REDUCING OCCUPATIONAL DISABILITY IN RURAL WORKERS

描述(改编自《调查员摘要》)：总计6.8个 据报道，私营企业工人中有100万人受伤和患病。 在1994年。重返工作岗位(RTW)计划促进 受伤的工人；RTW计划的理由是基于以下证据 积极主动的职业伤害管理可以显著减少 与工作有关的残疾的程度和持续时间。然而，这一证据 几乎完全来自大都市的大公司(例如波音) 区域。拟议项目的目标是系统地评估 农村开展护士协调远程医疗服务的可行性研究 设置。而不是将集中式系统转移到农村环境， RTW干预将利用人们对 当地社区护士和医生指导和提供干预 他们自己的社区。该项目将分三个阶段进行。 第一阶段包括对俄勒冈州三项研究的数据进行二次分析 (n=927名工人)针对农民工。这些数据与 针对腰背损伤的临床发现，形成了经验性 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。 干预措施包括四次对受伤人员的家庭/工作现场探访 专注于减少残疾的目标领域的工人。第三阶段重点 基于经验的农村风险降低模型的发展研究 受雇于小公司的工人。在这一背景下，具体目标 包括：1)使用来自以下项目的数据确定RTW干预的组成部分 俄勒冈州研究，2)培训当地护士提供干预，3) 在两个社区进行可行性研究，测试干预措施，4) 比较试验性和就业性的临床和就业结果 对照组，5)评估多点临床试验的可行性 在农村社区，以及6)开发基于经验的风险模型 减少农村社区工伤工人的数量。

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.