Predictive validity of a functional capacity evaluation: the physical work performance evaluation

The predictive validity of a Functional Capacity Evaluation, the Physical Work Performance Evaluation (PWPE), was examined in 30 workers compensation patients with musculoskeletal dysfunction who participated in an industrial rehabilitation program. Return-to-work recommendations were made by comparing the discharge PWPE to the physical requirements of the job. Kappa coefficients were used to compare PWPE recommendations to actual work at discharge, 3 months and 6 months. Substantial agreement was found between PWPE recommendations at all three follow-up points. This study provides preliminary evidence in support of the predictive validity of the PWPE for making return-to-work recommendations at the conclusion of an industrial rehabilitation program.     

Social Work in the Emergency Department—Implementation of a Domestic and Family Violence Screening Program

Abstract

Women who have experienced domestic and family violence use health services more frequently than women who have not. Early identification and intervention by the health system may reduce health problems associated with domestic and family violence and lead to savings for the health sector. This study aimed to evaluate the impact of a new domestic and family violence screening program, which was based on an ecological model and introduced by a social work team in the Emergency Department of a major metropolitan hospital. The evaluation method included an audit of social work case files to assess the effect on referral rates and a survey of Emergency Department staff to obtain perceptions of the impact of the program on the staff and clients. In the 3-month period following the introduction of the program, the rate of referral to social work increased by 213%. Staff agreed that the Emergency Department is an appropriate place to ask about domestic and family violence, under certain conditions. Findings suggest that an ecological social work model provides an approach to screening for domestic and family violence that not only contributes to increased identification and supportive client interventions but may also contribute to more sustainable systemic change.     

Assessment of the monitoring and evaluation system of a population-based program: Theory-driven evaluation approach

The purpose of this study was to assess the performance of a monitoring and evaluation system (M&E) for a population-based program and to identify factors influencing its performance. The state health department provided a grant, guide, and training for health districts to implement the program and report quarterly and annually to the M&E. Some health districts did not meet this requirement. We also found that the M&E did not adequately capture the actual work of the districts in communities as related to the work plan. We identified several factors that negatively affected the performances of the M&E. For example, the state and health districts did not have a shared vision on how to develop and implement the program, and what to report to the M&E. We proposed strategies that could improve the timeliness and content of reports to the M&E, as well as its utilization in the future.     

Perceptions of Self-Care Among MSW Students: Implications for Social Work Education

ABSTRACT

For students new to social work, self-care is a strategy for addressing potentially negative impacts of the profession. Curiously, however, participation in a university’s self-care program has been chronically low. The purpose of this study is to explore social work students’ perceptions of self-care and to create a database for supporting changes in social work education. Qualitative data were collected via an online survey from MSW students. The findings revealed 5 categories for student perceptions of self-care, including health, time, activities, balance, and professionalism, and 3 categories for self-care and the social work program, including academic program experiences, resources, and modeling. Implications of the study in developing and tailoring a self-care program to students in MSW programs are discussed.     

Teaching Note—Meeting the Demand for Behavioral Health Clinicians: Innovative Training Through the GLOBE Project

ABSTRACT

The national move toward integrated mental health and substance abuse service delivery has a significant impact on social work education and necessitates changes in how we train students. To address this need, the Global Leaders of Behavioral Health Education (GLOBE) training project was developed. GLOBE is a student training and stipend program that prepares students for clinical behavioral health practice in integrated care. This teaching note describes GLOBE, reports challenges encountered in its implementation, and provides strategies for overcoming them. The challenges include assigning students to grant-compliant field placements, engaging other health care professionals in the educational efforts, and implementing curriculum changes. Suggestions for social work program administrators interested in integrated care training are provided.     

