging workers in collaborative problem solving. In this study, half of all nurse case managers from a large workers’ compensation system were randomly selected and invited to participate in a randomized, controlled trial of an integrated case management (ICM) approach for WRUEDs. The focus of ICM was problem solving skills training and workplace accommodation. Volunteer nurses attended a 2 day ICM training workshop including instruction in a 6 step process to engage clients in problem solving to overcome barriers to recovery. A chart review of WRUED case management reports (n = 70) during the following 2 years was conducted to extract case managers’ reports of barriers to recovery and return to work. Case managers documented from 0 to 21 barriers per case (M = 6.24, SD = 4.02) within 5 domains: signs and symptoms (36%), work environment (27%), medical care (13%), functional limitations (12%), and coping (12%). Compared with case managers who did not receive the training (n = 67), workshop participants identified more barriers related to signs and symptoms, work environment, functional limitations, and coping (p < .05), but not to medical care. Problem solving skills training may help focus case management services on the most salient recovery factors affecting return to work.
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Affiliation(s)
- William S. Shaw
- Liberty Mutual Center for Disability Research, Hopkinton, MA, and University of Massachusetts Medical School, Worcester, MA
| | - Michael Feuerstein
- Uniformed Services University of the Health Sciences, Bethesda, MD, and Georgetown University Medical Center, Washington, DC
| | - Virginia I. Miller
- U.S. Department of Labor, Office of Workers’ Compensation Programs, Washington, DC
| | - Patricia M. Wood
- U.S. Department of Labor, Office of Workers’ Compensation Programs, Washington, DC
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Main CJ, Nicholas MK, Shaw WS, Tetrick LE, Ehrhart MG, Pransky G. Erratum to: Implementation Science and Employer Disability Practices: Embedding Implementation Factors in Research Designs. J Occup Rehabil 2017; 27:477. [PMID: 28853049 PMCID: PMC6828363 DOI: 10.1007/s10926-017-9725-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Chris J Main
- Arthritis Care UK Primary Care Center, Keele University, North Staffordshire, UK
| | - Michael K Nicholas
- Pain Management Research Institute, Sydney Medical School - Northern, Royal North Shore Hospital, St. Leonards, NSW, 2065, Australia.
| | - William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | | | - Glenn Pransky
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
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Ketelaar SM, Schaafsma FG, Geldof MF, Boot CRL, Kraaijeveld RA, Shaw WS, Bültmann U, Twisk J, Anema JR. Employees' Perceptions of Social Norms as a Result of Implementing the Participatory Approach at Supervisor Level: Results of a Randomized Controlled Trial. J Occup Rehabil 2017; 27:319-328. [PMID: 27557825 PMCID: PMC5591363 DOI: 10.1007/s10926-016-9659-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Purpose A multifaceted implementation strategy was targeted at supervisors to encourage them to apply a participatory approach (PA) in dealing with employees' work functioning problems due to health concerns. This paper assesses the effect on employees' perceived social norms regarding the use of the PA to deal with work functioning problems. Methods Three organizations participated in a cluster randomized controlled trial, with randomization at the department level. Supervisors in the PA intervention departments received the implementation strategy consisting of a working group meeting, supervisor training, and optional coaching. Supervisors in the control departments received written information about the PA only. In two of the organizations, employees were invited to complete surveys at baseline and at 6-month follow-up. The primary outcome was perceived social norms regarding the use of the PA to deal with work functioning problems. Secondary measures included attitudes and self-efficacy, and intention regarding joint problem solving, and sick leave data. Effects were analyzed using multilevel analyses to account for nesting of cases. Results At baseline, 273 employees participated in the survey, with follow-up analyses of 174 employees. There were no statistically significant group effects on employee outcome measures. The intervention group showed a larger reduction in mean sick days (from 4.6 to 2.4 days) versus the control group (from 3.8 to 3.6 days), but this difference did not reach statistical significance (p > .05). Conclusion The multifaceted strategy to implement the participatory approach for supervisors did not show effects on outcomes at the employee level. To gain significant effects at the employee level, may require that an implementation strategy not only targets management and supervisors, but also employees themselves. TRIAL REGISTRATION NTR3733.
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Affiliation(s)
- S M Ketelaar
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - F G Schaafsma
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
- Research Center for Insurance Medicine, Collaboration Between AMC-UMCG-UWV-VU University Medical Center, Amsterdam, The Netherlands.
| | - M F Geldof
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - C R L Boot
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Institute for Work and Health, Toronto, Canada
| | - R A Kraaijeveld
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - W S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | - U Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J Twisk
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands
| | - J R Anema
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, Collaboration Between AMC-UMCG-UWV-VU University Medical Center, Amsterdam, The Netherlands
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20
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Ketelaar SM, Schaafsma FG, Geldof MF, Kraaijeveld RA, Boot CRL, Shaw WS, Bültmann U, Anema JR. Implementation of the Participatory Approach for Supervisors to Increase Self-Efficacy in Addressing Risk of Sick Leave of Employees: Results of a Cluster-Randomized Controlled Trial. J Occup Rehabil 2017; 27:247-257. [PMID: 27402346 PMCID: PMC5405097 DOI: 10.1007/s10926-016-9652-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Purpose To study the effectiveness of a multifaceted strategy to implement the participatory approach (PA) for supervisors to increase their self-efficacy in addressing risk of sick leave of employees. Methods Supervisors from three organizations were invited to participate. Randomization was performed at department level. Supervisors (n = 61) in the intervention departments received the implementation strategy consisting of a working group meeting, supervisor training in PA application, and optional supervisor coaching. Supervisors in the control departments (n = 55) received written information on PA. The primary outcome was supervisors' self-efficacy to apply the PA, measured at baseline and 6 months' follow-up. The number of employees with whom supervisors discussed work functioning problems or (risk of) sick leave was also assessed. Effects were tested using multilevel analyses. Results The strategy did not increase self-efficacy to apply the PA. Subgroup analyses showed that self-efficacy increased for supervisors who at baseline reported to have discussed (risk of) sick leave with less than three employees during the last 6 months (B = 1.42, 95 % CI 0.34-2.50). Furthermore, the implementation strategy increased the number of employees with whom supervisors discussed work functioning problems or risk of sick leave (B = 1.26, 95 % CI 0.04-2.48). Conclusion Although the implementation strategy cannot be recommended for all supervisors, for supervisors who less frequently discuss (risk of) sick leave with employees the implementation strategy might be helpful. Trial registration NTR3733.
