Qualitative | Knowledge Translation for Employment Research Center

Hearing impairment, work and vocational enablement

Authors:

Krupa, T

Year Published:

2008

Publication:

International Journal of Audiology

Volume:

Number:

Pages:

S124-S130

Publisher:

Informa Healthcare

Background:

Employment is considered one of the major life areas. An increasing number of individuals with hearing loss are seeking help with occupational problems and need individualized employment supports.

Purpose:

This paper describes a recently developed vocational enablement protocol (VEP) addressing the specific needs of those with hearing loss in the workforce.

Setting:

The setting was an Audiological Center in a University Medical Center, in Amsterdam.

Sample:

The study sample include 86 patients with hearing loss aged 19-64 years.

Data Collection:

Data from the VEP was collected and discussed in a board multidisciplinary team.

Intervention:

Vocational enablement protocol (VEP)
evaluation of the work situation and problems from both the patient's and the professionals perspective, including an assessment of the auditory demands at the workplace</li>
diagnostic examination of the individual's auditory profile
assessment of the an individual's coping abilities
an examination of the workplace
recommendations for an enablement plan an options available
written report
Implementation of the recommendations

Control:

There was no control or comparison condition.

Findings:

Recommendations were made by the multidisciplinary team in the following areas: hearing aid (re)fitting, communication training, environmental modifications, psychosocial counseling, assistive listening devices, re-delegation of assignments, restructuring of time schedules, further medical examination, occupations retraining, hearing protection.

Conclusions:

This program may be regarded as a step forward in the management of people with hearing loss who experience problems as work, but there is still room for improvement. There is no scientific evidence available for the effectiveness and efficiency of the recommendations proposed.

URL:

http://www.ncbi.nlm.nih.gov/pubmed/19012121

Disabilities:

Hearing impairments

Populations:

Male & Female

Outcomes:

Other

NIDILRR Funded:

Research Design:

Qualitative

Peer Reviewed:

Yes

Influence of least restrictive environment and community based training on integrated employment outcomes for transitioning students with severe disabilities.

Authors:

Wickizer, T. M., Campbell, K., Krupski, A., & Stark, K.

Year Published:

2004

Publication:

Journal of Vocational Rehabilitation

Volume:

Number:

Pages:

149-156

Publisher:

IOS Press

Background:

In light of the data supporting the education of individuals with severe disabilities in natural contexts, it stands to reason that programs would no longer provide training in contexts other than those that result insurable employment opportunities. However, this continue to occur. Even with mandated transition planning integrated employment outcomes are not improving for students with severe disabilities. Many of these students will then enter the public welfare system and/or segregated adult programs.

Purpose:

The purpose of this study was to identify variables that are correlated with successful integrated employment outcomes for transitioning students with severe disabilities.

Setting:

The setting included 20 different schools sites within 12 school districts in a county in California.

Sample:

The sample included 104 students with severe disabilities, ages 18-22, who had exited school without diploma. Close to half (48%) of the participants had an IQ that placed them in the profound (25%) or severe (23%) category. The majority of the participants were white (53%), followed by Hispanic (28%), Asian (13%),African American (4%) and Pacific (2%). Around 53% of the students were males. Around 80% of the participants lived at home; the others lived in group homes.

Data Collection:

The specific variables measured in this study included: the influence of duration of community-based training (CBT) that included on-the-job training, on the-job training as a subset of CBT, the least restrictive environment (LRE), or the degree of integration with non-disabled peers during the school day, demographics(gender, ethnicity, home setting, behavior problems, physical disability and mental ability) as measured by
intelligence quotient (I.Q.).Data was collected by structured interview with teachers and administrators, record review and on site observations. Correlations were used to examine predictive relationships between the independent variables and the dependent variable of post-school integrated employment. Cross tabulations and chi-square analysis of correlated variables were then used to identify significance of specific variables on employment outcome.

Intervention:

The intervention was community based training. This included on the job training and physical integration with non disabled peers.

Control:

There was no comparison or control group

Findings:

These data indicate significant interactions between community based training (r = 0.387, p < 0.001), degree of integration with typical peers (r = 0.360, p < 0.001), andon-the-job training (r = 0.305, p = 0.001) and employment outcome. There were also strong intercorrelations among the three variables of CBT, degree of integration or LRE and on-the-job training.Transitioning students who received CBT and on the job training had a 69% integrated employment rate after leaving school.

