# Improving Access to Supported Employment for Veterans with Polytrauma/Traumatic Brain Injury

> **NIH VA I01** · VA BOSTON HEALTH CARE SYSTEM · 2022 · —

## Abstract

Anticipated impacts on Veteran healthcare: Supported Employment (SE) is an effective evidence-
based practice that focuses on competitive employment through job coaching and unlimited support. This
research aims to increase access to SE for Veterans with polytrauma/traumatic brain injury (PT/TBI) so
that more of these Veterans can reach their vocational potential. Ensuring that Veterans with PT/TBI can
access effective vocational rehabilitation services may help prevent numerous downstream health and
functional problems.
Project background: Many OEF/OIF/OND Veterans have experienced PT/TBI, which can result in
functional limitations and challenges to employment. Pogoda et al. found that among Veterans evaluated
in VHA PT/TBI clinics, approximately 20% reported that they were unemployed and looking for work, and
of these, 71.6% had a TBI diagnosis and were in their prime working years. Carlson et al. reported that
Veterans with PT/TBI have an interest in receiving SE services, yet are not routinely informed of
vocational rehabilitation programs. Though SE is targeted to Veterans with serious mental illness (SMI),
up to 25% of the SE caseload may be used for non-SMI clinical populations. However a recent review
found that more than one-half of VA SE programs were working below their caseload capacity and were
able to serve more Veterans. Moreover, very few PT/TBI clinics were referring Veterans to SE.
Project Objectives: The purpose of this study is to increase access to SE for Veterans with PT/TBI. This
will be achieved by (1) identifying actionable barriers and facilitators to referring Veterans to SE, providing
SE services to and retaining these clients, and integrating the SE and PT/TBI clinic teams, (2) developing
and refining an intervention package/toolkit for an SE-TBI program, and (3) implementing the intervention
and conducting qualitative and quantitative assessment of its effectiveness at local VA Medical Centers
(VAMCs) that are below SE caseload capacity.
Project Methods: Guided by the integrated-Promoting Action Research on Implementation in Health
Services (i-PARIHS) framework, for Aim 1, we will identify barriers and facilitators to SE-TBI by
interviewing SE vocational rehabilitation specialists and PT/TBI providers at (a) 4 VAMCs that have a
successful SE-TBI program, and (b) 12 VAMCs that are below SE caseload capacity. Based on findings
from Aim 1, we will adapt and refine current toolkit materials to develop a customizable intervention
package that includes menu-based choices (e.g., educational materials, marketing practices to facilitate
integration between the SE and PT/TBI clinic teams) to maximize success in SE referral and
implementation. Finally, for Aim 3, at the 12 VAMCs from Aim 1 that are below SE caseload capacity,
through external and internal facilitation, we will implement an intervention package to enhance PT/TBI
participation in SE and document: (a) its effectiveness for change in number of Veterans with PT/TBI
...

## Key facts

- **NIH application ID:** 10308554
- **Project number:** 5I01HX002162-04
- **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM
- **Principal Investigator:** Terri K. Pogoda
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-05-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10308554

## Citation

> US National Institutes of Health, RePORTER application 10308554, Improving Access to Supported Employment for Veterans with Polytrauma/Traumatic Brain Injury (5I01HX002162-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10308554. Licensed CC0.

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