These flexible work arrangements can enhance engagement, performance, and retention, and attract the best talent. Albertsen K, Nicholson AC, KailaKangas L, Some companies are even bringing changes to the standard five-day week.. Physical health:experimental measures, blood pressure, heart rate, total cholesterol, HDL, LDL, triglycerides, fasting plasma glucose, glycosylated haemoglobin, C reactive protein, Mainly workerorientated to take account of individual choice and control but some flexibility to address company needs, Excluded due to absence of health outcomes (job satisfaction only), Excluded due to design, no before measures and no primary health outcomes, Excluded as primary health outcomes were not reported using a validated instrument, Excluded, not an intervention study, also outcomes reported retrospectively, Excluded due to design, no before and after measures and no health outcomes, Excluded due to design, no control group or before measures, Excluded, does not qualify as a flexible working intervention according to our inclusion criteria, Excluded due to design, not an intervention study, crosssectional data only, Excluded due to design, retrospective data only, Excluded due to design, not an intervention study, Excluded, no primary health outcomes, considers retention, job satisfaction and organisational outcomes only, Excluded as followup period too short (2 weeks), Excluded due to primary health outcomes not being measured using a validated instrument, Time series design with comparison group but excluded as does not measure primary health outcomes (job and leisure satisfaction only), Excluded as no primary health outcomes (employee attitudes, job satisfaction, impact on work and leisure), Excluded due to no primary health outcomes (accidents only), Excluded, due to design crosssectional data only. And what is the prognosis for workplaces of the future? No significant differences in the interaction between time and group were observed for any of these lifestyle/behavioural changes. 190 ("Small and medium enterprises" or SMEs).ti,ab. Macdonald I, The secondary objectives were a) to compare whether there were any differential effects on physical and mental health and wellbeing in terms of job type, gender, age, ethnicity or socioeconomic status; and b) to examine how flexible working arrangements impact on the social wellbeing and worklife balance of employees and their families. Briggs TE, Katie plans to use her degree in psychology to improve her community and further her work for various non-profits in Riverside County. The authors examined the mental health outcome depression using a validated instrument (Diener 1999; Frey 2002; Perreira 2005; Veenhoven 1991) with a maximum followup period of 12 years. S224S200 or S201 or S202 or S204 or S205 or S206 or S207 or S208 or S209 or S210 or, S212 or S213 or S214 or S215 or S216 or S217 or S218 or S219 or S220 or S221 or, S223TX ((job* or employment) w2 (place* or site* or location* or setting*)), S204 TX "Small and medium enterprises", S203 TX ((company or companies) w5 (work* or employ* or job* or staff or personnel or, S199 (S65 or S66 or S67 or S68 or S69 or S70 or S71 or S72 or S73 or S74 or S75 or S80, or S81 or S82 or S85 or S87 or S88 or S89 or S90 or S91 or S92 or S93 or S94 or, S95 or S96 or S97 or S98 or S99 or S100 or S101 or S102 or S103 or S105 or S106, or S107 or S108 or S109 or S110 or S111 or S112 or S113 or S114 or S115 or S116, or S117 or S121 or S123 or S125 or S126 or S127 or S128 or S129 or S130 or S131, or S135 or S138 or S139 or S140 or S150 or S151 or S155 or S156 or S162 or S162, or S166 or S167 or S168 or S169 or S170 or S171 or S172 or S173 or S174 or S175, or S176 or S178 or S180 or S183 or S184 or S185 or S187 or S188 or S189 or S190, or S191 or S194 or S196 or S198)(S65 or S66 or S67 or S68 or S69 or S70 or S71, or S72 or S73 or S74 or S75 or S80 or S81 or S82 or S85 or S87 or S88 or S89 or, S90 or S91 or S92 or S93 or S94 or S95 or S96 or S97 or S98 or S99 or S100 or, S101 or S102 or S103 or S105 or S106 or S107 or S108 or S109 or S110 or S111 or, S112 or S113 or S114 or S115 or S116 or S117 or S121 or S123 or S125 or S126 or, S127 or S128 or S129 or S130 or S131 or S135 or S138 or S139 or S140 or S150 or, S151 or S155 or S156 or S162 or S162 or S166 or S167 or S168 or S169 or S170 or, S171 or S172 or S173 or S174 or S175 or S176 or S178 or S180 or S183 or S184 or, S185 or S187 or S188 or S189 or S190 or S191 or S194 or S196 or S198)(S65 or, S66 or S67 or S68 or S69 or S70 or S71 or S72 or S73 or S74 or S75 or S80 or S81, or S82 or S85 or S87 or S88 or S89 or S90 or S91 or S92 or S93 or S94 or S95 or, S96 or S97 or S98 or S99 or S100 or S101 or S102 or S103 or S105 or S106 or, S107 or S108 or S109 or S110 or S111 or S112 or S113 or S114 or S115 or S116 or, S117 or S121 or S123 or S125 or S126 or S127 or S128 or S129 or S130 or S131 or, S135 or S138 or S139 or S140 or S150 or S151 or S155 or S156 or S162 or S162 or, S166 or S167 orS168 or S169 or S170 or S171 or S172 or S173 or S174 or S175 or, S176 or S177 or S178 or S179 or S180 or S181 or S182 or S183 or S184 or S185 or, S186 or S187 or S188 or S189 or S190 or S191 or S192 or S193 or S194 or S195 or, S193 TX (work life or work life) w2 (balance*), S192 TX (work life or