IPS/Peer Support Intervention in the DTES

Optimizing the Employment Outcomes for People Living in the Downtown Eastside

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.

Study Overview

• Status: Unknown
• Conditions: Substance Use; Mental Illness; Behavior, Adaptive
• Intervention / Treatment: Behavioral: IPS/SP; Behavioral: WorkBC

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.

• Study Type: Interventional
• Enrollment (Anticipated): 72
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • British Columbia
    • Vancouver, British Columbia, Canada, V6A 1G9
      • Recruiting
      • Downtown Community Health Center
      • Contact: Smadar Levinson
    • Vancouver, British Columbia, Canada, V6A 3G3
      • Recruiting
      • Heatley Community Health Clinic
      • Contact: Smadar Levinson; Phone Number: 6046199150
    • Vancouver, British Columbia, Canada, V6B 1R3
      • Recruiting
      • Pender Community Health Clinic
      • Contact: Smadar Levinson; Phone Number: 6046199150

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 19 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Adults living in the DTES; 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; 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
Placebo Comparator: Individuals 19 yrs or older settled in DTES; 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; 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.

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

Collaborators and Investigators

• Sponsor: University of British Columbia
• Collaborators: Ministry of Social Development and Poverty Reduction, British Columbia
• Investigators: Principal Investigator: Skye Barbic, PhD, University of British Columbia

Publications and helpful links

General Publications

• Sveinsdottir V, Lovvik C, Fyhn T, Monstad K, Ludvigsen K, Overland S, Reme SE. Protocol for the effect evaluation of Individual Placement and Support (IPS): a randomized controlled multicenter trial of IPS versus treatment as usual for patients with moderate to severe mental illness in Norway. BMC Psychiatry. 2014 Nov 18;14:307. doi: 10.1186/s12888-014-0307-7.
• Campbell K, Bond GR, Drake RE. Who benefits from supported employment: a meta-analytic study. Schizophr Bull. 2011 Mar;37(2):370-80. doi: 10.1093/schbul/sbp066. Epub 2009 Aug 6.
• Latimer E, Lecomte T. [Individual Placement Support (IPS) for people with severe mental disorders : An approach to favor in Quebec?]. Sante Ment Que. 2002;27(1):241-67. French.
• Bond GR, Drake RE. Making the case for IPS supported employment. Adm Policy Ment Health. 2014 Jan;41(1):69-73. doi: 10.1007/s10488-012-0444-6.

Study record dates

Study Major Dates

• Study Start (Actual): November 14, 2018
• Primary Completion (Anticipated): November 30, 2019
• Study Completion (Anticipated): May 1, 2020

Study Registration Dates

• First Submitted: October 11, 2018
• First Submitted That Met QC Criteria: November 16, 2018
• First Posted (Actual): November 20, 2018

Study Record Updates

• Last Update Posted (Actual): June 17, 2019
• Last Update Submitted That Met QC Criteria: June 13, 2019
• Last Verified: June 1, 2019

More Information

Terms related to this study

• Keywords: Employment; Homeless
• Additional Relevant MeSH Terms: Chemically-Induced Disorders; Substance-Related Disorders; Mental Disorders
• Other Study ID Numbers: H18-02740

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No
• IPD Plan Description: It is a pilot study (early phase)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No