Preferences Of Professionals In The design Of A Decision Support Tool For Prognosis Of Work Ability In Individuals With A Work Disability Benefit: Results Of A Focus Group Study
1Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands; 2Dutch Institute of Employee Benefit Schemes (UWV), Amsterdam, The Netherlands; 3Research Center for Insurance Medicine, AMC-UMCG-VUmc, Amsterdam, The Netherlands
Aims: A model predicting future changes in work ability based on a broad range of factors can help professionals to make accurate predictions which contribute to better prognosis in individuals with a work disability benefit. The goal of this study was to explore the desired design and use of a decision support tool for insurance physicians (IPs) and labour experts (LEs), based on a prediction model for changes in work ability at one-year follow-up.
Methods: Data were collected during three focus group meetings with IPs and LEs of the Dutch Social Security Institute. Topics included the design and use of the decision support tool. Data were audio recorded and analysed according to the main principles of content analysis.
Results: In total 24 professionals participated (17 IPs and 7 LEs). Clarity and ease of use were mentioned as important features of the decision support tool. Dividing work disability claimants into categories based on the outcome of the prediction model and assigning colour labels to the classes is experienced as a straightforward and clear way of presenting the results of the prediction model and encourages professionals who use the tool to take action. Accurate prognoses of future work ability aids provision of effective interventions to return to work for work disability claimants who will benefit most from it. Concerning preferences on when to use the tool, professionals would first want to make their own judgement during the work disability assessment interview with the claimant and afterwards verify their evaluation with the decision support tool.
Conclusions: The decision support tool should be easy to access and interpret, to be sure that it takes only small effort from professionals to use the tool and to help them making accurate prognosis of future changes in work ability.
Systematic Review Evidence In One Minute Or Less
Institute for Work & Health, Canada
Introduction: Getting research evidence to knowledge users is a challenge. The Institute for Work & Health (IWH) initiated a systematic review (SR) program in 2004 to synthesize scientific literature on prevention of workplace injuries and disability. IWH SR products include two to three-page lay summaries (Sharing Best Evidence (SBE)). SBEs are popular but are considered long by some knowledge users. Our objective was to produce and post short videos that summarize key findings of SRs in one minute or less.
Methods: Video shorts are created by a multi-disciplinary team that includes a researcher, a video producer and a communications expert. The video shorts are based on high quality research (SR findings). Key messages are created in consultation with target stakeholders. The production process begins with a storyboard (frame-by-frame outline). Development requires careful attention to style, pacing, tone, clarity, visual interest and audience appeal. Video shorts are tested with members of the target audience before being posted. Video shorts take about four weeks to complete.
Results: Two one minute videos were developed by IWH made to reach busy stakeholders with evidence they need in their work. The first, posted since October 2016, has received over 2116 hits to date. The second, posted since May 2017 has received over 989 hits to date.
Length: Videos are kept as short as possible, less than one minute.
Format: No voice-overs are used. Simple graphics, images, text and short video clips are used, with instrumental background music.
Content: Key messages from research findings are delivered in brief snippets of text.
Conclusion: Our video shorts are designed to serve two purposes: provide viewers with key evidence they can use and link the viewer to the IWH website where they can read more information. One-minute research video shorts are an effective means of disseminating key research findings.
Work Ability Following a Traffic Injury--A Multidimensional Measurement Model
1Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Canada; 2UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada; 3Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada; 4Institute for Work & Health, Toronto, Canada; 5School of Public Health, University of Alberta, Canada; 6Department of Health Sciences, Lakehead University, Canada
Objective: The purpose of our study was to develop a multidimensional measurement model of the latent construct of work ability.
Study Design and Setting: We developed a biopsychosocial model, conceptually based on the International Classification of Functioning, Disability and Health framework. We used data from a population-based incidence cohort of all persons treated for traffic injuries in Saskatchewan, Canada. Eligible participants were adults with acute soft tissue injuries who were off work. A confirmatory factor analysis model was specified and evaluated.
Results: The best-fitting model measured work ability as a second-order factor. The four first-order factors represented physical, psychological and cognitive functioning, and activities and participation domains. About 95%, 67%, 64% and 46% of each respective factor’s total variance was common variance, explained by the latent construct of work ability. A total of 17 measured indicator variables formed the final factor structure and demonstrated significant factor loadings and goodness-of-fit criteria.
Conclusion: Physical functioning plays a dominant role in the assessment of work ability among those off work following a traffic injury. In addition, our study has demonstrated the importance of exploring psychological and cognitive functioning, and the ability to carry out activities of daily living, to the evaluation of work ability following a soft tissue injury.
