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Participatory Intervention for Workplace Improvements on Mental Health and Job Performance Among Blue-Collar Workers: A Cluster Randomized Controlled Trial

Tsutsumi, Akizumi MD; Nagami, Makiko MA; Yoshikawa, Toru MD; Kogi, Kazutaka MD; Kawakami, Norito MD

Journal of Occupational and Environmental Medicine: May 2009 - Volume 51 - Issue 5 - p 554-563
doi: 10.1097/JOM.0b013e3181a24d28
Original Articles

Objective: To explore the effect of participatory intervention for workplace improvement on mental health and job performance.

Methods: Eleven assembly lines were randomly allocated to six intervention and five control lines (47 and 50 workers, respectively). The primary outcome was defined as the improvement in the following measures during the intervention period: General Health Questionnaire and WHO Health and Work Performance Questionnaire.

Results: General Health Questionnaire scores significantly deteriorated in the control lines, whereas the score remained at the same level in the intervention lines. Health and Work Performance Questionnaire scores increased in the intervention lines, but decreased in the control lines, yielding a significant intervention effect (P = 0.048).

Conclusion: It is suggested that the participatory intervention for workplace improvement is effective against deterioration in mental health and for improving job performance.

From the Occupational Health Training Center (Dr Tsutsumi), University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu; Department of Clinical Psychology (Mr Nagami), Kansai University of Welfare Sciences, Kashiwara, Osaka; Department of Research (Dr Yoshikawa, Dr Kogi), The Institute for Science of Labour, Miyamae-ku, Kawasaki; and Department of Mental Health (Dr Kawakami), University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.

CME Available for this Article at

Akizumi Tsutsumi and coauthors have no commercial interest related to this research.

Address correspondence to: Akizumi Tsutsumi, Occupational Health Training Center, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan; E-mail:

©2009The American College of Occupational and Environmental Medicine