The effect of the Progressive Goal Attainment Program (PGAP) on cognitions and perceptions and workparticipation of workers with a chronic disease in the Netherlands

Because of better treatments, a changing lifestyle and the increased retirement
age, the number of people of working age with a chronic disease is rising.
Having a chronic disease can have a negative impact on work participation
(Schofield, 2008; Scharn, 2019). Therefore it is important to increase the work
participation of this group by for example intervening on factors that can
negatively influence their work participation.

During the project "Input of the worker in the occupational health management
and work disability assessmet" of the research program "the Worker in the
Center" a training program is developed. This training program can help
occupational and insurance physicians to take person-related factors into
account in the occupational healht management and work disaiblity assessment.
During this training program, occupational and insurance physicians learn about
the importance of 10 cognitions and perceptions for work participation
(perceived health, optimism/pessimism, catatrophizing thoughts, RTW
expectations, self-efficacy, perceived work-relatedness, fear-avoidance
beliefd, coping, locus of control and motivation; De Wit et al. 2018). They
also learn about different interventions that can change limiting cognitions
and perceptions, in order to increase work participation.

The Progressive Goal Attainment Program (PGAP) is an important intervention
which is focused on decrasing limiting cognitions and perceptions and
increasing work participation (Sullivan et al. 2006; Sulivan et al. 2013). The
intervention, which consists of a maximum of 10 sessions, is focused on
important cognitions and perceptions, such as fear-avoidance beliefs,
catastrohpzing, return to work expectations, self-efficacy, optimism/pessimism,
coping and motivation. The intervention is focused on different groups of
patients, among whom patients with pain, depression, posttraumatic stress
discorder, cancer and other chronic diseases. The intervention can be provided
by different occupational health professionals, such as occupational physicians
or occupational health nurses, after completing a short training program.

The intervention is effective in decreasing catastrophizing thoughts,
decreasing fear-avoidance beliefs and increasing return to work in Canada
(Sullivan et al. 2017, Sullivan & Adams, 2020; Sullivan et al. 2012). The
intervention is also implemented in different other countries such as the
United States (Hossain et al. 2013), Australia (Alderson et al. 2020), Ireland
(Raftery et al. 2013) and Africa (Ogunlana et al. 2018). The results of PGAP
are positive, but PGAP is not translated in Dutch yet and is also not
implemented in the Netherlands. Besides, it is unknown whether PGAP is
effective in the Netherlands and whether it is feasible to implement in the
Netherlands.

To study whether PGAP is effective in changing cognitions and perceptions and
increasing work participation of workers with a chronic diseae in the
Netherlands and to study whether implementing PGAP is feasible in the
Netherlands.

This study is a randomized controlled study, in which participants are
randomized in the intervention group (PGAP intervention) or in the control
group (waiting list control group, intervention is provided after all
participants in the intervention group participated in the intervention). The
researchers, PGAP providers and workers are not blind for their condition.

PGAP consists of a maximum of 10 weekly sessions between a trained PGAP
provider and a worker. The online or face-to-face meetings have a duration of
one hour. During the sessions the participants learn about the importance of
staying active, planning activities and setting goals. The also learn to be
more aware of their thoughts in certain situations, how they react on
situations and other better ways to react on certain situations. An
introduction video is used to inform the worker about the PGAP intervention.
Besides, all workers obtain a workbook, with information about for example the
importance of sleep, social activities and exercise, and in which activities
can be scheduled.
The goal of PGAP is retun to work. PGAP finishes if the worker is returned to
work. Therefore, it is possible that workers do not participate in all 10
sessions of PGAP. During the fourth session, there is an evaluation in which it
is determined whether return to work is possible. The PGAP intervention can be
provided by occupational health nurses, occupational physicians or
re-intergration specialisits of an occupational health and safety service.

Workers participate in a maximum of 10 PGAP sessions, during 1 hour per week.
In addition, they complete questionnaires during the screening (T0), 4-7 weeks
after T0, 9-12 weeks after T0 and 22-25 weeks after T0.