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 (TeachMeToBuild)

Royal Victoria Hospital, Canada

Status: Invitation-only

Conditions: Mental Health Issue; Substance Use Disorders; Distress, Emotional

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

Study type: Interventional

Funder types: Other

Identifiers

NCT05626374

R22-013

Details and patient eligibility

About

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.

Full description

The Trades & Diversity Training Program (TDTP) is a Canadian federal government-funded vocational construction skills training program for visible minority & female youth who are chronically under- and unemployed. The TDTP is a 12-week program that includes both in-classroom education and supervised hands-on experiential learning at participating construction sites. The trainees are supported by a case manager who identifies, plans and co-ordinates support services to minimize program absences and drop-out. The most significant barriers to successful program completion and long-term employment are mental health and substance use disorders. Historically, identification and rapid referral to mental health and addiction services has been difficult due to human resource limitations and limited access to timely healthcare services. This study will randomize cohorts enrolled in each 12-week training program located in 2 sites to the use of a self-report distress tool versus usual case management. The distress tool is a web-based self-reporting tool that is accessed by trainees on a daily basis to report their distress levels, the underlying reasons for this distress and whether this distress will prevent them from attending class or put them at-risk for drop-out. For those individuals whose distress levels threaten their program participation, the case manager is alerted immediately via an email notification. The case manager is then responsible for connecting with the trainees and engaging the rapid referral process for mental health and addictions healthcare services. The control cohorts will receive the usual case management approach of engaging students on an intermittent basis and providing support as needed.

Enrollment: 400 estimated patients

Sex: All

Ages: 18 to 49 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 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)

Exclusion criteria

• none

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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400 participants in 4 patient groups

Basic case management

Active Comparator group

Description:

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.

Treatment:

Behavioral: Basic Case Management

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

Experimental group

Description:

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.

Treatment:

Behavioral: Basic Case Management plus Distress Tool

Basic case management supplemented by rapid access healthcare services

Experimental group

Description:

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.

Treatment:

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

Basic case management supplemented by DT and rapid access healthcare services

Experimental group

Description:

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.

Treatment:

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