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Affiliation(s)
- S M Ketelaar
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - F G Schaafsma
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
- Research Center for Insurance Medicine, Collaboration Between AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands.
| | - M F Geldof
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - R A Kraaijeveld
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - C R L Boot
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Body@Work, Research Center Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands
| | - W S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | - U Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J R Anema
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, Collaboration Between AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
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Besen E, Gaines B, Linton SJ, Shaw WS. The role of pain catastrophizing as a mediator in the work disability process following acute low back pain. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/jabr.12085] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Elyssa Besen
- Liberty Mutual Research Institute for Safety; Hopkinton MA USA
| | - Brittany Gaines
- Liberty Mutual Research Institute for Safety; Hopkinton MA USA
- Department of Gerontology; University of Massachusetts-Boston; Boston MA USA
| | - Steven J. Linton
- CHAMP; School of Law, Psychology, and Social Work; Örebro University; Örebro Sweden
| | - William S. Shaw
- Liberty Mutual Research Institute for Safety; Hopkinton MA USA
- University of Massachusetts Medical School; Worcester MA USA
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Kristman VL, Shaw WS, Reguly P, Williams-Whitt K, Soklaridis S, Loisel P. Supervisor and Organizational Factors Associated with Supervisor Support of Job Accommodations for Low Back Injured Workers. J Occup Rehabil 2017; 27:115-127. [PMID: 27032398 PMCID: PMC4980120 DOI: 10.1007/s10926-016-9638-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Purpose Temporary job accommodations contribute to the prevention of chronic work disability due to low back pain (LBP) through the facilitation of early return to work; yet, workplace dimensions of job accommodation are poorly understood. The objective of this study was to determine supervisor and organizational factors associated with supervisors' support for temporary job accommodations for LBP injured workers. Methods Supervisors were recruited from 19 workplaces in the USA and Canada and completed an online survey regarding job accommodation practices and potential associated factors with respect to a case vignette of a worker with LBP. Multivariable linear regression was used to identify the most parsimonious set of factors associated with supervisors' support for accommodations. Results A total of 804 supervisors participated with 796 eligible for inclusion in the analysis. The final set of factors explained 21 % of the variance in supervisors' support for temporary job accommodations. Considerate leadership style (β = 0.261; 95 % CI 0.212, 0.310), workplace disability management policies and practices (β = 0.243; 95 % CI 0.188, 0.298), and supervisor autonomy for designing and providing workplace accommodations (β = 0.156; 95 % CI 0.071, 0.241) had the largest effect on supervisor support for accommodations. Conclusion Factors predicting supervisors' likelihood to accommodate LBP injured workers include use of considerate leadership style, workplace disability management policies and practices, and supervisor autonomy. Workplace interventions targeting these factors should be developed and evaluated for their ability to improve work disability prevention outcomes.
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Affiliation(s)
- Vicki L Kristman
- Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON, P7B 5E1, Canada.
- Institute for Work & Health, Toronto, ON, Canada.
- Division of Human Sciences, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Paula Reguly
- Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON, P7B 5E1, Canada
| | | | - Sophie Soklaridis
- Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON, P7B 5E1, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Patrick Loisel
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Shaw WS, Main CJ, Pransky G, Nicholas MK, Anema JR, Linton SJ. Employer Policies and Practices to Manage and Prevent Disability: Foreword to the Special Issue. J Occup Rehabil 2016; 26:394-398. [PMID: 27562584 PMCID: PMC5104772 DOI: 10.1007/s10926-016-9658-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Purpose Employer policies and practices have been shown to impact workplace disability, but research in this area has waned in recent years despite an aging workforce, a growing prevalence of chronic health conditions, and a larger proportion of working-age adults on permanent work disability in many jurisdictions. The purpose of this article is to describe the background rationale and methodology for an invited conference designed to improve research of employer strategies to curtail work disability. Methods A multidisciplinary team of 26 international researchers with published research in employer-based disability management or related fields were invited to attend a 3-day conference in Hopkinton, Massachusetts, USA. The overall goal was to review the status of current research of workplace disability management and prevention, examine its relevance for employer decision-making, compare conceptual frameworks or theoretical perspectives, and recommend future research directions. Working groups were organized and draft manuscripts were prepared in advance. Conference activities included working group presentations and critiques, discussions with a panel of industry consultants and advisors, group interaction and debate, generation of final recommendations, and manuscript revision. Results/Conclusion Six principal domains were established with respect to future research: (a) further elucidation of the key workplace factors that buffer the disabling effects of injury and illness; (b) more innovative and feasible options for workplace intervention; (c) measurement of workplace-relevant disability outcomes; (d) a stronger theoretical framework for understanding the factors behind employer uptake and implementation; (e) a focus on special clinical populations and occupations where disability risk is most troubling; and (f) better representation of workers and employers that reflect the diverse and changing nature of work. Final comments and recommendations of the working groups are presented in the following six articles in this special issue of the Journal of Occupational Rehabilitation. Conference attendees recommended changes in methodology, collaboration strategies, and theoretical perspectives to improve the practical and scientific impact of future research of employer practices.
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Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA.
- University of Massachusetts Medical School, Worcester, MA, USA.
| | - Chris J Main
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care Sciences and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Glenn Pransky
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Michael K Nicholas
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, Australia
| | - Johannes R Anema
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Steven J Linton
- CHAMP, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
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Main CJ, Nicholas MK, Shaw WS, Tetrick LE, Ehrhart MG, Pransky G. Implementation Science and Employer Disability Practices: Embedding Implementation Factors in Research Designs. J Occup Rehabil 2016; 26:448-464. [PMID: 27796914 PMCID: PMC5104783 DOI: 10.1007/s10926-016-9677-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Purpose For work disability research to have an impact on employer policies and practices it is important for such research to acknowledge and incorporate relevant aspects of the workplace. The goal of this article is to summarize recent theoretical and methodological advances in the field of Implementation Science, relate these to research of employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration culminating in an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, MA, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results A 4-phase implementation model including both outer and inner contexts was adopted as the most appropriate conceptual framework, and aligned well with the set of process evaluation factors described in both the work disability prevention literature and the grey literature. Innovative interventions involving disability risk screening and psychologically-based interventions have been slow to gain traction among employers and insurers. Research recommendations to address this are : (1) to assess organizational culture and readiness for change in addition to individual factors; (2) to conduct process evaluations alongside controlled trials; (3) to analyze decision-making factors among stakeholders; and (4 ) to solicit input from employers and insurers during early phases of study design. Conclusions Future research interventions involving workplace support and involvement to prevent disability may be more feasible for implementation if organizational decision-making factors are imbedded in research designs and interventions are developed to take account of these influences.
