title: State vocational services and employment in cancer survivors.
abstract: BACKGROUND
  This study investigated the association of state vocational rehabilitation services in the USA and work outcomes of cancer survivors who were unemployed prior to receipt of services.
  
  
  METHODS
  Administrative data obtained during fiscal year 2005 from the Rehabilitation Services Administration (RSA) database consisting of 1,201 closed cases with the diagnosis of cancer formed the sample of this study. All cancer survivors were unemployed at the time of application. Data on demographic characteristics, employment and vocational service variables were extracted and analyzed in relation to employment outcome data. Multivariate logistic regression was used to examine the relationship among services provided and work outcomes accounting for demographic characteristics of the participants.
  
  
  RESULTS
  Cancer survivors represented 0.4% of the total population that received vocational services in the state-federal vocational rehabilitation program. Of the unemployed cancer survivors who received services, 903 (57%) achieved successful employment while 670 (43%) were not employed following receipt of services. Gender (women; OR = 0.77, 95% CI = 0.61-0.97), lower educational levels (OR = 0.52, 95% CI = 0.33-0.81), provision of cash or medical benefits (e.g., Social Security Disability Insurance benefits; OR = 0.64, 95% CI = 0.50-0.82) were all associated with a greater likelihood of being unemployed at the end of vocational services. Counseling (OR = 1.33, 95% CI = 1.02-1.73), miscellaneous training (OR = 1.61, 95% CI = 1.06-2.44), rehabilitation technology services (OR = 1.22, 95% CI = 0.72-2.08), job placement services (OR = 2.37, 95% CI = 1.72-3.27), job search assistance (OR = 1.43; 95% CI = 1.02-2.01) maintenance services (OR = 1.92, 95% CI = 1.29-2.86), and other services (OR = 1.43, 95% CI = 1.07-1.90) were found to be significantly associated with increased odds for employment.
  
  
  CONCLUSIONS
  Vocational rehabilitation services were found to be associated with employment status. Future studies investigating the specific effects of certain vocational services for unemployed cancer survivors who qualify for these services are warranted.
  
  
  CONCLUSIONS
  Cancer survivors who are seeking employment or experiencing problems maintaining employment who can qualify should be encouraged to pursue services from state vocational rehabilitation agencies. Medical providers should also become familiar with services offered by state vocational rehabilitation agencies and consider the use of these services..
authors.affiliation: Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, Madison, WI 53706, USA. chan@education.wisc.edu
authors.forename: Fong
authors.initials: F
authors.lastname: Chan
authors.forename: David
authors.initials: D
authors.lastname: Strauser
authors.forename: Elizabeth
authors.initials: E
authors.lastname: da Silva Cardoso
authors.forename: Lisa
authors.initials: L
authors.lastname: Xi Zheng
authors.forename: Jacob Y C
authors.initials: JY
authors.lastname: Chan
authors.forename: Michael
authors.initials: M
authors.lastname: Feuerstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004651:Employment / Q000706:statistics & numerical data; D016832:Employment, Supported / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000534:rehabilitation*; D012050:Rehabilitation, Vocational / Q000191:economics / Q000706:statistics & numerical data; D013219:State Government; D017741:Survivors / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult
references.citation: Psychooncology. 2005 Nov;14(11):992-1004
references.pmid: 15744780
references.citation: AAOHN J. 2007 Jul;55(7):290-5
references.pmid: 17665826
references.citation: Cancer. 2004 Oct 15;101(8):1703-11
references.pmid: 15386303
references.citation: Eur J Cancer. 2007 Mar;43(5):914-20
references.pmid: 17314041
references.citation: CA Cancer J Clin. 2005 Sep-Oct;55(5):271-80
references.pmid: 16166073
references.citation: Psychooncology. 2002 May-Jun;11(3):188-98
references.pmid: 12112479
references.citation: Cancer. 2006 Jul 1;107(1):1-11
references.pmid: 16718655
references.citation: J Clin Oncol. 2006 Jan 20;24(3):345-53
references.pmid: 16421415
references.citation: Cancer. 2003 May 15;97(10):2554-64
references.pmid: 12733155
references.citation: Psychooncology. 2002 Mar-Apr;11(2):124-31
references.pmid: 11921328
references.citation: Health Soc Work. 1994 Aug;19(3):227-30
references.pmid: 7959406
references.citation: Acta Oncol. 2007;46(4):446-51
references.pmid: 17497311
references.citation: J Clin Oncol. 2006 Nov 10;24(32):5138-41
references.pmid: 17093276
references.citation: Cancer. 2005 Mar 15;103(6):1292-301
references.pmid: 15700265
references.citation: J Cancer Surviv. 2007 Sep;1(3):185-92
references.pmid: 18648969
references.citation: Cancer. 1991 Jan 1;67(1):206-13
references.pmid: 1985719