Trial Outcomes & Findings for Supported Employment in Patient Aligned Care Teams (NCT NCT02400736)

502 veterans were considered for this study, 140 were consented, 19 were not eligible, 2 were randomized in error, and 119 were randomized and included in the analyses. Of the 119 randomized participants, 100 (84%) participants completed the study.

Supported Employment in Patient Aligned Care Teams

Participants were categorized as a steady worker if they held a competitive job for 50% or more of the 12-month follow-up (i.e. 26 or more weeks out of 52 weeks).

Number of weeks out of 52 week follow-up in which the participant worked at least one hour in a competitive job.

The number of weeks from randomization until the participant worked in a competitive job.

For those participants, the income earned from any competitive jobs was added for the 52-week follow-up period.

Symptom Checklist-90-Revised (SCL-90-R): 90-item self-report survey; assesses nine dimensions. Each item is self-rated for level of discomfort/distress on scale of 0 "not at all" to 4 "extremely" for somatization (range 0 to 48), obsessive-compulsive symptoms (range 0 to 40), interpersonal sensitivity (range 0 to 36), depression (range 0 to 52), anxiety (range 0 to 40), hostility (range 0 to 24), phobic-anxiety (range 0 to 28), paranoid ideation (range 0 to 24), and psychoticism (range 0 to 40). Total score for a dimension is the sum of items and the distress score for each dimension is the sum divided by number of items in that dimension (range = 0 to 4). Global Severity Index is a mean of all items, calculated by dividing the sum of scores by the number of items (range 0 to 4). Higher score indicates greater distress and increase in score over time indicates worse outcome.

All income earned from competitive, transitional work, and other sources over the 12-month follow-up.

Rosenberg Self-Esteem Scale (RSES) is a 10-item self-report Likert-type questionnaire that asks participants to indicate the degree of their agreement or disagreement with statements about their self-esteem and self-depreciation from 0 = "strongly agree" to 3 = "strongly disagree". The items are summed and the scoring ranges from 0 to 30, with higher scores indicating a higher degree of self-esteem; a positive change in score over time indicates improved self esteem. A score less than 15 may indicate low self esteem.

Income earned ($) from competitive jobs over 12 months was compared between groups for all randomized participants who held a competitive job at some point.

Community Reintegration of Service Members (CRIS) is a self-report instrument used to evaluate the Veteran's reintegration into the community. The correlations between the CRIS and the 36-Item Short Form Health Survey scales of role physical, role emotional, and social functioning were 0.44-0.80 and the CRIS has strong reliability, conceptual integrity, and construct validity. In pilot studies with 126 veterans, working subjects had better CRIS scores then unemployed subjects. Items on the CRIS cover 9 aspects of participation: Learning and Applying Knowledge, General Tasks and Demands, Communication, Mobility, Self-care, Domestic Life, Interpersonal Relationships, Major Life Areas, and Community, Social and Civic Life. Subscale scores for 1) extent of participation, 2) perceived limitations, and 3) satisfaction with participation are calculated. For each of the 3 subscales, the minimum score is 10, the maximum score is 70. Higher scores are indication of better outcomes.

The number of weeks in which the participant was engaged in a transitional work assignment in the treatment as usual arm was subtracted from the 52 week follow-up and used as denominator in deriving the proportion of weeks worked in a competitive job. The IPS group did not engage in transitional work, so 52 weeks was the denominator in deriving the proportion of weeks worked in a competitive job.

Participant held a full-time competitive job during the 12-month follow-up. Full time was defined as working at least 30 hours per week.