@article{ref1,
title="A vocational intervention that enhances return to work after severe acquired brain injury: a pragmatic trial",
journal="Annals of physical and rehabilitation medicine",
year="2023",
author="Simpson, Grahame K. and McRae, Philippa and Gates, Thomas M. and Daher, Maysaa and Johnston, Deborah and Cameron, Ian D.",
volume="66",
number="8",
pages="e101787-e101787",
abstract="BACKGROUND: Following a severe acquired brain injury, individuals often have low return to work rates. The Vocational Intervention Program (VIP), a partnership of Brain Injury Rehabilitation Program community rehabilitation centres with external vocational rehabilitation providers in New South Wales, Australia, was developed to facilitate a return to competitive employment for working-age people. <br><br>OBJECTIVES: To evaluate the efficacy of the VIP partnership model, this intervention was compared to outcomes from a health-based brain injury vocational rehabilitation centre (H-VR) or community brain injury rehabilitation centres (&quot;treatment as usual&quot;; TAU). <br><br>METHODS: A 3-arm non-randomized controlled trial was conducted among the 12 adult rehabilitation centres of the NSW Brain Injury Rehabilitation Program. The VIP arm was delivered by 6 community rehabilitation centres in partnership with 3 external private Vocational Rehabilitation providers. The H-VR arm was delivered by 1 health-based vocational rehabilitation centre and the 5 remaining centres delivered TAU. Competitive employment status (&quot;Yes&quot;/&quot;No&quot;) and clinician ratings of disability and participation were collected pre- and post-intervention, and at 3-month follow-up. Multilevel models were conducted to investigate change over time by treatment arm. <br><br>RESULTS: In total, 148 individuals with severe brain injury were included in the trial: n = 75 (VIP), n = 33 (H-VR) and n = 40 (TAU). Sixty-five people (of 108, 60%) completed the VR intervention. A significant arm-by-time interaction was found, with higher return to work rates from pre- to post-intervention in VIP and H-VR arms compared to TAU (P = 0.0002). Significant arm-by-time interactions also indicated improved work-related participation and independent living skills from pre- to post-intervention in VIP and H-VR compared to the TAU arm (P < 0.05). These improvements were maintained at 3-month follow-up. <br><br>CONCLUSIONS: The VIP improved return to competitive employment at comparable rates to the specialist H-VR. Larger-scale adoption of the VIP model could provide significant improvements in vocational rehabilition sevices to support people in their return to work following severe brain injury. ANZCTR TRIAL REGISTRY NUMBER: ACTRN12622000769785.<p /> <p>Language: en</p>",
language="en",
issn="1877-0657",
doi="10.1016/j.rehab.2023.101787",
url="http://dx.doi.org/10.1016/j.rehab.2023.101787"
}