title: Individual Placement and Support in Spinal Cord Injury: A Longitudinal Observational Study of Employment Outcomes.
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 multisite study of a single-arm, nonrandomized cohort.
  
  
  
  SCI centers in the Veterans Health Administration (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.
  
  
  
  Over the 24-month period, 92 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 first jobs occurred within 4 to 6 months of beginning the program. Similar employment characteristics were observed in the subsample without TBI history 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 competitive employment, consistent with their expressed preferences at the start of the study. Among a subsample of veterans without TBI history enrolled as outpatients, employment rates were >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.
authors.affiliation: Veterans Affairs Health Services 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-slone@va.gov.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ottomanelli
authors.affiliation: Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA.
authors.forename: Lance L
authors.initials: LL
authors.lastname: Goetz
authors.affiliation: Veterans Affairs Health Services Research & Development Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans' Hospital, Tampa, FL.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Barnett
authors.affiliation: Veterans Affairs Health Services Research & Development Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans' Hospital, Tampa, FL.
authors.forename: Eni
authors.initials: E
authors.lastname: Njoh
authors.affiliation: Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Dixon
authors.affiliation: Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
authors.forename: Sally Ann
authors.initials: SA
authors.lastname: Holmes
authors.affiliation: Veterans Affairs North Texas Healthcare System, Dallas, TX; Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX.
authors.forename: James P
authors.initials: JP
authors.lastname: LePage
authors.affiliation: Veterans Affairs Palo Alto Health Care System, Palo Alto, CA; Division of Physical Medicine and Rehabilitation, Stanford University, Stanford, CA.
authors.forename: Doug
authors.initials: D
authors.lastname: Ota
authors.affiliation: Veterans Affairs Boston Health Care System, Boston, MA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA.
authors.forename: Sunil
authors.initials: S
authors.lastname: Sabharwal
authors.affiliation: Veterans Affairs Health Services Research & Development Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans' Hospital, Tampa, FL.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: White
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000453:epidemiology; D016832:Employment, Supported / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D062707:Return to Work / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000534:rehabilitation*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans
keywords: Employment, supported; Rehabilitation; Rehabilitation, vocational; Spinal cord injuries; Veterans