The Influence of State-Level Contextual Factors on State/Federal System Vocational Rehabilitation Employment Outcomes for Persons With Traumatic Brain Injury

The purpose of this exploratory study was to develop a preliminary understanding of the influence of state-level contextual factors predictive of employment outcomes for the U.S. State/Federal Vocational Rehabilitation System (State VR) participants with traumatic brain injury (TBI). Participants were 5,213 individuals with TBI with Individualized Plans for Employment closed during federal Fiscal Year 2016. A four-step hierarchical logistic regression model (5.6% explained variance) containing five demographic, three state-level economic, six state TBI service climate, and nine State VR service variable expenditures correctly classified 57.0% of cases as attaining or not attaining an employment outcome at closure. Significant predictors associated with an employment closure were (a) education, veteran status, and presence of a secondary area of disability impairment; (b) state-level per-capita income; (c) State VR specialized acquired brain injury (ABI)/TBI service and state TBI Implementation Partnership grant funding; and (d) State VR service expenditures on diagnosis and treatment, occupational or vocational training, on-the-job training, job readiness training, transportation, maintenance support, and benefits counseling. The practice, policy, and research implications of these findings are presented.