*Poster 18: Application of a Qualitative Methodology to Rate Pre- and Posttraumatic Brain Injury Employment

Objective: Little is known about qualitative differences between preinjury and postinjury jobs of individuals with traumatic brain injury (TBI). This paper describes a methodology used to rate jobs held by individuals with TBI, in terms of worker characteristics and occupational requirements, by utilizing the O*NET database. The information obtained will be used in the next phase of a project to make meaningful comparisons between pre- and postinjury employment and explore vocational trajectories for individuals post-TBI. The O*NET is the official standardized occupational classification system available by the U.S. Department of Labor and provides detailed information on 965 occupations. The primary objective of the study was to assess the interrater reliability of O*NET ratings using detailed job descriptions rather than job titles alone. Design: Observational, cross-sectional study. Setting: Research center at a large, urban medical center. Participants: Participants were 201 community-dwelling adults with TBI who were employed at the time of injury. A comprehensive vocational history on pre- and post-TBI jobs was obtained through a semi-structured interview, and included detailed information on each job held by a participant over his/her lifetime, including job title, type of business, major activities and duties, duration, and earnings. Interventions: None. Main Outcome Measures: Interrater agreement between O*NET occupational codes assigned by 2 pairs of raters based on detailed job information. Results: Interrater agreement rate was 69.6% for the first pair of raters, and 56.9% for the second pair of raters at the lowest level of the detailed O*NET occupations (8 digits), yielding a combined interrater agreement rate of 63.3%. Conclusions: The study revealed that coding of occupations using the O*NET database is an appropriate methodology for obtaining qualitative information on vocational characteristics. The use of open-ended qualitative job data appeared to improve the reliability of the rating system compared to past research. This qualitative methodology allows for a more comprehensive investigation of vocational history that will expand our understanding of post-TBI vocational functioning.