Table 1 Single interventions to increase employee participation and/or control
StudyDesign and methods appraisal*Setting and participantsInterventionImplementationPsychosocial outcomes (p<0.05)†,‡Health outcomes (p<0.05)‡
Landsbergis and Vivona-Vaughan (1995)30Prospective cohort study with comparison group. Some qualitative components 12-month follow-up Final sample: n = 77 Methods appraisal: 1, 2, 3, 4, 7, 8, 9, 10Two local government agencies, USA Managers, professionals and clerical staffProblem-solving committees moderated by external consultant for elected employee representatives and managersAuthors report support for the intervention from employers and employees, and that some of the committees’ proposals were implementedDemand (D) ↔ Decision latitude (C) ↔ Work involvement (C) ↔ Influence satisfaction (C) ↔ Supervisor relations (S) ↔ Feedback (S) ↔ Co-worker support (S) ↔ Group goal clarity (O) ↔ Open group process (O) ↑Mental health (Job Content Questionnaire) ↔
Bond and Bunce (2001)31Prospective cohort study with comparison group 12-month follow-up Final sample: n = 53 Methods appraisal: 1, 2, 3, 4, 6, 7, 10Central government office, UK Civil servants: various gradesParticipative action research: workers’ steering committee of volunteer employee representatives, set up by external consultant (psychologist)Few reported details. Committee’s proposals for more feedback opportunities in the workplace were adopted by managementSense of control (C) ↑ Job satisfaction (O) ↔ Self-rated performance (O) ↑Mental ill health (OSI) score: Occupational Stress Indicator ↑ Physical health ↔ Absenteeism ↑
Counte et al (1987)32Prospective cohort study with comparison group 3- and 6-month follow-up Final sample: n = 99 Methods appraisal: 1, 2, 3, 7, 8, 10Hospital. USA NursesParticipative management intervention: committees of nurses given control over personnel, work scheduling, training and some budgetingThree of the sour committees were reportedly well implemented, but the fourth was hindered by “power struggles”. Many nurses preferred the traditional, hierarchical model of hospital managementCo-worker satisfaction (S) ↔ Satisfaction with work (O) ↔Absenteeism ↔
Bourbonnais et al (2006)33 34Prospective repeat cross-sectional study with comparison group 12-month follow-up Final sample: 613 Methods appraisal: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10Hospital, Canada Nurses, orderlies and auxiliary nursesParticipatory intervention based on the German “Health Circles” model. Small groups of different types of employee representatives, led by an external moderator, meet every 2 weeks to identify psychosocial stressors and recommend solutions to employees and managementIntervention developed by researchers in consultation with nursing representatives, following assessment and observations of the workplace. Evidence of co-operation from management. Some of the less complex recommendations have “already been applied”Psychological demands (D) ↑ Decision latitude (C) ↔ Supervisor support (S) ↓ Co-worker support (S) ↑ Reward (O) ↑ Effort–reward imbalance (O)Psychological distress (Psychiatric Symptom Index) ↔ Sleeping problems (Nottingham Health Profile) ↔ Client-related burnout ↔ Work-related burnout ↑ Personal burnout (Copenhagen Burnout Inventory) ↔
Park et al (2004)35Prospective, controlled, repeat-cross-sectional study Baseline 6 months prior to intervention. Follow-up 1 year after intervention Final sample: n = 1463 Methods appraisal: 1, 2, 3, 6, 7, 8, 9, 10Retail store workers, USA All employeesAction teams created in each intervention store in which employee representative liaised with management and employees to improve team communication and cohesiveness, work scheduling, conflict resolution and recognition of good workImplementation took place during a period of recession and uncertainty (no explicit references to redundancies). Authors were looking for a buffering effect rather than positive improvements. Assisted by a professional facilitator, who helped build skills amongst team membersOrganisational support (S) ↑ Co-worker support (S) ↑ Involvement with others (S) ↔ Involvement with supervisors (S) ↑ Communication (O) ↔ Safety and health climate (O) ↔Overall health status (SF12) ↑ Job stress ↑
Smith et al. (1998)36Prospective, repeat cross-sectional study with nested cohort study with comparison groups 6-month follow-up Final sample n = 62 Methods appraisal: 1, 3, 4, 7, 8, 9, 10Police station, UK Police officersFlexible working hours, compared with more rigid 12-hour shift schedulesFew reported details on effectiveness of implementation or commitment of employers. Around 50% of employees supported the interventionWorkload (D) ↔ Work-pace control (C) ↔ Satisfaction with rota (O) ↑Mental health (GHQ12 mean score) ↑ Physical health (Physical Health Questionnaire) ↔
Wall and Clegg (1981)37Prospective cohort study 6- and 18-month follow-ups Final sample n = 29 Methods appraisal: 1, 2, 4, 5, 7, 9,1 0Factory, UK Manual workersImmediate control over production transferred to employee work groups with a steering group of representatives overseeing changeAuthors suggest that both employees and employers supported the intervention as a means of improving employees’ moraleWork complexity (D) ↓ Autonomy (C) ↑ Group identity (S) ↑ Work motivation (O) ↑ Job satisfaction (O) ↑Mental health (20-item GHQ mean scores) ↑
  • *Methods appraisal: 1 = prospective; 2 = representative sample; 3 = appropriate comparison group; 4 = baseline response >60%; 5 = 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. †D, demand; C, control; S, social support; O, other psychosocial outcome measures. ‡↑  =  improvement; ↓  =  worsening; ↔  =  little change/inconclusive (with reference to the DCS hypothesis that reduced demands and increased control and support are “improvements”).