Conclusions:

The combinations of least restrictive environments,CBT/on-the-job training, and innovative teacher advocacy are potent predictors of post school employment for students with severe disabilities, regardless of intellectual functioning.

URL:

http://www.kcdsg.org/files/content/Cheryl%20Jorgensen_Influence%20of%20LRE%20on%20Outcomes.pdf

Disabilities:

Intellectual disabilities

Populations:

Transition-age youth (14 - 24)

Hispanic or Latino

Asian

Black / African American

Native Hawaiian / other Pacific Islander

White / Caucasian

Male & Female

Outcomes:

Employment acquisition

NIDILRR Funded:

Not Reported

Research Design:

Single group

Qualitative

Peer Reviewed:

Yes

The shift to rapid job placement for people living with mental illness: An analysis of consequences

Authors:

Gignac, M. A. M., Jetha, A., Bowring, J., Beaton, D., & Badley, E.

Year Published:

2012

Publication:

Psychiatric Rehabilitation Journal

Volume:

Number:

Pages:

428-434

Publisher:

Psychiatric Rehabilitation Administration

Background:

The Individual Placement and Support (IPS) model, a standardized and evidence-based approach to supported employment (SE) for individuals living with mental illness, focuses on minimizing pre-employment training and supporting individuals to enter integrated competitive work settings. In an effort to address poor employment outcomes associated with many traditional approaches to vocational rehabilitation, policy structures and funding mechanisms have been developed that link pay incentives directly to job placement and maintenance rates. . The question of whether policy revisions encourage fidelity to models of best practice is a salient one in light of this observation. Indeed, heterogeneity within the IPS model persists despite the association between fidelity to the model and positive employment outcomes.

Purpose:

This article reports on the consequences of the revised policy for employment supports within the Ontario Disability Support Program, a disability benefit program administered by the provincial government in Ontario, Canada. The revised policy involves a change from a fee-for-service model to an outcome-based funding model. This revision has encouraged a shift from pre-employment to job placement services, with a particular focus on rapid placement into available jobs. This article reports on the findings from a case study of policy revision affecting employment supports for individuals living with mental illness in Ontario, Canada. The purpose is to examine the impact of this policy change, comprised largely of a new outcome-based funding model, with an eye to the principle and practice of rapid job placement.

Setting:

Recruitment focused on three main stakeholder groups: (1) program informants who were involved in developing and/or delivering employment services for people living with mental illness under the policy; (2) policy informants who were involved in constructing and/or implementing the policy; and (3) consumer informants who self-identified as a person living with a mental illness and were involved in informing the policy, planning services under the policy, or advocacy/activism related to the policy.

Sample:

Using a qualitative case study approach, 25 key informant interviews were conducted with individuals involved in developing or implementing the policy, or delivering employment services for individuals living with mental illness under the policy. Policy documents were also reviewed in order to explore the intent of the policy. Analysis focused on exploring how the policy has been implemented in practice, and its impact on employment services for individuals living with mental illness.

Data Collection:

Interviews were audio-recorded and transcribed verbatim.
The computer software program NVivo was used to organize the data for efficient analysis. Data from the key informant interviews and the documents were analyzed simultaneously. Emerging ideas were used to direct and focus later data collection and analysis according to the constant comparative approach. Guided by the principles of constructivist grounded theory, during initial coding we explored the data and considered different possible theoretical and analytical permutations. Later, coding became more focused and selective as we categorized data by grouping codes together and prioritizing some codes over others.

Intervention:

This study utilizes an interpretive approach to qualitative research. It draws on a case study of ODSP-ES, an employment support policy in Ontario, Canada to explore the consequences of this policy revision, with particular attention to the practice of rapid placement into jobs that was encouraged by the revised policy. The case study design is an effective approach to explore real-live events and broad social processes. While it can be difficult to generalize findings from case studies to other contexts, those conducted in contexts that are representative of other cases and that are focused on developing theoretical understandings of circumstances can offer broad insights and innovations.

Control:

There was no control or comparison condition.

