Translating Knowledge into Practical Guidance for Sustainable Employment Across the Life Course of Individuals with Disabilities: Study Protocol and Cohort Profile of the Work-Life Study on Spinal Cord Injury

Vocational integration (VI) services aim to support sustainable employment for persons with disabilities. However, in individuals with spinal cord injury (SCI), evidence on effective intervention targets and the evaluation of sustainable integration remains limited. The Work-Life Study aims to build an evidence base for supporting sustainable employment in Switzerland, by: (1) identifying typical work-life trajectories; (2) examining key work-life transitions and their predictors; (3) establishing a multi-state model for intervention targets; (4) exploring individual work-life narratives; and (5) developing guidelines for personalized VI practice. The study combines a mixed-methods design with a collaborative Integrated Knowledge Translation approach, actively involving VI professionals and individuals with SCI. Participants are recruited from the Swiss SCI Cohort Study (SwiSCI). Work-life history data are collected through a Biographical Survey and Biographical Interviews and analyzed alongside SwiSCI data. Guideline development includes a stakeholder meeting with representatives from the Swiss Paraplegic Group, SCI clinics, individuals with SCI, employers, and disability insurers. Of 2,041 eligible SwiSCI participants, 478 (23.4%) completed the Biographical Survey (median age 57.5 years; median time since SCI 19.1 years), with responders and non-responders showing comparable characteristics. Work-life data closely matched existing SwiSCI data (rho > 0.8), indicating good recall. The resulting guidelines will help VI providers coordinate rehabilitation services to optimally promote sustainable employment for individuals with SCI.