scholarly journals A structured mixed method process evaluation of a randomized controlled trial of Individual Placement and Support (IPS)

2020 ◽  
Author(s):  
Tonje Fyhn ◽  
Kari Ludvigsen ◽  
Silje E Reme ◽  
Frederieke Schaafsma
Keyword(s):  
Randomized Controlled Trial ◽  
Mixed Methods ◽  
Process Evaluation ◽  
Controlled Trial ◽  
Community Based ◽  
Individual Placement And Support ◽  
Randomized Controlled ◽  
Employment Specialist ◽  
Community Based Services ◽  
Individual Placement

Abstract Background The effect of Individual Placement and Support (IPS) has been widely documented, but in many studies, the majority of participants remains unemployed. Structured process evaluations that use mixed methods are scarce, although they could identify components that may enhance the effect of IPS. The aim of the current study is to provide a description of a structured mixed methods process evaluation of IPS in Norway. Methods The process evaluation was conducted alongside a randomized controlled trial including six IPS centers, comparing IPS with treatment as usual in a population of patients in treatment for moderate to severe mental illness. Mixed methods were used in the process evaluation, and outcome measures were reach, barriers and facilitators, and fidelity. Results The intervention reached the intended target group. All centers reached fair to good fidelity within the project period. Certain fidelity items seemed to indicate implementation issues related to employer contact, community-based services, and integration with health services. Less than half of the participants regarded their illness as a barrier for participation in IPS. Participants were overall satisfied and found the intervention useful, emphasizing the availability of the employment specialist and their consistent job focus, as well as the freedom to disclose their illness or not. Conclusions Certain fidelity items indicated implementation issues during the first year, namely providing community-based services, ensuring quality in employer contact, and integration with health treatment. The employment specialist clearly played an important role for participants. Most participants described this relationship as positive, empowering, and encouraging. Trial Registration The study was registered on clinicaltrials.gov prior to the inclusion period (reg.no: NCT01964092, registered 17/07/2013, https://clinicaltrials.gov/ct2/show/NCT01964092 ).

scholarly journals A structured mixed method process evaluation of a randomized controlled trial of Individual Placement and Support (IPS)

2020 ◽  
Author(s):  
Tonje Fyhn ◽  
Kari Ludvigsen ◽  
Silje E Reme ◽  
Frederieke Schaafsma
Keyword(s):  
Mental Illness ◽  
Randomized Controlled Trial ◽  
Mixed Methods ◽  
Process Evaluation ◽  
Controlled Trial ◽  
Work Rehabilitation ◽  
Individual Placement And Support ◽  
Randomized Controlled ◽  
Fidelity Scale ◽  
Individual Placement

Abstract Background: Individual Placement and Support (IPS) is an evidence-based work rehabilitation program helping people with moderate to severe mental illness to obtaini ordinary employment. Although IPS has proven superior to other work rehabilitation programs, in many studies, the majority of the participants remains unemployed. Structured process evaluations of IPS that use mixed methods are scarce, although they could identify implementation aspects that may enhance its effect. The aim of the current study is to assess reach, fidelity, and identify barriers and facilitators to implement IPS. Methods: The process evaluation was conducted alongside a randomized controlled trial including six IPS centers, comparing IPS with treatment as usual in a population of patients in treatment for moderate to severe mental illness. Mixed methods were used in the process evaluation, including focus group interviews with service providers, individual interviews and survey data from participants, and fidelity reviews using the validated IPS Fidelity Scale. Results: The intervention reached the intended target group. All centers reached fair to good fidelity according to the IPS Fidelity Scale within the project period (range 89-108, SD 7). Certain fidelity items indicated implementation issues related to employer contact, community-based services, and integration with health services. Survey data showed that less than half of the participants regarded their illness as a barrier for participating in IPS and that freedom of disclosure was important. Participant interviews gave further insight into the role of the IPS specialist, emphasizing their availability and consistent job focus. Conclusions: Indications of implementation challenges across centers during the first year suggest special attention should be given to these aspects in an early phase to ensure higher fidelity from the start and thus enhance the effectiveness of IPS. The IPS specialist played an important role for participants, and was described as positive, pushing in a positive way, and encouraging. More knowledge on the characteristics of successful IPS specialists could further enhance the effectiveness of the intervention. Trial Registration: The study was registered on clinicaltrials.gov prior to the inclusion period (reg.no: NCT01964092, registered 17/07/2013, https://clinicaltrials.gov/ct2/show/NCT01964092).

