Employment Accommodations Research Articles

Exploring Virtual Reality as an Employment Accommodation for Individuals With Albinism

Advances in virtual reality (VR) technology have created a wide range of remote work options. The goal of this study was to explore the experiences of individuals with albinism using VR work environments as a reasonable accommodation for remote work. Four cohorts of five participants each worked for 6 months at their leisure in a variety of virtual environments and met monthly with the research team to discuss positive and negative experiences with the technology and accessibility features. Using inductive thematic qualitative analysis, we followed a three-step coding process to identify themes in recorded transcripts of individual interviews and focus group discussions. The participants spent an average of 3.8 hours per week in VR, with an average session lasting 0.85 hours. From the coding analyses conducted by five coders, four themes were developed including the following: difficulties with VR’s limitations, recommendations for improving accessibility in VR, benefits that VR could bring to the workplace, and navigation practice applications for VR. While VR provided improved visual experiences for nearly all participants, there are needed features that could dramatically improve accessibility. Although individuals with low vision can customize many features of VR to optimize their visual experience, many of these accessibility features are specific to applications and not consistent across developers and hardware ecosystems. Despite its shortcomings, VR shows great promise as an accommodation for people with low vision. In particular, individuals participating in the current study found great utility in VR’s ability to assist with navigation of unfamiliar environments and its potential use in the workplace.

The adequacy of workplace accommodation and the incidence of permanent employment separations after a disabling work injury or illness.

This study aimed to estimate the influence of the adequacy of employer accommodations of health impairments in predicting permanent separation from the employment relationship in a cohort of workers disabled by a work-related injury or illness. The study used data from a retrospective, observational cohort of 1793 Ontario workers who participated in an interviewer-administered survey 18 months following a disabling injury or illness. The relative risks (RR) of a permanent employment separation associated with inadequate employer accommodations were estimated using inverse probability of treatment weights to reduce confounding. Over the 18-month follow-up, the incidence of permanent separation was 30.1/100, with 49.2% of separations related to health status. Approximately 51% of participants experiencing a separation were exposed to inadequate workplace accommodations, compared to 27% of participants in continuing employment. The propensity score adjusted RR of a health-related separation associated with inadequate accommodation was substantial [RR 2.72; 95% confidence interval (CI) 2.20-3.73], greater than the RR of separations not related to health (RR 1.68; 95% CI 1.38-2.21). Incidence of permanent separation in this cohort of Ontario labor force participants was approximately two times more frequent than would be expected. The adequacy of employer accommodation was a strong determinant of the risk of permanent separation. These findings emphasize the potential for strengthened workplace accommodation practices in this setting.

Impact of workplace accommodations on long-term work outcomes in a diverse sample of breast cancer survivors.

501 Background: Low-income and racial/ethnic minority workers in the US have limited access to work accommodations, such as schedule flexibility, if they become ill. Access to such accommodations is a key predictor of work status immediately after treatment for breast cancer. We evaluated the impact of accommodations on long-term work outcomes in a demographically diverse cohort of breast cancer survivors. Methods: We surveyed pre-diagnosis employed women, aged 18-64, who spoke Chinese, English, Korean, or Spanish and were undergoing treatment for stage I-III breast cancer in New York City. Recruitment was enriched for racial/ethnic minority and immigrant status. Surveys were administered (telephone or online) during treatment (baseline) and 4 months after completion of primary therapy. Long-term work status was evaluated in brief surveys 1 and 2 years later. The primary outcome was post-treatment work status (working full- or part-time vs. any other work status). We used X2 and Fisher's Exact Tests to examine associations between participant characteristics and work status, and logistic regression to adjust for relevant characteristics in multivariable analyses. Results: From 06/2012 to 08/2018, 497 participants completed baseline surveys; 479 completed 4-month post-treatment surveys, and 401 and 387 reported on their work status 1 and 2 years later. Overall, 22% self-identified as Black, 22% Chinese, 7.1% Korean, 27% Latina, 19% non-Latina white, and 2.7% as other; 58% were born outside of the US. Post-treatment work status remained relatively stable over time: 29% were not working 4 months after treatment completion, and 26% and 25% were not working 1 and 2 years later. Non-Latina white women were most likely to be working after treatment completion (89%), followed by Korean (74%), Black (73%), Chinese (69%), and Latina women (61%; overall p<0.001). Similar trends were observed 1 and 2 years later. Participants who reported that their employer had been accommodating in their 4-month post-treatment survey were more likely to be working 4 months after completion of treatment (83% vs. 57% of those with unaccommodating employers, p<0.001) and 1 year (85% vs. 60%, p<0.001) and 2 years later (84% vs. 65%, p<0.001). The relationship between employer accommodations and post-treatment work status across all time points remained significant after controlling for age, race/ethnicity, language, household income as a % of the Federal Poverty Level, job type, and receipt of chemotherapy. Conclusions: In this diverse cohort of breast cancer survivors, relative to work status 4 months post-treatment, work status was relatively stable 1 and 2 years later. Women whose employers had been accommodating during treatment were more likely to be working 1 and 2 years later. Increasing access to accommodations could improve long-term work outcomes and abrogate disparities in patients who undergo cancer therapy.

