A prospective study to examine the influence of secondary health conditions on vocational rehabilitation client employment outcomes

Authors: 
Johnstone, B., Price, T., Bounds, T., Schoop, L. H.,Schootman, M., & Schumate, D.
Year Published: 
2011
Publication: 
Disability and Health Journal
Volume: 
4
Pages: 
28-38
Publisher: 
Elsevier
Background: 

Previous research has demonstrated positive financial and health outcomes through worksite health promotion. However, with the employment rate of people with disabilities significantly lower than their non-disabled peers, many do not have the same opportunity for health care coverage. Additionally, people with disabilities tend to experience secondary health conditions such as depression, pain, and anxiety, at a much higher rate. One mechanism to support people with disabilities is the state vocational rehabilitation (VR) system.

Purpose: 

Using a longitudinal design, this study aims to evaluate the relationship between health factors and employment outcomes in a vocational rehabilitation setting.

Setting: 

Participants from a mix of rural and urban areas completed a baseline survey instrument including informed consent, during a VR visit. Follow-up surveys were delivered through first class mail to the participants' homes.

Sample: 

Participants were between 21 and 65 years of age, had a physical or mobility primary disability, had been accepted to work with state VR services, and had not worked with state VR for more than 6 months. Participants were predominately white (79.8%), men (47.7%) and women, with some college education (52.1%).

Data Collection: 

Data collection occurred at 6, 12, and 18 months following the initial VR visit. Researchers followed up with phone calls and additional mail to improve data integrity. Examples of measures used include the Secondary Conditions Surveillance Instrument, and questions from the BRFSS Quality of Life and Caregiving Module.

Intervention: 

No intervention was tested.

Control: 

There was no control group.

Findings: 

Two regression models were presented. The first model predicted employment at 18 months based on independent variables at baseline.The second model predicted employment at 18 months based on independent variables at 18 months. Both models indicated a decrease in the secondary conditions score would improve the probability of employment by approximately 1 percent. Participants' probability of being employed was approximately 16% higher when receiving counseling and guidance through state VR services.

Conclusions: 

Due to attrition and insufficient data to attain the necessary power, findings were not significant. However, trends indicate that VR staff could improve employment outcomes for people with disabilities through additional counseling or guidance services.

URL: 
https://www.ncbi.nlm.nih.gov/pubmed/21168805
Disabilities: 
Populations: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Social capital, employment and labor force participation among persons with disabilities

Authors: 
Burke, R. V., Allen, K. D., Howard, M. R., Downey, D., Matz, M. G., & Bowen, S. L.
Year Published: 
2015
Publication: 
Journal of Vocational Rehabilitation
Volume: 
43
Pages: 
17-31
Publisher: 
IOS Press
Background: 

The author begins by giving examples of human capital, social capital, and economic capital. Previously, disability policy research has focused very little on social capital and its relationship to labor force participation. Measuring social capital can include measurements on social reciprocity, levels of trust, and participation in community events. In the United States, people with disabilities have typically been shown to have lower social capital than their non-disabled counterparts.

Purpose: 

The author provides three hypothesis. First, that people with disabilities have lower levels of social capital than those without a disability. Second, people with disabilities in the labor force have higher levels of social capital than those not in the labor force with similar characteristics. Third, people with disabilities in the labor force who are employed will have higher levels of social capital than those individuals with a disability who are unemployed.

Setting: 

The Current Population Survey (CPS) collects employment statistics in the United States on a monthly basis for adults aged 18 and older.

Sample: 

Data from the 2010 CPS supplement on demographic data and labor force participation, restricted to those ages 25-61, resulted in an unweighted N of 67,009 (weighted N of 151,902,123). Gender of participants was relatively even with 49.31% male and 50.69% female. The sample was predominately White (80.00%) non-Hispanic (84.68%). Only 7.95% of participants reported a disability. The majority (73.85%) of participants were employed.

Data Collection: 

Data was collected on a monthly basis from the 2010 supplement of the CPS survey.

Intervention: 

There was no intervention.

Control: 

There was no control group.

Findings: 

The first two hypothesis were confirmed. Specifically, individuals with a disability had lower social capital than those without a disability. Additionally, people with disabilities who are part of the labor force were considered to have higher social capital than those who were not in the labor force. The third hypothesis, that people with disabilities who were in the labor force and employed would have greater levels of social capital than those who were not, was not supported by the data.

Conclusions: 

These data show that there is a divide between individuals with a disability and those without in regards to social capital. There was less of a distinction between employed people with disabilities and those who were not participating in the labor force in levels of social capital. To address these discrepancies, policymakers, advocates, and service providers should support innovative approaches to increasing social capital among those with a disability.

