Exclusive: Nurses with disabilities face discrimination in workplace

Source: Exclusive: Nurses with disabilities face discrimination in workplace | News | Nursing Times

Nurses with disabilities regularly face discrimination in the NHS, despite ongoing efforts to boost equality, an investigation by Nursing Times has found.

One nurse with a lifelong condition described how she had been told by colleagues she was a danger to herself and patients, and “should not be a nurse”.

Other nurses talked about job offers being withdrawn when a disability was mentioned and having to threaten court action to ensure managers made reasonable efforts to accommodate their needs.

They described their struggle to continue working in the NHS ahead of the introduction of a new Workforce Disability Equality Standard (WDES), which is designed to help trusts improve practice.

Holly Chadd, peer support officer at the Royal College of Nursing, told Nursing Times that discrimination was still a common problem experienced by disabled members.

Mayo Clinic Alumni Association | ‘It can be done:’ Mayo Clinic School of Medicine evolves, accommodating a student’s disabilities

When Leah Grengs Thompson, M.D. (MED ’17), was 6 years old, the Americans with Disabilities Act (ADA) became law. The ADA prohibits discrimination against individuals with disabilities in all areas of public life including jobs, schools, transportation.

leah grengs thompson

Leah, age 11

When Dr. Thompson was 11, she had a hemorrhagic stroke due to a benign brain tumor. Despite surgery, rehabilitation and years of therapy, she has permanent deficits including left-sided leg and arm weakness and significant vision loss.

Thanks to the ADA, she was accommodated through the years of her education but accepted that she was unable to do some things — play sports and drive, for example. She says she found her niche while volunteering at a Twin Cities hospital, near where she grew up.

“I hadn’t felt like I could do anything particularly well,” she says. “That changed when I started at the hospital. I loved working with patients and their families.

“I always assumed I wasn’t smart enough to be a doctor. My parents hadn’t gone to college, and I didn’t personally know anyone in medicine. When I started college and studied biology, I realized I was smart enough and became determined to go to medical school.”

A thriving undergrad

Dr. Thompson thrived at the University of Minnesota — inside and outside of the classroom —and earned bachelor’s degrees in neuroscience and anthropology and graduated summa cum laude. She received numerous scholarships:

  • Pediatric Brain Tumor Scholarship
  • Children’s Hospitals and Clinics of Minnesota Volunteer Services Scholarship
  • College of Biological Sciences Volunteer Award
  • University of Minnesota Access Abroad Scholarship
  • University of Minnesota Learning Abroad Center Scholarship
  • University of Minnesota Women’s Club Stephanie R. Boddy Scholarship
  • University of Minnesota Women’s Club Doris Doeden Scholarship
  • J.A. Wedum Foundation Scholarship
  • University of Minnesota President’s Student Leadership and Service Award

She traveled to Bolivia to assist in establishing clinics in impoverished rural communities and tutored at a homeless shelter in Minneapolis.

Dr. Thompson took the MCAT three times. “In college, I’d always sought accommodations and gotten extra time for exams due to my vision problems,” she says. “I was stubborn and didn’t ask for accommodations in taking the MCAT. I studied hard yet did poorly. I had trouble reading the passages. After I applied for accommodations, I did very well.”

Despite her successes, Dr. Thompson says she was so worried she wouldn’t get accepted to medical school due to her disabilities that she applied to 40 schools, using up all of her savings.

“I read the technical standards of the schools I applied to. They were difficult to interpret and understand,” she says. “I let all of the schools I interviewed at know about my physical limitations in advance. At a few schools, including Mayo, I met with a specialist to discuss my situation. This told me they took it seriously and would likely work to accommodate me.

“Mayo was where I really wanted to go. I jumped up and down when I was accepted.”

A self-accepting med school student

mayo clinic school of medicine

Leah Grengs Thompson, M.D., on Match Day

Dr. Thompson says she was shy at first with her medical school classmates. “I didn’t want to appear to need extra help or extra time for exams,” she says. “At Mayo Clinic, I learned to be more open and accepting of myself. Sometimes I can’t believe how lucky I am to have been able to go to medical school and do exactly what I want to do.”

