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Abstract
Introduction Improving the employment of people with disability (PWD) has emerged as a key priority for governments worldwide as a strategy for improving health outcomes through greater economic participation. However, a significant barrier remains the lack of understanding among businesses regarding the requirements for a disability-inclusive workplace. This challenge is particularly salient for small and medium enterprises (SMEs) that lack dedicated human resources to develop supportive organisational cultures. This scoping review will assist smaller businesses in enhancing their capacity to employ PWD by undertaking a synthesis of the factors that will enhance SME capacity to hire and retain PWDs.
Methods and analysis This protocol uses the six-staged process for scoping reviews proposed by Arksey and O’Malley. This process begins with identifying the scoping review research question (Stage 1) and discussing how studies will be selected (Stage 2). The search will include all English-language articles within Web of Science, Scopus, PsycINFO, PubMed, Cochrane Library, Embase, Medline, EBSCO Global Health and CINAHL since inception. We will also include relevant secondary sources from the grey literature. Following the search process, we will present information on selecting studies for inclusion in the scoping review (Stage 3) and chart the data relating to the included studies (Stage 4). In conclusion, the scoping review protocol will synthesise and report the results (Stage 5) and provide information on consultation with relevant stakeholders during the initial protocol specifications (Stage 6).
Ethics and dissemination Since the scoping review methodology aims at synthesising information from available publications, this study does not require ethical approval. We will submit an article reporting the results of the scoping review for publication in a scientific journal, present the findings at relevant conferences and disseminate them as part of future workshops with professionals in disability employment.
- public health
- health policy
- rehabilitation medicine
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Strengths and limitations of this study
This study aims to systematically identify and review research on the employment of people with disability within small and medium enterprises.
The review will follow the six-staged process for scoping reviews proposed by Arksey and O’Malley, and the results will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines.
The main limitations of the resulting review relate to the inclusion of English-language articles only and the exclusion of self-employed entrepreneurs who do not have employees.
Introduction
Improving disability inclusion is a significant population health issue. According to the WHO,1 over one billion people or around 15% of the world’s population live with some form of disability, with almost everyone experiencing some form of disability throughout their life. The prevalence of disability presents a significant challenge for governments worldwide, with the Organization for Economic Cooperation and Development (OECD) countries already spending around 2% of Gross Domestic Product (GDP) on disability and related welfare benefits.2 To reduce this financial burden and to increase access for people with disability (PWD) to the positive health and well-being outcomes that flow from greater economic participation,2 governments in countries like Australia, the UK and the USA have introduced employment support programmes to help prepare PWDs for suitable employment opportunities.
Regrettably, the disparity in the employment rate of PWD compared with employment in the general population has remained constant for decades.3–6 Underlying causes for low disability employment are varied and complex, encompassing both discriminatory (eg, employer discrimination) and non-discriminatory factors (eg, disincentives from government-issued disability payment and lower education or skill levels).7 Understanding the factors contributing to a more disability-inclusive workplace is crucial in increasing the demand for PWD in the workforce.8
The present scoping review responds by exploring the drivers of employment of PWD in small and medium-sized enterprises (SMEs). Focusing on SMEs is essential as they play a major role in most economies, accounting for around 90% of businesses and 50% of employment worldwide and contributing up to 40% of GDP.9 Research increasingly recognises that SMEs tend to make hiring decisions based on different factors than larger organisations.10 11 SMEs also often respond differently to policy initiatives in employment due to diverse organisational cultures and capacities.8 However, even though most of the working population is employed in SMEs, less research has gone into understanding how they make employment decisions compared with larger organisations.12 Research to date suggests that primary factors involved in the decisions by SMEs to hire PWDs fall under three categories: (1) the need for accommodations that may be costly or time-consuming; (2) lower levels of education or skill; and (3) stigma and discrimination from potential employers or coworkers.7 The findings of the scoping review will assist by mapping the existing literature on the drivers and benefits of employment of PWD in SMEs.
Methods and analysis
To ensure rigour in the methodology, this scoping review will follow the six-stage process developed by Arksey and O'Malley13 and refined by Levac et al,14 Colquhoun et al,15 and Daudt et al.16 The process follows (1) identification of the research question(s); (2) identification of studies relevant to the research question(s); (3) selecting of studies for inclusion; (4) charting information and data within the included studies; (5) collating, summarising and reporting results of the review; and (6) consultation with stakeholders and experts. In addition, the review will be reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) reporting guidelines for scoping review.17
Stage 1: identification of the scoping review research question/s
The present scoping review aims to uncover factors relating to SMEs’ organisation, management or culture that enhance their capacity to hire and retain PWD. Specifically, we will draw on the motivation–opportunity–ability framework18 to identify the following three guiding questions:
How does an understanding of requirements for disability-inclusive workplaces impact motivation for SMEs to employ PWD?
How do current recruitment practices affect the opportunities available for PWD within SMEs?; and
What employment supports (eg, work adjustments) enhance the ability of SMEs to retain employees with a disability?
