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Trial registered on ANZCTR
Registration number
ACTRN12612000769886
Ethics application status
Not yet submitted
Date submitted
13/04/2012
Date registered
19/07/2012
Date last updated
19/07/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
The Individual Placement and Support (IPS) model of supported employment in primary care to improve health and social outcomes
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Scientific title
Employment and health outcomes for Sickness Beneficiaries receiving IPS supported employment versus traditional vocational services: A primary care cohort study
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Secondary ID [1]
280320
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None
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Universal Trial Number (UTN)
U1111-1129-9546
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic unemployment
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Mental illness
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Substance dependency
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Condition category
Condition code
Mental Health
286509
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0
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Other mental health disorders
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Public Health
286510
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0
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Health service research
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Mental Health
286511
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0
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Addiction
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Individual Placement and Support (IPS) model of supported employment, also known as Evidence-Based Supported Employment (EBSE): individualized intensive employment support services integrated with primary health care services, provided by 2 Employment Consultants to general practice patients seeking Sickness or Invalid's Benefit renewals for work incapacity because of psychiatric or substance dependency problems. The Employment Consultants will see participants on a as-needed basis, depending on their health and vocational needs, for the total duration of the study period (18 months).
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Intervention code [1]
284674
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Rehabilitation
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Intervention code [2]
284813
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Prevention
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Intervention code [3]
284814
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Behaviour
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Comparator / control treatment
The comparison group will comprise Dunedin Work and Income clients matched for age, sex, NZDep2006 small area deprivation score, and work incapacity diagnosis to intervention group participants on a 2:1 ratio (control:intervention). This group will use existing employment support services available in the community, that is, "treatment as usual".
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Control group
Active
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Outcomes
Primary outcome [1]
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Acquisition of competitive employment (open job market). Employment consultants will keep in regular phone and face-to-face contact with clients during the job search and after employment is attained, as part of the IPS model of service delivery.
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Assessment method [1]
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Timepoint [1]
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During study period (18 months). At least monthly but it is likely that support will be more intensive during the job search phase and initially at job acquisition, and will be driven in part by client needs, although an assertive outreach approach may also be used to address the needs of clients who consistently fail to make contact.
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Primary outcome [2]
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Time to first job, duration of longest job tenure. Through contact with the Employment Consultant as described above.
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Assessment method [2]
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Timepoint [2]
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During study period (18 months). At least monthly.
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Primary outcome [3]
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Annualised number of weeks worked. Through contact with the Employment Consultant as described above.
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Assessment method [3]
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Timepoint [3]
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During study period (18 months). At least monthly.
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Secondary outcome [1]
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Psychological symptoms as assessed by the Kessler 10, Brief Psychiatric Rating Scale, Drug and Alcohol Use Scales
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Assessment method [1]
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Timepoint [1]
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During study period (18 months). 3-6 monthly, via questionnaires delivered by 2 researchers who are also clinical staff at the study clinic.
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Secondary outcome [2]
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Emergency department presentations and hospital inpatient admissions. By examination of medical records data (at Dunedin Hospital), by the 2 researchers mentioned above.
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Assessment method [2]
297039
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Timepoint [2]
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During study period (18 months), assessed at the end of the study period. Compared with the year prior to study commencement.
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Eligibility
Key inclusion criteria
All unemployed working age patients presenting during the 6-month run-in period to their GPs at the free clinic requesting a Sickness or Invalid’s Benefit renewal for predetermined psychiatric and substance dependency diagnoses will be eligible to participate.
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Minimum age
16
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria are an unwillingness to participate in a vocational rehabilitation programme, and medical conditions (other than those above) judged by the referring GP to preclude working 15 hours or more a week.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
The intervention cohort will be recruited from patients at the free clinic (Servants Health Centre) seeking assessment for the Sickness or Invalid’s Benefit because of psychiatric problems or substance dependency. Patients will be referred by their general practitioner, and patients consenting to enter the study will receive IPS delivered by the employment consultants.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
No randomization will be used.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Data for comparison with the IPS group will come from the Dunedin Work and Income office. They will identify a group of Sickness and Invalid’s Beneficiaries who live in matched NZDep2006 areas but who do not consult at the study clinic, and provide the research team with data on the employment status of this group. The comparison group will matched by frequency on a 2:1 ratio to IPS participants by age, sex, ethnicity and diagnostic classification. Because the reference intervention is treatment-as-usual, there will be no restriction on what vocational support members of the comparison group receive.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/08/2012
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
80
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
4258
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Otago
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Ministry of Social Development
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Address [1]
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Cnr Castle & St. Andrew Street Dunedin Dunedin 9016
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Country [1]
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New Zealand
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Primary sponsor type
Government body
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Name
New Zealand Health Research Council
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Address
PO Box 5541, Wellesley Street, Auckland 1141
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Country
New Zealand
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Secondary sponsor category [1]
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Government body
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Name [1]
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Southern Primary Health Organisation
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Address [1]
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1 Bond Street Dunedin, 9054
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Country [1]
283953
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New Zealand
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Other collaborator category [1]
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Charities/Societies/Foundations
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Name [1]
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Servants Health Centre
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Address [1]
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100 Princes Street, Dunedin 9016
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Country [1]
260731
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New Zealand
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
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Lower South Regional Ethics Committee
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Ethics committee address [1]
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c/- Ministry of Health Level 2, Reception 1-3 The Terrace Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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01/06/2012
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Approval date [1]
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Ethics approval number [1]
287104
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Summary
Brief summary
Chronic unemployment adversely affects health and increases suicide risk. New Zealand has very high youth unemployment and suicide rates. Unemployment is common in people with mental illness, and mental illness is the most frequent reason for work incapacity on the Sickness Benefit (SB). Unemployment, mental illness, and being on the SB are more common in Maori. The Individual Placement and Support (IPS) model of supported employment has proven effectiveness in specialist psychiatric care for helping people with mental illness find open employment. IPS is yet untested in primary care, where most SB medical assessments occur. Two employment consultants will be appointed and trained to deliver IPS to Sickness Beneficiaries with mental illness and/or substance dependence at Dunedin’s free GP clinic. A cohort study is proposed comparing employment outcomes between Sickness Beneficiaries receiving IPS at the free clinic and beneficiaries receiving existing employment support at Work and Income. Participants’ mental health symptoms and use of hospital services will also be monitored. Realistic Evaluation will be used to identify factors promoting the implementation and uptake of the IPS programme.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Lik Wei Loh
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Address
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Department of General Practice & Rural Health, Dunedin School of Medicine, University of Otago, P O Box 913, Dunedin 9054
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Country
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New Zealand
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Phone
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+64 21 650126
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Fax
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+64 3 4797431
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Email
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[email protected]
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Contact person for scientific queries
Name
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Lik Wei Loh
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Address
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Department of General Practice & Rural Health, Dunedin School of Medicine, University of Otago, P O Box 913, Dunedin 9054
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Country
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New Zealand
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Phone
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+64 21 650126
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Fax
8236
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+64 3 4797431
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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