To be able to do exactly what she wanted, though, is part of the spirit of the ADA.

A place of public accommodation

mayo clinic school of medicine

Robin Molella, M.D.

“Education is a place of public accommodation because we believe everyone has a right to be educated,” says Robin Molella, M.D. (MED ’90, I ’97, PREV ’99), director of Health, Disability & Accommodations for Mayo Clinic School of Medicine and a consultant in the Division of Preventive, Occupational and Aerospace Medicine at Mayo Clinic in Rochester. “The ADA started learning institutions down this path almost 30 years ago.”

Dr. Molella says Mayo Clinic School of Medicine has a history of accommodating individuals and, compared to other medical training institutions, “We’re quite far in this journey,” she says. “However, it’s not far enough. There’s pervasive ableism in medicine. And there’s a new desire to think about whether or not we’re doing everything we can to make our physician workforce as diverse as possible. Are we opening the doors of medical schools to more and more highly competent people who would be fabulous physicians?”

According to a recent New York Times story, more than 20 percent of the American population has a disability but as few as 2 percent of practicing physicians do. Most of those physicians acquired their disabilities after completing their medical training. Additionally, few people with disabilities are admitted to medical school, and those who are have higher attrition rates than nondisabled students. Why? Because they don’t always receive the support they need despite the ADA. Further, only one-third of medical schools explicitly state their support of accommodations for disabilities on their websites.

Every medical school determines its own technical standards, the cognitive and physical abilities required for admission. Mayo Clinic College of Medicine and Science has a robust Accommodation for Disabilities policy, which states that it will make reasonable effort to accommodate students, residents, fellows and postgraduates with disabilities as defined in Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990. Any student with a physical, psychiatric, sensory or learning disability may request reasonable accommodations after providing adequate documentation from appropriate licensed professionals to the Mayo Clinic College of Medicine.

“What do providers really need to be able to do?” asks Dr. Molella. “We must continuously ask what learners need to accomplish in medical school to define them as a physician. Not every physician needs the dexterity of a surgeon. If you plan to become an adult neurologist, must you catch babies in OB rotation? Are you disqualified if you can’t hold retractors for hours in surgery? How much of the shared training legacy in medical education is really necessary? We need to challenge our assumptions and better accommodate completely competent individuals with technology, for example, to ensure a diverse workforce.”

Working step by step, technical standard by technical standard to accommodate

Dr. Molella says Mayo Clinic School of Medicine was fully aware of Dr. Thompson’s limitations when she was admitted. “But we weren’t sure how we’d make it work,” she admits.

mayo clinic school of medicine

Alexandra Wolanskyj-Spinner, M.D.

Alexandra Wolanskyj-Spinner, M.D., (I ’95, HEMO ’98), senior associate dean for student affairs for Mayo Clinic School of Medicine since 2013 and a consultant in the Division of Hematology at Mayo Clinic in Rochester, had not yet encountered a student with physical challenges quite like Dr. Thompson’s when she entered the medical school.

“I saw this extremely bright, talented person pursuing medicine for the right reasons,” says Dr. Wolanskyj-Spinner. “How could we best help her to succeed?”

Dr. Wolanskyj-Spinner arranged for Dr. Thompson to meet with two Mayo physicians who have physical challenges to discuss how they have succeeded. She also arranged for the new medical student to meet with the student health and disabilities accommodations officer, Dr. Molella.

“Step by step, technical standard by technical standard, they came up with creative ways to help Leah succeed,” says Dr. Wolanskyj-Spinner, a consultant in the Division of Hematology.

She says, increasingly, students with disabilities will be applying for medical school. “They’ve been accommodated through higher education because of the ADA, and they want the same opportunities as anyone else. They’ll be our colleagues. This presents an opportunity for greater understanding and a shift in our education and culture. Mayo Clinic always spearheads the noblest of intentions.”

