Youth with spinal cord injuries improve quality of life with a model mentoring program called “Back on Track”

back-on-track-wheelchair-1595802_1920Shem, K., Medel, R., Wright, J., Kolakowsky-Hayner, S. A., & Duong, T. (2011). Return to work and school: A model mentoring program for youth and young adults with spinal cord injury. Spinal Cord, 49(4), 544-549.

Summarized by Jessica Cunningham, B. A., Lab Manager, Center of Evidence-Based Mentoring

 

Introduction: 

People who become disabled in adolescence and adulthood (as opposed to having congenital disability present at birth or who develop a disability in childhood or late adulthood) often have a hard time adjusting to living with their disability. Becoming disabled can have a large, negative impact on educational attainment as well as job opportunities; and these things, in turn, have a negative impact on a person’s quality of life. We know that mentoring provides the most benefits to at-risk youth, so mentoring special at-risk populations, such as youth with spinal cord injuries is particularly important. Research on mentoring these populations is also important; finding out what types of interventions work best for whom can help to inform best practices for mentoring in wider contexts, like disabled youth as a whole. The following study looked to improve the quality of life for youth with spinal cord injuries through a mentoring program designed to help youth get back to work and school.

Background:

Improvements to medical treatment and rehabilitation of spinal cord injuries has provided the medical field to turn its attention to improving the quality of life for people with spinal cord injuries instead of just treating acute symptoms. Returning to work and school are often seen as markers of successful rehabilitation. However, rates of employment for people with spinal cord injuries in the U.S. are low, and these injuries can be particularly devastating for youth and young adults between 16 and 26. Predictors of return to work after injury are pre-injury employment history and level of education, but if youth are injured before they have a chance to work or go to college, it makes it harder for them to pursue employment or higher education. Accessing what resources do exist can be difficult for young people, and many people do not receive the services they require. In order to address this service gap, the “Back on Track” mentoring program was established to help community reintegration of young people with spinal cord injuries.

Method:

People were eligible to participate in the program if they were aged between 16 and 26, and were motivated to return or transition to post-secondary education or employment. Each mentee was matched with a mentor with or without a disability, although the researchers tried to recruit mentors that also had spinal cord injuries. Mentors were trained, and pairs were required to have a minimum of three contacts per month through either face-to-face, telephone, or online meetings. Involvement in the program ceased when the mentee transitioned to employment or college, but mentors were not forbidden to continue their relationships with their mentees if they chose.

Thirty-nine people were enrolled as mentees, with the same number of mentors. Twenty-eight mentees were male, and the average age of participants was 19.9 years old. In terms of race and ethnicity, eight participants identified as Caucasian, twenty-one identified as Hispanic, four identified as African American, and two participants identified as some other race or ethnicity. Thirteen participants had been previously employed, and the rest had no previous history of employment. Seven participants dropped out of the program before being matched; some because they returned to school or work before being matched, others because they had lost patience with the program, substance abuse or other issues. Four mentees chose to continue their relationships after the conclusion of their involvement in the program.

The researchers asked all participants to complete the Craig Handicap Assessment and Reporting Technique (CHART), which has five subscales: physical independence, cognitive independence, mobility, occupation, and social integration. The researchers also asked participants to complete the Disability Rating Scale, Participation Index of the Mayo-Portland Adaptability Inventory, Supervision Rating Scale, and Satisfaction with Life Scale at enrollment and collected follow-up data every three months until they completed the program or quit. For mentees who completed the program, the last follow-up was four months after they left the program, and for those who quit, their most recent follow-up was used for analyses. All of these measures are a way to measure the quality of life for disabled people.

At the end of the program, researchers also administered a self-designed satisfaction survey for participants.

Results:

The average wait time to be matched was 210 days, and the average length of participation in the program was 17 months. Ten participants completed the program; seven returned to school, two returned to work, and one attended school less than half-time. There were no significant differences in likelihood of completing the program between the people who had been previously employed and those who had not.

The researchers found that there was a trend for improvement in the cognitive independence measure of the CHART, but not in any other measures for people who dropped out of the program. For those who completed the program, more improvements were found in the quality of life measures; there was a trend towards significance in the cognitive and occupation measures in the CHART, and statistically significant improvements on the Participation Index of the Mayo-Portland Adaptability Inventory, and Supervision Rating Scale, but not on the Satisfaction with Life Scale.

Ninety percent of participants who completed the program and the satisfaction survey said that their experiences in the program were positive and they planned to keep in touch with their mentors.

Discussion & Conclusions:

Previous research has shown that peer support and peer mentoring can be particularly effective, but despite the researchers’ best efforts to find people with similar injuries to mentor the people in their study, not all mentees were matched with disabled mentors. Due to the small sample size of the project, the impact of having a disabled mentor cannot be determined.

Thirty-four percent of participants who completed the program were successful in returning to work or school, and these rates are similar to those published in other studies. Similarly, the authors note that “QOL [quality of life] measures improved significantly in this program overall by being matched with mentors, but improvement in the QOL was more so with mentees who were successful in returning to work/school,” which is in line with other published literature on people with spinal cord injuries.

Further research in this area is needed, but this study shows the feasibility and potential efficacy of a mentoring program for young people with spinal cord injuries. The authors note that the need for research is high, as “unemployment in individuals with SCI remains a serious and prevalent problem, which is particularly disturbing given that employment positively affects QOL and longevity.”

To access the original research, click here.

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