This work was supported by the VA Health Services Research & Development Center for Healthcare Organization and Implementation Research, which provided financial support only.
Supported Employment, Traumatic Brain Injury, Veterans Interdisciplinary Health Team, Community Integration
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.
Pogoda TK, Carlson KF, Gormley KE, Resnick SG, Supported Employment for Veterans with Traumatic Brain Injury: Provider Perspectives, ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION (2017), doi: 10.1016/j.apmr.2017.06.029.