Ohio RETAIN Program for Employment Retention Among Disabled Individuals

Overseen By Amaka Osuoha, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mathematica Policy Research, Inc.

Disqualifiers: Retired, Workers' Comp claim, SSDI, Substance abuse, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 12 months

3200 Participants Needed

Trial Summary

What is the purpose of this trial?

The Retaining Employment and Talent after Injury/Illness Network (RETAIN) demonstration is a collaborative effort between the U.S. Department of Labor (DOL) and the Social Security Administration (SSA) to improve employment outcomes for individuals who experience injuries or illnesses that put them at risk of exiting the labor force and relying on disability programs and other public supports in the long term. RETAIN projects include a combination of medical provider services, stay-at-work/return-to-work (SAW/RTW) coordination services, and other SAW/RTW services. This evaluation will focus on the Ohio Department of Job and Family Services' implementation of "Ohio RETAIN." The evaluation will document how the project is implemented, describe enrollees, estimate the project's impacts on enrollees' outcomes, and assess whether the benefits outweigh the costs.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

What data supports the effectiveness of the treatment Ohio RETAIN?

Research on supported employment, which is similar to Ohio RETAIN, shows it can help people with disabilities keep their jobs by addressing various challenges they face at work. This includes using strategies like self-management and support from coworkers to improve job retention. ^{1 2 3 4 5}

Is the Ohio RETAIN Program safe for participants?

The available research does not provide specific safety data for the Ohio RETAIN Program or similar programs like RETAIN Kentucky. These programs focus on helping people return to work after injury or illness, but there is no mention of safety concerns in the studies reviewed. ^{1 6 7 8 9}

How does the Ohio RETAIN Program treatment differ from other treatments for employment retention among disabled individuals?

The Ohio RETAIN Program is unique because it focuses on employment retention for disabled individuals by integrating various strategies like supported employment, which combines job placement with ongoing support, unlike traditional rehabilitation methods that may not offer continuous assistance. ^{1 10 11 12 13}

Research Team

Jill Berk, PhD

Principal Investigator

Mathematica Policy Research, Inc.

Eligibility Criteria

The Ohio RETAIN trial is for people aged 18-65 living in specific counties of Ohio who have had a recent musculoskeletal injury or cardiovascular procedure, are currently working or job-seeking, and have work limitations prescribed by a doctor. It's not for those retired, with workers' comp claims, on disability insurance, substance abuse issues, legal representation, pregnancy, terminal disease or multi-system trauma.

Inclusion Criteria

I have documented work limitations due to my illness, confirmed by my healthcare provider.

I have a recent injury or surgery not caused by work that affects my job.

I have a recent significant injury or had a heart-related procedure.

Exclusion Criteria

Has legal representation

I am retired.

Pregnant

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the full set of RETAIN intervention activities, including medical provider services and SAW/RTW coordination services

12 months

Follow-up

Participants are monitored for employment outcomes and application for SSDI or SSI benefits

12 months

Treatment Details

Interventions

• Ohio RETAIN

Trial Overview Ohio RETAIN aims to help individuals stay employed after an injury or illness that could lead them to leave the workforce. The program includes medical services and coordination to facilitate staying at work or returning as soon as possible. This evaluation will measure how well it works and if it's cost-effective.

Participant Groups

Group I: RETAIN Programming Experimental Treatment 1 Intervention

The experimental group receives the full set of RETAIN intervention activities.

Group II: Control Active Control 1 Intervention

Medical providers who treat both treatment and control group enrollees receive training on stay-at-work/return-to-work best practices

Who Is Running the Clinical Trial?

Mathematica Policy Research, Inc.

Lead Sponsor

Trials

68

Recruited

31,130,000+

Social Security Administration

Collaborator

Trials

3

Recruited

8,400+

Findings from Research

A study of 1,484 individuals in supported employment programs revealed that job retention is influenced by various factors, including vocational skills, behavioral traits, economic conditions, and external circumstances.

