Alisa Grigorovich1,2, Mary Stergiou-Kita1,3,4, Thecla Damianakis5, Guylaine Le Dorze3,6,7, Carolyn Lemsky8, Debbie Hebert1,3. 1. a Toronto Rehabilitation Institute , University Health Network , Toronto , ON , Canada. 2. b Dalla Lana School of Public Health , University of Toronto , Toronto , ON , Canada. 3. c Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , ON , Canada. 4. d Institute of Work & Health , Toronto , ON , Canada. 5. e School of Social Work, University of Windsor , Windsor , ON , Canada. 6. f School of Speech-Language Pathology and Audiology, Faculty of Medicine , Université de Montréal , Montreal , QC , Canada. 7. g Centre for Interdisciplinary Research in Rehabilitation of Montreal , Montreal , QC , Canada. 8. h Community Head Injury Resources , Toronto , ON , Canada.
Abstract
OBJECTIVES: To understand how employment services (ES) are provided to persons with brain injuries (PWBIs) in Ontario, Canada, and the impact service delivery has on competitive-employment outcomes. DESIGN AND METHODS: A mixed-method case study of one community-based agency that provides specialized services to PWBIs. Relationships between demographic, service-related variables and employment outcomes (2009-2014) were analysed using chi-squares and analyses of variance. In addition, 14 interviews were conducted and analysed using thematic analysis. RESULTS: PWBIs accessed services on average of 16 years post injury; 64% secured at least one competitive-employment job, which was how employment success was defined in this study. Average job tenure was 368 days, and average job intensity was 3.8 hours/day. Employment success was significantly associated (p < 0.05) with use of job development, job coaching, case management and job retention services. Interviews revealed that PWBIs were provided five services: job goal(s) identification, assessment of work-related abilities/skills, job development, on-the-job supports and job retention assistance. Challenges to ES delivery included lack of suitable jobs and hiring incentives, and difficulties in establishing natural supports at the workplace. CONCLUSIONS: PWBIs' employment outcomes may be supported through provision of ES to assist with: the development of realistic job goals and job-finding skills, securing work, on-the-job coaching and advocacy with employers.
OBJECTIVES: To understand how employment services (ES) are provided to persons with brain injuries (PWBIs) in Ontario, Canada, and the impact service delivery has on competitive-employment outcomes. DESIGN AND METHODS: A mixed-method case study of one community-based agency that provides specialized services to PWBIs. Relationships between demographic, service-related variables and employment outcomes (2009-2014) were analysed using chi-squares and analyses of variance. In addition, 14 interviews were conducted and analysed using thematic analysis. RESULTS: PWBIs accessed services on average of 16 years post injury; 64% secured at least one competitive-employment job, which was how employment success was defined in this study. Average job tenure was 368 days, and average job intensity was 3.8 hours/day. Employment success was significantly associated (p < 0.05) with use of job development, job coaching, case management and job retention services. Interviews revealed that PWBIs were provided five services: job goal(s) identification, assessment of work-related abilities/skills, job development, on-the-job supports and job retention assistance. Challenges to ES delivery included lack of suitable jobs and hiring incentives, and difficulties in establishing natural supports at the workplace. CONCLUSIONS: PWBIs' employment outcomes may be supported through provision of ES to assist with: the development of realistic job goals and job-finding skills, securing work, on-the-job coaching and advocacy with employers.
Entities:
Keywords:
Acquired brain injury; community integration; community-based rehabilitation; mixed method; work