Introducing Motivational Interviewing in a Sickness Insurance Context: Translation and Implementation Challenges

Area of Science:

• Health Services Research
• Organizational Psychology
• Social Work

Background:

• Motivational interviewing (MI) is a behavioral change support method.
• Swedish sickness insurance officials received MI training to enhance return to work (RTW) post-sick leave.
• Organizational reforms necessitated the integration of MI into sickness insurance practices.

Purpose of the Study:

• To explore the experiences of introducing MI for RTW promotion in sickness insurance.
• To examine the translation and implementation process of MI within this specific context.

Main Methods:

• Qualitative approach utilizing 69 interviews with officials, managers, and coordinators.
• Data collected on two separate occasions.
• Analysis conducted through qualitative content analysis.

Main Results:

• Officials expressed positive views on MI but applied it inconsistently, using limited techniques individually.
• Implementation challenges included inadequate support, low managerial priority, competing projects, and high workloads.
• The educational intervention's impact was observed at the individual, not organizational, level.

Conclusions:

• Effective MI translation in sickness insurance requires organizational strategies fostering collective learning and shared experiences.
• Training alone does not guarantee method implementation; organizational factors are critical.
• Monitoring MI application is essential for accurately assessing intervention effectiveness.