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Implementing a Self-Management Intervention for People with a Chronic Compensable Musculoskeletal Injury in a Workers Compensation Context: A Process Evaluation

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Abstract

Purpose Determining factors critical for an intervention’s success, specifically for whom and under what circumstances, is necessary if interventions are to be effectively targeted and efficiently implemented. This paper describes a process evaluation undertaken to assess the implementation of a novel self-management (SM) intervention developed for those with a chronic compensable work-related musculoskeletal disorder seeking to return to work. Methods The process evaluation, assessing the ‘Self-Management for Return to Work’ intervention, examined data from program leader evaluations, telephone interviews with stakeholders (injured worker participants, vocational rehabilitation consultant program leaders and compensation insurance regulators), post-intervention focus group session feedback, attendance lists and researcher notes. Results The evaluation identified several challenges and barriers associated with conducting research within the VR environment and with the characteristics of those targeted i.e., injured workers with a chronic compensable condition. These issues were primary contributing factors to the modifications to the randomised controlled trial methodology and the trial’s premature cessation. Conclusions Despite the difficulties encountered, high stakeholder acceptability suggests that the concept and theory underlying the targeted SM intervention were not flawed, though there is room for further tailoring to both the program method and its timing. The results of this process evaluation provide a useful platform for others considering the implementation of interventions within the vocational rehabilitation context or with individuals with chronic, compensated injuries.

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Notes

  1. This distribution was calculated using an ex-post method whereby the workers’ compensation premiums paid by employers are considered a transfer cost to society rather than a cost to employers. Using an ex-ante approach it was estimated employers would have borne 16 % and the community 10 % of the total cost.

  2. Phase II clinical research may be defined as “exploring the dimensions of the therapeutic effect and making the necessary preparations for conducting a clinical trial... eventually [including] small-group cohort-control studies” [43].

  3. An active WC claim is defined as currently receiving some form of financial benefit from the Worker’s Compensation Scheme, regardless of return to work status. Participants may be back at work part-time and still receiving benefits.

  4. The RCT, including its evaluation, was approved by Monash University Human Research Ethics Committee (CF11/2335-2011001328).

  5. VR consultants were trained to deliver the standard CDSMP program by licensed trainers, and the two additional modules by members of the research team.

  6. Missing data for date of injury for n = 1 intervention group participant.

  7. N = 1 usual care participant outlier for time since injury was brought back to 2.5 SDs above the mean.

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Acknowledgments

The research reported herein was supported under the Australian Research Council’s Linkage Projects funding scheme (Project LP0989499). The views expressed herein are those of the authors and are not necessarily those of the Australian Research Council. The scientific research team would like to acknowledge the contributions of our: Funding and industry partners: The Australian Research Council, WorkSafe Victoria, Motor Accident Insurance Commission (MAIC) and Workers Compensation Regulatory Authority (Q-Comp). Research partners: The University of Queensland, Monash University and Flinders University. Other contributors: IPAR, Konekt, Recovre, Nabenet and Arthritis Victoria.

Conflict of interest

The authors have no conflicts of interest to declare in respect of this work.

Author information

Authors and Affiliations

  1. Monash Injury Research Institute, Building 70, Monash University, Clayton Campus, Melbourne, VIC, 3800, Australia

    Dianne M. Sheppard

  2. Institute for Safety, Compensation and Recovery Research (ISCRR), Monash University, Level 11, 499 St Kilda Road, Melbourne, VIC, 3004, Australia

    Susan Gargett & Niki Ellis

  3. Centre for Australian Military and Veteran’s Health, The University of Queensland, School of Population Health, Public Health Building (887), Herston Road, Herston, Brisbane, QLD, 4006, Australia

    Alison MacKenzie

  4. Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia

    Gwendolen Jull & Venerina Johnston

  5. Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia

    Jennifer Strong

  6. Department of Psychiatry, Flinders Human Behaviour and Health Research Unit (FHBHRU), School of Medicine, Flinders University, Sturt Road, Bedford Park, SA, 5042, Australia

    Malcolm Battersby

Authors
  1. Dianne M. Sheppard
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  2. Susan Gargett
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Corresponding author

Correspondence to Dianne M. Sheppard.

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Dr Gargett currently holds an adjunct position with ISCRR, Monash University.

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Sheppard, D.M., Gargett, S., MacKenzie, A. et al. Implementing a Self-Management Intervention for People with a Chronic Compensable Musculoskeletal Injury in a Workers Compensation Context: A Process Evaluation. J Occup Rehabil 25, 412–422 (2015). https://doi.org/10.1007/s10926-014-9551-4

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  • DOI: https://doi.org/10.1007/s10926-014-9551-4

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