Work It/Project 1: Efficacy of a Modified Vocational Rehabilitation Intervention

Specific aims

1)    To examine whether people who receive the modified VR intervention have less work limitation over two years of follow-up compared to persons receiving a control minimal intervention.

2)    To examine whether people who receive the modified VR intervention have greater self-efficacy for managing employment concerns over two years of follow-up compared to persons receiving a control minimal intervention.

Significance

Minimizing work loss, preventing work disability, and enhancing work outcomes are critical for working age adults who have arthritis. Work disability is rarely discussed in the context of primary care and there are few feasible and effective interventions in this area. There is a critical need to develop, evaluate, and disseminate effective tools that health care providers and consumers can use to enhance work outcomes. This research addresses this important area.

photo of Julie KeysorDescription

Principal Investigator: Dr. Julie Keysor

Work disability is a common outcome of arthritis disorders, with over 5% of US employment-aged adults reporting an arthritis-attributable limitation in ability to work. In a previous study, we found that a job retention vocational rehabilitation (VR) intervention developed for the study and conducted by rehabilitation counselors helped participants with rheumatic conditions maintain employment.  However, VR intervention has been largely unavailable to this population and remains a critical unmet need. Health professionals may be able to help fill this gap. Varekamp et al. note that, “Health professionals are in a position to identify patients at risk for work disability and to discuss work-related problems and solutions with these patients.”

Over the past four years we have been conducting studies to determine the role of health professionals, occupational and physical therapists in particular, in helping resolve work problems for persons with rheumatic conditions. Through these studies we developed a modified job retention VR intervention and important tools to enable therapists to assist their patients with rheumatic condition-related work problems. The results of our studies to date suggest that it is feasible for therapists to carry out the modified VR intervention using the tools to assess their patients’ work barriers and to assist them in developing solutions for barriers. It is important now to conduct tests to verify the efficacy of this intervention. We are now conducting a study to examine the efficacy of a modified VR intervention delivered by physical and occupational therapists to enhance work outcomes among employed persons with arthritis and other chronic rheumatic conditions (ie Lupus, Fibromyalgia, and Scleroderma) and chronic low back pain.