Promoting employment in persons living with HIV/AIDS

促进艾滋病毒/艾滋病感染者就业

• 批准号: 10551990
• 负责人: Carla J Rash
• 金额: $ 67.01万
• 依托单位: UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10551990
• 关键词: Address; Anti-Retroviral Agents; Back; Behavior; Behavior Therapy; Behavioral; Businesses; Characteristics; Clinic; Cognitive; Communicable Diseases; Connecticut; Contracts; Cost Effectiveness Analysis; Criminal Justice; Cultural Diversity; Development; Disease Progression; Disparity; Drug Use Disorder; Drug usage; Emotional; Emotional Stress; Employment; Evaluation; Face; Goals; HIV; HIV/AIDS; Health; Healthcare; Individual; Intervention; Job Application; Lead; Life Expectancy; Link; Mediator; Medical; Mental Depression; Methods; Monitor; Morbidity - disease rate; Occupations; Outcome; Participant; Patients; Persons; Physical Function; Positioning Attribute; Prize; Procedures; Productivity; Program Sustainability; Psychological reinforcement; Quality of life; Randomized; Readiness; Rewards; Risk Behaviors; Risk Reduction Behavior; Searching Behavior; Secure; Services; Structure; System; Time; Training; Unemployment; United States Social Security Administration; Veterans; Viral Load result; Well in self; Work; behavior change; behavioral economics; cognitive function; community setting; cost effective; cost effectiveness; cost estimate; depressive symptoms; disability; disenfranchised population; dual diagnosis; efficacious intervention; efficacy evaluation; enhanced care; experience; follow-up; health disparity populations; improved; improved outcome; indexing; marginalized population; medication compliance; meetings; mortality; novel; physical conditioning; programs; psychologic; psychological outcomes; psychological symptom; psychosocial; randomized, clinical trials; recruit; reinforcer; secondary outcome; service organization; standard care; substance use; volunteer; welfare

Abstract Many persons living with HIV/AIDS (PLWHA) are unemployed, with estimates indicating rates as high as 60%. Unemployment results in lower quality of life, greater depression and substance use, and it is associated with morbidity and mortality. Although PLWHA face substantial challenges in obtaining and maintaining jobs, interventions based upon behavior analytic and behavioral economics principles can be applied alongside best practices employment services to enhance behavior change and improve outcomes. These interventions involve provision of monetary-based reinforcers for objective evidence of behavior change. They can successfully enhance job-seeking activities, even in highly marginalized and disenfranchised populations. This study will examine the efficacy of reinforcing job-acquisition activities for improving employment outcomes in PLWHA who desire to return to the workforce in part- or full-time capacity. In total, this study will randomly assign 144 unemployed PLWHA to one of two interventions. All participants will receive usual unemployment services with an emphasis on specific issues related to HIV/AIDS, plus encouragement for completing activities geared toward employment readiness and acquisition. The enhanced intervention will involve that same treatment plus chances to win prizes ranging from $1 to $100 for engaging in job-related activities each week. Participants will receive study treatments for 16 weeks and complete follow- up evaluations throughout 18 months. Structured evaluations will assess employment outcomes, quality of life indices, physical and cognitive functioning, psychological symptoms, viral loads, and drug use and risk behaviors. The hypothesis is that participants reinforced for completing job-related activities will transition to employment at higher and faster rates and work more often than those who are not reinforced for job-related activities. We also expect the reinforcement intervention will increase quality of life, reduce depressive symptoms, and improve medical outcomes. Compared to the standard care condition, it may also maintain or improve cognitive functioning and medication adherence and reduce risk behaviors that spread infectious diseases. We will evaluate moderators and mediators of key employment and health outcomes, with an emphasis on exploring the extent to which work conditions (temporary, under the table, physically or emotionally demanding jobs etc.) impact psychosocial and physical health. We will conduct cost-effectiveness analyses to estimate the potential for wide scale dissemination of this intervention if efficacious. !

抽象的 许多患有艾滋病毒/艾滋病（PLWHA）的人失业，估计表明利率很高 为60％。失业导致生活质量较低，抑郁症和药物使用量更大，这是 与发病率和死亡率有关。尽管PLWHA在获得和 维持工作，基于行为分析和行为经济学原则的干预措施可以是 与最佳实践相同，以增强行为改变并改善结果。 这些干预措施涉及提供基于货币的增强剂，以进行行为改变的客观证据。 即使在高度边缘化和被剥夺权利的情况下，他们也可以成功增强寻求工作的活动 人群。这项研究将研究加强工作的活动的功效 希望以部分或全职能力返回劳动力的PLWHA的就业成果。总共 这项研究将将144个失业的PLWHA随机分配给两种干预措施之一。所有参与者都会 接收通常的失业服务，重点是与艾滋病毒/艾滋病有关的特定问题 鼓励完成旨在就业准备和收购的活动。增强 干预措施将涉及相同的治疗方法加上赢得奖品的机会，从1美元到100美元不等 每周与工作相关的活动。参与者将接受16周的学习治疗，并完成遵循 - 整个18个月进行评估。结构化评估将评估就业成果，生活质量 指数，身体和认知功能，心理症状，病毒负荷以及药物使用和风险 行为。假设是，加强完成与工作相关的活动的参与者将过渡到 比没有加强与工作有关 活动。我们还希望加强干预将提高生活质量，减少抑郁症 症状并改善医疗结果。与标准护理条件相比，它也可以维护或 改善认知功能和药物依从性并减少传播感染性的风险行为 疾病。我们将评估关键就业和健康成果的主持人和调解人 强调探索工作条件的程度（临时，桌子底下，身体或 在情绪上要求工作等。）影响社会心理和身体健康。我们将进行成本效益 分析以估计有效的大规模传播这种干预的潜力。 呢