Findings:

The findings highlight how employment support practices have evolved under the new policy. Although there is now an increased focus on employment rather than pre-employment supports, the financial imperative to place individuals into jobs as quickly as possible has decreased attention to career development. Jobs are reported to be concentrated at the entry-level with low pay and little security or benefits.

Conclusions:

These findings raise questions about the quality of employment being achieved under the new policy, highlight problems with adopting selected components of evidence-based approaches, and begin to explicate the influence that funding structures can have on practice.

URL:

http://www.ncbi.nlm.nih.gov/pubmed/23276235

Disabilities:

Emotional disturbance

Populations:

Male & Female

Outcomes:

Employment acquisition

Full-time employment

Part-time employment

Wages

NIDILRR Funded:

Research Design:

Qualitative

Peer Reviewed:

Yes

Preliminary assessment of a prototype advanced mobility device in the work environment of veterans with spinal cord injury

Authors:

Coviello, D. M., Zanis, D. A., & Lynch, K.

Year Published:

2004

Publication:

NeuroRehabilitation

Volume:

Number:

Pages:

161-170

Publisher:

IOS Press

Background:

Many environments are not accessible to individuals that use wheelchairs for ambulation.

Purpose:

The purpose of this study was to collect data on the potential for the Independence 3000 IBOT Transporter to improve employment satisfaction of veterans who use wheelchairs to work.

Setting:

Various offices made up the setting.

Sample:

Subjects were recruited from the Washington Office of the Paralyzed Veterans of America. Four male veterans with traumatic spinal cord injury were selected to participate in the study.

Data Collection:

Observations were made by trained clinicians and participants responded to a survey.

Intervention:

The intervention was the use of the IBOT in the work setting to hold eye-level discussions with colleagues, climb stairs, ascend steep ramps, and negotiate curbs.

Control:

There was no control or comparison condition.

Findings:

Half of the users felt that the IBOT would help them at work and all users felt it should be made available to veterans who use wheelchairs.

Conclusions:

A larger study should be conducted to determine if the IBOT affects work performance and the ability to return to work.

URL:

http://www.ncbi.nlm.nih.gov/pubmed/15201475

Disabilities:

Orthopedic impairments

Populations:

Outcomes:

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Factors affecting employment following spinal cord injury: A qualitative study

Authors:

Charbonneau, A., Bruning, W., Titus-Howard, T., Ellerbeck, E., Whittle, J., Hall, S., Campbell, J., Lewis, S., & Munro, S.

Year Published:

2001

Publication:

Rehabilitation Psychology

Volume:

Number:

Pages:

400-416

Publisher:

Educational Publishing Foundation

Background:

Results from the University of Michigan Model Spinal Cord Injury Care Systems database indicate that, even though 59% of persons with spinal cord injury (SCI) are employed before injury, the majority (75%) are not employed at follow-up after injury.

Purpose:

The purpose of the study was to examine factors influencing successful return to work following spinal cord injury (SCI).

Setting:

The setting included a variety of rehabilitation programs.

Sample:

Six employed and 6 unemployed persons with SCI were matched based on education, race, age, gender, time since injury, and level of function.

Data Collection:

This was a qualitative research design. Interviews were used to collect data.

Intervention:

Interviews were conducted regarding work history, family life, impact of disability, role models, barriers to employment, and satisfaction with vocational rehabilitation services received.

Control:

A comparison was made between employed persons to unemployed persons.

Findings:

Psychological and environmental factors were found to be the strongest moderating variables affecting employment. Key psychological factors associated with employment were optimism, self-esteem, achievement orientation, and role models. Key environmental factors were monetary incentives, disincentives, access, and accommodation.

Conclusions:

Employment barriers and the perception of these barriers as insurmountable need to be decreased. Policies that promote return to work with former employers are likely to improve employment rates for persons with SCI. A more intensive job exploration process using job shadowing of peers and positive peer models may also improve employment after SCI.

URL:

http://psycnet.apa.org/psycinfo/2001-05160-003

Populations:

Outcomes:

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

The quality of supported employment implementation scale (2000)

Authors:

Bond, G. R., Salyers, M. P., Dincin, J., Drake, R. E., Becker, D. R., Fraser, V. V., & Haines, M.

Year Published:

2000

Publication:

Journal of Vocational Rehabilitation

Volume:

Number:

Pages:

201-212

Publisher:

IOS Press

Background:

Supported employment as an approach to assist individuals with the most severe disabilities, with gaining and maintaining work, has been described in the literature since the nineteen eighties. However, its implementation has been variable in the United States. A scale to measure the quality of supported employment implementation would be beneficial.

Purpose:

The purpose of this study was to develop a checklist that could be used by program administrators or state planners to measure the implementation of supported employment programs for individuals with severe mental illness.

Setting:

The study sites were 17 supported employment programs located in Kansas and New Jersey.

Sample:

A total of 32 supported employment programs participated in the study. Twenty sites were in New Jersey and 12 in Kansas. Between the two states' programs, there was no significant difference in the longevity of the programs, number of employment specialist, number of consumers, staff to consumer ratios. They also did not differ in number of annual admissions.

Data Collection:

One and half hour semi structured telephone interviews were conducted with program managers using the Quality of Supported Employment Implementation Scale. The subscales were: vocational staffing, organization and services, from the Individual Placement and Support Fidelity Scale. After the interview, procedures were explained about collecting employment outcome data. Program directors were paid $100 for completing this activity. The data related to employment status of current consumers.

Intervention:

The intervention was the use of the Quality of Supported Employment Implementation Scale to evaluate services.

Control:

There was no comparison or control condition.

Findings:

The inter-interviewer agreement was moderately high. Overall, internal consistency of the total scale was poor, so the researchers subscales. All 33 items on the Quality of Supported Employment Implementation Scale showed some variation. Both states showed high ratings suggesting moderate to full implementation in most of the measured areas. However there were some differences at the subscale and item level. New Jersey had significantly higher implementation of planning and support, while Kansas had higher implementation of integration of mental health.

Conclusions:

The Quality of Supported Employment Implementation Scale can be used to describe supported employment programs for individuals with severe mental illness. More research is needed.

URL:

http://worksupport.com/Main/downloads/article5.pdf

Disabilities:

Emotional disturbance

Populations:

Male & Female

Outcomes:

Other

NIDILRR Funded:

Research Design:

Qualitative

Peer Reviewed:

Yes

The quality of supported employment implementation scale (2008)

Authors:

Bond, G. R., McHugo, G. J., Becker, D. R., Rapp, C. A., & Whitley, R.

Year Published:

2008

Publication:

Journal of Vocational Rehabilitation

Volume:

Number:

Pages:

201-212

Publisher:

IOS Press

Background:

Introduced in the 1980s supported employment (SE) is an approach to helping people with severe disabilities work in competitive employment positions. Although its principles are well described in the literature, its implementation has been variable throughout the U.S.

Purpose:

The purpose of this study was to develop a brief, self-explanatory checklist, suitable for use in a telephone interview format, and ultimately as an instrument completed by a program administrator or state planner, or as a self evaluation by a study site.

Setting:

The setting were supported employment programs in Kansas and New Jersey.

Sample:

The study sample included 32 supported employment programs across 2 states.

Data Collection:

A 1.5-hour semi-structured interview using the Quality of Supported Employment Implementation Scale (QSEIS) was conducted with program directors in 32 supported employment programs. The QSEIS total scale and 4 sub-scales were correlated with 9 indicators of employment outcomes, obtained from a retrospective survey completed by program directors in 24 of the programs.

Intervention:

The intervention was Fidelity of implementation of Individual Placement and Support model of supported employment.

Control:

There was no control or comparison condition.

Findings:

Substantial implementation of supported employment standards was found in these programs, with mean ratings exceeding 4.0 on a 5-point scale, for 18 of 33 items. Mean overall implementation was similar in both states, with somewhat different patterns, with NJ rating higher on Planning and Support, and KS rating higher on Integration of Mental Health and Rapid Job Search.

Conclusions:

The QSEIS is a pragmatic tool for describing supported employment programs for people with severe mental illness, although more work on psychometric precision and predictive validity is needed. The survey provides norms by which other providers and other states can compare their achievement of the principles of supported employment.

URL:

http://worksupport.com/Main/downloads/article5.pdf

Disabilities:

Emotional disturbance

Populations:

Male & Female

Outcomes:

Employment acquisition

NIDILRR Funded:

Not Reported

Research Design:

Qualitative

Peer Reviewed:

Yes