worklife) w2 (balance*), S186TX ((day or night or late or early or evening or core or stagger* or compress* or, irregular) w2 (work* or shift*1 or hours*)), S120 TX professional* help* with household work*, S119 TX professional* help* with housework, S118TX professional* help* with childcare, S113TX nonstandard employ* contract*, S112TX non standard* employ* contract*, S64S1 or S2 or S3 or S4 or S6 or S7 or S9 or S10 or S11 or S12 or S13 or S14 or, S15 or S16 or S17 or S18 or S19 or S20 or S21 or S22 or S23 or S24 or S25, or S26 or S27 or S29 or S30 or S31 or S35 or S36 or S37 or S38 or S39 or, S41 or S42 or S43 or S44 or S45 or S46 or S47 or S48 or S50 or S51 or S52, or S53 or S55 or S56 or S57 or S58 or S59 or S61 or S62 or S63 Search modes , S60 TX ((facilitat* or enable*1 or enabling or barrier*1 or obstruct* or encourage* or, prevent* or time or free or disrupt* or relationship* or conflict) w2 (cooking or, S54TX ((facilitat* or enable*1 or enabling or barrier*1 or obstruct* or encourage* or, prevent* or time or free or disrupt* or relationship* or conflict) w3 (household work, or house work or chores or hobbies or hobby or friends or family)), S49TX functional limitations profile, S40 TX ((GP or hospital or doctors or gps) w2 (consultation*1 or appointment*1)), S34TX (employee* or staff) w2 (health), S33TX ((employee* or staff) w2 health)), S32TX ((employee* or staff) w2 health), S28TX ((promot* or manag* or facilitat* or enable*1 or enabling or barrier*1 or, increas* or obstruct* or encourag* or prevent* or time or free or disrupt* or, relationship* or conflict) w2 (health or healthy or healthier)), S26 TX (musculo w2 skeletal w2 disorder*), S25 TX (musculoskeletal w2 disorder*). The short followup periods (12 months or less) employed in five of the studies reviewed (Dunham 1987; Kandolin 1996; Smith 1998; Rodriguez 2002; Viitasalo 2008) may not be sufficient to detect clinical changes, for example changes in biomarkers of cardiovascular disease or accumulated fatigue and stress. Bambra C, 1 exp Morbidity/ or morbidity.ti,ab. Marmot M, Further, it should be noted that although searches were conducted of relevant internet sites these were limited to English language only. Excluded as no primary health outcomes reported (secondary outcomes only), Not an intervention study, no before measures, no control group, longitudinal study of temporary workers, Controlled before and after study (followup period unclear from study protocol), A. H. Garde, The National Research Centre for the Working Environment, Lerso Parkall 105, DK2100 Copenhagen, Denmark. Generating an ePub file may take a long time, please be patient. Amelsvoort LGPM, Given the partial and methodologically limited evidence base these findings should be interpreted with caution. Blanchard VL, Effect of temporary contracts on perceived work characteristics and job strain: a longitudinal study. (Y/N/Unclear), Type of flexibility intervention and intervention details. Bambra C, Smith 1998 looked at the effects of flexibility within a compressed working week (CWW) shift system in the UK police service. Although the study on flexitime reported no significant effects in this review it should not be assumed that flexitime interventions have no health impacts as it is not possible to draw conclusions on the basis of one study alone, especially since the study considered only selfreported measures of physiological and psychological health and the followup period may not have been sufficient to discern any small changes in outcomes. Cochrane Database Syst Rev. knn@nrcwe.dk. Having a performance-driven culture will result in successful outcomes. For more detailed statistical information on effects in relation to primary outcomes see Table 1 and Table 2. Virtanen M, With more and more people thinking differently about how, when and where they work, flexible working is increasingly helping people access the labour market and stay in work. Valente F, Blue and white collar workers, mostly male. The flexibility of the "Working Scholars Fund program finally allowed Katie to achieve her longtime goal of a college degree. For a manager, flexible working hours can mean adjusting your working hours to be better aligned with your team, rather than you actually choosing the times that best suit your life. random allocation, matched control). Kandolin 1996 reported on a multiple intervention study which included changes to the direction and speed of shifts as well as the introduction of selfscheduling. 5. The individual search strategies are reproduced in Appendix 1. In line with an established body of research around the positive health effects of high levels of control in the workplace (Bosma 1997; North 1996; Stansfeld 1999), the findings of this review tentatively suggest that flexible working interventions that increase control and choice are likely to have a beneficial effect on at least some health and wellbeing outcomes. The studies were based in various occupational settings: healthcare organisations (n = 2); the police force (n = 1); a utilities organisation (office workers) (n = 1); airline company (line maintenance workers) (n = 1); and the general working population/various companies or organisations (n = 5). Ueffing E, 30 ((employee$ or staff) adj2 health).ti,ab. However, seven