178997 Prevention of long-term disability in back injuries: Screening and intervention

Sunday, October 26, 2008

Deborah Fulton-Kehoe, PhD, MPH , Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
Gary M. Franklin, MD, MPH , Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
Thomas M. Wickizer, PhD, MPH , Health Services, University of Washington, Seattle, WA
Jeremy V. Gluck, PhD, MPH , Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
Judith A. Turner, PhD , Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
Objectives: To develop a brief worker-completed questionnaire for use soon after a work-related back injury to (a) asses risk of work disability one year after injury and (b) design and implement interventions to reduce disability. Methods: In this prospective cohort study, 1885 workers provided information regarding pain, functional status, psychosocial, clinical, and work characteristics 2-3 weeks after filing a claim for a new back injury. Work disability status was assessed one year after injury. Classification and regression tree analysis (CART) was used to identify the best predictive model of work disability status. Results: Pain interference with ability to work (>5, 0-10 scale), not currently working, and radiating leg pain comprised the best model which accurately classified 77% of the workers. Interventions: The questionnaire will be used to target interventions which may include new employer-based incentives related to work modifications, targeted progressive reactivation exercises, and patient education aimed at worker fear avoidance and low work expectations. Use of the screening questionnaire and interventions will be pilot tested within an occupational health quality improvement project.

Learning Objectives:
To identify strongest risk factors for long-term disability from work. To identify links between risk factors and interventions.

Keywords: Occupational Health Care, Disability Studies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an epidemiologist (MPH, PhD). I participated in the design, analysis, and writing of this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.