Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 14;9(2):rkaf034.
doi: 10.1093/rap/rkaf034. eCollection 2025.

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

Simone Battista  1 , Jennifer Parker  1 , Angela Ching  1 , June Culley  2 , Sarah Long  2 , Alison Heard  2 , Alison Hammond  1 , Kathryn Radford  3 , Paula Holland  4 , Terence O'Neill  5   6 , Karen Walker-Bone  7   8 , Yeliz Prior  1
Affiliations

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

Simone Battista et al. Rheumatol Adv Pract. .

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.

Trial registration: ClinicalTrials.gov NCT03942783. Registered on 8 May 2019. ISRCTN Registry ISRCTN61762297. Registered on 13 May 2019. Retrospectively registered.

Keywords: health care; intervention implementation science; job security; occupational stress; occupational therapy; outcome and process assessment; qualitative research; rehabilitation; vocational; working conditions.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Themes and subthemes following the NPT framework. In the picture, the five main themes are represented in filled coloured boxes. Subthemes are shown in unfilled boxes of the matching-colour themes. NPT: Normalization Process Theory
See this image and copyright information in PMC

References

    1. UKGOV—Department for Work and Pensions. Working for a healthier tomorrow: work and health in Britain—GOV.UK. https://www.gov.uk/government/publications/working-for-a-healthier-tomor... (21 February 2024, date last accessed).
    1. Bechman K, Cook ES, Alveyn E et al Occupational impacts of early inflammatory arthritis: results from the National Early Inflammatory Arthritis Audit. Rheumatology 2024;63:1856–67. - PMC - PubMed
    1. Hammond A, Radford KA, Ching A et al The WORKWELL trial: protocol for the process evaluation of a randomised controlled trial of job retention vocational rehabilitation for employed people with inflammatory arthritis. Trials 2022;23:937–17. - PMC - PubMed
    1. Strand V, Wright GC, Bergman MJ et al Patient expectations and perceptions of goal-setting strategies for disease management in rheumatoid arthritis. J Rheumatol 2015;42:2046–54. - PubMed
    1. Madsen CMT, Bisgaard SK, Primdahl J et al A systematic review of job loss prevention interventions for persons with inflammatory arthritis. J Occup Rehabil 2021;31:866–85. - PubMed

Associated data

LinkOut - more resources