Customized Employment for Veterans With Spinal Cord Injury

Completed · Not applicable

Conditions studied: Spinal Cord Injury

In brief

The reason for conducting this study is to learn about the best ways to help Veterans with spinal cord injury (SCI) gain meaningful employment. Spinal cord injury is a medically complex disability that poses unique barriers to employment for Veterans. Returning to work after SCI improves health and quality of life, which in turn can lower risk for suicide in this high-risk population. Hence, the Department of Veterans Affairs (VA) supports interventions that help Veterans with SCI return to work and may prevent suicide. Customized employment (CE) is an innovative strategy for tailoring vocational services to meet the needs of people with complex disabilities. To address barriers to employment faced by Veterans with SCI, this study will evaluate whether a customized employment intervention used in non-VA settings can be adapted for use by the VA as a part of SCI medical rehabilitation. The research goal is to evaluate how a CE intervention for Veterans with SCI (ACCESS-Vets) can help them discover their strengths to find and maintain competitive integrated employment in their communities. This study will compare ACCESS-Vets with the usual evidence-based supported employment program, known as Individual Placement and Support (IPS). Veterans with SCI who chose to participate in this study will be randomly selected (i.e. by chance) to work with a vocational rehabilitation specialist as part of the ACCESS-Vets intervention or the usual IPS employment program for about 8 months. Study participants will complete study questionnaires before, during, and after their participation in the employment interventions. Some Veterans and their medical rehabilitation providers will be interviewed about their experiences with the employment interventions. The study expects to find that Veterans who participate in ACCESS-Vets will have better employment and quality of life outcomes then those who participate in IPS. The study will provide information about the strategies used in the ACCESS-Vets and IPS interventions for addressing barriers to employment. Ultimately, this study may provide a model for making VA vocational services for Veterans with SCI more effective and sustainable.

Key facts

Study ID

NCT04832802

Run by

VA Office of Research and Development

People needed

48

Starts

2022-02-14

Expected to finish

2025-06-01

Last updated by the study team

2025-06-10

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Veteran inclusion criteria
• English-Speaking Veterans
• 18 years of age or older
• Want to find work in their community
• Have received or are currently receiving IPS VA provider inclusion criteria
• CE providers and other clinical providers on the SCI interdisciplinary team and other stakeholders.

You may not qualify if…

• Veteran exclusion criteria
• Living more than a two hours drive from the VAMC
• Progressive spinal cord disorder or terminal diagnosis, e.g., multiple sclerosis
• Moderate to severe traumatic brain injury or Rancho Level of 6 or less on discharge from acute rehabilitation,
• Diagnosis of or documented treatment for psychosis in previous 6 months
• Untreated substance use disorder
• Visual, hearing, or cognitive impairment preventing consent or ability to participate in essential elements of the intervention VA provider exclusion criteria
• Providers who do not meet inclusion criteria

Where it is running

• James A. Haley Veterans' Hospital, Tampa, FL — Tampa, Florida, United States
• Hunter Holmes McGuire VA Medical Center, Richmond, VA — Richmond, Virginia, United States

Full record on ClinicalTrials.gov

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