“It was almost like it’s set up for people to fail” A qualitative analysis of experiences and unmet supportive needs of people with Long COVID

BackgroundAlmost twenty percent of adults with COVID-19 develop Long COVID, leading to prolonged symptoms and disability. Understanding the supportive needs of people with Long COVID is vital to enacting effective models of care and policies.Design/methodsThis qualitative sub-study explored the experiences of people with Long COVID and their unmet needs. Participants enrolled in a larger study to evaluate the post-acute cardiovascular impacts of COVID-19 were invited to participate in subsequent in-depth interviews. Participants were enrolled purposively until saturation at 24 participants. Data were analyzed using thematic content analysis.ResultsParticipants focused on adaptations to life with Long COVID and their unmet needs in different life spheres. Three domains, 1) occupational and financial; 2) healthcare-related; and 3) social and emotional support, emerged as areas affecting quality of life. Although participants were motivated to return to work for financial and personal reasons, Long COVID symptoms often resulted in the inability to perform tasks required by their existing jobs, and unemployment. Those who maintained employment through employer accommodations still needed additional support. Participants encountered diagnostic challenges, challenges in accessing specialty appointments, insurance loopholes, high healthcare costs, and medical skepticism. Existing social networks provided support for completing daily tasks; however, those with Long COVID typically turned to others with similar lived experiences for emotional support. Participants found government support programs inadequate and difficult to access in all three domains.DiscussionWe propose a five-pronged policy approach to support persons with Long COVID. These overarching recommendations are (1) improve public awareness of Long COVID; (2) improve clinical care quality and access; (3) implement additional school and workplace accommodations; (4) strengthen socioeconomic benefits and social services; and (5) improve research on Long COVID.

Occupations, retirement, and the value of disability insurance

Occupations vary greatly in physical intensity, and there are, correspondingly, many differences in later-life work disability risk, retirement patterns, and applications for Social Security Disability Insurance (SSDI)—a national program that insures shocks to work productivity due to disability, with about nine million current beneficiaries in the U.S. In light of its widespread coverage and large differences in utilization across occupations, this paper aims to measure the value of the SSDI program across a broad population and the extent to which it influences the major choice of occupation. Using data from the Health and Retirement Study and O*NET, I estimate a life-cycle equilibrium model of occupational choice, work, savings, and disability at older ages, and find that incorporating occupations and preference heterogeneity is an integral part of understanding work and SSDI application behavior. While SSDI coverage is nearly universal and the premiums from workers are uniform, estimates suggest that the value of the program varies greatly, from being worth 2.1 to 14.5 percent of earned income—depending on preferences and choice of occupation—though for all groups it is welfare improving. I also find that SSDI plays an important role in the choice of occupation for older workers, providing an insurance value that results in over ten percent more people choosing physically intense, blue-collar occupations at older ages. This overall effect, however, masks the underlying selection of less risk-averse individuals into blue-collar jobs, which, if not accounted for, would lead to overstating the effects of the SSDI program on behavior. A counterfactual experiment aimed at eliminating the distortion created by uniform SSDI tax rates shows that—even without any additional employer accommodation of disabled workers—occupation-specific tax rates lead to fewer aggregate work-disabled years.

