Cross-sectoral coaching for individuals with health impairments and at high risk of permanent work disability: Results of a process evaluation

Abstract

Purpose An innovative case management intervention in the city of Hamburg provides an open facility for individuals at high risk of permanent work disability, offering tailored guidance and support, regardless of the nature and extent of needs and legal jurisdiction. The intervention aims on preserving or restoring employability and preventing chronicity of illnesses or impending disability. Our process evaluation examined the implementation of the intervention. Methods Data were collected in 2021 as part of a mixed-methods study. A questionnaire survey was conducted at the start and after 12 months to analyze changes in health status, employment, and satisfaction with the intervention. Additionally, semi-structured, problem-centered interviews were conducted with stakeholders and participants to analyze the dose given and dose received. We also examined the population reached. Results Out of 145 eligible participants, 56% completed the initial questionnaire, and 28% successfully filled out the second questionnaire. Over 85% of the participants remained employed within a year. The Work Ability Score increased by an average of two points (p=0.001, n=36). There was a significant decrease in depression and anxiety scores. Participants expressed high satisfaction with all of the intervention components. Nine stakeholders and four participants were interviewed about the dose given and dose received. Stakeholders named services focusing on health and social stabilization to maintain of employability. This was intended to be realized through a cross-sectoral, low-Threshold, and coordinating counseling approach. The participants mentioned support to ensure their employability and the opportunities for professional reorientation as offers. Conclusion A new intervention was implemented to provide support for individuals with health impairments and at high risk of permanent work disability. Despite high initial levels of depression and anxiety, case management support had a positive impact. The Work Ability Score significantly improved. It was observed that the participants' employment situations were largely stabilized. The project will continue and be evaluated through a mixed-methods observational study (https://www.hgua-hamburg.de/).