Human resource management training of supervisors for improving health and well‐being of employees Edited (no change to conclusions)

Abstract

Abstract Background

Many workers suffer from work‐related stress and are at increased risk of work‐related cardiovascular, musculoskeletal, or mental disorders. In the European Union the prevalence of work‐related stress was estimated at about 22%. There is consensus that stress, absenteeism, and well‐being of employees can be influenced by leadership behaviour. Existing reviews predominantly included cross‐sectional and non‐experimental studies, which have limited informative value in deducing causal relationships between leadership interventions and health outcomes.

Objectives

To assess the effect of four types of human resource management (HRM) training for supervisors on employees' psychomental stress, absenteeism, and well‐being. We included training aimed at improving supervisor‐employee interaction, either off‐the‐job or on‐the‐job training, and training aimed at improving supervisors' capability of designing the work environment, either off‐the‐job or on‐the‐job training.

Search methods

In May 2019 we searched CENTRAL, MEDLINE, four other databases, and most relevant trials registers (ICTRP, TroPHI, ClinicalTrials.gov). We did not impose any language restrictions on the searches.

Selection criteria

We included randomised controlled trials (RCT), cluster‐randomised controlled trials (cRCT), and controlled before‐after studies (CBA) with at least two intervention and control sites, which examined the effects of supervisor training on psychomental stress, absenteeism, and well‐being of employees within natural settings of organisations by means of validated measures.

Data collection and analysis

At least two authors independently screened abstracts and full texts, extracted data and assessed the risk of bias of included studies. We analysed study data from intervention and control groups with respect to different comparisons, outcomes, follow‐up time, study designs, and intervention types. We pooled study results by use of standardised mean differences (SMD) with 95% confidence intervals when possible. We assessed the quality of evidence for each outcome using the GRADE approach.

Main results

We included 25 studies of which 4 are awaiting assessment. The 21 studies that could be analysed were 1 RCT, 14 cRCTs and 6 CBAs with a total of at least 3479 employees in intervention and control groups. We judged 12 studies to have an unclear risk of bias and the remaining nine studies to have a high risk of bias. Sixteen studies focused on improving supervisor‐employee interaction, whereas five studies aimed at improving the design of working environments by means of supervisor training.

Training versus no intervention

We found very low‐quality evidence that supervisor training does not reduce employees' stress levels (6 studies) or absenteeism (1 study) when compared to no intervention, regardless of intervention type or follow‐up. We found inconsistent, very low‐quality evidence that supervisor training aimed at employee interaction may (2 studies) or may not (7 studies) improve employees' well‐being when compared to no intervention. Effects from two studies were not estimable due to missing data.

Training versus placebo

We found moderate‐quality evidence (2 studies) that supervisor training off the job aimed at employee interaction does not reduce employees' stress levels more than a placebo training at mid‐term follow‐up. We found low‐quality evidence in one study that supervisor training on the job aimed at employee interaction does not reduce employees' absenteeism more than placebo training at long‐term follow‐up. Effects from one study were not estimable due to insufficient data.

Training versus other training

One study compared the effects of supervisor training off the job aimed at employee interaction on employees' stress levels to training off the job aimed at working conditions at long‐term follow‐up but due to insufficient data, effects were not estimable.

Authors' conclusions

Based on a small and heterogeneous sample of controlled intervention studies and in contrast to prevailing consensus that supervisor behaviour influences employees' health and well‐being, we found inconsistent evidence that supervisor training may or may not improve employees' well‐being when compared to no intervention. For all other types of interventions and outcomes, there was no evidence of a considerable effect. However, due to the very low‐ to moderate‐quality of the evidence base, clear conclusions are currently unwarranted. Well‐designed studies are needed to clarify effects of supervisor training on employees' stress, absenteeism, and well‐being.

Author(s)

Andreas Kuehnl, Christian Seubert, Eva Rehfuess, Erik von Elm, Dennis Nowak, Jürgen Glaser

Abstract

Plain language summary

Effects of training supervisors on employees' stress, absenteeism, and well‐being

Background

Supervisors are assumed to play a crucial role in creating the working conditions of their employees and thus promoting their health and well‐being. Training programmes are widely used to improve supervisors' skills in improving health and well‐being of their employees.

Review question

We examined the effects of four types of training for supervisors on employees' stress, absenteeism, and mental well‐being. We assessed the effects of training aiming to improve interaction between supervisors and employees, either off‐the‐job or on‐the‐job.We also assessed training aimed at improving supervisors' capabilities to design the work environment, either off‐the‐job or on‐the‐job.

Study characteristics

We included 25 studies of which 4 studies are awaiting assessment. The 21 studies that could be analysed included a total of 3479 employees. Sixteen studies trained supervisor‐employee interaction, either off‐the‐job (9 studies) or on‐the job (7 studies). Five studies trained the design of working environments, off‐the‐job in 2 studies and on‐the job in 3 studies. The 21 studies compared 23 interventions with no training, sham training or other training at various times of follow‐up.

Key results

There is no considerable effect of supervisor training on employees' stress (6 studies) or absenteeism (1 study) when compared to no training. There is inconsistent evidence that supervisor training may (2 studies) or may not (7 studies) improve employees' well‐being when compared to no training. Data were missing from two studies, so we could not calculate the effects of training on employee well‐being.

There is no effect of supervisor training on employees' stress (2 studies) or absenteeism (1 study) when compared to a placebo training. Data were missing from one study, so we could not calculate the effects of training on employee well‐being.

