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. 2025 Jun;35(2):374-389.
doi: 10.1007/s10926-024-10211-0. Epub 2024 Jun 10.

A Mixed-Methods Process Evaluation of the Maastricht Work-Related Support Intervention for Healthcare Professionals in Clinical Care

Maarten Butink  1   2   3 , Annelies Boonen  4   5 , Tim Boymans  5   6 , Vera Baadjou  5   7 , Emmelie Hazelzet  4 , Angelique de Rijk  8   5
Affiliations

A Mixed-Methods Process Evaluation of the Maastricht Work-Related Support Intervention for Healthcare Professionals in Clinical Care

Maarten Butink et al. J Occup Rehabil. 2025 Jun.

Abstract

Purpose: To perform the process evaluation of an intervention that aims to facilitate clinical healthcare professionals (HCP) to provide Maastricht Work-Related Support (WRS) to working patients with a chronic disease.

Methods: A mixed-methods approach was applied to address reach, efficacy, adoption, implementation, and maintenance (RE-AIM framework) as well as context of the Maastricht WRS intervention. Qualitative data included interviews with HCPs (N = 10), patients at two time points (N = 10 and N = 9), and field notes. Quantitative data included screening logbooks of HCPs, patient screening forms, and a questionnaire for patients. Content analysis or computation of frequencies was applied where applicable.

Results: Twenty-eight HCPs participated in the intervention (reach). They had a low attitude toward providing Maastricht WRS themselves (adoption). During clinical consultations, they addressed work for 770 of 1,624 (47%) persons of working age. Only 57% (437/770) had paid work, of which 10% (44/437) acknowledged a current need for support. Discussing work during clinical consultations by HCPs was hindered by other medical priorities and patients not disclosing problems (implementation). Over time, Maastricht WRS was less consistently provided (maintenance). Patients reported a positive impact of the intervention, such as fitness for work (efficacy). Context (e.g., lack of urgency, priority, time, and management support) played a pivotal role in the implementation.

Conclusion: This evaluation showed that HCPs had a positive attitude toward WRS in general, but their attitude toward provide Maastricht WRS themselves in daily clinical care was low. Recommendations include improving HCPs' attitude, addressing WRS as a key policy point, and facilitating time.

Keywords: Chronic diseases; Clinical care; Healthcare professionals; Intervention; Process evaluation; Work participation.

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Conflict of interest statement

Declarations. Conflict of Interest: The authors declare that they have no competing interests. Ethical Approval: This research has been approved by the Medical Ethical Committee of the Maastricht University Medical Center + , in Maastricht, the Netherlands (METC 2021–3001). Informed Consent: Informed consent was obtained from all patients for being included in the study. Consent for Publication: Not applicable.

Figures

Fig. 1
Fig. 1
Overview of Maastricht WRS pathway and components (orange)
Fig. 2
Fig. 2
Implementation and data collection timeline of the Maastricht WRS intervention
Fig. 3
Fig. 3
Consecutive phases required to achieve behavioral change among HCPs to provide Maastricht WRS, adopted from De Vries et al. [29] and as observed in the process evaluation
See this image and copyright information in PMC

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