Different strategies, such as compensatory techniques, self-management, and support from co-workers, are being explored to help individuals overcome behavioral challenges and improve their chances of keeping a job.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of behavioral deficits on employment retention: an illustration from supported employment. Kregel, J., Parent, W., West, M.[2014]

In a study involving 201 veterans with spinal cord injuries, those participating in the Supported Employment (SE) program were significantly more likely to secure competitive employment (30.8%) compared to those receiving Treatment as Usual (TAU) (10.5% and 2.3% for different TAU groups).

The SE program, based on the individual placement and support model, showed that most employment was achieved within the first year, with an average time to first job of about 17 weeks, highlighting the importance of early intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of supported employment for veterans with spinal cord injury: 2-year results. Ottomanelli, L., Barnett, SD., Goetz, LL.[2014]

In a study involving 201 veterans with spinal cord injuries, those who participated in a supported employment (SE) program were 2.5 times more likely to secure competitive jobs compared to those receiving treatment as usual (TAU) at intervention sites, and 11.4 times more likely compared to those in nonrandomized TAU at observational sites.

This research is significant as it is the first controlled study to demonstrate that a specific vocational rehabilitation program can lead to improved employment outcomes for veterans with spinal cord injuries, highlighting the effectiveness of SE in integrated vocational care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of supported employment for veterans with spinal cord injuries: results from a randomized multisite study. Ottomanelli, L., Goetz, LL., Suris, A., et al.[2012]

In a 24-month program of Individual Placement and Support (IPS) for veterans with spinal cord injury (SCI), 43.2% of participants secured competitive jobs, indicating the program's effectiveness in improving employment outcomes.

Among veterans without a history of traumatic brain injury, the employment rate was even higher at 52.2%, suggesting that IPS may be particularly beneficial for this subgroup.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Individual Placement and Support in Spinal Cord Injury: A Longitudinal Observational Study of Employment Outcomes. Ottomanelli, L., Goetz, LL., Barnett, SD., et al.[2018]

A systematic review of 9 trials involving employees on work absence for at least 4 weeks found that return to work (RTW) coordination programs led to a small but significant increase in the likelihood of patients returning to work compared to usual practice, with a risk ratio of 1.08.

RTW coordination also resulted in modest improvements in overall function, physical function, mental function, and pain levels, suggesting that while the effects are small, they may be clinically meaningful for patients at risk of long-term disability.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Return to work coordination programmes for work disability: a meta-analysis of randomised controlled trials. Schandelmaier, S., Ebrahim, S., Burkhardt, SC., et al.[2021]

The RETAIN Kentucky program, funded by the U.S. Department of Labor, aims to help individuals with non-work-related injuries and illnesses return to work or stay employed, utilizing RTW Coordinators for support.

After nearly 3 years of Phase 1, the program is transitioning to Phase 2, which will last 30 months and build on the insights gained to improve employment retention strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

RETAIN Kentucky: A return-to-work and stay-at-work program for people with disabilities grounded in the conservation of resources theory. Rumrill, P., Sheppard-Jones, K., Collett, JW., et al.[2022]

Approximately 65% of injured workers successfully returned to employment after participating in a return to work program, with significant factors influencing success including gender, motivation, and employer interest.

Workers from interested employers were 23 times more likely to return to work, while those whose intervention lasted over 5 months were 41% less likely to return compared to those with interventions of 3 months or less, highlighting the importance of timely and supportive employer engagement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Return-to-Work Program for Injured Workers: Factors of Successful Return to Employment. Awang, H., Shahabudin, SM., Mansor, N.[2018]

In California, 22.2% of State Disability Insurance (SDI) claims and 33.7% of Workers' Compensation (WC) claims last longer than 6 months, indicating a significant portion of claimants may be at risk of long-term disability.

The study suggests that understanding the characteristics of these claims can help predict which individuals are likely to remain disabled for at least 12 months, highlighting the need for early intervention services to improve outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Early Identification of Potential SSDI Entrants in California: The Predictive Value of State Disability Insurance and Workers' Compensation Claims. Neuhauser, F., Ben-Shalom, Y., Stapleton, D.[2019]

A study of 1850 patients with chronic disabling occupational musculoskeletal disorders found that older age, female sex, and extreme disability at admission were significant predictors of failing to retain work one year after treatment.

