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.
- Project dates: 2003-2008
- Funded by: National Institute on Disability and Rehabilitation Research Grant No: H133B080023; Centers for Disease Control Grant No: RO1DD000135
- Principal staff: Catherine Ipsen, Ph.D., Nancy Arnold, Ph.D., Craig Ravesloot, Ph.D., Tom Seekins, Ph.D.
- Related projects: