Identifying Vocational Rehabilitation Interventions and Their Behavioural Components to Help Cancer Survivors Return to and Remain in Work: A Scoping Review

Background A cancer diagnosis can substantially affect work participation. Vocational rehabilitation (VR) interventions are intended to support return-to-work and work retention. Purpose This scoping review aimed to describe the content, delivery and behavioural components of VR interventions for cancer survivors. Method MEDLINE, Embase, PsycINFO, AMED, CINAHL Ultimate and the Cochrane Library were searched, supplemented by hand-searching. Studies evaluating VR interventions for adult cancer survivors and reporting work-related outcomes were included. Data was extracted on participant characteristics, intervention content, delivery and behavioural intervention functions. Results Of the 17,390 studies identified, 14 reports describing 12 studies met the inclusion criteria. The collective sample included 2,139 participants, predominantly breast cancer survivors. VR interventions were delivered by healthcare professionals (n = 8), employers (n = 2) or vocational agencies (n = 3). Common VR components included vocational counselling/education (n = 9), case management/advocacy (n = 7), vocational assessment (n = 6), return to work planning/co-ordination (n = 6). The most frequently identified behavioural intervention functions were education (n = 12), training (n = 12), enablement (n = 12), environmental restructure (n = 10) and modelling (n = 8). Five studies did not report an underlying theory, model or approach. Conclusion VR interventions for cancer survivors varied in content, delivery and theoretical underpinning. Common VR intervention components and behavioural intervention functions were identified across studies and appeared broadly consistent with VR principles reported in other populations. Employer-directed and workplace-focussed interventions were relatively uncommon, highlighting an important evidence gap. These findings may inform the development of future VR interventions for people with Head and Neck Cancer, targeting healthcare professional behaviour, and may have relevance for the development of work-focused interventions across other health and disability populations.