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Affiliation(s)
- Chris J Main
- Arthritis Care UK Primary Care Center, Keele University, North Staffordshire, UK
| | - Michael K Nicholas
- Pain Management Research Institute, Sydney Medical School - Northern, Royal North Shore Hospital, St. Leonards, NSW, 2065, Australia.
| | - William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | | | - Glenn Pransky
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
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Abstract
Purpose Research of employer policies and practices to manage and prevent disability spans many disciplines and perspectives, and there are many challenges related to stakeholder collaboration, data access, and interventions. The purpose of this article is to synthesize the findings from a conference and year-long collaboration among a group of invited researchers intended to spur new research innovations in this field. Methods A multidisciplinary team of 26 international researchers with published research in employer-based disability management or related fields were invited to attend a 3-day conference in Hopkinton, Massachusetts, USA. The conference goals were to review the status of current research of workplace disability management and prevention, examine its relevance for employer decision-making, compare conceptual frameworks or theoretical perspectives, and recommend future research directions. In this paper, we summarize key points from the 6 resulting papers, compare them with an earlier 2005 conference on improving return-to-work research, and conclude with recommendations for further overarching research directions. Results/Conclusion In comparison with the 2005 conference, a greater emphasis was placed on organizational and social factors, employer roles and responsibilities, methods of implementation, non-clinical approaches, and facilitating stay-at-work as well as return-to-work. A special panel of employer consultants and representatives who were featured at the 2015 conference reinforced the importance of organizational culture, leadership style, and financial decision-making strategies at the employer level. Based on the conference proceedings, we recommend that future research in this area should strive for: (a) broader inclusion of workers and workplaces; (b) attention to multilevel influences in the workplace;
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Affiliation(s)
- Chris J Main
- Research Institute for Primary Care and Health Sciences, Room 1.56, Keele University, Keele, N. Staffordshire, ST5 5BG, UK.
| | - William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
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Kristman VL, Shaw WS, Boot CRL, Delclos GL, Sullivan MJ, Ehrhart MG. Researching Complex and Multi-Level Workplace Factors Affecting Disability and Prolonged Sickness Absence. J Occup Rehabil 2016; 26:399-416. [PMID: 27550629 PMCID: PMC5104770 DOI: 10.1007/s10926-016-9660-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Purpose There is growing research evidence that workplace factors influence disability outcomes, but these variables reflect a variety of stakeholder perspectives, measurement tools, and methodologies. The goal of this article is to summarize existing research of workplace factors in relation to disability, compare this with employer discourse in the grey literature, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability, held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results Predominant factors in the scientific literature were categorized as physical or psychosocial job demands, work organization and support, and workplace beliefs and attitudes. Employees experiencing musculoskeletal disorders in large organizations were the most frequently studied population. Research varied with respect to the basic unit of assessment (e.g., worker, supervisor, policy level) and whether assessments should be based on worker perceptions, written policies, or observable practices. The grey literature suggested that employers focus primarily on defining roles and responsibilities, standardizing management tools and procedures, being prompt and proactive, and attending to the individualized needs of workers. Industry publications reflected a high reliance of employers on a strict biomedical model in contrast to the more psychosocial framework that appears to guide research designs. Conclusion Assessing workplace factors at multiple levels, within small and medium-sized organizations, and at a more granular level may help to clarify generalizable concepts of organizational support that can be translated to specific employer strategies involving personnel, tools, and practices.
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Affiliation(s)
- Vicki L Kristman
- Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON, P7B 5E1, Canada.
- Institute for Work and Health, Toronto, ON, Canada.
- Division of Human Sciences, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Cécile R L Boot
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - George L Delclos
- Division of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas-Houston School of Public Health, Houston, TX, USA
- Center for Research in Occupational Health (CiSAL), Pompeu Fabra University, Barcelona, Spain
| | | | - Mark G Ehrhart
- Department of Psychology, San Diego State University, San Diego, CA, USA
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Shaw WS, Robertson MM, Pransky G, McLellan RK. Training to Optimize the Response of Supervisors to Work Injuries—Needs Assessment, Design, and Evaluation. ACTA ACUST UNITED AC 2016; 54:226-35. [PMID: 16729659 DOI: 10.1177/216507990605400506] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, Center for Disability Research, Hopkinton, MA, USA
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Shaw WS, Hartvigsen J, Woiszwillo MJ, Linton SJ, Reme SE. Psychological Distress in Acute Low Back Pain: A Review of Measurement Scales and Levels of Distress Reported in the First 2 Months After Pain Onset. Arch Phys Med Rehabil 2016; 97:1573-1587. [DOI: 10.1016/j.apmr.2016.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 01/11/2016] [Accepted: 02/04/2016] [Indexed: 11/15/2022]
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Williams-Whitt K, Kristman V, Shaw WS, Soklaridis S, Reguly P. A Model of Supervisor Decision-Making in the Accommodation of Workers with Low Back Pain. J Occup Rehabil 2016; 26:366-81. [PMID: 26811170 PMCID: PMC4939088 DOI: 10.1007/s10926-015-9623-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Purpose To explore supervisors' perspectives and decision-making processes in the accommodation of back injured workers. Methods Twenty-three semi-structured, in-depth interviews were conducted with supervisors from eleven Canadian organizations about their role in providing job accommodations. Supervisors were identified through an on-line survey and interviews were recorded, transcribed and entered into NVivo software. The initial analyses identified common units of meaning, which were used to develop a coding guide. Interviews were coded, and a model of supervisor decision-making was developed based on the themes, categories and connecting ideas identified in the data. Results The decision-making model includes a process element that is described as iterative "trial and error" decision-making. Medical restrictions are compared to job demands, employee abilities and available alternatives. A feasible modification is identified through brainstorming and then implemented by the supervisor. Resources used for brainstorming include information, supervisor experience and autonomy, and organizational supports. The model also incorporates the experience of accommodation as a job demand that causes strain for the supervisor. Accommodation demands affect the supervisor's attitude, brainstorming and monitoring effort, and communication with returning employees. Resources and demands have a combined effect on accommodation decision complexity, which in turn affects the quality of the accommodation option selected. If the employee is unable to complete the tasks or is reinjured during the accommodation, the decision cycle repeats. More frequent iteration through the trial and error process reduces the likelihood of return to work success. Conclusion A series of propositions is developed to illustrate the relationships among categories in the model. The model and propositions show: (a) the iterative, problem solving nature of the RTW process; (b) decision resources necessary for accommodation planning, and
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Affiliation(s)
- Kelly Williams-Whitt
- Faculty of Management, University of Lethbridge, Calgary Campus, Suite S6032, 345 - 6th Avenue SE, Calgary, AB, T2G 4V1, Canada.
