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

Publication date: Available online 20 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Lisa Ottomanelli, Lance L. Goetz, Scott D. Barnett, Eni Njoh, Thomas M. Dixon, Sally Ann Holmes, James LePage, Doug Ota, Sunil Sabharwal, Kevin T. White
ObjectiveTo 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).DesignLongitudinal, observational multi-site study of a single arm, non-randomized cohort.SettingSCI centers in the Veterans Health Administration (VHA) (n=7).ParticipantsVeterans 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).Intervention(s)IPS SE for 24 months.Main Outcome Measure(s)Competitive employment (CE).ResultsOver 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.Conclusion(s): 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.



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