Elizabeth da Silva Cardoso

Disparities in vocational rehabilitation services and outcomes for Hispanic clients with traumatic brain injury: do they exist?

ObjectiveExamine disparities in vocational rehabilitation (VR) services for Hispanic clients with traumatic brain injury. DesignLogistic regression analysis of secondary data. ParticipantsFive thousand eight hundred thirty-one European American and Hispanic clients. Main Outcome MeasuresType of services and employment status. ResultsEuropean Americans were 1.27 times more likely to obtain employment than were Hispanics. Hispanics with work disincentives had lower odds of returning to work and had more unmet basic needs (eg, food, shelter, and transportation) that need to be addressed in the rehabilitation process. Job placement and on-the-job support services were found to significantly improve employment outcomes. However, on-the-job support services were more likely to be provided to European Americans than to Hispanics.

State vocational services and employment in cancer survivors

BackgroundThis study investigated the association of state vocational rehabilitation services in the USA and work outcomes of cancer survivors who were unemployed prior to receipt of services.MethodsAdministrative data obtained during fiscal year 2005 from the Rehabilitation Services Administration (RSA) database consisting of 1,201 closed cases with the diagnosis of cancer formed the sample of this study. All cancer survivors were unemployed at the time of application. Data on demographic characteristics, employment and vocational service variables were extracted and analyzed in relation to employment outcome data. Multivariate logistic regression was used to examine the relationship among services provided and work outcomes accounting for demographic characteristics of the participants.ResultsCancer survivors represented 0.4% of the total population that received vocational services in the state-federal vocational rehabilitation program. Of the unemployed cancer survivors who received services, 903 (57%) achieved successful employment while 670 (43%) were not employed following receipt of services. Gender (women; OR = 0.77, 95% CI = 0.61–0.97), lower educational levels (OR = 0.52, 95% CI = 0.33–0.81), provision of cash or medical benefits (e.g., Social Security Disability Insurance benefits; OR = 0.64, 95% CI = 0.50–0.82) were all associated with a greater likelihood of being unemployed at the end of vocational services. Counseling (OR = 1.33, 95% CI = 1.02–1.73), miscellaneous training (OR = 1.61, 95% CI = 1.06–2.44), rehabilitation technology services (OR = 1.22, 95% CI = 0.72–2.08), job placement services (OR = 2.37, 95% CI = 1.72–3.27), job search assistance (OR = 1.43; 95% CI = 1.02–2.01) maintenance services (OR = 1.92, 95% CI = 1.29–2.86), and other services (OR = 1.43, 95% CI = 1.07–1.90) were found to be significantly associated with increased odds for employment.ConclusionVocational rehabilitation services were found to be associated with employment status. Future studies investigating the specific effects of certain vocational services for unemployed cancer survivors who qualify for these services are warranted.Implications for cancer survivorsCancer survivors who are seeking employment or experiencing problems maintaining employment who can qualify should be encouraged to pursue services from state vocational rehabilitation agencies. Medical providers should also become familiar with services offered by state vocational rehabilitation agencies and consider the use of these services..

State vocational rehabilitation services and employment in multiple sclerosis

Background: Obtaining and maintaining suitable employment can be a significant challenge for people with multiple sclerosis (MS). Objective: The objective of this article is to identify what vocational rehabilitation (VR) services helped MS clients obtain and maintain employment, after controlling for the effect of demographic covariates and disability-related government benefits. Methods: We retrieved data from the Rehabilitation Services Administration (RSA) 911 database in the fiscal year (FY) 2009, and used VR services as predictors to predict employment outcomes of people with MS by hierarchical logistic regression. Results: A total of 924 out of 1920 MS clients (48.1%) were successfully employed after receiving VR services. Logistic regression analysis results indicated that cash benefits (OR =0.51, p < 0.001) and public medical benefits (OR =0.76, p < 0.01) were negatively associated with employment outcomes, whereas counseling and guidance (OR = 1.68, p < 0.001), job placement assistance (OR = 2.43, p < 0.001), on-the-job supports (OR = 1.62, p < 0.01), maintenance services (OR = 1.59, p < 0.01), and assistive technology services (OR =2.09, p < 0.001) were significant predictors of positive employment outcomes. Conclusion: VR services were found to be associated with employment status. MS patients experiencing problems obtaining or maintaining employment should be encouraged to pursue services from state VR agencies.

Measuring Readiness to Change Among Individuals in Residential Therapeutic Community Programs for Treatment of Substance Abuse

The Stages of Change Scale—Substance Abuse (SCS-SA) was developed to measure readiness to change among individuals in treatment for substance abuse and was field tested with 457 participants in 7 therapeutic community programs in 4 different states. Factor analysis on SCS-SA items defined 4 subscales: Precontemplation, Determination, Participation, and Relapse. Using cluster analysis, 4 clusters of participants were identified, based on their profiles of SCS-SA subscale scores: (a) Indifferent, (b) Active Participation—Realistic, (c) Active Participation—Optimistic, and (d) Conforming. Finally, a discriminant analysis indicated significant differentiation among the clusters on the basis of sense of coherence scores. With continuing research to document reliability and validity, the SCS-SA appears to have potential in facilitating treatment planning and research to better understand readiness to change.

