Principal Investigator Margreth Grotle

Post Doctor Ida Løchting

PhD Students Fiona Aanesen, Tarjei Rysstad, Alexander Tingulstad

Collaborators Britt Elin Øiestad (Oslo Metropolitan University), Anne Therese Tveter (Diakonhjemmet Hospital; Oslo Metropolitan University), Kjersti Storheim (Oslo University Hospital), Hedda Eik (Oslo Metropolitan University; University of Oslo), Milada Cvancarova Småstuen (Oslo Metropolitan University), Thorgeir Hærnes (Norwegian Labour and Welfare Administration), Kristel Skorge (Norwegian Labour and Welfare Administration), Rigmor Berg (Norwegian Labour and Welfare Administration), Kari Paulsen (Norwegian Labour and Welfare Administration), Bjørn Are Hultman (Norwegian Labour and Welfare Administration), Nadine Foster (University of Queensland, Australia; Keele University, UK), Maurits van Tulder (Vrije University Amsterdam, the Netherlands), Gail Snowden, Gwen Wynne-Jones, Egil A. Fors (Norwegian University of Science and technology), Lene Aasdahl (Norwegian University of Science and technology), Esther Maas (Vrije University Amsterdam, the Netherlands), Aidan Cashin (Neuroscience Research Australia), Roger Hagen (Norwegian University of Science and technology), Gunnhild Bagøien (St. Olav’s University Hospital)

External Funding NFR

The MI-NAV project is a large research project with three work packages (WPs). The main objective of this MI-NAV project was to evaluate the effectiveness and cost-effectiveness of usual case management alone with usual case management plus MI or usual case management plus Stratified Vocational Advice Intervention (SVAI) on RTW among people on sick leave due to MSK disorders. Secondary objectives were to investigate: 1) the scientific evidence for the use of MI and the current NAV practice on counseling approaches in meetings with people on sick leave with musculoskeletal disorders, 2) the precision of a simple 9-item screening tool in identifying risk profiles among Norwegian people on sick leave due to musculoskeletal disorders, 3) the cost-effectiveness of the two interventions against usual NAV practice, 4) the mediating effect of self-efficacy, work ability and change in risk profile as potential mediators on RtW, and 5) 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:

In WP 1, the scientific evidence for the use of MI and the current NAV practice on counseling approaches in meetings with people on sick leave with MSK disorders were investigated by conducting a systematic mapping review and a survey and focus group interview of NAV caseworkers on their experiences of the RTW process among people with MSK disorders. Three papers have been published on results from WP1. In WP2, we have explored the most accurate screening tool to identify people at a high risk of prolonged sickness absence due to MSK disorder, and investigated MSK health, health-related quality-of-life, health care consumption, and costs across different risk profiles in individuals on sick leave due to MSK disorders. This was a prospective cohort study of people on sick leave due to MSK disorder of 4 weeks or more and they are followed in one year by NAV registry data as well as registry data on health care utilization. The study protocol is registered in ClinicalTrials.gov ID: NCT04196634,27.11.2019 and published (6). Three papers have been published from the WP2. In WP3 a multi-arm randomized controlled trial (RCT) was conducted within the NAV system in Norway. The trial is registered in ClinicalTrials.gov ID: NCT03871712. The protocol is published as well as statistical analysis plan for the main analyses (1). By autumn 2021 the 6 months follow-up of 450 included participants, aged 18-67 years, on 50-100% sick leave for >7 weeks due to MSK disorders have been completed. The primary outcome is the number of sick leave days from randomization to 6 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 evaluated by the EuroQoL 5D-5L and cost-benefit analyses will be performed on the 6 months follow-up data and is in process. Other secondary outcomes are number of sick leave days and time until sustainable RTW (≥4 weeks of at least 50% of their usual working hours) at 12 months, proportions of participants receiving sick leave benefits during 12 months of follow-up, and MSK symptoms influencing health at 12 months. The 12 months follow-up will be completed in April 2023.