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Systematic Review and Research
                 Synthesis

                               252
                      10:15AM to 1:15PM
Organizers: David Denyer, Cranfield U.; Rob B. Briner, U. of London

                    Primary Sponsor: Research Methods
Agenda
•    Evidence-based management (EBMgt)
•    Systematic review
•    Examples of systematic reviews
•    Research synthesis
•    Disseminating using syntheses
AIMS OF SESSION
The aims of the PDW are as follows:
1.  To demonstrate how to produce a systematic review and
    research synthesis in a fragmented field, like management
    research, that is pluralistic in both theory and method.
2.  To model appropriate systematic review processes for
    management and organization studies and criteria for
    choosing among alternatives
3.  To present different approaches to research syntheses
    including aggregative, interpretative, explanatory and
    integrative approaches.
4.  To show how systematic reviews and research syntheses can
    inform research, policy and practice.
5.  To present ways in which systematic reviews and research
    syntheses can be disseminated through web-based
    technologies.
EVIDENCE-BASED MANAGEMENT
WHAT IS EVIDENCE BASED
MANAGEMENT?




                 © CELL - Cranfield School of
                        Management
THE DEVELOPMENT OF EBMgt

Some basic assumptions:
 •  Research produced by management scholars could be
    useful to organizations
 •  Drawing on available evidence (including research
    produced by academics) is likely to improve decisions
 •  Organizations do not appear to be strongly aware of
    nor use research findings
 •  EBMgt is a potentially useful way of thinking about
    how we summarize research evidence and incorporate
    it (along with other things) into decision-making


                    7
THE DEVELOPMENT OF EBMgt

Almost every Academy of Management
  presidential address for the past 20 years has
  focused on this issue
 •  Hambrick - What if the Academy actually mattered?
 •  Huff - Mode1/2 knowledge production
 •  Van de Ven - Co-production of knowledge, engaged
    scholarship
 •  Bartunek - Collaborative research
 •  Pearce - What do we know and how do we really know
    it?
 •  Rousseau - Evidence-based Management
                   8
THE DEVELOPMENT OF EBMgt

Evidence-based management (EBMgt) draws on but is not the same
   as evidence-based medicine (more later)
EB Medicine is “integrating individual clinical expertise with the best
   available external…evidence from systematic research” in
   decision-making
Not about acting only on the basis of good evidence but rather about
   combining:

     What the practitioner already knows from their previous
      training, experience and current understanding of the
                    particular context/problem
                              WITH
  The best available external evidence about the issues they are
                           dealing with

                          9
THE DEVELOPMENT OF EBMgt

“Evidence-based management is about making
  decisions through the conscientious, explicit,
  and judicious use of four sources of
  information: practitioner expertise and
  judgment, evidence from the local context, a
  critical evaluation of the best available
  research evidence, and the perspectives of
  those people who might be affected by the
  decision.” (Briner, Denyer, Rousseau, 2009)

                  10
THE DEVELOPMENT OF EBMgt




(See Briner, Denyer and
 Rousseau, AMP 2009)


                          11
SYSTEMATIC REVIEW

             © CELL - Cranfield School of
                    Management
LITERATURE REVIEWS IN
MANAGEMENT
How many here have had training in reviewing literature?
Are we really “standing on the shoulders of giants”?
Do you recognize these sort of unqualified statements?
 •  “Previous studies have shown that…”
 •  “It has been demonstrated that…”
But how many studies? Demonstrated how? Did other
   studies find something else?
Very few systematic reviews in management




                    13
WHAT QUALITIES SHOULD
LITERATURE REVIEWS HAVE?
WHAT QUALITIES SHOULD
LITERATURE REVIEWS HAVE?
Comprehensive?          Focused?
Reader-friendly?        Exploratory?
Informative?            Inclusive? (of different types
Balanced?                  of evidence)
Insightful?             Transparent?
Critical?               Accurately referenced?
Rigorous?               Objective?
Accessible?             Replicable?
User led?               Interesting?
Up-to-date?             Standardized?

