A process evaluation of implementing a vocational enablement protocol for employees with hearing difficulties in clinical practice

Abstract

Objective: A multidisciplinary vocational rehabilitation programme, the Vocational Enablement Protocol (VEP) was developed to address the specific needs of employees with hearing difficulties. In the current study we evaluated the process of implementing the VEP in audiologic care among employees with hearing impairment. Design: In conjunction with a randomized controlled trial, we collected and analysed data on seven process parameters: recruitment, reach, fidelity, dose delivered, dose received and implemented, satisfaction, and perceived benefit. Study sample: Sixty-six employees with hearing impairment participated in the VEP. The multidisciplinary team providing the VEP comprised six professionals. Results: The professionals performed the VEP according to the protocol. Of the recommendations delivered by the professionals, 31% were perceived as implemented by the employees. Compliance rate was highest for hearing-aid uptake (51%). Both employees and professionals were highly satisfied with the VEP. Participants rated good perceived benefit from it. Conclusions: Our results indicate that the VEP could be a useful treatment for employees with hearing difficulties from a process evaluation perspective. Implementation research in the audiological setting should be encouraged in order to further provide insight into parameters facilitating or hindering successful implementation of an intervention and to improve its quality and efficacy.

Key Words::

• Hearing loss
• employee
• vocational integrated care programme
• multidisciplinary
• implementation
• clinical occupational physician
• audiology
• process evaluation
• perceived benefit
• satisfaction

Acknowledgements

The researchers would like to thank the assistance of the OHSs, the university medical hospital, the hearing-aid dispensers and the ‘Hearing Loss Association The Netherlands’ for their assistance with participant recruitment. We also thank the participants for their time and collaboration. We are especially grateful to Marlies Klijn for her assistance in all stages of the study and Rachel Williams for proofreading the manuscript. This research was funded by The Netherlands Organization for Health Research and Development (ZonMw). The trial is registered at the Dutch Trial Register (NTR) under trial registration number: NTR 2782.

Declaration of interest: Kramer, Goverts, and van Til were each involved both as researcher and as clinician in this study. They served as psychologist, audiologist, and clinical OP in the VEP, respectively.

Supplementary material available online

Supplementary Appendix 1.