Personal, environmental, and service-delivery determinants of employment quality for state vocational rehabilitation consumers: A multilevel analysis

BACKGROUND: This study used the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to examine the individual and interactional impact of personal characteristics, state vocational rehabilitation (VR) services, and state environmental factors on employment quality for people with disabilities served by the state-federal VR system. DESIGN: Quantitative descriptive research design using multilevel analysis. PARTICIPANTS: Data extracted from the Rehabilitation Services Administration (RSA) case service report (RSA-911) database and other related databases from FY 2007 to 2009 were analyzed using multilevel (hierarchical) linear modeling to investigate patterns explaining variations among state VR agencies in achieving quality employment outcomes for consumers whose cases were closed successfully. RESULTS: Consumer characteristics predominantly predicted employment quality among the personal, service, and environmental factors studied. Personal factors also explained a considerable amount of between-state differences in quality employment outcomes. Improvement in educational attainment was related to higher employment quality, whereas receiving supported employment and job placement-related services were associated with lower employment quality. Additionally, the proportion of consumers receiving social security benefits in a particular state and state per capita income factors were strong environmental predictors of employment quality. CONCLUSION: Personal and environmental factors used in the present study were useful in predicting the quality of employment outcomes of VR consumers. However, developing a better measurement model for assessing quality employment and including additional factors in future research is warranted.