Integrating Lawyers into the Perinatal Health Care Team: Initial Findings From an Innovative Medical–Legal Partnership [ID: 1377957

INTRODUCTION: Health-harming legal needs (HHLNs), social determinants of health that have a legal remedy, are drivers of poor health outcomes for Black women and children. HHLNs include inadequate access to safe housing, employment accommodations, and income supports. A medical–legal partnership (MLP) adds an attorney to the health care team to address patients’ HHLNs in a variety of health care settings. The Perinatal LAW Project (P-LAW), an MLP between the Georgetown University Health Justice Alliance and MedStar Washington Hospital Center Women’s & Infants’ Services, addresses perinatal patients’ HHLNs in an obstetrics and gynecology practice. METHODS: Perinatal LAW Project attorneys record client and case data in a legal case management system. The research team analyzed data for the first 18 months of the program (March 2021 to September 2022). RESULTS: One hundred thirty-one patients were referred for legal assistance, primarily by social workers and health navigators. Most patients were in their second and third trimesters. The majority of patients were Black or African American, aged 20–34, and lived under 200% FPL. The most common legal issues were in the areas of employment (parental leave, discrimination), housing (conditions, eviction), public benefits (food stamps, disability benefits), and family law (child support, domestic violence). The P-LAW addressed 150 legal issues and served 117 patients. CONCLUSION: Medical–legal partnership is a novel approach to addressing maternal health disparities. In our experience, legal services have a high utilization rate and patients often have more than one legal need. Future efforts to measure patient outcomes, including reduced maternal stress and medical appointment attendance, will build the evidence base for MLP in the perinatal context.

Investigating municipal and company influences on employment of people with chronic health conditions.

In many countries, people with chronic health conditions have a weaker attachment to the labour market and fewer chances of re-employment. Much of the existing literature estimates the importance of institutional factors at the level of the municipality of residence or employer accommodation at the company level individually. This study examined the two levels simultaneously to disentangle the separate effects of municipal-level and of company-level factors. Using full population data from Denmark, we estimated cross-classified multilevel models for people newly diagnosed with chronic conditions in 2010-2013 (more than 60,000 individuals in 20,000 companies). We tracked their employment outcomes for up to 5 years after diagnosis. The findings suggest that, in the short term, factors at the company level explain differences in the employment levels of individuals with chronic conditions more than institutional factors at the municipal level. A combination of average wage, company-level seniority, company size, and industry seem to explain much of company-level influence. In the longer term, the importance of company-level factors seemed to decline. Company-level factors explained blue collar workers' employment rates better than those of white collar workers, which is in line with the notion that blue collar workers expend more physical effort in their work so that they may be more reliant on company accommodation than white collar workers in the case of chronic conditions. Company-level factors affected the employment of persons newly diagnosed with chronic health conditions in the short term (in particular among workers in blue collar jobs), while municipal-level factors did not.

An evaluation of the role of community care in meeting the needs of people with multiple sclerosis in Ireland

