Putting Patient-Reported Functional Health Status Instruments into Occupational Health Services Practice: A Controlled Trial of the Worker-Based Outcomes Assessment System (WBOAS)

Details

• Personal Author:
  Callas PW ; Gaspari KC ; Ross RH ; Sargent JQ
• Description:
  The Intervention tested the effects of incorporating the Worker-based outcomes assessment system (WBOAS) into Occupational health services (OHS) practice at Fletcher Allen Health Care (FARC, Burlington VT). The WBOAS is a Work-related musculoskeletal disorders (WRMSD) treatment and secondary prevention improvement protocol designed to inform treatment by putting same-session (a) touchscreen-generated patient-reported outcomes trends graphics (contrasting initial, previous, and current visits on Physical and Behavioral health status, Pain symptoms and related attitudes, and Work role limitations) and (b) trends-based auxiliary treatment referral guidelines (for work site evaluation and redesign and for behavioral health care) into the hands of physical and occupational therapists (PT/OTs) and their patients. The study employed a prospective, parallel cohort, external control design--the strongest controlled trial frame possible given the impossibility, when the provider is integral to the intervention, of randomizing subjects same-site to test and control arms--and featured one Test and two Control site clinics. Subjects were F ARC employees with WRMSDs including strain/sprain, cumulative trauma (upper extremity, lower extremity, lower back), tendonitis, and carpal tunnel syndrome. Test site PT/OTs delivered Standard plus (WBOAS) care, i.e. Standard care augmented by same- session outcomes trends graphics (to set and re-set injury treatment and return-to-work goals) and trends-based referral guidelines (to initiate auxiliary worksite evaluation and redesign and/or behavioral health care). Control site PT/OTs delivered Standard care alone. Primary predictions were that, controlling for covariates such as patient-reported demographics, co-morbidities, injury severity, physical and behavioral health, work limitations, psychosocial profile, and work conditions, Test site subjects would exhibit higher rates of (I) clinical outcome.: treatment period Injury recovery (IR) and post-treatment period Re-injury avoidance (RA), (2) functional outcome: treatment period Return-to work (RTW) and post-treatment period Stay-at-work (SA W) success, and (3) Process outcome: post-treatment period evaluated Provider performance (PP) and Overall satisfaction (OS) with care, at no lower rate of (4) cost outcome: treatment or post-treatment period Cost-adjusted outcome (CaO). Secondary Predictions were that Test site subjects likewise would exhibit higher rates of (5) auxiliary care: treatment period referrals to Worksite evaluation and redesign (WSE, WSR) and to Behavioral health care (BHC). [Description provided by NIOSH]
• Subjects:
  Demography Hazardous Substances Health Personnel Musculoskeletal Diseases Musculoskeletal System Occupational Health Safety Workplace
• Keywords:
  Back-injuries Carpal-tunnel-syndrome Demographic-characteristics Health-care-personnel Health-hazards Injuries Injury-prevention Musculoskeletal-system-disorders Occupational-health Work-environment Worker-health

  More +
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  Massachusetts ; OSHA Region 1 ; Vermont
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-53
• NIOSHTIC Number:
  nn:20024377
• NTIS Accession Number:
  PB2018-100187
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R21-OH-007339, 2003 Dec; :1-53
• Contact Point Address:
  Robert H. Ross, Ph.D., HHD/EDC, 55 Chapel Street, Newton, MA 02458-1060
• Email:
  rross@edc.org
• Federal Fiscal Year:
  2004
• Performing Organization:
  Vermont University, Burlington, Vermont
• Peer Reviewed:
  False
• Start Date:
  20000930
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20030529
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0c0039004158d0a42240477b5481d7c64943f5bc5032dd6424ad3b243069b618955112d5c012942794962d07297037c097d00600288982dbb73c370160912712
• Download URL:
  https://stacks.cdc.gov/view/cdc/218224/cdc_218224_DS1.pdf
• File Type:
  [PDF - 6.86 MB ]