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Supported Employment, Traumatic Brain Injury, Veterans Interdisciplinary Health Team, Community Integration

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36 pages


Objective: In 2006, 13 sites were provided with one-time pilot funding to provide supported employment (SE) to Veterans with traumatic brain injury (TBI) history. In 2014, we surveyed SE providers at pilot and non-pilot sites that did not receive this funding. Our objectives were to identify any pilot and non-pilot site differences regarding current: (1) provision of SE to Veterans with TBI; (2) staffing and communication between the SE and polytrauma/TBI teams; and (3) provider perceptions on facilitators and barriers to providing, and suggestions for improving, SE.

Design: Mixed methods cross-sectional survey study.

Participants: Providers included a total of 54 SE supervisors and 90 vocational rehabilitation specialists (VRSs).

Main Outcome Measures: Web-based surveys of forced-choice and open-ended items included questions on SE team characteristics, communication with polytrauma/TBI teams, and experiences with providing SE to Veterans with TBI history.

Results: SE was provided to Veterans with TBI at 100% of pilot and 59.2% of non-pilot sites (p = .09). However, VRSs at pilot sites reported that communication with the polytrauma/TBI team about SE referrals was more frequent than at non-pilot sites (p = .003). In open-ended items, suggestions for improving SE were similar across pilot and non-pilot sites, and included increasing staffing for VRSs and case management, enhancing communication and education between SE and polytrauma/TBI teams, and expanding the scope of the SE program so that eligibility is based on employment support need, rather than diagnosis.

Conclusions: These findings may contribute to an evidence base that informs SE research and clinical directions on service provision, resource allocation, team integration efforts, and outreach to Veterans with TBI who have employment support needs.


Parts of this research were presented at the 2015 Annual Research Meeting of Academy Health, Minneapolis, MN (June 15, 2015); National Meeting of VA Health Services Research and Development Service, Philadelphia, PA (July 9, 2015); 2015 VA Office of Research & Development TBI State-of-the-Art Conference, Washington, DC (August 24, 2015); and the 2016 Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Summit, Falls Church, VA (September 13, 2016).

© 2017 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine

Authors' accepted manuscript of an article to be published in the Archives of Physical Medicine and Rehabilitation.



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