WORKWELL process evaluation: qualitative data analyses of the participant interviews at 12- and 36-month follow-ups

Battista, Simone; Parker, Jennifer; Ching, Angela; Culley, June; Long, Sarah; Heard, Alison; Hammond, Alison; Radford, Kathryn; Holland, Paula; O’Neill, Terence; Walker-Bone, Karen; Prior, Yeliz

Abstract

Objectives

This study aimed to qualitatively examine the delivery of the WORKWELL trial, a job retention vocational rehabilitation (JRVR) programme designed to help individuals with inflammatory arthritis (IA) maintain employment. A qualitative process evaluation used the Normalization Process Theory (NPT) to understand participant experiences and identify factors influencing implementation and outcomes.
Methods

Data were collected via one-to-one telephone interviews with trial participants at 12 and 36 months. An inductive reflexive thematic analysis was followed by a deductive analysis based on NPT’s four constructs (coherence, cognitive participation, collective action and reflexive monitoring).
Results

Sixty-two participants (mean age 51.0; 82.3% female) were interviewed, most diagnosed with RA (75.8%). Four secondary themes were generated under NPT constructs. For ‘Coherence’, themes included ‘Exploring the Purpose and Impact of Taking Part in WORKWELL’ and ‘Questionnaires as Instrument for Reflection’. In ‘Cognitive Participation’, the theme was ‘Commitment and Investment to WORKWELL’. For ‘Collective Action’, we identified ‘Key Actions for Successful WORKWELL’, and under ‘Reflexive Monitoring’, the theme was ‘Suggestions for Improving WORKWELL’. These themes reflected participants’ mixed feelings about the intervention, finding value in the intervention but highlighting the need for more tailored, timely and relevant content. Workplace support was crucial but often insufficient. Follow-up calls from researchers to ensure questionnaire completion were seen as a way to reflect and monitor their conditions. The pandemic’s impact on work environments also influenced outcomes.
Conclusion

Findings suggest that WORKWELL provided work support for participants, though its impact could be enhanced through greater customization, early intervention and stronger workplace engagement.

• Journal Article Type: Article
• Acceptance Date: Mar 7, 2025
• Online Publication Date: Mar 14, 2025
• Publication Date: Mar 14, 2025
• Deposit Date: Mar 26, 2025
• Publicly Available Date: Mar 26, 2025
• Journal: Rheumatology Advances in Practice
• Print ISSN: 2514-1775
• Electronic ISSN: 2514-1775
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 9
• Issue: 2
• Pages: rkaf034
• DOI: https://doi.org/10.1093/rap/rkaf034
• Keywords: job security, intervention implementation science, health care, qualitative research, occupational stress, vocational, rehabilitation, working conditions, occupational therapy, outcome and process assessment