Life skills and subjective well-being of people with disabilities: a canonical correlation analysis.

This study examined the canonical relationships between a set of life skill variables and a set of subjective well-being variables among a national sample of vocational rehabilitation clients in the USA. Self-direction, work tolerance, general employability, and self-care were related to physical, family and social, and financial well-being. This analysis also found that communication skill is related to family and social well-being, while psychological well-being is not related to any life skills in the set. The results showed that vocational rehabilitation services aimed to improve life functioning will lead to an improvement in subjective quality of life.

Vocational Services as Intervention for Substance Abuse Rehabilitation: Implications for Addiction Studies Education.

ABSTRACT This study examined factors influencing employment outcomes of people with substance-related disorders (SRDs) in state vocational rehabilitation (VR) agencies. The sample included 34,774 VR clients with SRDs from fiscal year 2001. Mean age of participants was 38.35 years. Predictor variables included personal and service variables and the criterion was employment. The chi-squared automatic interaction detector (CHAID) analysis indicated that job placement was the most significant predictor of employment for people with SRDs. Additional variables predicting employment were other services, substantial counseling, restoration services, case expenditures, being married, and work disincentives. The CHAID analysis provided useful information about effective VR services for people with SRDs. Implications for addictive studies education were discussed.

Social-Cognitive Predictors of STEM Career Interests and Goal Persistence in College Students with Disabilities from Racial and Ethnic Minority Backgrounds.

Objective: To examine the relations of science, technology, engineering, and mathematics’s (STEM) self-efficacy, outcome expectations, interests, and contextual supports and barriers to STEM educational goals in college students with disabilities from racial and ethnic minority backgrounds Design: Quantitative descriptive research design using hierarchical regression analysis (HRA) Participants: 115 underrepresented minority students with disabilities receiving services from the National Science Foundation (NSF) funded Minority-Disability (MIND) Alliance in STEM project at Hunter College, City University of New York and Southern University at Baton Rouge for the years 2008−2011. Outcome Measures: The Social-Cognitive STEM measures Results: The HRA results indicated that gender, advanced placement (AP) classes, father’s educational level, academic milestone self-efficacy, and STEM interest were significant predictors of goal persistence in African American and Hispanic college students with disabilities. The final model accounted for 57% of the variance in STEM persistence, which is considered a large effect size. Conclusion: The research findings provide good support for the use of the social cognitive career theory (SCCT) framework to identify predictors of STEM persistence and to design academic retention services and career development interventions for college students who are underrepresented minorities with disabilities.

Training Needs of Rehabilitation Counselors concerning Alcohol and Other Drugs Abuse Assessment and Treatment.

Forty-two rehabilitation counselors participated in a study regarding perceived training needs concerning alcohol and other drug abuse (AODA) treatment and assessment. Participants reported that 85% of consumers with whom they worked had AODA issues, yet over half rated their graduate training in AODA treatment and assessment as poor, and their practices were marginally proficient. Referral to self-help groups and cognitive-behavioral coping skills training were common intervention approaches. A change of curriculum requirements, continuing education opportunities and other professional training websites should be considered as an outlet to improve rehabilitation counselors’ competency to serve consumers with AODA issues.

Core Self-Evaluations as a Mediator between Functional Disability and Life Satisfaction in College Students with Disabilities Majoring in Science and Technology.

Purpose: To examine the mediational effect of core self-evaluations (CSE) on the relationship between functional disability and life satisfaction. Methods: A quantitative descriptive design using multiple regression analysis. The participants were 97 college students with disabilities receiving services through Hunter College’s Minority-Disability Alliance (MIND Alliance) in science, technology, engineering, and mathematics. Results: CSE was a partial mediator between functional disability and life satisfaction. After controlling for CSE, functional disability was no longer a significant predictor of life satisfaction. Conclusions: CSE partially mediated the impact of functional disability on life satisfaction. Future research should explore the development of interventions to increase CSE to reduce the effect of disability and to improve life satisfaction and employment outcomes for individuals with disabilities.

College Graduation to Employment in STEM Careers: The Experience of New Graduates at the Intersection of Underrepresented Racial/Ethnic Minority Status and Disability.

Purpose: To examine the recent labor market indicators of science, technology, engineering, and mathematics (STEM) versus non-STEM college graduates with disabilities. Method: The sample included bachelor of science (B.S.)/B.S.-level college graduates including 1,567,527 with a disability and 32,512,446 without a disability. Data were derived from the American Community Survey public use microdata files 2009–2011 inclusive. Three measures of labor market activity were used: labor force participation rate, unemployment ratio, and employment-to-population ratio. Results: Nonparametric tests of proportion with stringent alpha levels indicated that overall labor market participation was much lower for graduates with disabilities. Indicators improved somewhat for STEM graduates with disabilities perhaps because they persisted longer in their job search efforts. Within the sample of STEM graduates with disabilities, Whites experienced greater labor market participation than ethnic minorities. It was also found that supply-side interventions to improve STEM employment (i.e., government investment) have been markedly less effective than demand-side interventions (i.e., expanded recruitment of foreign STEM degree holders). Conclusion: Recent labor economics data and the expanded recruitment of foreign STEM degree holders bring into question whether or not a true STEM crisis exists today.