The psychosocial and health effects of workplace reorganisation 1 : a systematic review of interventions that aim to increase employee participation or control.

Abstract

Background: The "demand control support" model of workplace health may help researchers, practitioners and policy-makers understand how psychosocial interventions can improve workplace health and reduce health inequalities. We conducted a systematic review asking whether organisational-level interventions designed to increase employee participation in the workplace lead to health effects predicted by the demand control support model. Method: Systematic review, using narrative synthesis, of relevant intervention studies reporting both psychosocial and health outcomes from any country or time, in any language or format, identified from medical and social science databases, personal collections, bibliographies and expert consultations. Findings: We identified 15 studies including single and multiple intervention studies. Most involved …#732;participatory…#8482; (problem solving) employee committees. Two of the four more robust studies (prospective with comparison groups) of single participatory interventions found evidence of health (especially mental health) benefits; as did three robust studies, and some less robust evidence, of participatory interventions implemented alongside ergonomic improvements or individual-level health education. We found little evidence of health benefits, but some of adverse effects, when participatory interventions occurred alongside redundancies. The demand control support model was a useful tool for understanding health outcomes, especially with regards to employee control. Interpretation: Our review suggests that interventions that attempt to increase employee participation and control through workplace re-organisation are potentially health-improving, although more robust studies would strengthen this finding. If such interventions are to benefit employees' health they should be implemented within a favourable organisational climate and cannot be expected to protect workers from generally poor working conditions.