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

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

Translating Research into a Seamless Transition Model

Authors: 
Luecking, R. G. & Fabian, E. S.
Year Published: 
2015
Publication: 
Career Development and Transition for Exceptional Individuals
Volume: 
38
Number: 
1
Pages: 
4-13
Publisher: 
Sage
Background: 

This Research focuses on the implementation of a model for delivering seamless transition services based on the National Collaborative on Workforce and Disability/Youth(NCWD/Y) Guideposts. This research shares how this model has been applied in 11 of the 24 school districts in Maryland for special education populations.

Purpose: 

The purpose of this research is to provide preliminary data on the model‚ early impact on students transitioning to careers.

Setting: 

School districts in Maryland.

Sample: 

This study looked at eleven county-wide school districts in Maryland.

Data Collection: 

This study is a descriptive analysis.

Control: 

This study had no control.

Findings: 

This study provides early indication that the model has potential to be applied across disability categories as well as demographically diverse school systems. It also it has the potential to serve as a practice framework that alleviates barriers known to impede federal transition policy.

Conclusions: 

The model presented in this research potentially offers a defined pathway to employment, postsecondary education, and careers for youth with disabilities who are transitioning from public secondary education.

URL: 
https://www.michigan.gov/documents/mdhhs/Lueckings_Seamless_Model_511755_7.pdf
Disabilities: 
Populations: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Exploring Differences in the Content of Job Interviews between Youth with and without a Physical Disability

Authors: 
Lucca, A. M., Henry, A. D., Banks, S., Simon, L., & Page, S.
Year Published: 
2015
Publication: 
PLOS ONE
Volume: 
10
Number: 
3
Publisher: 
PLOS ONE
Background: 

This study looked at the similarities and differences among youth with disabilities on a mock job interview compared to their typically developing peers. Understanding the content of job interviews may highlight areas where individuals with disabilities perform differently than those with typical development and how these areas may present barriers to employment.

Purpose: 

The purpose of this research is to inform employment readiness programs and educate employers about the potential challenges associated with this recruitment method for those with disabilities.

Setting: 

This study is part of a larger, multi-method, cross-sectional observational study on employment readiness among youth with disabilities.

Sample: 

Employers and employment counselors (n = 19), and youth (n = 31) were interviewed for this study.

Data Collection: 

This study recruited youth through the use of advertisements at a pediatric rehabilitation hospital and community centers. Information packages were also sent to youth who were thought to meet the inclusion criteria.

Control: 

There was no control for this study.

Findings: 

The study found several similarities and differences between youth with disabilities and typically developing youth. For youth with disabilities, differences in job interview answers included: (1) disclosing their condition; (2) giving fewer examples related to customer service and teamwork skills; (3) experiencing greater challenges in providing feedback to team members and responding to scenario-based problem solving questions; and (4) drawing on examples from past work, volunteer and extracurricular activities.

Conclusions: 

Clinicians and educators should help youth recognize their marketable skills and how to highlight those skills in an interview. Employers should recognize that the experiences of youth with disabilities may be different than typically developing youth.

URL: 
http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0122084&type=printable
Disabilities: 
Populations: 
NIDILRR Funded: 
Research Design: 
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

Current Opinion in Psychiatry

Authors: 
Bond, G. R. & Kukla, M.
Year Published: 
2008
Publication: 
Current Opinion in Psychiatry
Volume: 
21
Number: 
4
Pages: 
362-369
Publisher: 
Wolters Kluwer Health/Lippincott Williams and Wilkins
Background: 

Researches continue to examples predictors of employment among three types of variables: patient characteristics, environmental characteristics, and interventions. Provision of supported employment is the strongest predictor of competitive employment among patients with schizophrenia. Patent characteristics show modest association with employment outcomes; environmental factors are presumed to have major influences, but have been little studied.

Purpose: 

Researchers continue to study factors that are relatively easy to study rather than those that are powerful and meaningful from a public health perspective. Truly critical factors are first, disability, insurance, and employment regulations that discourage most people from trying to work, and second, failure to align finances and organization of services with evidenced based practices." Article reviews current literature on the various factors being researched that impact employment outcomes for patients with schizophrenia.

Setting: 

This study is a systematic review. The included studies were undertaken in various locations and settings.

Sample: 

The study sample was recently published studies examining predictors of competitive employment for patients with schizophrenia.

Data Collection: 

Literature search included a combination of strategies,, including PubMed search with keywords, examination of table of contents from major journals in related fields, and consultation with leading researchers.

