Early Intervention to Promote Return to Work for People With Spinal Cord Injury

Study Overview
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Brief Summary
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For many people with spinal cord injury, seeking employment after injury is an important goal. There are services available to help people with disabilities. However, the best ways to coordinate and deliver these services are not yet known. This project will compare two ways of coordinating and delivering services that are designed to help people with spinal cord injury obtain employment.

Detailed Description
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Employment is important for financial security, social connection, and life satisfaction. Unfortunately, rates of unemployment remain high among people with spinal cord injury (SCI). To help address this challenge, the Northern New Jersey Spinal Cord Injury System (NNJSCIS) is conducting a single-site, randomized, controlled trial to compare two programs intended to increase rates of employment among people with SCI. The project will enroll 162 recently injured adults with SCI who are interested in becoming employed or returning to work and will compare different ways of delivering employment-related services in the first year after injury. Services will begin in inpatient rehabilitation and may include education, therapy, equipment provision, counseling, and other interventions. Information about employment status, earnings, community participation, and health will be collected through a combination of questionnaires and databases. Participants and service providers will also share their impressions of the programs via survey and focus groups. Analyses will examine the rate of participants employed at 1 year in each group, time to employment, earnings, community participation, and other aspects of well-being. Findings from this study will be used to determine which ways of delivering services are most effective in enabling employment by 1 year after injury, and to provide information to help other rehabilitation centers adopt effective programs.

Official Title
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Early Intervention to Promote Return to Work for People With Spinal Cord Injury

Conditions
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Spinal Cord Injuries, Spinal Cord Diseases

Intervention / Treatment
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* Other: State Counselor-Coordinated Services
* Other: Center Facilitator-Coordinated Services


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adults age 18 to 62 a neurological impairment secondary to an SCI that occurred less than 12 months prior to enrollment receiving inpatient rehabilitation at Kessler Institute for Rehabilitation (KIR) community living in the state of NJ after discharge from KIR have a goal to pursue competitive integrated employment or education/retraining leading to competitive integrated employment

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 62 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: State Counselor-Coordinated Services<br>In this program, services are coordinated by a counselor employed by the New Jersey State Division of Vocational Rehabilitation Services (NJDVRS), a state-based agency that assists people with disabilities who are interested in pursuing employment. While the participant is in inpatient rehabilitation or soon after their discharge, a member of the research team will assist them in completing the necessary documentation to apply for services from this agency. Services for which they are eligible will be provided directly through NJDVRS. | Other: State Counselor-Coordinated Services<br>* A counselor affiliated with the New Jersey State Division of Vocational Rehabilitation Services coordinates services that consider the participant's condition, needs and goals. Services participants may receive include: Education on programs designed to help people with spinal cord injury or brain injury pursue employment. Advice and guidance from professional counselors who have special training in helping people with disabilities pursue employment. Help completing applications for services. Assistance communicating with my employer about my needs and ways to accommodate them. Referrals to and services from other health care or technology providers.<br>|
| Other: Center Facilitator-Coordinated Services<br>In this program, services are coordinated by a facilitator who is employed by Kessler Institute for Rehabilitation and works cooperatively with NJDVRS. The facilitator will begin working with the participant during inpatient rehabilitation, or soon after discharge, depending on when they enroll in the study. Some services for which they are eligible will be provided through NJDVRS and others will be provided to them by the facilitator. | Other: Center Facilitator-Coordinated Services<br>* A facilitator affiliated with Kessler Institute for Rehabilitation coordinates services that consider the participant's condition, needs and goals. Services participants may receive include: Education on programs designed to help people with spinal cord injury or brain injury pursue employment. Advice and guidance from professional counselors who have special training in helping people with disabilities pursue employment. Help completing applications for services. Assistance communicating with my employer about my needs and ways to accommodate them. Referrals to and services from other health care or technology providers.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Employment Status (Percent Employed) | Proportion of participants in each group in competitive employment. | 12-months post-enrollment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Employment Efficiency (Median Time to Employment) | Median number of months from date of enrollment to date of competitive integrated employment; obtained through self-report. | 12-months post-enrollment | 
| Income | Earnings within the first 12 months post-enrollment as obtained from New Jersey Unemployment Insurance (UI) data. | 12-months post-enrollment | 
| Satisfaction with Life Scale (SWLS) | 5 item (2 minute) scale that provides global measure of life satisfaction. | Assessed at 1 month (baseline), 6, and 12 months post-enrollment. | 
| International SCI Quality of Life Basic Data Set | 3 item ( 1 minute) assessment of satisfaction with life as a whole, physical health, psychological health. | Assessed at 1 month (baseline), 6, and 12 months post-enrollment. | 
| Craig Handicap Assessment and Reporting Technique (CHART) | Subscales examine several objective physical independence, cognitive independence, mobility, occupation, social integration, and economic self-sufficiency; includes personal care assistance use. | Assessed at 1 month (baseline), 6, and 12 months post-enrollment. | 
| Spinal Cord Injury Quality of Life: Satisfaction with Social Roles and Activities (SCI-QoL) | 10 item short form (<5 minutes) examining extent of satisfaction or disappointment with social roles and activities; complements CHART. | Assessed at 1 month (baseline), 6, and 12 months post-enrollment. | 
| Patient Health Questionnaire (PHQ-9) | Measure of depressive symptomology (9 items; 3 minutes). | Assessed at 1 month (baseline), 6, and 12 months post-enrollment. | 
| Spinal Cord Injury Quality of Life: Self-Esteem | 8 item (<5 minute) short form; assesses emotional, evaluative, and cognitive perceptions of personal competence and worth. | Assessed at 1 month (baseline), 6, and 12 months post-enrollment. | 
| Spinal Cord Injury Quality of Life: Independence | 8 item (<5 minute) short form. | Assessed at 1 month (baseline), 6, and 12 months post-enrollment. | 
| Exit Survey | Includes rating scale and open-ended items pertaining to satisfaction with the program and suggestions for optimization of the programs. | 12-months post-enrollment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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employment, vocational rehabilitation