The assessment of functional work capacity in the South African mining industry

Overall physical work fitness is a prerequisite in numerous industries. Apart from improved productivity, it remains fundamental with regards to the maintenance of good health and safety. To address worker fitness in the mining industry, AngloGold Ashanti and Anglo Platinum Mining Houses developed a Functional Work Capacity (FWC) test battery. The FWC test battery consists of 19 work simulations representing the required functional work capacity to cope with all types of physical work tasks and work environments in the mining industry. This assessment tool is not only used to evaluate injured or medically affected workers for alternative placement but also to ensure that the new employee is placed in a job matching his physical capacity. This paper reviews the design process and application of the FWC test battery in the mining industry.     

Promoting Health and Wellness in African American Males through Rites of Passage Training

The current work presents exploratory research findings related to the effectiveness of Let the Circle Be Unbroken, an African-centered “rites of passage” training program, to promote health and well-being in a sample of high-risk, African American males. An abbreviated version of the ADPRC-TADPOLE questionnaire was administered to 39 African American boys, between the ages of 8 and 16 years, who were participating in a community-based “rites of passage” training program. Findings suggest that the Let the Circle Be Unbroken training program is a viable program for improving self-esteem among young African American males. The implications of this research are relevant to the reduction of some health disparities observed among underrepresented populations, especially African American males.     

Teaching Note—Educating Public Health Social Work Professionals: Results From an MSW/MPH Program Outcomes Study

Dual-degree programs in public health and social work continue to proliferate, yet there has been little research on master’s of social work (MSW)/master’s of public health (MPH) graduates. The purpose of this study was to describe and better understand the self-reported professional experiences, identities, roles, and outcomes associated with 1 group of graduates from an established MSW/MPH program. A 57-question electronic survey was administered to 214 alumni in 2010; the response rate was 71.4% (n = 153). Findings provide a snapshot of public health social work alumni experiences, including diverse employment opportunities, high career satisfaction, and a strong sense of reported public health and social work integration in the workplace.     

Health Promotion Project for University Students at a South African University: Results of a Pilot Survey

Globally, chronic diseases place a tremendous burden on health care systems all over the world. The increased prevalence of chronic diseases is mainly influenced by industrialization and decreased levels of physical activity. A cross-sectional qualitative and quantitative pilot survey, using a self-administered questionnaire and focus group discussions, was conducted with 73 students to assess the need for and feasibility of a health promotion program for university students at a rural South African university. The results of this survey suggest that there is a need for a health promotion program aimed at young adults who attend university.     

Health promotion and disease prevention: a look at demand management programs

This Issue Brief describes employers' efforts to contain health expenditures through demand management programs. These programs are designed to reduce utilization by focusing on disease prevention and health promotion. Demand management includes work site health promotion, wellness programs, and access management. Work site health promotion is a comprehensive approach to improving health and includes awareness, health education, behavioral change, and organizational health initiatives. Wellness programs usually include stress management, smoking cessation, weight management, back care, health screenings, nutrition education, work place safety, prenatal and well baby care, CPR and first aid classes, and employee assistance programs (EAPs). These programs are often viewed positively by workers and can have long-term benefits for employers above and beyond health care cost containment. Demand management can benefit employers by increasing productivity, employee retention, and employee morale and by reducing turnover, absenteeism, future medical claims, and ultimately expenditures on health care. Even though a growing number of employers are offering wellness programs, only 37 percent of full-time workers employed in medium and large private establishments were eligible for wellness programs by 1993. However, a recent survey found that 88 percent of major employers have introduced some form of health promotion, disease prevention, or early intervention initiative to encourage healthy lifestyles among their salaried employees. Distinctions must be drawn between short- and long-term strategies. Demand management can be thought of as a short-term strategy when the focus of the program is on creating more appropriate and efficient health care utilization. Disease prevention is characterized by longer-term health improvement objectives. Whether the purpose is to reduce utilization in the short term or in the long term, the ultimate goal remains the same: to reduce health care expenditures while improving overall health. This goal can be achieved through the use of health risk appraisals, organizational health risk appraisals, high risk programs, awareness programs, medical call centers, return to work programs, EAPs, and smoking cessation programs. Studies of a health program's cost effectiveness must disentangle the effects of many competing factors on cost effectiveness. For example, a health risk appraisal program may identify health problems of which the patient and the health care provider were unaware, resulting in the treatment of these health problems. At the same time, the employer may have switched from a nonmanaged pharmaceutical program to a managed program with incentives for participants to utilize generic and/or mail order drugs. As a result, when evaluating a health promotion program, the long-run impact on the program's cost effectiveness is most important.     

