abstract: 'Purpose Early intervention vocational rehabilitation (EIVR) can improve

  return to work (RTW) outcomes for people with spinal cord injury (SCI).

  However, mechanisms explaining how and why EIVR works are not well

  understood. This study aims to develop a conceptual framework describing

  key mechanisms of EIVR intervention effect following SCI. Methods We

  synthesised data from a realist literature review with data from

  interviews of people with SCI (n = 30), a survey of people with SCI who

  had received EIVR (n = 37), a focus group of EIVR providers and a focus

  group of community vocational providers. We first synthesised the

  literature review and interviews to develop an initial programme theory

  describing the contexts in which mechanisms are activated to produce

  EIVR outcomes. Then we used data from the survey and focus groups to

  further refine the EIVR programme theory. Finally, a conceptual

  framework was developed to support knowledge dissemination. Results By

  ensuring consistent messaging across the multi-disciplinary team, EIVR

  programmes establish and maintain hope that work is possible following

  injury. Conversations about work allow individuals to determine the

  priority of work following injury. These conversations can also improve

  self-efficacy by providing individualized support to envisage pathways

  toward RTW goals and maintain worker identity. The synthesised study

  findings highlight the contexts and resources required to trigger

  activation of these mechanisms. Conclusions EIVR key mechanisms of

  effect are not specific to SCI as a health condition, therefore enabling

  this framework to be applied to other populations who face similar

  impairments and return to work barriers.'
affiliation: 'Dunn, JA (Corresponding Author), Univ Otago, Dept Orthopaed Surg \&
  Musculoskeletal Med, Christchurch, New Zealand.

  Dunn, Jennifer A.; Nunnerley, J. L.; Snell, D. L., Univ Otago, Dept Orthopaed Surg
  \& Musculoskeletal Med, Christchurch, New Zealand.

  Martin, R. A.; Hackney, J. J.; Nunnerley, J. L.; Bourke, J. A.; Young, T., Burwood
  Acad Trust, Burwood Hosp, Christchurch, New Zealand.

  Martin, R. A., Univ Otago, Dept Med, Rehabil Teaching \& Res Unit, Wellington, New
  Zealand.

  Bourke, J. A., Griffith Univ, Menzies Hlth Inst, Nathan, Qld, Australia.

  Hall, A., New Zealand Spinal Trust, Burwood Hosp, Christchurch, New Zealand.

  Bourke, J. A.; Derrett, S., Univ Otago, Ngai Tahu Maori Hlth Res Unit, Prevent \&
  Social Med, Dunedin, New Zealand.'
author: Dunn, Jennifer A. and Martin, R. A. and Hackney, J. J. and Nunnerley, J. L.
  and Snell, D. L. and Bourke, J. A. and Young, T. and Hall, A. and Derrett, S.
author-email: Jennifer.dunn@otago.ac.nz
author_list:
- family: Dunn
  given: Jennifer A.
- family: Martin
  given: R. A.
- family: Hackney
  given: J. J.
- family: Nunnerley
  given: J. L.
- family: Snell
  given: D. L.
- family: Bourke
  given: J. A.
- family: Young
  given: T.
- family: Hall
  given: A.
- family: Derrett
  given: S.
da: '2023-09-28'
doi: 10.1007/s10926-022-10060-9
earlyaccessdate: AUG 2022
eissn: 1573-3688
files: []
issn: 1053-0487
journal: JOURNAL OF OCCUPATIONAL REHABILITATION
keywords: Vocational rehabilitation; Spinal cord injury; Return to work
keywords-plus: EMPLOYMENT OUTCOMES; SERVICE
language: English
month: MAR
number: '1'
number-of-cited-references: '29'
orcid-numbers: Dunn, Jennifer/0000-0002-2894-7533
pages: 179-188
papis_id: fc43757d43b94ba378511f4e5249b44e
ref: Dunn2023developingconceptual
times-cited: '1'
title: Developing A Conceptual Framework for Early Intervention Vocational Rehabilitation
  for People Following Spinal Cord Injury
type: Article
unique-id: WOS:000836142900001
usage-count-last-180-days: '2'
usage-count-since-2013: '3'
volume: '33'
web-of-science-categories: Rehabilitation; Social Issues
year: '2023'