Table 1. Studies included sorted firstly by intervention type and secondly by publication year.
| Study (ref #) | Type of intervention | Included in Meta-analysis | Targeted to symptomatic or high stressed participants? | Participants | Intervention, Duration + (n) | Control, n | Outcome(s) + Measure(s) | Baseline score (m,SD,n) | Post-intervention (from baseline) | Results—Post-intervention (m,SD,n) | Follow-up (from baseline) | Results—Follow-up (m,SD,n) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CBT based intervention | ||||||||||||
| Grime. (2004) (32)* | CBT | Yes | Yes | London, Occupational Health department. employees with >10 days sick leave in the past 6 months due to mental illness (n = 48) | ‘Beating the Blues’ a computerised CBT program for Depression and anxiety, 8 online sessions which last approximately an hour per week (n = 24) | WLC (n = 24) | Primary: Anxiety & Depression (HADS) | Intervention: Depression (7.96,3.43,24) Anxiety (11.75,3.87,24) Control: Depression (10.63,4.13,24) Anxiety (14.04,4.34,24) |
2 months | Depression Intervention (5.38, 3.93, 16) Control (8.61,3.86,23) Anxiety Intervention (10.13, 4.65,14) Control (12.00,4.31,23) |
3 months | Depression Intervention (5.00,4.12,13) Control (7.32,5.08,19) Anxiety Intervention (8.69,3.50,13) Control (9.47,5.26,19) |
| 6 months | Depression Intervention (5.07,4.57,14) Control (6.21,4.22,19) Anxiety Intervention (8.86,4.35,14) Control (9.16,4.37,19) |
|||||||||||
| Shimazu. et al. (2005) (45)* | CBT | Yes | No | Japan, any employee company wide in a construction machinery company (n = 225) | One-month web-based psycho-education based on social cognitive theory. Self-based program, 3 phases (5 chapters), (n = 112) | WLC (n = 113) | Primary: Stress (BJSQ) | Intervention: Stress (36.80,9.88,112) Control: Stress (38.30,9.39,113) |
5 weeks | Stress Intervention (35.70,5.68,105) Control (37.60,6.76,107) |
nil | not measured |
| Hasson. et al. (2005) (35)* ^ | CBT | Yes | No | Sweden, IT and media companies general employees (n = 317) | 12 month open access. Web-based self-help exercises—developed specifically for this study. Uses CBT techniques (n = 129) | WLC + info (n = 174) | Primary: Stress: (VAS) | Not reported | 12 months | Not reported | nil | not measured |
| Billings. et al (2008) # | CBT | Yes | No | USA, employees from a technology company on a health and activity promotion program (n = 309) | 3 month web-based. Participants could review sections more than once. Uses CBT—website is tailored around baseline answers for each participant depending on risks and needs (n = 154). | WLC (n = 155) | Primary: Stress: (symptoms of distress scale) Depression: (CES-D) Anxiety: (BAI) | Intervention: Stress (17.52,4.53,154) Depression (33.77,13.46,115) Anxiety (28.87,7.82,154) Control: Stress (16.81,3.78,155) Depression (32.15,10.08,155) Anxiety (27.98,7.43,155) |
3 months | Stress Intervention (16.03,4.18,113) Control (16.50,4.35,132) Depression Intervention (31.60,13.33,113) Control (31.57,10.56,132) Anxiety Intervention (27.54,7.53,113) Control (27.30,6.19,132) |
nil | not measured |
| Lappalainen. et al. (2013) (46) * ^ | CBT | Yes | Yes | Finland, males aged 28-58yrs with exhaustion, stress symptoms, or sleeping problems (n = 23) | ‘P4Well′, 3 month novel CBT intervention Delivered via multiple channels, including 3 group meetings, Internet/Web portal, mobile phone applications, and personal monitoring devices. (n = 11) | WLC (n = 12) | Primary: Depression–(BDI 21-item) | Intervention: Depression (14.64,7.61,11) Control: Depression (13.33,9.24,12) |