                   15
WHAT IS A SYSTEMATIC
REVIEW?
It’s research on existing research
With a clear, explicit and replicable methodology
   •  Clear review question
   •  Search strategy
   •  Quality criteria
Allows us to draw reliable conclusions about what we know
     and do not know about a given question or problem




                      16
Evidence-based
                                SYSTEMATIC
practice process                   REVIEW
                                1.  problem
                                    formulation;
                                2.  locating
Practice-                           studies;       What do   Informs
            Existing research                        we      practice
 relevant        studies        3.  study           know?
                                    selection                 Informs
 question                                          What we     future
                                    and
                                    evaluation;    do not    research
                                                    know?    questions
                                4.  analysis
                                    and
                                    synthesis;
                                5.  reporting of
                                    the results
THE QUESTIONS SRs ANSWER

  For any given specific problem:
What do we know?
What do we not know?
What are we not sure about?
How do we know we know or don’t know or are not sure
  that…?
What is the basis for our claims? (e.g., How much evidence?
  What quality?)




                      18
WHAT SORT OF QUESTIONS
CAN BE ADDRESSED IN A SR?
    Each would require much more specificity

Does team-building work?
Can you improve emotional intelligence?
Do increases in EI lead to performance improvements?
Does management development improve the
   performance of managers?
Does employee engagement predict organizational
   performance?
Is 360 degree feedback effective?
Can potentially great leaders be identified?
Is coaching effective?
                   19
Does team-building work?

How would you make this question more
specific?
WHAT SORT OF QUESTIONS
CAN BE ADDRESSED IN A SR?
Does team-building work?
•   What is meant by ‘team’? And what is not included as a ‘team’?
•   What kind of teams?
•   In which particular contexts or settings?
•   What is ‘team building’? And what is not ‘team building’?
•   What does ‘work’ mean?
•   ‘Work’ compared to any other team intervention? No intervention?
•   What outcomes are relevant?
•   What are the mechanisms, processes and theory which might
    account for possible effects of team building on outcomes?
•   What time periods are relevant for observing any possible effects?
•   What about possible negative effects or harm?
•   What types of data from what sorts of designs would in principle
    provide good quality, medium quality and poor quality evidence?


                           21
IDENTIFYING A TOPIC AND
SPECIFIC REVIEW QUESTIONS
What general area or topic do you want to focus on?
 Why?
What specific review question will you address? Is it
 specific enough?
Where is this question from? Why is it important or
 interesting?
Who is the review for? Practitioners? Researchers?
 Both?
What type of SR do you want to do?
What about a Rapid Evidence Assessment (REA)?


                     22
MAKING DECISIONS ABOUT
SEARCH STRATEGY
What sources of evidence?
What sources will you include or exclude and why?
How iterative can you be?
 •  Test the question doing some simple searches
 •  Does the question work?
 •  Does the search strategy work?




                     23
Once a body of evidence has been
collated….
How relevant is this to what we are seeking to
 understand or decide?

How representative is this of the population that
 concerns us?

How reliable, how well-founded theoretically,
 empirically is it?

  ‘These are tough but necessary tests for evidence based policy and
                        practice’ Solesbury 2004
SYSTEMATIC REVIEWS IN
MANAGEMENT
TYPES OF LITERATURE REVIEW

Explicit systematic: Explicit use of rigorous method - can vary as
   least as much as the range of methods in primary research
Implicit systematic: rigorous method but not stated
False systematic: described as systematic but with little evidence of
   explicit rigorous method
Argument/thematic: a review that aims to explore and usually
   support a particular argument or theme with no pretension to use
   an explicit rigorous method (though thematic reviews can be
   systematic)
Expert or ad hoc review: informed by the skill and experience of the
   reviewer but no clear method so open to hidden bias.
Rapid evidence assessment: a rapid review that may or may not
   be rigorous and systematic. If it is systematic then in order to be
   rapid it is likely to be limited in some explicit aspect of scope.
   (Gough 2007)

                         26
SRs IN MANAGEMENT

 Keupp &       The Past and the Future of    Journal of
 Gassmann      International                 Management
 (2009)        Entrepreneurship: A Review
               and Suggestions for
               Developing the Field
 Walker        A systematic review of the    Corporate
 (2010)        corporate reputation          Reputation Review
               literature: Definition,
               measurement, and theory

 Joyce,        Flexible working conditions   Cochrane Database
 Pabayo,       and their effects on          of Systematic
 Critchley &   employee health and           Reviews
 Bambara       wellbeing
 (2010)




                                                            27
Flexible working conditions and their effects on
employee health and wellbeing (Joyce et al, 2010)

Background: Flexible working conditions are increasingly popular in
  developed countries but the effects on employee health and
  wellbeing are largely unknown.
Objectives: To evaluate the effects (benefits and harms) of flexible
  working interventions on the physical, mental and general health
  and wellbeing of employees and their families.
Search strategy: Our searches (July 2009) covered 12 databases
  including the Cochrane Public Health Group Specialized Register,
  CENTRAL; MEDLINE; EMBASE; CINAHL; PsycINFO; Social
  Science Citation Index; ASSIA; IBSS; Sociological Abstracts; and
  ABI/Inform. We also searched relevant websites, hand searched
  key journals, searched bibliographies and contacted study
  authors and key experts.




