Social Work Support for Fractures

(SWRCT Trial)

Not yet recruiting at 2 trial locations

Overseen By Natalie Fleming, MSW

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Sheila Sprague

Disqualifiers: Incarceration, Terminal illness, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether having a social worker in the fracture clinic aids patient recovery after surgery. It focuses on patients with serious fractures requiring surgery who also face mental health issues, financial problems, or work limitations due to their injury. Participants will be divided into two groups: one will receive the usual medical care, while the other will also receive support from a social worker for up to a year. Those with arm or leg fractures operated on in the last 12 weeks may be suitable for this trial. The goal is to determine if social worker support can enhance mental health, financial stability, satisfaction with care, and reduce emergency visits and medication use. As an unphased trial, this study provides a unique opportunity to understand the broader benefits of social worker support in recovery.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on providing social work support rather than changing medical treatments.

What prior data suggests that social work support is safe for fracture patients?

Research has shown that social support, such as assistance from a social worker, can be very beneficial after surgery. People who feel supported often recover better and are less likely to experience serious issues like depression or anxiety post-surgery.

Regarding safety, involving a social worker in care is generally safe and poses no harm. Social workers provide support, not medical treatment, so there are no physical side effects. They offer emotional support and connect patients with necessary services, such as community resources or financial advice.

Overall, involving social workers is safe and can enhance recovery by providing crucial support during a challenging time. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike the standard care for fractures, which mainly focuses on medical treatment like casts and monitoring, the social work support being studied offers a more holistic approach. This treatment stands out because it provides personalized care plans that address not just physical healing but also emotional and social needs. By involving a social worker, patients receive tailored support, education, and advocacy, which can help improve their overall recovery experience. Researchers are excited about this approach because it has the potential to enhance patient outcomes by integrating emotional support with traditional medical care, offering a more comprehensive recovery pathway.

What evidence suggests that social work support is effective for improving recovery after a fracture?

Research has shown that social work support, which participants in this trial may receive, can aid recovery after a bone fracture. Studies have found that patients with social support after hip fractures tend to regain physical abilities, such as muscle strength, more effectively and experience better overall recovery. Social support is associated with improved mental health and greater satisfaction with care. By addressing both physical healing and mental and social needs, social work support can reduce stress and enhance recovery. Early evidence suggests that patients with this support might visit the emergency room less frequently and experience reduced anxiety and depression during recovery. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for Canadian patients recovering from a serious fracture requiring surgery. It's designed to see if social work support can help with their mental health, financial stability, and overall satisfaction during recovery. To join, patients must be willing to complete several questionnaires over the course of a year.

Inclusion Criteria

I have a broken bone in my arm or leg.

Willing to comply with the protocol

Willing to provide informed consent

Exclusion Criteria

Terminal illness with expected survival of less than 6 months

Expected injury survival of less than 6 months

Prior enrollment in the trial

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Vanguard Phase

Initial phase with two clusters enrolling participants for 8 months, with staggered introduction of social worker intervention

8 months

Batched Stepped-Wedge Phase

Participants are enrolled in batches, with staggered introduction of social worker intervention every 10 weeks

12 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Social Work Support

Trial Overview The study is testing whether having a social worker in the fracture clinic helps reduce emergency room visits and improves mental health and financial security after a serious injury. Half of the 2,000 participants will get this extra support while the other half will receive usual care without additional social work services.

How Is the Trial Designed?

Group I: Usual Care Arm Active Control 1 Intervention

Participants enrolled during the usual care phase will receive the current standard treatment for their fracture. The current standard of care post-surgery for fractures, in the fracture clinic, is to provide medical treatment for injuries including casts, monitoring for infection, x-rays, etc. This is provided by surgeons, nurses and technicians. Any psychosocial needs are managed at patient request either by the surgeon or another clinic health care professional (in the case of simple forms) or by a hospital social worker, who usually has a full-time workload outside of the fracture clinic.

Group II: Social Work Intervention Group Active Control 1 Intervention

Participants enrolled during the treatment phase at their clinic will receive social work support for 6 months from the time of enrollment. They will have an intake appointment with the social worker before or during their initial fracture clinic visit to assess their needs, identify goals that they can address with the support of the social worker, and collaboratively formulate a personalized care plan tailored to their specific circumstances. The social worker will then implement the plan, which may involve educating participants and their support network, coordinating delivery of care and benefits, making referrals to community services, advocating for the participant, and providing emotional support and brief counselling. The social worker will be accessible to participants for 6 months post-enrollment, following up via telephone, telemedicine or in-person to evaluate the effectiveness of the care plan and offer sustained ongoing support.

Who Is Running the Clinical Trial?

Sheila Sprague

Lead Sponsor

McMaster Surgical Associates

Collaborator

Trials

17

Recruited

46,500+

Orthopaedic Trauma Association

Collaborator

Trials

34

Recruited

5,100+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12220168/

Influences of social support following hip-fracture surgery ... Outcomes measured at 1, 3, 6, and 12 months included care receiver-specific outcomes (hip range of motion, muscle strength, nutritional status, ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S1525861023003262

Association of Social Support with Rehabilitation Outcome ... This study examined the effects of both functional and structural aspects of social support on rehabilitation outcomes among older adults with hip fracture ...

3. clinicaltrials.ucsf.edu clinicaltrials.ucsf.edu/trial/NCT06973655

Trial of Social Work Services in Fracture Clinic Setting The investigators propose a trial of 2,000 patients to determine if social worker support improves recovery for patients after a serious fracture by reducing ...

4. ideaexchange.uakron.edu ideaexchange.uakron.edu/cgi/viewcontent.cgi?article=3441&context=honors_research_projects

The Effects of Social Support On Recovery Outcomes of Hip ... Social support has been proven to be a beneficial tool in improving recovery outcomes of numerous patients, including but not limited to hip fracture patients.

5. jamda.com jamda.com/article/S1525-8610(23)00326-2/pdf

Association of Social Support with Rehabilitation Outcome ... Objectives: There is growing interest in the role of social support during the recovery after hip fractures. The research to date has been mainly focused on ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT06973655

Trial of Social Work Services in Fracture Clinic Setting The investigators propose a trial of 2,000 patients to determine if social worker support improves recovery for patients after a serious fracture by reducing ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8547508/

Health and social interventions to restore physical function ... Only about 40%–60% of patients with hip fracture recover their prefracture level of function and mobility with most recovery occurring in the ...

8. bmjopen.bmj.com bmjopen.bmj.com/content/12/5/e059225

Influence of social support on return to work after total hip ... This study underscores the importance of work-related social support originating from the occupational physician and supervisor in facilitating RTW after ...

9. bmcgeriatr.biomedcentral.com bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-025-06065-7

Influences of social support following hip-fracture surgery for ... High levels of perceived social support are associated not only with better functional recovery but also with decreased mortality following post ...

10. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11932223/

Health Professional Support for Friends and Family ... A cross-sectional online survey was conducted among health professionals who treat people in hospital following fractures.