3 months | Depression Intervention (6.20,3.30,11) Control (9.30,7.10,12) |
6 months | Depression Intervention (6.20,3.30,11) Control not measured |
| Boiler. et al. (2014) (47)* ^ | CBT | Yes | No | Netherland, Nurses and allied health professionals general employees (n = 423) | Based on screening results participants were offered a tailored web-based interventions ranging from 4 to 8 weeks (n = 212) | WLC (n = 211) | Primary: Depression (BSI), Secondary: Anxiety (BSI) | Intervention: Depression (0.31,0.32,212) Anxiety (0.21,0.24,212) Control: Depression (0.30,0.35,212) Anxiety (0.25,0.32,211) |
3 months | Depression Intervention (0.24,0.32,143) Control (0.26,0.35,82) Anxiety Intervention (0.16,0.24,143) Control (0.19,0.30,82) |
6 months | Depression Intervention (0.22,0.31,138) Control (0.29,0.35,70) Anxiety Intervention (0.17,0.24,138) Control (0.22,0.32,70) |
| Geraedts. et al. (2014) (two papers 48 & 49)* ^ | CBT | Yes | Yes | Netherland, employees from banking companies with elevated Depression (n = 231) | Web-based guided self-help intervention, called Happy@Work, 6 weekly sessions consisted of problem solving techniques and CBT, complete an assessment each week to move on (n = 116) | WLC (n = 115) | Primary: Depression (CES-D), Secondary: anxiety (HADS) | Intervention: Depression (25.70,7.50,116) Anxiety (10.60,3.80,116) Control: Depression (26.10,7.00,116) Anxiety (10.20,3.20,116) |
2 months | Depression Intervention (15.80,10.60,116) Control (18.30,9.10,115) Anxiety Intervention (7.60,3.80,116) Control (8.30,3.60,115) |
12 months | Depression Intervention (15.70,11.30,116) Control (16.20,10.70,115) Anxiety Intervention (6.80,4.10,116) Control (6.80,4.00,115) |
| Imamura. et al. (2014) & (2015) (two papers 50 & 53) * ^ | CBT | Yes | Yes | Japan, IT employees with no Major Depressive Disorder in last month or treated for mental health problems in last month (n = 762) | 6 week internet-based computerized CBT. 6 lessons, one lesson per week, approx. 30 mins each. Each lesson had homework. Given 10 weeks to complete study in whole (n = 381). | WLC + info (n = 381) | Primary: Depression (BDI-21), Secondary: stress (K6), anxiety (DASS) | Intervention: Stress (5.60,4.60,381) Depression (11.90,8.00,381) Anxiety (88.00,21.50,381) Control: Stress (5.60,4.70,381) Depression (11.80,8.00,381) Anxiety (87.40,20.90,381) |
3 months | Stress Intervention (5.60,4.60,270) Control (5.80,4.70,336) Depression Intervention (10.70,8.60,270) Control (11.70,8.30,336) Anxiety Intervention (87.40,21.70,270) Control (88.50,20.90,336) |
6 months | Stress Intervention (5.70,4.80,272) Control (6.40,5.10,320) Depression Intervention (11.30,9.60,272) Control (12.10,8.70,320) Anxiety Intervention (84.90,23.30,272) Control (87.00,22.80,320) |
| 12 months | Stress Intervention (5.40,4.70,239) Control (5.80,4.70,272) Depression Intervention (11.20,9.40,239) Control (11.60,9.00,272) |
|||||||||||
| Mori. et al. (2014) (51) * ^ | CBT | Yes | No | Japan, IT employees, system engineers with high computer literacy (n = 168) | 4-week intervention with homework. A Web-Based Training Program using CBT. 150 minute group class—participants use web based entries to log daily stresses (n = 85) | WLC (n = 83) | Primary: Psychological distress (K6). | Intervention: Stress (4.70,4.50,85) Control: Stress (4.80,4.50,83) |
1 month | Stress Intervention (4.20,4.90,85) Control (5.00,4.80,83) |
6 months | Stress Intervention (4.60,5.10,85) Control (5.63,5.00,83) |
