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Abstract
Introduction The sustainable employment outcomes and cost-effectiveness of Supported Employment (SE) and Individual Placement and Support (IPS) have been well reported. Research has also focused on various target groups, compliance with the quality criteria for the implementation of the SE/IPS method in diverse work life and social security contexts. However, the impact of employers’ interests and the quality and opportunities of jobs or the work itself for sustainable working careers have not been studied extensively. The objective of the proposed scoping review is to systematically explore what is known about sustainable employability in SE and IPS interventions in the context of the characteristics of work and perspectives of the employers.
Methods and analyses The scoping review methodological framework by Arksey and O’Malley and its recently enhanced versions are used as guidelines in this study. The literature search, which was conducted in Medline, Scopus, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and Social Science Premium Collection (ProQuest), identified a total of 2706 articles after the removal of duplicates. Key findings of selected studies will be charted, analysed and reported.
Ethics and dissemination The study does not require ethics approval, as the data are collected from secondary sources. The final version of the scoping review will be published in a peer-reviewed academic journal. Findings of the review will be used in the upcoming ethnographic observation at work study, which is part of the Finnish Work Ability Programme Evaluation Study (2020–2023).
- REHABILITATION MEDICINE
- QUALITATIVE RESEARCH
- PUBLIC HEALTH
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Strengths and limitations of this study
A comprehensive and precise strategy for conducting a scoping review about sustainable employability in Supported Employment and Individual Placement and Support interventions in the context of the characteristics of work and perspectives of the employers has been developed to map relevant literature and research gaps in the study field.
This protocol and the scoping review process will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocols and PRISMA extension for Scoping Reviews guidelines and well-acknowledged methodological frameworks.
Independent title, abstract and full-text screening, and data extraction by three reviewers will be performed to ensure inter-reviewer reliability.
As a scoping review, quality assessment of studies that will be finally included will not be undertaken.
The scoping review will be limited to English language, peer-reviewed qualitative and mixed-methods studies, and Finnish grey literature.
Introduction
The demand for labour is growing in many European countries. At the same time, greater employment opportunities should be made available to people with different kinds of disabilities and disadvantages, like long-term unemployment. The United Nations Convention on the Rights of Persons with Disabilities emphasises the right of persons with disabilities to work and to have good working conditions.1
Vocational rehabilitation is one of the key measures in strengthening working careers and in preventing prolonged or permanent work disability in western countries. The opportunities that rehabilitation provides for supporting working careers have not been used in an optimal manner in many respects, especially in the case of those in a weak labour market position.2 3
Supported Employment (SE) and Individual Placement and Support (IPS) are vocational rehabilitation approaches that are traditionally applied for persons with different disabilities.4–7 SE is defined as ‘paid work that takes place in normal work settings with provision for ongoing supportive services’.8 9 IPS is a model of SE originally developed for people with severe mental illness.10 The IPS model is based on adherence to eight core principles: focus on open employment, zero exclusion and eligibility based on service user choice, attention to service user preferences, rapid job search, integration of employment services and mental health treatment, personalised benefits counselling, targeted job development and individualised, long-term support.7
The Finnish Government’s Work Ability Programme (2020–2023) aims to raise participation in work and the employment rate.11 The objective of the programme is to facilitate and support access to sustainable employment for unemployed persons with a decreased ability to work, and prevent prolonged unemployment and incapacity for work.11 One of the interventions is to increase the use of SE methods in Finland in various target groups like people with learning or other disabilities or long-term unemployed people.11
Sustainable employability defines employability as action, which is realised in practical situations, that is, in certain work and its contexts.12 Sustainable employability means that people have working conditions that enable them to make a valuable contribution at work while safeguarding their health and well-being. Van der Klink et al12 included the aspect of work values also in their conception: work should create value both for the organisation and the worker. Further, when it comes to employers’ possibilities to offer sustainable careers, it should be sustainable in terms of both well-being and productivity, in this case especially taking account the impact of disability on task performance.13 In addition, Tengland added to his conception of the specific work ability one additional feature of work as a main factor to the specific work ability: meaningfulness of the average daily tasks in that work.14 Therefore, the sustainable ability to work is here defined as an action and interaction relationship between the individual, work values and qualities, and the working environment.