Other notable risk factors included nonworking status at discharge, antisocial personality disorder, receiving government disability benefits, and dependence on opiate pain medications, which can help tailor individualized treatment plans for better outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prediction of failure to retain work 1 year after interdisciplinary functional restoration in occupational injuries. Brede, E., Mayer, TG., Gatchel, RJ.[2012]

Job placement services significantly improve employment outcomes for individuals with orthopedic disabilities, yet only 25% of clients utilized these services, indicating a need for better access and awareness.

Clients receiving social security benefits had lower competitive employment rates (45%) compared to those without such benefits (60%), suggesting that these financial supports may discourage job seeking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Predicting employment outcomes of rehabilitation clients with orthopedic disabilities: a CHAID analysis. Chan, F., Cheing, G., Chan, JY., et al.[2022]

The Bristol Employment Collaborative (BEC) has created a successful model to improve employment opportunities for people with disabilities by training them as personal assistance services workers, addressing both unemployment and healthcare labor shortages.

Since its launch in 2009, BEC has implemented a certificate program through a local community college, with the first class graduating just ten weeks after enrollment, demonstrating a quick pathway to employment in a high-demand field.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Creating employment opportunities for people with disabilities in healthcare: the Bristol Employment Collaborative. Laszlo, A., Henry, A., Goldsberry, J., et al.[2022]

Supported employment is effective in helping 278 severely disabled individuals, including those with chronic mental illness and traumatic brain injury, to find and keep jobs in competitive industries.

The study revealed differences in outcomes based on disability type, such as variations in wages and job retention, providing a baseline for future evaluations of supported employment programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supported employment: an alternative model for vocational rehabilitation of persons with severe neurologic, psychiatric, or physical disability. Wehman, PH., Revell, WG., Kregel, J., et al.[2018]

In a study of 449 individuals with psychiatric disabilities over 13 years, those who received supported employment services were nearly three times more likely to be employed compared to those who did not receive these services.

Participants in the supported employment group earned significantly more per month and were much more likely to achieve nonbeneficiary status with Social Security, although the benefits of supported employment diminished over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Long-Term Effects of Evidence-Based Supported Employment on Earnings and on SSI and SSDI Participation Among Individuals With Psychiatric Disabilities. Cook, JA., Burke-Miller, JK., Roessel, E.[2019]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

The impact of behavioral deficits on employment retention: an illustration from supported employment. [2014]

2. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of supported employment for veterans with spinal cord injury: 2-year results. [2014]

3. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of supported employment for veterans with spinal cord injuries: results from a randomized multisite study. [2012]

4. United States pubmed.ncbi.nlm.nih.gov

Individual Placement and Support in Spinal Cord Injury: A Longitudinal Observational Study of Employment Outcomes. [2018]

5. United States pubmed.ncbi.nlm.nih.gov

Return to work coordination programmes for work disability: a meta-analysis of randomised controlled trials. [2021]

6. Netherlands pubmed.ncbi.nlm.nih.gov

RETAIN Kentucky: A return-to-work and stay-at-work program for people with disabilities grounded in the conservation of resources theory. [2022]

7. China pubmed.ncbi.nlm.nih.gov

Return-to-Work Program for Injured Workers: Factors of Successful Return to Employment. [2018]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Early Identification of Potential SSDI Entrants in California: The Predictive Value of State Disability Insurance and Workers' Compensation Claims. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Prediction of failure to retain work 1 year after interdisciplinary functional restoration in occupational injuries. [2012]

10. England pubmed.ncbi.nlm.nih.gov

Predicting employment outcomes of rehabilitation clients with orthopedic disabilities: a CHAID analysis. [2022]

11. Netherlands pubmed.ncbi.nlm.nih.gov

Creating employment opportunities for people with disabilities in healthcare: the Bristol Employment Collaborative. [2022]

12. United States pubmed.ncbi.nlm.nih.gov

Supported employment: an alternative model for vocational rehabilitation of persons with severe neurologic, psychiatric, or physical disability. [2018]

13. United States pubmed.ncbi.nlm.nih.gov

Long-Term Effects of Evidence-Based Supported Employment on Earnings and on SSI and SSDI Participation Among Individuals With Psychiatric Disabilities. [2019]