Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Health Serv Res. 2022 Jun;57 Suppl 1(Suppl 1):95-104. doi: 10.1111/1475-6773.13905. Epub 2022 Mar 4.
To explore how stakeholders responded to research evidence regarding supported employment (e.g., vocational rehabilitation), and ways evidence could be incorporated into policy and action.
Qualitative data were collected from three stakeholder groups-people with lived experience of mental health challenges, community health advocates, and state health policy makers.
This study consisted of two sequential steps. First, three focus groups were conducted after presenting stakeholder groups (inclusive of 22 participants) with simulation data showing that improvement in employment status had a stronger impact on mental health than improvement in education or income for racially/ethnically diverse groups. Second, with guidance from focus group findings, researchers conducted additional in-depth interviews (n = 19) to gain a deeper understanding of the opportunities and challenges related to incorporating these findings into policy and practice.
DATA COLLECTION/EXTRACTION METHODS: Focus groups and in-depth interviews were conducted, audio recorded, transcribed, and analyzed using a thematic analysis approach.
People with lived experience described the positive effect of employment in their own life while highlighting the need to increase workplace accommodations and social supports for those with mental health challenges. Across stakeholder groups, participants emphasized the need for linguistic and cultural competence to promote equity in delivery of supported employment programs. Stakeholders also underscored that centralizing existing resources and using evidence-based approaches are crucial for successful implementation.
Implementing effective supported employment programs should focus on meeting the specific needs of target individuals, as many of those needs are not considered in current employment-related programming. Collecting information from diverse users of research demonstrates what other aspects of supported employment are required for the likelihood of successful uptake. Implementation and dissemination efforts need to fortify collaborations and knowledge transfer between stakeholders to optimize supported employment and mental health resources.
探讨利益相关者如何对支持性就业(例如职业康复)的研究证据做出反应,以及如何将证据纳入政策和行动。
定性数据来自三个利益相关者群体收集:有心理健康挑战经历的人、社区健康倡导者和州卫生政策制定者。
本研究由两个连续的步骤组成。首先,在向利益相关者群体(包括 22 名参与者)展示模拟数据后,进行了三次焦点小组讨论,这些数据表明,对于不同种族/族裔群体,改善就业状况对心理健康的影响强于改善教育或收入。其次,在焦点小组研究结果的指导下,研究人员进行了额外的深入访谈(n=19),以更深入地了解将这些发现纳入政策和实践的机会和挑战。
资料收集/提取方法:进行焦点小组和深入访谈,录音、转录,并使用主题分析方法进行分析。
有亲身经历的人描述了就业对他们自己生活的积极影响,同时强调需要增加工作场所的适应能力和对心理健康挑战人士的社会支持。在所有利益相关者群体中,参与者都强调需要语言和文化能力,以促进支持性就业计划的公平交付。利益相关者还强调,集中现有资源并采用基于证据的方法对于成功实施至关重要。
实施有效的支持性就业计划应侧重于满足目标个人的特定需求,因为当前与就业相关的方案中没有考虑到许多这些需求。从研究的不同使用者那里收集信息,展示了支持性就业成功实施还需要哪些其他方面。实施和传播工作需要加强利益相关者之间的合作和知识转移,以优化支持性就业和心理健康资源。