The power of outcomes: FOTO Industrial Outcomes Tool -- Initial assessment

OBJECTIVE: To demonstrate how outcomes assessment can assist in describing clients receiving rehabilitation in occupational health rehabilitation clinics and to describe the preliminary assessment of internal consistency reliability and construct validity of the FOTO Industrial Outcomes Tool. METHODS: 266 adults referred for acute work rehabilitation (AWR), work conditioning/hardening (WC/WH) or a Functional Capacity Evaluation (FCE) comprised the data set. Clients were treated between July 1998 and January 1999 in 15 clinics from 6 states by 46 clinicians participating in the Focus on Therapeutic Outcomes (FOTO) national rehabilitation database beta test. For AWR and WC/WH, clients completed a health status questionnaire on intake and discharge, and health status was assessed prior to the FCE. Comprehensive demographic data were collected describing the clinics, clinicians, clients and work status collected 2 weeks following discharge. RESULTS: Internal consistency reliability coefficients for the health status scores ranged from 0.57 to 0.89. Construct validity was supported. CONCLUSION: Results demonstrate the power of collecting outcomes from a variety of constructs for clients receiving industrial rehabilitation services. Initial reliability and construct validity findings were adequate and support continuing data analyses.     

Health professionals' attitudes and practices in relation to Functional Capacity Evaluations

Functional Capacity Evaluations (FCE's) are part of practice in work injury prevention and rehabilitation, and are designed to define an individual's functional abilities or limitations in the context of safe, productive work tasks. Qualitative research methodology was used to investigate the attitudes and behaviours of health professionals in relation to FCE use. The study aimed to identify why health professionals chose a particular FCE, and to identify what factors influence health professionals' clinical judgements when providing results and recommendations for the individual being assessed. Five health professionals from the Hunter Region of New South Wales, Australia, participated in semi-structured, individual interviews using a phenomenological approach. Following inductive analysis of the data, four themes reflecting participants' attitudes and behaviours of FCE use emerged: i) referrals and expectations, including why and when the assessment is completed ii) outcomes, -- what the results aim to provide iii) workplace/practice/usage issues and iv) skills of the assessor. The results indicate the need for further research on the clinical utility of FCE's. A large scale quantitative study would allow results to be generalised to a wider community of FCE users.     

How local health departments work towards health equity

BackgroundHealth inequities are exacerbated when health promotion programs and resources do not reach selected populations. Local health departments (LHDs)¹ have the potential to address health equity via engaging priority populations in their work. However, we do not have an understanding of what local agencies are doing on this front.MethodsIn the summer of 2016, we collaborated with informants from thirteen LHDs across North Carolina. Via semi-structured interviews, the research team asked informants about their LHD’s understanding of health equity and engaging priority populations in program planning, implementation, and evaluation.FindingsAll informants discussed that a key function of their LHD was to improve the health of all residents. LHDs with a more comprehensive understanding of health equity engaged members of priority populations in their organizations’ efforts to a greater extent than LHDs with a more limited understanding. Additionally, while all LHDs identified similar barriers to engaging priority populations, LHDs that identified facilitators more comprehensively engaged members of the priority population in program planning, implementation, and evaluation.ConclusionsLHDs are ideally situated between the research and practice worlds to address health equity locally. To promote this work, we should ensure LHDs hold an understanding of health equity, have the means to realize facilitators of health equity work, and recognize the complex context in which health equity work exists.     