The sustainable employment outcomes and cost-effectiveness of SE and IPS have been well reported.10 15–17 Besides the effectiveness of these approaches, research has focused on the quality criteria for the implementation of the SE/IPS method and in diverse work life and social security contexts.18–22 Also, various target groups like people with severe mental illness, spinal cord injury and affective disorders have been in the focus of the research.5 6 16 However, employers’ interests and the quality and opportunities of jobs or the work itself for sustainable working careers have been less studied. For example, in a scoping review by Chen and Lal where the purpose was to explore stakeholder perspectives on IPS for employment, they found only one study where an employer was a stakeholder.23 In a review by Moen et al, various stakeholder experiences about participating in IPS were also investigated.24 However, the characteristics of the jobs or work remain unexplored to our knowledge.
We know that the working career impacts of work-related rehabilitation are due to the interaction between the facilitators of or obstacles to the rehabilitation process and other components of a complex system. A Finnish study found that the mechanisms that promote or hinder rehabilitation at work emerge through the actions taken by the workplace and especially the rehabilitee’s supervisor.25 However, research on SE and IPS has dedicated less attention to the impact of employers’ interests and the quality and opportunities of jobs or the work itself for sustainable working careers.
Objective
The objective of the proposed scoping review is to systematically explore what is known about sustainable employability in SE and IPS interventions in the context of the characteristics of work and perspectives of the employers. Furthermore, the aim is to discover the extent and nature of the literature and any gaps in it.
Methods and analysis
From the 14 acknowledged review types,26 a scoping review design was chosen as it is the most suitable for the objective of this study. Key elements of a scoping review are exploratory mapping of literature in a field, iterative process, inclusion of grey literature, no quality assessment of included studies and an optional consultation phase.27
The methodological framework for scoping reviews was originally introduced by Arksey and O’Malley and has been later refined in studies such as Levac et al and O’Brien et al.27–29 These frameworks as well as the Joanna Briggs Institute Manual for Evidence Synthesis are used as a guideline in this scoping review.30 There are four main reasons to undertake a scoping review: (1) to examine the extent, range and nature of research activity, (2) to determine the value of undertaking a full systematic review, (3) to summarise and disseminate research findings, and (4) to identify research gaps in the existing literature.27 Reasons 1, 3 and 4 provide the justification for this scoping review.
This scoping review is conducted in five stages: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collating, summarising and reporting the results.27 Each of these stages is discussed in more detail below. This protocol article and the scoping review process follow the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocols and PRISMA extension for Scoping Reviews.31 32 The scoping review process has started in August 2021 and planned end date is November 2022.
Stage 1: identifying the research question
The research question of the study is: What is known from the existing literature about sustainable employability in SE and IPS interventions in the context of the characteristics of work and perspectives of the employers?
The research subquestions are: (1) What kind of work tasks do the work of an employed person consist of?; (2) What kind of interaction is required to work with coworkers or clients at work?; (3) How do the employee and the supervisor describe the fluency and meaningfulness of their work?
Stage 2: identifying relevant studies
Although scoping reviews tend to target broader topics compared with systematic reviews, a predefined strategy is required to guide the research process.27 The eligibility criteria of the studies, databases and search strategy were discussed and agreed within the multidisciplinary research team.
Eligibility criteria
The inclusion and exclusion criteria presented in box 1 will be used in the screening process. Before taking the decision to conduct a scoping review, the research team screened references from the ‘Evidence for IPS PowerPoint: Reference List (4/1/21)’ to find relevant articles about the topic of this review.33 Although no such articles were found, the studies that were closest to the topic were qualitative or mixed-methods studies. The decision to limit the search only to qualitative or mixed-methods articles was made due to both this preliminary finding and the limited time and personnel resources available.
Inclusion and exclusion criteria
Inclusion criteria
Published in English language.
Studies published prior to 31 August 2021.
Studies that address supported employment or Individual Placement and Support (IPS) interventions, the characteristics of work or perspectives of the employers, and/or if title or abstract includes relevant keywords (eg, supported employment, IPS, employer or work).
Peer-reviewed qualitative or mixed-methods articles.