                        28
Flexible working conditions and their effects on
employee health and wellbeing (Joyce et al, 2010)

Selection criteria: Randomized controlled trials (RCT), interrupted
  time series and controlled before and after studies (CBA), which
  examined the effects of flexible working interventions on
  employee health and wellbeing. We excluded studies assessing
  outcomes for less than six months and extracted outcomes
  relating to physical, mental and general health/ill health measured
  using a validated instrument. We also extracted secondary
  outcomes (including sickness absence, health service usage,
  behavioral changes, accidents, work-life balance, quality of life,
  health and wellbeing of children, family members and co-workers)
  if reported alongside at least one primary outcome.
Data collection and analysis: Two experienced review authors
  conducted data extraction and quality appraisal. We undertook a
  narrative synthesis as there was substantial heterogeneity
  between studies.



                         29
Flexible working conditions and their effects on
      employee health and wellbeing (Joyce et al, 2010)
Main results: Ten studies fulfilled the inclusion criteria. Six CBA studies reported on
  interventions relating to temporal flexibility: self-scheduling of shift work (n = 4),
  flexitime (n = 1) and overtime (n = 1). The remaining four CBA studies evaluated a
  form of contractual flexibility: partial/gradual retirement (n = 2), involuntary part-time
  work (n = 1) and fixed-term contract (n = 1). The studies retrieved had a number of
  methodological limitations including short follow-up periods, risk of selection bias
  and reliance on largely self-reported outcome data. Four CBA studies on self-
  scheduling of shifts and one CBA study on gradual/partial retirement reported
  statistically significant improvements in either primary outcomes (including systolic
  blood pressure and heart rate; tiredness; mental health, sleep duration, sleep quality
  and alertness; self-rated health status) or secondary health outcomes (co-workers
  social support and sense of community) and no ill health effects were reported.
  Flexitime was shown not to have significant effects on self-reported physiological
  and psychological health outcomes. Similarly, when comparing individuals working
  overtime with those who did not the odds of ill health effects were not significantly
  higher in the intervention group at follow up. The effects of contractual flexibility on
  self-reported health (with the exception of gradual/partial retirement, which when
  controlled by employees improved health outcomes) were either equivocal or
  negative. No studies differentiated results by socio-economic status, although one
  study did compare findings by gender but found no differential effect on self-
  reported health outcomes.
                                   30
Flexible working conditions and their effects on
employee health and wellbeing (Joyce et al, 2010)

Authors’ conclusions: The findings of this review
  tentatively suggest that flexible working interventions
  that increase worker control and choice (such as self
  scheduling or gradual/partial retirement) are likely to
  have a positive effect on health outcomes. In contrast,
  interventions that were motivated or dictated by
  organizational interests, such as fixed-term contract
  and involuntary part-time employment, found equivocal
  or negative health effects. Given the partial and
  methodologically limited evidence base these findings
  should be interpreted with caution. Moreover, well-
  designed intervention studies are needed to delineate
  the impact of flexible working conditions on health,
  wellbeing and health inequalities.

                    31
PART 3: EXAMPLE OF AN SR

First example: Not really a systematic
  review
Second example: Large systematic review
  conducted for UK’s Health & Safety
  Executive




              32
First example
(but NOT a systematic review)
Stress interventions
 •  Primary (reduce presence of ‘stressors’)
 •  Secondary (preventative - training)
 •  Tertiary (treating harmed individuals)
For decades virtually all writers claimed primary interventions are
   effective
Similar claims at the start of many papers:
 •    It has been shown that…
 •    It is well-established that…
 •    Previous research has demonstrated that…
 •    There is mixed evidence that…
 •    All meaningless without systematic reviews