URL: 
https://content.iospress.com/articles/journal-of-vocational-rehabilitation/jvr751
Disabilities: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Variations in social capital among vocational rehabilitation applicants

Authors: 
da Silva, C. E., Romero, M. G., Chan, F., Dutta, A., & Rahimi, M.
Year Published: 
2017
Publication: 
Journal of Vocational Rehabilitation
Volume: 
46
Pages: 
187-194
Publisher: 
IOS Press
Background: 

The authors examine the intricacies of individual and community level social capital. Specifically, the relationship between social capital and state vocational rehabilitation (VR) agencies interaction with individuals with disabilities. Previous research reveals that people with disabilities will typically have lower levels of social capital than their non-disabled counterparts. However, this relationship has not been shown to be causational.

Purpose: 

The goal of this work is to examine how social capital varies by employment status for VR applicants. It is also hypothesized that levels of social capital would vary by employment status for VR applicants when controlling for disability and individual characteristics.

Setting: 

In 2014 and 2015 Mathematica Policy Research collected survey data from applicants to the New Jersey Division of Vocational Rehabilitation Services, the Mississippi Department of Rehabilitation Services, and Opportunities for Ohioans with Disabilities.

Sample: 

2,804 surveys were completed. After cleaning data with missing social capital information, 2639 cases remained. The sample was relatively split between male (49.9%) and female (50.1%) participants. Half (50.5%) identified as non-Hispanic white, with 37.5% identifying as non-Hispanic black, with age ranging from 25-34 (22.6%) to as high as 55-65 (18.7%) years old. Less than 57% of applicants reported having access to someone who could help with financial concerns.

Data Collection: 

Data collection was done across three state VR agencies. Social capital was measured by looking at four questions including if applicants had anyone that they could rely on for help: 1. finding a job 2. borrowing money to pay an urgent bill, 3. with transportation to get to work urgently, and 4. help with a serious personal crisis.

Intervention: 

No intervention was presented.

Control: 

There was no control or comparison condition.

Findings: 

Both hypothesis were confirmed. Additionally, disability type, employment status, and perceived health had an effect on social capital. Overall, younger, healthier, employed, and less severely disabled individuals were shown to have higher rates of social capital than their counterparts. This remained true across all four social capital questions.

Conclusions: 

This work confirms that there is a strong link between employment status and social capital. As social capital has shown to be lower for individuals with severe disabilities, it would be beneficial for state VR agencies to pay close attention to supporting this community. Similarly, those individuals with a disability onset age of 25 or older could benefit greatly from additional support.

URL: 
https://content.iospress.com/articles/journal-of-vocational-rehabilitation/jvr854
Disabilities: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Psychological Interventions to Facilitate Employment Outcomes for Cancer Survivors: A Systematic Review and Meta-Analysis

Authors: 
Frank, E., Soreca, I., Swartz, H., Fagiolini, A., Mallinger, A., Thase, M., Grochocinski, V., Houck, P., & Kupfer, D.
Year Published: 
2015
Publication: 
Research on Social Work Practice
Volume: 
28
Number: 
1
Pages: 
84-98
Publisher: 
SAGE
Background: 

The number of cancer survivors continues to increase in the United States and around the world. Cancer survivors typically have a higher rate of unemployment as compared to their healthy counterparts. Additionally, survivors were 4 times more likely to be employed when they received employment related supports. While other reviews of this subject have been conducted, this review includes more recent research, focuses more squarely on psychosocial interventions more broadly, and expands the definition of employment outcomes to include additional interventions.

Purpose: 

This systematic review focuses on examining interventions that facilitate cancer survivors' employment outcomes, including (a) employment status, (b) return to work, (c) absenteeism, and (d) time spent on work disability or sick leave. This review expands the scope of previous reviews to include additional employment outcome measures, across additional databases.

Setting: 

Interventions included in this review typically took place in medical settings.

Sample: 

Twelve studies met the criteria for inclusion in this review and included over 2000 participants who had been diagnosed with cancer. Participants were typically over the age of 50. Only four studies reported ethnicity of participants.

Data Collection: 

Data collection in all included studies was done through a hospital or clinic. Recruitment was typically through referrals or after a medical procedure.

Intervention: 

The interventions, for included studies described in this review, included behavioral, psychological, educational, or vocational content that facilitated cancer survivors' employment outcomes.

Control: 

There was no control group.

