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: 9902382
• 负责人: Carla J Rash
• 金额: $ 70.14万
• 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/9902382
• 关键词: AIDS/HIV problem; Address; Alcohol or Other Drugs use; Anti-Retroviral Agents; Back; Behavior; Behavior Therapy; Behavioral; Businesses; Caring; Characteristics; Clinic; Cognitive; Communicable Diseases; Connecticut; Contracts; Cost Effectiveness Analysis; Criminal Justice; Cultural Diversity; Development; Disease Progression; Drug Use Disorder; Drug usage; Emotional; Emotional Stress; Employment; Evaluation; Face; Goals; HIV; Health; Healthcare; Individual; Intervention; Job Application; Lead; Life Expectancy; Link; Mediator of activation protein; Medical; Mental Depression; Mental Health; Methods; Monitor; Morbidity - disease rate; Occupations; Outcome; Participant; Patients; Persons; Physical Function; Population; Positioning Attribute; Prize; Procedures; Program Sustainability; Psychological reinforcement; Quality of life; Randomized; Randomized Clinical Trials; Readiness; Rewards; Risk Behaviors; Secure; Services; Structure; System; Time; Training; Unemployment; United States Social Security Administration; Veterans; Viral Load result; Well in self; Work; base; behavior change; behavioral economics; cognitive function; community setting; cost effective; cost effectiveness; cost estimate; depressive symptoms; disability; disenfranchised population; dual diagnosis; experience; follow-up; health disparity; improved; improved outcome; indexing; medication compliance; meetings; mortality; novel; physical conditioning; programs; psychological outcomes; psychological symptom; psychosocial; recruit; reinforcer; secondary outcome; service organization; standard care; 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 许多艾滋病毒/艾滋病感染者 (PLWHA) 失业，估计表明失业率高达 为 60%。失业会导致生活质量下降、抑郁加剧和药物滥用，而且 与发病率和死亡率相关。尽管艾滋病毒感染者在获得和 维持工作、基于行为分析和行为经济学原理的干预措施可以是 与最佳实践就业服务一起应用，以促进行为改变并改善结果。 这些干预措施包括提供基于货币的强化物，以获取行为改变的客观证据。 他们可以成功地加强求职活动，即使是在高度边缘化和被剥夺权利的地方 人口。本研究将检验加强就业活动对于改善就业的有效性 希望以兼职或全职身份重返劳动力市场的感染者的就业结果。总共， 这项研究将随机分配 144 名失业的 PLWHA 接受两项干预措施之一。所有参与者将 接受常规失业服务，重点关注与艾滋病毒/艾滋病相关的具体问题，另外 鼓励完成旨在就业准备和就业的活动。增强型 干预将涉及相同的治疗，并有机会赢得 1 至 100 美元的奖品 每周参加与工作相关的活动。参与者将接受为期 16 周的研究治疗并完成随访 18 个月内进行评估。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、病毒载量以及药物使用和风险 行为。假设为完成与工作相关的活动而强化的参与者将转变为 与那些没有因工作相关而得到加强的人相比，就业率更高、更快，工作频率也更高 活动。我们还预计强化干预将提高生活质量，减少抑郁 症状，并改善医疗结果。与标准护理条件相比，它还可以维持或 改善认知功能和药物依从性，并减少传播传染病的危险行为 疾病。我们将评估关键就业和健康结果的调节者和中介者， 强调探索工作条件（临时的、私下的、身体上的或 情绪要求高的工作等）会影响心理和身体健康。我们将进行成本效益 进行分析以估计该干预措施如果有效的话大规模传播的潜力。 ！