Article Details

Research Database: Article Details

Citation:  Kielhofner, G., Braveman, B., Fogg, L., & Levin, M. (2008). A controlled study of services to enhance productive participation among people with HIV/AIDS. American Journal of Occupational Therapy, 62 (1), 36-45.
Title:  A controlled study of services to enhance productive participation among people with HIV/AIDS
Authors:  Kielhofner, G., Braveman, B., Fogg, L., & Levin, M.
Year:  2008
Journal/Publication:  American Journal of Occupational Therapy
Publisher:  American Occupational Therapy Association
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  Not reported
Research design:  Quasi-experimental

Structured abstract:

Background:  With improved treatment options, more individuals with HIV/AIDS are surviving longer and returning to productivity. Few studies have examined interventions that improve employment outcomes for HIV/AIDS survivors.
Purpose:  This study assessed the effectiveness of a model program designed to increase productive participation among people living with HIV/AIDS within supportive-living facilities. The model program is entitled Enabling Self-Determination (ESD).
Setting:  This study was implemented in four supportive living units in metropolitan Chicago, IL. These units exclusively serve individuals with HIV/AIDS.
Study sample:  The study sample consisted of 65 individuals with HIV/AIDS who were randomly assigned to the intervention group or a standard care group. The study group was predominantly male (82%) and African-American (71%).
Intervention:  The ESD model consists of eight weekly one-hour sessions led by an Occupational Therapist. Sessions were designed with both educational and peer support components. Examples of sessions include: Managing one’s own physical and mental health; Developing skills and habits for independent living; Developing occupational roles,habits, and skills; Building vocational confidence (job search, interviewing, etc.); and Learning self-advocacy and self-management skills.
Control or comparison condition:  A non-randomized two-group design was used. This design was used because having both intervention and control conditions in the same residence would have contaminated the study. Two residences served as the intervention settings, and the other two as standard treatment settings.
Data collection and analysis:  Demographic and impairment data were collected at baseline. Information on engagement in productive activities (either employment, education, or volunteering) was collected at three, six, and nine months following completion of the ESD or standard treatment. Data analysis consisted of first comparing the two groups to determine if they differed on baseline variables. Then, chi-square analyses were used to compare employment status at the three, six, and nine-month checkpoints.
Findings:  No significant differences were found between the two groups. Of the original 65 participants, employment outcome data could be obtained for 46. Attrition rates were not significantly different for the two groups. Participants in the ESD group were significantly more likely to be employed at each of the three checkpoints. Employment rates for the ESD group were more than double those of the standard treatment group.
Conclusions:  The findings of this study support the efficacy of the ESD model for individuals with HIV/AIDS, and that the benefits can be sustained over time. Replication of the ESD model with larger study groups and other populations would more fully evaluate the efficacy of the model.

Disabilities served:  HIV / AIDS
Populations served:  Gender: Female and Male
Race: Black / African American
Race: White / Caucasian
Ethnicity: Hispanic or Latino
Ethnicity: Not Hispanic or Latino
Interventions:  Career counseling
Non-psychological counseling
Peer mentor
Training and technical assistance
Outcomes:  Employment acquisition