| Phillips. et al. (2014) (52) * | CBT | Yes | Yes | UK, transport, health and communications sectors who reported issues with difficulty in some tasks at work (n = 637) | 5 week web-based intervention ‘MoodGYM’ five one hour long modules containing CBT skills for preventing and coping with Depression (n = 318) | WLC + info (n = 319) | Primary: Depression (PHQ-9), and (Generalized Anxiety Disorder GAD) | Intervention: Stress (19.90,8.00,318) Depression (14.50,5.40,318) Anxiety (13,50.4.00,318) Control: Stress (20,70.7.00,319) Depression (14.60,5.60,319) Anxiety (13.20,5.00,319) |
6 weeks | Stress Intervention (16.00,9.10,171) Control (16.50,8.60,188) Depression Intervention (9.90,6.10,164) Control (10.20,6.00,176) Anxiety Intervention (9.50,6.00,166) Control (10.20,5.70,181) |
3 months | Stress Intervention (15.00,10.10,102) Control (15.90,8.60,129) Depression Intervention (9.30,6.90,97) Control (10.30,6.90,122) Anxiety Intervention (8.40,6.40,98) Control (10.10,6.50,123) |
| Takechi. et al. (2015) (56) $ | CBT | No, no control group | No | Japan, Manufacturing company, general employees (n = 81) | 10-week single group study, CBT exercise program workbook focusing on dysfunctional thoughts and problem solving, followed by 10 weeks of at home exercises. | nil | Primary: Psychological distress (K6). | Intervention: Stress (4.39,3.70,81) |
10 weeks | Stress Intervention (3.53,2.70,44) |
Nil | not measured |
| Birney. et al. (2016) (61)* | CBT | Yes | Yes | USA, Employees with mild to moderate depressive symptoms (n = 300) | 6 weeks CBT mobile phone app “MoodHacker” (n = 150) | WLC (n = 150) | Primary: Depression (PHQ-9) | Intervention: Depression (13.20,4.30,150) Control: Depression (13.60,3.80,150) |
10 weeks | Depression Intervention (8.80,5.10,130) Control (9.50,5.00,141) |
Nil | not measured |
| Stress Management Interventions | ||||||||||||
| Cook. et al. (2007) (62)* | Stress Mx | Yes | No | USA, human resource employees (n = 419) | Web-based multimedia health promotion program ‘Health Connection’ for the workplace offering guidance on stress management (n = 209) | WLC + info (n = 210) | Primary: Stress | Intervention: Stress (14.21,4.90,209) Control: Stress (15.05,4.60,210) |
3 months | Stress Intervention (13.70,4.90,209) Control (14.30,4.50,210) |
nil | not measured |
| Eisen. et al. (2008) (36)* | Stress Mx | No, face-to-face control group | No | manufacturing company general employees (n = 257) | 2 week online intervention: two sessions online stress management program (n = 123) | completing identical intervention instructor led workshop (n = 134) | Stress: (Occupational Stress inventory, OSI-R) | Intervention: Stress (45.80,14.90,123) Control: Stress (42.90,20.50,134) |
2 weeks | Stress Intervention (38.30,9.30,24) Control (21.70,15.20,75) |
1 month | Stress Intervention (33.30,16.30,15) Control (21.10,14.50,48) |
| Cook. et al. (2015) (34)* | Stress Mx | Yes | No | USA, Employees aged 50–68 years global IT company (n = 278) | ‘HealthyPast50’ is a web-based. Open access for 3 months, 5 modules on stress and mood management, healthy eating, active lifestyle, and smoking (n = 138) | WLC (n = 140) | Primary: Stress (The Ultimate Stress Management, Self-Assessment, and Coping Guide) | Intervention: Stress (3.24,0.50,138) Control: Stress (3.20,0.40,140) |
3 months | Stress Intervention (3.30,0.50,109) Control (3.34,0.50,130) |
nil | not measured |
| Ebert. et al. (2014) (63)* ^ | Stress Mx | Yes | Yes | German, teachers with elevated depressive symptoms currently employed (n = 150) | 6 weeks, 5 lessons, based on problem solving techniques, internet-based problem-solving training (iPST), one lesson per week and practice problem solving skills between each lesson (n = 75) | WLC (n = 75) | Primary: depressive symptoms (CES-D), Secondary: stress (PSQ) | Intervention: Stress (0.66,0.15,75) Depression (22.76,9.20,75) Control: Stress (0.67,0.14,75) Depression (22.80,9.15,75) |
