A Cluster Randomized, 2x2 Factorial, Superiority Study to Compare the Effectiveness of Adding a Remote Self-reporting Tool for Distress and a Fit-for-purpose Mental Health & Addictions Service to Usual Case Management on Program Completion and Employment Among Unemployed Visible Minorities and Women Enrolled in a Vocational Training Program
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 发起方
- 入组人数
- 400
- 试验地点
- 1
- 主要终点
- Program attendance
研究概览
简要总结
Youth unemployment is a chronic problem in most societies. Some young adults are neither in employment, education or training (NEET), and are at high risk of chronic unemployment, social disengagement and poor quality of life. Identifying this high risk population and providing them with career skills training and opportunities is critical for their full participation in society. Vocational training programs provide an opportunity for these NEET youth to develop a skilled trade. Barriers to successful completion of these programs include high prevalence of mental health and substance use disorders among NEET youth. This study will use a daily self-report distress tool to identify vocational program trainees at risk of absence or drop-out due to mental health and/or substance abuse issues. These at-risk trainees will then be referred to a mental health crisis program through a fit-for-purpose referral process to accommodate their training program requirements. It is hypothesized that early identification and referral for mental health and substance abuse issues will reduce both program absence and drop-out rates and result in improved in long-term employment for these NEET youth.
详细描述
The Trades & Diversity Training Program (TDTP) is a Canadian federal government-funded vocational construction skills training program for visible minority & female youth who are chronically under- and unemployed. The TDTP is a 12-week program that includes both in-classroom education and supervised hands-on experiential learning at participating construction sites. The trainees are supported by a case manager who identifies, plans and co-ordinates support services to minimize program absences and drop-out. The most significant barriers to successful program completion and long-term employment are mental health and substance use disorders. Historically, identification and rapid referral to mental health and addiction services has been difficult due to human resource limitations and limited access to timely healthcare services. This study will randomize cohorts enrolled in each 12-week training program located in 2 sites to the use of a self-report distress tool versus usual case management. The distress tool is a web-based self-reporting tool that is accessed by trainees on a daily basis to report their distress levels, the underlying reasons for this distress and whether this distress will prevent them from attending class or put them at-risk for drop-out. For those individuals whose distress levels threaten their program participation, the case manager is alerted immediately via an email notification. The case manager is then responsible for connecting with the trainees and engaging the rapid referral process for mental health and addictions healthcare services. The control cohorts will receive the usual case management approach of engaging students on an intermittent basis and providing support as needed.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 49 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •must be a visible minority or female
- •must be fluent in English or French
- •must have an active Ontario Health Insurance Plan number
- •must have a valid Canadian Social Insurance Number
- •Access to wi-fi network and computing device (phone, tablet, computer)
排除标准
- 未提供
研究组 & 干预措施
Basic case management
Basic case management with bi-weekly meetings between case manager and trainees that includes check-ins, frequent visits to construction sites and monitoring of feedback forms from mentors. Case managers attempt to connect trainees with external support services as needed.
干预措施: Basic Case Management (Behavioral)
Basic case management supplemented by self-reporting distress tool (DT)
Basic case management plus access to the self-report daily distress tool. The trainees are provided web-based access to the daily distress tool and report their distress levels using a validated visual analog scale (Distress Thermometer), along with reporting their risk of missing work/class or dropping out of the program. The case manager responds to the distress tool by coordinating external support services as needed.
干预措施: Basic Case Management plus Distress Tool (Behavioral)
Basic case management supplemented by rapid access healthcare services
Basic case management supplemented by a fit-for-purpose rapid referral process for trainees with active mental health and/or substance use disorders affecting their program participation.
干预措施: Basic Case Management plus rapid mental health & addictions healthcare access (Behavioral)
Basic case management supplemented by DT and rapid access healthcare services
Basic case management supplemented by both the self-report distress tool and rapid referral process for those trainees at-risk of program absence or drop-out from either mental health or addictions issues.
干预措施: Basic Case Management plus Distress Tool and rapid mental health & addictions healthcare access (Behavioral)
结局指标
主要结局
Program attendance
时间窗: 12 weeks from program enrolment
Difference in proportion of absence-free program days, where absence-free day is defined as being present in class or work setting by case manager or supervisor. Maximum number of absence-free days is 48 days (12 weeks x 4-day work week). A day is defined as an 8- to 10-hour work day from Monday to Thursday.
Program completion
时间窗: 12 weeks from program enrolment
Difference in proportion of drop-outs, where a drop-out is defined as an apprentice who fulfils any of the following criteria: 1. Has missed more than 50% of class/work days, or 2. Who has elected to leave the program for reasons other than taking another job or returning to school
Post-program employment
时间窗: 24 weeks post-program completion
Difference in proportion of full-time employment, where full-time employment is defined as paid work ≥ 30 (median) hours per week at their main or only job. The reference period that will be used to determine full-time employment is the 4-week period preceding the 24-month post-program completion date.
次要结局
- Access to healthcare services(12 weeks from program enrolment)
- Healthcare utilization(12 weeks from program enrolment)
- Apprentice satisfaction(12 weeks from program enrolment)
- Acceptability of self-report distress tool(12 weeks from program enrolment)
- Feasibility of self-report distress tool(12 weeks from program enrolment)
- Compliance of self-report distress tool(12 weeks from program enrolment)
研究者
Giulio DiDiodato
Chief Research Scientist
Royal Victoria Hospital, Canada