Employment Outcomes For People Research Articles

Exploring the workplace factors and their influence on the employment outcomes for people with multiple sclerosis

BackgroundHigh unemployment rate of people with multiple sclerosis (PwMS) is associated with substantial economic costs. Whilst the impact of MS symptoms and other disease-related factors on employment outcomes of PwMS has been assessed, limited evidence exists on the impacts of workplace factors. ObjectiveTo investigate the most common individual and group workplace factors associated with unemployment or a perceived risk of unemployment in PwMS, and to identify patient subgroups that are more susceptible to changes in employment status due to such factors. MethodsData from the Australian MS Longitudinal Study (AMSLS) on employment status and workplace factors were used. Fifteen workplace factors were classified under four groups: organisational, commuting, moving around at work, and equipment usage factors. Participants answered ‘Yes’ to each factor if it related to their unemployment and/or perceived risk of becoming unemployed and a group factor was considered “Yes” if at least one individual factor within it was answered as “Yes”. The proportions of “Yes” responses were calculated for both individual and group factors. Total number of individual factors was calculated and descriptive analyses and ordered logistic regression were used to summarize the total number of factors affecting each participant, and their association with participants’ occupations, sex, disability severity and disease duration. ResultsCommon workplace factors influencing employment were organisational (39.8 % perceived risk, 44.0 % lost employment), commuting (28.9 % perceived risk) and equipment usage difficulty (30.9 % lost employment). Common individual factors included inflexible working conditions, lack of suitable work, commuting difficulties, architectural barriers, and requirement to stand for long periods to use equipment. Professionals, blue-collar workers, and those with moderate/severe disability were more likely to report a higher number of workplace factors risking their employment. ConclusionsWorkplace factors undermine PwMS employment, with variations among subgroups based on occupation and disability severity. Understanding these barriers is crucial for supporting PwMS in the workforce.

The Mediating Role of Self-Determination in the Relationship Between Assistive Technology and Employment Outcomes for People with Disabilities in Saudi Arabia

The current research study conducts an investigation of the dynamic relationship between three key variables: assistive technology (AT) provision, self-determination (SD), and employment outcomes (EOs) as they pertain to persons with disabilities (PwDs) in Saudi Arabia (KSA). The main objective of the study is to investigate the function of AT in improving EOs for PwDs and contextualize the mediating effect of SD on the observed relationship. The study features a quantitative study design which utilizes survey data obtained from a sample size of 120 PwDs. The study participants are employed in either private or public sector organizations situated in Riyadh and Al-Jouf regions of KSA. The conducted survey provides measurements, using a Likert scale, for AT provision, various aspects of SD (decision-making autonomy, self-belief, self-advocacy, goal setting, and persistence and resilience), and EOs (job placement, satisfaction, retention, income level, and career advancement). For data analysis, the study utilizes the partial least square-structural equation modeling. The study findings demonstrate significant direct and indirect effects of AT provision on EOs for PwDs—with SD playing a key mediating role. Specifically, positive effects of AT can be observed in job placement, satisfaction, income level, retention, and career advancements—SD is observed as a key facilitator of AT adoption and effectiveness (EFF) within workplace settings. The findings emphasize the key role of AT investment (accessibility and EFF) in the enhancement of the SD skills of PwDs, and the resulting effect of more inclusive workplace environments for PwDs in KSA.

Demographic and Vocational Rehabilitation Service Correlates of Employment Outcomes in People With Substance Use Disorders During COVID-19

This study examined the demographic and vocational rehabilitation (VR) service correlates of employment outcomes (achievement of competitive employment, hourly wage, and weekly hours) among individuals with substance use disorders (SUDs) during the COVID-19 pandemic, using the Rehabilitation Services Administration Case Services Report (RSA-911) database for fiscal year 2020. Data from 9,536 individuals were analyzed. Hierarchical logistic regression and hierarchical linear regression analyses revealed that multiple demographic and VR service variables were significantly associated with achievement of competitive employment, hourly wage, and weekly work hours at exit. Particularly, having a vocational training license/certificate, employment at Individualized Plan for Employment, and having an associate or bachelor’s degree were the strongest demographic correlates of more positive employment outcomes; while short-term job supports, maintenance, and other services were the strongest VR service correlates of more positive employment outcomes. Implications of the findings were discussed to promote VR service outcomes for people with SUD in the postpandemic era.

