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Objective:To investigate differences of the perceived unmet needs in a post-acute brain injury sample when referred to Resource Facilitation (RF) among various race/ethnic groups.Participants and Methods:The methodology utilizied within this study consisted of a retrospective chart review, which was sourced from a clinical database serving chronic outpatients in the Midwest region. The main outcome measure was the Service of Unmet Needs & Service Use (SUNSU). The sample consisted of N = 455 subjects, which included a small sample size of Hispanics (N=7). Therefore, African American and Hispanic groups were combined for a total minority sample (N=84). Clinical disorders included within the study was an ABI from either stroke, anoxic injury, ruptured aneurysm, or tumor resection surgery. Eligibility criteria included participants’ admission into a RF program, a vocational goal, and a diagnosis of a moderate to severe TBI or other ABI. Lastly, key sociodemographic features included age, race, ethnicity, education, and sex.Results:Significant differences were found between ethnic groups (white non-Hispanics and minority group) in terms of years of education (p=<.01). White non-Hispanics had higher education (M=13.39, SD=2.23), reported significantly more rural addresses (40.2%, p=<.01), and had private insurance coverage more frequently than the minority group (33.7%, p=<.01). The full model was statistically significant, R2=.077 = F(4,450) = 9.387, p<.0001; adjusted R2 = .069. The addition of ethnicity led to a statistically significant increase in R2 of .019, F(1,450) =9.025, p<.0005.Conclusions:Ethnicity was found to be a predictive factor for greater unmet needs even after controlling for insurance, employment status, and urbanicity. It is currently unknown RF’s success rate in providing culturally competent services to different racial/ethnic groups, which consider factors such as primary language spoken, immigration status, and additional ethnocultural factors that could deter accurate reporting of unmet needs by minoritized groups. Future studies should investigate barriers in referring and meeting eligibility for this program and analyze post-treatment data to determine if the impact of racial, geographic, and insurance disparities is mitigated with RF treatment.

Background The job interview can be challenging for autistic adolescents considering the required social communication skills. Further, having decreased awareness of personal strengths may make it difficult to advocate for oneself to a future employer. The purpose of the current pilot randomized controlled trial (RCT) is to examine the preliminary efficacy and feasibility of a combined interventional approach using: the Virtual Interview Tool for Autistic Transition-Age Youth (VIT-TAY) and Kessler Foundation Strength Identification and Expression (KF-STRIDE). Method Twenty autistic transition-age youth (TAY) were randomly assigned to two groups: an intervention group ( n = 10) that received 9 h of VIT-TAY (interviewing practice with a virtual human), and three lessons of KF-STRIDE (positive psychology intervention to learn and discuss one’s personal character strengths) and a services-as-usual (SAU) group ( n = 10). The primary outcome was measured using a video-recorded mock job interview performed at pre- and post-test, which was rated by blinded assessors. Secondary outcomes included self-reports of job interview skill, interview anxiety, work readiness and recent job search behavior. Results Paired samples t-tests revealed significant differences between pre- and post-test in the intervention group (but not the control group) on the mock interview total score ( p = 0.02, d = 0.76) and self-reported job interview skills total score ( p = 0.02, d = 0.75). The intervention group (but not the control group) had improvements in work-readiness ( p = 0.06, d = 0.53) and job search behavior ( p = 0.07, d = 0.52) that were characterized by medium effect sizes. Conclusions This pilot study suggests that combining VIT-TAY with KF-STRIDE leads to improvements in performance-based and self-reported job interview skills.

Disability following traumatic brain injury (TBI) can impact community integration as well as employment post injury. Considering the impact unemployment can have on quality of life, recovery, and the economy, several targeted interventions have been identified in the literature. One successful evidence-based intervention is called resource facilitation (RF). RF is an intervention targeted at improving employment rates in the TBI community with resulting return to work rates well above established return to work rates published in the brain injury population. Even with the success of RF, variability in outcome in a concern. Identification of variables that contribute to positive or negative employment outcomes could help target at-risk patients earlier in the treatment protocol and influence clinical recommendations during treatment. This project was designed to identify the complex relationship between predictor variables and return to work after participation in the RF program. Although many models exist currently in the literature, none of the published models are appropriate for the RF population. Additionally, currently published models typically involve linear regression models making the relationships between predictor variables difficult to detect. Structural equation modeling (SEM) was used to test the variables identified in the literature and identify direct and indirect predictors of outcome. SEM allows for direct testing of mediating variables as well as proposed latent variables within one prediction model. A preliminary model based on theoretical considerations as well as empirical evidence was used as a starting point. Although the initially hypothesized model was not an appropriate fit for the current dataset, two statistically sound models were generated during post hoc testing. Upon successfully identifying the two prediction models, results indicate that brain injury survivors with childhood injuries cannot be modeled in the same sample as brain injury survivors injured as adults, suggesting a difference between rehabilitation patients and “habilitation” patients.