Findings: 

There were 20,249 records found after the initial search. After screening, 70 records remained to be evaluated in full-text. Of those 70, 58 records were excluded with reasons. This left 12 studies to be evaluated in the quantitative synthesis. Of the 10 studies that included measures of employment status, those that were randomized controlled trials (RCTs) showed no significant difference when examined alone. When combined with Quasi Experimental Designs (QEDs) the weighted mean effect size for employment status was OR= 2.18, p=.002. Two studies measured number of hours worked, and showed no significant results, OR = 0.89, p =.67. Four RCTs measured sick leave and results were nonsignificant OR = 1.18, p =.39.

Conclusions: 

The multicomponent nature of the interventions in this review make it difficult to pinpoint exactly "what works". Further exploration of employment outcomes in relevant research would allow for a more in-depth analysis of intervention effects. Additional RCTs would also strengthen the field.

URL: 
http://journals.sagepub.com/doi/pdf/10.1177/1049731515604741
Populations: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Rehabilitation Research Policy and Education

Authors: 
Arango-Lasprilla, J. C., da Silva Cardoso, Wilson, L. M., Romero, M. G., Chan, F., & Sung, C.
Year Published: 
2011
Publication: 
Rehabilitation Research Policy and Education
Volume: 
25
Number: 
3
Pages: 
149-162
Publisher: 
Elliott and Fitzpatrick Inc.
Background: 

Employment impacts the quality of life for individuals with spinal cord injury. Most studies that look at vocational service patterns for individuals with spinal cord injury focus on European Americans. Ethnic minority groups within the United State are growing. These changes also impact referrals to Model Spinal Cord Injury Systems. This presents new challenges to rehabilitation professionals.

Purpose: 

The purpose of this study was to identify demographic and service related patterns for Hispanics with spinal cord injury receiving services from state vocational rehabilitation agencies and examine similarities and differences in vocational rehabilitation services and employment outcomes between a group of European Americans and Hispanics with spinal cord injuries.

Setting: 

This study included individuals with SCI served by multiple vocational rehabilitation agencies in various settings.

Sample: 

Data for this study came from the Rehabilitation Services Administration Case Service report %

Control: 
There was no control or comparison condition.
Findings: 

Minor differences in case dollar expenditures and service patterns were noted between the two groups. Vocational rehabilitation services that impacted successful work outcomes included: assistive technology services, basic support services and job placement services.

Conclusions: 

Hispanic status of vocational rehabilitation clients does not affect employment outcomes. Hispanics appear to have more risk factors than European American clients. Vocational rehabilitation counselors were able to support the needs of Hispanic clients.

URL: 
http://eric.ed.gov/?id=EJ987046
Disabilities: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

The Diversity Partners Project: Multi-systemic knowledge translation and business engagement strategies to improve employment of people with disabilities

Authors: 
Catalano,D., Pereira, A., P., Wu, M., Y., Ho, H., & Chan, F.
Year Published: 
2016
Publication: 
Journal of Vocational Rehabilitation
Volume: 
46
Number: 
3
Pages: 
273-285
Publisher: 
IOS Press
Background: 

The Diversity Partners Project was created to develop, test, and launch a new learning intervention to improve employment outcomes for people with disabilities. Key arbiters were identified as employment service professionals (ESPs) who are skilled in using labor market data, building relationships with employers, community based disability service professionals, and staffing firm staff who specialize in locating human resources. This project was developed in response to policy changes like Section 503 of the Rehabilitation Act, Title I and Title IV of the Workforce Innovation and Opportunities Act.

Purpose: 

The purpose of this project was to test a learning intervention that would improve the relationships between ESPs and employers, and illustrate a systematic knowledge translation approach to the project. These research questions were used as a framework for development efforts:

1. How does an external agency create ongoing engagement in local ESP organizations? 2. What competencies will lead to ESPs being successful? 3. What situations do ESPs face when building relationships?

Setting: 

An online "Toolbox" was created through a knowledge translation process and included beta testing and feedback.

Sample: 

Target audiences included national ESPs and employers.

Data Collection: 

Online surveys and interviews were conducted.

Intervention: 

The intervention consisted of online modules on a website that contained information pertinent to organizational leadership and frontline personnel. Content modules included learning objectives, a diagnostic test, plain language learning content, case scenarios and more.

Control: 

There was no control condition.

Findings: 

Specific evaluation activities have yet to be developed.

Conclusions: 

Knowledge translation is difficult to achieve in varied contexts with segmented audiences and siloed systems. It is still too early to determine any concrete conclusions about the effectiveness of the Diversity Partners project.

