| 1. |
- Main, Chris J., et al.
(author)
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Implementation Science and Employer Disability Practices : Embedding Implementation Factors in Research Designs
- 2016
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In: Journal of occupational rehabilitation. - : Springer-Verlag New York. - 1053-0487 .- 1573-3688. ; 26:4, s. 448-464
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Journal article (peer-reviewed)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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| 2. |
- Ekberg, Kerstin, et al.
(author)
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New Business Structures Creating Organizational Opportunities and Challenges for Work Disability Prevention.
- 2016
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In: Journal of occupational rehabilitation. - : Springer. - 1053-0487 .- 1573-3688. ; 26:4, s. 480-489
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Journal article (peer-reviewed)abstract
- Purpose Flexible work arrangements are growing in order to develop resource-efficient production and because of advanced technologies, new societal values, changing demographics, and globalization. The article aims to illustrate the emerging challenges and opportunities for work disability prevention efforts among workers in alternate work arrangements. 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 roundtable discussion with experts having direct employer experience. Results Both worker and employer perspectives were considered, and four common alternate work arrangements were identified: (a) temporary and contingent employment; (b) small workplaces; (c) virtual work/telework; and (d) lone workers. There was sparse available research of return-to-work (RTW) and workplace disability management strategies with regard to alternate work patterns. Limited research findings and a review of the grey literature suggested that regulations and guidelines concerning disabled workers are often ambiguous, leading to unsatisfactory protection. At the workplace level, there was a lack of research evidence on how flexible work arrangements could be handled or leveraged to support RTW and prevent disability. Potential negative consequences of this lack of organizational guidance and information are higher costs for employers and insurers and feelings of job insecurity, lack of social support and integration, or work intensification for disabled workers. Conclusions Future studies of RTW and workplace disability prevention strategies should be designed to reflect the multiple work patterns that currently exist across many working populations, and in particular, flexible work arrangements should be explored in more detail as a possible mechanism for preventing disability. Labor laws and policies need to be developed to fit flexible work arrangements.
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| 3. |
- Pransky, Glenn S., et al.
(author)
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Sustaining Work Participation Across the Life Course.
- 2016
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In: Journal of occupational rehabilitation. - : Springer. - 1053-0487 .- 1573-3688. ; 26:4, s. 465-479
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Journal article (peer-reviewed)abstract
- Introduction Many disability prevention strategies are focused on acute injuries and brief illness episodes, but there will be growing challenges for employers to manage circumstances of recurrent, chronic, or fluctuating symptoms in an aging workforce. The goal of this article is to summarize existing peer-review research in this area, compare this with employer discourse in the grey literature, and recommend future research priorities. Methods The authors participated in a year-long sponsored 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 scientific and industry literature, group discussion to identify key areas and challenges, drafting of initial documents, and feedback from peer researchers and a special panel of experts with employer experience. Results Cancer and mental illness were chosen as examples of chronic or recurring conditions that might challenge conventional workplace return-to-work practices. Workplace problems identified in the literature included fatigue, emotional exhaustion, poor supervisor and co-worker support, stigma, discrimination, and difficulties finding appropriate accommodations. Workplace intervention research is generally lacking, but there is preliminary support for improving workplace self-management strategies, collaborative problem-solving, and providing checklists and other tools for job accommodation, ideas echoed in the literature directed toward employers. Research might be improved by following workers from an earlier stage of developing workplace concerns. Conclusions Future research of work disability should focus on earlier identification of at-risk workers with chronic conditions, the use of more innovative and flexible accommodation strategies matched to specific functional losses, stronger integration of the workplace into on-going rehabilitation efforts, and a better understanding of stigma and other social factors at work.
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| 4. |
- Reme, Silje Endresen, et al.
(author)
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Distressed, immobilized, or lacking employer support? : a sub-classification of acute work-related low back pain
- 2012
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In: Journal of occupational rehabilitation. - : Springer. - 1053-0487 .- 1573-3688. ; 22:4, s. 541-552
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Journal article (peer-reviewed)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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| 5. |
- Shaw, William S., et al.