Employment outcomes of people with Long Covid symptoms: community-based cohort study.

Evidence on the long-term employment consequences of SARS-CoV-2 infection is lacking. We used data from a large, community-based sample in the UK to estimate associations between Long Covid and employment outcomes. This was an observational, longitudinal study using a pre-post design. We included survey participants from 3 February 2021 to 30 September 2022 when they were aged 16-64 years and not in education. Using conditional logit modelling, we explored the time-varying relationship between Long Covid status ≥12 weeks after a first test-confirmed SARS-CoV-2 infection (reference: pre-infection) and labour market inactivity (neither working nor looking for work) or workplace absence lasting ≥4 weeks. Of 206 299 participants (mean age 45 years, 54% female, 92% white), 15% were ever labour market inactive and 10% were ever long-term absent during follow-up. Compared with pre-infection, inactivity was higher in participants reporting Long Covid 30 to <40 weeks [adjusted odds ratio (aOR): 1.45; 95% CI: 1.17-1.81] or 40 to <52 weeks (aOR: 1.34; 95% CI: 1.05-1.72) post-infection. Combining with official statistics on Long Covid prevalence, and assuming a correct statistical model, our estimates translate to 27 000 (95% CI: 6000-47 000) working-age adults in the UK being inactive because of Long Covid in July 2022. Long Covid is likely to have contributed to reduced participation in the UK labour market, though it is unlikely to be the sole driver. Further research is required to quantify the contribution of other factors, such as indirect health effects of the pandemic.

The impact of sleep quality on health, participation and employment outcomes in people with spinal cord injury: Analyses from a large cross-sectional survey.

Poor sleep is common in people with spinal cord injury (SCI), yet little is known about its impact on employment and participation outcomes. This study aimed to (1) describe the sleep quality of a large sample of Australians with SCI and compare the results to data from an adult control and other clinical populations; (2) examine associations between sleep quality and participant characteristics; and (3) explore the relationship between sleep and outcomes. Cross-sectional data from the Australian arm of the International Spinal Cord Injury (Aus-InSCI) survey from 1579 community-dwelling people aged >18 years with SCI were analysed. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Relationships between participant characteristics, sleep quality and other outcomes were examined with linear and logistic regression. The PSQI was completed by 1172 individuals; 68% reported poor sleep (global PSQI score >5). Subjective sleep quality in people with SCI was poor (mean PSQI=8.5, SD 4.5) when compared to adults without SCI (PSQI=5.00, SD 3.37) and with traumatic brain injury (PSQI=5.54, SD 3.94). Financial hardship and problems with secondary health conditions were significantly associated with worse sleep quality (p<0.05). Poor sleep quality was strongly associated with lower emotional wellbeing and energy, and greater problems with participation (p<0.001). Individuals engaged in paid work reported better sleep quality (mean PSQI=8.1, SD 4.3) than unemployed individuals (mean PSQI=8.7, SD 4.6; p<0.05). Following adjustment for age, pre-injury employment, injury severity and years of education, better sleep quality remained strongly associated with being employed (OR 0.95, 95% CI 0.92 to 0.98; p=0.003). This study demonstrated pervasive and impactful relationships between sleep quality and important SCI outcomes. Poor sleep quality was strongly associated with worse emotional wellbeing and vitality, unemployment and lower participation. Future studies should aim to determine whether treating sleep problems can improve outcomes for people living with SCI.