| | - Vicki Kristman
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
- Institute for Work and Health, Toronto, ON, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada
| | - William S Shaw
- Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
| | - Sophie Soklaridis
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Paula Reguly
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
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Gross DP, Armijo-Olivo S, Shaw WS, Williams-Whitt K, Shaw NT, Hartvigsen J, Qin Z, Ha C, Woodhouse LJ, Steenstra IA. Clinical Decision Support Tools for Selecting Interventions for Patients with Disabling Musculoskeletal Disorders: A Scoping Review. J Occup Rehabil 2016; 26:286-318. [PMID: 26667939 PMCID: PMC4967425 DOI: 10.1007/s10926-015-9614-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Purpose We aimed to identify and inventory clinical decision support (CDS) tools for helping front-line staff select interventions for patients with musculoskeletal (MSK) disorders. Methods We used Arksey and O'Malley's scoping review framework which progresses through five stages: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies for analysis; (4) charting the data; and (5) collating, summarizing and reporting results. We considered computer-based, and other available tools, such as algorithms, care pathways, rules and models. Since this research crosses multiple disciplines, we searched health care, computing science and business databases. Results Our search resulted in 4605 manuscripts. Titles and abstracts were screened for relevance. The reliability of the screening process was high with an average percentage of agreement of 92.3 %. Of the located articles, 123 were considered relevant. Within this literature, there were 43 CDS tools located. These were classified into 3 main areas: computer-based tools/questionnaires (n = 8, 19 %), treatment algorithms/models (n = 14, 33 %), and clinical prediction rules/classification systems (n = 21, 49 %). Each of these areas and the associated evidence are described. The state of evidentiary support for CDS tools is still preliminary and lacks external validation, head-to-head comparisons, or evidence of generalizability across different populations and settings. Conclusions CDS tools, especially those employing rapidly advancing computer technologies, are under development and of potential interest to health care providers, case management organizations and funders of care. Based on the results of this scoping review, we conclude that these tools, models and systems should be subjected to further validation before they can be recommended for large-scale implementation for managing patients with MSK disorders.
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Affiliation(s)
- Douglas P. Gross
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Susan Armijo-Olivo
- Faculty of Rehabilitation Medicine, University of Alberta, 3-62 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - William S. Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA 01748 USA
| | - Kelly Williams-Whitt
- University of Lethbridge, Calgary Campus, Suite S6032, 345 - 6th Avenue SE, Calgary, AB T2G 4V1 Canada
| | - Nicola T. Shaw
- Algoma University, 1520 Queen Street East, CC 303, Sault Ste. Marie, ON P2A 2G4 Canada
| | - Jan Hartvigsen
- University of Southern Denmark, Odense, Denmark
- Center for Muscle and Joint Health, Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, 5230 Odense M, Denmark
| | - Ziling Qin
- Faculty of Rehabilitation Medicine, University of Alberta, 3-62 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Christine Ha
- Faculty of Rehabilitation Medicine, University of Alberta, 3-62 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Linda J. Woodhouse
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Ivan A. Steenstra
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON M5G 2E9 Canada
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Boot CRL, de Kruif ATCM, Shaw WS, van der Beek AJ, Deeg DJ, Abma T. Factors Important for Work Participation Among Older Workers with Depression, Cardiovascular Disease, and Osteoarthritis: A Mixed Method Study. J Occup Rehabil 2016. [PMID: 26210996 PMCID: PMC4854935 DOI: 10.1007/s10926-015-9597-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Purpose The aim of this study was to gain insight into differences and similarities in factors important for work participation in older (58-65 years) workers among three different chronic diseases: depression (D), cardiovascular disease (C), and osteoarthritis (O). Methods A mixed method design was used, with a qualitative part (in-depth interviews) with 14 patients with D, C or O and a quantitative part based on the 2002-2003 cohort of the Longitudinal Aging Study Amsterdam. We analysed and compared 3-year (response 93 %) predictors of paid work in 239 participants with D, C, or O using regression analyses. The qualitative findings were integrated with the quantitative findings aiming at complementarity. Results Common factors important for work participation were: working at baseline; male gender; lower age; partner with paid work; better physical and mental health; and higher mastery scores. The qualitative analyses added autonomy in work and provided contextual information regarding the perceived importance of working as factors important for participation in paid work. For D and C, work gave purpose in life and enhanced social contacts. Participation in work was perceived as necessary to structure life only for D. Conclusion Most factors important for work participation were similar for D, C, and O. However, the interviews revealed that for D, the context and the meaning attributed to these factors differed.