7 weeks | Stress Intervention (0.55,0.20,75) Control (0.62,0.17,75) Depression Intervention (22.81,9.15,75) Control (21.20,8.37,75) |
3 months | Stress Intervention (0.48,0.27,75) Control (0.56,0.25,75) Depression Intervention (15.37,8.40,75) Control (19.87,14.00,75) |
| 6 months | Stress Intervention (0.53,0.20,75) Control (0.60,0.16,75) Depression Intervention (14.53,13.80,75) Control (19.91,10.42,75) |
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| Umanodan. et al. (2014) (64)* | Stress Mx | Yes | No | Japan, general employees in a manufacturing company (n = 266) | 6 week Computer based stress management training (SMT) 6 lessons (one per week)—self paced. 2-phased learning process (n = 142) | WLC (n = 121) | Primary: Stress (BJSQ) | Intervention: Stress (2.00,0.50,142) Control: Stress (2.10,0.56,121) |
9 weeks | Stress Intervention (1.90,0.45,142) Control (2.00,0.55,121) |
19 weeks | Stress Intervention (2.00,0.04,142) Control (2.00,0.55,121) |
| Stansfeld, S., et al. (2015) (65)* ^ | Stress Mx | Yes | No | UK, manager and general employees of the NHS Mental Health Trust (n = 275) | Online health promotion program based around understanding stress through a series of linked topics with case examples. Six fortnightly modules for 3 months (n = 216) | WLC (n = 59) | psychological distress (GHQ-12) | Intervention: Stress (2.80,3.50,216) Control: Stress (3.20,3.40,59) |
3 months | Stress Intervention (2.90,3.50,216) Control (2.90,3.40,59) |
nil | not measured |
| Heber. et al. (2016) (66)* ^ | Stress Mx | Yes | Yes | Germany, mainly recruited by a large health insurance company of highly stressed employees (n = 264) | 7 sessions. 1–2 sessions per week. web-based Internet stress management interventions (iSMI) problem solving, emotion regulation strategies + booster session (n = 132) | WLC (n = 132) | Primary: Stress (PSS). Secondary: Depression (CES-D, HADS) | Intervention: Stress (25.90,3.90,132) Depression (23.34,8.50,132) Anxiety (11.20,3.30,132) Control: Stress (25.15,3.96,132) Depression (23.77,7.60,132) Anxiety (10.70,3.40,132) |
7 weeks | Stress Intervention (17.90,6.17,132) Control (22.90,6.10,132) Depression Intervention (15.60,9.10,132) Control (21.40,8.80,132) Anxiety Intervention (7.80,3.90,132) Control (10.30,3.50,132) |
6 months | Stress Intervention (16.08,6.00,132) Control (22.10,5.80,132) Depression Intervention (13.80,7.70,132) Control (31.50,8.50,132) Anxiety Intervention (6.73,3.40,132) Control (9.65,3.60,132) |
| Mindfulness Based Interventions | ||||||||||||
| Glück. et al. (2011) (67)* | Mindfulness based | Yes | No | Austria, Germany & Switzerland General employees of universities, car dealership, broadcasting station, and health care consulting companies in (n = 50) | web based mindfulness training 13 days two modules each module lasted for 6 days with 20 mins per day (n = 28) | WLC (n = 21) | Primary: Stress (PSQ) | Intervention: Stress (40.06,16.40,28) Control: Stress (35.10,13.40,21) |
2 weeks | Stress Intervention (34.40,15.00,26) Control (34.72,15.35,18) |
3 months | Stress Intervention (27.90,11.20,19) Control group not tested |
| Wolever. et al. (2012) (68)* | Mindfulness based | No, face-to-face control group | Yes | USA, insurance carrier employees with elevated stress levels (n = 96) | 12 week online interventions lasted 1hr per week (n = 52) | In person mindfulness training (n = 44) | Primary: Stress (PSS), Secondary: Depression (CES-D) | Intervention: Stress (24.50,0.50,52) Depression (19.60,1.30,52) Control: Stress (24.85,0.53,44) Depression (20.00,1.40,44) |