                             33
First example
(but NOT a systematic review)

Reviewed 12 job redesign studies (Briner
 & Reynolds, 1999)
Most designed to increase autonomy




                 34
Wall et al (1986):
Manufacturing; autonomous workgroups;
18 and 30 month follow-ups

Variable                       Outcome
Intrinsic satisfaction         Increase
Extrinsic satisfaction         Increase short-term
Job motivation                 No effect
Org. commitment                No effect
Mental health                  No effect
Performance                    No effect
Turnover                       Increase
Disciplinary dismissals        Increase

                          35
Cordery et al (1993):
Manufacturing;
Autonomous workgroups; 12 month follow-up

Variable                         Outcome
Intrinsic satisfaction           Increase
Extrinsic satisfaction           Increase short-term
Org. commitment                  Increase
Trust in management              Increase
Absenteeism                      Increase
Turnover                         Increase




                         36
Griffin (1991);
Bank tellers; increase responsibility and authority,
24 and 48 month follow-ups

Variable                      Outcome
Satisfaction                  Increase short-term
Org. commitment               Increase short-term
Performance                   Increase
Absenteeism                   No effect
Propensity to quit            No effect


                     37
First example
(but NOT a systematic review)
All showed exactly same pattern of results
 •  Some things get better
 •  Some things get worse
 •  Some stayed the same
How can it be generally claimed that primary
 interventions are effective?
Where or what is the evidence for this widely-
 made claim?



                    38
Review of existing supporting scientific
knowledge to underpin standards of good
practice for key work-related stressors –
Phase 1


Full text available from:
http://www.hse.gov.uk/research/rrpdf/
rr024.pdf
                39
Context

Health and Safety Executive similar to
 NIOSH responsible for guidelines,
 checking adherence to legislation,
 factory inspections, research
Wanted to develop management standards
 for ‘stress’
Under pressure to do something

             40
The Work Characteristics for
Review
Workload               Proactive support
Work scheduling        Reactive Support
Work design            Conflict at the individual
Physical environment     and/or team level
Skill discretion         (bullying and/or
                         harassment)
Decision authority



                41
The Review Questions

What proportions of the population are exposed
 to harmful levels of each of the nine stressors?
What are the effects of the nine stressors on
 health, well-being and performance?
What are the mechanisms by which stressors
 have these effects?
What organisational activities reduce stress?


                  42
Four review questions
                                         (A) What          (B) What are the      (C) What are the     (D) What
                                         proportions of    effects of the nine   mechanisms           organisational
                                         the population    stressors on          through which        activities reduce
                                         are exposed to    health, well-being    stressors have       the levels of each
                                         harmful levels    and organisational    effects on health,   of the nine
                                         of each of the    performance?          well-being and       stressors and
                                         nine stressors?                         organisational       what are the
                                                                                 performance?         subsequent effects
                                                                                                      on health, well-
                                                                                                      being and
                                                                                                      organisational
                                                                                                      performance?

Nine stressors
1) Poorly designed/managed workload
2) Poorly designed/managed work
scheduling
3) Poorly designed/managed work design
4) Poorly designed/managed physical
environment


                                          43
44

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Systematic Reviews and Research Synthesis, Part 1

