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Individual Placement and Support in Spinal Cord Injury: A Longitudinal Observational Study of Employment Outcomes.

Research paper by Lisa L Ottomanelli, Lance L LL Goetz, Scott D SD Barnett, Eni E Njoh, Thomas M TM Dixon, Sally Ann SA Holmes, James J LePage, Doug D Ota, Sunil S Sabharwal, Kevin T KT White

Indexed on: 25 Jan '17Published on: 25 Jan '17Published in: Archives of Physical Medicine and Rehabilitation



Abstract

To determine the effects of a 24-month program of Individual Placement and Support (IPS) supported employment (SE) on employment outcomes for veterans with spinal cord injury (SCI).Longitudinal, observational multi-site study of a single arm, non-randomized cohort.SCI centers in the Veterans Health Administration (VHA) (n=7).Veterans with SCI (n=213) enrolled during an episode of either inpatient hospital care (24.4%) or outpatient care (75.6%). More than half the sample (59.2%) had a history of traumatic brain injury (TBI).IPS SE for 24 months.Competitive employment (CE).Over the 24-month period, 92 of the entire sample of 213 IPS participants obtained competitive jobs for an overall employment rate of 43.2%. For the subsample of participants without TBI enrolled as outpatients (n=69), 36 obtained competitive jobs for an overall employment rate of 52.2%. Overall, employed participants averaged 38.2 ± 29.7 weeks of employment, with an average time to first employment of 348.3 ± 220.0 days. Nearly 25% of 1(st) jobs occurred within 4 to 6 months of beginning the program. Similar employment characteristics were observed in the subsample without TBI histories enrolled as outpatients.Almost half of the veterans with SCI participating in the 24-month IPS program as part of their ongoing SCI care achieved CE, consistent with their expressed preferences at the start of the study. Among a sub-sample of veterans without any TBI history enrolled as outpatients, employment rates exceeded 50%. Time to first employment was highly variable, but quite long in many instances. These findings support offering continued IPS services as part of ongoing SCI care to achieve positive employment outcomes.