People with MS (PwMS) can experience a number of diverse needs which may be met by community-based services such as those delivered by MS Ireland (MSI), where Community Workers (CWs) provide support to PwMS on an individualised basis. However, while such support may be critical in helping PwMS adapt and cope with the challenges of living with MS, there has been little evaluation of the outcomes and impacts of this service to date. This study aimed to explore the perceived effectiveness and impacts of community work from the perspectives of both PwMS and CWs. Using stakeholder engagement and public and patient involvement (PPI), two surveys were developed for (1) CWs, and (2) services users of MSI. A series of open and closed questions centred on the effectiveness of community work in meeting twelve distinct categories of needs taken from an adapted framework of rehabilitation and healthcare needs of PwMS. Both CWs and service users rated the extent to which these various needs were met through community work, as well as describing the mechanisms by which needs were met, and the challenges faced in meeting these needs. Separately, both groups described the perceived impacts of community work using open-text responses. Fifteen CWs and 367 PwMS, 269 (73%) of whom knew their CW, participated. Both groups rated community work positively in meeting the needs for information, emotional/psychological support and coordination of care, with lower perceived capacity for community work to meet needs for employment accommodations, caregiver support and homecare. Mann Whitney U tests did not find any significant difference between groups in the perceived capacity of community work to meet the various needs examined (p>.05). Core mechanisms by which CWs meet needs are by signposting to relevant services, listening, and facilitating peer support. Difficulty accessing external services was the primary challenge identified in meeting needs. Positive impacts of community work included the role that CWs play in fostering confidence and acceptance of MS, and in helping service users overcome the challenges of MS. Results suggest how CWs can help meet the needs of PwMS, while also highlighting the numerous positive impacts that community work has for this group. While it is clear that a number of unmet needs may remain due to a lack of access to other external services, this study shows how community-based services may play an important role in helping PwMS adapt to living with MS.

Moralizing the law: Lactating workers and the transformation of supervising managers

AbstractThe Lactation at Work Law amended the Fair Labor Standards Act to mandate employer accommodation of employees' breast milk expression. Interviews with employees, human resource specialists, and supervising managers in nine industries found that some organizations' supervising managers, who initially perceived accommodations only as a legal mandate furthering managerial goals, over time changed to understanding lactation accommodations through a children's-health lens that created morality-driven motivations for legal compliance–a “moralization of the law.” Educational discussions with lactating employees not only provided these supervising managers with insights into lactation at work, but also sensitized them to ethical issues surrounding lactation accommodations.

Responding to Disability Onset in the Late Working Years: What do Older Workers do?

This study uses occupational data from the Health and Retirement Study to document the link between disability onset and occupational transitions among older adults who are working and do not report a disabling condition at age 55. We find that one-quarter of workers go on to experience new disabilities before full-retirement age. Relative to their peers who do not report disabilities, stopping work and significant occupational changes are more common among workers who experience new disabilities. Our results suggest that policies to support labor force attachment might consider the importance of new disability onset and whether employer accommodations might help workers with new disabling conditions remain in the jobs they held when their health began to limit their work.

Employment outcomes and experiences of people with seeing disability in Canada: An analysis of the Canadian Survey on Disability 2017.

BackgroundMany individuals with disabilities face barriers to meaningful employment. Legislation has been put in place to ensure employment equity for individuals with disabilities in Canada. However, little is known about the employment profile and experiences of people with seeing disabilities.ObjectivesThe objectives of our research study were to explore the employment rates of people with seeing disabilities in Canada, the factors associated with being employed, and supports and barriers that affect their work participation.MethodsWe used the nationally representative data from the Canadian Survey on Disability (CSD) 2017, collected by Statistics Canada. The CSD is a national cross-sectional survey of Canadians 15 years of age and above who face a functional limitation due to a health-related condition, representing more than 6 million (n = 6,246,640) Canadians. Our analyses focused on people who reported having a seeing disability. A subset of the complete dataset was created, focusing on individuals with a seeing disability. Weighted descriptive analyses were performed using SPSS. Multivariate logistic regression analyses were conducted for individuals between 25–64 years of age to identify predictors of employment.ResultsOut of the estimated 892,220 working-age adults (25–64 years) with a seeing disability who were represented by the survey, 54% were employed, 6% were unemployed and 40% were not in the labour force. Early onset of seeing disability (OR: 1.33; 95% CI: 1.32–1.35), less severe seeing disability (OR: 1.51; 95% CI: 1.49–1.53), education above high school (OR: 2.00; 95% CI: 1.97–2.02) and daily use of the internet (OR: 2.46; 95% CI: 2.41–2.51) were positively related with employment. The top three employment accommodations that were needed and were made available included: modified work hours (45%); work from home (38.5%) and a modified workstation (37%). The top three needed but least available accommodations were technical aids (14%), communication aids (22%) and a computer with specialized software or adaptation (27%). Overall, 26% reported that an accommodation was required but was not made available by the employer. While 75% of individuals with a seeing disability were out of the labour force due to their condition, the remaining identified barriers that prevented them from working which included (top 3): (i) too few jobs available (20%); (ii) inadequate training/experience (19%), (iii) past attempts at finding employment were unsuccessful (19%).ConclusionAdults with seeing disability in Canada experience lower labour force participation than the general population. Rigorous programs are required to assist them with the job search, job retraining and workplace accommodations. It is important for governments to improve efforts towards inclusive education and develop strategies that promote digital literacy of employees and job seekers with visual impairments. Although accessibility legislations have been put in place, programs should be established that provide accessibility solutions for various employers, enabling them to hire individuals with different abilities.

