Objective:Little is known about the association between service intensity and fidelity scale score in supported employment programs. This study compares service contents and intensity in low- and h...

Contents and Intensity of Services in Low- and High-Fidelity Programs for Supported Employment: Results of a Longitudinal Survey

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). 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. 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. 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. UMIN000025648

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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.

BACKGROUND The Japanese version of the individualized Supported Employment Fidelity scale (JiSEF) was developed by modifying the 25-item Individual Placement and Support Fidelity Scale (IPS-25). While a preliminary study partly confirmed the concurrent validity with vocational outcomes, this replication study aimed to examine the stability of the concurrent validity and the inter-rater reliability of the JiSEF and to test its convergent validity with IPS-25. METHODS Fidelity assessments were conducted in 2016 (n = 17), 2017 (n = 13), and 2018 (n = 18) to examine the employment rate and the fidelity scores at the agency level. We also evaluated the fidelity scores for the IPS-25 in 2018. We examined the associations between the fidelity scale scores and vocational outcomes for the concurrent validity and between the fidelity scales for convergent validity. The inter-rater reliability was examined in the 2016 and 2017 assessments. RESULTS High intraclass correlation coefficients (0.93 in 2016 and 0.92 in 2017) were obtained for the inter-rater reliability. The JiSEF score in each year was associated with the agency employment rate (r = 0.710, P = 0.001 in 2016; r = 0.722, P = 0.005 in 2017; and r = 0.665, P = 0.003 in 2018). A supplementary longitudinal data analysis also confirmed the association between the JiSEF score and the employment outcomes. Additionally, the JiSEF was significantly correlated with the IPS-25 (r = 0.760, P < 0.001). CONCLUSIONS This study stably replicated good inter-rater reliability and concurrent validity of the JiSEF. Additionally, the convergent validity was confirmed. Further studies with large samples are needed to confirm these findings.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/npr2.12172

Assessing stable validity and reliability of the Japanese version of the individualized supported employment fidelity scale: A replication.

Objective To review the evidence of supported employment interventions in low-to-middle income countries, documents their impact for persons with mental disorders in the open labour market and well as support decision making for its wider implementation in the workplace. Design The scoping review is conducted following guidelines in the Arksey and O’Malley (2005) Framework. Data sources and eligibility Eleven databases which are PubMed, Scopus, Academic Search Premier, the Cumulative Index to Nursing and Allied Health Literature, Africa-Wide Information, Humanities International Complete, Web of Science, PsychInfo, SocINDEX, Open Grey and Sabinet were searched for articles published between January 2006 and January 2022. Both peer-reviewed articles and grey literature were eligible if they were on supported employment interventions in low-to-middle income countries. Only articles published in English were included. Study appraisal and synthesis Articles were screened at title, abstract and full article levels by two independent teams with the use of Rayyan software. Deductive thematic analysis was used to synthesize evidence on the supported employment interventions implemented in LMICs, capturing evidence of their outcomes for persons with mental disabilities securing competitive work. Results The search yielded 7347 records and after screening by title and abstract, 188 studies were eligible for full article screening. Eight studies were included in this scoping review. Thematic descriptions of the findings were based on the availability of supported employment interventions within the context, the type of supported employment interventions as well as mental health and vocational outcomes in the workplace. Conclusions There is limited evidence of supported employment interventions in low-to-middle income countries despite the promising potential it has as an intervention to address mental health problems in the workplace and facilitate work participation by persons with mental disabilities.

Supported employment interventions for workplace mental health of persons with mental disabilities in low-to-middle income countries: A scoping review

Community participation is associated with physical, cognitive, and mental health benefits for people with serious mental illnesses (SMI) and is recognized as a critical component of health functioning. Developing reliable measurement of participation in different cultural contexts and languages is important to expanding knowledge in this area. The aim of this study was to translate a psychometrically sound English-language community participation measure into Japanese and examine its test-reliability with a population of Japanese people with SMI. Self-reported data were gathered twice from 253 individuals within 48 h using the Temple University Community Participation-Japanese version (TUCP-J) at Type-B Continuous Employment Support Centers in Japan between November 2020 and February 2021. Participant responses were similar on four of the five participation subscales. At the item-level, participants provided consistent responses on 26 out of 27 of the items about amount of participation and had high item-level concordance (77-93%) on their ratings of the importance (Yes; No) of each participation activity and their reported participation sufficiency (Enough; Not Enough; Too Much: 73-88%). Overall, the results demonstrated strong evidence of test-retest reliability of the TUCP-J and identified a number of areas that were important to respondents, but where they were reporting not doing enough. 

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Measuring Community Participation Among Japanese with Serious Mental Illnesses

Objective In spite of the effectiveness of the individual placement and support model of supported employment (IPS) for the recovery of people with mental illness, the implementation and dissemination of IPS in Japan have not been straightforward. This paper summarizes barriers against the implementation of IPS in Japan and discusses potential strategies to overcome them. Method We reviewed IPS research performed in Japan through literature search, and summarized current employment services and policies in Japan along with a practice report of an ongoing IPS program in a local city in Japan. Results Barriers against the implementation of IPS in Japan included: (a) systems designed mainly for group-based services, (b) weak recognition of IPS, and (c) cultural background. Nevertheless, we identified 4 intervention studies of IPS in Japanese settings, and all found that more than 40% of the participants gained their employment through IPS. By utilizing available services, the IPE program in Hamada City achieved ∼50% employment rate and sufficient fidelity. Conclusions and implications for practice The present data indicate that, by combining currently available services, IPS can be implemented successfully in Japan. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Implementing the individual placement and support model of supported employment in Japan: Barriers and strategies.

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Implementing the individual placement and support model of supported employment in Japan: Barriers and strategies.