Addressing Employment Barriers Among Persons with Homeless Experiences: Implementation Lessons For Advancing Equity From an Electronic-Bicycle-Supported Vocational Rehabilitation Pilot.

Abstract

To combat persistent health and social disparities, the VA Greater Los Angeles and its community partners piloted a novel vocational rehabilitation program that employed persons who have experienced homelessness (PEHs) as app-based food deliverers. The program focused on removing barriers to employment, providing subsidized electronic bicycles for deliveries and personal use; "priority status" as deliverers; and access to financial literacy coaching. We aimed to characterize program experiences, with a lens toward program scale-up. We conducted semi-structured interviews with a convenience sample of 6 participants and 5 vocational rehabilitation staff. Interviews explored motivations to participate (among participants), and program strengths/challenges. Data were analyzed using rapid qualitative methods. PEHs reported high motivation to participate due to the e-bike and flexible scheduling of work duties. Interviewees reported positive program impacts including: financial relief; reduced transportation barriers; and improved mental health. Suggesting for improvement included enhanced technical support (with the app and e-bike); improved communication among program partners; and more individualized employment opportunities. These data suggest the value of this novel vocational rehabilitation model for PEHs. Specific recommendations for program scale-up include a centralized platform for participant technical support requests; and regular communication and data sharing agreements between implementation partners.