Christina Björklund

Bakgrund Kränkande särbehandling och mobbning är allvarliga arbetsmiljöproblem. Trots lagstiftning har chefer ofta svårt att omsätta riktlinjer i praktiken på grund av tidsbrist, begränsade resurser och bristande organisatoriskt stöd. Syfte Studien undersöker vad som påverkar chefers efterlevnad av riktlinjer mot kränkande särbehandling och mobbning samt hur implementeringen fungerar när chefer erbjuds utbildning och stödjande workshops. Genomförande Studien genomförs i tre faser: Intervjuer med 20 chefer för att identifiera hinder och möjliggörare. Utbildning och workshops med 6–8 ledningsgrupper, följda med kvalitativa och kvantitativa metoder. Uppföljande intervjuer efter sex månader. Förväntade resultat Studien identifierar centrala hinder, möjliggörare och strategier för att omsätta riktlinjer i praktiken. Resultaten kan stärka chefers förmåga att agera tidigt och effektivt och därmed bidra till en tryggare arbetsmiljö.

Research problem and specific questionsTeacher retention is a problem for many schools. In some municipalities 15-25% of teachers quit every year. While some turnover is necessary, too much instability is harmful for both students’ results and teachers’ health. There is therefore an urgent need to minimize teacher turnover. Limitations of studies examining work-characteristics associated with teacher turnover are that they have mainly been cross-sectional register studies. Knowledge is lacking on the relative importance of these work-characteristics in teachers’ retention decision, and whether teachers are willing to make trade-offs between these characteristics. This project aims to investigate which work-related factors teachers consider in their decision to remain in the profession (aim 1)

to examine the preferences of teachers and the trade-offs they are willing to make to stay in their profession (aim 2)

to assess how national reforms align with teacher’s work-characteristic preferences (aim 3).Data and methodThe project applies a discrete-choice experiment (DCE), consisting of three parts: a Delphi-survey (n=30 teachers

Aim 1), a DCE-survey (n=1500 teachers

Aim 2), and four focus-group interviews (Aim 3). The Delphi-survey and DCE-survey allow for the quantification of the relative importance of teachers´ work characteristics and the trade-offs they are willing to make to remain in their profession. The interviews allow for situational context to be explored and influential ‘hidden’ variables to be elucidated. The interviews provide a more nuanced understanding of the preferences identified in the DCE-survey and of whether national reforms match teacher’s preferences.Societal relevance and utilisationDespite national reforms to attract and retain teachers, a shortage of ~12 000 teachers in Sweden is prognosed by 2035. This project will inform policymakers and schools on how to facilitate a work-environment that ensures teacher’s motivation to remain in their profession.Plan for project realisationPlan for realisation includes recruitment of participants, data-collections, statistical analysis, reporting and communicating results. The multidisciplinary group has extensive experience with the proposed methodology, including DCEs, and with conducting research in schools. Costs are mainly related to salaries.

Despite national reforms and measures to attract and retain teachers, a shortage of ~12 000 teachers in Sweden, is prognosed by 2035. The project will provide insights into the factors that impact teacher retention and inform policies aimed at improving teacher job satisfaction and reducing turnover rates. The purpose is to examine teachers’ perceptions concerning the relative importance of different personal and work factors for their retention and to examine how existing national reforms and measures to attract, recruit and retain teachers align with teacher preferences, e.g., teacher salary structure, the introduction of support staff. The multidisciplinary group has experience with the methodology, and with conducting research in schools. The 3-year project consists of three consecutive studies combining a Delphi-method (n=30 teachers), a discrete choice experiment (DCE) conducted through a quantitative survey (n=1500 teachers), and a qualitative study using focus-group interviews. The Delphi-method and DCE allow for the quantification of the relative importance of teachers' work characteristics and the trade-offs they are willing to make. The interviews allow for situational context to be explored and influential ‘hidden’ variables to be elucidated and will provide a more nuanced understanding of the preferences identified and whether national reforms match teacher’s preferences.

