This project aimed to evaluate the effectiveness of Motivational Interviewing on return to work among sicklisted people due to musculoskeletal disorders. This was a randomised trial within NAV.
Musculoskeletal disorders are the main cause of sickness absence and disability benefits in Norway, and the single leading cause of disability worldwide.
Facilitating return to work and preventing long-term sickness absence are critical concerns for the Norwegian Labour and Welfare Administration (NAV).
The main objective of the project was to evaluate the effectiveness and cost-effectiveness of usual case management alone with usual case management plus Motivational Interviewing (MI) or usual case management plus Stratified Vocational Advice Intervention (SVAI) on return to work among people on sick leave due to musculoskeletal (MSK) disorders.
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Participants
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More about the project
The secondary objectives of the project were to investigate
- the scientific evidence for the use of MI and the current NAV practice on counselling approaches in meetings with people on sick leave due to musculoskeletal disorders
- the precision of a simple nine-item screening tool in identifying risk profiles among Norwegian people on sick leave due to musculoskeletal disorders
- the mediating effect of self-efficacy, work ability and change in risk profile on return to work
- potential predictors for successful outcome at 12 months follow-up.
All data collection in the MI-NAV project has been completed, and a summary for the status for each of the three work packages (WP) is as follows.
Work package 1
In WP1, the scientific evidence for the use of MI and the current NAV practice on counselling approaches in meetings with people on sick leave with musculoskeletal disorders were investigated by conducting a systematic mapping review and a survey and focus group interview of NAV caseworkers on their experiences of the return-to-work process among people with musculoskeletal disorders.
Three papers have been published on results from WP1.
Work package 2
In WP2, we have explored the most accurate screening tool to identify people at a high risk of prolonged sickness absence due to musculoskeletal disorders, and investigated musculoskeletal health, health-related quality-of-life, health care consumption, and costs across different risk profiles in individuals on sick leave due to musculoskeletal disorders.
This was a one-year prospective cohort study of people on sick leave due to musculoskeletal disorders. The study protocol is registered, and three papers have been published from the WP2.
Work package 3
In WP3 a multi-arm randomized controlled trial (RCT) was conducted within the NAV system in Norway. The protocol is published as well as statistical analysis plan for the main analyses.
By autumn 2021 the six months follow-up of 450 included participants, aged 18-67 years, on 50-100 percent sick leave for more than seven weeks due to MSK disorders have been completed.
The primary outcome is the number of sick leave days from randomization to six months follow-up, and the primary analysis is in process and has been completed and results are published in Journal of Occupation and Environmental medicine.
Two process evaluations, one for each intervention, have been conducted, including fidelity of the interventions, and have been published in two papers during 2021.
Cost-utility and cost-benefit analyses will be performed on the six months follow-up data and is in process. The 12 months follow-up was completed in April 2023.
