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Research Objectives
To determine whether a Customized Employment (CE) model adapted for SCI rehabilitation
(ACCESS-Vets) is more effective than standard care (IPS) for helping Veterans with
Spinal Cord Injury obtain and maintain employment. Previously, Individual Placement
and Support Supported Employment is the only vocational intervention that has been
rigorously studied and shown to be effective with Veterans with spinal cord injury.
Design
4-year, 2-site randomized clinical trial, concurrent mixed methods.
Setting
VA Medical Centers, Tampa and Richmond.
Participants
100 Veterans with SCI ages 18-65, who desire employment and live near the VAMC will
be randomly assigned using a priori generated matrix and complete surveys at baseline,
6, 9, and 12 months. A sub-sample of 30 Veterans and 20 providers will complete qualitative
interviews.
Interventions
CE using the following elements: Discovery, job planning, development, negotiation,
accommodations and retention supports. Control group: IPS using evidence-based supported
employment. Assignment is unblinded. The primary adaptation will be integrating CE
into medical rehabilitation.
Main Outcome Measures
Competitive integrated employment as defined by the Work Innovation and Opportunity
Act7. Secondary outcomes: employment indicators, quality of life (QOL) and participation.
Results
168 medical records reviewed for basic inclusion/exclusion criteria, 26 Veterans screened,
11 met inclusion criteria and were enrolled. Of the 11 participants enrolled 7 completed
baseline surveys and were randomized to treatment arms (intervention n=3; control
n=4).
Conclusions
The proportion of Veterans who attain employment will be greater for the ACCESS-Vets
than IPS group and they will have higher job satisfaction, wages and retention. Employed
Veterans will demonstrate significant improvements in self-sufficiency, QOL, and participation.
Interview data will show how strategies used in the adapted intervention and standard
care address barriers to employment and impact outcomes.
Author(s) Disclosures
The authors declare that they have no conflict of interest.Funding and disclaimer:
VA Office of Research and Development, VA Rehabilitation Research and Development
(RR&D) #D3349R. Contents of this poster do not represent the views of the Department
of Veterans Affairs or the United States Government. Clinical trial # NCT04832802
Key Words
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© 2022 Published by Elsevier Inc.
