Year of Award


Document Type


Degree Type

Doctor of Philosophy (PhD)

Degree Name

Interdisciplinary Studies

Department or School/College

Interdisciplinary Studies Program

Committee Chair

Tom Seekins

Commitee Members

Nancy Arnold, Doug Dalenberg, David Patterson, Jeffrey Greene


disability, health promotion, secondary conditions, Vocational Rehabilitation


University of Montana


The majority of wellness programs are offered at the worksite to full-time employees. Research about these programs indicates that participating employees experience improved health and work-related outcomes, and that outcomes are exaggerated for workers with multiple health risk factors.

People who are not employed or are underemployed cannot access health promotion services at the worksite. This is a significant barrier for people with physical disability because they experience lower rates of employment and higher rates of secondary health conditions than the general population.

Compromised health reduces the probability of full-time employment. Secondary health issues such as pain, depression, anxiety, fatigue, and sleep problems are each associated with worse employment outcomes. Many secondary health conditions, however, can be managed through health promotion activities. Increasing participation in wellness programs may be a viable strategy for improving health and employment outcomes of adults with physical disability. Vocational Rehabilitation provides one possible access point for this delivery.

The purpose of this study was to explore the viability of offering health promotion services within VRs array of services. Consumers of VR (n = 246) were recruited into this study to explore relationships among secondary health conditions, health promoting lifestyle behaviors, and employment. 162 consumers provided data at baseline and an 18 month follow-up measure, and constitute the study sample.

A binary logistic regression model was developed to assess how baseline secondary health conditions and health promoting lifestyle behaviors impacted employment outcome at 18 months. The model included variables to control for demographic characteristics (age, gender, education, marital status), disability severity, and economic indicators (receipt of public insurance benefits). Overall, the sum of secondary conditions score was the only significant predictor of employment. Because secondary conditions can be reduced and managed with health promotion programming, this research supports continued exploration about potential health promotion delivery within the VR system.

Ipsen_Appendix_A_Counselor_responsibility.pdf (93 kB)
Appendix A: Counselor Responsibility

Ipsen_Appendix_A_Surveillance_instrument.pdf (90 kB)
Appendix A: Surveillance Instrument

Ipsen_Appendix_B_11_point_summary.pdf (57 kB)
Appendix B: 11-Point Summary



© Copyright 2008 Catherine Adele Ipsen