An evolving medical school

leah grengs thompson

Leah Grengs Thompson, M.D., at graduation with Fredric Meyer, M.D., executive dean for education, Mayo Clinic College of Medicine and Science

Dr. Thompson’s medical school journey wasn’t without bumps. A resident judged her harshly as a result of her physical limitation in an evaluation, using language that Dr. Wolanskyj-Spinner describes as judgmental and insensitive. “I asked the clerkship director to look at the evaluation and determine if it had unfairly affected Leah’s grade. He agreed it was inappropriate and changed the grade to reflect her overall performance. Situations like that provide us with opportunities to learn and better educate all of our learners and faculty members. Leah helped us look at ourselves and our practices, and we evolved and became more open minded. She took us to a place of greater possibilities and acceptance. We developed and standardized new processes and can better serve our diverse students in this regard, which is a priority for our school.”

According to Dr. Wolanskyj-Spinner, Dr. Thompson’s effect on how the school approaches disabilities is only a small part of her legacy. “Leah was integral to many initiatives to improve the quality of life for our students. She played important leadership and advocacy roles including serving on the Student Life and Wellness Committee and the Student Support Advisory Board, and spearheading our student lounge remodeling and My Story program. She enriched our school, her peers and my life. She’s an incredibly compassionate, empathetic person, which is extremely important in medicine, and I am proud to call her my colleague.

“I’m excited to watch Leah as she continues to knock down barriers and break glass ceilings. She will be a leader in her field. She left a permanent legacy at our school.”

A future without heroic effort

Dr. Molella points out that the medical school will have succeeded when students such as Dr. Thompson don’t have to be more courageous or heroic than any other medical student to succeed in medical education.

“Leah overcame incredible adversity to accomplish what she did. It really shouldn’t take that,” says Dr. Molella. “We have to make it easier to achieve this success without double or triple the effort anyone else has to put forth. That will happen when we continuously value diversity and make accommodations. What we gain in the end is so precious and valuable. Not a single person in Leah’s class will look at a person with a disability the way they would have without her in their class. Many vulnerable patient populations will be grateful to have physicians who better understand them and the challenges they face.

“Leah’s story is a success because of her. She had the stamina, willingness and desire to make it work despite the hurdles. Her success shows us it can be done.”

Dr. Thompson’s new chapter

mayo clinic school of medicine

Leah Grengs Thompson, M.D., with her husband, Daniel, at her graduation from Mayo Clinic School of Medicine

Today Leah (Grengs) Thompson, M.D., is a resident in psychiatry at the University of North Dakota in Fargo. She’s also recently married and gotten a rescue dog, Murphy.

A highlight of her medical school experience was serving on the Student Wellness Committee.

“I considered myself a mentor to students in the classes below me,” she says. “I tried to help those who asked for help. I learned so much from my classmates and physicians I worked with.”

mayo clinic school of medicine

Leah Grengs Thompson, M.D., on her wedding day

Dr. Thompson helped to start the monthly My Story program in which students and staff members share struggles they’ve faced — losing a loved one at a critical time, struggling with addiction or suicidal thoughts, having a physical disability, failing an exam. According to Amit Sood, M.D. (ADGM 05, CLRSH ’06), chair of the Mayo Mind Body Initiative and a consultant in the Division of General Internal Medicine at Mayo Clinic in Rochester, My Story highlights stories in which people have found a resilient pathway through life’s narrow lanes.

“Students love the My Story program,” says Dr. Sood. “Leah took on this project, which we’re expanding to all three Mayo campuses for all 4,000 learners.”

Dr. Thompson says she was surprised to learn that physicians who seemed to “have it all together” have gone through challenges similar to everyone else’s. “I had no idea of the things others had been through. Just because you’re a department head or well published doesn’t mean you’re immune to feeling completely alone. It helps to know others have had similar obstacles.

