Effectiveness of Supported Employment for Veterans With Spinal Cord Injuries: Results From a Randomized Multisite Study

Ottomanelli, Lisa; Goetz, Lance L.; Surís, Alina; McGeough, Charles; Sinnott, Patricia L.; Toscano, Rich; Barnett, Scott D.; Cipher, Daisha J.; Lind, Lisa; Dixon, Thomas M.; Holmes, Sally Ann; Kerrigan, Anthony J.; Thomas, Florian P.

doi:10.1016/j.apmr.2012.01.002

Cited by 90 publications

(83 citation statements)

References 26 publications

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“…Individuals receiving SE were 2.5 times more likely to gain employment than those receiving usual care at the site offering the intervention, and 11.4 times more likely than those receiving usual care at a site that did not. 12 Study authors noted that at the site offering the SE intervention, there was an elevated awareness and attention to vocational issues, and that this translated into increased use of conventional vocational rehabilitation services among the control group. This highlights the positive impact that established vocational rehabilitation programs can have if they are adequately promoted and utilized, in addition to added benefit from greater integration and personalization of services.…”

Section: Discussionmentioning

confidence: 99%

“…12 This trial included an intervention site with a group that received SE, a control group which received treatment as usual along with a control group at another site. It was found that individuals receiving SE were 2.5 times more likely to obtain competitive employment than individuals who received treatment as usual at the same site, and 11.4 times more likely than those in the control group at the other site.…”

Section: Study Selectionmentioning

confidence: 99%

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Interventions for improving employment outcomes among individuals with spinal cord injury: A systematic review

2014

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databases was performed on 31 December 2013. To be included in the review, studies needed to investigate interventions among individuals with SCI where employment was an outcome. Exclusion criteria include (i) reviews, (ii) studies not published in English and (iii) non-peer reviewed publications. Results: Fourteen studies met the inclusion criteria, two were randomized controlled trials. The strongest evidence finds that supported employment can improve employment outcomes among individuals with SCI. The use of service dogs has also been shown to improve employment outcomes. The remaining 12 studies are observational and predominantly focus on vocational rehabilitation programs. Conclusion: There is a dearth of high-quality intervention research that targets employment outcomes in individuals with SCI. Consequently, conclusions are mostly based on evidence from observational studies. Vocational rehabilitation programs are the primary focus of this evidence, but conclusions may be confounded, as individuals may be self-selecting for these programs. Additional randomized trials on employment interventions are needed to overcome these limitations. Studies should aim to identify which components of these programs have the greatest influence on employment outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Interventions for improving employment outcomes among individuals with spinal cord injury: A systematic review

2014

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“…This may foster cultural change within the team and significantly enhance client access to VR services. 34 …”

Section: Challenges In Early Interventionmentioning

confidence: 99%

Integrated services and early intervention in the vocational rehabilitation of people with spinal cord injuries

Bloom

Dorsett

McLennan

2017

Spinal Cord Ser Cases

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INTRODUCTION:The design was a narrative review. The objective of the study was to investigate the potential for early vocational rehabilitation (VR) interventions for people with spinal cord injury (SCI) in overcoming barriers in returning to work, and to pinpoint factors contributing to effectiveness in early VR intervention for this population. The setting was at Queensland, Australia. MATERIALS AND METHODS: Synthesis of the findings of a literature search of online databases ProQuest and CINAHL, using keywords relating to the employment situation and VR of people with SCI. Themes were identified and analysed in accordance with the research objectives. RESULTS: Despite increasing government commitment to the workforce and social participation of people with disabilities, Australians living with SCI have significantly diminished employment outcomes compared with the general population. Current VR approaches usually do not commence until some months post discharge, potentially missing a window of opportunity to preserve pre-existing employment or assist in vocational decision making. The review found that there are opportunities for enhancing VR service provision following SCI, namely integrating the VR programme within the primary rehabilitation team thus facilitating early VR intervention. DISCUSSION: Emerging evidence shows promising results for early intervention in VR; however, questions remain regarding ideal intervention approaches, and it is clear that further empirical investigation is required to support the use of early intervention models post SCI. The study was sponsored by Motor Accident Insurance Commission (MAIC).

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“…It is noticeable that two studies describe the same intervention in the same population over 1 and 2 years. 15,16 Table 2 shows the design and the quality of the included studies. All studies involve a total of 2053 subjects; however, many studies were non-comparative case studies [17][18][19][20][21][22] or case series.…”

Section: Resultsmentioning

confidence: 99%

Hospital- and community-based interventions enhancing (re)employment for people with spinal cord injury: a systematic review

et al. 2015

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Study design: Systematic Review. Objectives: To investigate the effect of interventions enhancing (re)employment following spinal cord injury (SCI). Setting: Studies from multiple countries were included. Methods: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, PsycINFO and SPORTDISCUS databases were searched. Randomized controlled trials (RCTs) and non-randomized studies (NRSs) describing a hospital-or a community-based intervention aiming at employment in a SCI population were selected. Quality appraisal was done using the SIGN methodology, and the quality of evidence was graded using the Grade approach. Data extraction was performed according to the Cochrane Handbook. Employment rate and duration were primary outcomes. Results: Only one RCT, including 201 patients describing an intervention over 1 and 2 years, was of sufficient quality. In this study, the employment rate was 26% after 1 and 31% after 2 years for competitive work, compared with 10% in the treatment as usual-intervention site (TAU-IS) control group and 2% in the treatment as usual observational site (TAU-OS) after 1 and 2 years. Other studies were of low quality and describe higher employment rates from 36 to 100%. Conclusions: Only one RCT was of sufficient quality and showed evidence that a vocational rehabilitation programme based on the principles of supported employment integrated in a multidisciplinary team enhances employment for SCI people. As the vast majority of studies included in this review are of low methodological quality, further research is needed.

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Effectiveness of Supported Employment for Veterans With Spinal Cord Injuries: Results From a Randomized Multisite Study

Cited by 90 publications

References 26 publications

Interventions for improving employment outcomes among individuals with spinal cord injury: A systematic review

Interventions for improving employment outcomes among individuals with spinal cord injury: A systematic review

Integrated services and early intervention in the vocational rehabilitation of people with spinal cord injuries

Hospital- and community-based interventions enhancing (re)employment for people with spinal cord injury: a systematic review

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