Family Partner: study protocol for a pilot randomised study of a home-visitation intervention in Norway.

AIM: Every year, about 5% of children in Norway experience severe child maltreatment and need support from the child welfare services. However, research-supported interventions for this group are lacking. The current study piloted an intensive home-visitation intervention, Family Partner, which aims to reduce child maltreatment among at-risk parents by improving parental skills, agency and trust in the welfare services, and children's well-being. The randomised controlled trial piloted in this study examines the acceptability of the Family Partner intervention for staff and families and evaluates its feasibility for a full-scale randomised controlled trial. METHODS: This protocol outlines a prospective, parallel, pilot randomised trial of the Family Partner intervention in three Norwegian municipal child welfare services. The participants are families with children under 12 years of age, where the parents are identified as having challenges. Families in the treatment group receive the Family Partner intervention, while families in the control group receive ordinary child welfare services. Data are collected at baseline, and at 3, 6, 12 and 18 months after recruitment. The pilot study monitor retention and adherence to inform the feasibility of a future full-scale randomised study. To assess the acceptability of the trial and intervention, a subsample of the participating families, as well as the family partners and representatives of the child welfare services in each municipality, are invited to complete qualitative interviews. CONCLUSIONS: The results will guide the design of a fully powered randomised controlled trial of the Family Partner intervention compared with ordinary child welfare services. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04957394; Pilot Trial of Family Partner: a Child Maltreatment Prevention Intervention (FAMPART); registered on 12 July 2021.

Improving interprofessional collaboration in schools: A cluster-randomized study evaluating the effectiveness of the LOG model on collaboration practices.

Although interprofessional collaboration is emphasized as important in schools, little is known about how it should be organized. We analyzed the effects of an organizational model of interprofessional collaboration, the LOG model. The model aims to improve interprofessional collaboration by identifying and improving various meeting places for collaboration, involving municipal school leaders, principals, staff, and interprofessional collaborators, and by increasing feedback from meeting places in and around schools. In a cluster-randomized design including 35 Norwegian primary schools, 19 schools were randomized to the experimental group and implemented the LOG model, and 16 were randomized to a control group. A total of 142 interprofessional collaborators (e.g., school nurses, social workers, and principals) received a questionnaire prior to randomization, with one- and two-year follow-up. Using a validated scale to measure interprofessional team collaboration, we evaluated the effects of the model on collaborators' perceptions in four dimensions: (a) Reflection on process, (b) Professional flexibility, (c) Newly created professional activities, and (d) Role interdependence. During the first, but not the second year of follow-up, the results demonstrated positive and statistically significant effects of the LOG model on the dimensions Reflection on process (p< .001) and Newly created professional activities (p= .016). Our findings demonstrate the potential of interventions addressing interprofessional collaboration at the organizational level.

Improving interprofessional collaboration in Norwegian primary schools: A cluster-randomized study evaluating effects of the LOG model on teachers' perceptions of interprofessional collaboration.

Increased demand for interprofessional collaboration within the educational field also increases the need for the development and evaluation of interventions to improve collaboration. In Norway, the LOG model was developed and implemented in compulsory schools to facilitate interprofessional collaboration by increasing arenas for more efficient use of existing interprofessional resources. We evaluate the effects of the model on teachers' perceptions of interprofessional collaboration in a cluster-randomized trial, with 19 schools randomized to the experimental group and 16 schools to the control group. We use data from 5th-7th grade teachers in the 35 participating schools (N = 157) prior to randomization and one-year into the implementation. Response rates were 70% and 74%, respectively. The PINCOM-Q scale was used to analyze effects of the model on various dimensions of interprofessional collaboration. At the one-year follow-up, the LOG model demonstrates no significant effects on teachers' perceptions of interprofessional collaboration. However, there is an indication of effect on the organizational aim dimension (ES = -0.39, CI = -0.82-0.03), but the evidence is not conclusive.

Translation and cultural adaptation of evidence-informed leaflets on the work-health interface: a pragmatic approach to cultural adaptation.