“I loved being a student at Mayo and gave everything I could to help others.”

After helping fellow students, Dr. Thompson found herself in need of help at the end of 2016. A brain scan showed some abnormal growth in the area of her childhood tumor. She had gamma knife surgery in January during the time she was interviewing for residency. She says Dr. Wolanskyj-Spinner acted as a surrogate parent to her during that time, helping her figure out her treatment options and how to navigate her residency interviews.

“After helping so many other students, it was crazy that I ended up needing help myself,” she says. “In the past, I’d have been shy about opening up. But I’d learned how to do that and called Dr. Wolanskyj-Spinner right away and asked for her help. She was wonderful.”

A recent scan showed the tumor is stable although lifelong monitoring is required.

PCPID Releases Report on Direct Support Workforce | Administration for Community Living

February 14, 2018 The President’s Committee for People with Intellectual Disabilities (PCPID) has released its 2017 report, America’s Direct Support Workforce Crisis: Effects on People with Intellectual Disabilities, Families, Communities and the U.S. Economy.

Source: PCPID Releases Report on Direct Support Workforce | ACL Administration for Community Living

Direct support professionals (DSPs) provide services and supports that empower people with intellectual disabilities to live in the community.

In the report, PCPID notes that DSPs promote participation in the U.S. economy “by helping people with an (intellectual disability) get jobs and by enabling family members to work.”  The report describes the current state of the DSP workforce as a “crisis,” noting that the average DSP wage is $10.72, most work two or three jobs, and the average annual DSP turnover rate is 45%.

The report also explores:

  • How these issues affect individuals, families, and human services systems.
  • The factors that contribute to these issues
  • Promising practices to strengthen the direct support workforce

PCPID serves in an advisory capacity to the President of the United States and the Secretary of Health and Human Services (HHS) promoting policies and initiatives that support independence and lifelong inclusion of people with intellectual disabilities in their respective communities. The committee includes representatives from several federal agencies and 13 citizen members.

Read the full report (PDF) or a plain-language version (PDF).

CDC – NIOSH Total Worker Health Webinar Series

NIOSH Total Worker Health® program

Source: CDC – NIOSH Total Worker Health Webinar Series

Webinar Series

Recognizing the complex, often interlinked hazards affecting the health, safety, and well-being of today’s workforce, the NIOSH Total Worker Health® program is excited to present a free webinar series aimed at providing the latest research and case studies for protecting the safety and health of workers everywhere. All 90-minute webinars are recorded and are available for on-demand viewing.

Webinar Series Learning Objectives

  • Describe recent trends in demographics, employment conditions, worker safety, injury, and illness as they relate to the health and well-being of workers.
  • Describe the relationship between at least one health condition and at least one condition of work.
  • Discuss the latest findings supporting rationale for implementing a Total Worker Health® approach.
  • List one potential opportunity for integration between health protection and policies, programs, and practices that promote health and advance worker safety, health and well-being.
  • Develop workplace programs and interventions that integrate elements of occupational safety and health protection with policies, programs, and practices that promote health and advance worker safety, health and well-being.
  • Identify sources of information on prevention of adverse worker health and safety outcomes and the promotion of Total Worker Health®.

Nurse Suicide: Breaking the Silence – National Academy of Medicine

Source: Nurse Suicide: Breaking the Silence – National Academy of Medicine | National Academy of Medicine

ABSTRACT | The purpose of this paper is to raise awareness of and begin to build an open dialogue regarding nurse suicide. Recent exposure to nurse suicide raised our awareness and concern, but it was disarming to find no organization-specific, local, state, or national mechanisms in place to track and report the number or context of nurse suicides in the United States. This paper describes our initial exploration as we attempted to uncover what is known about the prevalence of nurse suicide in the United States. Our goal is to break through the culture of silence regarding suicide among nurses so that realistic and accurate appraisals of risk can be established and preventive measures can be developed.