scholarly journals A structured mixed method process evaluation of a randomized controlled trial of Individual Placement and Support (IPS)

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Tonje Fyhn ◽  
Kari Ludvigsen ◽  
Silje E. Reme ◽  
Frederieke Schaafsma
Keyword(s):  
Mental Illness ◽  
Randomized Controlled Trial ◽  
Mixed Methods ◽  
Process Evaluation ◽  
Controlled Trial ◽  
Work Rehabilitation ◽  
Individual Placement And Support ◽  
Randomized Controlled ◽  
Fidelity Scale ◽  
Individual Placement

Abstract Background Individual Placement and Support (IPS) is an evidence-based work rehabilitation program helping people with moderate to severe mental illness to obtain ordinary employment. Although IPS has proven superior to other work rehabilitation programs, in many studies, the majority of the participants remain unemployed. Structured process evaluations of IPS that use mixed methods are scarce, although they could identify implementation aspects that may enhance its effect. The aim of the current study is to assess reach, fidelity, and identify barriers and facilitators to implement IPS. Methods The process evaluation was conducted alongside a randomized controlled trial including six IPS centers, comparing IPS with treatment as usual in a population of patients in treatment for moderate to severe mental illness. Mixed methods were used in the process evaluation, including focus group interviews with service providers, individual interviews and survey data from participants, and fidelity reviews using the validated IPS Fidelity Scale. Results The intervention reached the intended target group. All centers reached fair to good fidelity according to the IPS Fidelity Scale within the project period (range 97–109, SD 8.1) (see Table 5). Certain fidelity items indicated implementation issues related to employer contact, community-based services, and integration with health services. Survey data showed that less than half of the participants regarded their illness as a barrier for participating in IPS and that freedom of disclosure was important. Participant interviews gave further insight into the role of the IPS specialist, emphasizing their availability and consistent job focus. Conclusions Indications of implementation challenges across centers during the first year suggest special attention should be given to these aspects in an early phase to ensure higher fidelity from the start and thus enhance the effectiveness of IPS. The IPS specialist played an important role for participants and was described as positive, pushing in a positive way, and encouraging. More knowledge on the characteristics of successful IPS specialists could further enhance the effectiveness of the intervention. Trial registration The study was registered on clinicaltrials.gov prior to the inclusion period (reg.no: NCT01964092, registered 17/07/2013).

scholarly journals Evaluating the Effects of a Rent Subsidy and Mentoring Intervention for Youth Transitioning Out of Homelessness: Protocol for a Mixed Methods, Community-Based Pilot Randomized Controlled Trial

10.2196/15557 ◽  
2019 ◽  
Vol 8 (12) ◽  
pp. e15557
Author(s):  
Naomi S Thulien ◽  
Nicole Kozloff ◽  
Elizabeth McCay ◽  
Rosane Nisenbaum ◽  
Andrea Wang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Mixed Methods ◽  
Young People ◽  
Social Integration ◽  
Controlled Trial ◽  
Community Integration ◽  
Community Based ◽  
Market Rent ◽  
Randomized Controlled ◽  
Formerly Homeless