  • 1. Systematic Review and Research Synthesis 252 10:15AM to 1:15PM Organizers: David Denyer, Cranfield U.; Rob B. Briner, U. of London Primary Sponsor: Research Methods
  • 2. Agenda •  Evidence-based management (EBMgt) •  Systematic review •  Examples of systematic reviews •  Research synthesis •  Disseminating using syntheses
  • 4. The aims of the PDW are as follows: 1.  To demonstrate how to produce a systematic review and research synthesis in a fragmented field, like management research, that is pluralistic in both theory and method. 2.  To model appropriate systematic review processes for management and organization studies and criteria for choosing among alternatives 3.  To present different approaches to research syntheses including aggregative, interpretative, explanatory and integrative approaches. 4.  To show how systematic reviews and research syntheses can inform research, policy and practice. 5.  To present ways in which systematic reviews and research syntheses can be disseminated through web-based technologies.
  • 6. WHAT IS EVIDENCE BASED MANAGEMENT? © CELL - Cranfield School of Management
  • 7. THE DEVELOPMENT OF EBMgt Some basic assumptions: •  Research produced by management scholars could be useful to organizations •  Drawing on available evidence (including research produced by academics) is likely to improve decisions •  Organizations do not appear to be strongly aware of nor use research findings •  EBMgt is a potentially useful way of thinking about how we summarize research evidence and incorporate it (along with other things) into decision-making 7
  • 8. THE DEVELOPMENT OF EBMgt Almost every Academy of Management presidential address for the past 20 years has focused on this issue •  Hambrick - What if the Academy actually mattered? •  Huff - Mode1/2 knowledge production •  Van de Ven - Co-production of knowledge, engaged scholarship •  Bartunek - Collaborative research •  Pearce - What do we know and how do we really know it? •  Rousseau - Evidence-based Management 8
  • 9. THE DEVELOPMENT OF EBMgt Evidence-based management (EBMgt) draws on but is not the same as evidence-based medicine (more later) EB Medicine is “integrating individual clinical expertise with the best available external…evidence from systematic research” in decision-making Not about acting only on the basis of good evidence but rather about combining: What the practitioner already knows from their previous training, experience and current understanding of the particular context/problem WITH The best available external evidence about the issues they are dealing with 9
  • 10. THE DEVELOPMENT OF EBMgt “Evidence-based management is about making decisions through the conscientious, explicit, and judicious use of four sources of information: practitioner expertise and judgment, evidence from the local context, a critical evaluation of the best available research evidence, and the perspectives of those people who might be affected by the decision.” (Briner, Denyer, Rousseau, 2009) 10
  • 11. THE DEVELOPMENT OF EBMgt (See Briner, Denyer and Rousseau, AMP 2009) 11
  • 12. SYSTEMATIC REVIEW © CELL - Cranfield School of Management
  • 13. LITERATURE REVIEWS IN MANAGEMENT How many here have had training in reviewing literature? Are we really “standing on the shoulders of giants”? Do you recognize these sort of unqualified statements? •  “Previous studies have shown that…” •  “It has been demonstrated that…” But how many studies? Demonstrated how? Did other studies find something else? Very few systematic reviews in management 13
  • 15. WHAT QUALITIES SHOULD LITERATURE REVIEWS HAVE? Comprehensive? Focused? Reader-friendly? Exploratory? Informative? Inclusive? (of different types Balanced? of evidence) Insightful? Transparent? Critical? Accurately referenced? Rigorous? Objective? Accessible? Replicable? User led? Interesting? Up-to-date? Standardized? 15
  • 16. WHAT IS A SYSTEMATIC REVIEW? It’s research on existing research With a clear, explicit and replicable methodology •  Clear review question •  Search strategy •  Quality criteria Allows us to draw reliable conclusions about what we know and do not know about a given question or problem 16
  • 17. Evidence-based SYSTEMATIC practice process REVIEW 1.  problem formulation; 2.  locating Practice- studies; What do Informs Existing research we practice relevant studies 3.  study know? selection Informs question What we future and evaluation; do not research know? questions 4.  analysis and synthesis; 5.  reporting of the results
  • 18. THE QUESTIONS SRs ANSWER For any given specific problem: What do we know? What do we not know? What are we not sure about? How do we know we know or don’t know or are not sure that…? What is the basis for our claims? (e.g., How much evidence? What quality?) 18
  • 19. WHAT SORT OF QUESTIONS CAN BE ADDRESSED IN A SR? Each would require much more specificity Does team-building work? Can you improve emotional intelligence? Do increases in EI lead to performance improvements? Does management development improve the performance of managers? Does employee engagement predict organizational performance? Is 360 degree feedback effective? Can potentially great leaders be identified? Is coaching effective? 19
  • 20. Does team-building work? How would you make this question more specific?