studies did account for differences between the intervention and control groups at baseline(Calvo 2009; De Raeve 2007; de Vaus 2007; Dooley 2000; Rodriguez 2002; Smith 1998; Viitasalo 2008). Carmichael JC, Smith 1998 drew attention to the effect of motivational issues (that is whether or not workers support the intervention) on the acceptance and adjustment to work schedule changes. As a result . (e.g. Gill Stewart shares her thoughts with me on the benefits for organizations. The Cochrane Database of Systematic Reviews, Gradual retirement, sense of control, and retirees' happiness, Health effects of transitions in work schedule, work hours and overtime in a prospective cohort study, Scandinavian Journal of Work Environment & Health, Does gradual retirement have better outcomes than abrupt retirement? Mental health: psychological stress (GHQ12, Unclear as to whether overtime was dictated by the employer or requested by the employee, Controlled before and after study, 12, 24 and 36 months follow up, Australia,workers with various types of employment, Gradual retirement defined as a retirement transition characterised by a progressive withdrawal from work or a withdrawal and then return parttime, Mental health: positive and negative affect (, Unclear but likely to be workernegotiated to enhance postretirement life satisfaction, Controlled before and after study, 24month follow up, National Longitudinal Survey of Youth, USA, Involuntary parttime employment (inadequate employment), Mental health: psychological functioning (Center for Epidemiologic Studies Depression scale CESD), Multiple intervention study, outcome data are reported for involuntary parttime workers pooled with workers on a poverty wage, Controlled before and after study, 3 and 6 months follow up, Corporate office of a Midwestern utility organisation, nonsupervisory (professional, clerical and technical) and supervisory personnel. In contrast, interventions that were motivated or dictated by organisational interests, such as fixedterm contract and involuntary parttime employment, found equivocal or negative health effects. DeebSossa N, The tool is based on established guidance for the evaluation of nonrandomised studies (CRD 2001; Deeks 2003). Pirretti AE, Is there an appropriate control group (e.g. For men after undertaking overtime work the odds of becoming a need for recovery case were 1.31 (95% CI 0.87 to 1.98) and the odds of men becoming a psychological distress case were 1.16 (95% CI 0.83 to 1.64). Similarly, none of the studies included adequate information on the presence or absence of employee, union or managerial support for the intervention and whether or not those implementing the intervention had appropriate experience and access to the necessary resources to deliver the intervention effectively. This has the potential to stifle innovation and lessen engagement within the workplace. It is therefore important that the international evidence base relating to flexible working is synthesised and appraised to ascertain whether or not the health effects of flexibility vary by socioeconomic status or demographic characteristics (that is by age, ethnicity or gender). Flexible work environments are wholly enabled by a digital workplace - video conferencing and digital collaboration - and it's a good thing for employee engagement. Both Calvo 2009 and de Vaus 2007 found that control over retirement was related to better health outcomes. Equally for women, after undertaking overtime work the odds of becoming a need for recovery case or a psychological distress case were also nonsignificant: OR 1.47 (95% CI 0.64 to 3.38) and OR 0.81 (95% CI 0.40 to 1.62) respectively. Vezina M, These included arrangements apparently actively chosen by the worker (Y/N), reasons for practices (open text) and worker or employer favourable (Y/N) (please refer to Appendix 2 for further details). The ePub format uses eBook readers, which have several "ease of reading" features Recent UK research by Capability Jane reveals the demand for flexible working is substantial: However, fewer than 10% of UK advertised jobs currently offer flexibility; the gap between supply and demand is huge. 28 ((promot$ or manag$ or facilitat$ or enable$1 or enabling or barrier$1 or increas$ or obstruct$ or encourag$ or prevent$ or time or free or disrupt$ or relationship$ or conflict) adj2 (health or healthy or healthier)).ti,ab. Social inequalities in the impact of flexible employment on different domains of psychosocial health, Journal of Epidemiology and Community Health. Booth ML, No studies fulfilling our inclusion criteria were conducted in low or middleincome countries. And most over-50s want to ease slowly into retirement through reducing hours and working flexibly. Shift. The balance of flexibility and security for labour market participants is a perennial challenge for policy-makers. Benach J, Garde AH, 2. overtime hours per week) and the temporal duration of overtime working (the period may be less than six months). Supervising/Managing 1. Influence on own working hours/worktime control. Flexibility is the umbrella term used to describe any role that breaks the traditional norm of a rigid 9-to-5, five-day week structure. Studies were included if the mean age of participants was within the