3 months | Stress Intervention (14.90,0.80,52) Control (16.94,0.86,44) Depression Intervention (11.10,1.20,52) Control (14.23,1.30,44) |
nil | not measured |
| Ahtinen. et al. (2013) (57)$ | Mindfulness based | No, no control group | No | Finland, general employees from a technology University (n = 15) | 4 week mobile phone app intervention “Oiva” mental wellness training app. With 4 intervention modules to be taken weekly | nil | Primary: Stress (PSS) | Intervention: Stress (3.10,0.20,15) |
1 month | Stress Intervention (2.50,0.10,15) |
nil | not measured |
| Aikens. et al. (2014) (69)* | Mindfulness based | Yes | No | USA, general employees (n = 90) | 7 week web-based online mindfulness training program. 1 hour per week modules (n = 44) | WLC (n = 45) | Primary: Stress (PSS-14) | Intervention: Stress (24.50,6.30,44) Control: Stress (24.80,8.16,45) |
7 weeks | Stress Intervention (18.00,7.00,36) Control (23.30,8.50,42) |
6 months | Stress Intervention (18.80,6.70,31) Control (19.81,7.40,32) |
| Ly. et al. (2014) (70)* | Mindfulness based | Yes | No | Sweden, middle managers or have staff responsibilities in the private sector (n = 73) | 6 week smartphone app mindfulness based. 6 modules one for each week. each module had an audio lecture, text & exercises (n = 36) | WLC (n = 37) | Primary: Stress (PSS-14). | Intervention: Stress (24.30,8.30,36) Control: Stress (24.50,5.90,37) |
6 weeks | Stress Intervention (19.50,7.30,36) Control (23.30,8.00,37) |
nil | not measured |
| Mak. et al. (2015) (58)* | Mindfulness based | Yes | No | China, University staff—general employees (n = 321) | two arm intervention: 8 week online mindfulness training, one lesson per week that took 23–30 (107) | WLC (n = 107) | Primary: Stress (PSS-10), Depression, Anxiety (DASS-21) | Intervention: Stress (1.70,0.60,107) Depression (6.10,6.30,107) Anxiety (6.70,5.20,107) Control: Stress (1.63,0.70,55) Depression (5.47,7.60,55) Anxiety (6.20,8.00,55) |
2 months | Stress Intervention (1.65,0.50,58) Control (1.62,0.70,48) Depression Intervention (5.70,6.80,58) Control (5.60,7.70,48) Anxiety Intervention (6.60,5.40,58) Control (5.70,7.30,48) |
3 months | Stress Intervention (1.70,0.50,44) Control (1.63,0.70,24) Depression Intervention (6.80,7.20,44) Control (5.90,8.12,24) Anxiety Intervention (7.30,6.40,44) Control (5.70,7.60,24) |
| the second group had the identical training plus HAPA (health action process approach) to test enhanced efficacy (n = 107) | Intervention: Stress (1.80,0.60,107) Depression (6.95,7.70,107) Anxiety (7.50,6.60,107) Control: Stress (1.63,0.70,54) Depression (5.47,7.60,54) Anxiety (6.20,8.00,54) |
Stress Intervention (1.70,0.60,58) Control (1.62,0.70,48) Depression Intervention (6.50,7.40,58) Control (5.60,7.70,48) Anxiety Intervention (6.30,6.60,58) Control (5.70,7.30,48) |
Stress Intervention (1.70,0.60,37) Control (1.63,0.70,24) Depression Intervention (6.90,7.70,37) Control (5.90,8.12,24) Anxiety Intervention (6.50,6.60,37) Control (5.70,7.60,24) |
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| Allexandre. et al. (2016) (71)* | Mindfulness based | Yes | No | USA, General employees from a corporate call centre (n = 91) | 8 week web-based educational program based on mindfulness meditation. 1 session per week (n = 54) | WLC (n = 37) | Primary: Stress (PSS-10) | Intervention: Stress (25.60,5.40,54) Control: Stress (25.40,5.70,37) |
2 months | Stress Intervention (19.80,7.60,30) Control (24.00,7.20,25) |
4 months | Stress Intervention (19.40,7.70,27) Control (22.50,7.20,20) |
