Effects of a systematically offered social and preventive medicine consultation on training and health attitudes of young people not in employment, education or training (NEETs): An interventional study in France

BackgroundNEETs (young people not in employment, education or training) are at higher risk for poorer mental and physical health. In France, the Missions locales (MLs) are the only social structures dedicated to this population. We sought to determine whether the systematic offer of a social and preventive medicine consultation at a ML might increase NEET participants’ access to training in the 12 months following the intervention.MethodsThis intervention research was a parallel randomised controlled interventional study conducted at five MLs in mainland France in 2011–2012. It included 976 NEETs aged 18 to 25 years who attended one of the five MLs. At inclusion, participants were randomly assigned (1:1:1) to three groups: those in the first group were invited to see a social worker (not studied in this paper), those in the second group were invited to see a doctor and a social worker (intervention group), and the third was a control group. The primary outcome was participation in at least one training session during the year following study inclusion.ResultsAmong the 976 participants, 504 were randomly assigned to the intervention group and 472 to the control group; 704 (72.1%) were included in the analyses. A significantly higher proportion of the participants in the intervention group participated in a training session in the 12 months following the intervention than of those in the control group (63.3% vs 55.6%; p = 0.04). This difference was significantly greater for women, those less than 21 years of age, those unstably housed and those with a lower level of education.ConclusionsSocial and preventive medicine consultations that are fully integrated into the social services for NEETs have an impact on their access to training and contribute to changing some of their health-related behaviours. This may improve their access to the labour market.

背景：未就业、未接受教育或未接受培训的年轻人（NEETs）面临更差的身心健康风险。在法国，地方使命机构（MLs）是唯一致力于此人群的社会结构。本研究旨在探究在地方使命机构中系统地提供社会及预防医学咨询是否能够提高NEET参与者在干预后的12个月内接受培训的机会。方法：本干预研究是一项在2011-2012年间于法国大陆五个地方使命机构进行的平行随机对照干预研究。研究纳入了976名18至25岁的NEETs，他们中的一员参加了一个地方使命机构的活动。在纳入研究时，参与者被随机分配（1:1:1）至三个组别：第一组被邀请会见社会工作者（本文未对此进行研究），第二组被邀请会见医生和社会工作者（干预组），第三组为对照组。主要结果是参与至少一次培训课程。结果：在976名参与者中，504人被随机分配到干预组，472人被分配到对照组；704人（占72.1%）参与了分析。干预组中有显著更高比例的参与者在干预后的12个月内参与了培训课程，与对照组相比（63.3% vs 55.6%；p = 0.04）。这一差异在女性、年龄小于21岁、无固定住所以及教育水平较低的人群中更为显著。结论：将社会及预防医学咨询完全融入NEETs的社会服务中，对提高他们接受培训的机会有显著影响，并有助于改变他们的某些与健康相关的行为。这可能会改善他们进入劳动市场的机会。