Employment Outcomes for People With Autism Spectrum Disorder: A Theory Mapping of the Evidence

Background:People with autism spectrum disorder (ASD) are three to four times less largely to be with employment compared to neurotypical others. Theory based studies may provide helpful indicators for the design and implementation of employment supports for people with ASD.Objective:This critical review examined the extent of the evidence for theory in studies on employment outcomes for people with ASD and taking into account social inequality. For the evidence, 35 studies were selected for review if they were published in the period 2000–2016 and assessed for the association between work participation with ASD applying descriptive survey or quasi-experimental design.Methods:Studies were examined for use of any theory, including four predetermined theory types: social liminality, psychosocial, behavioral, and structural-infrastructural. They were also content-analyzed to determine if they cited any evidence of social inequality influences on employment outcomes with ASD.Findings:Results indicated that none of the studies explicitly applied and tested a theory on work participation with ASD. Rather, the majority of the studies were implicitly framed on predominantly behavioral type theory with minor elements of workplace psychosocial support theory-oriented interventions. Regard of structural-infrastructural type theory addressing social inequality is incidentally addressed by a few of the studies (n= 3) that examined family income status influences.Conclusion:In conclusion, extant studies on the association between employment outcomes and ASD are seriously limited in their explanatory value by a lack of theoretical grounding. They also neglect influences of antecedent social inequality in employment outcomes with ASD. Future studies should apply specific theory to questions on employment outcomes with ASD to provide usable evidence to inform employment support policy instruments and interventions for people with ASD.

Workplace accommodations during the COVID-19 pandemic: A scoping review of the impacts and implications for people with disabilities.

The COVID-19 pandemic has led to widespread changes in the way people work. Some of these changes represent the same kinds of work modifications or adjustments that have often been requested as workplace accommodations, and which may improve labour market and employment outcomes for people with disabilities. The aim of this scoping review was to examine the literature on workplace accommodations in the pandemic and their impacts and implications for people with disabilities. Following a search of six international databases, articles were selected by two reviewers, and data were abstracted in accordance with scoping review methodology. A thematic analysis was used to report the relevant findings. Thirty-seven articles met the inclusion criteria, and three main themes were identified: positive impacts of pandemic-related workplace accommodations on people with disabilities (e.g., improved accessibility, reduced stigma around workplace accommodations, rapid implementation of workplace accommodations, opportunities for advocacy); negative impacts (e.g., worsened physical and mental health, new accommodation needs); and action needed and recommendations (e.g., revisit legislation and policy on accommodations, ensure representation of people with disabilities). Overall, our review identified a mixed assessment of the impacts of pandemic-related accommodations on people with disabilities. However, there was a broader consensus regarding the importance of learning from the experiences of the pandemic to improve workplace accommodation policies in the future. The pandemic may present opportunities for improving workplace accommodation policies, but our review also highlights the need for more research examining how workplace changes due to the COVID-19 pandemic have impacted people with disabilities.

Do Area-Level Environmental Factors Influence Employment for People with Disability? A Scoping Review.

Employment is an important social determinant of health and wellbeing. People with disability experience labour market disadvantage and have low labour force participation rates, high unemployment rates, and poor work conditions. Environmental factors are crucial as facilitators of or barriers to participation for people with disability. Understanding how the physical, social, and economic characteristics of local areas influence employment for people with disability can potentially inform interventions to reduce employment inequalities. We conducted a scoping review of research investigating associations between area-level environmental factors and employment for people with disability. Eighteen articles published between 2000 and 2020 met the inclusion criteria, and data were extracted to map the current evidence. Area-level factors were categorised into six domains relating to different aspects of environmental context: socioeconomic environment, services, physical environment, social environment, governance, and urbanicity. The urbanicity and socioeconomic environment domains were the most frequently represented (15 and 8 studies, respectively). The studies were heterogeneous in terms of methods and data sources, scale and type of geographic units used for analysis, disability study population, and examined employment outcomes. We conclude that the current evidence base is insufficient to inform the design of interventions. Priorities for future research are identified, which include further theorising the mechanisms by which area-level factors may influence employment outcomes, quantifying the contribution of specific factors, and interrogating specific factors underlying the association between urbanicity and employment outcomes for people with disability.

