title: A proof-of-concept study of the "Employment and Arthritis: Making It Work" program.
abstract: OBJECTIVE
  Work disability is a common outcome of inflammatory arthritis (IA), yet few services address employment. We conducted a proof-of-concept study of the "Employment and Arthritis: Making It Work" self-management program aimed at preventing work disability and maintaining at-work productivity in employed people with IA.
  
  
  METHODS
  The program was developed using the precede-proceed model and self-management concepts. Program goals included modifying risk factors for work disability and enhancing self-management of work problems due to IA, as identified in initial focus groups. The program included a self-learning manual, 5 group sessions, and individual visits with an occupational therapist for an ergonomic assessment and a vocational rehabilitation counselor. It was pilot tested in 2 groups (n = 19) and evaluated over 12 months of followup.
  
  
  RESULTS
  Participants consisted of 19 employed women with IA. Process evaluation demonstrated feasibility and excellent attendance and use of the self-learning manual. By 1 year, 80% reported increased confidence in requesting job accommodations, 74% had requested an accommodation, and 71% of requested accommodations were implemented. The occupational therapist and vocational rehabilitation counselor visits resulted in recommendations for change in 100% and 74% of participants, respectively, with implementation of some recommended changes in 89% and 63%, respectively. Improvements were observed in self-confidence in managing problems at work, fatigue interference with work, measures of limitations, and at-work productivity.
  
  
  CONCLUSIONS
  We developed a novel intervention to prevent work disability in patients with IA, combining self-management group sessions and professional assessments aimed at job retention, which resulted in people making changes to adapt their work to their arthritis, and improved fatigue, self-efficacy, and at-work productivity.
authors.affiliation: University of British Columbia and Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada. dlacaille@arthritisresearch.ca
authors.forename: Diane
authors.initials: D
authors.lastname: Lacaille
authors.forename: Margaret A
authors.initials: MA
authors.lastname: White
authors.forename: Pam A
authors.initials: PA
authors.lastname: Rogers
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Backman
authors.forename: Monique A M
authors.initials: MA
authors.lastname: Gignac
authors.forename: John M
authors.initials: JM
authors.lastname: Esdaile
mesh_terms: D000328:Adult; D001168:Arthritis / Q000523:psychology* / Q000534:rehabilitation*; D004185:Disability Evaluation; D004526:Efficiency; D004651:Employment / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D016730:Program Development; D012648:Self Care / Q000523:psychology*