Attachment L-3

Attachment L-3:

Descriptions of Outcome Measures for MSD Intervention Study

OI: MSD Symptoms (Individual employee level) Rated by employees impacted by target interventions Collected at baseline and every 3 months from baseline through completion Participants will also be asked to report severe episodes of back or shoulder pain that occurred within the last 3 months Ordinal data (but often treated as continuous when scores are averaged)
Label	Description	Comments
OIa	--NASS Lumbar Spine Outcome Assessment Instrument - 17 items with a 6-point response scale: None of the time (=1) - all the time (=6); not at all bothersome (=1) - extremely bothersome (=6) Notes: Factor analysis (Daltory et al, 1996) has identified two scales: 1) Pain & Disability scale: items on frequency and bothersomeness of back pain, plus nine items on disability because of pain, for a total of 11 items (questions 1a-b, 5-13). The mean score of this scale will be calculated. (OIa-1) 2) Neurogenic Symptom scale: six items on frequency and bothersomeness of leg or foot pain, numbness, and tingling (questions 4a-b, 5a-b, 6a-b). The mean score of this scale will be calculated. (OIa-2) The NASS outcome has been found to have acceptability, high re-test reliability, internal reliability, and validity for low back pain and disability (Daltroy et al 1996; Schochat et al 2000; Pose et al 1999; Padua et al 2001; Bosković et al 2009; Schneider et al 2007; Schluessmann et al 2009; Sigl et al 2006; Weigl et al 2006; Schaeren et al 2005). See Attachment H-1 for a copy of the NASS instrument.	Primary outcome Example null hypotheses: OIa-1: There will be no difference between mean Pain & Disability scale score ratios (pre/ post intervention scores) when groups are compared (focusing on time period Baseline A to B) OIa-2: Duration of intervention will not be significantly associated with post mean back Pain & Disability scale score declines
OIb	--Quick DASH Outcome Measure with Work Module Option DASH stands for "Disabilities of the Arm, Shoulder and Hand." The Quick DASH Outcome Measure is a self-reported questionnaire designed to measure physical function and symptoms in people with any of several MSD of the upper limb. The Quick DASH Outcome Measure is scored in two components: the disability/symptom section (11 items, scored 1-5) and the optional Work section (4 items, scored 1-5). (Beaton et al 2001) See Attachment H-2 for a copy of the Quick DASH instrument.	Secondary outcome Example null hypotheses: OIb-1: There will be no difference between mean DASH disability/symptom score ratios (pre/ post intervention scores) when groups are compared (focusing on time period Baseline A to B) OIb-2: Duration of intervention will not be significantly associated with post mean DASH disability/symptom score declines
OIc	--Borg CR-10 RPE (Ratings of perceived exertion) (Borg, 1982) Please rate the OVERALL PHYSICAL EFFORT level demanded by your job today. 0 = Nothing at all; 0.5 = Extremely weak (just noticeable); 1 = Very Weak; 2 = Weak (light); 3 = Moderate; 4 ; 5 = Strong; 6; 7 = Very Strong; 8; 9; 10 = Extremely strong (almost max); . = Maximal;	Secondary outcome
OE: WC data, Quality, Productivity (Establishment level) Rates will be calculated quarterly (4 times per year)
Label	Description	Comments
OEa	--Workers compensation (WC) data (collected for all participating establishments, from 2 years pre intervention through study duration) Intervention specific and general establishment WC MSD case incidence (per 100 FTE) WC MSD lost time case incidence (per 100 FTE) WC MSD cost per 100 FTE* *Analysis of financial related WC outcomes will be deferred until Fall 2015 to allow for proper loss development of claims.	Secondary outcome
OEb	--Absenteeism measures TBD* Intervention specific and general establishment *Will be identified a priori	Secondary outcome
OEc	--Quality measures TBD* Intervention specific and general establishment *Will be identified a priori	Secondary outcome
OEd	--Productivity measures TBD* Intervention specific and general establishment *Will be identified a priori	Secondary outcome