Community-based research explores impact of job injuries on workers’ lives

The Research Action Alliance on the Consequences of Work Injury has brought together academics and injured workers in a five-year research project that is scientifically documenting and communicating the effects of work injury. As the initiative moves past its halfway mark, the academic and injured worker communities take a look at its achievements and the opportunity it has provided to learn from each other.

It began simply enough. A group of injured worker representatives and researchers came together in December 2003 to explore joint research projects. Inspired by the possibilities of this collaboration, the group decided to apply for funding through a program called the Community-University Research Alliance.

In 2006, the group received a resounding endorsement from the program administrator, the Social Sciences and Humanities Research Council. The council awarded $1 million to the group for the next five years (and, thanks to matching funds, this number has grown by half again). A formal partnership between the injured worker community and research organizations, including the Institute for Work & Health (IWH), was born. It is called the Research Action Alliance on the Consequences of Work Injury (RAACWI – pronounced raa-kwee).

Today, both the injured workers and researchers involved are proud of what they have achieved together. Talk to injured workers, and they will tell you that their work with researchers has allowed them to add the weight of evidence to their personal stories of post-injury hardship. Talk to researchers, and they will tell you that the quality of their work has been greatly enhanced by having direct access to injured workers and their experiences.

Talk to either, and the word “trust” invariably pops up early in the conversation. RAACWI community lead Steve Mantis, secretary of the Ontario Network of Injured Workers Groups, puts it this way: RAACWI really is a partnership. A lot of trust has been developed between the injured worker community and researchers. It’s blossomed beyond our initial expectations.

Dr. Emile Tompa, a scientist at IWH and the RAACWI academic lead, concurs. Building this kind of trust is a long process, and it takes time, he says. But it’s been worth every minute. It has resulted in meaningful work and real results. That’s the most satisfying reward an applied researcher like me can hope for.

Initiative sets ambitious goals

RAACWI’s work is guided by an overarching question: How does the workers’ compensation system help or hinder the protection of injured workers — immediately and over time — against the negative economic, social, physical and mental health consequences of injury?

The group’s research is divided into four themes: legislation, financial security and work experiences, health and well-being, and history and political activism. The specific questions being asked by individual research projects range from “What role do doctors play within the workers’ compensation system?” to “What are the mental health and addiction consequences of a work injury?”

Through this collaborative research, RAACWI hopes to achieve the following:

  • add to the body of research about the consequences of work injury and illness;
  • encourage evidence-informed policy decision-making in workers’ compensation;
  • equip injured workers with skills to continue their involvement in research and communication;
  • increase academia’s capacity to conduct community-based research in this area;
  • increase sensitivity to and knowledge of injured workers’ experiences; and
  • increase awareness of the need to involve non-academic communities in research.

RAACWI research results in concrete action

At a symposium held in May, 75 people heard how far RAACWI has come in meeting these goals. They learned how RAACWI’s work is contributing to concrete change, practical tools and improved skills among both community and academic members.

For example, RAACWI research contributed to a new “anti-stigma” initiative at the Workplace Safety and Insurance Board (WSIB), which WSIB President Jill Hutcheon described at the symposium. She acknowledged that there exists “a very real perception that injured workers are ‘lazy’ and ‘scamming’ the system.” This misperception exists among some employers who don’t understand the need for time to heal, some neighbours who look skeptically upon an injured worker out gardening, and even some WSIB staff who see employers as the paying client, forgetting that injured workers gave up their right to sue in the historical compromise that gave birth to the workers’ compensation system.

Hutcheon promised to lead the way in combating this stigma. Based on RAACWI research, we are introducing a new initiative this year to reduce stigmatizing attitudes and behaviours among WSIB front-line workers and WSIB communications, she said. I know changing attitudes and behaviours isn’t easy, but I believe that, in partnership with RAACWI, we can make change. We want to ensure a positive and respectful environment for injured workers.

Another concrete outcome of RAACWI work is its involvement in a guide to help those injured workers whose safe and sustainable return to work might be getting bogged down in complications. The guide is based on IWH research that identified the problems or “red flags,” as well as RAACWI-funded workshops at which solutions or “green lights” were identified.

It focuses on those rare but potentially costly situations in which claims are not proceeding in a straightforward manner, IWH Scientist Ellen MacEachen said at the RAACWI symposium (see details).

RAACWI builds skills

Perhaps most impressive is the degree to which RAACWI is increasing the ability of injured workers to get involved in research, and scientists to work with the injured worker community. RAACWI identified early on that, in order for injured workers to participate as equals in research, and to share their research knowledge with other injured workers and decision-makers in workers’ compensation and the provincial government, they need training to get their skills and confidence up, says community lead Mantis. This has been a big success.

RAACWI offers the Injured Workers’ Speakers’ School, a weekly program lasting 12 weeks. Upon completion, graduates are prepared to get more actively involved in research and to speak confidently.

This was evident at the symposium, at which four graduates told their stories. For example, Beryl Brown framed her story around the concept of “remembering” — remembering her joy and excitement about contributing to her new home in Canada, the day she heard her workplace injury might be permanent, and the days of pain, depression and poverty that followed. I remember nights of great pain, praying to God for some measure of peace so I could sleep, she said. I remember the mean things said by people who should have cared.

After hearing Brown and her colleagues, panel members commenting on the presentations unanimously agreed that the Speakers’ School is working. You are articulate spokespersons for injured workers, putting into words what others are silently thinking, one panel member said. You have all touched my heart and the hearts of every other person in this room, another said.

As for the academic world, Tompa reports that RAACWI has supported four post-doctoral, 17 PhD/masters and 10 undergraduate students. The hope is to build a group of scientists who continue to pursue community-based research interests.

Ontario Minister of Labour Peter Fonseca closed the RAACWI symposium on a positive note. With goodwill and collaboration, we will be able to build a stronger, more resilient system that is fair to everyone, he said. It’s crucial that we’re all here to get it right. This is how constructive ideas emerge to address the obstacles of injured workers.

To find out more about RAACWI, go to: www.consequencesofworkinjury.ca.

Source: At Work, Issue 57, Summer 2009: Institute for Work & Health, Toronto