Identifying factors that promote successful vocational rehabilitation case closure: Comparison of individual characteristics, VR experiences and state economic conditions

BACKGROUND: Despite the series of public policies being implemented to strengthen vocational rehabilitation (VR) services, individuals with disabilities remained at the substantial deficit in employment outcomes compared with individuals without disabilities. OBJECTIVE: We aimed to examine effects of vocational rehabilitation services on the employment outcomes for people with disabilities while accounting for individual characteristics and state economic conditions. Findings had implications for VR program improvement. METHOD: We used the RSA-911 data covering cases from 2015 to 2017, in addition to state unemployment rate and poverty rate in 2017 to address the research questions. A logistic regression model was estimated with Generalized Estimating Equations to predict the probability of successful case closure by individual demographic characteristics, number of VR services received, and state economic conditions. RESULTS: State economic conditions were not associated with employment outcomes among VR participants. Being female, Black, having physical disabilities, and not having a job at application were disadvantageous in employment outcomes. The more varieties of vocational services that individuals received, the higher odds of successful case closure. CONCLUSIONS: VR services have significant beneficial impact on individual employment outcomes. The strongest beneficial impact may be achieved by providing a combination of different types of services that are designed to help individuals find or sustain employment.

Impact of cognitive remediation on the prediction of employment outcomes in severe mental illness

ObjectiveCognitive functioning is a potent predictor of work in people with a severe mental illness, including those receiving vocational services. Cognitive remediation has been shown to improve cognitive functioning and work outcomes in people receiving vocational services. However, it is unknown whether it reduces the strength of cognitive functioning as a predictor of work outcomes compared to people receiving vocational services alone. MethodData were pooled from five randomized controlled trials evaluating the effects of adding cognitive remediation to vocational rehabilitation vs. vocational services alone. A battery of baseline cognitive functioning measures was examined to identify predictors of competitive work outcomes over the following two years. Study condition (i.e., receipt of cognitive remediation) was included in the analyses to evaluate whether cognitive functioning was a weaker predictor of work outcomes in people receiving cognitive remediation compared to those receiving vocational services alone. ResultsCognitive functioning was a stronger predictor of wages earned and weeks worked in participants receiving vocational services alone than those who also received cognitive remediation. Cognitive functioning did not predict job acquisition in either study condition. ConclusionCognitive remediation may improve employment outcomes in people receiving vocational services in part by reducing the adverse effects of impaired cognitive functioning on work performance.

Three Year Longitudinal Study of Graduate Employment Outcomes for Australian Apprentices and Trainees with and without Disabilities

ABSTRACT People with disabilities in Australia face significant employment barriers. Research and policy initiatives over the past fifteen years have consistently emphasised the benefits of vocational education and training generally, and apprenticeship and traineeships specifically, as leading to positive vocational pathways and employment outcomes for people with disabilities. However, there is a dearth of evidence of graduate outcomes for apprentices and trainees with disabilities. This paper presents the employment outcomes including hours of work and salaries for a cohort of apprenticeship and traineeship graduates with and without disabilities across a three-year longitudinal Australian study. Overall, there are positive employment outcomes for the research participants although graduates without a disability achieved better outcomes than graduates with disabilities and participants in receipt of the disability support pension had significantly lower wages than other participants with disabilities. There are indications that the gap in outcomes between graduates with and without disabilities has reduced over time, although generalisability of the findings may be limited by the observational study design. Nevertheless, the study has confirmed positive employment and related outcomes for apprenticeship and traineeship graduates with disabilities, which were sustained, or arguably improved, over the three-year period covered by the study.

Comorbidities are prevalent and detrimental for employment outcomes in people of working age with multiple sclerosis

Background: More work is needed to understand the burden of comorbidities in people with multiple sclerosis (MS). Objective: To assess prevalence of 30 comorbidities and impacts of comorbidities on employment outcomes in a working-aged MS cohort. Methods: Participants were from the Australian MS Longitudinal Study (n = 929). Information on specific comorbidity was obtained (whether or not each was present, doctor-diagnosed, limited their activities and being treated). Results: Comorbidities most frequently reported to limit activities were osteoarthritis (51%), migraines (40%), anxiety (33%), depression (29%) and allergies (18%). Mean MS-related work productivity loss in past 4 weeks was 1.3 days for those without comorbidities and 2.5 days for those with any comorbidity. The annual population costs of work productivity loss were highest for people with depression, allergies, anxiety, migraines and osteoarthritis. Higher number of comorbidities was associated with more work productivity loss and a higher likelihood of not working. These associations were substantially reduced after adjustment for MS symptom severity. Conclusions: Comorbidities substantially impact employment outcomes and these effects were mainly mediated through MS symptom severity. This suggests that optimal and simultaneous management of comorbidities may be a viable strategy to reduce MS symptom severity, which in turn could improve employment outcomes.

