title: Effectiveness of supported employment for veterans with spinal cord injury: 2-year results.
abstract: OBJECTIVE
  To examine if supported employment (SE) remains more effective than treatment as usual (TAU) in returning veterans to competitive employment after spinal cord injury (SCI) at 2-year follow-up.
  
  
  METHODS
  Prospective, randomized, controlled, multisite trial of SE versus TAU with 24 months of follow-up.
  
  
  METHODS
  SCI centers.
  
  
  METHODS
  Subjects (N=201) were enrolled and completed baseline interviews. At interventional sites, subjects were randomized to SE (n=81) or TAU (n=76). At observational sites, 44 subjects were enrolled in a nonrandomized TAU condition.
  
  
  METHODS
  The intervention was a SE program called the SCI Vocational Integration Program, which followed the principles of the individual placement and support model of SE for persons with mental illness.
  
  
  METHODS
  Competitive employment in the community within 2 years.
  
  
  RESULTS
  For the entire 2-year follow-up period, SE subjects were significantly more likely to achieve employment (30.8%; 95% confidence interval [CI], 21.8-41.6) than either the TAU subjects at the intervention sites (10.5%; 95% CI, 5.2-19.7; P<.001) or the TAU subjects at the observational sites (2.3%; 95% CI, 0.0-12.9; P<.002). Most subjects who obtained competitive employment did so in year 1, and the average time to first employment was about 17 weeks.
  
  
  CONCLUSIONS
  SE was better than usual practices in improving employment outcomes for veterans with SCI across a 2-year follow-up period. Although SE continued to be superior to traditional practices over the entire study, the first year of participation in SE may represent a critical window for achieving employment after SCI.
authors: Veterans Affairs Health Services Research and Development (R&D)/Rehabilitation Research & Development Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans' Hospital, Tampa, FL; Department of Rehabilitation and Mental Health Counseling, University of South Florida, Tampa, FL. Electronic address: lisa.ottomanelli@va.gov.
authors: Lisa
authors: L
authors: Ottomanelli
authors: Veterans Affairs Health Services Research and Development (R&D)/Rehabilitation Research & Development Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans' Hospital, Tampa, FL.
authors: Scott D
authors: SD
authors: Barnett
authors: Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA.
authors: Lance L
authors: LL
authors: Goetz
mesh_terms: D000041:Absenteeism; D004651:Employment / Q000706:statistics & numerical data*; D016832:Employment, Supported; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D062707:Return to Work; D012456:Salaries and Fringe Benefits / Q000706:statistics & numerical data; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000534:rehabilitation*; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*
keywords: Employment, supported; Rehabilitation; Rehabilitation, vocational; Spinal cord injuries; Veterans