Protocol for Developing and Evaluating the Efficacy of an App-based Behavioral Intervention to Help Individuals with Unemployment-Related Emotional Distress Return to Work: Distress Return-to-work InterVEntioN (DRIVEN) (Preprint)

Abstract

Employment plays an important role in maintenance of mental and physical health. Losing a job creates emotional distress, which can in turn interfere with effective job seeking. Thus, a program for job seekers that provides support for both the logistics of job seeking as well as emotional distress may help people find employment and improve emotional well-being.

To test the efficacy of the six-week intervention for job seekers in a randomized controlled trial.

This is a parallel-assignment randomized control trial comparing a six-week return-to-work intervention versus job-seeking as usual. Assessments will be taken weekly during the intervention as well as 8 and 16 weeks later. Outcomes assessments include employment status, mood, job seeking behavior, and related emotional experiences. The intervention and control-group procedures will be administered remotely, allowing the study to take place in seven major US cities. Eligible participants will be adults ages 18 to 65 years, currently unemployed, and actively searching for work. Prior to their unemployment, they must have been employed full-time (35 hours per week or more) for at least one year, with a salary of $100,000 per annum or less. They must own a smartphone (iPhone or Android), be willing and able to provide informed consent, have a PROMIS Depression T score of 45, and be able to complete the study in English. Exclusion criteria will include current moderate or severe alcohol or substance use disorders, current symptoms of mania or psychosis, or being employed, retired, or a full or part-time student. This six-week intervention is called DRIVEN (Distress Return-to-work InterVEntioN); it includes three sessions of tele-job-coaching, as well as weekly app-based exercises, videos, and resources. Cognitive-behavioral techniques are integrated into the program with two main psychological foci: “Thinking flexibly”, which focuses on taking different perspectives and challenging negative cognitive distortions, and “Taking action”, which focuses on principles of behavioral activation, including taking small, achievable actions to increase self-efficacy. The intervention will be alpha- and beta-tested before the randomized control trial to ensure it is feasible and relevant for job seekers. The control group will receive “job seeking as usual”, which consists of weekly referrals to online “self-help” articles related to employment advice, such as résumé preparation, networking, and interviewing.

The primary outcome measure is the Job Search Behavior Scale; employment status will also be assessed throughout the trial. A mixed-model regression analysis will be used to compare job-searching behavior in the intervention versus control group. A time-to-event analysis (i.e., survival analysis) will be used to compare employment status in the two experimental groups. Secondary outcomes will also be evaluated, including job search self-efficacy, and mental health related outcomes such as anxiety and depression.

Once the analyses are completed, the results will be reported to clinicaltrials.gov.

NCT06026280