Department of Psychiatry, McGill University.
Douglas Hospital Research Centre.
Psychiatr Rehabil J. 2020 Mar;43(1):2-8. doi: 10.1037/prj0000355. Epub 2019 Apr 4.
To describe facilitators, barriers, and strategies to implementation of the Canadian national At Work/Au travail program. This program funded supported employment services, following some of the principles of the Individual Placement and Support (IPS) model, in 12 sites across Canada.
We conducted on-site individual interviews (12) and focus groups (15) with 35 employment support workers, 12 team supervisors or managers, and 10 directors or CEOs. Interview summaries were created and coded using thematic analysis techniques. Codes were then distilled into themes grouping prominent barriers and facilitators to implementation.
Four themes emerged: (i) national program structure: Flexible eligibility criteria and flexibility in use of subsidy funds were perceived as generally helpful, although there were difficulties associated with communication around noneligibility decisions and outcome targets; (ii) training and reinforcement: The support provided to sites was generally thought to be an important facilitator, especially when more intensive. Several participants viewed the online IPS training as a facilitator; (iii) external factors: Rules concerning impacts of employment earnings on benefits could be viewed as a barrier; and (iv) internal factors: Facilitators included strong leadership, positive staff attitudes, and larger program size. Several participants reported staff resistance as a barrier.
Several features of the national program structure and leadership emerged that could be maintained if the program were extended elsewhere. The flexibility allowed for spending of wage subsidy funds, as well as the provision of more intensive training, were both perceived as potential enhancements to an eventual expansion of the program. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
描述加拿大国家就业计划（At Work/Au travail）实施的促进因素、障碍因素和策略。该计划在加拿大 12 个地点资助和提供支持性就业服务，遵循个体安置与支持（IPS）模式的一些原则。
我们对 35 名就业支持工作者、12 名团队主管或经理以及 10 名主任或首席执行官进行了现场个人访谈（12 次）和焦点小组讨论（15 次）。使用主题分析技术创建和编码访谈摘要。然后将代码提炼为主题，将实施的主要障碍和促进因素分组。
出现了四个主题：（i）国家计划结构：灵活的资格标准和补贴资金的使用灵活性被认为是普遍有帮助的，尽管在非资格决定和结果目标方面的沟通存在困难；（ii）培训和强化：向各站点提供的支持通常被认为是一个重要的促进因素，特别是当支持更密集时。一些参与者认为在线 IPS 培训是一个促进因素；（iii）外部因素：有关就业收入对福利影响的规定可能被视为一个障碍；（iv）内部因素：促进因素包括强有力的领导、积极的员工态度和更大的项目规模。一些参与者报告称，员工抵制是一个障碍。
国家计划结构和领导力的几个特征可以保留，如果该计划在其他地方扩展。资金的灵活性允许支出工资补贴资金，以及提供更密集的培训，都被认为是该计划最终扩展的潜在增强因素。
