Process Evaluation of a Workplace Integrated Care Intervention for Workers with Rheumatoid Arthritis

Abstract

Purpose To perform a process evaluation of the implementation of a workplace integrated care intervention for workers with rheumatoid arthritis to maintain and improve work productivity. The intervention consisted of integrated care and a participatory workplace intervention with the aim to make adaptations at the workplace. Methods The implementation of the workplace integrated care intervention was evaluated with the framework of Linnan and Steckler. We used the concepts recruitment, reach, dose delivered, dose received, fidelity and satisfaction with the intervention. Data collection occurred through patient questionnaires and medical records. Results Participants were recruited by sending a letter including a reply card from their own rheumatologist. In total, we invited 1973 patients to participate. We received 1184 reply cards, and of these, 150 patients eventually participated in the study. Integrated care was delivered according to protocol for 46.7 %, while the participatory workplace intervention was delivered for 80.6 %. Dose received was nearly 70 %, which means that participants implemented 70 % of the workplace adaptations proposed during the participatory workplace intervention. The fidelity score for both integrated care and the participatory workplace intervention was sufficient, although communication between members of the multidisciplinary team was limited. Participants were generally satisfied with the intervention. Conclusions This process evaluation shows that our intervention was not entirely implemented as intended. The integrated care was not delivered to enough participants, but for the intervention components that were delivered, the fidelity was good. Communication between members of the multidisciplinary team was limited. However, the participatory workplace intervention was implemented successfully, and participants indicated that they were satisfied with the intervention.

Effectiveness of a return-to-work program for workers without an employment contract, sick-listed due to common mental disorders

“…Their explanations for this low protocol adherence were similar to the barriers mentioned by the stakeholders in our study, namely, organizational constraints and limited availability of suitable workplaces (36,37). Furthermore, in a recent study about an integrated workplace intervention for Dutch workers with rheumatoid arthritis, Van Vilsteren et al (38) found that it was difficult to implement an integrated care approach. This is in line with an earlier Dutch study by Anema et al (39) that revealed limited collaboration between OHC professionals and other healthcare providers in the Netherlands.…”

A multimedia campaign to improve back beliefs in patients with non-specific low back pain: a process evaluation

“…The reach of the current study was not as high as for example the study performed by Buist et al, where the reach was 22.4% in an integrated healthcare system [ 18 ]. It must be noted that assessing the actual reach of a target population in implementation research is hard to measure, as is also discussed by Van Vilsteren et al in their process evaluation of a workplace intervention for workers with rheumatoid arthritis [ 19 ]. For example, the amount of patients that were invited to participate could have been an overestimation, since the HCPs inviting the patients could have excluded patients without reporting exclusions to the research team.…”

The Workwell trial: protocol for the process evaluation of a randomised controlled trial of job retention vocational rehabilitation for employed people with inflammatory arthritis.

“…The audio-recording of each therapist's initial treatment session with one participant (up to n=40) will be listened to by members of the research team, using a structured delity checklist, to assess whether the therapist went through the assessment process appropriately, identi ed and appropriately prioritized the participant's problems, planned, and commenced an appropriate treatment plan. The completed WES-RC and the accompanying trial treatment notes for that participant will also be analyzed to evaluate whether the problems, plan and solutions, as discussed, were recorded in the WES-RC and the treatment notes record the ful llment of the treatment plan [29][30][31].…”

“…We have therefore prioritised what is achievable within limited resources. To our knowledge, one other JRVR trial in arthritis has conducted a process evaluation [31]. This focused on implementation (recruitment, reach, dose, treatment delity and satisfaction).…”