2019 HSR&D/QUERI National Conference

1029 — Striving to Work: A Veteran-Centered Participatory Approach to Identify Strategies to Overcome Employment Barriers

Lead/Presenter: Lisa Ottomanelli,  Rehabilitation Outcomes Research Section, James A. Haley Veterans' Hospital, Tampa
All Authors: Ottomanelli L (Rehabilitation Outcomes Research Section, James A. Haley Veterans' Hospital, Tampa), O'Neill J (Disability and Employment Research, Kessler Foundation), Cotner, B (Rehabilitation Outcomes Research Section, James A. Haley Veterans' Hospital) Fyffe D, (Center for Spinal Cord Injury Research, Kessler Foundation) Hathaway W (Rehabilitation Outcomes Research Section, James A. Haley Veterans' Hospital) Ching D (Rehabilitation Outcomes Research Section, James A. Haley Veterans' Hospital) Quinn A (Center for Spinal Cord Injury Research, Kessler Foundation) White K (James A. Haley Veterans' Hospital)

Objectives:
The objective of this study is to utilize a Veteran-centered approach to understand the workplace experience from the perspective of individuals with disabilities and examine how Veterans with Spinal Cord Injury (SCI) strive to work and overcome employment barriers. The aim of this 4-phase project is to develop consumer informed action plans for employment interventions to guide current VA system-wide and community initiatives to enhance employment services. This presentation will report on Veteran engagement in Phase 1 activities including a Veteran Engagement Council, Community Action Board, and focus groups.

Methods:
This study uses a participatory-based research method. Phase 1 methods included: (1) Discussing with a standing research center's Veteran Engagement Council (VEC) employment strategies, study recruitment, and dissemination plans; (2) Convening a Community Action Board (CAB) of Veterans with SCI to develop and refine focus group structured interview guides and (3) Conducting focus groups of Veterans with SCI to discuss employment barriers and strategies for overcoming them.

Results:
Through an iterative participatory process, Phase 1 study results included: (1) the VEC recommended emphasizing multi-faceted approaches to recruitment, employment strategies, and dissemination; (2) the CAB helped develop and refine focus group interview guides to ensure relevance to Veterans with SCI; (3) Focus groups highlighted the strengths of peer networks, planning, and accommodations to be successful in workplace.

Implications:
This presentation highlights the practical and personal factors that facilitate and inhibit resuming employment for Veterans with SCI. Engaging Veterans in this early phase of research sets the stage for the development of a Veteran-centric vision for an action plan for employment services in subsequent study phases.

Impacts:
Active participation of Veterans, which continues through Phase 4, enhances the relevance of study measures for Veterans with SCI and the validity of the project procedures and outcomes. As this DoD funded study is conducted in collaboration with a Spinal Cord Injury Model System (Kessler), a wide perspective from Veterans with SCI treated in VHA and the SCIMS will broaden the impact of study findings to inform enhancements to existing and emerging employment services and facilitate delivery of personalized, pro-active and patient-driven health care based on Veteran preferences.