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Affiliation(s)
- Cécile R L Boot
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
- Body@Work, Research Center on Physical Activity, Work and Health, Amsterdam, The Netherlands.
| | - Anja Th C M de Kruif
- Department of Metamedica/Medical Humanities, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
- Department of Health Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands
| | - William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Allard J van der Beek
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
- Body@Work, Research Center on Physical Activity, Work and Health, Amsterdam, The Netherlands
| | - Dorly J Deeg
- Department of Epidemiology and Biostatistics/Longitudinal Aging Study Amsterdam, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Tineke Abma
- Department of Metamedica/Medical Humanities, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
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Abstract
PURPOSE The aim of this paper is to develop and test a model of direct and indirect relationships among individual psychosocial predictors of return-to-work (RTW) outcomes following the onset of low back pain (LBP). METHODS We utilize secondary analysis of a larger study of adults seeking treatment for work-related LBP with recent onset. In total, 241 participants who completed a baseline survey, a short follow-up survey, and a longer follow-up survey after 3 months were included in our analyses. The participants were required to have LBP with onset of less than 14 days, be 18 years or older, and be fluent in English or Spanish. The analyses utilized structural equation models to test the direct and indirect relationships among the variables and RTW outcomes at 3 months. RESULTS Our results indicated a good fit for our model (χ2 = 69.59, df = 45, p < .05; RMSEA = .05; CFI = .95; WRMR = .61). Pain, catastrophizing, fear-avoidance beliefs, organizational support, and RTW confidence were all found to have indirect relationships with the outcomes. RTW confidence and RTW expectations were found to have direct relationships with the outcomes. CONCLUSIONS The process of returning to work after an episode of LBP is a complex process involving many interrelated factors. Understanding the relationships among critical individual factors in the RTW process may be important for the treatment and rehabilitation of those with LBP. Results suggest that if injured workers are struggling with fear avoidance, pain catastrophizing and confidence issues, they might benefit from the application of cognitive behavioral therapy techniques.
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Affiliation(s)
- Elyssa Besen
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA,
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Johnston V, Way K, Long MH, Wyatt M, Gibson L, Shaw WS. Supervisor competencies for supporting return to work: a mixed-methods study. J Occup Rehabil 2015; 25:3-17. [PMID: 24715502 DOI: 10.1007/s10926-014-9511-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE Line supervisors often play an important role in the return to work (RTW) process; whether they possess the competencies needed to carry out this work effectively is unknown. The aim of this research was to determine the competencies supervisors need in order to facilitate a worker's RTW following absence due to a mental health condition or a musculoskeletal disorder. METHODS Supervisors from five Australian industries with high rates of compensable claims participated in focus groups to elicit the knowledge, skills, and personal characteristics required to support returning workers. From a multi-stage analysis of responses, RTW competencies were developed, allocated to clusters of related items, and incorporated into an online survey administered to rehabilitation professionals. RESULTS 29 supervisors participated in 1 of 5 focus groups. Analysis of focus group data identified 84 generic competencies, eight specific to mental health conditions, and two to musculoskeletal disorders, arranged in 11 clusters. Survey respondents (n = 344) represented a variety of rehabilitation professionals and jurisdictions. Nearly all agreed that supervisors should receive training to support RTW. Over 50 % of respondents rated 90 of 94 competencies as very important or essential. The highest ratings were for competencies relating to personal attributes, knowledge of RTW processes, and empathetic support of the worker. CONCLUSIONS Supervisors and rehabilitation professionals perceive effective support of RTW requires supervisors to have a range of knowledge, skills, and personal characteristics. Our competency model should undergo workplace testing to evaluate its validity.
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Affiliation(s)
- Venerina Johnston
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia,
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Shaw WS, Kristman VL, Williams-Whitt K, Soklaridis S, Huang YH, Côté P, Loisel P. The Job Accommodation Scale (JAS): psychometric evaluation of a new measure of employer support for temporary job modifications. J Occup Rehabil 2014; 24:755-65. [PMID: 24643785 PMCID: PMC4465389 DOI: 10.1007/s10926-014-9508-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION An employer offer of temporary job modification is a key strategy for facilitating return-to-work for musculoskeletal conditions, but there are no validated scales to assess the level of support for temporary job modifications across a range of job types and organizations. OBJECTIVE To pilot test a new 21-item self-report measure [the Job Accommodation Scale (JAS)] to assess its applicability, internal consistency, factor structure, and relation to physical job demands. METHODS Supervisors (N = 804, 72.8 % male, mean age = 46) were recruited from 19 employment settings in the USA and Canada and completed a 30-min online survey regarding job modification practices. As part of the survey, supervisors nominated and described a job position they supervised and completed the JAS for a hypothetical worker (in that position) with an episode of low back pain. Job characteristics were derived from the occupational informational network job classification database. RESULTS The full response range (1-4) was utilized on all 21 items, with no ceiling or floor effects. Avoiding awkward postures was the most feasible accommodation and moving the employee to a different site or location was the least feasible. An exploratory factor analysis suggested five underlying factors (Modify physical workload; Modify work environment; Modify work schedule; Find alternate work; and Arrange for assistance), and there was an acceptable goodness-of-fit for the five parceled sub-factor scores as a single latent construct in a measurement model (structural equation model). Job accommodations were less feasible for more physical jobs and for heavier industries. CONCLUSIONS The pilot administration of the JAS with respect to a hypothetical worker with low back pain showed initial support for its applicability, reliability, and validity when administered to supervisors. Future studies should assess its validity for use in actual disability cases, for a range of health conditions, and to assess different stakeholder opinions about the feasibility of job accommodation strategies.
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Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA,
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Reme SE, Shaw WS, Boden LI, Tveito TH, O'Day ET, Dennerlein JT, Sorensen G. Worker assessments of organizational practices and psychosocial work environment are associated with musculoskeletal injuries in hospital patient care workers. Am J Ind Med 2014; 57:810-8. [PMID: 24737462 DOI: 10.1002/ajim.22319] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hospital patient care (PC) workers have high rates of workplace injuries, particularly musculoskeletal injuries. Despite a wide spectrum of documented health hazards, little is known about the association between psychosocial factors at work and OSHA-recordable musculoskeletal injuries. METHODS PC-workers (n = 1,572, 79%) completed surveys assessing a number of organizational, psychosocial and psychological variables. Associations between the survey responses and injury records were tested using bivariate and multivariate analyses. RESULTS A 5% of the PC-workers had at least one OSHA-recordable musculoskeletal injury over the year, and the injuries were significantly associated with: organizational factors (lower people-oriented culture), psychosocial factors (lower supervisor support), and structural factors (job title: being a patient care assistant). CONCLUSIONS The results show support for a multifactorial understanding of musculoskeletal injuries in hospital PC-workers. An increased focus on the various dimensions associated with injury reports, particularly the organizational and psychosocial factors, could contribute to more efficient interventions and programs.