  • 21. WHAT SORT OF QUESTIONS CAN BE ADDRESSED IN A SR? Does team-building work? • What is meant by ‘team’? And what is not included as a ‘team’? • What kind of teams? • In which particular contexts or settings? • What is ‘team building’? And what is not ‘team building’? • What does ‘work’ mean? • ‘Work’ compared to any other team intervention? No intervention? • What outcomes are relevant? • What are the mechanisms, processes and theory which might account for possible effects of team building on outcomes? • What time periods are relevant for observing any possible effects? • What about possible negative effects or harm? • What types of data from what sorts of designs would in principle provide good quality, medium quality and poor quality evidence? 21
  • 22. IDENTIFYING A TOPIC AND SPECIFIC REVIEW QUESTIONS What general area or topic do you want to focus on? Why? What specific review question will you address? Is it specific enough? Where is this question from? Why is it important or interesting? Who is the review for? Practitioners? Researchers? Both? What type of SR do you want to do? What about a Rapid Evidence Assessment (REA)? 22
  • 23. MAKING DECISIONS ABOUT SEARCH STRATEGY What sources of evidence? What sources will you include or exclude and why? How iterative can you be? •  Test the question doing some simple searches •  Does the question work? •  Does the search strategy work? 23
  • 24. Once a body of evidence has been collated…. How relevant is this to what we are seeking to understand or decide? How representative is this of the population that concerns us? How reliable, how well-founded theoretically, empirically is it? ‘These are tough but necessary tests for evidence based policy and practice’ Solesbury 2004
  • 26. TYPES OF LITERATURE REVIEW Explicit systematic: Explicit use of rigorous method - can vary as least as much as the range of methods in primary research Implicit systematic: rigorous method but not stated False systematic: described as systematic but with little evidence of explicit rigorous method Argument/thematic: a review that aims to explore and usually support a particular argument or theme with no pretension to use an explicit rigorous method (though thematic reviews can be systematic) Expert or ad hoc review: informed by the skill and experience of the reviewer but no clear method so open to hidden bias. Rapid evidence assessment: a rapid review that may or may not be rigorous and systematic. If it is systematic then in order to be rapid it is likely to be limited in some explicit aspect of scope. (Gough 2007) 26
  • 27. SRs IN MANAGEMENT Keupp & The Past and the Future of Journal of Gassmann International Management (2009) Entrepreneurship: A Review and Suggestions for Developing the Field Walker A systematic review of the Corporate (2010) corporate reputation Reputation Review literature: Definition, measurement, and theory Joyce, Flexible working conditions Cochrane Database Pabayo, and their effects on of Systematic Critchley & employee health and Reviews Bambara wellbeing (2010) 27
  • 28. Flexible working conditions and their effects on employee health and wellbeing (Joyce et al, 2010) Background: Flexible working conditions are increasingly popular in developed countries but the effects on employee health and wellbeing are largely unknown. Objectives: To evaluate the effects (benefits and harms) of flexible working interventions on the physical, mental and general health and wellbeing of employees and their families. Search strategy: Our searches (July 2009) covered 12 databases including the Cochrane Public Health Group Specialized Register, CENTRAL; MEDLINE; EMBASE; CINAHL; PsycINFO; Social Science Citation Index; ASSIA; IBSS; Sociological Abstracts; and ABI/Inform. We also searched relevant websites, hand searched key journals, searched bibliographies and contacted study authors and key experts. 28
  • 29. Flexible working conditions and their effects on employee health and wellbeing (Joyce et al, 2010) Selection criteria: Randomized controlled trials (RCT), interrupted time series and controlled before and after studies (CBA), which examined the effects of flexible working interventions on employee health and wellbeing. We excluded studies assessing outcomes for less than six months and extracted outcomes relating to physical, mental and general health/ill health measured using a validated instrument. We also extracted secondary outcomes (including sickness absence, health service usage, behavioral changes, accidents, work-life balance, quality of life, health and wellbeing of children, family members and co-workers) if reported alongside at least one primary outcome. Data collection and analysis: Two experienced review authors conducted data extraction and quality appraisal. We undertook a narrative synthesis as there was substantial heterogeneity between studies. 29
  • 30. Flexible working conditions and their effects on employee health and wellbeing (Joyce et al, 2010) Main results: Ten studies fulfilled the inclusion criteria. Six CBA studies reported on interventions relating to temporal flexibility: self-scheduling of shift work (n = 4), flexitime (n = 1) and overtime (n = 1). The remaining four CBA studies evaluated a form of contractual flexibility: partial/gradual retirement (n = 2), involuntary part-time work (n = 1) and fixed-term contract (n = 1). The studies retrieved had a number of methodological limitations including short follow-up periods, risk of selection bias and reliance on largely self-reported outcome data. Four CBA studies on self- scheduling of shifts and one CBA study on gradual/partial retirement reported statistically significant improvements in either primary