Stage 2: identifying relevant studies
A comprehensive search of Web of Science, Scopus, PsycINFO, PubMed, Cochrane Library, Embase, Medline, EBSCO Global Health and CINAHL will be conducted using the following search terms: ‘small business’ OR ‘medium business’ OR ‘small enterprise’ OR ‘medium enterprise’ OR ‘small company’ OR ‘medium company’ AND disability AND (employment OR hire OR hiring OR recruit* OR inclus* OR access* OR capacity OR retain* OR job OR capability OR competence OR facilit*). To ensure that we capture the broadest possible definition of disability, we will follow the guidance of Walsh et al19 to include a wide range of additional search terms associated with the WHO’s International Classification of Functioning, Disability and Health. Please see the online supplemental appendix 1 for a complete listing of search terms for the different databases. The search period will include all relevant articles since the inception of each database.
Supplemental material
The study will include all English-language studies that examine the hiring policies and employment practices of SMEs about PWD but exclude articles focused on larger organisations or self-employed entrepreneurs that do not have employees. More detailed information on the inclusion and exclusion criteria is provided in table 1. These criteria were informed by discussion among the authors.
Inclusion and exclusion criteria
A preliminary search was conducted on 12 February 2023 to check the efficacy of the proposed search strategy. This preliminary search resulted in 38 publications from Web of Science, 94 from Scopus, 46 from PsycINFO, 95 from PubMed, 13 from Cochrane Library, 22 from Embase, 35 from Medline and 33 from CINAHL. A casual review of the resulting papers revealed that the search strategy returned many papers that fit well with the paper’s objective.
We will also undertake a secondary search of the reference list of all identified studies to capture additional academic and non-academic reports and publications for inclusion in the scoping review. In doing so, we will follow the recommendations of the National Institute of Health Library for accessing information that falls outside of academic databases20 and include a search of WorldCat, Google Scholar, WHO and Open Grey to capture relevant reports and publications. Please see online supplemental appendix 1 for a complete listing of search terms for the different sites.
Stage 3: selection of studies
Studies identified through the search will be imported into Covidence, identifying duplicate publications and assisting the selection and extraction process outlined here. Two researchers will independently undertake each step of the process. An initial screening based on titles and abstracts will identify additional duplicates not identified by Covidence and publications irrelevant to the present research. The full-text review will then identify studies for inclusion based on the inclusion criteria shown in table 1. A clear rationale will be provided for any studies excluded at this stage. Disagreements at any stage of the process will be resolved by discussion between the authors. A PRISMA flow chart will be included in the final publication for transparency.
Stage 4: charting the data
Data charting will be carried out by the authors using Covidence. The template used to chart the data will be based on the characteristics outlined in table 2. Interpretation of these characteristics will be agreed on through discussion with all the authors and a preliminary literature search. The template will be refined to integrate new characteristics as they arise.
Data extraction template
A strength of scoping reviews is that they impose fewer constraints on the type of data to be collected or the range of studies that can be included compared with a systematic review or meta-analysis. However, this strength comes at the expense of being able to more formally assess quality or bias.21 Though most scoping reviews do not include any evaluation of manuscript quality or risk assessment of bias, the present review will assess the quality of included studies using the Mixed-Methods Appraisal Tool (MMAT), which has been used in previous scoping reviews.22 The MMAT was chosen because it provides a short and reliable method for appraising a range of study designs. It is useful in a scoping review where many research designs are included.23 24 The authors include an assessment of the quality of evidence to help inform directions for future research.
Stage 5: collecting, synthesising and reporting the results
The review will be reported following the PRISMA-ScR.17 A narrative synthesis of findings will be presented as a thematic analysis of the key findings. Levac et al14 advised using thematic analysis to aid with the description and understanding of key findings that can be quite broad in a scoping review. A summary table of key findings will include information on the general characteristics of included studies, relevant quality assessments and the relevant data extracted from each included study. Any relevant descriptive statistics found through the data extraction process will be used to supplement the narrative synthesis. The conclusions, strengths and limitations of the review will also be presented in the final report.
Stage 6: patient and public involvement
There was no patient involvement in the design of this scoping review protocol. However, the protocol was shared with members of an advisory group comprising academics with expertise in disability studies, representatives from Government programmes in support of disability employment, and peak bodies representing SMEs and disability employment service providers. The resulting findings from the scoping review will also be circulated to this advisory group for comment and feedback before finalisation.
Ethics and dissemination
This scoping review includes data from publicly available published studies and therefore does not require ethics approval. Findings from this review will be disseminated via peer-reviewed publications, with a plain-English summary prepared and shared with the advisory group members and their respective networks. We will also present the findings at relevant conferences and disseminate them as part of future workshops with professionals in disability employment.
Ethics statements
Patient consent for publication
Supplementary materials
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Footnotes
Contributors BWK initiated the study. AW drafted the manuscript. BWK edited the draft manuscript and handled the revisions. Both authors read and approved the final manuscript.
Funding This research was supported by the Australian Research Council (IC210100008, LP130100066).
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.