I Use a Wheelchair. And Yes, I’m Your Doctor. – The New York Times

When I was in the third year of my medical residency, I was asked to evaluate a new state-of-the-art, fully accessible exam table that would be used in doctors’ offices to better provide care for patients with mobility-related disabilities. The table could go as low as 18 inches off the ground to enable easier transfers for wheelchair users and had extra rails and grips to provide support for patients with impaired balance. I was to assess this equipment as a “user expert.” Although the table was designed

Source: I Use a Wheelchair. And Yes, I’m Your Doctor. – The New York Times

When I was in the third year of my medical residency, I was asked to evaluate a new state-of-the-art, fully accessible exam table that would be used in doctors’ offices to better provide care for patients with mobility-related disabilities. The table could go as low as 18 inches off the ground to enable easier transfers for wheelchair users and had extra rails and grips to provide support for patients with impaired balance.

I was to assess this equipment as a “user expert.” Although the table was designed to accommodate patients with disabilities, I rolled up to it to evaluate it from the perspective of a physician. “Do you want my opinion as a patient, or as a doctor?” I asked the surprised representatives from the medical equipment company.

I have been a wheelchair user since early childhood, when I sustained a spinal cord injury in a farming accident. I am now a practicing physician in the field of rehabilitation and sports medicine.

In my busy outpatient clinical practice, I witness the spectrum of patients’ reactions when they find out that their doctor is, herself, disabled. Typically those first few seconds after entering an exam room — before the patient’s guard goes up — are the most informative.

I find that these reactions are somewhat generational. Younger patients, having grown up amid a growing awareness of disability in society, typically do not react at all. They have clearly encountered empowered people with disabilities working in various professional roles. Older patients often seem confused, curious or, in rare circumstances, dismayed.

Several months ago, I wheeled into the room of an elderly woman. She looked at me, placed her hand on mine and, with a kind look asked, “Are you an invalid?” More recently, a jovial older man exclaimed, “You’ve got to be kidding me!” A few times, patients will hesitate to tell me their concerns, indicating “Well, doc, I feel bad complaining about this to you, when clearly your problems are bigger than mine.”

Several years ago, while in my residency, I was in line at our hospital cafeteria. Although my badge reading “Dr. Blauwet” and stethoscope were clearly visible, a man next to me in line said: “You look like you are doing pretty well. When are you going to be discharged?” Clearly, my wheelchair was the only thing he saw. Moreover, he equated my wheelchair with illness, rather than empowerment.

Over the years, I’ve thought a lot about situations like these, and I do not believe they come so much from direct prejudice as from people’s lack of experience with doctors who are also wheelchair users. A recent study revealed that less than 3 percent of medical school trainees are people with disabilities, and of these, only a small proportion are individuals with mobility impairment. How can we expect our patients or colleagues to know about the perspectives and needs of physicians with disabilities when we remain invisible to them? The reason for this underrepresentation is complicated. Most physicians with mobility disabilities will tell you that the problem is not that we lack the ability to do our job competently. As with many other educated, skilled professionals, we know how to choose a path that suits our talents and abilities. Reasonable accommodations, such as the use of standing wheelchairs in the operating room, give us the access we need to do our work. The larger barrier to entry for prospective doctors with disabilities, however, is bias, both overt and hidden.

A colleague who is quadriplegic recounted a medical school admissions officer telling him, “I’m afraid that you will not meet the technical standards for admission.” Although steeped in bias and probably illegal, this response was at least more direct than the more common form of discrimination where otherwise strong applicants with disabilities simply do not receive an interview or a call back. As our peers are accepted into prestigious schools and academic positions, we sit on the sidelines, left to question whether the fault lies with us or the system. Many give up their aspirations of a career in medicine altogether, electing to pursue work more “traditionally suited” for people with disabilities. Others lose sleep, questioning whether it was the right decision to disclose their disability in the application materials.

