Absence of conflict of interest.
Citation
Highlights
- The study’s objective was to examine the impact of engaging in transitional work on outcomes measuring competitive employment and income for U.S. military veterans with post-traumatic stress disorder (PTSD).
- The study used a nonexperimental design to compare the outcomes of veterans who held a transitional work assignment and those who did not. All veterans were offered the opportunity to participate in transitional work as part of receiving Department of Veterans Affairs (VA) vocational rehabilitation services. Data sources included patient records from VA medical centers and daily logs completed by participants that included copies of paystubs or tax forms. Outcomes were analyzed using regression analysis.
- The study found a negative statistically significant relationship between engaging in transitional work and competitive employment and time to first competitive job within six months after veterans were offered participation in the transitional work program. The study found no statistically significant relationship between transitional work participation and competitive employment nine months after the offer of transitional work. There was no statistically significant relationship between transitional work participation and income.
- The quality of causal evidence presented in this report is low because the authors compared outcomes of veterans who participated in transitional work to a control group of veterans who were offered transitional work but did not participate. Veterans who participated in transitional work could differ in observable and unobservable ways, affecting the observed employment outcomes. This means we are not confident that the estimated effects are attributable to transitional work; other factors are likely to have contributed.
Intervention Examined
Transitional Work
Features of the Intervention
Transitional work provides veterans with a vocational assessment and a temporary minimum-wage work assignment. Work assignments are arranged with partner employers and are exclusively for veterans. Veterans holding a transitional work assignment are paid by the transitional work program, not the employer. Examples of transitional work assignments include: landscaping, maintenance, housekeeping, and food service jobs. Veterans also received job search counseling to obtain a competitive job during their transitional work assignment.
Features of the Study
The study is a secondary analysis of data from the Veterans Individual Placement and Support Towards Advancing Recovery (VIP-STAR) study, a multisite randomized controlled trial that compared the impacts of individualized placement and support (IPS) and vocational rehabilitation that included transitional work assignments for veterans with PTSD. The VIP-STAR study included 571 veterans between 18 and 65 years of age who (1) received vocational rehabilitation services; (2) had been diagnosed PTSD; (3) were unemployed; (4) expressed interest in seeking competitive employment; and (5) were medically cleared to return to work. The study uses data from 270 veterans who were randomized to the transitional work program while receiving vocational services at 12 VA medical centers from December 2013 through April 2015. The authors compared employment outcomes of 141 veterans who held a transitional work assignment during the 18-month study period to 129 veterans who did not.
Within the group assigned to the transitional work program, 81 percent were male, 50 percent were White, and had on average 8 years of past military service.
Employment outcomes were measured using daily logs that participants submitted at each monthly or bi-monthly vocational rehabilitation program visit during the 18-month study period. Daily logs included copies of paystubs or tax forms. The authors used a statistical model to compare the outcomes of veterans who engaged in transitional work and those who did not.
Findings
Employment
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The study found no statistically significant relationship between engaging in transitional work and holding a competitive job for 9 months or longer, obtaining a competitive job within 12 months of receiving the offer of transitional employment, obtaining a competitive job within 18 months, holding a full-time competitive job, types of jobs held, weeks competitively employed, days competitively employed, and weeks competitively employed full-time.
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The study found a negative statistically significant relationship between engaging in transitional work and time to first competitive job and obtaining a competitive job within 6 months after veterans received the offer of the transitional work program.
Earnings and Wages
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The study found no statistically significant relationship between engaging in transitional work and income.
Considerations for Interpreting the Findings
The authors compared outcomes of veterans who engaged in transitional work to a control group of veterans who were offered transitional work, but did not participate. Veterans who self-selected to participate in transitional work could differ in observable and unobservable ways, affecting the observed employment outcomes.
Causal Evidence Rating
The study receives a low evidence rating because veterans self-selected into transitional work. Veterans who participated in transitional work could differ in observable and unobservable ways, affecting the observed employment outcomes. This means we are not confident that the estimated effects are attributable to transitional work; other factors are likely to have contributed.