Given the prevalence of work stress-related ill-health in the Western world, it is important to find cost-effective, easy-to-use and valid measures which can be used both in research and in practice. To examine the validity and reliability of the single-item stress question (SISQ), distributed weekly by short message service (SMS) and used for measurement of work-related stress. The convergent validity was assessed through associations between the SISQ and subscales of the Job Demand–Control–Support model, the Effort–Reward Imbalance model and scales measuring depression, exhaustion and sleep. The predictive validity was assessed using SISQ data collected through SMS. The reliability was analysed by the test–retest procedure. Correlations between the SISQ and all the subscales except for job strain and esteem reward were significant, ranging from −0.186 to 0.627. The SISQ could also predict sick leave, depression and exhaustion at 12-month follow-up. The analysis on reliability revealed a satisfactory stability with a weighted kappa between 0.804 and 0.868. The SISQ, administered through SMS, can be used for the screening of stress levels in a working population.

This study is a process evaluation of a trial examining the effects of an organizational intervention (Productivity Measurement and Enhancement System or ProMES) on employee stress. The aims were to explore the implementation process and fidelity to the intervention guidelines, examine the influence of contextual factors (hindrances and facilitators) and explore participants’ experience of working with ProMES. We used the UK Medical Research Council (MRC) guidance to guide the process evaluation. The recruitment, reach and dose delivered were satisfactory and participation high. The employees felt ProMES clarified priorities, gave control and increased participation in decision-making. However, difficulty in obtaining statistical productivity data from the central administration office (a central feature of the intervention) hindered full implementation and regular feedback meetings. Staffing shortages interfered with the implementation process, while having seven design teams and one consultant prevented all occupational groups from working simultaneously. A detailed examination of access to necessary organizational data should be undertaken before implementing ProMES. We recommend a better introduction for new employees, more work on design and packaging and giving employees more training in how to use the software program. The study contributes to our understanding of process evaluations in research into organizational stress management interventions.

The aim of this study is to explore whether a participatory, organizational intervention can reduce work-related risk factors, and thereby prevent stress-related ill health. We build on the job demand-control and effort-reward imbalance models of stress. It is a two-armed randomized trial, with one primary health care unit receiving the intervention and a two-unit control group. Validated questionnaires for the assessment of psychosocial work environment and health were administered, at the baseline and at 6 and 12-month follow up. The primary outcome was job strain. Secondary outcomes were effort–reward imbalance, exhaustion, sleep, and recovery. Group-level objective data on workload and data about relevant processes during the study were continuously collected. The changes in the intervention group with regard to job strain, effort-reward imbalance, exhaustion, sleep and recovery were not statistically different from changes in the control group. For the non-exhausted employees though, reward was significantly higher at follow up compared to baseline, but only in the intervention group. An important piece of information is that the objective workload was statistically significantly higher in the intervention group throughout the study. Not all the components of the intervention were implemented as intended. Context and process information, such as objective data and implementation fidelity are necessary for a valid interpretation of the results.

Background: The study evaluates the cost-effectiveness of the Productivity Measurement and Enhancement System (ProMes) intervention to reduce employee work-related stress and enhance work performance. Methods: A prospective cohort study was used to undertake the evaluation from a business perspective. Objective workload data and stress were gathered repeatedly over a 17-month period (i.e., before and after intervention). Independent t-test and an interrupted time series (ITS) analysis were used in the analysis. The average cost-effectiveness ratio (ACER) was calculated as a ratio of the average cost of the intervention and the effect sizes of the different outcomes to reflect the average cost per clinician for each unit change in outcome. Results: Based on the results of the ITS analysis, an expenditure of EUR 41,487 was linked with no change in stress levels, according to the ACER for stress. In addition, the expenditures associated with each unit change were EUR 3319 for overall tasks per hour worked, EUR 2761 for visits per hour worked, EUR 2880 for administrative tasks, but EUR 9123 for answering phone calls. Conclusions: ProMes is not cost–effective in terms of work-related stress levels, but the intervention seemed to have increased efficiency in some objective work performance measures, albeit at a relatively high extra cost.

Exploring stress trajectories in detail and over a long time may give valuable information in terms of both understanding and practice. We followed a group of primary health care employees in a randomized controlled trial. The objective was to describe their experience of stress, explore the intra-individual variability and examine the association between the experience of stress and the objective workload. Weekly text messages with a single item stress question were distributed in two time series: 12 weeks at the beginning of the trial and 26 weeks after the 6-month follow up. Aggregated objective data about workload were collected from their administration office and related to stress levels. There was a seasonal variation, with higher stress during the fall than in spring and summer. The analysis comparing high and low stress subgroups showed that the stress trajectory of a high-stress subgroup was different from that of a low-stress subgroup. Individuals with high exhaustion scores had higher odds of belonging to a subgroup of individuals with high intra-individual variability in stress experience. The objective workload was measured in two ways and was strongly associated with the stress experience. We found that the lower the productivity, the higher the feeling of stress.