AIM: Our aim was to translate and culturally adapt three evidence-informed leaflets on the work-health interface from English into Norwegian. Integral to this aim was the exploration of the quality and acceptability of each of the adapted leaflets to Norwegian-speaking stakeholders; general practitioners, people who deal with health issues in the workplace, and the general population. BACKGROUND: Common health problems, such as musculoskeletal pain, account for most workdays lost and disability benefits in Norway. To facilitate return to work, it may be important to have access to evidence-informed information on the work-health interface for stakeholders involved in sickness absence processes. However, there is limited information material available in Norwegian that is tailored for the different stakeholders. Cultural adaptation is an emerging strategy for implementing health information across different populations and regions. Guidelines on cultural adaptation are not well-suited for translating and adapting evidence-informed health information material. METHODS: We conducted a pragmatic cultural adaptation process informed by existing guidelines. Our conceptual framework for adaptation is situated between adaptation and translation and comprises appraisal, forward- and back-translation, review in multiple steps, sense checking, and re-designing using a transcreation approach. Using an online survey, we aimed to evaluate the overall quality, value, acceptability, and clarity of each of the adapted leaflets to a total of 30 end-users. FINDINGS: We translated and culturally adapted three leaflets from English to Norwegian. Adapted leaflets were found to be clearly presented, acceptable, and valued by 45 Norwegian end-users. No differences in key concepts between original and back-translated leaflets emerged through the review process by the original author and forward translators. We used a pragmatic approach in this study that might be useful to others culturally adapting evidence-informed health information material.

Individual supported work placements (ReISE) for improving sustained return to work in unemployed people with persistent pain: an internal pilot study of a cohort randomised controlled approach.

BACKGROUND: Persistent pain is a frequent cause of sick leave and work disability in Norway. A return-to-work intervention featuring supported work placements, developed in the UK, demonstrated feasibility, and a return-to-work rate of 20% within 6 months was observed in the sample. We sought to adapt the intervention for delivery in Norway and to confirm feasibility prior to a full-scale trial. METHODS: In this internal pilot, we used a pragmatic cohort randomised controlled approach with national recruitment in Norway. We recruited people who were unemployed (for at least 1 month), having persistent pain (for at least 3 months), aged between 18 and 64, and wanting to return to work. We initially recruited people to an observational cohort study of the impact of being unemployed with persistent pain. After baseline measurement, we randomly sub-sampled participants to whom we offered the intervention, which featured individual case management and support, work-familiarisation sessions, and the offer of a 6-week part-time unpaid work placement. We assessed recruitment rates (aiming to recruit 66, and sub-sample 17 within 6 months); optimal recruitment pathways; intervention acceptance rates; the feasibility of data collection; using video links for work-familiarisation sessions and remote case manager support. RESULTS: The pilot ran from June to November 2022. Of 168 people expressing interest, 94 consented. Recruitment posts on Facebook yielded the most 'expressions of interest' (66%, n = 111). After screening for eligibility, we included 55 participants. Of these, 19 were randomised to be offered the intervention. Of these, less than half (n = 8) consented to intervention participation. Remote case manager and work-familiarisation sessions appeared feasible. Following a delay in identifying placements, three participants received offers of work placements, with one starting and completing during the pilot period. Data collection methods were feasible, and no adverse events were reported. CONCLUSIONS: Recruitment and logistical processes, such as remote management by video link, are feasible. However, delivery of the intervention is challenging. In particular, sourcing placements and the time required for identifying appropriate placements was more challenging than anticipated. A full-scale trial is feasible but will require improvements to the placement identification processes. TRIAL REGISTRATION: ISRCTN85437524 (Referring to the ReISE trial, of which this internal pilot was a part), Registered 31 of May 2022 https://doi.org/10.1186/ISRCTN85437524 TRIAL FUNDING: Norwegian Research Council.

Study protocol for a randomized controlled trial of supportive parents - coping kids (SPARCK)-a transdiagnostic and personalized parent training intervention to prevent childhood mental health problems.

