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支持患有精神健康问题的失业个体在求职和精神健康康复中三管齐下的干预措施的有效性(3for1):一项非随机对照研究的研究方案。

Effectiveness of a three-component intervention supporting unemployed individuals with mental health issues in their job search and mental health recovery (3for1): study protocol of a non-randomized controlled study.

机构信息

Department of Psychiatry and Psychotherapy II, Section Public Mental Health, Ulm University and BKH Günzburg, Parkstraße 11, Ulm, 89073, Germany.

Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, Ulm, 89081, Germany.

出版信息

BMC Public Health. 2024 Nov 14;24(1):3159. doi: 10.1186/s12889-024-20323-0.

Abstract

BACKGROUND

There is a vicious cycle between unemployment and mental health issues. Unemployed individuals with mental health issues require individualized support at multiple levels in order to promote their mental health, and obtain and retain employment. The 3for1-intervention program aims to provide such support with three components (short-term psychotherapy, job coaching based on the Individual Placement and Support approach, and peer support). This study protocol outlines how the effectiveness of this three-component intervention program in terms of re-employment, mental health, and psychosocial outcomes will be evaluated.

METHODS

The 3for1-intervention program will be evaluated with a non-randomized controlled trial design in a multi-center study. 500 eligible participants aged between 18 and 60 years from six job centers in Southern Germany will be allocated to a control group or an intervention group. Allocation is time-based, with the control group being recruited first, followed by recruitment of the intervention group. The control group will receive treatment as usual, whereas the intervention group will receive treatment as usual as well as access to the three intervention components over a period of 12 months. Assessment will be conducted at baseline (t0), and 12 (t1) and 18 (t3) months later. The primary outcome will be the proportion of participants who are in employment subject to social insurance contributions at t1. Differences between control and intervention group will be tested with logistic regression analysis, controlling for relevant covariates. Analyses of secondary outcomes will relate to group differences regarding re-employment, health and well-being, social integration, help-seeking, and self-stigma at t1 and t2, applying logistic regression analysis or analysis of covariance. Additionally, usage of health services will be measured to evaluate the intervention program's cost effectiveness.

DISCUSSION

The 3for1-intervention aims to improve employability and mental health outcomes of a vulnerable population with high need for assistance. Improvements for this population would benefit the German welfare state as well. This study could provide valuable insights into the feasibility, implementation, and sustainability of this individualized, multi-level support program within German job centers.

TRIAL REGISTRATION

This trial is registered with the German Clinical Trials Register: DRKS00029002 (registered on 11 May 2022).

摘要

背景

失业和心理健康问题之间存在着恶性循环。失业且有心理健康问题的个人需要在多个层面获得个性化支持,以促进其心理健康,并获得和维持就业。3for1 干预计划旨在通过三个组成部分(短期心理治疗、基于个体安置和支持方法的工作指导以及同伴支持)提供这种支持。本研究方案概述了如何评估该三组分干预计划在再就业、心理健康和心理社会结局方面的效果。

方法

3for1 干预计划将采用非随机对照试验设计在一项多中心研究中进行评估。从德国南部六个就业中心招募 500 名年龄在 18 至 60 岁之间、符合条件的参与者,将他们分配到对照组或干预组。分配是基于时间的,先招募对照组,然后招募干预组。对照组将接受常规治疗,而干预组将在 12 个月内接受常规治疗以及三种干预措施的支持。评估将在基线(t0)、12 个月(t1)和 18 个月(t3)后进行。主要结局是 t1 时处于受社会保险覆盖的就业状态的参与者比例。将通过逻辑回归分析,控制相关协变量,检验对照组和干预组之间的差异。对次要结局的分析将涉及 t1 和 t2 时关于再就业、健康和幸福感、社会融合、寻求帮助和自我污名化的组间差异,应用逻辑回归分析或协方差分析。此外,将测量卫生服务的使用情况,以评估干预计划的成本效益。

讨论

3for1 干预旨在提高弱势群体的就业能力和心理健康结局,这些人有很高的援助需求。这一人群的改善也将使德国福利国家受益。本研究可以为德国就业中心内这种个体化、多层次支持计划的可行性、实施和可持续性提供有价值的见解。

试验注册

本试验在德国临床试验注册中心注册:DRKS00029002(于 2022 年 5 月 11 日注册)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/11562621/1d1279083f45/12889_2024_20323_Fig1_HTML.jpg

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