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Administration and Policy in Mental Health and Mental Health Services Research

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Open Access 01-03-2022 | Original Article

Predictive Association of Low- and High-Fidelity Supported Employment Programs with Multiple Outcomes in a Real-World Setting: A Prospective Longitudinal Multi-site Study

Authors: Sosei Yamaguchi, Sayaka Sato, Takuma Shiozawa, Asami Matsunaga, Yasutaka Ojio, Chiyo Fujii

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 2/2022

Abstract

Purpose

The individual placement and support (IPS) model of supported employment is a leading evidence-based practice in community mental health services. In Japan, individualized supported employment that is highly informed by the philosophy of the IPS model has been implemented. While there is a body of evidence demonstrating the association between program fidelity and the proportion of participants gaining competitive employment, the association between fidelity and a wider set of vocational and individual outcomes has received limited investigation. This study aimed to assess whether high-fidelity individualized supported employment programs were superior to low-fidelity programs in terms of vocational outcomes, preferred job acquisition, and patient-reported outcome measures (PROMs).

Methods

A prospective longitudinal study with 24-month follow-up analyzed 16 individualized supported employment programs. The Japanese version of the individualized Supported Employment Fidelity scale (JiSEF) was used to assess the structural quality of supported employment programs (scores: low-fidelity program, ≤ 90; high-fidelity program, ≥ 91). Job acquisition, work tenure, work earnings, job preference matching (e.g., occupation type, salary, and illness disclosure), and PROMs such as the INSPIRE and WHO-Five Well-being index were compared between groups.

Results

There were 75 and 127 participants in the low-fidelity group (k = 6) and high-fidelity group (k = 10), respectively. The high-fidelity group demonstrated better vocational outcomes than the low-fidelity group, i.e., higher competitive job acquisition (71.7% versus 38.7%, respectively, adjusted odds ratio (aOR) = 3.6, p = 0.002), longer work tenure (adjusted mean difference = 140.8, p < 0.001), and better match for illness disclosure preference (92.6% versus 68.0%, respectively, aOR = 5.9, p = 0.003). However, we found no differences between groups in other preference matches or PROM outcomes.

Conclusion

High-fidelity individualized supported employment programs resulted in good vocational outcomes in a real-world setting. However, enhancing service quality to increase desired job acquisition and improve PROMs will be important in the future.

Clinical Trial Registration

UMIN000025648

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Title: Predictive Association of Low- and High-Fidelity Supported Employment Programs with Multiple Outcomes in a Real-World Setting: A Prospective Longitudinal Multi-site Study
Authors: Sosei Yamaguchi
Sayaka Sato
Takuma Shiozawa
Asami Matsunaga
Yasutaka Ojio
Chiyo Fujii
Publication date: 01-03-2022
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 2/2022
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-021-01161-3

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Predictive Association of Low- and High-Fidelity Supported Employment Programs with Multiple Outcomes in a Real-World Setting: A Prospective Longitudinal Multi-site Study

Abstract

Purpose

Methods

Results

Conclusion

Clinical Trial Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Clinical Trial Registration

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