Liza M. Conyers

Expanding Understanding of HIV/AIDS and Employment Perspectives of Focus Groups

The employment-related issues and concerns of 46 individuals with HIV/AIDS diagnoses were explored using grounded theory methods. Participants, who ranged in age from 22 to 58 years, represented diverse ethnic backgrounds reflective of the emerging demographics of HIV and were at various stages of the employment process. The key categories that emerged from the data fell into 3 main areas: (a) impact of HIV/AIDS, (b) motivation to work, and (c) barriers to employment. The data analysis led to the expansion of the 5-construct, 6-process ecological model (Szymanski & Hershenson, 1998) by placing greater emphasis on the role of mediating factors in understanding the employment-related issues and concerns of people with HIV and in expanding the interpretation of the developmental process as it relates to emergent disability. Use of an ecological approach to rehabilitation planning is recommended.

The Effect of Early Childhood Intervention and Subsequent Special Education Services: Findings from the Chicago Child-Parent Centers:

This article explores patterns of special education services during the elementary grades among children who participated in either the Child-Parent Center (CPC) Preschool Program or other early childhood programs in the Chicago Public Schools. The study sample included 1,377 low-income, racial minority children in the Chicago Longitudinal Study. Controlling for family background characteristics that might affect educational performance, children who participated in Child-Parent Center preschool had a significantly lower rate of special education placement (12.5%) than the comparison group (18.4%), who participated in an alternative all-day kindergarten program. The estimated impact of CPC preschool intervention was best explained by the cognitive advantage hypothesis. This article provides support for the long-term impact of the CPC preschool intervention on special education outcomes.

Multigroup Ethnic Identity Measure Scores in a Sample of Adolescents From Zimbabwe

This study examined the structural validity of scores on the 20-item Multigroup Ethnic Identity Measure (MEIM; Phinney, 1992) in a group of 196 students attending secondary school in Zimbabwe. MEIM scores yielded 2 factors (Ethnic Identity, or EI, and Other Group Orientation, or OGO) as in previous studies, with the EI factor being more viable. Factor analysis of the 14 EI items resulted in a single factor, in contrast to findings of previous studies. The authors suggested that the OGO factor may be less viable in majority groups, that the EI items may best be explained by a single factor, and that the MEIM would benefit from more scale development work.

Examining the role of vocational rehabilitation on access to care and public health outcomes for people living with HIV/AIDS.

Abstract Purpose: The purpose of this study is to examine the role of vocational rehabilitation services in contributing to the goals of the National HIV/AIDS strategy. Three key research questions are addressed: (a) What is the relationship among factors associated with the use of vocational rehabilitation services for people living with HIV/AIDS? (b) Are the factors associated with use of vocational rehabilitation also associated with access to health care, supplemental employment services and reduced risk of HIV transmission? and (c) What unique role does use of vocational rehabilitation services play in access to health care and HIV prevention? Method: Survey research methods were used to collect data from a broad sample of volunteer respondents who represented diverse racial (37% Black, 37% White, 18% Latino, 7% other), gender (65% male, 34% female, 1% transgender) and sexual orientation (48% heterosexual, 44% gay, 8% bisexual) backgrounds. Results: The fit of the final structural equation model was good (root mean square error of approximation = 0.055), with 90% upper bound of 0.058, Comparative Fit Index = 0.953, TLI = 0.945). Standardized effects with bootstrap confidence intervals are reported. Conclusions: Overall, the findings support the hypothesis that vocational rehabilitation services can play an important role in health and prevention strategies outlined in the National HIV/AIDS strategy. Implications for Rehabilitation Vocational rehabilitation services can play a unique role in contributing to the goals of the National HIV/AIDS strategy by increasing access to care, increasing use of job support services and reducing health-risk behaviors. Increased job confidence and more positive health perception reduced HIV stigma, which is a key mediator to use of vocational rehabilitation services. The Behavioral Model of Vulnerable Populations is a useful framework to evaluate the impact of vocational rehabilitation services on access to health care and health-risk behaviors.

A Representational Theory Perspective of Minority Status and People with Disabilities: Implications for Rehabilitation Education and Practice.

Minority is a term that has become particularly visible within the rehabilitation literature due to the increasing focus on the application of minority models to the understanding of the disability experience. At the same time, it is also one of the most ill-defined and misunderstood terms. In this article, the authors explore the meaning of minority status by discussing its core elements from a representational theory perspective. By doing so, they show that minority status is different from racial, ethnic, and cultural membership, although it partially overlaps with each of these constructs in some contexts. The authors argue that although race, culture, and ethnic minority status can attenuate or exacerbate minority status in some settings, these demographics are neither necessary nor sufficient conditions for minority status. Finally, the authors illustrate how many people with disabilities meet the essential criteria for minority status as outlined by representational theory and draw implications for rehabilitation practice, education, and research.

