Abstract:

Concept mapping is increasingly being used as an approach to enhance the development of evidence-based public health interventions. In a prior collaborative-participatory study, Agile methodology was used to co-create the web-based Pain-at-Work (PAW) Toolkit with healthcare professionals, employers, and people with chronic or persistent pain. The aim of the PAW Toolkit is to support employees with pain to self-manage their condition at work. In this study, a group concept mapping study was undertaken to integrate perspectives of a range of stakeholders with differing experiences and expertise to update and refine the PAW Toolkit content and presentation ready for testing in a feasibility trial. The objective of this study was to describe the use of concept mapping as an active learning tool used to facilitate the design process for the web-based PAW Toolkit aimed at helping vocationally active adults self-manage chronic pain at work. Participants were employees, managers, trade union representatives, human resource and occupational health specialists, university researchers and healthcare professionals. Qualitative data obtained from free-text responses in the two previously conducted online surveys were used to support the process. This was a 4-step mixed methods process. In Step 1, using free-text responses in previously conducted online surveys with employees who have chronic pain (n=274), statements were generated indicating the education priorities of people with pain with specific relation to the workplace. In Step 2, participants (n=20) individually sorted statements into meaningful grouping and rating them in terms of perceived importance, and confidence that a web-based Toolkit could address each (using 5-item Likert scales: ‘importance’ and ‘confidence’). In Step 3, statements were mapped to each other to identify concepts, and participants identified labels for each concept. In Step 4, labels and statement ratings were used to identify important and feasible concepts as content priorities for intervention development and refinement. Concept mapping confirmed the theory of change, identified key intervention elements, provided a visual map of generated ideas and their relationships to one another, and assisted in identifying priorities for the PAW Toolkit to support employees with chronic or persistent pain. In the final PAW Toolkit, delivery of priority content draws on the principles of persuasive system design, is asynchronous (not prescheduled and flexible access at a time to suit the end user), used direct instruction (information and advice) and experiential learning (advice being acted on by the end user). The feasibility and acceptability of the PAW Toolkit to employees and employers is now being tested in a cluster-randomised workplace trial.

Keywords:

Digital, Workforce, Chronic Pain, Concept Mapping, Participatory Design.