Improving Interprofessional Collaboration in Norwegian Primary Schools
Condition: Interprofessional Team Collaboration
Study type: Interventional

Summary: 
      This study includes designing, implementing and evaluating the effectiveness of process-based
      measures for improving interprofessional collaboration in Norwegian primary schools (5-7th
      grades). Focusing on leadership and organizational development, the overarching aim is to
      improve the use of existing interprofessional competence within schools. The interventions
      include meetings at municipal-level (strategic), school-level (operative) and class-level
      (operative), with feedback procedures to ensure communication between and within all levels.
      Also school internal and school external collaborators are involved at all levels of
      intervention.

      In order to avoid contradictory roles, an implementation team is responsible for developing
      and implementing the intervention, while the research team conduct an independent evaluation.
      The model will be evaluated by a cluster-randomized design to evaluate the effectiveness of
      the intervention. The hypothesis is that schools that utilize the process-based intervention
      (intervention group) will improve their interprofessional team work in a way that enhances
      the pupil's learning- environment and teachers professional competence, self-efficacy and
      efficient use of working hours compared to their counterparts in the control group. We
      anticipate main effects to be found at pupil level, mainly through improved early assessment,
      intervention and efficient follow-up. The project is a collaboration between four Norwegian
      municipalities and includes a total of 37 Schools, half of which will be randomized to
      experimental condition and half to control condition.

      The project is financed by The Norwegian Directorate for Education and Training with a
      duration of three years and three months. The project is led by Professor Ira
      Malmberg-Heimonen. The project is a collaboration between Faculty of Social Sciences and the
      Work Research Institute (AFI), at Oslo and Akerhus University College of Applied Sciences.
      Participants in the project are Ira Malmberg-Heimonen (project leader), Anne Grete Tøge,
      Therese Saltkjel, Knut Fossestøl, Elin Borg and Selma Therese Lyng. Participants in the
      implementation team are Øyvind Pålshaugen, Hanne Christoffersen and Christian Wittrock, also
      from Oslo and Akerhus University College of Applied Sciences, in addition to Torbjørn Lund
      from the Arctic University of Norway
    

Detailed description: 
      Comprehensive process-based intervention for improving interprofessional team collaboration
      in schools. A cluster-randomized study.

      Start at 01.04.2017 Finnish at 30.06.2020. Funding: The Norwegian Directorate for Education
      and Training Collaboration: All public schools at primary level in four Norwegian
      municipalities

      Primary schools participating in the study:

      From the municipality of Ålesund: Åse, Aspøy, Blindheim, Ellingsøy, Emblem, Flisnes, Hatlane,
      Hessa, Larsgården, Lerstad, Spjelkavik, Vik and Stokke, and Voldsdalen.

      From the municipality of Harstad: Bergseng, Bjarkøy, Harstad, Kanebogen, Kila, Lundenes,
      Medkila skole, Seljestad and Sørvik From the municipality of Nedre Eiker: Mjøndalen,
      Krokstad, Solberg, Steinberg, Stenseth and Åsen.

      From the municipality of Lillehammer: Vingar, Vingrom, Søre Ål, Røyslimoen, Kringsjå, Ekrom
      and Buvollen (will be merged), Hammartun and Jørstadmoen

      Advisory Board for the project:

      Senior researcher Mary Visher, Manpower Demonstration Research Corporation (MDRC), USA
      Professor Nancy Cartwright, Durham University, UK, and University of California, San Diego,
      USA Analyst and content director Jarl Inge Wærnes, LearnLab, Oslo Norway

      There are interprofessional resources in Norwegian schools and municipalities that are not
      fully utilized/exploited. Oslo and Akershus University College of Applied Sciences has been
      commissioned to design, implement and evaluate the effectiveness of a process-based model for
      interprofessional team collaboration in Norwegian primary schools. In order for municipal
      school owners and leaders to better utilize the potential related to existing
      interprofessional resources in schools, municipalities will implement a process-based model
      with a focus on leadership and better coordination of existing interprofessional resources.
      While the work process will be the same for all schools enrolled to experimental group, the
      content of the intervention will vary based on local conditions, resources and needs. A
      manual describes how the work process should be carried out. The model is hereafter referred
      to as the LOG-model, a Norwegian acronym, referring to the terms leadership, organization and
      coordination