Identifying the job accommodation needs of American workers with mid-career neurological disabilities: A multiple case study investigation

BACKGROUND: The COVID-19 pandemic has wrought an unprecedented toll on vocational rehabilitation efforts to assist workers with disabilities in maintaining their careers. OBJECTIVE: To demonstrate the use of a psychometrically sound assessment instrument and resource-driven planning procedure to help workers with disabilities resume or retain their employment. METHODS: Four employed people with neurological disabilities who took part in a larger job retention project funded by the United States Department of Labor completed structured interviews to determine their needs for employment accommodations during COVID-19. A trained interviewer administered the Work Experience Survey (WES) in teleconsultation sessions with each participant to identify: (a) barriers to worksite access, (b) difficulties performing essential job functions, (c) concerns regarding continued job mastery, and (d) extent of job satisfaction. RESULTS: Owing primarily to the sequelae of their disabling conditions and less so to social distancing requirements and telecommuting technology, participants reported a wide range of accessibility barriers and difficulties in performing essential functions of their jobs that they believed had the potential to significantly affect their ongoing productivity. Considering the stress and uncertainty that have accompanied the COVID-19 pandemic, it is surprising that the majority of participants reported high levels of job mastery and job satisfaction. CONCLUSION: The interviewer concluded the WES interview by recommending a job accommodation plan, which included suggestions from Job Accommodation Network (JAN) consultants.

Cohort profile: the Ontario Life After Workplace Injury Study (OLAWIS)

PurposeThe substantial economic burden of work-related injury and illness, borne by workers, employers and social security programmes, is primarily attributed to the durations of work disability among workers whose recovery...

Missed work, lost income, and job loss in survivors of colorectal cancer and their partners: A dyadic study.

145 Background: Many survivors of colorectal cancer face long-term job loss stemming from their diagnosis. However, little is known about employment outcomes among their partners and virtually nothing is known about employment impacts among survivor-partner dyads. Methods: In 2019-20 we surveyed 1150 patients who, in 2014-18, underwent resection of Stage III colorectal cancer and were seen at a community oncology practice, academic cancer center, or reported to Georgia SEER (51% RR). Patients gave a separate survey to their partner. 299 partners (73% RR) completed surveys. Patients and partners were asked about employment consequences of the patient’s cancer. Availability of job support benefits and prevalence of adverse employment outcomes were described among partners. Descriptive statistics were generated to identify trends in job loss within dyads. Results: Among partners, 56% were <age 65, 63% female, 86% white, 27% had < high school education. 61% were employed at time of patient’s diagnosis. Among these, 15% had no job support benefits. 33% had paid sick leave, 47% had flexible work schedule, 28% had unpaid time off. Due to the patient’s cancer, 43% missed 7-30 days work and 13% missed >1 month. Due to the patient’s cancer, 18% lost $2000-$10,000 in income and 11% lost >$10,000. 27% were no longer working at the time of survey. In 47% of dyads, both patient and partner were working before patient’s diagnosis. Among those, in 29% only 1 member of dyad was still working at time of survey and in 11% neither member of dyad was still working. In 15% of dyads, only the partner was working before patient’s diagnosis. Among those, in 50% the partner was no longer working at time of survey. In 16% of dyads, only the patient was working before diagnosis. Among those, in 48% the patient was no longer working at time of survey. Job loss in dyads was associated with older age, lower annual income, and lack of flexible work schedule. Conclusions: Missed work and loss of income are common among partners of patients with colorectal cancer. Job loss affects nearly half of dyads in the survivorship period. Employer accommodations such as flexible scheduling may help mitigate job loss among survivors and their partners. [Table: see text]

