Abstract
Purpose :
Vocational rehabilitation (VR) services aim to help legally blind individuals secure, regain or retain employment following vision loss, as rates of employment among legally blind VR consumers are reportedly low. We evaluated factors contributing to successful VR among individuals receiving services from the Massachusetts Commission for the Blind (MCB) to inform future improvements in services and outreach.
Methods :
Using existing data from MCB’s central registry of legally blind consumers, logistic regression was used to examine potential predictors of rehabilitation success. Age, gender, race, and diagnosis were explored as possible predictors. Case events between Jan 1, 2018 to Sept 4, 2020 were included in analyses (n=938). Rehabilitation success was a binary outcome defined as maintaining employment for 90 days.
Results :
Mean age of consumers was 42 years (SD 17.5); 51% were men, 65% were white. Most common diagnoses included retinal degeneration (13%), glaucoma (8.7%), and diabetic retinopathy (DR) (6.92%). Half of case events had a successful outcome (n=468). Common reasons for unsuccessful outcomes were lack of interest (35%) and being unable to locate the consumer (27%). Those younger than 39 years were 36% less likely to have VR success than those aged 40-44 (OR=0.64; 95% CI= 0.38-1.07; p=0.09). Gender was not a significant predictor of VR success (p=0.30). Those with DR were 45% less likely (OR=0.55; 95% CI= 0.31-0.96; p=0.04) and those with glaucoma were 44% less likely (OR=0.56; 95% CI= 0.33-0.94; p=0.03) to have VR success than those with congenital diagnoses. Asian, black, biracial, and biracial white-latinx consumers were all less likely to be rehabilitated than whites (p’s <0.05). There was a significant interaction between race and age among those ≤ 39 years, with those who are biracial being 78% less likely (OR=0.22; 95% CI= 0.06-0.6; p=0.007) and those who are latinx-white being 64% less likely (OR=0.36; 95% CI= 0.18-0.70; p=0.003) to have VR success than whites.
Conclusions :
The significant association between age, race, and diagnosis with VR success suggests that these factors should be considered in VR programs. Glaucoma and DR are more prevalent among black and latinx populations, who had lower rates of VR success and are under-represented in VR programs. More targeted outreach and tailored rehabilitation programs may be warranted for these populations.
This is a 2021 ARVO Annual Meeting abstract.