URL: 
https://content.iospress.com/download/journal-of-vocational-rehabilitation/jvr862?id=journal-of-vocational-rehabilitation%2Fjvr862
Disabilities: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Characteristics and experiences of Youth who are Deaf-Blind

Authors: 
McGilloway, S., & Donnelly, M.
Year Published: 
2017
Pages: 
1-38
Publisher: 
The NRTC on Blindness & Low Vision
Background: 

According to the National Center on Deaf-Blindness' (NCDB) there have been 8,937 individuals from age 3 to 21, identified with deaf-blindness. Approximately two thirds of transition-age youth with deaf-blindness have participated in state vocational rehabilitation (VR) programs. However, very limited research exists that gives an accurate depiction of the deaf-blind community's experience.

Purpose: 

This report describes deaf-blind youth in a sample from 2001 to 2009 and examines the population's characteristics, secondary school experiences, academic achievements, postsecondary school attendance, and employment experiences. The perspective of this report is from that of parents/guardians, youth, and teachers.

Setting: 

Data for this report come from the National Longitudinal Transition Study-2 (NLTS2) from 2001 to 2009. Data for this sample were collected via mail surveys and interviews of youth and their parents/guardians, surveys of school personnel, and district assessments.

Sample: 

Participants included young adults who identified as having visual and auditory loss as a primary disability.

Data Collection: 

Data collection used in this NLTS2 sample were conducted every two years with a total of five waves from 2001 to 2009 with the largest sample size occurring during Wave 1 (170).

Intervention: 

There was no intervention.

Control: 

There was no control group.

Findings: 

A detailed description of the school and employment experience of young adults who are deaf-blind is included in this report. However several commonalities presented themselves within this sample including that the majority of respondents (92% or more), lived with their parent(s) or other relatives, received transition planning for adult life, received special services from their school, and most had one or more accommodation identified on their individualized education program (IEP).

Conclusions: 

Although this dataset has been used to represent transition aged youth with disabilities in the past, this report is the first for young adults who are deaf-blind in the United States at a national level. These data are somewhat dated and it would be beneficial to continue this research with a more recent sample.

URL: 
http://www.blind.msstate.edu/docs/characteristicsAndExperiencesOfYouthWhoAreDeafBlind.pdf
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
No

Attachment and Employment Outcomes for People With Spinal Cord Injury: The Intermediary Role of Hope

Authors: 
Blonk, R. W., Brenninkmeijer, V., Lagerveld, S. E., & Houtman, I. L.
Year Published: 
2017
Publication: 
Rehabilitation Counseling Bulletin
Volume: 
60
Number: 
2
Pages: 
77-87
Publisher: 
SAGE
Background: 

Compared to people without disabilities, people with spinal cord injury (SCI) have significantly lower employment rates. There are approximately 270,000 people in the United States living with a SCI. Recently, industrial/organizational (I/O) psychology has focused on adopting positive psychological approaches to work related behaviors. Positive organizational behavior (POB) and I/O psychology findings indicate that attachment and hope are related to important vocational variables.

Purpose: 

This study explores the relevance of attachment and hope for vocational rehabilitation (VR), in relation to full time employment, for individuals with SCI. More specifically, this study aims to a) examine the relationship between attachment, hope, and full-time employment for individuals with SCI, and b) to examine the mediation effect of hope on the relationships between attachment and full-time employment for individuals with SCI.

Setting: 

Participants were recruited from SCI advocacy organizations, specifically through newsletters. Data were collected via an anonymous online survey.

Sample: 

Participants (N =84) ranged from 21 to 64 years of age (M= 47.05,SD= 10.72). There were 57 males, and 26 females in the sample, with one participant not responding to the gender question. Participants were predominantly Caucasian (88.1%), with 48 participants reporting being unemployed (57.2%) and 23 participants reporting full-time employment (27.4%). A large majority of participants (85.5%) reported completing some post-secondary education.

Data Collection: 

Employment was coded as binary, employed full time or not employed full-time. The Attachment Style Questionnaire (ASQ, Feeney, Noller, & Hanrahan, 1994) was used to measure attachment. The Trait Hope Scale (THS; Snyder et al., 1991) was developed as a 12-item instrument to score total hope, pathways thoughts, and agency thoughts.

Intervention: 

There was no intervention.

Control: 

There was no control group.

Findings: 

Results indicate that attachment and hope were significantly related and predictive of full-time employment. Hope was also a significant mediator between attachment and full-time employment.

