Dalla Lana School of Public Health

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

September 10/2018

By: Ana Gajic, St. Michael’s Hospital 

Health care organizations can play a key role in supporting unemployed patients find a job, suggests a new study by University of Toronto and St. Michael’s Hospital researchers.

“Employment status is a key social determinant of health, or a social aspect that impacts our well-being,” said Andrew Pinto, an assistant professor in the Dalla Lana School of Public Health and the Department of Family and Community Medicine.

“Our goal with this research was to look at how health care settings can assist patients with gaining employment, and which strategies work best,” said Pinto, who is also a family physician and researcher in The Upstream Lab at Centre for Urban Health Solutions (C-UHS).

To identify the key features of interventions where health care organizations supported patients in gaining employment, Dr. Pinto 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 per cent. 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.