Single group

Outcomes:

NIDILRR Funded:

Not Reported

Research Design:

Qualitative

Peer Reviewed:

Yes

Employment outcomes for hard-to-reach persons with chronic and severe substance use disorders receiving assertive community treatment

Authors:

Gold, P., Meisler, N., Santos, A., Carnemolla, M., Williams, O., & Keleher, J.

Year Published:

2004

Publication:

Substance Use and Misuse

Volume:

Number:

Pages:

2425-2489

Publisher:

Informa Healthcare

Background:

Individuals with the most chronic and severe substance use disorders receive little clinical and rehabilitative benefit from treatment programs.The majority drop out of intensive outpatient programs and therapeutic communities within 30 days of admission. Those who do complete planned treatment fail to generalize the benefits associated with abstinence and the development of other skills to employment. Less than one third work and those who do earn wages below poverty levels. This population may improve employment outcomes with long term integrated substance abuse rehabilitation and support services like the Assertive Community Treatment (ACT)approach. This team based approach will be expensive. Cost-benefit analysis is needed to persuade states to adopt this method.

Purpose:

The purpose of this study was to evaluate the effectiveness of the ACT approach with individuals who experience severe substance use disorders.

Setting:

The setting for the study was Ernest E. Kennedy Center, a private nonprofit center providing treatment for substance dependence serving Berkeley and Charleston counties in coastal South Carolina.

Sample:

The study sample included 35 individuals with severe substance use disorders.

Data Collection:

A wide range of clinical, functional, and psycho-social processes and outcomes were measured. Measures were completed at three time-points: admission to the ACT program (baseline), and 6 months and 12 months post admission.

Intervention:

The intervention was Assertive Community Treatment (ACT). The ACT model delivers an integrated package of treatment, rehabilitation, and support to reduce substance misuse and increase employment. Interventions include assistance with client-environmental interactions and medical interventions to manage substance abuse.

Control:

The study included a single-group design. Participants functioned as own controls.

Findings:

Thirty four of the 35 clients completed the 2-year service demonstration project. Generally, clients modestly reduced substance misuse and increased employment.

Conclusions:

The project shows promising outcomes, however the sample size was small and limits inferences of causation and generalization of the process.

URL:

http://www.ncbi.nlm.nih.gov/pubmed/15603010

Populations:

Outcomes:

Return to work

Wages

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Between unemployment and employment: Experience of unemployed long-term pain sufferers

Authors:

Gold, P. B., Meisler, N., DuRoss, D., & Bailey, L.

Year Published:

2012

Publication:

Work: A Journal of Prevention, Assessment and Rehabilitation

Volume:

Number:

Pages:

475-485

Publisher:

IOS Press

Background:

Unemployment is a growing problem worldwide. In Sweden the employment rate in June 2010 was 9.8%. Studies in Sweden have produced evidence of positive effects for the rehabilitation of long-termed unemployed people, with or without disabilities. Long-term musculoskeletal pain is one of the three most common reasons for long-term sick absenteeism.

Purpose:

This study explored and analysed how patients experienced possibilities for, and barriers to, work return after participation in a multi-professional pain-rehabilitation program followed by a coached work-training program (CWT).

Setting:

The setting was a multi-professional pain rehabilitation program.

Sample:

Eleven informants with long-term musculoskeletal pain who had participated in the CWT program for 4‚Äì21 months comprised the study.

Data Collection:

A qualitative emergent design was used. Data collected with interviews were analyzed using the constant comparison method of grounded theory. Triangulation in researchers were used.

Intervention:

The intervention was participation in pain-rehabilitation program and a coached work training program.

Control:

There was no control or comparison condition.

Findings:

The analyses of the interviews resulted in the development of a three-category theoretical model, which was named "a way back to work". The main category "Experience of a way back to work" consisted of the informants' experience during the process between unemployment and employment. The category "Support" describes the help the informants received from various actors, and the category "Negative response" describes negative responses from the actors involved, which was an important barrier in the process between unemployment and employment.

Conclusions:

Professional individualized support, participants feeling involved in their rehabilitation process, coaching at real workplaces and multi-professional team including health care personnel, were valuable during the process towards work.

URL:

http://content.iospress.com/articles/work/wor01394

Populations:

Outcomes:

Return to work

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Providing effective employment supports for persons living with HIV: The KEEP project

Authors:

Factors affecting vocational outcomes of people with chronic illness participating in a supported competitive open employment program in Hong Kong

Year Published:

2005

Publication:

Journal of Vocational Rehabilitation

Volume:

Number:

Pages:

105-114

Publisher:

IOS Press

Background:

The Kirk Employment Empowerment Project (KEEP) was a three-year demonstration project funded by the Rehabilitation Services Administration (RSA) to test strategies for improving employment outcomes of individuals with HIV/AIDS. KEEP sought to identify and test service strategies that would be effective for individuals who have multiple barriers to employment, and individuals from populations that are typically underrepresented in HIV/AIDS research.

Purpose:

The purposes of this article are to (1) describe the KEEP model and (2) provide data regarding program outcomes.

Setting:

The study setting was the Horizon House, a treatment center for individuals with HIV/AIDS in Philadelphia, PA.

Sample:

The study sample was 148 individuals who were referred to and accepted for KEEP services. The sample was predominantly African-American (72.3%) and male (60%). A substantial proportion had co-occurring disorders, with over a third report a psychiatric disorder.

