Clinical trial NCT05626374: Comparing the Effect of Adding a Remote Self-reporting Tool for Distress and Fit-for-purpose Mental Health & Addictions Service to Usual Case Management on Dropout Rates in a Vocational Training Program
Official title: 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
Study type: INTERVENTIONAL
Overall status: ENROLLING_BY_INVITATION
Phase: NA
Conditions: Mental Health Issue
Substance Use Disorders
Distress, Emotional
Keywords: mental health issues
substance use disorders
multi-centre trial
cluster randomized
factorial design
vocational training program
vulnerable youth
unemployment
Lead sponsor: Royal Victoria Hospital, Canada
Sponsor class: OTHER
First posted: 2022-11-23
Enrollment: 400
Sex: ALL
Minimum age (years): 18
Maximum age (years): 49
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: FACTORIAL
Intervention model description: 2x2 factorial design, cluster-randomized, multicentre trial
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: 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.

Detailed description: 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.

Eligibility criteria: Inclusion Criteria:

* 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)

Exclusion Criteria:

- none

Primary outcomes:
measure: Program attendance
timeFrame: 12 weeks from program enrolment
measure: Program completion
timeFrame: 12 weeks from program enrolment
measure: Post-program employment
timeFrame: 24 weeks post-program completion
Secondary outcomes:
measure: Access to healthcare services
timeFrame: 12 weeks from program enrolment
measure: Healthcare utilization
timeFrame: 12 weeks from program enrolment
measure: Apprentice satisfaction
timeFrame: 12 weeks from program enrolment
measure: Acceptability of self-report distress tool
timeFrame: 12 weeks from program enrolment
measure: Feasibility of self-report distress tool
timeFrame: 12 weeks from program enrolment
measure: Compliance of self-report distress tool
timeFrame: 12 weeks from program enrolment
Other outcomes:
Locations:
city: Barrie
country: Canada
facility: Royal Victoria Regional Health Centre
state: Ontario
Study officials:
affiliation: Royal Victoria Regional Health Centre
name: Giulio DiDiodato, MD PhD
role: PRINCIPAL_INVESTIGATOR
References: