title: Facilitators and barriers to employment among veterans with spinal cord injury receiving 12 months of evidence-based supported employment services.
abstract: BACKGROUND
  Return to work is associated with positive rehabilitation outcomes for persons with spinal cord injury (SCI); however, more research is needed on vocational support for persons with disabilities seeking employment.
  
  
  OBJECTIVE
  The association between facilitators and barriers of employment and employment outcome was examined among Veterans with SCI who participated in an evidence-based supported employment (EBSE) program.
  
  
  METHODS
  Using a mixed-methods, nested case-control design, data on facilitators and barriers to employment were extracted from qualitative interviews and quantitative measures administered in person to 34 Veterans with SCI who completed 12 months of an EBSE program. Participants who did (case) and did not (control) obtain competitive employment were matched on time since SCI. Facilitators and barriers to employment were compared between the groups.
  
  
  RESULTS
  Self-report measures administered at baseline were examined; there were no statistically significant factors that predicted employment outcomes after 12 months of EBSE program participation. Qualitative interview data revealed program-specific facilitators and Veteran characteristics that were associated with employment outcomes.
  
  
  CONCLUSIONS
  Qualitative data illustrate how the integration of the vocational rehabilitation specialist on the medical team is helpful for addressing identified disability-specific barriers, including practical matters such as transportation and caregiving schedules, to facilitate employment outcomes.
authors.affiliation: VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital , Tampa, Florida.
authors.forename: Bridget A
authors.initials: BA
authors.lastname: Cotner
authors.affiliation: VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital , Tampa, Florida.
authors.forename: Eni N
authors.initials: EN
authors.lastname: Njoh
authors.affiliation: VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital , Tampa, Florida.
authors.forename: John K
authors.initials: JK
authors.lastname: Trainor
authors.affiliation: VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital , Tampa, Florida.
authors.forename: Danielle R
authors.initials: DR
authors.lastname: O'Connor
authors.affiliation: VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital , Tampa, Florida ; Institute for Credentialing Research, American Nurses Credentialing Center , Washington, DC.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Barnett
authors.affiliation: VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital , Tampa, Florida ; Department of Rehabilitation and Mental Health Counseling, University of South Florida , Tampa, Florida.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ottomanelli
mesh_terms: D000328:Adult; D001107:Architectural Accessibility; D016022:Case-Control Studies; D003201:Computers; D003863:Depression / Q000150:complications; D004185:Disability Evaluation; D004522:Educational Status; D004651:Employment / Q000523:psychology; D016832:Employment, Supported / Q000458:organization & administration; D055317:Evidence-Based Practice; D005221:Fatigue / Q000150:complications; D005260:Female; D006304:Health Status; D006801:Humans; D018868:Insurance, Disability / Q000191:economics; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010348:Patient Care Team / Q000458:organization & administration; D011788:Quality of Life; D012656:Self-Help Devices; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D014186:Transportation; D014728:Veterans
keywords: Veterans; spinal cord injury; supported employment; vocational rehabilitation