1. This work received support from KT Canada funding from the Canadian Institutes of Health
Research (CIHR)
Welcome!
Organizational interventions for
the prevention of workplace
stress: Evidence and implications
for public health
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4. The Health Evidence Team
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1. Saves you time
2. Relevant & current evidence
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7. A Model for Evidence-Informed
Decision Making
Source: National Collaborating Centre for Methods and Tools. (revised 2012). A Model for Evidence-Informed DecisionMaking in Public Health. [fact sheet]. Retrieved from http://www.nccmt.ca/pubs/FactSheet_EIDM_EN_WEB.pdf

8. Evidence-Informed Decision Making
1. Cultivate a culture of inquiry, critical thinking
and evidence-based practice “culture”
2. Ask a clear, focused, searchable question
3. Search for the best available evidence
4. Critically appraise the relevant evidence

9. Evidence-Informed Decision Making
5. Synthesize and integrate the evidence with expertise,
local context, and client preference
6. Implement and evaluate the outcome(s) of the
change in practice or policy
7. Engage in knowledge exchange

10. Review
Bergerman, L., Corabian, P., and Harstall, C. (2009).
Effectiveness of organizational interventions for the
prevention of workplace stress (Report). Alberta,
Canada: Institute of Health Economics. Retrieved from:
http://www.ihe.ca/documents/Interventionsforpreven
tionofworkplace_stress.pdf.

11. Importance of this Review
• 1 in 4 Canadian workers described their daily
lives as highly stressful (General Social Survey,
2010)
• High level of workplace stress results in a loss of
productivity through absenteeism, reduced work
output, and increased disability claims
• 3 in 4 short-term disability claims in Canada are
related to mental health problems

12. Poll Question #1
Who has heard of a PICO(S)
question before?
1.Yes
2.No

13. Searchable Questions
1. Population (situation)
2. Intervention (exposure)
3. Comparison (other group)
4. Outcomes
5. Setting
Think “PICOS”

14. Evidence Summary:
Greco (2013)
Objective: To evaluate the effectiveness of organizationallevel interventions for the prevention of occupational
stress in terms of reducing stress, psychological
symptoms, absenteeism, presenteeism, and turnover.
P Employed adults
I Organizational-level interventions including: job redesign or
restructuring, participation and autonomy, training and
education, coworker support groups, physical and
environmental characteristics, communication, role issues
C Other intervention or no intervention
O Stress, burnout, psychological wellbeing, sickness or
absenteeism, and turnover or retention

15. Overall Considerations
• Quality Rating: 9 (strong) Methodologically strong
review based on 6 systematic reviews (including 105
studies), varying in quality: 1 high, 4 moderate and 1
low quality
• No firm conclusion can be drawn about most
effective type of interventions or strategies due to
variability in study population, intervention, and
outcomes
The evidence summary only provides data for effective
interventions in high quality studies.

16. What’s the evidence Outcomes reported in the review
1. Interventions aimed at reducing stress (2 SR; 11
interventions assessed in 37 studies)
2. Interventions aimed at reducing burnout (6 SR; 10
interventions assessed in 105 studies)
3. Interventions aimed at improving psychological
wellbeing (5 SR; 28 interventions assessed in 95
studies)

17. What’s the evidence Outcomes reported in the review
4. Interventions aimed at reducing absence and
absenteeism (2 SR; 11 interventions assessed in 76
studies)
5. Interventions aimed at reducing turnover (2 SR; 4
interventions assessed in 39 studies

18. What’s the evidence -
Reducing Stress
1. Training and Education with theory, role playing and
experiential exchanges (TRA) (1 SR, 1 high quality study):
moderate to small effect on stress immediately following
intervention (MD -0.34, 95% CI -0.62 to -0.06) but no effect at
6 months (MD -0.19, 95% CI -0.49 to 0.11)
2. Action teams with management and employees to improve
team communication and cohesiveness, working scheduling,
conflict resolution and recognition of good work
(PAR/COM/JRD) (1 SR, 1 good quality study) were effective at
reducing stress compared to no-intervention control groups (P=
0.02)
No Impact for: two job redesign or restructuring interventions (JRD), two co-worker support
groups / education and training interventions (CSG/TRA), job redesign or restructuring/
training and education (JRD/TRA), training and education (TRA), two co-worker support
group interventions (CSG), and participation and autonomy/ training and education
(PAR/TRA)

19. What’s the evidence Reducing Burnout
1. A participatory intervention to identify psychological stressors
and solutions (PAR) (1 SR, 1 high quality study) had a large to
small effect on work-related burnout compared to control (MD
-1.83, 95% CI -3.58 to -0.09)
2. Job redesign or restructuring/co-worker support groups/
communication interventions (JRD/CSG/COM) (4 low quality
SR and one study) produced inconsistent results
No Impact for: job redesign or restructuring/ communication/ co-worker
support groups (JRD/COM/CSG), two job redesign or restructuring/
education and training interventions

20. What’s the evidence Improving Psychological Wellbeing
1. A participatory stress reduction committee, more and smaller
teams with sub-supervisors, more on-the-job training, and
ergonomic improvements (JRD/PAR/PEC) (2 SR, 1 high quality
study) significantly improved mean depression scores in the short
term (pre 41.1, post 38.6) compared to controls (pre 41.5, post
42.3) (P = 0.025)
2. Control over production transferred to employee work groups
with a steering group of representatives responsible for
overseeing change (1 SR, 1 good quality study) significantly
improved mental health (P <0.05)

21. What’s the evidence Improving Psychological Wellbeing
3.
A participative action research intervention (1 SR, 1 good
quality study) significantly improved mental health
4.
Flexible working hours (1 SR, 1 good quality study)
significantly improved mental health compared to controls (P
<0.05)
No impact for co-worker support groups/ training and education, participation and
autonomy/ communication/ role issues (PAR/COM/RIS), job redesign or
restructuring, training and education/ co-worker support groups/ participation
and autonomy, job redesign or restructuring/role issues, participation and
autonomy interventions, participation and autonomy/ training and education, and
participation autonomy/ job redesign or restructuring interventions

22. What’s the evidence Reducing Absence and Absenteeism
1. A participatory stress reduction intervention (2 SR, 1
high quality study) significantly reduced absenteeism
compared to controls (P <0.05)
2. An intervention of more teamwork, more personnel, role
clarification, production goals, fewer supervisors, a
partial change in shift system, increased feedback and a
new vending machine and microwave
(JRD/RIS/COM/PEC) (1 SR, 1 high quality study)
significantly reduced sick leave (P <0.05)

23. What’s the evidence Reducing Absence and Absenteeism
3. A participative action research intervention (1 SR, 1 high
quality study) significantly reduced absenteeism compared to a
control group (P <0.05)
No impact - of job redesign or restructuring, job redesign or restructuring/
training and education, participation and autonomy/ job redesign or
restructuring

24. What’s the evidence Reducing Turnover
No impact - Change to a primary care nursing model with support from
managers, advice on core skills and promotion of effective interprofessional
communication

25. General Implications
• Workplace stress reduction interventions should be
rigorously evaluated
• Rigorous research should:
1. Continue to assess the effectiveness and potential harms
of workplace interventions
2. Determine which interventions or strategies are most
effective

26. Poll Questions # 2 and 3
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