Exclusion criteria
Studies that do not address supported employment or IPS intervention.
Studies that do not take the characteristics of work or perspectives of the employers into consideration.
Studies where full-text articles cannot be obtained.
Databases and grey literature
The literature search was conducted in the following electronic databases: Medline, Scopus, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and Social Science Premium Collection (ProQuest). In addition to database searches, reference lists of reviews by Moen et al and Chen and Lal were included and screened.23 24 Finnish grey literature about the review topic will also be screened.
Search strategy
The search strategy for the Medline database is presented in box 2. The search strategies for other databases are presented in the online supplemental file 1. The search strategy was kept as broad as possible to reduce the risk that some potentially relevant studies would be excluded in the database searches. This decision was made as our preliminary finding because there is not much research done about the study topic. An information specialist from the University of Helsinki was consulted to verify the search terms and relevant databases. Search terms can be divided into three categories: the first category covers the concepts ‘supported employment’, ‘Individual Placement and Support’ and ‘sustainable employment’ (including synonymous terms, eg, ‘job retention’ and ‘staying at work’); the second category includes employer-related and work-related terms; while the third category limits the search to qualitative research and mixed-methods articles. The design of the studies will not be defined in the search as the aim of the scoping review is to identify all relevant literature from the field.27 The Boolean term ‘OR’ is used between the terms in each category, and the Boolean term ‘AND’ is used in the synthesis of all three categories.
Supplemental material
Search strategy for Medline database
(individual* adj2 placement* adj2 support*).mp.
Customi* Employment Support*.mp.
“Individual* placement*”.mp.
exp Employment, Supported/ or “support* employment*”.mp.
“transitional employment”.mp.
“sustainable employment”.mp.
“job retention”.mp.
“staying at work”.mp.
1 or 2 or 3 or 4 or 5 or 6 or 7 or 8
employer*.mp.
exp Workplace/
exp Work/
work*.mp.
job.mp.
supervisor*.mp.
10 or 11 or 12 or 13 or 14 or 15
exp Qualitative Research/
qualitative.mp.
“mixed* method*”.mp.
17 or 18 or 19
9 and 16 and 20
The literature search from electronic databases identified a total of 3157 articles. In addition to electronic database searches, five articles that were found from grey literature were also included.23 24 After the removal of duplicates, a total of 2706 articles were included in the screening process which is described in more detail in the next chapter.
Stage 3: study selection
Study citations found from the electronic database searches were exported into EndNote V.X9 software. Duplicates (n=456) were removed using an automation tool. The study selection process started from title and abstract screening by three reviewers. From the titles (n=2706) that met the predefined inclusion criteria, study abstracts (n=409) were reviewed independently. The pilot testing for inclusion and exclusion criteria was made at the beginning of the screening for first 50 titles and abstracts. The differences that emerged in interpretation during the pilot testing were discussed and consensus was reached among the reviewers. As a result of the pilot testing, no changes or refinements were considered necessary to the eligibility criteria. This decision was made as the preliminary finding indicated that there is not much research done about the study topic.
After the pilot testing, reviewers met at the beginning, midpoint and final stages of the title and abstract screening and discussed about disagreements and challenges that were faced in study selection. From the 409 abstracts, 42 articles were selected for the full-text screening which is the next phase of the study selection process. Full-text screening will begin in March 2022. Three reviewers will independently read the full-text articles to assess further eligibility for inclusion in the scoping review. Possible disagreements on study inclusion will be resolved by discussion until the consensus is reached. Studies that do not meet the inclusion criteria will be excluded.
Stage 4: charting the data
After the study selection stage, key items will be charted from the articles that are included in the final scoping review. The data will be extracted by three reviewers independently to ensure inter-reviewer reliability. Possible disagreements will be resolved by discussion. The planned content of data that will be charted are as follows: title of the study, author(s) and year of publication, country of study, stakeholder group/employer/work, number of interviews, number of organisations, aim(s) of the study, design/theoretical framework and concepts, context (field of business and size of the workplace) and key findings.23 27 30 At the first phase of the analysis, we are entering text data. In the analysis process, the goal is to summarise the descriptions into qualitative categories. For the data extraction, customised form will be constructed and piloted on a few included studies to ensure that all the relevant data of interest will be extracted. Categories may change or additional categories may emerge in the reviewing process as the charting of the data can be an iterative process.30 The data charting is planned for May 2022.
