Yes

Participants are followed for 24 months by a case manager to gather employment data.

An ex post facto design, using data mining as a statistical analysis strategy. Data was taken from the RSA-911 report for all the persons with SCI closed by State Vocational Rehabilitation agencies in 2001. A chi-squared automatic interaction detector (CHAID) based data mining analysis was used to identify the strongest associations between predictors (VR services) and the outcome variable (employment outcomes).

The Wisconsin Card Sorting Test and the Tower of London Test were administered to participants. In addition, the Vocational Cognitive Rating Scale was completed by the participant's case manager or supervisor of a rehabilitation facility or center. After the pretest each participant started either the virtual or psychosocial training. The content and structure of the two programs were similar. Each included an introduction to training objectives, training in specific vocational skills and practice and a review of those skills. The virtual program was interactive in nature. The psycho educational vocational training system included a training manual and was delivered under the guidance of a trainer. Post test were also conducted on the previously cited measures. Information about the participants employment status was collected at one, three and six month intervals. Statistical analysis were performed using SPSS for Windows Version 17.

Vocational outcome at time of initial placement and at 1-year follow-up was measured using the Vocational Integration Scale. The Mayo-Portland Adaptability Inventory (MPAI), a scale based on the Portland Adaptability Inventory was used for rating the range of physical, cognitive, emotional, and social impairments and disabilities resulting from BI. It was completed by rehabilitation staff, the patient and a significant other. Rating scale (Rasch) analyses of the Staff MPAI based on 305 assessments led to a reduction in the number of items from 30 to 22 by eliminating non-contributing items. An indicator of Impaired self-awareness ISA was item 24 from the Staff MPAI, which rates level of indifference or lack of awareness of deficits. The second indicator of ISA used was the difference between the Rasch-converted score for 22-item Staff MPAI and the Rasch-converted score for the 22-item Survivor MPAI. Preinjury vocational status, the presence of other non-brain injuries, time since injury, and the Rasch-transformed Staff MPAI appeared to have some value in predicting the level of initial vocational placement. At 1-year follow-up, vocational status was predicted by time since injury and Rasch Staff MPAI. The VIS at initial placement also significantly predicted VIS at follow-up (Spearman coefficient 5 .75, n 5 101, p, .0001). The efficiency of services (i.e., months to placement) was significantly predicted by preinjury education, injury severity, time since injury, Rasch Staff MPAI, Rasch Survivor MPAI, and the difference between the Rasch Staff MPAI and Rasch Survivor MPAI. To control for experiment-wise error, potential predictor variables were further scrutinized using regression analyses.

Evaluation and outcome data were analyzed for each participant. For those who completed the program, work outcomes was measured using the Vocational Independence Scale at program end and 1-year follow-up and Rasch-analyzed Mayo-Portland Adaptability Inventory (MPAI-22) and goal attainment scaling (GAS) at program end. Data was collected from the Independent Living Scale, VIS, GAS and MPAI-22 when participants entered and exited the program to measure this factor. Logistic regression analysis was conducted for the ILS and VIS were for those who completed the program one year post completion with potential outcome predictors that included: age, education, severity of injury, type of injury, time post injury, degree of impairment prior to program participation.

Routine standardized data was collected on all clients at baseline and 12 month follow-up using the MiData (minimum dataset) package. This is a Microsoft Access database that was specifically designed as a clinician friendly tool to be incorporated into routine clinical practice

The study collected data on patient employment and behaviors from the following sources: personal interviews, vocational activities log and employment documentation. Employment measures drew on and integrated information from these sources. The major employment outcome was the attainment of a paid job.
To provide a single overall index of vocational outcomes, they were combined into a four-level, ordinal measure of highest level of vocational attainment:
1. Attained a competitive job (highest).
2. Attained an informal job.
3. Performed constructive activity other than paid employment.
4. None of the above (lowest).
CES counselors left during the study period. Patients who received no counseling (N=24) were excluded from this sample. The interview follow up rate for follow up at 12 months was 91%. The main analytical technique was multiple logistic regression with statistical significance set at p < .05 (2-tailed). Vocational intervention condition was introduced into the analysis as an indicator variable (CES=1, standard=0). The statistical control for period of intervention, as described above, is also an indicator variable (earlier cases = 1, later cases = 0). All analyses of employment outcomes included the baseline measure of the outcome variable as a covariate. Since the study had no dollar measure of earnings prior to baseline, work in the prior 6-month period was used as the covariate in the analysis of earnings as an outcome. Patient baseline variables were examined to determine whether any were significantly associated with both an employment outcome and vocational intervention assignment (CES vs. standard counseling); none were. Thus, none of these variables was a potential confounder in the regression analysis. Work in the pre-study period was included as a covariate in the multivariate analysis, however, to enable the potential independent effect of the CES intervention on employment outcomes to be determined.

The research measures included participant characteristics and employment. Control variables included: age, severity of psychiatric symptoms, severity of physical health problems and active substance use. Gender was also added.
Psychiatric symptoms were measured using the Positive and Negative Syndrome Scale. Physical health problems were measured through PANSS probes, Medicaid claims, and interviews. Substance abuse was identified through records, reports and interviews. Two motivational control variable were collected related to interest in working at baseline and match of random assignment to participant preference. The programs kept the same service logs and other records.
The data analysis plan included benchmark comparisons of program performance by using published outcome data from exemplary SE programs. A comparison of ACT and clubhouse outcomes was completed using a services of hierarchical regression analyses.

Hours worked were measured weekly, and work performance was assessed biweekly with the use of the Work Behavior Inventory. Hope and self-esteem were assessed at baseline and at 5 months with the Beck Hopelessness Scale and the Rosenberg Self-Esteem Schedule.

An action research approach was used. Results were presented for each 3 groups of participants. The individualized approach was successful for 17 of the adult participants. By the end of year four 56% had secured full time and part time work. Among the special education group 27 people had the chance to participate in one to three work experiences. Eighteen required one to one ongoing support throughout the duration of the work placement. Some parents of the young adults in this group reported feeling less anxious about what would happen when the child left school. The mainstream group required work experience for short periods of time. A program spanning the entire school year was not possible due to difficulties associated with being released from school. During the engagement phase individuals completed a individual induction, an assessment, a vocational profile, and an action plan. The plan was reviewed and updated every six months.