Working Well with a Disability

Working well with a Disability represents a line of research that translates our work in health promotion to the vocational arena.  Access to health-promotion programs is limited for many people with disabilities due to employment, financial, and insurance barriers.  Vocational Rehabilitation (VR) offers a systematic delivery access point for people who are not employed or who lack viable alternatives for obtaining or paying for health promotion services.

The most prevalent secondary conditions reported by VR consumers with physical disabilities include fatigue, physical conditioning problems, sleep problems, chronic pain, depression, eating or weight problems, and anxiety.  Many of these conditions are associated with worse employment outcomes for the general population and people with disabilities.  Fortunately, health promotion programs, including the Living Well with a Disability health promotion program, reduce limitation from secondary conditions and may reduce work-related health issues such as employee absenteeism, presenteeism (?), and health care utilization.

Working Well research began with an analysis of Behavioral Risk Factor Surveillance System (BRFSS) data to explore the relationship between days of limitation from secondary conditions and health promoting behaviors and employment for people with disabilities.  A logistic regression model showed that the probability of employment was higher for people reporting fewer days of limitation and who engaged in exercise after controlling for socio-demographic and disability variables including age, education, receipt of SSI or SSDI, and disability severity.

We constructed a similar logistic regression model with data from VR consumers to determine if secondary health conditions predicted downstream employment outcomes.  A lagged binary logistic model (n=264) showed that baseline employment status and limitation from secondary conditions were significant predictors of competitive employment at 18 months.

We used this background research as the foundation for adapting the Living Well program for VR consumers and testing its effectiveness (n = 297). Working Well group participants who attended over half of the Working Well sessions reported significantly lower rates of limitation from secondary conditions over the 1 year study span.  This work has resulted in additional applications of health promotion programming within Vocational Rehabilitation including Health Plans to Employment.

Links to Project Publications Available on UMScholarWorks:

Building the Case: Health Promotion for Vocational Rehabilitation Consumers

Findings from a Study of the Working Well with a Disability Program

Linking Health, Secondary Conditions and Employment Outcomes

Working Well with a Disability

Links to Scholarly Articles and Abstracts:

A Prospective Study to Examine the Influence of Secondary Conditions on Vocational Rehabilitation Client Employment Outcomes

Building the Case for Delivering Health Promotion Services withing the Vocational Rehabilitation System

Health, Secondary Conditions and Employment Outcomes for Adults with Disabilities

Working Well with a Disability: Health Promotion as a Means to Employment

Quick Links: Employment & Vocational Rehabilitation

Current Projects

  • Rural Contracted Services
    Vocational Rehabilitation agencies purchase job development services from vendors. How vendors are paid influences service reach, delivery outcomes, and pacing. The goal of this project is to increase the quality and number of vendors that provide job placement and development services in rural communities.
  • Rural Self-Employment Opportunities
    Self-employment is an important option for rural consumers of Vocational Rehabilitation services. The goal of this project is to develop and evaluate a state Vocational Rehabilitation self-employment process.
  • Use of Social Media for Employment
    In keeping with current job-search methods, Vocational Rehabilitation counselors should have capacity to guide consumers on the use of social media for a wide range of job-search and related tasks. This project will develop a recommended state Vocational Rehabilitation policy to guide use of social media and develop and evaluate training for VR counselors.

