Implementing a Stratified Vocational Advice Intervention for People on Sick Leave with Musculoskeletal Disorders: A Multimethod Process Evaluation.
Fiona Aanesen, Britt Elin Øiestad, Margreth Grotle and 6 others
PMID 34606049WHAT IT FOUND
Physiotherapists delivered a telephone-based vocational advice intervention to 89% of those randomised.
They covered core topics and made action plans, but rarely contacted employers or GPs, and no face-to-face meetings occurred due to lack of facilities and pandemic restrictions.
Key findings
01The intervention was delivered by telephone only, with high fidelity to the conversation guide, but no face-to-face or workplace meetings took place.
02Stakeholder collaboration was poor; physiotherapists rarely contacted employers, GPs, or the welfare administration, often due to lack of confidence or participant refusal.
03Physiotherapists found the limit on phone sessions for low/medium risk patients a barrier to effective case management.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was conducted during the COVID-19 pandemic, which prevented face-to-face meetings due to social distancing and lack of facilities, limiting the generalisability of findings regarding in-person delivery. Only 10% of participants consented to audio recording, so the qualitative data on session content may not represent all interactions. The study did not include interviews with participants, so their perspective on the acceptability and helpfulness of the intervention is unknown. Eighteen participants were stratified into the wrong risk group, which affected the fidelity assessment of the number of sessions delivered.
Declared interests
The study was funded by the Research Council of Norway and the Norwegian Fund for Post-Graduate Training in Physiotherapy. No specific conflicts of interest were declared by the authors in the provided text.
The easy way to misread this
Do not conclude that the intervention is ineffective because stakeholder contact was low. This is a process evaluation, not an outcome trial. The low contact with employers may have been caused by the pandemic restrictions and the specific training and confidence levels of the physiotherapists, rather than an inherent flaw in the intervention design.