Customized Employment for Spinal Cord Injury (ACCESS-Vets Trial)

Recruiting in Palo Alto (17 mi)

+1 other location

Overseen ByLisa Ottomanelli, PhD

Age: 18+

Sex: Any

Travel: May be covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: VA Office of Research and Development

No Placebo Group

Trial Summary

What is the purpose of this trial?The reason for conducting this study is to learn about the best ways to help Veterans with spinal cord injury (SCI) gain meaningful employment. Spinal cord injury is a medically complex disability that poses unique barriers to employment for Veterans. Returning to work after SCI improves health and quality of life, which in turn can lower risk for suicide in this high-risk population. Hence, the Department of Veterans Affairs (VA) supports interventions that help Veterans with SCI return to work and may prevent suicide. Customized employment (CE) is an innovative strategy for tailoring vocational services to meet the needs of people with complex disabilities. To address barriers to employment faced by Veterans with SCI, this study will evaluate whether a customized employment intervention used in non-VA settings can be adapted for use by the VA as a part of SCI medical rehabilitation. The research goal is to evaluate how a CE intervention for Veterans with SCI (ACCESS-Vets) can help them discover their strengths to find and maintain competitive integrated employment in their communities. This study will compare ACCESS-Vets with the usual evidence-based supported employment program, known as Individual Placement and Support (IPS). Veterans with SCI who chose to participate in this study will be randomly selected (i.e. by chance) to work with a vocational rehabilitation specialist as part of the ACCESS-Vets intervention or the usual IPS employment program for about 8 months. Study participants will complete study questionnaires before, during, and after their participation in the employment interventions. Some Veterans and their medical rehabilitation providers will be interviewed about their experiences with the employment interventions. The study expects to find that Veterans who participate in ACCESS-Vets will have better employment and quality of life outcomes then those who participate in IPS. The study will provide information about the strategies used in the ACCESS-Vets and IPS interventions for addressing barriers to employment. Ultimately, this study may provide a model for making VA vocational services for Veterans with SCI more effective and sustainable.

Eligibility Criteria

This trial is for English-speaking Veterans aged 18-65 with spinal cord injury who want to work in their community. They must be living within a two-hour drive from the VAMC, not have progressive disorders like multiple sclerosis, severe brain injuries, psychosis treated in the last 6 months, untreated substance abuse, or impairments that prevent consent.

Inclusion Criteria

I am between 18 and 65 years old.

Exclusion Criteria

I am a veteran with a serious brain injury, rated Rancho Level 6 or lower.

I live more than two hours away from the Veterans Affairs Medical Center.

I am a veteran treated for psychosis in the last 6 months.

I am a veteran with a worsening spinal condition or a terminal illness like multiple sclerosis.

Participant Groups

The study tests whether Customized Employment (ACCESS-Vets) can help Veterans with SCI find and keep jobs better than the usual job support program (IPS). Participants will be randomly assigned to either ACCESS-Vets or IPS and followed for about 8 months.

2Treatment groups

Experimental Treatment

Active Control

Group I: ACCESS-Vets Intervention GroupExperimental Treatment1 Intervention

This group will receive ACCESS-Vets, a customized employment intervention adapted for use in VA healthcare.

Group II: IPS (Usual Care) GroupActive Control1 Intervention

This group will receive IPS (Individual Placement and Support), the usual evidence-based supported employment program in VA.