(author)
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3(rd) place, PREMUS best paper competition : development of the return-to-work self-efficacy (RTWSE-19) questionnaire - psychometric properties and predictive validity
- 2011
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In: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 37:2, s. 109-119
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Journal article (peer-reviewed)abstract
- Objective: The 19-item return-to-work self-efficacy (RTWSE-19) scale is a new self-report measure intended to assess workers’ beliefs of their current ability to resume normal job responsibilities following pain onset. The aim of this study was to evaluate the factor structure, internal consistency, and predictive and concurrent validity of RTWSE-19 among workers with acute low-back pain.Methods: Patients (N=399, 59% male, mean age 37 years) consulting for acute, work-related low-back pain completed an original 28-item version of the new scale along with concurrent measures of pain, functional limitation, activity avoidance, workplace physical demands, and pain catastrophizing. The assessment was repeated at visit 2, and work limitations and duration of sickness absence were assessed by questionnaire at 3-month follow-up. Exploratory factor analysis (principal component analysis with varimax rotation) was used to assess content validity of the scale, and scores were compared to concurrent pain measures and with disability outcomes at 3 months.Results: The full response range (1-10) was utilized on all 28 items, and there were no ceiling or floor effects. Mean item scores ranged from 4.9 (”reducing physical workload”) to 8.3 (”describing injury to supervisor”). The exploratory factor analysis supported three underlying factors (eigenvalue > 1.0): (i) meeting job demands; (ii) modifying job tasks; and (iii) communicating needs to others. Internal consistency (alpha) for the three scales were 0.98, 0.92, and 0.81, respectively. At visit 2, self-efficacy scores improved for “meeting job demands” and “modifying job tasks”, but not for “communicating needs to others”. After controlling for pain and functional limitation, both sickness absence and persistent work limitations were predicted by self-efficacy assessed at visit 2 (P < 0.05), but self-efficacy assessed at visit 1 did not predict sickness absence.Conclusions: The RTWSE-19 is a new measure with adequate reliability and validity to measure the confidence of workers to meet job demands, modify job tasks, and communicate needs to co-workers and supervisors. When assessed 1-2 weeks after pain onset, the scale is predictive of disability outcomes.
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| 6. |
- Shaw, William S., et al.
(author)
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Employer Policies and Practices to Manage and Prevent Disability : Foreword to the Special Issue
- 2016
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In: Journal of occupational rehabilitation. - New York, USA : Springer. - 1053-0487 .- 1573-3688. ; 26:4, s. 394-398
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Journal article (peer-reviewed)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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| 7. |
- Shaw, William S., et al.
(author)
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Patient clusters in acute, work-related back pain based on patterns of disability risk factors
- 2007
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In: Journal of Occupational and Environmental Medicine. - : Ovid Technologies (Wolters Kluwer Health). - 1076-2752 .- 1536-5948. ; 49:2, s. 185-193
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To identify subgroups of patients with work-related back pain based on disability risk factors. METHODS: Patients with work-related back pain (N = 528) completed a 16-item questionnaire of potential disability risk factors before their initial medical evaluation. Outcomes of pain, functional limitation, and work disability were assessed 1 and 3 months later. RESULTS: A K-Means cluster analysis of 5 disability risk factors (pain, depressed mood, fear avoidant beliefs, work inflexibility, and poor expectations for recovery) resulted in 4 sub-groups: low risk (n = 182); emotional distress (n = 103); severe pain/fear avoidant (n = 102); and concerns about job accommodation (n = 141). Pain and disability outcomes at follow-up were superior in the low-risk group and poorest in the severe pain/fear avoidant group. CONCLUSIONS: Patients with acute back pain can be discriminated into subgroups depending on whether disability is related to pain beliefs, emotional distress, or workplace concerns
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| 8. |
- Shaw, William S., et al.
(author)
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The Pain Recovery Inventory of Concerns and Expectations A Psychosocial Screening Instrument to Identify Intervention Needs Among Patients at Elevated Risk of Back Disability
- 2013
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In: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 55:8, s. 885-894
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Journal article (peer-reviewed)abstract
- Objective: To reduce a full psychosocial test battery to a brief screening questionnaire to triage return-to-work strategies among patients with low back pain (LBP). Methods: Workers (N = 496) with acute, work-related LBP completed multiple psychosocial measures at intake, then a 3-month follow-up of pain, function, and work status. A sensitivity analysis was conducted to reduce the number of items while maintaining scale reliability, preserving associations with outcomes, and maintaining separation between patient subgroups. Results: The pool of items was trimmed from 129 to 46 items, describing elements of emotional distress, pain beliefs, organizational support, and activity limitation. A confirmatory cluster analysis replicated previous findings of three risk subgroups: distressed, avoidant, and lacking employer support. Conclusions: The reduced measure is a reliable and valid screening measure that can be used to identify early intervention needs among working adults with LBP.
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