Abstract
BackgroundDespite over 2 decades of research, the ability to prevent work-related low back pain (LBP) and disability remains elusive. Recent research suggests that interventions that are focused at the workplace and incorporate the principals of participatory ergonomics and return-to-work (RTW) coordination can improve RTW and reduce disability following a work-related back injury. Workplace interventions or programs to improve RTW are difficult to design and implement given the various individuals and environments involved, each with their own unique circumstances. Intervention mapping provides a framework for designing and implementing complex interventions or programs. The objective of this study is to design a best evidence RTW program for occupational LBP tailored to the Ontario setting using an intervention mapping approach.MethodsWe used a qualitative synthesis based on the intervention mapping methodology. Best evidence from systematic reviews, practice guidelines and key articles on the prognosis and management of LBP and improving RTW was combined with theoretical models for managing LBP and changing behaviour. This was then systematically operationalized into a RTW program using consensus among experts and stakeholders. The RTW Program was further refined following feedback from nine focus groups with various stakeholders.ResultsA detailed five step RTW program was developed. The key features of the program include; having trained personnel coordinate the RTW process, identifying and ranking barriers and solutions to RTW from the perspective of all important stakeholders, mediating practical solutions at the workplace and, empowering the injured worker in RTW decision-making.ConclusionIntervention mapping provided a useful framework to develop a comprehensive RTW program tailored to the Ontario setting.
Highlights
Despite over 2 decades of research, the ability to prevent work-related low back pain (LBP) and disability remains elusive
Despite over two decades of research, the ability to prevent workrelated low back pain (LBP) disability remains elusive [3]. This is true in Ontario, where there has been an alarming increase in the duration of disability following occupational LBP
Studies in Quebec [6] and the Netherlands [7] suggest that early intervention using participatory ergonomics and return-to-work (RTW) coordination whose primary focus is the workplace, may hold promise in reducing disability and improving RTW following an episode of LBP
Summary
Despite over 2 decades of research, the ability to prevent work-related low back pain (LBP) and disability remains elusive. Despite over two decades of research, the ability to prevent workrelated low back pain (LBP) disability remains elusive [3] This is true in Ontario, where there has been an alarming increase in the duration of disability following occupational LBP. Studies in Quebec [6] and the Netherlands [7] suggest that early intervention using participatory ergonomics and return-to-work (RTW) coordination whose primary focus is the workplace, may hold promise in reducing disability and improving RTW following an episode of LBP. In these studies an ergonomist and/or occupational physician coordinate RTW by identifying injured worker and workplace barriers to RTW. This approach demonstrated a two fold improvement in RTW compared to clinical interventions
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