IPS/Peer Support Intervention in the DTES

Study Overview
=================
Brief Summary
-----------------
Individual placement support (IPS) is an evidence-based supported employment model for people with severe mental illness, designed to achieve employment in mainstream competitive jobs, either part-time or full-time. The aim of this study is to assess the (i) effectiveness of embedding the (IPS)/Peer Support intervention as part of the primary care centre in securing employment of adults living in the downtown eastside in comparison to the usual treatment WorkBC (control group). (ii) effectiveness of IPS/Peer Support versus the usual treatment (WorkBC) in improving mental illness, quality of life and personal recovery through participation in employment.

Detailed Description
-----------------
This 18-month mixed methods study consists of an effectiveness multi-site randomized controlled trial of the IPS/peer support intervention plus an embedded qualitative exploration of participants' experiences. All clients receiving primary care services from one DTES clinical site who are employment ready and are not receiving mental health services will be randomly assigned to IPS & Peer Support (experimental group) or WorkBC (control group). Clients are required to participate in the intervention for 16 weeks and will be assessed at baseline, 1-, 3-, and 6-months post study intervention start-date for both groups. Assessments will include the 5 questionnaires administered at baseline which cover the following: Employment Quality, Employment Sustainability, Education Quality and Quantity, Quality of Life, Community Engagement and Clinical significant levels of depression and anxiety.

Official Title
-----------------
Optimizing the Employment Outcomes for People Living in the Downtown Eastside

Conditions
-----------------
Behavior, Adaptive, Mental Illness, Substance Use

Intervention / Treatment
-----------------
* Behavioral: IPS/SP
* Behavioral: WorkBC


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Adults, age 19 and over, accessing primary care services at the primary care centre listed in this study (CH Pender Community Health Centre) At least one visit to VCH Pender Community Health Centre Currently unemployed and not in school or post-secondary training. Able to provide informed consent and fluent in English (intervention is currently offered in English only). Not hospitalized at the time of recruitment. Exclusion Criteria: • Adults, age 19 and over who have access to mental health services

Ages Eligible for Study
-----------------
Minimum Age: 19 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: 72 clients receiving primary care services from one DTES clinical site who are employment ready will be randomly assigned to IPS and Peer Support (experimental group) or WorkBC (control group).
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Adults living in the DTES<br>36 out of the 72 recruited participants who live in the DTES will be randomly assigned to the intervention group (IPS & Peer Support). The IPS and Peer Support will actively work and support with each of the 36 participants in seeking employment and education for 16 weeks. IPS/SP will help participants identify their employment and educational goals, identify potential employers, help prepare their resumes and for interviews, and provide ongoing support during the 16 weeks. 36 out of the 72 participants who live in the DTES will be randomly assigned to the control group (WorkBC). Participants will be provided with WorkBC employment services. | Behavioral: IPS/SP<br>* The 72 recruited clients receiving primary care services from one DTES clinical site who are employment ready will be randomly assigned to IPS and Peer Support (experimental group) or WorkBC control group<br>|
| Placebo Comparator: Individuals 19 yrs or older settled in DTES<br>36 out of the 72 recruited participants who live in the DTES will be randomly assigned to the intervention group (IPS & Peer Support). The IPS and Peer Support will actively work and support with each of the 36 participants in seeking employment and education for 16 weeks. IPS/SP will help participants identify their employment and educational goals, identify potential employers, help prepare their resumes and for interviews, and provide ongoing support during the 16 weeks. 36 out of the 72 participants who live in the DTES will be randomly assigned to the control group (WorkBC). Participants will be provided with WorkBC employment services. | Behavioral: WorkBC<br>* 36 out of the 72 participants who live in the DTES will be randomly assigned to the control group (WorkBC). Participants will be provided with WorkBC employment services.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Securing employment | RC will follow-up with all recruited clients who get employed through the IPS/Peer Support intervention and the WorkBC control group. | 18 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PHQ-9 Questionnaire to measures level of depression | Participants will answer the questions on this questionnaire using a likert scale. A scoring system will calculate the final total number and we will assess mean change from the baseline. The minimum score is 0/27 and the maximum score is 27 | 18 months | 
| GAD7 questionnaire to measure general anxiety disorder | Participants will answer the questions on this questionnaire using a likert scale. A scoring system will calculate the final total number and we will assess mean change from the baseline. The minimum score is 0/21. The maximum score is 21. | 18 months | 
| C-PROM questionnaire to measure Personal Recovery | Participants will answer the questions on this questionnaire using a likert scale. A scoring system will calculate the final total number and we will assess mean change from the baseline. Minimum score is 0/120. Maximum score is 120 | 18 months | 
| REQOL questionnaire measures Recovery Quality of Life | Participants will answer the questions on this questionnaire using a likert scale. A scoring system will calculate the final total number and we will assess mean change from the baseline. Minimum score is 0/64. Maximum score 64. | 18 months | 
| SWL questionnaire measures satisfaction with life | Participants will answer the questions on this questionnaire using a likert scale. A scoring system will calculate the final total number and we will assess mean change from the baseline. Minimum score is 5/35. Maximum score is 35. | 18 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Homeless, Employment