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Background: Individual Placement and Support (IPS) is an evidence-based practice that helps persons with mental and/ or physical disabilities, including spinal cord injury, find meaningful employment in the community. While employment is associated with positive rehabilitation outcomes, more research is needed on the impact of IPS participation on non-vocational outcomes, particularly quality of life (QOL). Objective: To identity QOL outcomes experienced with (1) IPS participation and (2) IPS participation leading to employment. Methods: Using a mixed method design, data on quality of life outcomes were collected from 151 interviews and 213 surveys completed by veterans with SCI participating in IPS. Results: At 12 months, participants who obtained competitive employment (CE) and those who did not (no-CE) showed improvement on most measures. In months 12-24, the CE group showed improvements on all study measures while the no-CE group declined on many indices. Statistically significant changes were observed between participants who obtained CE versus no-CE on several measures. Themes were identified from interview data related to productivity and well-being. Productivity themes were (1) contributing to society, (2) earning an income, and (3) maintaining employment. Themes for well-being were (1) mental health/self-confidence, (2) physical health, and (3) goal setting. Themes were associated with IPS participation irrespective of employment outcomes. Conclusion: IPS participants who were competitively employed report consistent improvement in handicap, health-related QOL, and life satisfaction measures across time. Qualitative findings revealed improved QOL outcomes in productivity and well-being for veterans participating in IPS overall, regardless of employment outcomes.

Background:Return to work is associated with positive rehabilitation outcomes for persons with spinal cord injury (SCI); however, more research is needed on vocational support for persons with disabilities seeking employment. Objective: The association between facilitators and barriers of employment and employment outcome was examined among Veterans with SCI who participated in an evidence-based supported employment (EBSE) program. Methods: Using a mixed-methods, nested case-control design, data on facilitators and barriers to employment were extracted from qualitative interviews and quantitative measures administered in person to 34 Veterans with SCI who completed 12 months of an EBSE program. Participants who did (case) and did not (control) obtain competitive employment were matched on time since SCI. Facilitators and barriers to employment were compared between the groups. Results: Self-report measures administered at baseline were examined; there were no statistically significant factors that predicted employment outcomes after 12 months of EBSE program participation. Qualitative interview data revealed program-specific facilitators and Veteran characteristics that were associated with employment outcomes. Conclusions: Qualitative data illustrate how the integration of the vocational rehabilitation specialist on the medical team is helpful for addressing identified disability-specific barriers, including practical matters such as transportation and caregiving schedules, to facilitate employment outcomes.

Reintegration is known to be a difficult time for veterans. Peer support programs offer a good strategy for military and veterans, particularly as it relates to reintegration. We review an innovative, peer support program implemented at a veteran run community agricultural initiative (CAI). This project was a case-study evaluation using a mixed methods design including participant observations; qualitative interviews with a total of 34 CAI members and affiliates; and administered surveys to a total of 67 CAI members and affiliates. Survey results suggested that CAI participation contributed to improvements in communication, forming bonds, and developing new friendships with veterans, non-veterans, family members, and strangers, as well as increased involvement in community events. Interviews revealed that the CAI's informal peer-support culture and intentional normalization of sharing stories helped promote wellness and reintegration. The CAI continues to refine its peer support model. The organization is overcoming common barriers by leveraging community partnerships to bring veterans into the fold and expanding their peer support model to veteran organizations with similar missions. This approach will ultimately lead to a culture of peer support across agencies and spread the reach of the CAI's mission for veterans.

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