Data Collection:

Employment tracking data were collected for each participant upon job start, significant job changes, and job end. Initial baseline interviews were conducted by research staff with each participant to obtain demographic data and income, motivation to work and satisfaction with life issues in general as reflected by participants responses to quality of life items. Follow-up interviews were conducted at 6-month intervals for the duration of the project. Descriptive statistics were used to report outcomes for participants.

Intervention:

The KEEP model emphasizes rapid attachment in the workforce and expecting participants to do as much for themselves as possible with support. Among the specific individualized services offered by ESC‚ were assessment and evaluation, job search assistance, benefits and legal counseling, disability management education, on-site job support (such as help negotiating with an employer), job-related problem-solving, specific skills training (such as learning to use public transportation), referral to auxiliary services, coordination and collaboration with other service providers, and other miscellaneous wrap-around services.

Control:

The study used a pre/post intervention design without a control or comparison condition.

Findings:

Of 148 participants in the project, 114 (77%) were employed at some point during the project. They held a total of 278 jobs during the project, averaging 2.4 jobs per participant. Sixty-three percent of participants were employed for 90 days or longer during the project, Earnings ranged from $2.50 per hour to $44.23 per hour, with an average hourly wage of $8.49 (median $7.50/hour). Of the 278 jobs, only 4 paid less than minimum wage. The vast majority of all jobs obtained (87.4%) did not include any benefits at any time.

Conclusions:

The fact that they achieved such high employment rates in the KEEP project supports the evidence that for people with a variety of disabilities, a history of competitive employment, no matter how limited, can be considered an indicator for future employment success. Employment also contributed to improved health and physical functioning.

URL:

http://content.iospress.com/articles/journal-of-vocational-rehabilitation/jvr00278

Disabilities:

Emotional disturbance

Populations:

Hispanic or Latino

Black / African American

White / Caucasian

Urban

Outcomes:

NIDILRR Funded:

Research Design:

Specific learning disabilities

Peer Reviewed:

Yes

An evaluation of the efficacy of training people with learning disabilities in a virtual environment

Authors:

Brouwers, E. P. M., Tiemens, B. G., Terluin, B., & Verhaak, P. F. M.

Year Published:

2002

Publication:

Disability and Rehabilitation

Volume:

Number:

Pages:

622-626

Publisher:

Informa Healthcare

Background:

The majority of people with learning disabilities in the United Kingdom do not get the opportunity to work because they are often denied appropriate vocational training.

Purpose:

To evaluate the efficacy of using a virtual kitchen for vocational training of people with learning disabilities.

Setting:

The settings were schools for training in catering for individuals with disabilities in the United Kingdom.

Sample:

The sample size included 24 catering students with learning disabilities.

Data Collection:

Pre-test, post-test, and improvement scores were collected.

Intervention:

The intervention was vocational training in food preparation in the virtual kitchen, real training and using traditional workbook methods.

Control:

Students were their own controls.

Findings:

Virtual training was found to be as beneficial as really training and more beneficial than workbook training.

Conclusions:

Vocational students with learning disabilities were able to use the virtual environment and were motivated to learn using this training method. Depending on the task being trained, virtual training had a more beneficial effect on real task performance than workbook training, even when the virtual kitchen was not modeled on the real training kitchen. (p. 622)

URL:

http://www.ncbi.nlm.nih.gov/pubmed/12182802

Disabilities:

Populations:

Outcomes:

Other

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Rehabilitation of injured workers with chronic pain: A stage of change phenomenon

Authors:

Yamamoto, S., Unruh, D., & Bullis, M

Year Published:

2007

Publication:

Journal of Occupational Rehabilitation

Volume:

Number:

Pages:

727-742

Publisher:

Springer

Background:

Work-related injuries incur direct and indirect losses to workers, industry, and society, as well as quality-of-life costs to the injured workers families. Direct costs include wages, disability settlements and pensions, assessment and treatment provided by the health care system,diagnostic examinations, hospitalizations, and surgery. Indirect costs include loss of work productivity from the injured workers, employers, and their families, training of replacement workers, lost tax revenues, and administrative expenses. Quality-of-life costs relate to the losses stemming from the chronic pain experienced by the injured workers and other psychosocial burdens on their families. To minimize these losses, the primary goal of rehabilitation have been to improve work capacity and achieve early return to work (RTW).

Purpose:

This study was designed to explore the stages of change involved in return to work (RTW) for a group of workers who had been suffering from chronic pain.

Setting:

The setting included Hong Kong Workers Health Center and the Department of Rehabilitation Sciences of The Hong Kong Polytechnic University.

Sample:

The study sample included 67 injured workers between the ages of 20 and 60.

Data Collection:

Assessments of the participants on various measures were conducted before and during the program, and at the end of the follow-up period (3 months post program).

Intervention:

The intervention was a 6 week return to work program divided into a three week rehabilitation/ readiness component and a three-week placement component.

Control:

There was no control or comparison condition.

Findings:

The overall RTW rate of the participants was 65.7%. Most importantly, the participants RTW outcomes were found to be significantly predicted by their readiness for RTW (action) at the baseline. In the third week, their RTW was significantly predicted by their confidence in returning to work and their readiness for RTW (action). By the sixth week, their RTW outcomes were predicted by their readiness for RTW (pre-contemplation).

Conclusions:

The results enable us to better understand the stage-of-change factors that might influence injured workers, resumption of a productive work role and the rehabilitation process of RTW.

URL:

http://www.ncbi.nlm.nih.gov/pubmed/17955346

Populations:

Outcomes:

Return to work

NIDILRR Funded:

Research Design: