This research is the 3rd Phase in our evaluation of Making it WorkTM program. In this phase, we are conducting a randomized controlled trial of our eLearning program—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 a gap of utmost importance in the health care services available for people with arthritis, and has a great potential for improving quality of life and reducing the cost of arthritis.

We had previously tested a face-to-face version of the program (Phase 1). We have since converted our program into a web-based program so that its benefits can be offered to a larger number of people, especially those people living in areas with few services (Phase II). Furthermore, the video group meetings are 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 controlled trial (RCT), is 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 British Columbia, Alberta and Ontario. We sent letters of invitation to individuals who attended outpatient arthritis programs, rheumatoid arthritis educational workshops from Arthritis Consumer Experts, and rheumatology practices, as well as people enrolled in a benefit plan for teachers in Alberta. Participants were randomly assigned to receiving the program or receiving usual care (control group) with some written information on work and arthritis. As such, people had a 50-50 chance of receiving the program right away or having to wait until the end of the study to receive the program.

The program 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 provide knowledge and demonstrate skills and techniques;
• 5 bi-weekly online video group sessions conducted as real-time 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 online modules; and,
• Online 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 randomized to the intervention have received the program, and some of the people randomized to usual care who have completed the five-year study period, are now receiving the program.

The Making-it-WorkTM program was successful in preventing productivity loss and work cessation longer than two months in workers with inflammatory arthritis across three Canadian provinces, over two years.

We still need to continue to follow everyone for a total of five years, with online questionnaires filled out every six months, in order for us to see whether the program prevents people from having to completely stop work due to their arthritis.