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Affiliation(s)
- Silje Endresen Reme
- Harvard School of Public Health; Boston Massachusetts
- Uni Health; Uni Research AS; Bergen Norway
| | - William S. Shaw
- Liberty Mutual Research Institute for Safety; Hopkinton Massachusetts
| | | | | | | | - Jack T. Dennerlein
- Harvard School of Public Health; Boston Massachusetts
- Northeastern University; Boston Massachusetts
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Shaw WS, Besen E, Pransky G, Boot CRL, Nicholas MK, McLellan RK, Tveito TH. Manage at work: a randomized, controlled trial of a self-management group intervention to overcome workplace challenges associated with chronic physical health conditions. BMC Public Health 2014; 14:515. [PMID: 24885844 PMCID: PMC4051380 DOI: 10.1186/1471-2458-14-515] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 05/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The percentage of older and chronically ill workers is increasing rapidly in the US and in many other countries, but few interventions are available to help employees overcome the workplace challenges of chronic pain and other physical health conditions. While most workers are eligible for job accommodation and disability compensation benefits, other workplace strategies might improve individual-level coping and problem solving to prevent work disability. In this study, we hypothesize that an employer-sponsored group intervention program employing self-management principles may improve worker engagement and reduce functional limitation associated with chronic disorders. METHODS In a randomized controlled trial (RCT), workers participating in an employer-sponsored self-management group intervention will be compared with a no-treatment (wait list) control condition. Volunteer employees (n = 300) will be recruited from five participating employers and randomly assigned to intervention or control. Participants in the intervention arm will attend facilitated group workshop sessions at work (10 hours total) to explore methods for improving comfort, adjusting work habits, communicating needs effectively, applying systematic problem solving, and dealing with negative thoughts and emotions about work. Work engagement and work limitation are the principal outcomes. Secondary outcomes include fatigue, job satisfaction, self-efficacy, turnover intention, sickness absence, and health care utilization. Measurements will be taken at baseline, 6-, and 12-month follow-up. A process evaluation will be performed alongside the randomized trial. DISCUSSION This study will be most relevant for organizations and occupational settings where some degree of job flexibility, leeway, and decision-making autonomy can be afforded to affected workers. The study design will provide initial assessment of a novel workplace approach and to understand factors affecting its feasibility and effectiveness. TRIAL REGISTRATION Clinicaltrials.gov: NCT01978392 (Issued November 6, 2013).
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Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Rd,, Hopkinton, MA 01748, USA.
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Arends I, Bültmann U, Shaw WS, van Rhenen W, Roelen C, Nielsen K, van der Klink JJL. How to engage occupational physicians in recruitment of research participants: a mixed-methods study of challenges and opportunities. J Occup Rehabil 2014; 24:68-78. [PMID: 23690088 DOI: 10.1007/s10926-013-9452-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE To investigate barriers and facilitators for research participant recruitment by occupational physicians (OPs). METHODS A mixed-methods approach was used. Focus groups and interviews were conducted with OPs to explore perceived barriers and facilitators for recruitment. Based on data of a cluster-randomised controlled trial (cluster-RCT), univariate and multivariate analyses were conducted to investigate associations between OPs' personal and work characteristics and the number of recruited participants for the cluster-RCT per OP. RESULTS Perceived barriers and facilitators for recruitment were categorised into: study characteristics (e.g. concise inclusion criteria); study population characteristics; OP's attention; OP's workload; context (e.g. working at different locations); and OP's characteristics (e.g. motivated to help). Important facilitators were encouragement by colleagues and reminders by information technology tools. Multivariate analyses showed that the number of OPs within the clinical unit who recruited participants was positively associated with the number of recruited participants per OP [rate ratio of 1.43, 95 % confidence interval 1.24-1.64]. CONCLUSIONS When mobilising OPs for participant recruitment, researchers need to engage entire clinical units rather than approach OPs on an individual basis. OPs consider regular communication, especially face-to-face contact and information technology tools serving as reminders, as helpful.
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Affiliation(s)
- Iris Arends
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands,
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Johnston V, Shaw WS. Helping workers help themselves: empowering physiotherapy clients to manage musculoskeletal problems at work. Physical Therapy Reviews 2013. [DOI: 10.1179/1743288x13y.0000000087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Shaw WS, Campbell P, Nelson CC, Main CJ, Linton SJ. Effects of workplace, family and cultural influences on low back pain: What opportunities exist to address social factors in general consultations? Best Pract Res Clin Rheumatol 2013; 27:637-48. [DOI: 10.1016/j.berh.2013.09.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kraaijeveld RA, Schaafsma FG, Boot CRL, Shaw WS, Bültmann U, Anema JR. Implementation of the participatory approach to increase supervisors' self-efficacy in supporting employees at risk for sick leave; design of a randomised controlled trial. BMC Public Health 2013; 13:750. [PMID: 23941563 PMCID: PMC3751359 DOI: 10.1186/1471-2458-13-750] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 08/08/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The burden of sick leave for society and organisations underlines the urgent need to prevent sick leave. An effective workplace intervention for organisations to shorten sick leave episodes is the Participatory Approach (PA). In this study, we hypothesize that implementation of the PA for supervisors within organisations may prevent sick leave as well. However, implementation of the PA within an organisation is difficult, and barriers at different levels (employee, supervisor and organisational) exist. Therefore, the primary aim of this study is to evaluate the effectiveness of a multifaceted implementation strategy of the PA. METHODS In a cluster randomised controlled trial (RCT) a multifaceted implementation of the PA will be compared with a minimal implementation strategy of the PA. Participating organisations are a university medical centre, a university and a steel factory. Randomisation will take place at department level. Intervention departments will receive a multifaceted implementation strategy of the PA, which incorporates a working group, supervisor training, and supervisor coaching. Control departments will receive the minimal implementation strategy of the PA, consisting of written information only. The primary outcome measure is self-efficacy of supervisors in joint problem solving to improve work functioning of employees with health complaints and to prevent sick leave. A secondary outcome measure at supervisor level is self-efficacy in communicating with employees about situations of reduced work functioning or being at risk for sick leave. Secondary outcome measures at employee level are attitude, self-efficacy, and social influence, with regard to addressing situations of reduced work functioning or being at risk for sick leave, as well as work functioning, psychological well being, and sick leave. Measurements will take place at baseline, and after six and twelve months follow-up. A process evaluation will be performed as well. DISCUSSION This study will be relevant for all organisations with employees at risk for sick leave in health care, education, and industry. Study results will give an insight into the effectiveness of the multifaceted implementation strategy of the PA for supervisors to improve work functioning of employees with health complaints, and to prevent sick leave.
