Table 3 Summary of evidence of the psychosocial and health effects of autonomous group interventions
StudyDesign and methods appraisal∗Setting and participantsIntervention and implementation†Psychosocial outcomes (p<0.05)‡§Health outcomes (p<0.05)‡
Parker (2003)48Prospective cohort with comparison group3-year follow-upFinal sample n _ 368Methods appraisal: 1, 2, 4, 6, 7, 8, 9, 10Factory floor, UKManual workersLean production: A, lean teams; B, assembly lines; C, workflow formalisation and standardisationIntroduced for economic reasons to increase productivity and improve product quality. Context of increased demand for product. Few reported details on effectiveness of implementation or commitment of employeesJob autonomy (C)Skill utilisation (C)Participation in decision-making (C)↓↓↓Job depression(Warr Job Related Anxiety Scale)Job anxiety(Warr Job Related Anxiety Scale)↔↓
Jackson and Mullarky (2000)49Retrospective cross-section with comparison group.Final sample n _ 556Methods appraisal: 2, 3, 7, 8, 9, 10Factory floor (four sites), UKManual workers (female)Lean productionIntroduced to increase productivity. Managers in charge of implementation. Few reported details on effectiveness of implementation or commitment of employees. However, authors comment that intervention group received an increase in payProblem-solving demands (D)Skill utilisation demands (D)Monitoring demands (D)Production pressure (D)Production responsibility (D)Individual timing control (C)Collective timing control (C)Role breadth (C)Task variety (C)Individual method control (C)Collective method control (C)Social contact (S)Co-worker trust (S)Group cohesiveness (S)Social support (S)↓↓↓↓↓↓↓↑↑↔↔↑↑↓↔Job-related strain(Warr Job Related Anxiety Scale)
Jackson and Martin (1996)50¶Prospective cohort with comparison group7-month follow-upFinal sample n _ 44Methods appraisal: 1, 2, 5, 7, 8, 9, 10Factory floor, UKManual workersJust in timeIntroduced by managers to increase productivity. Few reported details on effectiveness of implementation or commitment of employeesProduction pressure (D)Problem solving demands (D)Monitoring demands (D)Timing control (C)Skill utilisation (C)Method control (C)Boundary control (C)Task variety (C)↓↔↑↓↑↔↔↔Psychological strain(GHQ-12)
Mullarky et al (1995)51††Prospective repeat cross-sectionPhase 1: 14-month follow-upPhase 2: 4-month follow-upFinal sample n _ 44Methods appraisal: 1, 2, 4, 5, 7, 9Factory floor, UKManual workersJust in timeIntroduced to increase productivity. Few reported details on effectiveness of implementation or commitment of employeesMonitoring demandsProblem solving demandsProduction responsibilityIndividual timing controlMethod controlBoundary controlTeam timing controlTeam method controlCo-worker supportGroup cohesiveness↓↔↔↑↑↑↑↔↑↑General strain(GHQ-12)Job-related anxiety(GHQ-12)Job-related depression(GHQ-12)↔↔↔
Wall et al (1986)31A: Prospective cohort with comparison group at 6-month follow-up, prospective cohort at 18- and 30-month follow-upsB: Prospective cohort with 12- and 24-month follow-upsFinal sample n _ 50Methods appraisal: 1, 2, 4, 7, 10Factory floor, UKManual and shop floor supervisorsAutonomous work groupsIntervention occurred in a purpose-built factory which was designed with increasing factory floor responsibility and job redesign in mind. Researchers were not involved in the design or implementation of the intervention. Employee support for the intervention was mixed. Training on intervention was providedWork group autonomyMental health(GHQ-12)
Christmansson et al (1999)52Prospective repeat cross-section12-month follow-upFinal sample n _ 12Methods appraisal: 1, 4 5, 9, 10Factory floor, SwedenManual and shop floor supervisorsAutonomous work groupsIntervention introduced to improve efficiency and reduce prevalence of work-related musculoskeletal disorders in a department with historically a high incidenceMixed response to intervention from employees, managers supportive. Few reported details on effectiveness of implementationPsychological workloadInfluence on and control of workRelationship with other workersSupervisor climate↔↑↓↔Upper extremity pain disordersPsychosomatic reactions↓↔
  • ∗Methods appraisal (box 2): 1, prospective; 2, representative sample; 3, appropriate comparison group; 4, baseline response > 60%; , follow-up > 80% in cohort, > 60% in cross-section; 6, adjustment for non-response and drop-out; 7, conclusions substantiated by data; 8, adjustment for confounders; 9, all intervention group exposed, non-contaminated comparison group; 10, appropriate statistical tests.

  • †See box 1.

  • ‡D, demand; C, control; S, support.

  • §↑, Improvement; ↓, worsening; ↔, little change.

  • ¶Linked to Mullarky et al. (1995)51

  • ††Linked to Jackson and Martin (1996).50