Comparing the Effect of Adding a Remote Self-reporting Tool for Distress and Fit-for-purpose Mental Health & Addictions Service to Usual Case Management on Dropout Rates in a Vocational Training Program

NCT05626374 | Enrolling By Invitation

• 1 other identifier: R22-013
• Study Type: interventional
• Target: 400
• Locations: 1 country
• Sites: 1

Brief Summary

Youth unemployment is a chronic problem in most societies. Some young adults are neither in employment, education or training (NEET), and are at high risk of chronic unemployment, social disengagement and poor quality of life. Identifying this high risk population and providing them with career skills training and opportunities is critical for their full participation in society. Vocational training programs provide an opportunity for these NEET youth to develop a skilled trade. Barriers to successful completion of these programs include high prevalence of mental health and substance use disorders among NEET youth. This study will use a daily self-report distress tool to identify vocational program trainees at risk of absence or drop-out due to mental health and/or substance abuse issues. These at-risk trainees will then be referred to a mental health crisis program through a fit-for-purpose referral process to accommodate their training program requirements. It is hypothesized that early identification and referral for mental health and substance abuse issues will reduce both program absence and drop-out rates and result in improved in long-term employment for these NEET youth.

Conditions

Mental Health Issue; Substance Use Disorders; Distress, Emotional

Keywords

mental health issues; substance use disorders; multi-centre trial; cluster randomized; factorial design; vocational training program; vulnerable youth; unemployment

Outcome Measures

Primary Outcomes (3)

• Program attendance

  Difference in proportion of absence-free program days, where absence-free day is defined as being present in class or work setting by case manager or supervisor. Maximum number of absence-free days is 48 days (12 weeks x 4-day work week). A day is defined as an 8- to 10-hour work day from Monday to Thursday.

  12 weeks from program enrolment

• Program completion

  Difference in proportion of drop-outs, where a drop-out is defined as an apprentice who fulfils any of the following criteria: 1. Has missed more than 50% of class/work days, or 2. Who has elected to leave the program for reasons other than taking another job or returning to school

  12 weeks from program enrolment

• Post-program employment

  Difference in proportion of full-time employment, where full-time employment is defined as paid work ≥ 30 (median) hours per week at their main or only job. The reference period that will be used to determine full-time employment is the 4-week period preceding the 24-month post-program completion date.

  24 weeks post-program completion

Secondary Outcomes (6)

• Access to healthcare services

  12 weeks from program enrolment

• Healthcare utilization

  12 weeks from program enrolment

• Apprentice satisfaction

  12 weeks from program enrolment

• Acceptability of self-report distress tool

  12 weeks from program enrolment

• Feasibility of self-report distress tool

  12 weeks from program enrolment

Study Arms (4)

Basic case management

ACTIVE COMPARATOR

Basic case management with bi-weekly meetings between case manager and trainees that includes check-ins, frequent visits to construction sites and monitoring of feedback forms from mentors. Case managers attempt to connect trainees with external support services as needed.

Behavioral: Basic Case Management

Basic case management supplemented by self-reporting distress tool (DT)

EXPERIMENTAL

Basic case management plus access to the self-report daily distress tool. The trainees are provided web-based access to the daily distress tool and report their distress levels using a validated visual analog scale (Distress Thermometer), along with reporting their risk of missing work/class or dropping out of the program. The case manager responds to the distress tool by coordinating external support services as needed.

Behavioral: Basic Case Management plus Distress Tool

Basic case management supplemented by rapid access healthcare services

EXPERIMENTAL

Basic case management supplemented by a fit-for-purpose rapid referral process for trainees with active mental health and/or substance use disorders affecting their program participation.

Behavioral: Basic Case Management plus rapid mental health & addictions healthcare access

Basic case management supplemented by DT and rapid access healthcare services

EXPERIMENTAL

Basic case management supplemented by both the self-report distress tool and rapid referral process for those trainees at-risk of program absence or drop-out from either mental health or addictions issues.

Behavioral: Basic Case Management plus Distress Tool and rapid mental health & addictions healthcare access

Interventions

Basic Case Management BEHAVIORAL

Usual case management support during 12-week training program

Basic case management

Basic Case Management plus Distress Tool BEHAVIORAL

Usual case management support during 12-week training program plus daily self-reports of distress using Distress Thermometer tool

Basic case management supplemented by self-reporting distress tool (DT)

Basic Case Management plus rapid mental health & addictions healthcare access BEHAVIORAL

Usual case management support during 12-week training program plus rapid access referral process for healthcare crisis services

Basic case management supplemented by rapid access healthcare services

Basic Case Management plus Distress Tool and rapid mental health & addictions healthcare access BEHAVIORAL

Usual case management support during 12-week training program plus daily distress self-reports plus rapid access referral process for healthcare crisis services

Basic case management supplemented by DT and rapid access healthcare services

Eligibility Criteria

• Age: 18 Years - 49 Years
• Gender Eligibility Details: Female based on self-representation of gender identity
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• must be a visible minority or female
• must be fluent in English or French
• must have an active Ontario Health Insurance Plan number
• must have a valid Canadian Social Insurance Number
• Access to wi-fi network and computing device (phone, tablet, computer)

You may not qualify if:

• \- none

Sponsors & Collaborators

• Royal Victoria Hospital, Canada: lead

Study Sites (1)

Royal Victoria Regional Health Centre

Barrie, Ontario, L4M6M2, Canada

Location

Related Publications (1)

• Bailey S, Stoner C, Cruise K, DiDiodato G. Protocol for a cluster randomized study to compare the effectiveness of a self-report distress tool and a mental health referral service to usual case management on program completion among vulnerable youth enrolled in a vocational training program. PLoS One. 2024 Aug 1;19(8):e0294806. doi: 10.1371/journal.pone.0294806. eCollection 2024.

  PMID: 39088460 DERIVED

MeSH Terms

Conditions

Substance-Related Disorders

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders

Study Officials

• Giulio DiDiodato, MD PhD

  Royal Victoria Regional Health Centre

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Chief Research Scientist

Model Details: 2x2 factorial design, cluster-randomized, multicentre trial

Study Record Dates

• First Submitted: November 15, 2022
• First Posted: November 23, 2022
• Study Start: January 15, 2023
• Primary Completion: January 15, 2026
• Study Completion (Estimated): January 15, 2027
• Last Updated: November 20, 2024

Record last verified: 2024-11

Locations

CA (1)