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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

Pathways to work. Achieving coordinated services in work integration of groups on the margins of the labour market - INTEGRATE

Alternative title: INTEGRATE - et kjernemiljø om forskning på koordinert innsats for inkludering av marginaliserte i arbeidsmarkedet

Awarded: NOK 24.7 mill.

The purpose of INTEGRATE has been to develop a core research group on coordinated efforts to achieve work inclusion for groups that are marginalized in the labour market. The rationale was that comprehensive and coherent trajectories towards employment require coordinated efforts between the support system and the workplaces because the key to labour market participation lies with the employers. Coordination is also needed between schools, health services and labour and welfare services because many who are marginalized struggle with multiple problems. Furthermore, the relationship between the services and the individual is crucial. When INTEGRATE started, this was an under-explored area of research. INTEGRATE has therefore developed both research capacity and research-based knowledge for national and international audiences. This is done in collaboration with international experts, through own PhD and postdoctoral fellows and through a network of many researchers and fellows. INTEGRATE has been a collaboration between OsloMet - Oslo metropolitan university and Høgskolen i Innlandet (HINN) and has been linked to the Competence Centre for Work Inclusion (KAI) at OsloMet and to the Competence Centre for Public Innovation (KOI) at HINN. KAI and KOI continue the knowledge production and dissemination on INTEGRATE’s field of research. To strengthen the research field, INTEGRATE have published overviews of the research traditions on coordination and work inclusion – in Social Policy & Administration and the European Journal of Social Work; an article on organizational theoretical approaches in Tidsskrift for Velferdsforskning; a chapter in The Oxford Handbook of governance and public management for social policy, and two chapters in the Norwegian books “Organisasjonsperspektiv på samordning av helse- og velferdstjenester" and INTEGRATEs own anthology, "Samhandling og arbeidsinkludering". The research overviews have shown that there are several and fairly separate streams of research, both in general and around vulnerable young people in particular, and that both Norwegian and international research on coordinated services is theoretically weak. Both the research and the field of practice will benefit from cross-disciplinary knowledge exchange, syntheses of empirical and practice-based studies and more use of organizational theoretical perspectives. Researchers from INTEGRATE have also contributed to research reviews about measures and service innovations aimed at vulnerable young people outside of education and work. These reviews show that good collaborative practices and holistic, multifaceted, and parallel efforts are important, and that forms of cross-sector collaboration is the subject of new innovations. Furthermore, INTEGRATE's researchers have approached the methodological challenges of studying and explaining processes and being able to see the processes in the light of whether the services are coordinated or not and built a database that makes it possible to study the processes of individuals in the light of the context in which they are part of such as local geography and labour markets and of features of the services. Methodologically, it is a challenge to document in quantitative analyses that paths towards employment often are far from linear. A useful approach in quantitative life course research is methods that construct longer and more holistic career paths, made up of sequences of different duration. INTEGRATE-researchers have demonstrated that when the research is to capture, for example, relapses, revolving door problems, and swirls between services, a sequence analysis is particularly well suited. Controlled studies are considered an important methodological design for assessing the effects of interventions, but it is challenging when the interventions are complex, such as when they require collaboration across professions and services. Methodical designs which study both the effects and the processes behind them are then required, and which take account of implementation challenges. INTEGRATE-researchers have tested such designs and written several articles about the challenges. For example, a known challenge when interventions are tested in ordinary services, not in laboratories, is that the ideas behind are spread beyond the trial. Consequently, the control group also receives interventions similar to those being tested by the trial. A knowledge gap in research on work inclusion is what kind of jobs marginalized groups end up in and the physical and psychosocial working environment of these jobs. Based on surveys of living conditions, INTEGRATE have therefore further developed and tested a job exposure matrix and found that this is a well-suited measure of occupations' mechanical and psychosocial job strain. By linking job exposure to occupational codes in register data, researchers can show whether and how job strain affects progress towards labour market participation.

The overall objective of INTEGRATE was to build research-based and user-focused knowledge on the design of services that supports coordinated assistance in pathways to work for marginalized groups, i.e. groups that struggle to find and retain a place in the regular labour market. INTEGRATE was established to cultivate a strong interdisciplinary research environment and, in collaboration with a group of acknowledged international experts, address pressing knowledge needs, using a pluralism of methods and theoretical perspectives. An outcome of many international and Norwegian reviews of current research is a comprehensive overview of knowledge status and gaps in this previously under-researched and weakly theorised and synthesised field of research. Another outcome is strengthened research capacity on coordinated services towards labour market participation, developed through INTEGRATE’s own PhD and postdoc fellows and other fellows and researchers in the wider INTEGRATE environment, as well as a Marie Sklodowska-Curie Individual Fellowship from 2020 to 2024. A third outcome is significant international collaboration about scientific publications and new research projects that extend the collaboration beyond INTEGRATE. In 2019 researchers from INTEGRATE was granted funding for two RCN-projects, Organising for Outcome and ENGAGE (engaging employers in work inclusion), both involving international collaborations and comparations between Norway and other European countries. A fourth outcome is Norwegian contributions to the international research discussions in the field, through INTEGRATEs own international conference in November 2019, through regular participation in European/international conferences such as EGOS (organisation studies), ESPAnet (social policy) and the Street-level bureaucracy conference, and through scientific publications in prominent international journals and a research handbook. As of now we count 55 scientific publications. A fifth outcome is incorporation of the theme of coordinated services towards work inclusion in the curricula of higher education aimed at the field of practice, as well as future PhD students. INTEGRATE's Norwegian anthology aimed at students, practitioners and researchers has contributed to this. A sixth outcome is contributions to Norwegian policy debates via podcasts, chronicles, meetings, and seminars organized by Competence Centre for Work Inclusion at OsloMet. Together with other research projects at OsloMet, the most active research institution in the field of labour market inclusion, INTEGRATE’s achievements will help to remedy the problem that too many working age citizens are excluded from the labour market at a time of labour shortage in many industries and public services.

The proposal concerns the establishment of an interdisciplinary core group to develop research-based and user-focused knowledge that supports coordinated assistance to enable integrated and coherent pathways to work for groups who struggle to find and retain a place in the ordinary labour market. This field of knowledge is important because coordinated efforts across public sectors and private organizations are needed in supporting pathways to work for marginalised groups. Coordination is needed between public services and employers because the work place is the key to employment. Coordination is needed between health services and labour and welfare services because somatic, mental and vocational rehabilitation often are parallel, not sequential, processes. The core group involves researchers from Oslo and Akershus University College and Inland Norway University of Applied Sciences - INN University in collaboration with the Norwegian Labour and Welfare Administration (NAV), international experts from acknowledged institutions in Europe and Beyond,and a panel of relevant users groups from health and welfare services. The research will be organized in work packages (WPs) that comprise multiple perspectives, multilevel analyses and mixed methods. The core group will investigate the trajectories of the individuals, organizing of integrated service provision, and collaboration with employers. The group will contribute to new insights into how individuals cope with long-term health problems, to service innovation through co-creation of services, and to knowledge based practice through RCT-evaluations of complex interventions. The group will stimulate development of innovative research design. The core group will be organized with a management team, a forum of principal investigators and WP-leaders, an international expert group and a reflective body of users. The core group will be linked to HiOA's Centre for Work Inclusion (KAI), established in partnership with NAV.

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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester