Job stress interventions and the organization of work.

Interventions that aim at improving health by changing the organization of work-in terms of task characteristics, work conditions, and social aspects-have shown their potential, but results are mixed, and many studies do not use their methodological potential. It is proposed that interventions at the organizational level are likely to have a more diverse effect than at the individual level, as the number of subsystems, with potentially diverging interests, is larger. Even well-implemented interventions are not likely to lead to improvements in all parameters for all participants, and trade-offs have to be considered. Methodological improvement is necessary but should not only focus on design issues, but also on careful documentation and subgroup analyses. A combination of person-focused and organization-focused approaches is the most promising. Finally, evidence points to the limited utility of economic arguments for the acceptance of health promotion projects; the necessity of professional trust is therefore emphasized.