Conclusions: 

Vocational rehabilitation counselors should strive to maintain and enhance positive time perspective for individuals with secure attachment. Individuals with low agency/low pathways experience increased barriers to the goal pursuit process and would benefit from increased direction.

URL: 
http://journals.sagepub.com/doi/pdf/10.1177/0034355215621036
Disabilities: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Working with schools: What employment providers need to know for successful collaboration

Authors: 
Grunert, B. K., Smucker, M. R., Weis, J. M., & Rusch, M. D.
Year Published: 
2016
Publication: 
Journal of Vocational Rehabilitation
Volume: 
46
Pages: 
355-359
Publisher: 
IOS Press
Background: 

In 2004, the Individuals with Disabilities Education Act (IDEA) mandated that transition services focus on improving academic and functional achievement of students with disabilities. In 2008 report from the National Council on Disability (NCD) highlighted that outcomes were not being accessed in regards to the benefits being provided to youth with disabilities. Additionally, in 2014 the Workforce Innovation and Opportunity Act, addressed the role of Vocational Rehabilitation Services, that were being provided through the states, in relation to supporting youth with disabilities and transition services.

Purpose: 

This paper examines a collaborative transition model and preliminary results of a 5-year study. The study evaluated the effects of embedded employment resources in schools, the impact on agency connections, employment outcomes, and lessons learned. These results were then used as the basis for the National Association of People Supporting Employment First (APSE) Conference and associated workshop. There were three questions that guided the workshop discussions.

Setting: 

One example that was provided looked at the Indiana School-to-Work Collaborative. IN*SOURCE is a parent training and information center in Indiana that provides information to families.

Sample: 

Students with a disability who had difficulties meeting diploma requirements and were hoping to enter the workforce where the primary target of the Collaborative. There were 208 Experimental Sites and 66 Control Sites. Examples of Agencies involved included Vocational Rehabilitation, Employment Providers, Case Management Providers and several others.

Data Collection: 

Implementation and data collection occurred over three years. Metrics measured included number of internships obtained, employment rate for students, and pay.

Intervention: 

There were 7 aspects of the Collaborative that focused on integrating services for students. Some examples include having a single-point-of-contact, participating in internships through the school, and having Benefits Information Network (BIN) liaisons available for students and families.

Control: 

The control sites included districts that did not have employment resources embedded into schools.

Findings: 

Students were more likely to be connected to vocational services when they are embedded within schools.

Conclusions: 

Schools and employment supports should be integrated to offer students with disabilities the most opportunities for success.

URL: 
https://content.iospress.com/download/journal-of-vocational-rehabilitation/jvr872?id=journal-of-vocational-rehabilitation%2Fjvr872
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Barriers to and Facilitators of Employment among Americans with Multiple Sclerosis: Results of a Qualitative Focus Group Study

Authors: 
Bolton, B. F., Bellini, J. L., & Brookings, J. B.
Year Published: 
2016
Publication: 
Journal of Rehabilitation
Volume: 
82
Number: 
2
Pages: 
59-69
Publisher: 
National Rehabilitation Association
Background: 

Multiple sclerosis (MS) is a complex and chronic neurological disease. There are approximately 450, 000 people living in the United States who have been diagnosed with MS. These people can experience a wide variety of symptoms including fatigue, mobility problems, visual impairments and much more. Due to these symptoms employment retention and acquisition can be challenging.

Purpose: 

This research focuses on two primary questions. One, what are the most commonly reported barriers and facilitators to employment that are identified by people with MS? Two, what are the most commonly reported employment information and resource needs reported by people with MS?

Setting: 

Participants were recruited from five stakeholder groups of people with physical disabilities. These groups included the National MS Society, United Spinal Cord Injury Association, World Institute on Disability, United Cerebral Palsy, and National Centers for Independent Living.

Sample: 

Participants in this study were 25 predominantly Caucasian (n=18, 72%) females (n=19, 76%) between 18 and 64 years of age.

Data Collection: 

Telephone focus groups were conducted and provided transcripts for the research team to analyze using NVivo 10 using a conventional qualitative content analysis approach.

Intervention: 

The research team developed a focus group protocol for this study that was delivered over the phone.

Control: 

There was no control group.

Findings: 

There were three main themes (and additional sub-themes) as a result of this research. Participants reported facing future uncertainty, feeling a sense of loss, and discussed issues related to navigating the workplace.

Conclusions: 

Vocational Rehabilitation counselors would benefit by increased knowledge around the issues that people with MS face in the workplace, especially in the area if disclosure.

URL: 
http://www.worksupport.com/documents/116767876.pdf
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes