Thanks to advances in health treatments and medical procedures, a growing number of people with chronic health conditions no longer have to leave the labour force as they might have in the past.
Yet for many people with chronic health conditions, working can still be challenging when their symptoms flare or worsen and their ability to work is hampered by their job demands, organizational policies and practices or work environments. Although these workers can ask for accommodation during such episodes, many choose not to. For some, having to disclose a health condition to get help is not a trade-off they are willing to make.
This is where a new tool developed at the Institute for Work & Health (IWH) comes in. Called the Job Demands Accommodation Planning Tool—JDAPT for short—this anonymous, interactive and online questionnaire allows workers with chronic conditions to learn about potential accommodations specific to their job demands. If implemented, these supports may help them continue to work safely, comfortably and productively in their jobs, all without having to disclose their health condition.
The JDAPT questionnaire, available in English and French, asks a user to identify the specific job tasks that they find challenging during episodes of health-related difficulties, to what degree and if these challenges change over time. Based on the completed questionnaire, the JDAPT generates a list of potential changes to the user’s job tasks that they can make, or ask for, to manage their health-related difficulties.
A question we often hear from people with chronic, episodic health conditions is, ‘Should I say something to my employer so that I can get support?’ says Dr. Monique Gignac, IWH Senior Scientist and director of Accommodating and Communicating Episodic Disabilities (ACED)—the large research partnership that led the development of the JDAPT.
The purpose of the JDAPT is to give people a way to think about the specific accommodations and supports that they need and can ask for. We hope that by using the JDAPT, workers and workplaces can focus on work solutions and not on the medical conditions or health symptoms that people may have.
Tool designed for wide range of conditions
The JDAPT, which was launched to an audience of over 450 people attending an IWH Speaker Series webinar in March 2023, is designed for workers living with one or more of a broad spectrum of chronic, episodic health conditions. Examples include mental health conditions, such as depression and anxiety, Crohn’s disease, colitis, multiple sclerosis, migraine, rheumatic diseases like arthritis and lupus, chronic fatigue syndrome, many musculoskeletal conditions (e.g. low-back pain, tendinopathies), HIV/AIDs and many forms of cancer. Based on what is known so far, a potential addition to this list is post-COVID-19 condition, also known as long Covid.
Despite having different causes, these conditions have a key feature in common. Symptoms can come and go. Periods of good health are punctuated by episodes of disabling symptoms that are often unpredictable in severity and duration. What’s more, symptoms are often invisible; to managers and colleagues, workers living with these conditions may appear in good health.
People living with these conditions can go for a long time without any limitations in their daily activities, but episodes or flares can return, says Gignac.
Because the symptoms can be hidden to others, and because it can be hard to predict what the next episode will be like, it can be very difficult for these individuals to decide whether or not to disclose their health issues.
Previous studies conducted by Gignac have found that people often choose not to disclose. In several studies conducted by the research team, between one-quarter and one-half of about 3,400 workers surveyed said they had not talked to their supervisors about their health limitations at work. Although their reasons varied, Gignac found that workers who have unmet accommodation needs experience greater job limitations, more job disruptions and greater perceived productivity losses.
Deciding whether to reveal or conceal a need for support is a complex, and very personal, decision. In the meantime, the JDAPT helps those needing support to work through their needs and get support and accommodation ideas. By using the JDAPT, individuals can identify the different aspects of the job where they encounter health-related difficulties. The tool then provides suggestions of job modifications that they can ask for—without having to go into detail about the health reasons behind their requests. In many cases, the adjustments can be something individuals undertake on their own.
How the JDAPT works
The JDAPT is relevant to a wide variety of job types and workplace contexts. As mentioned, it can be used by people living with a wide variety of health conditions. It goes beyond many functional workplace assessment tools that focus only on the physical or cognitive demands of a job. The JDAPT covers not just physical and cognitive demands; it also asks users to think about the interpersonal demands they face, as well as the conditions of their day-to-day work (see sidebar below).
As users make their way through the 24 job demands, they’re asked to determine whether each job demand is an important part of their job. For the job demands relevant to their job, users are then asked whether they encounter difficulties meeting the job demand due to their health difficulties. If yes, they are asked to indicate if those difficulties are constant or changing over time.
Once users have gone through the questions about the demands of their jobs—and the health-related difficulties they experience with each of the relevant demands—they are provided with a customized list of job modifications they can ask for or undertake themselves. Some are small adjustments that workers can make on their own. Some are accommodations that may involve the help or cooperation of co-workers at work. Others are changes that users need to formally request from the HR department.
Users can save a PDF of their job demands summary and their list of potentially helpful strategies for reference later or as a resource for conversations with their supervisor. Beyond that, results are not recorded anywhere or shared with anyone. No data is retained or preserved by the browser-based app, ensuring complete anonymity for users.
What workers are saying about the JDAPT
In 2022, the ACED team won the grand prize in an inclusive design competition hosted by MaRS and CIBC, called Inclusive Design Challenge: Support At Work, for its work on the JDAPT.
The ACED team has also conducted a sensibility study on JDAPT to assess the tool for comprehensiveness, understandability, relevance, feasibility and length. The sample of 69 participants included 46 workers in different types of work arrangements and organizational sizes, from a broad range of job types and sectors. Also recruited were 23 representatives of organizations, including supervisors, disability managers and human resources professionals.
Across these different groups, users rated the JDAPT highly in almost every category. Over 95 per cent said the instructions were clear and the examples were helpful. They said the job demands questions and examples were relevant to their jobs and that they were motivated to complete the tool.
In their comments, participants said the tool helped them think about their health in new ways. It also helped them better understand the links between specific job demands and areas where support might make a difference. For example, a support teacher living with fibromyalgia told the research team,
The JDAPT gives me information about the areas I struggle with the most at work. It gives me a jumping off point to talk to my employer about how they can help modify my job.
This research is being followed up with a study of 279 workers who have completed the JDAPT and will be asked about their perceptions and use of the supports suggested by JDAPT three and nine months later
The JDAPT for workers is now available in English and French; a version of the tool for managers will be out in the summer of 2023.
Our hope is, by using the tool, workers can access the support they need, says Gignac.
They will no longer be unsure of their options, but will have a range of support ideas that fit their specific job challenges.
In the next phase of the ACED research project, Gignac’s team is developing a tool to help people decide whether communicating their health difficulties with others at work is the right decision for them taking into account their needs, preferences, and working situation.