Category: Military and Veterans Affairs; Spinal Cord Injury
Objective : To describe how providers use a toolkit and identify changes to improve usability.
Design :
Formative evaluation of a newly developed toolkit.
Setting : A VA SCI Center.
Participants (or Animals, Specimens, Cadavers) :
Fourteenproviders at a Midwest Veterans' Affairs Medical Center (SCI clinicians, vocational rehabilitation counselors, and SCI leadership) were purposively recruited from the VA SCI Center to participate in a field test of an Individual Placement and Support (IPS) Supported Employment toolkit and qualitative interviews.
Interventions :
Over a six-month period,providers were trained and received ongoing mentored support in using a toolkit, "Tools for a Working Life with Spinal Cord Injury (SCI): Translating Evidence-Based Employment Services into Practice," to increase use of the IPS model of supported employment in their SCI Center.
Main Outcome Measure(s) :
Semi-structured qualitative phone interviews of providers at a VA SCI Center at two time-points, baseline and 6 months later. Interviews were audio recorded with permission and extensive notes were taken during the interview. Matrix analysis, a rapid assessment approach, was used to identify salient themes from the interviews.
Results :
At baseline, most participants had reviewed some or all the toolkit while others reported not having time to review due to busy workload and schedules. Participants described making referrals to the vocational program and increasing discussions about employment. Follow-up interviews identified recommendations to improve usability of the toolkit: (1) reduce the amount of information; (2) increase user-friendliness and access to toolkit materials; (3) reorganize the content by discipline; (4) add resources for patient education; and (5) provide guidance for clinical champions.
Conclusions :
The field test of the toolkit simultaneously engaged providers in IPS implementation and knowledge translation as their experiences informed further toolkit revisions. Pilot testing of the revised toolkit is needed.
.jpg "Bridget Cotner photo")
Bridget Cotner
– Health Science Specialist, James A Haley Veterans Hospital, Tampa, Florida
Lisa Ottomanelli
– Clinical Psychologist, James A Haley Veterans’ Hospital, Rehabilitation Outcomes Research Center, Tampa, FloridaNora Arriola
– Health Science Specialist, James A Haley Veterans’ Hospital, Tampa, FloridaRich Toscano
– National Program Evaluation Specialist / Research, US Department of Veterans Affairs, Saint Simons Island, GeorgiaJoseph Carlomagno
– National Supported Employment Program Specialist, Therapeutic and Supported Employment Services, U.S.Department of Veteran Affairs, Montpelier, Vermont