Effectiveness of an interactive website aimed at empowerment of disability benefit claimants: results of a pragmatic randomized controlled trial.
BACKGROUND
The aim of this study was to investigate the effectiveness of an interactive website aimed at empowerment of disability claimants, prior to the assessment of disability by an insurance physician.


METHODS
A randomized controlled trial was conducted. Claimants applying for a work disability pension after being sick-listed for 104 weeks, were randomized into either an intervention group or control group. Participants who were randomized into the intervention group were able to logon to the website www.wiagesprek.nl , which mainly consisted of five interactive modules aimed at increasing knowledge, self-awareness, expectations, self-efficacy, and active participation. Participants from the control group were directed to a 'sham' website with commonly available information only. The primary outcome was empowerment. Secondary outcomes included coping, knowledge, claimant satisfaction, perceived justice, and physician satisfaction. Outcomes were assessed at baseline, 2 days before the disability assessment, as well as 1 day after, 6 weeks, and 4 months after the disability assessment.


RESULTS
Claimants were randomly assigned to the intervention group (n = 123) or a control group (n = 119). The intervention had no significant short- and long-term effects on empowerment, but the intervention increased claimants' knowledge significantly compared to the control group. Claimant satisfaction with the disability assessment interview and claimant perceived justice on the outcome of the assessment were lower in the intervention group (statistically not significant). Furthermore, the intervention had a significant negative effect on claimants perceived procedural justice.


CONCLUSIONS
Although knowledge increased significantly, the intervention www.wiagesprek.nl was not successful in reaching its primary target, that is, to increase levels of empowerment among disability claimants, prior to the assessment of disability.
Department of Public and Occupational Health, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands. d.samoocha@vumc.nl
David
D
Samoocha
Ingrid A K
IA
Snels
David J
DJ
Bruinvels
Johannes R
JR
Anema
Allard J
AJ
van der Beek
D000328:Adult; D001364:Awareness; D003194:Computer-Assisted Instruction; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018868:Insurance, Disability; D020407:Internet; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010358:Patient Participation / Q000523:psychology; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011209:Power, Psychological; D020377:Self Efficacy
Sociol Health Illn. 2007 May;29(4):497-514
17498165
BMJ. 2008 Jul 16;337:a485
18632672
J Med Internet Res. 2002 Apr-Nov;4(2):E13
12554560
Disabil Rehabil. 2011;33(9):734-42
20804446
Disabil Rehabil. 2006 Jan 30;28(2):111-5
16393841
J Health Soc Behav. 1978 Mar;19(1):2-21
649936
J Orthop Sports Phys Ther. 1994 May;19(5):249-60
8199618
J Clin Epidemiol. 2004 Mar;57(3):223-8
15066681
Am J Community Psychol. 1987 Apr;15(2):121-48
3604997
Am J Community Psychol. 1995 Oct;23(5):581-99
8851341
J Gen Intern Med. 2005 Sep;20(9):852-4
16117755
Disabil Rehabil. 2008;30(24):1885-90
19037781
Am J Ind Med. 2004 Apr;45(4):338-45
15029565
Patient Educ Couns. 2006 Oct;63(1-2):12-23
16406464
BMC Med Inform Decis Mak. 2009 May 10;9:23
19426557
J Trauma. 2006 Dec;61(6):1447-52
17159689
J Med Internet Res. 2010 Jun 24;12(2):e23
20581001
BMC Med Res Methodol. 2003 Dec 22;3:28
14690550
J Gen Intern Med. 1996 Sep;11(9):525-32
8905501
J Psychosom Res. 1995 Aug;39(6):755-65
8568732
BMJ. 2001 Feb 24;322(7284):468-72
11222423
Eur J Epidemiol. 2008;23(10):655-60
18712484
BMC Public Health. 2009 Oct 06;9:375
19807905
J Med Internet Res. 2005 Mar 31;7(1):e11
15829473
Prev Med. 1986 Sep;15(5):451-74
3534875
Int J Law Psychiatry. 2007 Jul-Oct;30(4-5):427-43
17692917
J Med Internet Res. 2002 Dec;4(3):E17
12554548
Spine (Phila Pa 1976). 1996 Oct 15;21(20):2397-400
8915080
BMC Public Health. 2006 Aug 29;6:219
16939642
Health Expect. 1998 Jun;1(1):37-49
11281860