| Cognitive/Assertion Training Interventions | ||||||||||||
| Abbott. et al. (2009) (59)* | Cognitive training | No, cognitive training | No | Australian Industrial organisation general employees (n = 53) | Internet-based program teaching resilience through cognitive training. 7 core modules (n = 26) | WLC (n = 27) | Primary: Depression, Anxiety, Stress: (DASS-21) | Intervention: Stress (10.70,7.40,26) Depression (5.30,5.10,26) Anxiety (2.30,2.20,26) Control: Stress (7.60,6.90,27) Depression (3.78,5.40,27) Anxiety (2.07,2.80,27) |
10 weeks | Stress Intervention (9.70,6.00,26) Control (1.56,2.40,27) Depression Intervention (4.70,4.90,26) Control (3.70,5.30,27) Anxiety Intervention (2.30,2.20,26) Control (6.30,4.90,27) |
nil | not measured |
| Borness. et al. (2013) (60)* | Cognitive training | No, cognitive training | No | Australian Public Sector general employees (n = 135) | 16 week of online Cognitive Training based around, memory, attention, language, executive function, program is called ‘Spark!’ with three 20 minute sessions per week (n = 67) | active control program (n = 68) general knowledge information | Primary: Stress (JSS, Secondary: Depression, Anxiety, DASS-42) | Intervention: Stress (10.70,6.70,67) Depression (6.20,6.20,67) Anxiety (5.40,5.60,67) Control: Stress (11.00,8.80,68) Depression (7.40,6.80,68) Anxiety (6.60,5.80,68) |
4 months | Stress Intervention (10.90,7.90,58) Control (5.80,8.20,62) Depression Intervention (7.30,6.90,58) Control (6.80,7.60,62) Anxiety Intervention (6.20,7.10,58) Control (6.60,11.50,62) |
nil | not measured |
| Yamagishi. et al. (2007) (54)$ | Assertion training | No, poor quality + no control group | No | Japan, shift nurses (n = 25) | web-based assertion training (70 minutes) ‘Internet navigware’: pre, post & follow-up. Training was accessible for 3 weeks (n = 25) | nil | Primary: Stress, Depression–(JSBQ) | Intervention: Stress (2.21,0.73,25) Depression (38.52,9.31,25) |
3 weeks | Stress Intervention (2.11,0.72,25) Depression Intervention (36.84,8.81,25) |
1 months | Stress Intervention (2.01,0.77,25) Depression Intervention (37.44,10.74,25) |
| Yamagishi. et al. (2008) (55)* | Assertion training | No, poor quality | No | Japanese shift working Nurses (n = 60) | 9 weeks sixty minute web-based training was provided weekly (n = 30) | WLC (n = 30) | Primary: Stress, Anxiety, Depression—JSBQ) | Intervention: Stress (2.54,0.67,30) Depression (1.85,0.70,30) Anxiety (2.18,0.80,30) Control: Stress (2.35,0.80,30) Depression (1.89,0.90,30) Anxiety (2.03,0.80,30) |
5 weeks | Stress Intervention (2.58,0.60,30) Control (2.79,0.80,30) Depression Intervention (1.93,0.70,30) Control (2.04,0.80,30) Anxiety Intervention (2.26,0.70,30) Control (2.33,0.80,30) |
9 weeks | Stress Intervention (2.60,0.70,30) Control (2.67,0.70,30) Depression Intervention (1.71,0.50,30) Control (1.78,0.60,30) Anxiety Intervention (2.00,0.69,30) Control (2.10,0.80,30) |
Key:
* Randomised controlled trial,
# Controlled Trial,
$ Pre-intervention post-intervention,
^ Guided,
Questionnaires used: Hospital Anxiety Depression Scale (HADS), Brief Job Stress Questionnaire (BJSQ), Centre of Epidemiologic Studies Depression scale (CES-D), Beck Anxiety Inventory (BAI), Visual Analogue Scale (VAS), Beck’s Depression Inventory (BDI-21), Brief Symptom Inventory (BSI), Kessler 6 (K6), Depression Anxiety Stress Scales DASS, 21 & 42), Patient Health Questionnaire-9 (PHQ-9), Work and Social Adjustment Scale (WSAS), Perceived Stress Scale (PSS, 10 &14), Patient Satisfaction Questionnaire (PSQ), General Health Questionnaire (GHQ-12), Job satisfaction Survey (JSS), Job Stress Burnout (JSBQ)