Improving Interprofessional Collaboration in Norwegian Primary Schools

Improving Interprofessional Collaboration in Norwegian Primary Schools - A Cluster-randomised Study Evaluating the Effects of the LOG-model.

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

Study Overview

• Status: Completed
• Conditions: Interprofessional Team Collaboration
• Intervention / Treatment: Other: LOG-model; Other: TAU

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.

• Study Type: Interventional
• Enrollment (Actual): 4130
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Norway
  • Harstad, Norway, 9403
    • Bergseng skole
  • Harstad, Norway, 9405
    • Harstad skole
  • Harstad, Norway, 9407
    • Seljestad primary school
  • Harstad, Norway, 9411
    • Kanebogen skole
  • Harstad, Norway, 9414
    • Medkila skole
  • Harstad, Norway, 9415
    • Kila skole
  • Harstad, Norway, 9419
    • Sørvik skole
  • Harstad, Norway, 9420
    • Lundenes skole
  • Harstad, Norway, 9425
    • Bjarkøy skole
  • Lillehammer, Norway, 26013
    • Søre Ål skole
  • Lillehammer, Norway, 2607
    • Vingrom skole
  • Lillehammer, Norway, 2608
    • Vingar skole
  • Lillehammer, Norway, 2609
    • Hammartun skole
  • Lillehammer, Norway, 2611
    • Røyslimoen skole
  • Lillehammer, Norway, 2618
    • Kringsjå skole
  • Lillehammer, Norway, 2624
    • Ekrom skole
  • Lillehammer, Norway, 2625
    • Buvollen skole
  • Lillehammer, Norway, 2625
    • Jørstadmoen Skole
  • Nedre Eiker, Norway, 3050
    • Mjøndalen skole
  • Nedre Eiker, Norway, 3050
    • Åsen skole
  • Nedre Eiker, Norway, 3053
    • Steinberg Skole
  • Nedre Eiker, Norway, 3055
    • Krokstad skole
  • Nedre Eiker, Norway, 3055
    • Stenseth Skole
  • Nedre Eiker, Norway, 3057
    • Solberg skole
  • Ålesund, Norway, 6025
    • Aspøy skole
  • Ålesund, Norway, 6025
    • Blindheim primary school
  • Ålesund, Norway, 6025
    • Ellingsøy primary and secondary school
  • Ålesund, Norway, 6025
    • Emblem skole
  • Ålesund, Norway, 6025
    • Flisnes skole
  • Ålesund, Norway, 6025
    • Hatlane skole
  • Ålesund, Norway, 6025
    • Hessa skole
  • Ålesund, Norway, 6025
    • Larsgården skole
  • Ålesund, Norway, 6025
    • Lerstad skole
  • Ålesund, Norway, 6025
    • Spjelkavik primary school
  • Ålesund, Norway, 6025
    • Stokke og Vik skole
  • Ålesund, Norway, 6025
    • Voldsdalen skole
  • Ålesund, Norway, 6025
    • Åse Skole

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 10 years to 14 years (Child)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Pupils in grades 5 - 7 in 4 municipalities and 37 primary schools
• Teachers in grades 5-7 in 4 municipalities and 37 primary schools
• Interprofessional collaborators at municipal level

Exclusion Criteria:

• NA

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Single Group Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: LOG-model schools; Experimental schools implement the LOG-model	Other: LOG-model; 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.
Active Comparator: Treatment as usual schools - TAU; Control schools performing interprofessional team collaboration as usual	Other: TAU; Ordinary practices related to interprofessional team collaboration

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in interprofessional team collaboration among staff	Perceptions of Interprofessional Collaboration model questionnaire(teachers and collaborators)	improvement from baseline (2017) to +12 (2018) months and +24 (2019) months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in teacher self-efficacy	Norwegian teachers self-efficacy scale	improvement from baseline to +12 and 24 months (measured yearly)
Change in learning environment (teacher-level)	Questions from the OECD TALIS Survey (national teacher survey)	+12 and 24 months after baseline
Change in teaching practices	Questions from the OECD TALIS Survey	+12 and 24 months after baseline
Change in special needs education	amount of pupils who receive special needs education (amount at class or school level)	change between baseline and +12 and +24 months after (measured yearly)
Change in learning enviroment (pupils)	Questions from the Norwegian "Elevundersøkelsen" (National pupils survey)	+12 and +24 after baseline

Collaborators and Investigators

• Sponsor: Oslo Metropolitan University
• Collaborators: The Norwegian Directorate for Education and Training

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2017
• Primary Completion (Actual): June 30, 2020
• Study Completion (Actual): June 30, 2020

Study Registration Dates

• First Submitted: August 2, 2017
• First Submitted That Met QC Criteria: August 11, 2017
• First Posted (Actual): August 14, 2017

Study Record Updates

• Last Update Posted (Actual): September 7, 2020
• Last Update Submitted That Met QC Criteria: September 4, 2020
• Last Verified: August 1, 2019

More Information

Terms related to this study

• Keywords: cluster-randomized; primary school; interprofessional team collaboration; learning environment; teacher's self-efficacy; teachers working ours; pupils learning outcome
• Other Study ID Numbers: 54470 (NSD)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: After embargo + 5 years after finishing study (2025)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No