Wong 2008.
| Methods | Allocation: randomised Design: single centre Duration: 18 months Country: Hong Kong, China |
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| Participants | N = 92 Diagnosis: diagnosed at least 2 years previously as having a mental illness. Included: 70% schizophrenia spectrum, 18% affective disorder Setting: the Occupational Therapy Department, Kwai Chung Hospital Age: between 18‐55 years, mean 33.6 years Gender: 60% male Ethnicity: ‐ Substance abuse: ‐ Living situation: ‐ Marital status: 90% never married Employment status: unemployed Working history: mean months working at a paid job in the past 5 years: 17 months Motivation: expressed an interest in competitive employment Education: 68% grade 7‐11, 22% post secondary (grade 12 or above) Disability benefit: ‐ Excluded: serious medical illness that might affect their long‐term ability in competitive work |
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| Interventions |
SE (N = 46) The SE programme of this study was based on the IPS model. The employment specialist was integrated into the participant’s clinical management team. The employment specialist assisted the participant to search for a competitive job on the basis of his or her educational background, work preference, and previous work experience. Once employed, on‐the‐job training and follow‐along support was provided. If employment was terminated for any reason, the employment specialist would assist the participant to recover from job loss and help him or her look for another job. The maximum caseload was limited to 20. The IPS programme developers were invited to conduct a 1‐week intensive training on the programme implementation as well as to rate the present programme by using the IPS Fidelity Scale. The local IPS programme received high ratings of implementation fidelity (scored 69 out of 75, which is equivalent to good implementation of SE). TVR (N = 46) The programme was implemented in the form of PVT in various work groups in a simulated environment. The primary objective of this programme was to equip participants with skills and knowledge related to choosing, obtaining, and keeping a competitive job in the community by using a stepwise train‐place approach. Although the participants were attending the programme, they were encouraged to seek open competitive employment by themselves by using the normal channels for job hunting, such as newspaper advertisements and Internet searches, as well as personal contacts with potential employers. |
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| Outcomes | Percentage of participants who obtained competitive employment Percentage of participants who obtained non‐competitive employment Weeks in competitive employment Days to first competitive employment Dropouts |
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| Notes | Definition competitive employment: a job paid at the market rate, for which anyone can apply, and not controlled by a service agency | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | "Participants were individually randomly assigned by using random numbers generated by computer" |
| Allocation concealment (selection bias) | Unclear risk | No details |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and personnel could identify the given intervention by contents of the programme |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | Measurements were conducted by the employment specialists |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | 1 participant in the control group was lost to follow‐up |
| Selective reporting (reporting bias) | Low risk | All listed outcomes were reported |
| Other bias | Low risk | This study was supported by grant 216033 from the Health Care and Promotion Fund, Food and Health Bureau, Hong Kong |