Abstract PR03: Disparities in work status after treatment for breast cancer: A controlled, longitudinal study

Abstract Low-income and minority groups appear to be at increased risk of post-treatment job loss and its sequelae, including financial strain and bankruptcy. However, the drivers of disparities in job loss are not understood. We surveyed employed women aged 18-64 with stage I-III breast cancer who spoke Chinese, English, Korean, or Spanish. Baseline surveys (telephone or online) were administered during adjuvant treatment; follow-up surveys were conducted 4 months after completion of active treatment except endocrine and targeted therapy (i.e., trastuzumab with or without pertuzumab). The primary outcome was post-treatment work status (working full- or part-time vs. any other work status). We used healthy peers to control for disparities in non-cancer unemployment and multivariable analyses to identify predictors of work status in patients. Our sample (n=479) was 28% Latina, 23% black, 21% non-Latina white, 19% Chinese, and 7% Korean; 56% were foreign-born. Overall, 31% had a household income <200% of the federal poverty level; 26% were under-/uninsured; 33% worked in service/manufacturing jobs at baseline, 19% in sales/administrative jobs, and 47% in management/profession jobs. Most underwent chemotherapy (85%). Four months after treatment completion, 71% of the survivors reported that they were working. The proportion of working patients versus controls was 0.69 for Chinese, 0.73 for Korean, 0.75 for Latinas, 0.78 for blacks, and 0.98 for non-Latina whites. Independent predictors of not working among patients were receipt of chemotherapy (OR 2.20; 95% CI 1.04-4.64); older age (OR 1.06; 95% CI 1.03-1.09); black (OR 2.37; 95% CI 1.01-5.56), Chinese (OR 2.91; 95% CI 1.20-7.05), or Korean (OR 3.68; 95% CI 1.24-10.98) race (vs. non-Latina white); household income <200% of poverty (OR 3.00; 95% CI 1.68-5.35); and service/manufacturing job-type at baseline (OR 2.41; 95% 1.30-4.44, vs. manager/professional). Having an employer who was not accommodating also predicted not working post-treatment (OR 3.05; 95% CI 1,88-4.95). Breast cancer exerts a disparate negative impact on work status in minority and low-income women, which persists after controlling for disparities in background unemployment. Women who work in service or manufacturing jobs are at greater risk. Furthermore, receipt of chemotherapy is a predictor of job loss, even after controlling for race and income. However, employer accommodations appear to abrogate the negative impact of chemotherapy on work status. Interventions are needed to promote job retention in minority and low-income women, particularly those who lack work accommodations or are in high-risk jobs. This abstract is also being presented as Poster A100. Citation Format: Victoria S. Blinder, Sujata Patil, Carolyn Eberle, Gabriel Jung, Lewis J. Kampel, Caroline Hwang, Ting Bao, Mark E. Robson, Manmeet Malik, Francesca Gany. Disparities in work status after treatment for breast cancer: A controlled, longitudinal study [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr PR03.

Unmet Need for Workplace Accommodation.

We use experimental survey methods in a nationally representative survey to test alternative ways of identifying (1) individuals in the population who would be better able to work if they received workplace accommodation for a health condition; (2) the rate at which these individuals receive workplace accommodation; and (3) the rate at which accommodated workers are still working four years later, compared to similar workers who were not accommodated. We find that question order in disability surveys matters. We present suggestive evidence of priming effects that lead people to understate accommodation when first asked about work-limiting health problems. We also find a sizeable fraction of workers who report they receive a workplace accommodation for a health problem but do not report work limitations per se. Our preferred estimate of the size of the accommodation-sensitive population is 22.8 percent of all working age adults. We find that 47-58 percent of accommodation-sensitive individuals lack accommodation and would benefit from some kind of employer accommodation to either sustain or commence work. Finally, among accommodation-sensitive individuals, workers who were accommodated for a health problem in 2014 were 13.2 percentage points (18.5 percent) more likely to work in 2018 than those who were not accommodated in 2014.

