title: Availability, need for, and use of work accommodations and benefits: are they related to employment outcomes in people with arthritis?
abstract: OBJECTIVE
  To examine the availability, need, and use of workplace policies for workers with osteoarthritis (OA) and inflammatory arthritis (IA) and their association with employment outcomes.
  
  
  METHODS
  Participants (n = 219) were employed, ages ≥25 years, and diagnosed with OA or IA. They were recruited through community advertising and rheumatology clinics in 2 Canadian provinces. Respondents completed a 35-45-minute telephone interview assessing demographics (age, sex), health (diagnosis, pain, activity limitations), work context (job control), employment outcomes (workplace activity limitations, absenteeism, productivity losses, reduced hours), benefits (extended health, short-term leaves), and accommodations (flexible hours, modified schedules, special equipment/adaptations, work-at-home arrangements). Regression analyses examined differences in benefit/accommodation need and use.
  
  
  RESULTS
  Many participants reported that arthritis impacted their work. But with the exception of extended health benefits, ∼50-65% of participants reported not needing each individual benefit/accommodation, although only 7.3% of respondents reported needing no benefits or accommodations at all. Greater job control and education were associated with greater perceived need and use of benefits/accommodations. Need was also associated with greater activity limitations, and disclosure of arthritis was related to use of benefits/accommodations. Participants needing but not using workplace policies often had significantly poorer employment outcomes compared to those using benefits/accommodations.
  
  
  CONCLUSIONS
  Findings are relevant to workers with arthritis and to employers. Results suggest that individuals with arthritis are unlikely to be a drain on workplace resources. Many individuals do not use benefits/accommodations until needed, and among those using them, there were generally positive relationships with diverse employment outcomes.
authors.affiliation: Institute for Work and Health, Toronto Western Research Institute, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Monique A M
authors.initials: MA
authors.lastname: Gignac
authors.affiliation: Toronto Western Research Institute, Toronto, Ontario, Canada.
authors.forename: Xingshan
authors.initials: X
authors.lastname: Cao
authors.affiliation: Institute for Work and Health and Toronto Western Research Institute, Toronto, Ontario, Canada.
authors.forename: Jessica
authors.initials: J
authors.lastname: McAlpine
mesh_terms: D000041:Absenteeism; D000328:Adult; D002170:Canada; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004526:Efficiency; D005260:Female; D006291:Health Policy; D006301:Health Services Needs and Demand / Q000331:legislation & jurisprudence*; D006801:Humans; D007342:Insurance Benefits / Q000331:legislation & jurisprudence*; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000331:legislation & jurisprudence*; D016272:Occupational Health / Q000331:legislation & jurisprudence*; D010003:Osteoarthritis / Q000175:diagnosis / Q000628:therapy; D010561:Personnel Staffing and Scheduling / Q000331:legislation & jurisprudence*; D012307:Risk Factors; D018582:Sick Leave / Q000331:legislation & jurisprudence; D013997:Time Factors; D016526:Workload / Q000331:legislation & jurisprudence; D017132:Workplace / Q000331:legislation & jurisprudence*