Anyone can enter, at any time, the minority group of people with disabilities. The most common cause of new, adult-onset disability is — simply put — aging. Physicians are often reluctant to disclose new-onset or progressive disability (like loss of hearing or vision, or reduced mobility) because of the fear of being stigmatized; medicine, after all, is still dominated by the prototype of physical prowess.

Dr. Lisa Iezzoni, a professor of medicine at Harvard Medical School, has been an important mentor to me for many years. She recounted her experience as a medical student at Harvard in the early 1980s, a decade before the passage of the Americans With Disabilities Act. In her first year at the medical school, after experiencing some physical and sensory symptoms, she was given a diagnosis of multiple sclerosis. Late in her third year, after a fall, she started using a cane, but her aspirations to pursue an internal medicine residency remained, despite the overt discouragement she received. At a student-faculty dinner, an influential professor told her: “There are too many doctors in the country right now for us to worry about training a handicapped physician. If that means someone gets left by the wayside, that’s too bad.”

The medical school refused to write a letter of recommendation for her residency application, so she could not pursue the training required for clinical practice. She pursued health policy research instead and became the first female professor of medicine at the Beth Israel Deaconess Medical Center and now directs the Mongan Institute Health Policy Center at Massachusetts General Hospital. Despite having had an extraordinarily successful career, she sometimes wonders what could have been if she had been able to practice medicine.

My experience, more than two decades later, was vastly different. As an undergraduate at the University of Arizona, I became interested in applying to medical school. I investigated the application process and took coursework that would set me up for success. I studied, networked, did internships and engaged in various activities that would strengthen my application. Additionally, throughout this time, I nurtured my alter ego as an athlete, pursuing the sport of wheelchair racing, and ultimately represented the United States in three Paralympic Games.

In the fall of 2002, I applied to medical school, received interviews at several prestigious universities and was accepted to the Stanford University School of Medicine. Throughout this process, I never once feared that my disability would get in the way of success. I could focus on my academic performance rather than expending mental energy around concerns of hidden bias.

As a member of the “A.D.A. generation,” I was blissfully ignorant that my visible disability could, in fact, derail my success. I simply assumed that I would be evaluated on merit, like my peers. (I also realized that my athletic success perhaps made me seem more “able.”) I now understand the privilege of that perspective. I cannot completely separate my disability identity from my professional role.

People with disabilities often express fear or dissatisfaction with our health care system because they face poor access and discriminatory attitudes. This must change. Perhaps having more doctors with disabilities is one solution. As with any underrepresented group in medicine, professional diversity should reflect our population’s diversity. That simple change can bring awareness, empathy and a shared experience that ultimately makes all of us better.

Cheri A. Blauwet (@CheriBlauwetMD), an assistant professor at Harvard Medical School, is a seven-time Paralympic medalist and serves on the board of the United States Olympic Committee.

Disability is a weekly series of essays, art and opinion by and about people living with disabilities.

The entire series can be found here. To reach the editors or submit an essay for consideration, write opinionator@nytimes.com and include “Disability” in the subject field. Follow The New York Times Opinion section on Facebook and Twitter (@NYTOpinion), and sign up for the Opinion Today newsletter.

Working and Training with a Disability Just How Far Have Attitudes Evolved: Neurology Today

Professionalism: Working and Training with a Disability Just How Far Have Attitudes Evolved?

Source: Working and Training with a Disability Just How Far Have Attitudes Evolved: Neurology Today

Professionalism: Working and Training with a Disability Just How Far Have Attitudes Evolved?

Hurley, Dan

doi: 10.1097/01.NT.0000526684.14066.b8
Neurologists and physicians who have neurologic disorders and disabilities discuss the challenges they have overcome to train and work with patients.

Dealing with severe bilateral sensorineural hearing loss is straightforward enough for Regina Troxell, MD, now in her fifth year as a child neurology fellow at Memorial Hermann in Houston: She relies on a hearing aid and lip reading to communicate. But, she said, dealing with some of her colleagues is sometimes somewhat more complicated.