Control: 

There were no comparison or control conditions.

Findings: 

Implementing supported employment services with high fidelity to the IPS model clearly improves competitive employment outcomes.

Conclusions: 

According to the published literature, the single best predictor of competitive employment for patients with schizophrenia is supported employment. Despite numerous studies seeking to identify patients characteristics predicting employment, the reported findings have been generally unimpressive. Many factors influencing employment outcomes continue to be understudied, including societal and cultural factors, access to supported employment, regulatory factors, and criminal justice involvement.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/18520741
Disabilities: 
Populations: 
NIDILRR Funded: 
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

Barriers to Employment for Transition-age Youth

Authors: 
Nuechterlein, K. H., Subotnik, K. L., Turner, L. R.,Ventura, J., Becker, D. R., & Drake, R. E.
Year Published: 
2016
Publication: 
Administration and Policy in Mental Health
Volume: 
44
Number: 
3
Pages: 
354-358
Publisher: 
Springer
Background: 

Youth with developmental and psychiatric disabilities face substantial vocational challenges, even after receiving employment services. This study examined employment barriers for 280 transition-age youth with disabilities enrolled in supported employment in eight community rehabilitation centers.

Purpose: 

Youth with disabilities encounter many barriers to employment. Awareness of these barriers may help employment programs anticipate challenges and develop strategies.

Setting: 

Eight Programs in the evaluation of the Illinois Balancing Incentive Program supported employment project.

Sample: 

The sample of the current study consisted of 280 youth with developmental and psychiatric disabilities from 8 of the 10 programs in the evaluation of the Illinois Incentive Program.

Data Collection: 

Responses from eight Individual Placement Support programs (four serving youth with developmental disabilities and four serving youth with psychiatric disabilities) were aggregated.

Control: 

There was no control for this study.

Findings: 

Common barriers for youth with developmental disabilities were lack of work experience, transportation problems, cognitive problems, disengagement from the IPS program, and lack of social skills. Common barriers for youth with psychiatric disabilities were transportation problems, failure to engage in the IPS program, poor control of psychiatric symptoms, and lack or work experience.

Conclusions: 

Though both groups benefited from Individual Placement Support programs, addressing common barriers is imperative. Transportation problems, lack of work experience, engagement issues, and lack of family support were barriers present in both groups.

URL: 
https://link.springer.com/article/10.1007/s10488-016-0773-y
Disabilities: 
Populations: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

A vocational rehabilitation intervention for young adults with physical disabilities: participants' perception of beneficial attributes

Authors: 
Bai, M. I., Sattoe, J. N. T., Schaardenburgh van, N. R., Floothuis, M. C. S. G., Roebroeck, M. E., & Miedema, H. S.
Year Published: 
2017
Publication: 
Child: Care, Health and Development
Volume: 
43
Number: 
1
Pages: 
114-125
Publisher: 
Wiley Online Library
Background: 

This study explores the barriers and facilitators that young adults with physical disabilities experienced while finding and maintaining employment after an intervention program that supports work participation.

Purpose: 

To ascertain the participant-perceived beneficial attributes of the program and participants' recommendations for additional components.

Setting: 

Semi-structured interviews with former intervention participants, which were recorded and transcribed.

Sample: 

Young adults with disabilities (n= 19) that formerly participated in the study.

Data Collection: 

Data was extracted from the clients' charts and logged in a digital data extraction form. The following background characteristics were reviewed from the charts: age, gender, medical diagnosis, educational level and type of education.

Intervention: 

At Work' is a multidisciplinary vocational rehabilitation intervention for young people with physical disabilities. It aims to provide support for finding and maintaining regular employment after finishing post-secondary education.

Control: 

There was no control for this study.

Findings: 

Physical functions and capacities, supervisor's attitude, self-esteem and self-efficacy and openness and assertiveness were experienced barriers and facilitators for finding and maintaining employment. Improvement of self-promoting skills and disclosure skills through job interview-training, increased self-esteem or self-efficacy through peer-support, a suitable job through job placement, improvement of work ability through arrangement of adjusted work conditions and change of supervisor's attitude through education provided to the supervisor were perceived as beneficial attributes of the program.

Conclusions: 

Findings suggest that programs supporting work participation should provide real-world experiential opportunities that allow young adults with physical disabilities to develop new insights, self-efficacy and life skills.

URL: 
http://onlinelibrary.wiley.com/doi/10.1111/cch.12407/full
Disabilities: 
Populations: 
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