REDUCING OCCUPATIONAL DISABILITY IN RURAL WORKERS

描述（改编自研究者摘要）：共6.8 据报道，私营企业工人中有100万人受伤和患病， 在1994年。 重返工作（RTW）计划促进了 受伤的工人; RTW计划的基本原理是基于证据， 积极主动的职业伤害管理可以大大减少 与工作有关的残疾的程度和持续时间。 然而，这一证据 几乎完全来自大公司（例如，波音）在大都市 地区 拟议项目的目标是系统地评价 在农村提供护士协调的RTW服务的可行性 设置. 与其将中央集权制度转移到农村， RTW的干预将利用 当地社区护士和医生指导和提供干预措施， 他们自己的社区。 该项目将分三个阶段进行。 第1阶段包括对来自三项俄勒冈州研究的数据进行二次分析 （n=927工人）针对农村工人。 这些数据，结合 临床发现解决下背部损伤，形成经验 RTW干预的基础。 第二阶段包括可行性研究 在两个地点（蒙大拿州的米苏拉和俄勒冈州的拉格兰德）交付，60名工人 将被随机分配到RTW干预或标准护理。 干预措施包括对受伤人员进行四次家庭/工作现场访问 工作人员侧重于减少残疾的目标领域。 第三阶段重点 关于为农村妇女制定一个以农业为基础的减少风险模式的报告 在小公司工作的工人。 在这方面，具体目标 包括：1）使用来自 俄勒冈州研究，2）培训当地护士提供干预，3） 进行可行性研究，测试两个社区的干预措施，4） 比较临床和就业结果之间的实验和 对照组，5）评价多中心临床试验的可行性 6）建立一个以风险为基础的模型 减少农村社区的受伤工人。

DESCRIPTION (Adapted from the Investigator's Abstract): A total of 6.8 million injuries and illnesses were reported in private industry workers during 1994. Return-to-work (RTW) programs promote optimal recovery in injured workers; the rationale for RTW programs is based on evidence that proactive management of occupational injuries can significantly reduce the magnitude and duration of work-related disability. However this evidence comes almost exclusively from large companies (e.g., Boeing) in metropolitan areas. The objective of the proposed project is to systematically evaluate the feasibility of delivering nurse-coordinated RTW services in rural settings. Rather than transfer a centralized system to the rural setting, the RTW intervention will capitalize on the familiarity and expertise of local community nurses and physicians to direct and provide interventions in their own communities. The project will be conducted in three phases. Phase 1 includes a secondary analysis of data from three Oregon studies (n=927 workers) directed toward rural workers. These data, combined with clinical findings addressing low-back injuries, form the empirical foundation for the RTW intervention. Phase 2 includes a feasibility study delivered in two sites (Missoula, Montana and LaGrande, Oregon), 60 workers will be randomly assigned to either the RTW intervention or standard care. The intervention is comprised of four home/worksite visits to injured workers focusing on targeted areas of disability reduction. Phase 3 focuses on the development of an empirically-based risk reduction model for rural workers employed in small companies. Within this context, specific aims include: 1) Finalize components of the RTW intervention using data from the Oregon studies, 2) Train local nurses to provide the intervention, 3) Conduct a feasibility study testing the intervention in two communities, 4) Compare clinical and employment outcomes between the experimental and control groups, 5) Evaluate the feasibility of a multi-site clinical trial in rural communities, and 6) Develop an empirically-based model of risk reduction for injured workers in rural communities.