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

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.


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


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.


There was no control group.


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.


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 No specific disability
Populations Male & Female
Outcomes Employment acquisition
NIDILRR Funded Yes
Research Design Observational, Quasi-experimental
Peer Reviewed Yes