Workplace restructurings in intervention studies – a challenge for design, analysis and interpretation

A case study approach is used to describe naturally occurring organizational changes in four, large, Nordic intervention projects that ran 3–5 years, covered 3–52 worksites, cost 0.25 mill–2.2 mill €, and involved 3–7 researchers.In all four cases, high rates of closing, merging, moving, downsizing or restructuring was observed, and in all four cases at least one company/worksite experienced two or more re-organizations during the project period. If individual worksites remained, ownership or (for publicly owned) administrative or legal base often shifted. Forthcoming closure led employees and managers to seek employment at other worksites participating in the studies. Key employees involved in the intervention process often changed.Major changes were the rule rather than the exception. Frequent fundamental changes at worksites need to be taken into account when planning intervention studies and raises serious questions concerning design, analyses and interpretation of results. The frequent changes may also have deleterious implications for the potential effectiveness of many real life interventions directed toward worksites. We urge researchers and editors to prioritize this subject in order to improve the quality of future intervention research and preventive action.There is an urgent need for studies that look at the feasibility and effectiveness of interventions at the workplace [1]. Psychosocial and organizational circumstances have been identified as risk factors for lack of wellbeing, poor health, sickness absence and early retirement. Contrary to traditional risk factors these risk factors characterize the workplace rather than the individual employees. Interventions must thus be targeted toward the workplace rather than the individual. Similarly, intervention studies must be designed so that the workplaces are the units of intervention (and control) and also the units of statistical analysis. This will create new challenges for design and analysis of interv