“If an attending says something when we’re rounding and I don’t hear because there’s background noise in the hallway, or they’re not facing me, it can become an issue,” Dr. Troxell said. “A couple of times it has come up during evaluations, where they wrote, ‘I don’t know if she didn’t hear what I told her or just didn’t do it.’ Maybe they’re not comfortable asking me at the time of the event because it’s a disability.”

Getting misunderstood or underestimated has been a near-universal experience, said neurologists and other physicians who happen to have disabilities in interviews with Neurology Today. The physicians and medical students — who discussed a wide range of disabilities, from hemiparesis, multiple sclerosis, and cerebral palsy to spinal injuries and hearing loss — said handling their disability is often easier than handling their fellow physicians’ biases. But there are signs that progress has been made toward greater acceptance, they said.

Internet and cell phone usage patterns among young adults with intellectual disabilities

Source: JARID

Authors Cristina Jenaro, Noelia Flores, Maribel Cruz, Ma Carmen Pérez, Vanessa Vega, Víctor A Torres

First published: 24 July 2017



The risks and opportunities associated with the use of technologies are of growing research interest. Patterns of technology usage illuminate these opportunities and risks. However, no studies have assessed the usage patterns (frequency, duration, and intensity) and related factors in young people with intellectual disabilities.


Questionnaires on Internet and cell phone usage patterns, the Internet Over-Use Scale and the Cell-Phone Over-Use Scale, as well as the Beck Depression Inventory were filled out in one-on-one interviews of 216 youth with intellectual disabilities.


Young people with disabilities make more social and recreational rather than educational use of these tools, and show higher rates of excessive use of both technologies than a comparison group of 410 young people without disabilities. Also, their overuse is associated with other unhealthy behaviors.


The framework of support needs of people with disabilities should be considered to promote healthy Internet and cell phone use.

What Effect Does Transition Have on Health and Well-Being in Young People with Intellectual Disabilities? A Systematic Review

 Source: JARID

Background Transition to adulthood might be a risk period for poor health in people with intellectual disabilities. However, the present authors could find no synthesis of evidence on health and well-being outcomes during transition in this population. This review aimed to answer this question. MethodPRISMA/MOOSE guidelines were followed. Search terms were defined, electronic searches of six databases were conducted, reference lists and key journals were reviewed, and grey literature was searched. Papers were selected based on clear inclusion criteria. Data were extracted from the selected papers, and their quality was systematically reviewed. The review was prospectively registered on PROSPERO: CRD42015016905. Results A total of 15 985 articles were extracted; of these, 17 met the inclusion criteria. The results of these articles were mixed but suggested the presence of some health and well-being issues in this population during transition to adulthood, including obesity and sexual health issues. Conclusion This review reveals a gap in the literature on transition and health and points to the need for future work in this area.

Prospects for an Impact Evaluation of Project SEARCH: An Evaluability Assessment

Source: Prospects for an Impact Evaluation of Project SEARCH: An Evaluability Assessment

Authors: Arif A. Mamun, Lori Timmins, and David C. Stapleton

Project SEARCH has emerged as a promising program to address the challenges related to improving employment outcomes of youth with disabilities. It is a high school to work transition program that integrates employers and businesses with other educational and community rehabilitation service providers to engage youth with disabilities in paid work experiences. Recent monitoring and evaluation efforts suggest promising employment outcomes for Project SEARCH participants, but there has not yet been a rigorous impact evaluation with a large sample to demonstrate that these outcomes are substantially better than they would be if the participants had only relied on services and supports that are available outside of Project SEARCH.

In this report we present several design options for a rigorous impact evaluation of Project SEARCH. Relying on information we gathered from document reviews and from site visits conducted for this evaluability assessment, we propose two leading evaluation designs: one under the existing setting, where we take Project SEARCH sites, students, and other partners as given; and another under a demonstration setting, where we allow for the evaluation to play a role in determining the setting within which these players interact. We also discuss a few other alternative design options that we considered, but have concluded they are less appealing than those recommended.

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