In this application we are applying for funding to convert our effective implementation strategy into a digital tool. The implementation strategy consists of the following components: educational meeting, implementation team, workshops, iterative problem-solving method and internal facilitator and supports organisations with the implementation of the national, evidence-based Guideline for the prevention of mental ill-health at the workplace. The goal of the tool is to make the strategy widely accessible and usable for organisations that seek support with the systematic prevention of mental ill-health among employees. The tool is expected to impact organisations’ routines and work-methods towards psychosocial risk management and employees’ mental health. By applying a user-centred approach, we will in a participatory manner include end-users’ perspectives, and ideas in converting the components of the implementation strategy to the digital tool. This will be done via design sessions and usability-testing. The tool will provide support through web-based education (e.g., pre-recorded webinars, training (e.g., video tutorials), manuals and worksheets. The target audience will be public-sector organisations (e.g., schools, elderly care, and social services), however the generic nature of the guideline and implementation strategy will make the tool applicable to other organisations.  The application builds on our previous projects and ongoing Forte-financed project, in which we tested the effectiveness and functioning of the implementation strategy in six Swedish municipalities among over 70 schools. The strategy was shown to be effective in improving adherence to the guideline. Moreover, results show that guideline adherence is associated with improvements in health outcomes and psychosocial work environment. The focus is now on the scale-up of the implementation strategy for widespread use through a digital tool to increase its uptake and population health impact.

Research problem and specific questionsThe profession of publicly financed personal assistant provides opportunities for persons with disabilities (‘assistance users’) to participate fully in society. The profession has specific working conditions that make it essential to study from a health perspective: personal assistants work in various environments, they often work alone in the user’s home, under varying terms of employment depending on whether the assistance organizer is private, public, cooperative or the users themselves. Moreover, the profession has high levels of sickness absence, is female-dominated, low-waged, and requires no formal education. Therefore, research on how health and the work environment interact in this profession is necessary to ensure a sustainable working life. Previous research has highlighted the importance of employers (with responsibility for safety and health at work) in the return to work process.The aim is to examine personal assistants’ and their employers’ perceptions of facilitators and barriers for return to work after sickness absence due to common mental disorders (CMDs).Data and MethodThe project has a qualitative approach. Data will be collected through two semi-structured interviews three months apart with 20–25 personal assistants and 20–25 employers/ managers.Societal relevance and utilisationCMDs are common causes of sickness absence, and women have a higher risk of becoming sick-listed than men. The profession of personal assistants suffers from high sickness absence and various insecure working conditions. Knowledge should be translated into practical measures through collaboration, remain sensitive to the legal rights of assistance users, and be useful in employers’ occupational safety and health management.Plan for project realisationThe main costs consist of salaries for the projects’ researchers. Additional costs include fees for ethical review, transcription services, language review, and collaboration.

There is an urgent need for more knowledge on effective implementation strategies, as two-thirds of implementation efforts fail to achieve the intended change, and half have no effect on outcomes of interest. These implementation failures are partly due to the limited understanding of how implementation strategies work—the mechanisms of change through which implementation strategies affect implementation. This project will fill this research-gap by incorporating mediation analyses into a cluster randomized controlled trial that compares the effectiveness of two implementation strategies for implementing the Guideline for the prevention of mental ill-health at the workplace in schools. Schools are chosen as the setting for implementation given the high prevalence of mental ill-health among teachers. Moreover, they lack a structured approach to the prevention of mental ill-health. The aim of the project is to investigate how implementation strategies affect the defined mechanisms and guideline implementation. The mechanisms of the following implementation strategies will be compared: a discrete strategy that includes an educational meeting (control group) and a multifaceted strategy (intervention group) that combines the educational meeting with workshops, implementation teams and evaluative and iterative strategies (e.g. Plan-Do-Study-Act cycles). Our hypothesis is that schools that receive the multifaceted implementation strategy will show a greater increase in guideline adherence at follow-up than schools that only participate in an educational meeting. Mechanisms that will be tested include hypothesized mediators originating from the individual behavior change theory COM-B. The project will be conducted in primary schools (n=50) in four municipalities in Sweden. Adherence to the guideline will be assessed at baseline and 6, 12- and 24-months follow-up, and mediators at baseline and 3, 6, 9, 12- and 24-months follow-up. Mixed methods will be used.