Background Although the risk factors associated with young people entering and becoming entrenched in street life have been thoroughly investigated, peer-reviewed evidence is scarce to nonexistent for rigorous interventions targeting social integration outcomes for young people who have experienced homelessness. From the limited research that has been done, emerging evidence signals that, although structural supports such as subsidized housing and social service providers are important, these resources alone are insufficient to help young people integrate into the mainstream society. Objective The overarching aim of this study is to assess whether and how rent subsidies and mentorship influence social integration outcomes for formerly homeless young people living in market rent housing in 3 Canadian cities. The primary outcome measures for this study are community integration (psychological and physical) and self-esteem at 18 months. Secondary outcomes include social connectedness, hope, and academic and vocational participation at 18 months. Exploratory outcomes include income, perceived housing quality, engulfment, psychiatric symptoms, and participant perspectives of intervention barriers and facilitators. Methods This is a convergent mixed methods, open-label, 2-arm parallel randomized controlled trial (RCT) with 1:1 allocation embedded within a community-based participatory action research (CBPAR) framework. The intervention will provide 24 young people (aged 16-26 years), who have transitioned out of homelessness and into market rent housing within the past year, with rent subsidies for 24 months. Half of the young people will also be randomly assigned an adult mentor who has been recruited and screened by 1 of our 3 community partners. Data collection will occur every 6 months, and participants will be followed for 30 months. Results Ethical approval for this study has been obtained from the Providence, St Joseph’s, and St Michael’s Healthcare Research Ethics Board (number 18-251). Enrollment took place from April 2019 to September 2019. Preliminary analysis of the baseline quantitative and qualitative data is underway. Conclusions This pilot RCT will be the first to test the impact of economic and social support on meaningful social integration for formerly homeless young people living in market rent housing. We believe that the mixed methods design will illuminate important contextual factors that must be considered if the intervention is to be scaled up and replicated elsewhere. Importantly, the CBPAR framework will incorporate the perspectives of the community, including formerly homeless young people, who are in the best position to determine what might work best in the context of their lives. Trial Registration Clinicaltrials.gov NCT03779204; https://clinicaltrials.gov/ct2/show/NCT03779204. International Registered Report Identifier (IRRID) DERR1-10.2196/15557

scholarly journals Evaluating the Effects of a Rent Subsidy and Mentoring Intervention for Youth Transitioning Out of Homelessness: Protocol for a Mixed Methods, Community-Based Pilot Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Naomi S Thulien ◽  
Nicole Kozloff ◽  
Elizabeth McCay ◽  
Rosane Nisenbaum ◽  
Andrea Wang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Mixed Methods ◽  
Young People ◽  
Social Integration ◽  
Controlled Trial ◽  
Community Integration ◽  
Community Based ◽  
Market Rent ◽  
Randomized Controlled ◽  
Formerly Homeless

BACKGROUND Although the risk factors associated with young people entering and becoming entrenched in street life have been thoroughly investigated, peer-reviewed evidence is scarce to nonexistent for rigorous interventions targeting social integration outcomes for young people who have experienced homelessness. From the limited research that has been done, emerging evidence signals that, although structural supports such as subsidized housing and social service providers are important, these resources alone are insufficient to help young people integrate into the mainstream society. OBJECTIVE The overarching aim of this study is to assess whether and how rent subsidies and mentorship influence social integration outcomes for formerly homeless young people living in market rent housing in 3 Canadian cities. The primary outcome measures for this study are community integration (psychological and physical) and self-esteem at 18 months. Secondary outcomes include social connectedness, hope, and academic and vocational participation at 18 months. Exploratory outcomes include income, perceived housing quality, engulfment, psychiatric symptoms, and participant perspectives of intervention barriers and facilitators. METHODS This is a convergent mixed methods, open-label, 2-arm parallel randomized controlled trial (RCT) with 1:1 allocation embedded within a community-based participatory action research (CBPAR) framework. The intervention will provide 24 young people (aged 16-26 years), who have transitioned out of homelessness and into market rent housing within the past year, with rent subsidies for 24 months. Half of the young people will also be randomly assigned an adult mentor who has been recruited and screened by 1 of our 3 community partners. Data collection will occur every 6 months, and participants will be followed for 30 months. RESULTS Ethical approval for this study has been obtained from the Providence, St Joseph’s, and St Michael’s Healthcare Research Ethics Board (number 18-251). Enrollment took place from April 2019 to September 2019. Preliminary analysis of the baseline quantitative and qualitative data is underway. CONCLUSIONS This pilot RCT will be the first to test the impact of economic and social support on meaningful social integration for formerly homeless young people living in market rent housing. We believe that the mixed methods design will illuminate important contextual factors that must be considered if the intervention is to be scaled up and replicated elsewhere. Importantly, the CBPAR framework will incorporate the perspectives of the community, including formerly homeless young people, who are in the best position to determine what might work best in the context of their lives. CLINICALTRIAL Clinicaltrials.gov NCT03779204; https://clinicaltrials.gov/ct2/show/NCT03779204.

Sign in / Sign up

Export Citation Format

Share Document