Outcomes Measurement

SUMMARY

Outcomes measurement in health and mental health should be of vital concern to social workers since public support and financing will follow evidence of effectiveness. Social work in health and mental health requires a framework for conceptualizing outcomes measurement so that the profession can focus clearly on the work to be done in outcomes measurement. This framework should distinguish among the various ways that outcomes measurement can be used to advance policy, program and practice. This article discusses two applications of outcomes measurement, namely for improving policies and programs, and, second, for conducting outcomes research. Other dimensions that could be included in an outcomes measurement framework for social work in health and mental health are identified but not elaborated. The author's objective is to make a strong case for the role that outcomes measurement can play in both the improvement of social work policies and programs in health care, through performance measurement, as well as in advancing the healthcare knowledge base, through outcomes research.     

Addiction Social Work Fellowship Program in Canada

Substance use disorders (SUD) disproportionally contribute to the global social and economic cost of disease; however, their treatment has been inadequate in large part due to an enduring research to practice gap in which competencies for treating and preventing SUDs are often lacking from social work education curricula. Training social workers in managing SUDs has been separated from nurse and physician training, partly due to the long-standing divide between the behavioral health and medical care system. Recently, a new interdisciplinary fellowship in addiction social work, nursing and medicine has been established in Vancouver, Canada. We describe the novel fellowship program and outline initial impact of the training on knowledge and skills in addiction social work from our qualitative evaluation of the fellowship. We conclude that training social workers, and other allied health professionals alongside physicians and nurses may extend the reach of this type of training program even further.     

An investigation of a workplace-based return-to-work program for shoulder injuries

The purpose of this study was to investigate and evaluate the current workplace management of rotator cuff injuries in a manufacturing plant. The secondary aims were to examine the impact of the company's return-to-work processes, compare outcomes to current industry standards for work (re)entry and to identify the components that characterized this workplace-based return-to-work (RTW) program. This investigation involved a case study approach comprised of an examination of the program context using interviews, onsite visits, a document review and a retrospective analysis of the RTW experiences of 184 workers with shoulder injuries. Findings revealed that the workplace-based RTW program was consistent with and shaped by the organizational culture of problem solving, knowledge exchange and equitable participation of workers, supervisors and health professionals. These components contributed to the program in achieving the following outcomes for workers with shoulder injuries. One-third of workers were placed on modified duties within three days, 56% of workers who engaged in an early RTW program returned to work within one month. Overall, 87.8% of workers with rotator cuff injuries successfully returned to pre-injury work. The implications of developing capacity for workplace-based programs to manage injuries at work are discussed.     

Human Sexuality Education in Marriage and Family Therapy Graduate Programs

Given the likelihood that marriage and family therapists will encounter clients with sexual concerns, it is important to know how graduate training programs are preparing future clinicians to work with this domain of life. Sixty‐nine marriage and family therapy (MFT) program directors completed an online survey to examine how sexual health education is integrated into graduate training programs. Findings indicate that while the majority of program directors value sexuality curriculum, and most programs require at least one course in this area, there are barriers to privileging sex topics in MFT graduate programs. Barriers include few MFT faculties with expertise in human sexuality and marginalized sexual health topics. Implications for training MFT graduate students and their work with future clients are discussed.     

Development of an e-health education program at the workplace using formative research – Technologies for improving quality of life

Backgrounde-Learning, a means by which to expand people’s access to information can be effective in promoting health in the workplace. This study to present steps in the development of an e-health education program at the workplace.ObjectiveThis study aimed to present all steps of develop a telehealth education program for computer users using formative research to identify themes to health education for workers.MethodsA team of expert conducted focus groups with administrative workers (n = 36 participants) to identify thematic health to the development of program. Three meetings were audio video recorded, and notes. All data were based on constant analysis, classical content analysis and keywords in-context.ResultsThe content of the nine audio videos included four musculoskeletal health topics (Walking Program, Back School, Muscle Relaxation Techniques, and Work-related Musculoskeletal Diseases); three to healthy diet (Eating and Commensality, Ultra-processed Food and Food labeling, and Oil and Fat); two to mental health (Burnout Syndrome and the Meaning of work).ConclusionThe proposed steps in the development of a workplace e-health education program were successfully achieved. The engagement of the workers’ staged focus groups was fundamental to the choice of themes relevant to the population in question.