Prescribing employment: Study identifies key features of interventions to help patients get jobs

Study examines health-care interventions to support patients’ seeking work

TORONTO, September 10, 2018 – Health care organizations can play a key role in supporting unemployed patients find a job, suggests a new study from the Centre for Urban Health Solutions (C-UHS) of St. Michael’s Hospital.

“Employment status is a key social determinant of health, or a social aspect that impacts our well-being,” said Dr. Andrew Pinto, a family physician at St. Michael’s Hospital and an assistant professor at the Department of Family and Community Medicine at the University of Toronto. “Our goal with this research was to look at how health care settings can assist patients with gaining employment, and which strategies work best.”

To identify the key features of interventions where health care organizations supported patients in gaining employment, Dr. Pinto, who is also researcher in The Upstream Lab at C-UHS and and an assistant professor at the Dalla Lana School of Public Health, and his team conducted a systematic review of studies of interventions within health care settings that aimed to help patients find jobs. They identified 88 studies that met the study’s criteria.

The literature revealed that most interventions were successful, and of these, the average gain in any type of employment with support from health care organizations was 51%. The research also revealed which factors made interventions most effective for patients to gain employment. 

The five key factors common in successful interventions were:

1. A multidisciplinary intervention team – A team composed of both health-care workers and employment specialists who have open communication were more likely to meet patient employment needs.

2. A package of services for patients – Offering patients expert advice, a job search, feedback, networking, education, training and peer mentorship made them more successful in their job search.

3. One-on-one services, tailored to the patient – Interventions that were tailored to the person’s preferences, skills, education and previous work experiences were most impactful.

4. A comprehensive view of social needs – Interventions that took a holistic approach to addressing other social determinants of health, such as housing, were more successful in helping patients find jobs.

5. An intervention team that works with employers – Communication with employers proved to be important. With clear communication between the intervention team and employers, both parties could ensure that specific needs, such as accommodation for disabilities, were met.

“We recognize that these interventions may not be possible for all organizations,” Dr. Pinto said. “Our study can assist with the design of successful employment interventions that are realistic. Certain team-based primary care organizations have the opportunity to develop a pathway for patients dealing with unemployment.”

At St. Michael’s, this work informed a pilot study through which patients with precarious employment at the St. Michael’s Family Health Team received employment support and intervention. Dr. Pinto and his team are currently analyzing this data.

This study was funded by the Atkinson Foundation Decent Work Fund.

Author: Ana Gajic, St. Michael's Hospital