A Participatory Ergonomic Interventon For Reducing Physical Exertion And Musculoskeletal Pain Among Childcare Workers. A Cluster Randomized Controlled Trial
1NFA, Denmark; 2University of Southern Denmark
The prevalence of musculoskeletal pain (MSP) is persistently high throughout the world. Participatory ergonomics may represent a solution for reducing the work demands and reduce MSP. We present the results of a participatory ergonomics intervention aimed at reducing physical exertion during work and MSP amongst childcare workers.
This study used a two-arm cluster randomized design, with clusters formed based on childcare institutions. Three workshops were conducted during the 4-month intervention period. Participants identified risk factors for strenuous work and MSP, developed solutions for reducing the identified risk factors and implemented them in their team. Physical exertion during work (scale from 0-10), MSP (duration and intensity) and work-related pain interference (days per month) was measured monthly. Analyses were performed according to intention to treat, including all eligible randomized participants.
Preliminary results show significant effects on physical exertion of -0.6 (95% confidence interval -1.09 to -0.14), and work-related pain interference of -2.7 (95% confidence interval -4.47 to -0.91) after the intervention compared to the control group. Non-significant reductions were found for duration of low back pain, duration of neck pain and for low back pain intensity and neck pain intensity.
Preliminary results of the study showed beneficial effects of the 4-month intervention. Participatory ergonomics therefore seems to be an effective solution for both reducing physical work exertion and work-related pain interference. Further analyses will be conducted to see whether the participatory ergonomics is also beneficial for sickness absence and for work ability.
Enhancing Return-To-Work Among Partially Work Disabled Workers: Development Of A Triage Instrument And Decision Aid For Labour Experts.
1Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands.; 2Research Center for Insurance Medicine (KCVG), AMC-UMCG-VUmc Amsterdam,The Netherlands; 3Arbeidsdeskundig Kennis Centrum (AKC), The Netherlands; 4Dutch Institute of Employee Benefit Schemes (UWV), Amsterdam, The Netherlands
Labour experts can experience difficulties choosing the right RTW interventions for partially work disabled workers. An understanding of relevant factors and effective interventions could help labour experts improve the vocational rehabilitation process of partially disabled workers. In the present study, we describe the design of a study with the aim to develop a triage instrument and decision aid for labour experts to help improve their service and to be able to offer individually tailored service to partially work disabled workers receiving a long term disability benefit with the aim to improve RTW.
Development of the instrument:
The instrument and decision aid will be developed along the lines of the International Classification of Functioning, Disability and Health (ICF) model. Based on the obstructing RTW factors of the individual, relevant effective interventions to improve these obstructing RTW factors are suggested to the labour expert.
Several studies will provide input for the instrument and decision aid. First, two systematic literature reviews are currently being conducted to provide input on relevant obstructing factors for RTW and to provide input on effective RTW-interventions. Second, focus groups are currently being conducted among labour experts to provide expert-based input for the instrument concerning important RTW factors and concerning the position of the instrument in the vocational rehabilitation process. Based on the results of these studies a first version of the instrument will be designed. Next, a Delphi Study will be held to reach consensus about the content and placement of the final instrument.
The aim of this study is to develop a triage instrument and decision aid for labour experts to enhance individually tailored service to partially disabled workers. The (cost)effectiveness of the instrument will be evaluated in a randomized controlled trial among partially work disabled workers.
Good Working Body - Development Of An eHealth System For Repeated Measures Of Musculoskeletal Pain In Workplace Context
1The National Research Centre for the Working Environment, Denmark; 2Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
Electronic health (eHealth) systems are increasingly being used to assess pain. This study aims to describe the development of a new system for measuring musculoskeletal pain in workplace contexts – “Good working body” (GWB).
GWB was developed in close collaboration between researchers, ergonomic consultants and work environment representatives from workplaces, a pension company and an eHealth company. First, need and potential for the system was discussed. A non-systematic literature review for pain assessments (e.g. questionnaires) was performed. Different formulations and types of questions as well as layout of the questions were tested among 10 workers with cognitive interviews.
The system was tested among 10 cleaners to ensure feasibility and acceptability for all workers but particularly those with high need (e.g. blue-collar workers with high physical work demands and high pain levels). In Denmark, many cleaners are non-western immigrants with Danish as second language. Use of figures and shortly phrased questions was therefore chosen to ease comprehensibility. Through the cognitive interviews, specific question formulations and layout were chosen. GWB contains a body chart with 9 body regions and pain intensity scales for all regions (VAS 0-10). Additionally, the system contains questions about activity limitation and use of pain relievers. GWB monitors the musculoskeletal pain of every worker by asking simple questions in an interval according to the workplaces’ need. The system then provides simple feedback to the individual. Management and HR receive monthly reports on the general level of musculoskeletal pain to serve as a launch pad for initiating relevant changes.
The system is meant to be applicable for all workers, including those with low literacy levels. The frequent monitoring of musculoskeletal pain can help workplaces to identify workers in greatest need of work adaptations due to pain at an early stage and thus prevent work disability.