Table 1 Description of the four components according to the TIDieR checklist
Brief name | Postal information | Telephone counseling | Initial one-on-one interview | Case management |
|---|---|---|---|---|
Why | Individuals are addressed personally with postal information. The individuals to be contacted are selected by means of a standardized and validated risk index [14]. This score enables sensitive and specific identification of persons who will receive a disability pension without additional intervention. The postal contact is intended to ensure that the selected individuals decide to call the case manager and participate in our case management intervention. In formulating the cover letter, we drew on the self-determination theory [15]. This theory assumes that individuals perform self-determined actions to satisfy their needs for competence, social inclusion, and autonomy. The persons contacted should feel competent to grasp the information through appropriate language. Their autonomy is confirmed, in that the offer is designated as a voluntary measure. The demand for social inclusion is met by the objective of equal participation that we have formulated. The better the cover letter can meet the three criteria, the more the individuals will be motivated to call the case managers. The cover letter also communicates that the three needs can be met as part of the intervention. | The telephone counseling session is intended to clarify all important questions regarding case management, data protection, confidentiality, and voluntariness. It should also pave the way for an initial interview. At the end of the initial telephone contact, the information provided should enable the person to decide whether case management is an option for him/her. | The person and the case manager get to know each other. During the initial interview, all further questions about case management, study participation, data protection, confidentiality and the voluntary nature of participation are clarified. The person should make an informed decision about participating in the case management intervention. The case manager should use the health, personal, and biographical information provided by the participant to develop initial ideas for possible services and support. Finally, the case manager needs to clarify the eligibility of the individual person for our model assessing some medical data. | Case management is a person-centered individual case intervention. We chose this approach to individually assess the multiple interactions of health problem, environment and person described in the model of the International Classification of Functioning, Disability, and Health [16] and to allow shared planning on how to improve the individual’s participation. The involvement of other stakeholders in the social environment recognizes that disability is also a social situation. To increase the likelihood that participants will achieve their goals, goals are formulated as specific, measurable, achievable, relevant, and time-bound. Coaching approaches are used to enhance the participant’s self-reflection skills, acceptance of illness, resilience, and motivation. A resource-based approach aims to activate available skills. |
What (materials) | Personalized letters | Guideline for initial telephone contact and computerized documentation | Guideline for initial one-on-one interview; computerized documentation; questionnaire for the collection of medical data to check eligibility; study information; informed consent form (in duplicate); baseline questionnaire | Worksheet “Analysis of needs and agreement on objectives”; computerized documentation; toolbox with working materials on medical and vocational rehabilitation, rehabilitation aftercare, reintegration and job retention (graded return-to-work, company integration management, rights and obligations of the employer, degree of disability, and termination), reorientation and job acquisition (career orientation, job application training), health and therapeutic services, social security and support; follow-up questionnaire at the end of the case management intervention |
What (procedures) | The selection of the persons to be contacted is made using a computerized algorithm that combines various characteristics stored in the individual accounts at the pension insurance institution (e.g., age and duration of receipt of sickness benefits and unemployment benefits) [6]. We applied weights when combining the various administrative data. Individuals with a risk index score of at least 60 points and who have received sickness benefits in the past year are contacted by the German Pension Insurance North. | The person contacted calls the case manager using the contact details provided in the personalized letter and is informed in a telephone counseling about the goals and implementation of the case management intervention. An initial one-on-one interview is arranged with the case manager. | The person meets with the case manager at an agreed upon location for an initial one-on-one interview. | Case management includes an initial phase of up to three appointments, a phase of individually tailored support and a final evaluation meeting. Intermediate assessment meetings are held at regular intervals to review and, if necessary, update needs and goals. Individualized assistance includes, among other things, consultations on health and social benefits, joint workplace meeting, support in applying for further services, acquisition of potential new employers or internships, coaching on reorientation and job applications, and educational and psychological interventions. |
Who provided | German Pension Insurance North (provision of data and dispatch of information letters) and researchers (calculation of the risk index) | Case manager | Case manager | Case manager |
How | Postal and individually | By phone and individually | In presence and individually | In presence and individually; if necessary, with the involvement of other stakeholders (e.g., employer, employee representatives, and company physician) |
Where | German Pension Insurance North (provision of data and dispatch of information letters) and University of Lübeck (calculation of the risk index) | Workplace of the case manager | Residence of the person or agreed meeting place | Residence of the participant or agreed meeting place or workplace of the case manager; if necessary, other institutions (e.g., offices and counseling centers) |
When and how much | Once per individual in several waves | Once after receiving the postal information and 10 to 15 min | Once after telephone counseling and 1 h | Up to 50 h within 1 year after initial interview and approval by the German Pension Insurance North; familiarization (two to three appointments); monitoring and interim review (every 3 months); final interview (one appointment) |
Tailoring | Not planned | Not planned | Not planned | The elements individually tailored to the needs of the participants are derived from the jointly developed goals. The dose of case management is also individual. The upper limit is 50 h. Mandatory and regular interim meetings are held to structure the intervention. The toolbox outlined above, with its various working materials, supports the individual design of the case management intervention. |
How well | The calculation of the risk index scores uses administrative data with high validity and is performed with a computer syntax. Sampling is described in a guideline to ensure standardized implementation. | The implementation of the telephone counseling is described in a guideline to ensure standardized implementation. The initial telephone contact is documented by the case manager in a standardized manner. To support the accuracy of the implementation, the telephone contacts are discussed with the researchers in bi-weekly video conferences. | The initial one-on-one interview is described in a guideline to ensure standardized implementation. The initial one-on-one interview is documented by the case manager in a standardized manner. To support the accuracy of the implementation, the interviews are discussed with the researchers in bi-weekly video conferences. | All processes that are mandatory in the case management intervention are described in guidelines to ensure standardized implementation (entry into case management, including needs analysis and goal finding, monitoring and final interview). The toolbox provides materials that can be used by the case managers to customize their approach. The case management is documented in a standardized manner to track the accuracy of the implementation of the guideline, as well as the frequency of use of the toolbox elements and contacts with participants and external institutions. Regular video conferences will be held to support accuracy of implementation throughout the process. At the end of the intervention, all case management participants are asked using standardized questionnaires which case management components they received during the intervention. |