common working age range (16 to 64 years). Martimo KP, It is acknowledged that there are limitations associated with the subjective nature of measurements of worklife balance. Flexitime was shown not to have significant effects on selfreported physiological and psychological health outcomes. Various workplaces (45 companies), Netherlands. Brisson C, To avoid introducing bias into the narrative synthesis, we reported the results of each study judiciously and made efforts to avoid inappropriate emphasis on the findings of any one particular study or author (Deeks 2008). Smaller, more agile companies have evolved naturally, realizing the increased opportunities provided by new technology to build virtual and bespoke teams, especially in fields where rare or highly technical expertise is required. Employment conditions and health inequalities, Final Report to the WHO Commission on Social Determinants of Health (CSDH), Community studies reporting association between selfrated health and mortality. 21]. It is well recognised that interventions which increase workers autonomy or decision latitude and lead to greater alignment between employee needs and the work environment are likely to increase job satisfaction (Baltes 1999), reduce stress and the likelihood of stressrelated morbidity and ultimately lead to improvements in workers health (Bosma 1997; Kuper 2003; Marmot 2006). changing the dynamics of decisionmaking) level (Bambra 2007). In: Higgins JPT, Green S (editors). Concerns regarding whether or not the sample was representative were apparent in five studies and three studies did not use a matched or randomly allocated control group. irregular) adj2 (work$ or shift$1 or hours$)).mp. ERM case studies: employment impact of relocation of multinational companies across the EU, Available at: http://www.eurofound.europa.eu/emcc/erm/studies/tn0810026s/tn0810026s_4.htm. Shipley MJ, Publication bias relating to commercial studies outside of the public domain may also limit conclusions regarding the size of the available evidence base. In: Higgins JPT, Green S (editors). GL, Sprigg CA, Working Scholar. for the Cochrane Health Equity Field. Allen S, Likewise, we retrieved no relevant publications fulfilling our inclusion criteria from the website searches. No studies differentiated results by socioeconomic status, although one study did compare findings by gender but found no differential effect on selfreported health outcomes. Box 1: Flexible working interventions included in the search strategy for this review. Were the arrangements likely to benefit the employer or the worker? Costa G. The standard shiftwork index: a battery of questionnaires for assessing shiftwork related problems. Petticrew M, Pryce 2006 found no significant changes in primary health outcomes, although improvements in some secondary outcomes were noted when comparing intervention and control groups. Ropponen T. Occupational stress questionnaire: user's instructions, Finnish Institute of Occupational Health, Reviews 19, Helsinki, A scoring system for subjective health complaints. Agile working puts the emphasis on the activity or task itself rather than the location it's . The small number of studies identified may indicate that publication bias is an issue here, where studies reporting equivocal or negative findings are less likely to be published. Is there adequate adjustment for the majority of known confounders (e.g. This association remained significant after controlling for family poverty status and marital status (b = 0.71, Beta = 0.04, t = 2.98, P < 0.05). et al. Moreau M, Karasek 1992 suggests that work tasks can be restructured in three key ways: (i) job enrichment and enlargement (task variety); (ii) collective coping and decisionmaking (teamworking); or (iii) the use of autonomous production groups, all of which are likely to increase levels of control and possibly supervisor and coworker support. Four controlled before and after studies examined the effects of selfscheduling on shift workers (Kandolin 1996; Pryce 2006; Smith 1998; Viitasalo 2008). Study participants were defined as adults of working age working for profit or pay in formal labour. Backer G, An analysis of disadvantaged socioeconomic positions and myocardial infarction in the Stockholm Heart Epidemiology Program (SHEEP). In a study of gradual/partial retirement, de Vaus 2007 used life satisfaction as a quality of life outcome measured using a scale validated by Campbell 1976. Employers. In one study (De Raeve 2007) where the intervention involved a transition from working no overtime to overtime working, it was unclear as to whether the workers elected to work overtime or whether overtime was dictated by the employer. Elo AL, Similarly, it is important to understand the socioeconomic patterning of flexible working arrangements and the impacts such inequalities might have on health and wellbeing. A range of physical and mental health outcomes, as well as worklife balance, were measured using validated instruments including the General Health Questionnaire (GHQ12, Goldberg 1972) and the Standard Shiftwork Index (Barton 1992). Ease slowly into retirement through reducing hours and working flexibly defined as adults of working working. 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