The effectiveness of Return to Duty Intervention: Evaluating an interdisciplinary approach to supporting Canadian Armed Forces members who have physical and non-physical disorders

Abstract

The rate of musculoskeletal and mental health disorders is high in the Canadian Armed Forces, and can preclude service members from being employable and deployable. The aim of this thesis was to analyze the effectiveness of the Return to Duty intervention at decreasing morbidity and assisting service members to be retained by the Canadian Armed Forces. Using a multiple baseline single subject design, the physical and mental function of the participants was measured repetitively pre, during and post-intervention. In total, 23 participants were enrolled in the Return to Duty intervention, where they received physical training with health and work literacy once a week for 10 weeks in a group. Analysis was performed with descriptive statistics and visual analysis using Minimally Important Difference for significance. Six months post-intervention, return to duty outcome was measured. The confirmed return to duty rate was 39.1% at 6 months post-intervention, with an additional 34.8% expecting to return to duty. Amongst the measures, the 4 Squares Step Test, Work Ability Index and SF-36v2 physical component improved in respectively 70.6%, 47.1% and 66.7% of the confirmed and expected favorable outcome group (73.9% of the sample). Deterioration in function was found mostly in the unfavorable group, notably in mental health measures; possibly indicating that mental health could be a mediator of return to duty. Overall, most of the repeated measures did not change meaningfully, potentially suggesting an ecological model of return to work. The study found a superior confirmed return to duty rate compared to nationally in the Canadian Armed Forces, and a superior expected favorable return to duty rate, compared to any bases/wings. The return to duty processes in the Canadian Armed Forces have not been previously published therefore, this thesis provides a novel contribution to the scientific literature. Furthermore, this thesis helps to understand factors that might increase the retention of the service members in the Canadian Armed Forces. Finally, this work makes recommendations for future studies in return to duty in armed forces.