Progressive Goal Attainment Program for Veterans (PGAP for Vets)

VA Connecticut Healthcare System, Michael E. DeBakey VA Medical Center, The Boeing Company, Bristol-Myers Squibb, The Community Foundation for Greater New Haven, Disabled American Veterans

The purpose of this study is to test the effectiveness of the Progressive Goal Attainment Program (PGAP) in improving employment outcomes and community engagement among U.S. veterans with disabilities.

Veterans with disabilities often have low self-esteem and motivation, significant depression and a belief that their disability precludes them from gainful employment. The Progressive Goal Attainment Program (PGAP) is specifically designed to target these psycho-social risk factors of disability. PGAP is a structured, 10-week intervention that focuses on helping clients develop a planned activity schedule to assist them in resuming desirable life activities, including employment. The PGAP for Veterans Project will test the feasibility of delivering PGAP to U.S. military veterans. The research will focus on the best means of service delivery, staffing needs and how to coordinate PGAP in a larger veteran service system. MDRC will also gather information on the target population, recruitment methods, the feasibility of scaling and replication, and employment outcomes among the sample. Two hundred veterans will be enrolled and randomly assigned into the study across two sites: Errera Community Care Center within (part of the VA Connecticut Health Care System) and the Michael DeBakey VA Medical Center in Houston, Texas.

Perceived Disability, Mental Wellness, Employment, Social Integration and Engagement, Goal Achievement

The Progressive Goal Attainment Program (PGAP) is a behavioral intervention originally developed in Canada at McGill University in order to increase return to work and community integration for individuals who receive worker's compensation. PGAP is the first disability program that is specifically designed to target the psycho-social risk factors of disability. The premise behind PGAP is that inactivity and attitudinal barriers increase work disability, and these issues are a primary cause of unemployment for individuals with physical and mental disabilities. PGAP is a structured, 10-week intervention that focuses upon helping clients develop a planned activity schedule to assist them in resuming desirable life activities.

Lehman Quality of Life Interview: Participants to rate their level of satisfaction with several domains of their lives (e.g. daily activities, social relations etc.) and their feelings about their lives as a whole on a 1-7 ("delighted" to "terrible") scale.

Citizenship Measure: 42-item scale that asks about the person's involvement in community and social activities and their ability to act and make choices on their own behalf on a 1-5 ("not at all/never" to "a lot/very often") scale

Inclusion Criteria: Self-reporting a disability. Unemployed or under-employed. Likely to benefit from PGAP (i.e. unengaged in social and community activities, difficulty attaining work due to motivational factors). Exclusion Criteria: Does not consent to be in the study. Significant barriers: serious substance abuse, significant psychotic disorders and cognitive disabilities that would preclude them from active participation in PGAP.

Adams H, Ellis T, Stanish WD, Sullivan MJ. Psychosocial factors related to return to work following rehabilitation of whiplash injuries. J Occup Rehabil. 2007 Jun;17(2):305-15. doi: 10.1007/s10926-007-9082-3. Epub 2007 May 8.

Sullivan MJ, Adams H, Rhodenizer T, Stanish WD. A psychosocial risk factor--targeted intervention for the prevention of chronic pain and disability following whiplash injury. Phys Ther. 2006 Jan;86(1):8-18. doi: 10.1093/ptj/86.1.8.

Sullivan MJ, Feuerstein M, Gatchel R, Linton SJ, Pransky G. Integrating psychosocial and behavioral interventions to achieve optimal rehabilitation outcomes. J Occup Rehabil. 2005 Dec;15(4):475-89. doi: 10.1007/s10926-005-8029-9.

Hossain F, Baird P, and Pardoe R. Improving employment outcomes and community integration for veterans with disabilities: Early implementation of the Progressive Goal Attainment Program (PGAP) for Veterans Demonstration. April 2013. New York: MDRC.

http://www.mdrc.org/publication/improving-employment-outcomes-and-community-integration-veterans-disabilities