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

Not Applicable

Not yet recruiting

• Conditions: Spinal Cord Injuries; Spinal Cord Diseases
• Interventions: Other: Center Facilitator-Coordinated Services; Other: State Counselor-Coordinated Services

• Registration Number: NCT05506657
• Lead Sponsor: Kessler Foundation

Brief Summary

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

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.

Study Timeline

• Study First Submitted: 2022-01-19
• Status Verified: 2022-08
• Study First Submitted QC: 2022-08-17
• Last Update Submitted: 2022-08-17
• Study First Posted: 2022-08-18
• Last Update Posted: 2022-08-18
• Study Start: 2022-09-30
• Primary Completion: 2026-02-28
• Study Completion: 2026-08-31

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 162

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

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Center Facilitator-Coordinated Services	Center Facilitator-Coordinated Services	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.
State Counselor-Coordinated Services	State Counselor-Coordinated Services	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.

Primary Outcome Measures

Name	Time	Method
Employment Status (Percent Employed)	12-months post-enrollment	Proportion of participants in each group in competitive employment.

Secondary Outcome Measures

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