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Process evaluation of an interorganizational cooperation initiative in vocational rehabilitation: The Dirigo project
Linkoping Univ, Dept Med & Hlth Sci, Natl Ctr Work & Rehabil, S-58381 Linkoping, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Socialmedicinsk epidemiologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Socialmedicinsk epidemiologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Karolinska Inst, Sect Social Work, Dept Neurobiol, Care Sci & Soc, Stockholm, Sweden. (Socialmedicinsk epidemiologi)
2017 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, 431Article in journal (Refereed) Published
Abstract [en]

Background: This study analyzes the process of establishing and developing a cooperative vocational rehabilitation project with special focus on organizational and professional aspects. In the project, officials from the Swedish Social Insurance Agency and the Swedish Public Employment Service worked cooperatively with participants on long-term sick leave, youths with disability benefits, and people receiving social allowances. The officials used Motivational Interviewing (MI) as a method when meeting participants, and were able to offer flexible and tailored case management. The goal was to improve work ability and promote self-sufficiency.

Methods: The process evaluation was carried out through continuous data collection throughout the project (2012-2014), resulting in a total of 28 individual interviews and 17 focus groups with officials and managers. The material was categorized through an inductive content analysis, and analyzed using social capital as a theoretical frame.

Results: The evaluation points to how issues related to design, organization and management contributed to the project not reaching its goals, e.g. problems with recruitment of participants, the funding structure, and staffing problems on the managerial level. Still, officials reported positive effects of close cooperation, which was perceived as facilitating the case management by fostering a mutual understanding and access to resources and rehabilitation measures from more than one authority.

Conclusions: Cooperative work combined with the use of MI and flexible case management seem to promote an increased trust between officials from different authorities and participants, which in the study is conceptualized as bonding and bridging social capital (between officials) and linking social capital (between officials and participants). The organizational problems combined with the relatively large differences in approaches between the project and regular practice obstructed implementation, where the authorities involved did not appear to be ready for implementing methodologies that require organizational restructuring.

Place, publisher, year, edition, pages
2017. Vol. 17, 431
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-322288DOI: 10.1186/s 12889-017-4357-xISI: 000401863200003Scopus ID: 28490328OAI: oai:DiVA.org:uu-322288DiVA: diva2:1096561
Available from: 2017-05-18 Created: 2017-05-18 Last updated: 2017-07-03Bibliographically approved

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Andersén, ÅsaAnderzen, IngridLarsson, Kjerstin

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