An In-House Vocational Training (IHVT) Program for Individuals With Chronic Mental Illnesses: The Employment Outcomes Reported by a Multicenter Study

Abstract Date Presented 04/04/19 An IHVT program was designed to improve employment outcomes for people with chronic psychiatric disorders. This client-centered program includes the areas of work-related behaviors, on-the-job skills, and life balance alongside the ongoing vocational counseling. The program outcomes showed satisfactory employment rates (52.9 to 65.6%) and high employment sustainability (greater than 6 months). The IHVT is a promising alternative to traditional vocational training. Contributing Authors: Shang-Liang Wu Additional Authors and Speakers: Eric Hwang Primary Author and Speaker: Hui-Ling Lee

Work Motivation and Employment Outcomes in People with Severe Mental Illness

Purpose To study associations between the level of self-reported work motivation and employment outcomes in people with severe mental illness (SMI) enrolled in a vocational rehabilitation program. Methods Data of 151 study participants, collected from a randomised controlled trial with a 30-month follow-up period, were used for a secondary data analysis. Multiple logistic regression, linear regression and cox regression analyses were performed to analyse the association between the level of work motivation at baseline and job obtainment, duration of job, and time until job obtainment during the 30-month follow-up period. Results No statistically significant associations were found between the level of work motivation and job obtainment (OR 1.83, 95% CI 0.55–6.06, p = 0.32), job duration (B = − 0.74, 95% CI − 2.37 to 0.89, p = 0.37, R-squared = 0.03), or time until job obtainment (HR = 1.53, 95% CI 0.64–3.68, p = 0.34). Conclusions The results of this study show no statistically significant associations between the level of work motivation and employment outcomes in people with SMI enrolled in a vocational rehabilitation program. These associations may be underestimated due to range restriction of the work motivation’s level. Further research is recommended to increase knowledge on the associations between work motivation and employment outcomes, as it could be relevant for further understanding success in vocational rehabilitation.

장애인 구직행동 패턴이 취업에 미치는 영향 분석 연구 : 사회연결망 분석의 적용

장애인 구직행동 패턴이 취업에 미치는 영향 분석 연구 : 사회연결망 분석의 적용

Correlates of Perceived Job Performance Among Employed Adults With Multiple Sclerosis

BackgroundThe expectation to remain in the labor force is a powerful indicator of long-term employment outcomes for people with multiple sclerosis (MS), and it is determined in part by perceived current job performance.ObjectiveThis study identified correlates of perceived job performance among working adults with MS.MethodParticipants included 611 members of nine National Multiple Sclerosis Society chapters representing 21 states and Washington, DC. Participants were employed, and primarily female (81%), older (average age of 48 years), and White (77%).ResultsHierarchical multiple regression analysis revealed that males, Whites, people without or with low levels of cognitive impairment, and those who reported stronger job/person matches and higher levels of job satisfaction were more likely than other participants to positively evaluate their own job performance. The aggregated predictors explained 20% of the variability in participants’ job performance self-ratings.ImplicationsFindings show the complexity in predicting how satisfied employed people with MS are with their overall job performance, which in turn shapes their expectations and intentions about staying in or disengaging from the workforce. The implications of the findings for rehabilitation counseling interventions and for identifying adults with MS who would benefit from early intervention are discussed.

