Trial lecture title: The next generation of research-based return-to-work coordination in Norway.
The ordinary opponents are:
- First opponent: Professor Marius Steiro Fimland, NTNU, Norway
- Second opponent: Professor Staffan Josephsson, Karolinska Institutet, Sweden
- Leader of the committee: Professor Vibeke Lohne, OsloMet, Norway
The leader of the public defence is Dean Gro Jamtvedt, OsloMet.
The main supervisor is Professor Randi Wågø Aas, OsloMet and University of Stavanger. The co-supervisor is Professor Ellen Ramvi, University of Stavanger.
Thesis abstract
Return to work (RTW) coordination has been found to promote a quicker return to work for sick-listed workers. However, there is still an ongoing debate on the best practices of RTW coordination.
In Norway, little is known about how RTW coordination is currently practiced. Therefore, the aim of this thesis was to explore and describe coordination practices and challenges in RTW processes, and reveal whether current coordination models increase the possibility for work participation among sick-listed employees.
Methods
The thesis apply data from the Rapid-RTW cohort study of sick-listed employees participating in RTW programmes in Norway, and investigates the associations between personal, intervention, and predictive factors related to being provided with a coordinator in Rapid-RTW programmes (study I), and associations of being provided with a coordinator and length of time until RTW (study II).
Further, data from two qualitative studies were applied: a group interview study exploring stakeholders’ opinions on challenges and needed changes in the follow-up of sick-listed employees in Norway (study III), and an individual interview study with supervisors that investigates their experiences with fostering work integration (study IV).
Results
Paper I revealed that being provided with a coordinator were common in Rapid-RTW programmes; however, the coordinator was only responsible for coordinating their own services.
Employees with a coordinator had more professionals involved and more contact with other stakeholders.
Paper II revealed that employees provided with a coordinator experienced their first RTW later than those who were not provided with a coordinator.
However, this result did not remain statistically significant in the adjusted analysis. For the first full-RTW, there was no statistically significant difference between those who were, and those who were not provided with a coordinator.
Paper III details the problems experienced and identifies needed changes in the RTW processes. The experts suggested that the services should be better coordinated, closer cooperation between stakeholders across levels and services and the provision of a local RTW coordinator.
In paper IV, challenges related to obtaining successful integration were related to maintaining cooperation in different phases of the process between the employee and the manager, and between other stakeholders.
Conclusion
The studies in this thesis revealed that the current concept of RTW coordination in Norway seems undefined, underdeveloped, and seems to have limited impact on RTW.
The thesis challenge both practice and politics in rethinking future RTW coordination, including all three intervention arenas – the workplace, health care, and social insurance/NAV.
