Efficacy of Supported Employment within the OIF/OEF Patient Aligned Care Team

OIF/OEF 患者协调护理团队内支持性就业的功效

• 批准号: 8862128
• 负责人: LORI L. DAVIS
• 金额: --
• 依托单位: TUSCALOOSA VETERANS AFFAIRS MEDICAL CTR
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8862128
• 关键词: Address; Afghanistan; Area; Back; Bipolar I; Caring; Categories; Client satisfaction; Clinic; Communities; Conflict (Psychology); Diagnosis; Diagnostic; Disabled Persons; Employment; Event; Face; Freedom; Health; Health Services Accessibility; Healthcare; Home environment; Hospital Costs; Individual; Iraq; Left; Life; Link; Location; Major Depressive Disorder; Medical; Mental Health; Mental disorders; Mentally Ill Persons; Methods; Modeling; Modification; Occupations; Outcome; Participant; Patient-Centered Care; Patients; Persons; Population; Post-Traumatic Stress Disorders; Primary Health Care; Provider; Psychologist; Quality of life; Randomized; Randomized Controlled Trials; Recovery; Rehabilitation Outcome; Research; Role; Schizophrenia; Services; Site; Social Workers; Specialist; Supported Employment; Symptoms; Target Populations; Time; Unemployment; Veterans; Vocational rehabilitation; War; Work; base; cohort; community reintegration; evidence base; follow-up; improved; innovation; meetings; operation; patient oriented; primary care setting; programs; prospective; public health relevance; response; satisfaction; self esteem; severe mental illness; standard of care; stem

 DESCRIPTION (provided by applicant): Efficacy of Supported Employment within the OIF/OEF Patient Aligned Care Team Background: Veterans returning from Iraq and Afghanistan wars often confront unemployment as they reintegrate into civilian life. Over the past two decades, studies of Individual Placement and Support (IPS) supported employment have yielded remarkably robust and consistent vocational rehabilitation outcomes. However, IPS has predominantly only been studied in mental health settings and in the seriously mentally ill populations. Access to a mental health setting for recently deployed Veterans is often delayed by months or years, and thus, result in substantial delay of referrals to vocational rehabilitation programs which leave many Veterans vulnerable to continued unemployment and a deteriorating trajectory. Methods: This is a single site, prospective, randomized, controlled study to evaluate the efficacy of IPS when delivered within a primary care Patient Aligned Care Team (PACT) designated for Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) Veterans. Participants will be OEF/OIF/OND Veterans receiving care in the PACT who are currently unemployed and have a disabling or potentially disabling Axis I diagnosis, other than a serious mental illness and will be randomized 1:1 to either IPS or the VHA standard of care called Transitional Work Program. Compared to Transitional Work Program (control condition), IPS delivered within a PACT is hypothesized to result in a higher rate of steady workers, as defined by working >50% of the weeks in the 12-month follow-up period in a competitive job (primary); quality of life, and self esteem (secondary), improved community re-integration (exploratory), improved psychiatric symptoms (exploratory), and lower rates of high intensity crisis events/services (exploratory). In addition, IPS delivered within a PACT will be feasible and yield very good Veteran satisfaction. Significance: In an innovative approach, this study breaks from the diagnostic categorical approach and the mental health treatment setting and evaluates the efficacy of IPS when delivered in a primary care setting, specifically a PACT that serves Veterans who have returned from the Iraq or Afghanistan conflicts. Making a substantial paradigm shift, this study will integrate IPS within a PACT for the first time ever. The research is directly linked to the RR&D priority areas of improving vocational outcomes and promoting recovery in OEF/OIF/OND Veterans.