      The evaluation will be conducted as a cluster-randomized trial, where 37 primary schools will
      be randomly assigned to experimental and control groups. Schools randomized to experimental
      group will implement the LOG-model, while schools assign to the control group will work as
      previously with interprofessional collaboration. While schools in the experimental group will
      receive economic resources to compensate for implementing the model and participating in the
      research, schools randomized to control group will get, however, somewhat less financial
      compensation for taking part in the research. The implementation team offer supervision and
      support to schools randomized to the experimental group throughout the project period.

      The main working method in the LOG-model is the interchange and feedback process between
      discursive practices, i.e. the discussion of interprofessional team collaborating measures
      and the execution/testing of these measures.

      Staff from Oslo and Akershus College of Applied Sciences will have different roles in the
      project. Beside the implementation team with the role of facilitating implementation
      processes in schools randomized to experimental group, the process evaluation team will study
      implementation processes mainly based on qualitative data. The researchers in the
      effect-evaluation team will mainly work with quantitative data.

      Prior to randomization a baseline questionnaire will be collected from the teachers and their
      interprofessional collaborators e.g. educational and psychological counseling services,
      public health nurses and child welfare social workers. Baseline information on pupils will be
      based on a survey data collected autumn 2017 and survey data and administrative data for
      follow-up + 12 and + 24 months. Long-term effects for pupils will be measured after the
      project has formally ended, up to 4 years after baseline, given that the Norwegian
      Directorate for Education and Training authorize access and deliver administrative data for
      follow-up.

      The project will assess whether schools randomized to experimental group that are
      implementing the LOG-model improve their interprofessional collaboration in a way that has
      positive effects on learning environment, learning outcomes and early intervention for
      pupils. At teacher level we expect the model to increase competence for interprofessional
      collaboration, teacher self-efficacy and more efficient use of teachers working time.

      This knowledge will inform the debate on what the effects of interprofessional team
      collaboration can be in schools.

      The project is funded by The Norwegian Directorate for Education and Training and led by
      professor Ira Malmberg-Heimonen, Oslo and Akershus University College.

      Participants in the project are Ira Malmberg-Heimonen (project leader), Knut Fossestøl,
      Øyvind Pålshagen, Elin Borg, Selma Therese Lyng, Anne Grete Tøge, Hanne Christensen,
      Thorbjørn Lund and Therese Saltkjel.
    

Intervention name(s): LOG-model; TAU
Intervention type(s): Other; Other
Intervention description(s): Besides the LOG-manual, school owners and leaders receive economic compensation and the intervention team will supervise the implementation. School-owners, school leaders and teachers will participate in dialogue-seminars at the municipal level and the school level respectively. The aim is to discuss and agree on the goal and content of the work and discuss the experiences from the implementation. The main arena for discussing and practical implementation will be in local collaborating teams or "resource teams" in each school. The resource teams at schools will consist of various interprofessional competences in addition to the school leader. The main method in the LOG-model is the interchange and feedback process between the discussion of measures and the execution of these measures.; Ordinary practices related to interprofessional team collaboration
Allocation: Randomized
Intervention model: Single Group Assignment
Intervention model description: Cluster-randomized study. After baseline, schools will be randomized to experimental and control groups schools. The LOG-model is implemented in experimental schools, while control group schools continues with their ordinary practices ("treatment as usual"). Effects on teachers are analyzed on the follow up areas: interprofessional team collaboration, teachers working hours, teacher's self-efficacy. Effects on pupils are analyzed on the follow up areas: learning environment- and outcome, early intervention. Effects on school level are analyzed on the follow up areas: special needs education, pupils learning outcome.
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: interprofessional team collaboration; primary school; learning environment; teacher's self-efficacy; teachers working ours; pupils learning outcome; cluster-randomized