Abstract
BackgroundA requirement of the Government’s Pathways to Work (PtW) agenda was to introduce a Condition Management Programme (CMP). The aim of the present study was to identify the differences between those who engaged and made progress in this telephone-based biopsychosocial intervention, in terms of their health, and those who did not and to determine the client and practitioner characteristics and programme elements associated with success in a programme aimed at improving health.MethodsData were obtained from the CMP electronic spreadsheets and clients paper-based case records. CMP standard practice was that questionnaires were administered during the pre- and post-assessment phases over the telephone. Each client’s record contains their socio-demographic data, their primary health condition, as well as the pre- and post-intervention scores of the health assessment tool administered. Univariate and multivariate statistical analysis was used to investigate the relationships between the database variables. Clients were included in the study if their records were available for analysis from July 2006 to December 2007.ResultsOn average there were 112 referrals per month, totalling 2016 referrals during the evaluation period. The majority (62.8%) of clients had a mental-health condition. Successful completion of the programme was 28.5% (575 “completers”; 144 “discharges”). Several factors, such as age, health condition, mode of contact, and practitioner characteristics, were significant determinants of participation and completion of the programme. The results showed that completion of the CMP was associated with a better mental-health status, by reducing the number of clients that were either anxious, depressed or both, before undertaking the programme, from 74% to 32.5%.ConclusionsOur findings showed that an individual's characteristics are associated with success in the programme, defined as completing the intervention and demonstrating an improved health status. This study provides some evidence that the systematic evaluation of such programmes and interventions could identify ways in which they could be improved.
Highlights
A requirement of the Government’s Pathways to Work (PtW) agenda was to introduce a Condition Management Programme (CMP)
The main stages of withdrawal from the programme were clients not attending the first agreed upon appointment (21.4%), clients not proceeding with the CMP after their initial assessment (15.3%), and clients discharged having completed only some of the planned activity (15.6%)
The results showed that participation in the CMP was associated with a better health status, by reducing by more than 50% the clients that were either anxious, depressed or both before undertaking the programme, i.e. from 74% to 32.5%
Summary
A requirement of the Government’s Pathways to Work (PtW) agenda was to introduce a Condition Management Programme (CMP). In response to the large increases in the incapacity benefit (IB) claimants which occurred in the ten years up to 1995, the Government introduced Pathways to Work (PtW) under the Welform Reform agenda to reduce the numbers receiving health-related benefits from 2.6 million in 2006/07 to 1.6 million or fewer by 2016/17 [1]. The PtW scheme was intended to encourage employment among people claiming incapacity benefits [3]. Aside from the time spent on benefits, low confidence, beliefs that work will be harmful for their health, and financial hindrances when moving off benefits for low-paid employment are health and condition-independent factors that encourage remaining on benefits [2,6]. Low income and unemployment are associated with reduced healthrelated quality of life in the working age population, whereas returning to a form of work can improve health and wellbeing [6,7,8,9,10,11]
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