This research is a natural extension of our previous studies on Work Disability (WD), which led to the development of a novel intervention to help people with inflammatory arthritis maintain employment. This unique program, called Making it WorkTM, was created to improve an aspect of disease management that is too often ignored by health care professionals – the management of employment issues. It fills an important gap in the health care services available for people with arthritis, and has a great potential for improving quality of life and reducing the large indirect cost of arthritis. We have converted our self-management program into a web-based program so that the benefits can be offered to a larger number of people with rheumatoid arthritis. For the program to be implemented widely, further testing has been necessary to demonstrate its effectiveness at preventing work cessation and improving at-work productivity loss. In this study, we have used a randomized controlled trial design to test the effectiveness and cost-utility of our web-based program compared to a control group receiving usual care. Our program is unique worldwide in that it combines the benefits of video conferencing group sessions focused on improving self-management, with assessments by health professionals specifically addressing employment. The web-based technology for delivery of the program is at the leading edge of trends in the field of adult education and self-management. This research is one of few initiatives worldwide to develop and test the effectiveness of interventions specifically targeted at employment. In this age of evidence-based health care delivery, the highest level of evidence, provided by a randomized control-led trial (RCT), has been needed for our research to translate into a new service offered to people with arthritis. How was this study conducted? Participants were recruited from across BC, Alberta and Ontario. We sent letters of invitation to individuals who attended outpatient arthritis programs, RA educational workshops from Arthritis Consumer Experts, and rheumatology practices. Participants were randomized into control and study groups. As such, each eligible recruit had a 50-50 chance of receiving the program. Members of the study group have participated in the program, which consists of three main components:

• 5 web-based e-learning modules on topics related to work and arthritis. These modules include a combination of text, art work, audio recordings, video-clips, self-learning activities, and animations to demonstrate skills and techniques;
• 5 bi-weekly video group sessions conducted as real-time web-based meetings led by a trained facilitator. Participants were able to share experiences with the group, discuss problems encountered and strategies used to overcome them, report on progress, and practice techniques shown in the simulation sequences; and,
• In-person consultations with employment-related professionals. Participants met with an occupational therapist (OT) and a vocational rehabilitation counsellor (VRC) to determine what changes were needed and to develop an individualized plan for making those changes.

Currently, all participants are in the process of filling out questionnaires online which they started at the beginning of the trial and continue to fill out every six months. Data collected includes: information about demographics, disease measures, costs, work-related risk factors, quality of life, and work outcomes. We will begin analysis of this data to evaluate the effect of the intervention in June 2019. Who is funding the research? This research is funded by a grant from the Canadian Institutes of Health Research (CIHR)