Stage 5: collating, summarising and reporting the results
The overall study process will be presented using a flow diagram, which will include information on the numbers of sources of evidence screened, assessed for eligibility and included in the review, with reasons for exclusions at each stage.31 Stage 5 of the scoping review will be divided into three steps: (1) descriptive numerical summary analysis and qualitative thematic analysis of the charted information about the included studies, (2) narrative report on the findings in relation to the research question and the study purpose, and (3) discussion about the meaning of the findings and study implications.27 28 30 First, there will be a description of the number of articles which describes the context of the characteristics of work and perspectives of the employers; second, a description of different work tasks and interactions the work requires; and last, a description of meanings employees and employers give to work/job. Also, if the framework data are available in included studies, thematic categories will be compiled which describe found theoretical frameworks and concepts at general level. Possible new areas for development will be discussed.
Like in previous stages, at first, three reviewers will screen the included articles and chart the data independently. Reviewers will meet regularly during the process and possible disagreements will be resolved by discussion until the consensus is reached.
Patient and public involvement
No patient involved.
Ethics and dissemination
The aim of this proposed scoping review is to provide insight into what is known about sustainable employability in SE and IPS interventions in the context of the characteristics of work and perspectives of the employers. To our knowledge, this review will be the first to systematically map the literature about the topic; for example, a recently published review has explored IPS and stakeholders from a different and broader perspective.23 Through a new point of view, the extent and nature of the literature and any gaps in it can be discovered, and the need for further research can be determined.
The final version of the scoping review will be published in a peer-reviewed academic journal. Findings of the review will be used in an upcoming ethnographic observation at work study, which is part of the Finnish Work Ability Programme Evaluation Study (2020–2023) conducted by the Finnish Institute of Occupational Health and Finnish Institute for Health and Welfare.34 35
The study does not require ethics approval, as the data are collected from secondary sources. The study has a few limitations. One is that only English-language, peer-reviewed qualitative or mixed-methods articles are included in the review. This decision was made due to both the findings from the preliminary literature screening and the limited time and personnel resources available. The other limitation is that the review addresses both SE and IPS interventions, which differ from each other in many ways. As a result, drawing conclusions from the study results should be treated with caution. However, as the main interest of the study is in the quality and opportunities of jobs or the work itself for sustainable working careers instead of the interventions, it was decided to include both approaches in the literature search. Both interventions have been included in the previously published reviews as well.16 23 The third limitation is related to the features of the IPS intervention; as in many cases, the employers are not aware if the employee is disabled or employed through the IPS. Therefore, it is not possible to investigate the characteristics of work or perspectives of the employers in all situations as the information from the employers is compromised by clients’ selection bias. The fourth limitation was identified during the review process by authors that relates to conducting a scoping review in general. To enhance reliability, the precise strategy for conducting a scoping review is essential. However, there might be a risk that too rigour approach may narrow the scope and reduce coverage of the review. On the other hand, too broad strategy reduces the reliability of the review. A balance was sought in this matter during the review process. As a scoping review, quality assessment of studies that will be finally included will not be undertaken.
Ethics statements
Patient consent for publication
Acknowledgments
We would like to acknowledge Katri Larmo, an information specialist from the University of Helsinki, who was consulted and refined the search strategy of this proposed scoping review.
References
Supplementary materials
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Footnotes
Contributors All authors have made contributions to the development of this protocol article. The objectives and study question were originally developed by PJ-P. The review design was chosen by consensus among the research team. The search terms and electronic databases were selected by PJ-P and JP with the assistance of an information specialist from the University of Helsinki. MJ, KU and PJ-P provided substantive expertise in the research topic. JP initiated the first draft of the manuscript after which all authors participated in writing, editing and providing feedback. All authors have approved the final version of the manuscript.
Funding This study is part of the Finnish Work Ability Programme Evaluation Study (2020–2023) funded by the Ministry of Social Affairs and Health of Finland (grant VN/25745/2020).
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.