One study that evaluated supervisor training compared to another type of training to reduce employees' stress did not provide enough data to calculate its effects.

Quality of the evidence

The quality of the evidence was very low for most outcomes due to risk of bias in the studies, inconsistent results, and imprecise effects. Researchers should consider the shortcomings of studies included in this review in order to conduct well‐designed studies in the future and report them appropriately.

Conclusions

Overall, the data suggest that training of supervisors may not lead to reduced levels of stress and absenteeism, or improved levels of well‐being in their employees. The discrepancy between the apparent scientific consensus and the empirical evidence might be attributed to weak study designs.High quality studies are needed to clarify if supervisor training affects employees' stress, absenteeism, and well‐being.

Author(s)

Andreas Kuehnl, Christian Seubert, Eva Rehfuess, Erik von Elm, Dennis Nowak, Jürgen Glaser

Reviewer's Conclusions

Authors' conclusions

Implications for practice

The results of our systematic review do not support the utility of leadership interventions to have a beneficial impact on employees' stress, absenteeism, and well‐being. However, HR managers might use the evidence base of studies in this review to generate ideas on suitable leadership interventions in terms of training content, designs, and processes, as well as the possibility of evaluating potential effects of planned interventions with established measures. They should be aware of the methodological shortcomings in evaluative research in organisations and should strive to collaborate with researchers in order to improve the evidence base in this field. By applying evidence‐based management practices (Rousseau 2012) to supervisor training interventions instead of merely copying existing approaches currently practised in organisations, professionals may contribute to both uncovering the effects of particular supervisor interventions and gaining knowledge about how to design effective interventions to strengthen employee health and well‐being.

Implications for research

In this systematic review, we focused on the general population of employees working in organisations and changes in their perceptions of stress, absenteeism and well‐being as a result of their supervisors receiving training in interaction with employees or in work‐design. While the small number of studies currently does not allow for analyses that compare interventions across different industries, differences across industries (e.g., in the degree of supervisors' influence or in the relevance of certain outcomes) are nevertheless plausible. It is therefore important that future studies report industries and/or occupations targeted by the interventions as accurate as possible.

So far, the overall very low‐quality evidence from the included studies does not offer clear guidance for the design of neither the content of interventions (improving dyadic interaction between supervisors and employees versus improving capabilities of the supervisor to adapt the work environment in a beneficial way), nor the setting of interventions (off‐ versus on‐the‐job). For this reason, we invite researchers conducting intervention studies in the future to define leadership behaviour more clearly and to describe leadership interventions as well as organisational settings more precisely. Reporting on leadership interventions should be improved, such that content as well as procedures are documented more comprehensively. It is of utmost importance that the rationale of how interventions are thought to translate into outcomes is clarified early on. Currently, the complex system of a specific organisational setting in which an intervention takes place seems to be reduced to its in‐ and outputs without considering internal processes (i.e., a 'black box') in many studies. There is a complex path from a training programme being perceived as helpful by a supervisor, to the ability and opportunity to transfer new skills into changes in daily work settings, to employees noticing and responding to these changes, and also, eventually, to measurable changes in psychomental health and organisational performance. Therefore, we encourage researchers to analyse the process from the delivery of a supervisor intervention to observable effects in employees' health and well‐being at multiple levels (Sitzmann 2019), both as a form of manipulation check and to obtain information about the transmission process. In the light of scarce evidence for effective supervisor training to affect employees, it might prove fruitful to first investigate in detail the determinants of a successful transmission process and their interrelations before expending resources on actual training. Furthermore, interventions that were reported to be effective may be taken as preliminary model interventions for future research. However, the multitude of parameters that may potentially affect typical field intervention studies currently impedes clear evidence‐based recommendations grounded in the scarce and diverse information contained in available study reports.

Regarding comparisons, most studies contrasted supervisor training with no intervention. More rigorous designs that compared supervisor training to a placebo or even other training were a minority among the included studies. There is an obvious need for more research, with higher methodological standards, on the effectiveness of leadership interventions on employee health and well‐being. Future studies should aim to establish stronger, experimental (RCT, cRCT) or at least quasi‐experimental designs with comparison groups receiving a placebo or other training in order to improve the very limited and scarce evidence base. In conducting controlled intervention studies, researchers should be aware of the various risks of bias, for example, with respect to allocation of participants to intervention groups, appropriate statistical analysis, selective reporting of findings, or insufficient protection of studies against contamination. Moreover, important statistical information was lacking in a number of studies, which made it difficult or impossible to compare results between studies directly. Therefore, we encourage researchers to report complete and accurate information on statistical procedures and results by adhering to current reporting standards (e.g. Appelbaum 2018).

While outcomes of interest were classified in three broad domains (psychomental stress, absenteeism and well‐being), there was great diversity within these domains. The outcomes investigated most frequently were job satisfaction as an indicator of well‐being and burnout as an indicator of stress. Both outcomes for absenteeism were also diverse in terms of unit (duration vs. frequency) and reference timeframe (6 vs. 12 months). The use of standardised and validated outcome measures for well‐being, stress and absenteeism could facilitate future synthesis of evidence. More differentiated implications for research regarding extended PICO aspects like time (training duration, follow‐up intervals) or settings (e.g., training on‐ versus off‐the‐job) cannot be inferred due to the restricted number and quality of evidence of previous studies.

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