BACKGROUND: To meet the scientific and political call for effective prevention of child and youth mental health problems and associated long-term consequences, we have co-created, tested, and optimized a transdiagnostic preventive parent-training intervention, Supportive parents - coping kids (SPARCK), together with and for the municipal preventive frontline services. The target group of SPARCK is parents of children between 4 and 12 years who display symptoms of anxiety, depression, and/or behavioral problems, that is, indicated prevention. The intervention consists of components from various empirically supported interventions representing different theorical models on parent-child interactions and child behavior and psychopathology (i.e., behavioral management interventions, attachment theory, emotion socialization theory, cognitive-behavioral therapy, and family accommodation intervention). The content and target strategies of SPARCK are tailored to the needs of the families and children, and the manual suggests how the target strategies may be personalized and combined throughout the maximum 12 sessions of the intervention. The aim of this project is to investigate the effectiveness of SPARCK on child symptoms, parenting practices, and parent and child stress hormone levels, in addition to later use of specialized services compared with usual care (UC; eg. active comparison group). METHODS: We describe a randomized controlled effectiveness trial in the frontline services of child welfare, health, school health and school psychological counselling services in 24 Norwegian municipalities. It is a two-armed parallel group randomized controlled effectiveness and superiority trial with 252 families randomly allocated to SPARCK or UC. Assessment of key variables will be conducted at pre-, post-, and six-month follow-up. DISCUSSION: The current study will contribute with knowledge on potential effects of a preventive transdiagnostic parent-training intervention when compared with UC. Our primary objective is to innovate frontline services with a usable, flexible, and effective intervention for prevention of childhood mental health problems to promote equity in access to care for families and children across a heterogeneous service landscape characterized by variations in available resources, personnel, and end user symptomatology. TRIAL REGISTRATION: ClinicalTrials.gov ID: NTCT05800522.

Individual supported work placements (ReISE) for improving sustained return to work in unemployed people with persistent pain: study protocol for a cohort randomised controlled trial with embedded economic and process evaluations.

BACKGROUND: Around one-third of workdays lost in Norway are due to musculoskeletal conditions, with persistent (chronic) pain being the most frequent cause of sick leave and work disability. Increasing work participation for people with persistent pain improves their health, quality of life, and well-being and reduces poverty; however, it is not clear how to best help unemployed people who have persistent pain to return to work. The aim of this study is to examine if a matched work placement intervention featuring case manager support and work-focused healthcare improves return to work rates and quality of life for unemployed people in Norway with persistent pain who want to work. METHODS: We will use a cohort randomised controlled approach to test the effectiveness and cost-effectiveness of a matched work placement intervention featuring case manager support and work-focused healthcare compared to those receiving usual care in the cohort alone. We will recruit people aged 18-64, who have been out of work for at least 1 month, had pain for more than 3 months, and want to work. Initially, all (n = 228) will be recruited to an observational cohort study on the impact of being unemployed with persistent pain. We will then randomly select one in three to be offered the intervention. The primary outcome of sustained return to work will be measured using registry and self-reported data, while secondary outcomes include self-reported levels of health-related quality of life and physical and mental health. Outcomes will be measured at baseline and 3, 6, and 12 months post-randomisation. We will run a process evaluation parallel to the intervention exploring implementation, continuity of the intervention, reasons for participating, declining participation, and mechanisms behind cases of sustained return to work. An economic evaluation of the trial process will also be conducted. DISCUSSION: The ReISE intervention is designed to increase work participation for people with persistent pain. The intervention has the potential to improve work ability by collaboratively navigating obstacles to working. If successful, the intervention may be a viable option for helping people in this population. TRIAL REGISTRATION: ISRCTN Registry 85,437,524 Registered on 30 March 2022.

Norwegian Social Work and Child Welfare Students' Attitudes Toward Research-Supported Treatments.

