A clinical trial of a telehealth work support program for stroke survivors

Arm 1: Work Support Program (WSP) The Work Support Program is a telehealth-delivered, individualised work support intervention for adults who have had a stroke. The program is delivered individually by trained Work Support Program Clinicians (health professionals) via telephone or videoconference. The WSP is guided by a facilitator manual based on pilot work and designed specifically for this trial. The program has four mandated sessions (assessment sessions and discharge), with the remaining sessions guided by the participants individual goals and needs. The intervention includes: • Having a WSP Clinician for up 6-months. • Three specialised assessment sessions (up to 1 hour each or split across shorter sessions if required) that enable identification of gaps in care, barriers and facilitators to work, and an individualised Workplace Action Plan. • This WSP Clinician will identify gaps in current supports/care; identify and facilitate referrals; and communicate with care providers/workplaces/support people as appropriate (and with permission) to ensure the participant is accessing appropriate supports/services. • For those returning to work, the WSP Clinician will participate in development of a Return to Work Plan, and delivery of that plan, including liaison with workplaces (with permission). • For those who are unemployed, the WSP Clinician will support liaison with disability employment services and assist in identifying and applying for potential jobs. Additional strategies (CV review; interview practice; role plays and so on) will be implemented as required. • For those currently working, the WSP Clinician will support the participant in following their Workplace Action Plan, with revisions to the plan as new barriers emerge. This may include liaison with the workplace as required (with permission). • Additional support around enhancing work-life balance will be provided as appropriate (psychoeducation, identification of barriers and strategy identification/goal setting). WSP clinicians will also be trained in supporting emotional adjustment to stroke, person centred goal setting and problem solving. • A discharge plan at the end of the intervention delivery. Training: WSP Clinicians will undergo structured training prior to delivery, including a minimum of 4 hours of online videos/reading; 3 hours of face to face training, and 3 hours of role plays prior to the first participant enrolment; followed by regular individual/group supervision and fidelity checks during study delivery. Duration & Frequency: Up to 6 months post-enrolment. Frequency of sessions and number of sessions are not pre-specified, but will be agreed upon by the WSP Clinician and participant, based on their needs and goals. Session length will also vary depending on session content (approx. 15 minutes to 1 hour maximum). There are four mandated sessions, as such “per protocol” will be defined as a minimum of 4 sessions attended. Mode: Telehealth (telephone or videoconference), delivered individually. Delivered by: Trained Work Support Program clinicians (registered health professionals with at least 2 years clinical experience). Fidelity: Clinical notes will be coded and audited. For fidelity analysis, Work Support Program Clinicians will digitally record the sessions (with client’s permission). On an ongoing basis an independent fidelity assessor will review audio recordings for 10% of randomly selected participants, rating against a checklist of expected activities according to the manual for percentage adherence, with any barriers to delivery and new/additional strategies not currently in the manual noted.