[Online Rehab-Need Test (OREST): Effectiveness of an Invitation to Proactive Screening (self-test) for the Need for Medical Rehabilitation Among Individuals Covered by the German Statutory Pension Insurance Agencies in Baden-Württemberg and the Rhine Region]. / Online-Rehabedarfstest (OREST): Wirksamkeit einer Einladung zu einem proaktiven Screening (Selbsttest) auf Bedarf an medizinischen Rehabilitationsmaßnahmen bei Versicherten der Deutschen Rentenversicherung Baden-Württemberg und Rheinland.

PURPOSE: Up to now, there has been a lack of proactive approaches on the part of the rehabilitation providers, while simultaneously a suspected unmet rehabilitation need exists in some groups of insured persons. Therefore, the effectiveness of the invitation to a web-based self-test for rehabilitation needs as a new access route to medical rehabilitation was evaluated. The main question was whether the intervention leads to more approved rehabilitation applications in the follow-up period of 22 months and whether this effect is also apparent after controlling other influencing variables. METHODS: A randomized, controlled study with N=8000 insured persons of two regional statutory pension insurance agencies was conducted to check the effectiveness of the intervention. Insured persons of the intervention group (IG; n=4000) were informed by mail about the web-based self-test and received individual access data for it (user ID and PIN). The control group (CG; n=4000) received no information about the self-test. The primary outcome was the rate of approved rehabilitation applications, the secondary outcome was the application rate regardless of approval. RESULTS: Groups do not differ significantly in terms of primary or secondary outcomes. Even after controlling for other influencing factors, the intervention does not contribute to the prediction of outcomes, but some control variables, such as previous rehabilitation experience, prove to be important predictors for the application. CONCLUSION: The mere offer of a self-test for rehabilitation need by the pension insurance institution has no effect on the application process. Hence a letter from the pension insurance institution as the sole means of access does not appear suitable for increasing the rate of meaningful rehabilitation applications.

Development and Formative Evaluation of a Communication Skills Training Program for Persons with Rheumatic and Musculoskeletal Diseases.

OBJECTIVE: Our aim was to develop and evaluate a two-module training program (KOKOS-Rheuma) specifically designed to enhance the ability of persons with rheumatic and musculoskeletal diseases to communicate in various everyday situations. DESIGN: KOKOS-Rheuma deals with communication at work (particularly superiors), with physicians, acquaintances, strangers and staff members of authorities and institutions and focuses on communication skills such as "saying no" and "giving and receiving feedback." Members of the German League against Rheumatism (GLR) were trained to deliver the program to self-help groups over two sessions or in a full-day session. The participants, trainers and observers completed a short evaluation form after each module or at the end of the full-day session. MAIN OUTCOME MEASURES: The evaluation was based on 232 participant, 51 trainer, and 8 observer evaluation forms. RESULTS: The participants rated all aspects of the training as good. The training was rated higher in the single session format. The great majority would recommend the course to other people. CONCLUSION: After the revision of the training manual, KOKOS-Rheuma can be recommended for inclusion in the training schedule of the GLR. We recommend that future trainers receive more extensive preparation for delivering the course that highlights the preparation time required.