Meta-analysis of the effects of health promotion intervention in the workplace on depression and anxiety symptoms
Martin, A and Sanderson, K and Cocker, FM, Meta-analysis of the effects of health promotion intervention in the workplace on depression and anxiety symptoms, Scandinavian Journal of Work, Environment and Health, 35, (1) pp. 7-18. ISSN 0355-3140 (2009) [Refereed Article]
Objectives: The aim of the study was to investigate whether different types of health promotion intervention in the workplace reduce depression and anxiety symptoms. Methods: A systematic review and meta-analysis of the literature was undertaken on workplace health promotion published during the period 1997-2007. Studies were considered eligible for inclusion if they evaluated the impact of an intervention using a valid indicator or specific measure of depression or anxiety symptoms. The standardized mean difference was calculated for each of the following three types of outcome measures: depression, anxiety, and composite mental health. Results: Altogether 22 studies were found that met the inclusion criteria, with a total sample size of 3409 employees postintervention, and 17 of these studies were included in the meta-analysis, representing 20 intervention -control comparisons. The pooled results indicated small, but positive overall effects of the interventions with respect to symptoms of depression [SMD 0.28, 95% confidence interval (95% CI) 0.12-0.44] and anxiety (SMD 0.29, 95% CI 0.06-0.51), but no effect on composite mental health measures (SMD 0.05, 95% CI -0.03-0.13). The interventions that included a direct focus on mental health had a comparable effect on depression and anxiety symptoms, as did the interventions with an indirect focus on risk factors. Conclusions: When the aim is to reduce symptoms of depression and anxiety in employee populations, a broad range of health promotion interventions appear to be effective, although the effect is small.