Evaluating a multidimensional support program to support breast cancer survivors' transition back to suitable work

RTW Support intervention The intervention will provide a biopsychosocial (BPS) assessment followed by individually-tailored return to work (RTW) support. Tailored services include health coaching (enabling breast cancer survivors to successfully manage their transition to good work and living well), liaison with clinicians and employers, and individualised RTW planning and monitoring. The intervention is to be delivered face-to-face and individually by a trained occupational rehabilitation (OR) consultant, with some follow-ups by telephone and assessments online. The duration, intensity and dose will vary, as part of the tailored / personalised nature of the intervention. The tailoring or the personalisation of the intervention content is a unique feature and potential strength of the intervention. The tailoring will be determined by a combination of the BPS assessment results (assessment delivered during the first session with the OR consultant), and the discussion of those results with the breast cancer survivor. The consultant is trained to use the initial assessment results and associated discussions with the breast cancer survivor to determine the tailoring of the intervention content; consultant guidelines also exist to assist with this decision-making, and senior consultants with experience delivering the intervention during the pilot phase will be made available as ‘champions’ or mentors to provide advice as required. Based on the pilot study, delivery of the entire multimodal program is expected to take a minumum of 12 weeks and a maximum of 28 weeks. For those undertaking the health coaching component, a series of weekly (up to 8) health coaching sessions will take place during this period. Each health coaching session typically takes around 60 minutes, and the BPS assessment an additional 15 minutes when required (i.e. typically the initial and final health coaching session). The health coaching and RTW services delivered face-to-face will be delivered from IPAR Rehabilitation offices in a variety of locations across Australia. The delivery of the program by specially trained OR consultants is another unique aspect of the program, which is also being evaluated. OR consultants will all receive specialised breast cancer survivor training, delivered by a representative of Cancer Council NSW, and featuring a presentation from a breast cancer survivor speaking about her experiences transitioning back to the workplace. Liaison with clinicians and employers is usual care, everyday practice for OR consultants. Over and above this, however, is another unique component of this intervention. Part of the service offering will also include, where relevant to the breast cancer survivor employee, support and education for their employer to facilitate the return to a supportive work environment. This is only relevant for breast cancer survivors returning to their pre-diagnosis employer after having medical leave. Individualised RTW planning and monitoring is again usual care, everyday practice for OR consultants. For this intervention, the additional breast cancer-specific training undertaken by all consultants means that particular care will be taken to ensure that the RTW planning takes into consideration the unique needs and requirements of breast cancer survivors during their rehabilitation. The components of the tailored multimodal intervention, as outlined above, are delivered in a flexible fashion across the 12-28 week period. The health and well-being of the breast cancer survivor involved, and their needs and circumstances following initiation of the intervention determines the overall duration. At the end of each month, as per usual care practice, each consultant will record in the Case Manager software, the intervention component status as either: not yet recommended; recommended but not yet initiated; partially completed; fully completed. Initiation and completion dates are also recorded, and for the Health Coaching, the specific modules completed are also recorded.