outcomes (including systolic blood pressure and heart rate; tiredness; mental health, sleep duration, sleep quality and alertness; self-rated health status) or secondary health outcomes (co-workers social support and sense of community) and no ill health effects were reported. Flexitime was shown not to have significant effects on self-reported physiological and psychological health outcomes. Similarly, when comparing individuals working overtime with those who did not the odds of ill health effects were not significantly higher in the intervention group at follow up. The effects of contractual flexibility on self-reported health (with the exception of gradual/partial retirement, which when controlled by employees improved health outcomes) were either equivocal or negative. No studies differentiated results by socio-economic status, although one study did compare findings by gender but found no differential effect on self- reported health outcomes. 30
  • 31. Flexible working conditions and their effects on employee health and wellbeing (Joyce et al, 2010) Authors’ conclusions: The findings of this review tentatively suggest that flexible working interventions that increase worker control and choice (such as self scheduling or gradual/partial retirement) are likely to have a positive effect on health outcomes. In contrast, interventions that were motivated or dictated by organizational interests, such as fixed-term contract and involuntary part-time employment, found equivocal or negative health effects. Given the partial and methodologically limited evidence base these findings should be interpreted with caution. Moreover, well- designed intervention studies are needed to delineate the impact of flexible working conditions on health, wellbeing and health inequalities. 31
  • 32. PART 3: EXAMPLE OF AN SR First example: Not really a systematic review Second example: Large systematic review conducted for UK’s Health & Safety Executive 32
  • 33. First example (but NOT a systematic review) Stress interventions •  Primary (reduce presence of ‘stressors’) •  Secondary (preventative - training) •  Tertiary (treating harmed individuals) For decades virtually all writers claimed primary interventions are effective Similar claims at the start of many papers: •  It has been shown that… •  It is well-established that… •  Previous research has demonstrated that… •  There is mixed evidence that… •  All meaningless without systematic reviews 33
  • 34. First example (but NOT a systematic review) Reviewed 12 job redesign studies (Briner & Reynolds, 1999) Most designed to increase autonomy 34
  • 35. Wall et al (1986): Manufacturing; autonomous workgroups; 18 and 30 month follow-ups Variable Outcome Intrinsic satisfaction Increase Extrinsic satisfaction Increase short-term Job motivation No effect Org. commitment No effect Mental health No effect Performance No effect Turnover Increase Disciplinary dismissals Increase 35
  • 36. Cordery et al (1993): Manufacturing; Autonomous workgroups; 12 month follow-up Variable Outcome Intrinsic satisfaction Increase Extrinsic satisfaction Increase short-term Org. commitment Increase Trust in management Increase Absenteeism Increase Turnover Increase 36
  • 37. Griffin (1991); Bank tellers; increase responsibility and authority, 24 and 48 month follow-ups Variable Outcome Satisfaction Increase short-term Org. commitment Increase short-term Performance Increase Absenteeism No effect Propensity to quit No effect 37
  • 38. First example (but NOT a systematic review) All showed exactly same pattern of results •  Some things get better •  Some things get worse •  Some stayed the same How can it be generally claimed that primary interventions are effective? Where or what is the evidence for this widely- made claim? 38
  • 39. Review of existing supporting scientific knowledge to underpin standards of good practice for key work-related stressors – Phase 1 Full text available from: http://www.hse.gov.uk/research/rrpdf/ rr024.pdf 39
  • 40. Context Health and Safety Executive similar to NIOSH responsible for guidelines, checking adherence to legislation, factory inspections, research Wanted to develop management standards for ‘stress’ Under pressure to do something 40
  • 41. The Work Characteristics for Review Workload Proactive support Work scheduling Reactive Support Work design Conflict at the individual Physical environment and/or team level Skill discretion (bullying and/or harassment) Decision authority 41
  • 42. The Review Questions What proportions of the population are exposed to harmful levels of each of the nine stressors? What are the effects of the nine stressors on health, well-being and performance? What are the mechanisms by which stressors have these effects? What organisational activities reduce stress? 42
  • 43. Four review questions (A) What (B) What are the (C) What are the (D) What proportions of effects of the nine mechanisms organisational the population stressors on through which activities reduce are exposed to health, well-being stressors have the levels of each harmful levels and organisational effects on health, of the nine of each of the performance? well-being and stressors and nine stressors? organisational what are the performance? subsequent effects on health, well- being and organisational performance? Nine stressors 1) Poorly designed/managed workload 2) Poorly designed/managed work scheduling 3) Poorly designed/managed work design 4) Poorly designed/managed physical environment 43
  • 44. 44