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Affiliation(s)
- Ruben A Kraaijeveld
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, PO Box 7057, Amsterdam, 1007 MB, The Netherlands
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Abstract
BACKGROUND The increasing prevalence of older workers and chronic health conditions represents a growing occupational health concern. More research is needed to understand risk factors, apply and adapt theories, and test workplace-focused interventions that might prevent work disability and disengagement among chronically ill workers. METHODS A 2-h roundtable symposium involving 28 participants was held at an international conference (Second Scientific Conference on Work Disability Prevention & Integration, Groningen, The Netherlands) in October 2012. In that symposium, small groups of participants were invited to discuss theoretical, methodological, and implementation considerations for studying workplace function and well-being among workers with chronic health conditions. As a follow-up to the symposium, the organizers invited authors to submit original articles to a Special Section of the Journal of Occupational Rehabilitation for peer review and publication. RESULTS Results of the symposium reflected the need to address social, not just physical, aspects of the workplace, to include both individual-level and organizational interventions, and to integrate employer perspectives and operational models. Contributions to the Special Issue focus on outcome measurement, symptom self-management at work, job accommodations, prognostic factors for disability escalation, and the perceived needs of affected workers. CONCLUSIONS The content of the Special Section reflects an evolving body of research that continues to grapple with basic issues around choice of outcome measures, level of intervention, and the optimal ways to meet the needs of workers with chronic health conditions, including supporting efforts to manage symptoms and function at work. Future research should focus on integrating organizational and individual-level interventions.
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Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748, USA.
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Shaw WS, Chin EH, Nelson CC, Reme SE, Woiszwillo MJ, Verma SK. What circumstances prompt a workplace discussion in medical evaluations for back pain? J Occup Rehabil 2013; 23:125-34. [PMID: 23054227 DOI: 10.1007/s10926-012-9392-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
PURPOSE To determine how frequently workplace topics emerge in the interactions between patients and providers in an evaluation for low back pain (LBP) and to determine its association with patient and provider characteristics. METHODS Adults with work-related LBP (N = 97; 64 % male; median age = 38) completed a demographic questionnaire and a survey of disability risk factors, then agreed to audio-taping of their visits with a participating occupational healthcare provider (n = 14). Utterance-level verbal exchanges were categorized by trained coders using the Roter interaction analysis system. In addition, coders flagged any instance of workplace discussion between patients and providers. RESULTS Workplace discussions occurred in 51 % of visits, and the most frequent topic was physical job demands. Workplace discussions were more frequent among the oldest and youngest patients and when patients were seen by providers who were more patient-centered and made more efforts to establish patient rapport and engagement. However, patients reporting numerous disability risk factors and workplace concerns in the pre-visit questionnaire were no more likely to discuss workplace topics with their providers (p > 0.05). Only the patient-centered orientations of providers and patients remained statistically significant predictors in multivariate modeling (p < 0.05). CONCLUSIONS Workplace discussions are facilitated by a patient-centered orientation and by efforts to establish patient engagement and rapport, but workplace discussions are no more frequent among patients with the most significant workplace concerns. Screening questionnaires and other assessment tools may be helpful to foster workplace discussions to overcome possible barriers for returning to work.
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Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA.
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Reme SE, Shaw WS, Steenstra IA, Woiszwillo MJ, Pransky G, Linton SJ. Distressed, immobilized, or lacking employer support? A sub-classification of acute work-related low back pain. J Occup Rehabil 2012; 22:541-552. [PMID: 22644216 DOI: 10.1007/s10926-012-9370-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION One possibility for reducing the disabling effects of low back pain (LBP) is to identify subgroups of patients who might benefit from different disability prevention strategies. The aim of this study was to test the ability to discern meaningful patient clusters for early intervention based on self-reported concerns and expectations at the time of an initial medical evaluation. METHODS Workers seeking an initial evaluation for acute, work-related LBP (N = 496; 58 % male) completed self-report measures comprising of 11 possible risk factors for chronicity of pain and disability. Outcomes of pain, function, and return-to-work were assessed at 3-month follow-up. A K-means cluster analysis was used to derive patient subgroups based on risk factor patterns, and then these subgroups were compared with respect to 3-month outcomes. RESULTS Eight of the 11 measures showed significant associations with functional recovery and return-to-work, and these were entered into the cluster analysis. A 4-cluster solution met criteria for cluster separation and interpretability, and the four clusters were labeled: (a) minimal risk (29 %), (b) workplace concerns (26 %); (c) activity limitations (27 %); and (d) emotional distress (19 %). Functional outcomes were best in the minimal risk group, poorest in the emotional distress group, and intermediate in the other two groups. A global severity index at baseline also showed highest overall risk in the emotional distressed group. CONCLUSIONS Patterns of early disability risk factors from this study suggest patients have differential needs with respect to overcoming emotional distress, resuming normal activity, and obtaining workplace support. Classifying patients in this manner may improve the cost-benefit of early intervention strategies to prevent long-term sickness absence and disability due to LBP.
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Affiliation(s)
- Silje Endresen Reme
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02215, USA.
