Effectiveness Of Vocational Interventions Research Articles

Non-medical interventions to enhance return to work for people with cancer.

Non-medical interventions to enhance return to work for people with cancer.

Interventions for improving employment outcomes for workers with HIV.

The vast majority of people infected with human immunodeficiency virus (HIV) are adults of working age. Therefore unemployment and job loss resulting from HIV infection are major public health and economic concerns. Return to work (RTW) after diagnosis of HIV is a long and complex process, particularly if the individual has been absent from work for long periods. There have been various efforts to improve the RTW of persons living with HIV (HIV+), and many of these have been assessed formally in intervention studies. To evaluate the effect of interventions aimed at sustaining and improving employment in HIV+ persons. We conducted a comprehensive search from 1981 until December 2014 in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, OSH UPDATE databases (CISDOC, HSELINE, NIOSHTIC, NIOSHTIC-2, RILOSH), and PsycINFO. We considered for inclusion all randomized controlled trials (RCTs) or controlled before-after (CBA) studies assessing the effectiveness of pharmacological, vocational and psychological interventions with HIV+ working-aged (16 years or older) participants that had used RTW or other indices of employment as outcomes. Two review authors independently screened all potential references for inclusion. We determined final selection of studies by consensus. We performed data extraction and management, as well as Risk of bias assessment, in duplicate. We measured the treatment effect using odds ratio (OR) for binary outcomes and mean difference (MD) for continuous outcomes. We applied the GRADE approach to appraise the quality of the evidence. We found one RCT with 174 participants and five CBAs with 48,058 participants assessing the effectiveness of vocational training (n = 1) and antiretroviral therapy (ART) (n = 5). We found no studies assessing psychological interventions. The one RCT was conducted in the United States; the five CBA studies were conducted in South Africa, India, Kenya, and Uganda. We graded all six studies as having a high risk of bias.The effectiveness of vocational intervention was assessed in only one study but we could not infer the intervention effect due to a lack of data.For pharmacological interventions, we found very low-quality evidence for a beneficial effect of ART on employment outcomes in five studies. Due to differences in outcome measurement we could only combine the results of two studies in a meta-analysis.Two studies compared employment outcomes of HIV+ persons on ART therapy to healthy controls. One study found a MD of -1.22 days worked per month (95% confidence interval (CI) -1.74 to -1.07) at 24-months follow-up. The other study found that the likelihood of being employed steadily increased for HIV+ persons compared to healthy individuals from ART initiation (OR 0.35, 95% CI 0.26 to 0.47) to three- to five-years follow-up (OR 0.73, 95% CI 0.42 to 1.28).Three other studies compared HIV+ persons on ART to HIV+ persons not yet on ART. Two studies indicated an increase in the likelihood of employment over time due to the impact of ART for HIV+ persons compared to HIV+ persons pre-ART (OR 1.75, 95% CI 1.44 to 2.12). One study found that the group on ART worked 12.1 hours more (95% CI 6.99 to 17.21) per week at 24-months follow-up than the average of the cohort of ART and pre-ART HIV+ persons which was 20.1 hours.We rated the evidence as very low quality for all comparisons due to a high risk of bias. We found very low-quality evidence showing that ART interventions may improve employment outcomes for HIV+ persons. For vocational interventions, the one included study produced no evidence of an intervention effect. We found no studies that assessed psychological interventions. We need more high-quality, preferably randomized studies to assess the effectiveness of RTW interventions for HIV+ persons.

John L. Holland's Contributions to Vocational Psychology: A Review and Evaluation

John L. Holland pioneered in assessing the environments of colleges and universities and their influence on students. His research has been central in the development of knowledge about nonacademic accomplishments. His theory of vocational personalities and work environments revolutionized the delivery of vocational assistance worldwide. He made contributions to research on originality and interpersonal competence. And he influenced our field through his influence on other psychologists. Persistence, focus, horizon-scanning, the interpretation of evidence in novel ways, revision of ideas based on evidence, an emphasis on the practical, generosity with colleagues, and intellectual tension are themes that characterize Holland's working style and explain his enormous influence. Much remains to be done to fully explore and extend Holland's theoretical contributions in the areas of development and socialization, personal and environmental change, assessment and influences of environments, and effects of vocational interventions.

The effects of vocational interventions on the complexity and positivity of occupational judgments

Ninety-two subjects, who were pretested for levels of cognitive complexity and occupational positivity, participated in one of four self-administered vocational interventions in which they completed (1) J. L. Holland's (1970, The self-directed search, Palo Alto, CA: Consulting Psychologists Press) Self-Directed Search, (2) J. Bodden's (1970), Journal of Counseling Psychology, 17, 364–368) Occupational Information, (3) a computer interactive career program, or (4) an attention-control condition. Post-test and 2-week follow-up assessments indicated that, across groups, subjects decreased in levels of complexity but increased in levels of occupational positivity over time. These effects were qualified by significant interactions which suggested the differential impact of various types of career interventions on vocational judgments. Results are discussed in relation to the literature on cognitive complexity and vocational information processing.