Relationship among Breastfeeding Exposure, Knowledge, and Attitudes in Collegiate Males Residing in East Texas.

Researchers exploring breastfeeding attitudes and knowledge among women suggest the decision to breastfeed is influenced by the male partner, yet few studies address males. Because collegiate males will soon enter fatherhood, assessment of their attitudes and knowledge may inform interventions aimed at increasing intention to breastfeed. This study aimed to describe collegiate males' exposure to, attitude toward, and knowledge about breastfeeding. A cross-sectional online survey was used with males ≥ 18 years of age enrolled at a Texas public university. Attitude indices measured included social limitations, public displays of breastfeeding, and employer accommodations. Descriptive statistics, correlational and regression analyses were employed. The participants' (N = 949) average age was 25.48 years; > 80% reported not being fathers. Exposure to breastfeeding was high; > 80% witnessed breastfeeding and/or had someone close breastfeed. High attitude scores indicated social acceptability of breastfeeding. Knowledge appeared limited: only 16% identified the recommendation of exclusive breastfeeding for the first 6 months of life; > 50% overlooked the reduced risk for overweight/obesity, ear infections, diarrhea, or food allergies. Correlations between knowledge, exposure, total attitude, and index scores were positive (p < .01) except for the public displays index. Stepwise multiple regression determined that breastfeeding exposure, knowledge scores, and father's educational level predicted total attitude score, (R2 = 0.13, F (3,851) = 44.02, p < .01). The positive attitudes outcome among this male population is promising for breastfeeding support and advocacy. Education efforts improving knowledge will likely increase behavioral intention, resulting in increased breastfeeding rates and duration.

Disability Disclosure and Workplace Accommodations for Youth With Disabilities: Youth and Employer Perspectives

To explore how young people with disabilities disclose their condition and ask for workplace accommodations, and understand employer accommodation practices and how they create an inclusive environment.

Managing work and cancer treatment: Experiences among survivors of hematological cancer.

The current study was performed to characterize the employment status of survivors of hematological cancer who have an informal caregiver from the time of diagnosis through the first 6 months of treatment. Using a mixed methods approach, semistructured interviews with survivors of hematological cancer were conducted within 6 months of the initiation of cancer treatment. Interviews assessed cancer treatment status, barriers and facilitators to employment, financial and insurance status, and relationship with the primary caregiver. These results are part of a longitudinal study of cancer survivors and informal caregivers. A total of 171 patients were enrolled. Within 6 months of beginning cancer treatments, approximately 35% were no longer employed. Reasons to remain employed included financial need, employee benefits, and a sense of purpose and normalcy. Employer accommodations and supportive colleagues facilitated continued employment. Logistic regression analysis demonstrated that having a higher household income, a desire to work, nonphysical job tasks, and congruent survivor-caregiver communication were associated with greater odds of remaining employed. Within 6 months of initiating cancer treatment, the majority of survivors of hematological cancer had maintained employment. Because of the limitations imposed by the physical stress of cancer treatments, as well as the need to maintain employment to continue receiving employee benefits to cover such treatments, survivors of hematological cancer likely would benefit from employment accommodations that are sensitive to their unique needs. Cancer 2018;124:2824-2831. © 2018 American Cancer Society.

Disability Measurement in the Health and Retirement Study.

The Health and Retirement Study (HRS) has provided extensive and detailed national data on disability since it began in 1992, and has been used extensively in studies of disability trends and trajectories. We summarize conceptual frameworks used to characterize disability and review the HRS measures of functioning, work disability, and employer accommodations. HRS survey questions have experienced changes in wording, skip logic, or other design features over the life of the study, and we comment on the analytic challenges posed by those changes. Among our conclusions are (1) work disability and benefit eligibility are important concepts that should be considered for redesign to better reflect current concepts and policy issues; (2) methodological studies of changes in wording or skip logic should be undertaken; and (3) minor additions to survey content in areas such as temporal reference periods or changes in social-participation activities would improve measurement.