Purpose: Evidence-based practice (EBP) has increasingly become a part of social work education, but there is a lack of knowledge about students' attitudes toward it. This study evaluated Norwegian social work students' attitudes toward research-supported treatments (RSTs).Method: Attitudes were measured with the Evidence-Based Practice Attitude Scale-36 (EBPAS-36), a validated measure including 12 subscales.Results: The findings suggest that master's students are more positive toward RSTs compared to bachelor's students. Having less educational training in EBP was associated with more skepticism toward the concept, suggesting that educational training in EBP contributes to facilitating a positive attitude toward RSTs.Discussion: These findings indicate a need to emphasize EBP in social work education. To enable EBP engagement in practice, we argue that emphasis should be put on teaching students to critically appraise research.

Social inequality and health: the role of social capital.

The aim of the article is to examine whether and to what degree the unequal distribution of social capital in the population explains the relationship between socioeconomic position and health in Norway. Theoretical insight and empirical evidence seem to suggest that social capital mediates the effect of socioeconomic position on health outcomes. However, only a few studies have addressed this question and those that have done so have used few and simple indicators of social capital. This study is based on a nationwide cross-sectional survey (N = 3190) commissioned by Statistics Norway. The survey was designed to cover a comprehensive set of variables measuring different aspects of the theoretical construct of social capital. Two health outcomes, self-perceived health and longstanding illness, were analysed. The results showed that the mediating role of social capital between socioeconomic position and health was negligible for both health outcomes. After controlling for socio-demographic variables and socioeconomic position, only neighbourhood satisfaction and generalised trust showed a significant association with self-perceived health, whereas none of the social capital variables had any significant association with longstanding illness. Some theoretical and methodological implications of the results are discussed.

Program theory within policy-initiated evaluations: the Norwegian low-income family study.

Using as an example a project where the Norwegian Labor and Welfare Directorate developed a comprehensive model for the follow-up of low-income families, this article demonstrates the process of developing a program theory for policy-initiated interventions. The data consist of interviews with program developers, political documents from early stages, and observations of the program's development. The results demonstrate that, although research inspired the program developers, the program was also the outcome of policy priorities, experiences from earlier projects, and input from the practice field. Multiple sources contributed to its relevance for the practice field, however, increasing its complexity. The program includes several intervention levels and follow-up areas and partially builds on elements found to be important across interventions. Although a program theory can be difficult to conceptualize within policy-initiated interventions, it is important to articulate it prior to evaluation and, if necessary, reassess it when data have been analyzed.

The Effects of Skill Training on Social Workers' Professional Competences in Norway: Results of a Cluster-Randomised Study.

Using a cluster-randomised design, this study analyses the effects of a government-administered skill training programme for social workers in Norway. The training programme aims to improve social workers' professional competences by enhancing and systematising follow-up work directed towards longer-term unemployed clients in the following areas: encountering the user, system-oriented efforts and administrative work. The main tools and techniques of the programme are based on motivational interviewing and appreciative inquiry. The data comprise responses to baseline and eighteen-month follow-up questionnaires administered to all social workers (n = 99) in eighteen participating Labour and Welfare offices randomised into experimental and control groups. The findings indicate that the skill training programme positively affected the social workers' evaluations of their professional competences and quality of work supervision received. The acquisition and mastering of combinations of specific tools and techniques, a comprehensive supervision structure and the opportunity to adapt the learned skills to local conditions were important in explaining the results.

Effective group training techniques in job-search training.

The aim was to examine the effects of group training techniques in job-search training on later reemployment and mental health. The participants were 278 unemployed workers in Finland in 71 job-search training groups. Five group-level dimensions of training were identified. The results of hierarchical linear modeling demonstrated that preparation for setbacks at the group level significantly predicted decreased psychological distress and decreased symptoms of depression at the half-year follow-up. Trainer skills at the group level significantly predicted decreased symptoms of depression and reemployment to stable jobs. Interaction analyses showed that preparation for setbacks at the group level predicted fewer symptoms of psychological distress and depression, and shared perceptions of skilled trainers at the group level predicted fewer symptoms of depression among those who had been at risk for depression.