Completed Projects

COMPLETED PROJECTS | 2008 - 2013

 
  • Comparing Rural/Urban Vocational Rehabilitation Service Delivery
    We compiled 2008 and 2009 RSA-911 data with zip and county code information from 47 VR agencies and used these data to compare rural and urban caseloads and outcomes. As compared to urban, rural caseloads had a higher rate of transition aged students and a lower rate of consumers with mental health disability. Outcomes were different in terms of closure rates to self-employment, supported employment in integrated settings, and time to IPE plan development. Rural and urban data comparisons provide the basis for more targeted evaluation of VR delivery practices.
  • Health Plans to Employment
    People with disabilities often experience health problems such as pain, weight gain, or high blood pressure. These problems can make it difficult to hold a job. Participation in health promotion programs can have positive effects on health but services are often limited in rural areas. Health Plans to Employment is a virtual health promotion program that consumers can access from their homes.
  • Premature Exit from VR Services
    Consumers leave VR services for a number of reasons. Some leave because services are too slow, they are unable to find a job, or they have problems connecting with the VR counselor. Sometimes consumers are frustrated because promised services are not forthcoming. Finding solutions to these problems will save valuable VR funding as well as improve outcomes for VR consumers.
  • VR Agencies' Use of Telecommunications to Deliver Services
    People in rural areas have trouble getting to in-person meetings with VR counselors because of transportation barriers. Telecommunication may be one way to increase services to these consumers. Research on this topic led to the development of the Telecom Toolbox, an online service designed to educate VR counselors about using telecommunications to serve consumers.

COMPLETED PROJECTS | prior to 2008

 
  • Community and Economic Development
    This project developed a process for people with disabilities and agencies that provide disability services to assist with economic development in rural areas. One outcome of the project was a grant that supported low-income entrepreneurs and led to the development of 79 small businesses.
  • Vocational Rehabilitation Agency Self-Employment: Rural/Urban Use
    This project identified differences in rural and urban counselor attitudes and their use of self-employment as an employment outcome. Rural counselors used self-employment at higher rates than urban counselors, but both desired additional training in how to support consumers in business development.
  • State Vocational Rehabilitation Agency Self-Employment Policies and Procedures
    This project collected and analyzed state Vocational Rehabilitation agency policies and procedures on self-employment to develop a model policy for adoption.
  • National Study of People with Disabilities who are Self-Employed
    People with disabilities are self-employed at higher rates than the general population. This study surveyed entrepreneurs with disabilities to learn more about their successes and challenges as business owners.
  • Steps for Vocational Rehabilitation Counselors: Helping a Consumer Start a Business
    VR counselors are trained as employment counselors, not business developers. In order to provide services to consumers who want to start their own businesses, counselors need information and training. To address this gap, we developed a training designed for VR counselors to help them provide better services to people who want to be self-employed.
  • Vocational Rehabilitation Linkages with Small Business Development Centers
    This project focused on encouraging VR agencies to work with Small Business Development Centers. This collaboration is sometimes hard because each agency has different responsibilities. RTC: Rural looked at the ways in which the services provided by each agency overlapped and developed a process for collaboration.
  • Action on Self Employment
    The RTC: Rural and the Abilities Fund hosted a national conference to advance the cause of self-employment for people with disabilities. The conference focused on consumer access to capital.
  • Worker Cooperatives
    Worker cooperatives have a long history in rural America. Members of the cooperative co-own and manage the business and share costs and responsibilities. This project researched and described ways for people to organize and manage worker-owned businesses.
  • Working Well with a Disability
    Working Well with a Disability (WWD) is a program that was developed to help people with disabilities find and maintain employment by setting goals and improving their health. It was adapted from the RTC: Rural’s health promotion program, Living Well with a Disability (LWD). Researchers who developed LWD found that the healthier people are, the more they are able to do. The WWD program builds on LWD but focuses on consumers who are employed or seeking employment.

Products & Training

  • American Indian Disability Technical Assistance Center
    The American Indian Disability Technical Assistance Center (AIDTAC) was a national center providing information, training, and technical assistance to vocational rehabilitation and employment-related services assisting American Indians and Alaska Natives with disabilities.
  • Self-Employment Online Curriculum
    This is an online, self-employment training program for vocational rehabilitation counselors, counselors working in Section 121 programs and students pursuing a degree in vocational rehabilitation.
  • Telecom Toolbox
    Telecom Toolbox is an online resource for Vocational Rehabilitation counselors to help build their capacity to use online communication methods while providing services to consumers.
  • Working Well with a Disability
    Working Well with a Disability is a peer-led health promotion workshop that focuses on creating a healthy and balanced lifestyle that supports employment. Training is available.

External Resources