Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes. This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from employment. Secondary data analysis was conducted of data gathered in routine clinical practice. Univariate analysis coupled with previous research and clinical consultation was used to select variables to be included in the initial model, followed by a backward stepwise approach to model building for the final multiple logistic regression model with an outcome of successful or unsuccessful goal attainment (employment or education). Sixty-three percent of participants in the enhanced IPS successfully attained employment or education. Significant relationships from bivariate analyses were identified between outcomes (employment or education) and seven psychosocial variables. Adapting Routines to Minimise Difficulties, Work Related Goals, and Living in an Area of Lesser Deprivation were found to be significant in predicting employment or education in the final multiple logistic regression model R2 = 0.16 (Hosmer-Lemeshow), 0.19 (Cox-Snell), 0.26 (Nagelkerke). Model χ2(7) = 41.38 p < .001. An enhanced IPS service had a 63% rate success in achieving employment or education, higher than comparable studies and provides an alternative to IPS-Lite and IPS-standard for more complex populations. Motivational and habitual psychosocial variables are helpful in predicting who may benefit from an enhanced IPS intervention supporting people after prolonged absence from employment. NCT04083404 Registered 05 September 2019 (retrospectively registered).

中文翻译：

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基于人类职业模型（MOHO）的增强的个人安置和支持（IPS）干预；前瞻性队列研究。

就业有利于身心健康，但是患有严重精神疾病（SMI）的人通常被排除在就业之外。标准个人安置和支持（IPS）可有效支持约55％患有SMI的人就业或接受教育。当前的研究认为增强IPS可以改善需要更复杂干预措施的患者的预后。临床医生需要更好地了解谁将从这些增强的IPS干预中受益。这项研究提供了一种新的增强型IPS干预措施，以及一种预测谁可能取得成功结果的方法。这项前瞻性队列研究包括SMI患者，他们参加了增强的IPS服务，并且长期缺勤。对常规临床实践中收集的数据进行了二级数据分析。使用单变量分析结合先前的研究和临床咨询来选择要包含在初始模型中的变量，然后采用逐步逐步建立最终多方Logistic回归模型的模型，以实现目标成功或失败的结果（就业或教育）。增强型IPS的参与者中有63％成功获得了就业或教育。在结果（就业或受教育程度）与七个社会心理变量之间，通过双变量分析确定了重要的关系。在最终的多元逻辑回归模型R2 = 0.16（Hosmer-Lemeshow），0.19（Cox-Snell）中，发现调整例程以最大程度地减少困难，与工作相关的目标以及在贫困程度较小的地区生活对预测就业或教育具有重要意义。 ，0。26（Nagelkerke）。模型χ2（7）= 41.38 p <.001。增强的IPS服务在实现就业或教育方面的成功率达到63％，高于同类研究，并且为更复杂的人群提供了IPS-Lite和IPS-standard的替代产品。动机和惯常的社会心理变量有助于预测谁可能会从长时间的失业后支持人们的IPS干预中受益。NCT04083404注册于2019年9月5日（追溯注册）。动机和惯常的社会心理变量有助于预测谁可能会从长时间的失业后支持人们的IPS干预中受益。NCT04083404注册于2019年9月5日（追溯注册）。动机和惯常的社会心理变量有助于预测谁可能会从长时间的失业后支持人们的IPS干预中受益。NCT04083404注册于2019年9月5日（追溯注册）。