Value of schizophrenia treatment II: Decision modelling for developing early detection and early intervention services in the Czech Republic

BackgroundPositive findings on early detection and early intervention services have been consistently reported from many different countries. The aim of this study, conducted within the European Brain Council project “The Value of Treatment”, was to estimate costs and the potential cost- savings associated with adopting these services within the context of the Czech mental health care reform. MethodsCzech epidemiological data, probabilities derived from meta-analyses, and data on costs of mental health services in the Czech Republic were used to populate a decision analytical model. From the health care and societal perspectives, costs associated with health care services and productivity lost were taken into account. One-way sensitivity analyses were conducted to explore the uncertainty around the key parameters. ResultsIt was estimated that annual costs associated with care as usual for people with the first episode of psychosis were as high as 46 million Euro in the Czech Republic 2016. These annual costs could be reduced by 25% if ED services were adopted, 33% if EI services were adopted, and 40% if both, ED and EI services, were adopted in the country. Cost-savings would be generated due to decreased hospitalisations and better employment outcomes in people with psychoses. ConclusionsAdopting early detection and early intervention services in mental health systems based on psychiatric hospitals and with limited access to acute and community care could generate considerable cost- savings. Although the results of this modelling study needs to be taken with caution, early detection and early intervention services are recommended for multi-centre pilot testing accompanied by full economic evaluation in the region of Central and Eastern Europe.

Got Clean Slate? New Study Suggests that Criminal Record Clearing May Increase Earnings

An estimated one in three American adults has a criminal record. While some records are for serious offenses, most are for arrests or relatively lowlevel misdemeanors. In an era of heightened security concerns, easily available data, and increased criminal background checks, these records act as a substantial barrier to gainful employment and other opportunities. Harvard sociologist Devah Pager describes people with criminal records as “marked” with a negative job credential. In response to this problem, lawyers have launched unmarking programs to help people take advantage of legal record clearing remedies. We studied a random sample of participants in one such program to analyze the impact of the record clearing intervention on employment outcomes. Using methods to control for selection bias and the effects of changes in the economy in our data, we found evidence that: (1) the record clearing intervention boosted participants’ employment rates and average real earnings, and (2) people sought record clearing remedies after a period of suppressed earnings. More research needs to be done to understand the durability of the positive impact and its effects in different local settings and labor markets, but these findings suggest that the record clearing intervention makes a meaningful difference in employment outcomes for people with criminal records. The findings also suggest the importance of early intervention to increase employment opportunities for people with criminal records. Such interventions might include more legal services, but they might also include record clearing by operation of law or another mechanism that does not put the onus of unmarking on the person with a criminal record.

Attachment and Employment Outcomes for People With Spinal Cord Injury

The purpose of this article is to evaluate the mediation effect of hope on the relationship between attachment and full-time employment for people with spinal cord injury (SCI). Quantitative descriptive research design using logistic regression, multiple regression, and correlational techniques were used. Eighty-four persons with SCI were recruited from several SCI advocacy organizations in Canada, the United Kingdom, and the United States. The results show that secure attachment, anxious attachment, and hope were significantly related to employment. Hope was found to be a significant mediator of the relationship between attachment and full-time employment. Results provide support for the use of hope-based interventions by vocational rehabilitation counselors working with individuals with SCI.

Maintaining my employment: Learning from people living and working with mental illness

IntroductionEngagement in occupation, including employment, is central to mental health recovery. However, evidence demonstrates that people living with mental illness struggle to maintain their employment. The aim of this qualitative study was to gain a rich understanding of the experiences of people living with mental illness who have managed to maintain their employment, and specifically, the strategies they actively choose and use to stay in work.MethodSemi-structured interviews explored the perspectives of 10 people living with mental illness who were successfully maintaining their employment. Data were analysed using constant comparative analysis.ResultsParticipants described maintaining employment through a conscious and active process of using individualised combinations of specific strategies within the broader categories of: identifying and connecting with helpful people; looking after all of me; having a job that fits with who I am; staying motivated; positive reflection and re-framing; and choosing and using strategies in the workplace.ConclusionOccupational therapists might better support long-term employment outcomes for people living with mental illness by adopting a more recovery-oriented approach, facilitating people to actively identify, choose and use their own strategies to maintain employment.