Activity Coaching: A treatment program for increasing activityACHIEV meeting October 2014

Purpose of today’s presentation

Background on Activity Coaching Update on UW research Recommendations from Steering Committee Next steps Feedback from ACHIEV

PGAP™ at L&I

Pilot project started January 2012 19 trained coaches – all PTs and OTs Initially only within COHE areas

– Now statewide

Added 4 Spanish-speaking coaches in March >55 interpreters oriented to program

16

Between first, middle and last sessions

Statistically significant decreases in all scales

Scores improved for 50% – 80% of workers

Changes in assessment scores – UW Research

4

Matching Algorithm - UW

Six month follow-up period About 44 days more time loss among PGAP

subjects Relative risk of remaining on time loss of

about 1.9 times higher for PGAP subjects

Matching Algorithm - Confounders

Pain Pain interference with work Function Disability Co-morbidities Severity of injury Psychosocial -

– Fear avoidance– Recovery expectations– Catastrophizing

Discussion

PGAP targets psycho-social issues that have been shown to affect recovery from work-related injuries. – Our research shows that PGAP improves these

psycho-social issues, at least in the short-term. – We cannot yet say from our research that PGAP

improves a worker's ability to return to work• Confounders• Small sample size• Early in pilot

Success Measures

Increase in activity and function- Coaches have reported increased activity for some participants.

Improvement in psycho-social measures –

Statistically significant increases in scores for most workers while they remain in treatment.

Return to work – Cannot isolate from other L&I programs. Small sample size.

What questions are not yet answered?

Increases in activity for PGAP participants? Improvements in psycho-social measures

sustained over time? Long-term effect of PGAP on return to work? Other (additional) measures, such as

– Are there fewer protests and other friction costs?– Does PGAP move the claim forward?

Recommendations from Steering Cmte.

Continue activity coaching through a phased integration.

Work with Return to Work Svcs. and Claims. Monitor closely for two years.

– Assessment scores– Return to work outcomes– Increase in activity– Coordination and integration with other L&I

programs