A general framework for selecting work participation outcomes in intervention studies among persons with health problems: a concept paper

Abstract

Background Work participation is important for health and can be considered as engagement in a major area of life which is of significance for most people, but it can also be thought of as fulfilling or discharging a role. Currently, academic research lacks a comprehensive classification of work participation outcomes. The International Classification of Functioning is the foremost model in defining work functioning and its counterpart work disability, but it does not provide a critical (core) set of outcomes. Standardizing the definitions and nomenclature used in the research of work participation would ensure that the outcomes of studies are comparable, and practitioners and guideline developers can better decide what works best. As work participation is a broad umbrella term including outcome categories which need unambiguous differentiation, a framework needs to be developed first. Aim To propose a framework which can be used to develop a generic core outcome set for work participation. Methods First, we performed a systematic literature search on the concept of (work) participation, views on how to measure it, and on existing classifications for outcome measurements. Next, we derived criteria for the framework and proposed a framework based on the criteria. Last, we applied the framework to six case studies as a proof of concept. Results Our literature search provided 2106 hits and we selected 59 studies for full-text analysis. Based on the literature and the developed criteria we propose four overarching outcome categories: (1) initiating employment, (2) having employment, (3) increasing or maintaining productivity at work, and (4) return to employment. These categories appeared feasible in our proof-of-concept assessment with six different case studies. Conclusion We propose to use the framework for work participation outcomes to develop a core outcome set for intervention studies to improve work participation.

Which outcomes should always be measured in intervention studies for improving work participation for people with a health problem? An international multistakeholder Delphi study to develop a core outcome set for Work participation (COS for Work)

“…In the second phase, we created a framework to aid the selection of work participation outcomes. 7 The framework outlines four main stages of work participation: outcomes assessing whether a person is successful in acquiring or initiating employment (stage 1), outcomes indicating whether a person is in employment, can retain employment or lost work within the duration of the study, that is, having employment (stage 2), outcomes that measure increasing or maintaining productivity at work (stage 3) when persons experience limitations or restrictions with working or have less output, and outcomes that assess return to employment and sick leave from work (stage 4) when people (temporarily) stop attending work and are on sick leave. Phase three involved a survey among reviewers and trial authors showing different reasons and preferences for choosing and using work outcomes.…”

Return To Work Programs for Disabled Workers: Dynamic Tendencies of Personal and Professional Determinants

“…Stakeholders and employers may have critical concerns about the productivity and occupational outcomes of a rehabilitation program for workers with disabilities returning to work after occupational injuries. 13 They may worry about the efficiency and effectiveness of the program in preparing these workers to return to their previous job roles, and may also be concerned about the potential impact on overall company productivity if these workers are not able to fully return to their previous levels of performance. Furthermore, stakeholders and employers may be worried about the long-term consequences for workers with disabilities in terms of their occupational prospects.…”