Is any job better than no job? Labor market experiences and depressive symptoms in people living with HIV

The purpose of this study is to determine the relationship between the psychosocial work environment and labor market experiences (including unemployment) on mental health among adults living with HIV. We used data provided by 538 participants at clinical and community sites across Ontario, Canada. Generalized estimating equation models showed that employment was associated with lower depressive symptoms. For employed participants, adverse psychosocial work conditions, specifically job insecurity, psychological demands, and decision authority were associated with depressive symptoms. For the entire sample, the number of adverse psychosocial work conditions was associated with higher depressive symptoms while participants working in poor quality jobs reported similar levels of depressive symptoms than those who were unemployed or not in the labor force. This study showed that poor quality employment (as assessed by having a high number of adverse psychosocial work exposures) was associated with a similar level of depressive symptoms as unemployment, suggesting that “bad jobs” may not offer the same mental health benefits as “good jobs.” Policies to improve employment outcomes should take the quality of employment into account to maximize mental health benefits as better employment may lead to better mental health.

A narrative literature review regarding job retention strategies for people with chronic illnesses.

Job retention is a major concern for individuals with chronic illnesses, who represent a rapidly growing vocational rehabilitation (VR) consumer population. The purpose of this article is to examine selected job retention considerations for consumers with chronic illnesses. The authors (a) describe distinguishing characteristics of chronic illnesses in terms of populations affected and psychosocial implications, (b) discuss the vocational implications of chronic illnesses, (c) provide general considerations for the provision of job retention services, and (d) examine job retention strategies aimed at improving employment outcomes for individuals with chronic illnesses.

RehabilitationResearch in the 21st Century: Concerns and Potential Solutions

In a recent qualitative investigation of research priorities, members of the National Council on Rehabilitation Education (NCRE) identified barriers to conducting research that fell primarily within three areas: (a) accessibility, (b) research skills, and (c) organizational cultures. Directly related to each of these barriers is the availability of resources to carry out activities that address them. The ramifications of such barriers are significant as research is essential to the growth and development of the field of Rehabilitation. The purpose of this paper is to discuss these barriers at length and explore strategies that can be implemented at individual and organizational levels to address them.

Validating the client-focused considering work model for people living with HIV and quantifying phases of change of commitment to work

Abstract The primary purpose of this study was to validate the client-focused considering work model and to gain a better understanding of the nature of the relationship among the four domains purported to influence the considering work process (medical, psychosocial, financial/legal and vocational). A second goal of the study was to quantify the relationship between these four domains and the phases of considering work (contemplation, preparation, action, resolution). Structural equation modeling was used to analyze data of 1702 diverse (43% Black, 31% White, 19% Latino 7% other) unemployed respondents who were recruited from AIDS Service Organizations (ASO) and networks across the United States to complete the National Working Positive Vocational Development and Employment Needs Survey (NWPC-VDENS). Overall the results of this study supported the validity of the client-focused considering work model and helped to provide a deeper level of understanding of the relationship among the domains of influence and their contribution to the level of commitment to the considering work process. Implications for Rehabilitation This model enables rehabilitation professionals to consider interventions for clients at different phases (contemplation, preparation, action) of considering work. Rehabilitation professionals are encouraged to provide prevocational services to engage people with HIV in the considering work process. When assisting PLWH within the considering work process, it is important to assess not only medical status but also psychosocial, financial and vocational concerns.

Rehabilitation Service Utilization Among African American Women Living With HIV/AIDS Applying the Behavioral Model for Vulnerable Populations

African American women are disproportionately affected by HIV/AIDS. As individuals with HIV/AIDS are living longer and healthier lives, research exploring the appropriateness of rehabilitation services has increased. To date, no research has examined the specific use of vocational rehabilitation (VR) services among HIV-positive African American women. The purpose of this study was to apply the behavioral model for vulnerable populations (BMVP) to examine key predisposing, enabling, and need variables related to and predictive of the utilization of VR services among African American women with HIV/AIDS. Survey research methods were used to collect data from a sample of 313 African American women living with HIV/AIDS, recruited from AIDS Service Organizations and national HIV/AIDS networks across the United States, who volunteered to complete the National Working Positive Coalition–Vocational Development and Employment Needs Survey. Hierarchical logistic regression statistical analyses were conducted to identify key factors predictive of use of VR services. Receipt of income benefits and knowledge of VR services were found to be predictive of the utilization of VR services among African American women living with HIV/AIDS.