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Exploring the Association between Individual-Level Attributes and Fidelity to a Vocational Rehabilitation
Katie E Powers1, Roshan das Nair2,3, Julie Phillips1
1Injury, Inflammation & Recovery Sciences, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
Summary
Occupational therapist mentoring increased intervention fidelity for early stroke vocational rehabilitation. Higher fidelity and therapist experience positively impacted stroke survivors' return-to-work outcomes.
Area of Science:
- Rehabilitation science
- Occupational therapy
- Health services research
Background:
- Understanding therapist attributes influencing intervention fidelity and patient outcomes is crucial for effective implementation.
- Early stroke specialist vocational rehabilitation (ESSVR) aims to support stroke survivors' return to work (RTW).
Purpose of the Study:
- To explore the relationship between Occupational Therapist (OT) attributes, ESSVR fidelity, and stroke survivor RTW outcomes.
- To identify factors influencing the faithful delivery of a complex vocational rehabilitation intervention.
Main Methods:
- 39 OTs were surveyed and trained in ESSVR delivery across 16 sites.
- OTs received monthly mentoring; fidelity was assessed via retrospective case review.
- Regression analyses examined links between OT attributes, fidelity, and RTW outcomes.
Main Results:
- Fidelity scores averaged 78.8%; only OT engagement in mentoring significantly predicted fidelity.
- Increased fidelity and more years of stroke rehabilitation experience were associated with positive RTW outcomes.
Conclusions:
- Mentoring OTs can enhance ESSVR fidelity, potentially improving stroke survivor RTW.
- Experienced OTs may be more effective in supporting RTW.
- Upskilling OTs for complex interventions requires mentoring alongside training to ensure fidelity.
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