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Shaw WS, Woiszwillo MJ, Krupat E. Further validation of the Patient-Practitioner Orientation Scale (PPOS) from recorded visits for back pain. Patient Educ Couns 2012; 89:288-91. [PMID: 22954491 DOI: 10.1016/j.pec.2012.07.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 07/20/2012] [Accepted: 07/31/2012] [Indexed: 05/22/2023]
Abstract
OBJECTIVE More patient-centered communication is associated with improved patient satisfaction and health status, fewer malpractice complaints, and increased adherence. In a study of medical encounters for acute low back pain (LBP), we conducted a secondary analysis to assess the validity of the Patient Practitioner Orientation Scale (PPOS), a measure of patient-centeredness. METHODS Fourteen clinicians and 89 of their patients with acute LBP completed the PPOS and agreed to have verbal exchanges recorded and coded using the Roter Interaction Analysis System (RIAS). We examined correlations between the PPOS and counts of patient and provider utterances within 8 RIAS verbal exchange categories. RESULTS Providers with a more patient-centered orientation asked fewer biomedical questions, posed more lifestyle questions, gave more lifestyle advice, and did more rapport-building. Their patients shared more lifestyle information and made more attempts at rapport building and provider engagement. In contrast, the patient-centered orientation of patients showed no effect on communication. CONCLUSION The PPOS scores of providers, but not patients, predicted significant and meaningful differences in the verbal exchanges of patients and providers. PRACTICE IMPLICATIONS The results support the validity of the PPOS measure and provide further evidence of the extent to which provider orientation influences patient communication and exchange.
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Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748, USA.
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Ciriello VM, Shaw WS, Rivard AJ, Woiszwillo MJ. Dynamic training of the lumbar musculature to prevent recurrence of acute low back pain: a randomized controlled trial using a daily pain recall for 1 year. Disabil Rehabil 2012; 34:1648-56. [DOI: 10.3109/09638288.2012.656787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Shaw WS, Findley PA, Feuerstein M. Twenty years of multidisciplinary research and practice: the Journal of Occupational Rehabilitation then and now. J Occup Rehabil 2011; 21:449-54. [PMID: 22065200 DOI: 10.1007/s10926-011-9339-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Early research of work disability in the 1980s showed a complexity of factors influencing pain and health-related functional limitation at work; hence, multidisciplinary perspectives were necessary to understand the complex interplay between biomechanical, organizational, social, and psychological factors impacting work disability. To address this need, the Journal of Occupational Rehabilitation was founded in 1991 with the goal of providing a scientific, yet practical forum for presenting multidisciplinary research and practice in work disability. Now, the 20-year collection of articles in the Journal reflects important trends and directions in the field of occupational rehabilitation. METHODS We conducted a retrospective summary of the past 20 years of the Journal of Occupational Rehabilitation, including its inaugural goals and intent, rates of submission and acceptance, trends in the types of articles published, study topics, global distribution of authors, and future directions. RESULTS The original goal of providing a multidisciplinary scientific and practical forum has been met, but current trends reflect a maturing scientific evidence base, with less representation of employer-based case studies and practical innovations. There has been a dramatic increase in the international representation of studies, authors, and peer reviewers outside of the US. Also, published studies now address work disability for a larger number of health concerns. CONCLUSIONS Contributions to the Journal continue to reflect a multidisciplinary perspective, but the Journal has seen significant changes with respect to international representation, the expanding study of non-musculoskeletal sources of work disability, and the maturing scientific evidence base in the field of occupational rehabilitation. Future volumes of the Journal will likely reflect continuing changes in the global economy, workforce fitness, and job demands.
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Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA 01748, USA.
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Shaw WS, Tveito TH, Geehern-Lavoie M, Huang YH, Nicholas MK, Reme SE, Wagner G, Pransky G. Adapting principles of chronic pain self-management to the workplace. Disabil Rehabil 2011; 34:694-703. [DOI: 10.3109/09638288.2011.615372] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Brouwer S, Franche RL, Hogg-Johnson S, Lee H, Krause N, Shaw WS. Return-to-work self-efficacy: development and validation of a scale in claimants with musculoskeletal disorders. J Occup Rehabil 2011; 21:244-58. [PMID: 20865445 PMCID: PMC3098360 DOI: 10.1007/s10926-010-9262-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
INTRODUCTION We report on the development and validation of a 10-item scale assessing self-efficacy within the return-to-work context, the Return-to-Work Self-Efficacy (RTWSE) scale. METHODS Lost-time claimants completed a telephone survey 1 month (n = 632) and 6 months (n = 446) after a work-related musculoskeletal injury. Exploratory (Varimax and Promax rotation) and confirmatory factor analyses of self-efficacy items were conducted with two separate subsamples at both time points. Construct validity was examined by comparing scale measurements and theoretically derived constructs, and the phase specificity of RTWSE was studied by examining changes in strength of relationships between the RTWSE Subscales and the other constructs at both time measures. RESULTS Factor analyses supported three underlying factors: (1) Obtaining help from supervisor, (2) Coping with pain (3) Obtaining help from co-workers. Internal consistency (alpha) for the three subscales ranged from 0.66 to 0.93. The total variance explained was 68% at 1-month follow-up and 76% at 6-month follow-up. Confirmatory factor analyses had satisfactory fit indices to confirm the initial model. With regard to construct validity: relationships of RTWSE with depressive symptoms, fear-avoidance, pain, and general health, were generally in the hypothesized direction. However, the hypothesis that less advanced stages of change on the Readiness for RTW scale would be associated with lower RTWSE could not be completely confirmed: on all RTWSE subscales, RTWSE decreased significantly for a subset of participants who started working again. Moreover, only Pain RTWSE was significantly associated with RTW status and duration of work disability. With regard to the phase specificity, the strength of association between RTWSE and other constructs was stronger at 6 months post-injury compared to 1 month post-injury. CONCLUSIONS A final 10-item version of the RTWSE has adequate internal consistency and validity to assess the confidence of injured workers to obtain help from supervisor and co-workers and to cope with pain. With regard to phase specificity, stronger associations between RTWSE and other constructs at 6-month follow-up suggest that the association between these psychological constructs consolidates over time after the disruptive event of the injury.
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Affiliation(s)
- Sandra Brouwer
- Department of Health Sciences, Work & Health, University Medical Center Groningen, Antonius Deusinglaan, The Netherlands.
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Shaw WS, Reme SE, Linton SJ, Huang YH, Pransky G. 3rd place, PREMUS best paper competition: development of the return-to-work self-efficacy (RTWSE-19) questionnaire – psychometric properties and predictive validity. Scand J Work Environ Health 2011; 37:109-19. [DOI: 10.5271/sjweh.3139] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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