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Meta-Analysis
. 2019 Feb 20;14(2):e0212208.
doi: 10.1371/journal.pone.0212208. eCollection 2019.

Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support

Donald E Frederick  1 , Tyler J VanderWeele  1   2
Affiliations
Meta-Analysis

Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support

Donald E Frederick et al. PLoS One. .

Abstract

Supported employment is a treatment whereby those with severe mental illness (or other disabilities) receive aid searching for competitive employment and mental health (or other) treatments concurrently. The most popular implementation of supported employment is individual placement and support (IPS). We conducted meta-analytic analyses of the randomized controlled trials of IPS. We found that subjects in IPS, compared to usual treatment conditions, had better vocational outcomes (obtained any competitive employment: RR = 1.63, 95%CI = [1.46, 1.82]; job tenure: d = 0.55, 95%CI = [0.33, 0.79]; job length: d = 0.46, 95%CI = [0.35, 0.57]; income: d = 0.48, 95%CI = [0.36, 0.59]) Non-vocational outcomes estimates, while favoring IPS, included the null (quality of life: d = 0.30, 95%CI = [-0.07, 0.67]; global functioning: d = 0.09, 95%CI = [-0.09, 0.27]; mental health: d = 0.03, 95%CI = [-0.15, 0.21]). Analysis of the expected proportion of studies with a true effect on non-vocational outcomes with d>0.2 showed some reason to expect a possible improvement for quality of life for at least some settings (Prop = 0.57, 95%CI = [0.30, 0.84]).

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow chart.
Our literature search found 368 unique articles and we found another 5 that were referenced in articles. We initially screened articles to check that they used an RCT design, extended the duration of a previous RCT experiment, or performed secondary analysis on a previous RCT. We found that 49 articles met this criterion plus the 5 that we found referenced in other articles. We then read those articles and excluded ones that used a mixed treatment (e.g., IPS plus some other component) or did not report an outcome variable of interest. We excluded 24 articles for these reasons. This left 30 articles in total that we used for analysis.
Fig 2
Fig 2. Competitive employment outcomes.
A) For having held a competitive employment job for any portion of the experimental period B) For having held a competitive employment job at end of the experiment.
Fig 3
Fig 3. Time to first competitive employment job results.
Fig 4
Fig 4. Competitive employment job tenure and job duration results.
A) Job tenure, which is the duration of the longest held competitive employment job. B) Job duration, which is the total length of competitive employment.
Fig 5
Fig 5. Income outcome results.
Fig 6
Fig 6. Quality of life outcome.
Fig 7
Fig 7. Global functioning and mental health outcomes.
A) Global functioning. B) Mental health.
See this image and copyright information in PMC

References

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