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. !

摘要