Activity Coaching: A treatment program for increasing activity ACHIEV meeting October 2014

Purpose of today’s presentation  Background on Activity Coaching  Update on UW research  Recommendations from Steering Committee  Next steps  Feedback from ACHIEV

PGAP™ at L&I  Pilot project started January 2012  19 trained coaches – all PTs and OTs  Initially only within COHE areas –Now statewide  Added 4 Spanish-speaking coaches in March  >55 interpreters oriented to program 16

 Between first, middle and last sessions  Statistically significant decreases in all scales  Scores improved for 50% – 80% of workers Changes in assessment scores – UW Research 4

Matching Algorithm - UW  Six month follow-up period  About 44 days more time loss among PGAP subjects  Relative risk of remaining on time loss of about 1.9 times higher for PGAP subjects

Matching Algorithm - Confounders  Pain  Pain interference with work  Function  Disability  Co-morbidities  Severity of injury  Psychosocial - –Fear avoidance –Recovery expectations –Catastrophizing

Discussion  PGAP targets psycho-social issues that have been shown to affect recovery from work- related injuries. –Our research shows that PGAP improves these psycho-social issues, at least in the short-term. –We cannot yet say from our research that PGAP improves a worker's ability to return to work Confounders Small sample size Early in pilot

Success Measures  Increase in activity and function- Coaches have reported increased activity for some participants.  Improvement in psycho-social measures – Statistically significant increases in scores for most workers while they remain in treatment.  Return to work – Cannot isolate from other L&I programs. Small sample size.

What questions are not yet answered?  Increases in activity for PGAP participants?  Improvements in psycho-social measures sustained over time?  Long-term effect of PGAP on return to work?  Other (additional) measures, such as –Are there fewer protests and other friction costs? –Does PGAP move the claim forward?

Recommendations from Steering Cmte.  Continue activity coaching through a phased integration.  Work with Return to Work Svcs. and Claims.  Monitor closely for two years. –Assessment scores –Return to work outcomes –Increase in activity –Coordination and integration with other L&I programs