Mapping community pathways to employment for youth with disabilities—a realist review

Abstract

Background and objectives: Youth with disabilities face significant challenges in accessing employment and transitioning from school-to-work settings. Youth in intersectional contexts face additional barriers. The ecological development theory posits that macro factors such as policies, programs, universal design, and accessible community infrastructure may foster youth participation across sectors and create pathways to employment. This review aimed: (a) to identify the community-based factors related to the employment of youth ages 15–25 with all types of disabilities, and (b) describe the contexts and mechanisms within employment readiness programs that contribute to successful school-to-work employment outcomes. Methods: We conducted a realist review following RAMESES standards on Medline, PsycINFO, ERIC, Policy Commons, Sociological Index, Google Scholar, REHABData and Canadian Research Index. Search terms were related to employment, disabilities, youth, and community factors. Analysis was grounded in the Ecological Systems Theory. The Child Community Health Inclusion Index (CHILD-CHII) Macro-Level factors were used as a framework for data extraction and analysis, including transportation, staff training, community design, awareness initiatives, healthcare access, general programs/services, volunteer/work, education, technology, web-mapping, accessibility policies, and social factors. The Gender Based Analysis Plus (GBA+) Framework was used to explore intersectionality in the programs described. Data was grouped into context, mechanisms, and outcomes to provide an overview of what programs exist, in what circumstances and what type of outcomes are considered successful employment in the existing research. Results: From 13,167 studies identified, 56 articles met the inclusion criteria. The most prominent Mechanisms included: education (n = 25) such as skills training (social, Cv writing, etc.) or providing information on post high school education options, and general programs/services (n = 38) such as job search or readiness training, and mentorship programs. Successful transition involved skills building, providing social supports, and increasing collaboration and communication between school and workspaces. Negative findings included skills learnt in program settings not translating to real-world settings, services for youth ending after program completion, a failure of coordination between community systems, and structural barriers in the workplace (youth dealing with pain management/fatigue). No considerations of intersectionality were addressed in the majority of these studies. Discussion: Existing youth employment programs focus mainly on the micro environment aspects and individual skills training, job preparedness and individual/employer-targeted strategies. Few mechanisms addressing the meso environment include socials supports and some limited services; however, the macro context of development is rarely addressed, with policies, standards, regulations and systems-levels programs that are not designed to favor employment outcomes for youth with disabilities, particularly those with intersectional realities. Understanding community ecologies, and system-level determinants of employment is critical to the development of inclusive communities and equitable employment opportunities.