Original research
Replication of a Prospective Randomized Controlled Trial of Resource Facilitation to Improve Return to Work and School After Brain Injury

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Abstract

Objective

To determine the extent to which previous findings on the effectiveness of resource facilitation to impact return to work and school could be replicated.

Setting

Outpatient rehabilitation clinic.

Participants

Outpatients with acquired brain injury (N=44).

Intervention

Fifteen months of resource facilitation services.

Main Outcome Measures

A revised version of the Vocational Independence Scale and the Mayo-Portland Adaptability Inventory-4 Participation Index.

Results

Participants randomized to the resource facilitation group demonstrated a significant advantage in terms of rate and timing of return to productive community-based work relative to control participants. When examining only return to competitive work (and not return to school), 69% of the resource facilitation group was able to return compared with 50% of the control participants. Analyses of measures of participation in household and community activities revealed that both groups improved significantly over the 15-month study period, but no significant advantage for either group was demonstrated.

Conclusions

This study replicates the positive impact of resource facilitation in improving productive community-based activity, including competitive employment and volunteering in the community.

Section snippets

Participants

Forty-four patients with acquired brain injury were recruited while participating in inpatient or outpatient programs. Inclusion criteria for the study were as follows: TBI or diffuse encephalopathy, including metabolic, infectious, or toxic (but not because of alcohol abuse) encephalopathy, or intracranial hemorrhage; between 18 and 60 years old; English as a native language or nonnative speaker with the assistance of a relative who is an English speaker or a translator; the individual with a

Participant characteristics

Forty-four participants consented to participate in the study. Of the participants, 62% were men, and 95% were white. Analyses of demographic and injury-related characteristics revealed no significant differences (P>.05) between the groups at enrollment for time since injury, age, sex, years of education, baseline cognitive functioning (Cognitive Log), participation (M2PI), and psychological adjustment (BSI-18).

Review of the results for the Orientation Log and Cognitive Log revealed that all

Discussion

The participants who received resource facilitation were found to have a significant advantage in terms of resuming community-based productive roles and activities relative to control participants. Not only were resource facilitation participants more likely to resume productive activities in the community, but they were found to do so at a faster rate (ie, significantly earlier) than control participants.

In this study, the resource facilitation group returned to competitive work, school, or

Conclusions

This study replicates the positive impact of resource facilitation in improving productive community-based activity, including competitive employment, volunteering in the community, and return to college or a university. Replication however of the impact of resource facilitation on measures of participation in activities in the home and community at large was not demonstrated.

Supplier

  • a.

    SAS version 9.4; SAS.

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    • Cited by (0)

    Supported by the Indiana Spinal Cord and Brain Injury Research Board (grant no. 040100) and the Rehabilitation Hospital of Indiana Foundation.

    Disclosures: none.

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    Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.