Abstract
BackgroundMotivational interviewing (MI), mainly used and shown effective in health care (substance abuse, smoking cessation, increasing exercise and other life style changes), is a collaborative conversation (style) about change that could be useful for individuals having problems related to return to work (RTW). The aim of this paper is to describe the design of a randomized controlled trial evaluating the effect of MI on RTW among sick listed persons compared to usual care, in a social security setting.MethodsThe study is a randomized controlled trial with parallel group design. Individuals between 18 and 60 years who have been sick listed for more than 7 weeks, with a current sick leave status of 50–100%, are identified in the Norwegian National Social Security System and invited to participate in the study. Exclusion criteria are no employment and pregnancy. Included participants are randomly assigned to the MI intervention or one of two control groups. The MI intervention consists of two MI sessions offered by caseworkers at the Norwegian Labor and Welfare Service (NAV), while the comparative arms consist of a usual care group and a group that receives two extra sessions without MI content (to control for attentional bias). The primary outcome measure is the total number of sickness absence days during 12 months after inclusion, obtained from national registers. Secondary outcomes include time until full sustainable return to work, health-related quality of life and mental health status. In addition, a health economic evaluation, a feasibility/process evaluation and qualitative studies will be performed as part of the study.DiscussionA previous study has suggested an effect of MI on RTW for sick listed workers with musculoskeletal complaints. The present study will evaluate the effect of MI for all sick listed workers, regardless of diagnosis. The knowledge from this study will potentially be important for policy makers, clinicians and other professionals` practical work.Trial registrationClinicalTrials.gov: NCT03212118 (registered July 11, 2017).
Highlights
Motivational interviewing (MI), mainly used and shown effective in health care, is a collaborative conversation about change that could be useful for individuals having problems related to return to work (RTW)
The design of the randomized controlled trial (RCT)-study is three-armed, comparing 1) an intervention comprised of two motivational interviewing (MI) sessions after 7 and 9 weeks of sick leave, 2) a control arm consisting of two non-MI sessions and 3) treatment as usual
– Is MI cost-effective compared to usual care? – Is MI more effective in reducing anxiety, depression and sleeping problems than usual care? – Does the level of resilience have an impact on RTW? – How do caseworkers at Norwegian Labor and Welfare Service (NAV) and the sick listed workers evaluate the MI intervention? – What do sick listed and caseworkers perceive as benefits and challenges in using MI to facilitate the RTW process?
Summary
Motivational interviewing (MI), mainly used and shown effective in health care (substance abuse, smoking cessation, increasing exercise and other life style changes), is a collaborative conversation (style) about change that could be useful for individuals having problems related to return to work (RTW). The literature suggests that the involvement and coordination of different stakeholders are of importance [5, 9], as work disability is the result of a combination of individual, workplace, healthcare, compensation system and social factors [13]. The process of returning to work after a longer period of sick leave has been described as a dynamic process including the individual’s interactions with these factors or systems [14]. While going through this process the sick listed worker may experience different levels of self-efficacy and motivation towards behavioral change that could be necessary for RTW [14]. One approach which has been suggested as useful in promoting such factors is motivational interviewing (MI) [16]
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