Based on the research gaps that emerged from the literature review, here are several suggestions about how to improve research methodology which would in turn help answer key questions, both about the effectiveness and the cost-effectiveness of OHSMSs:
Use stronger research designs (e.g., avoid cross-sectional designs, use of comparison groups).
Consider and control confounding to a greater extent (i.e., increase use of control groups, increase measurement of confounders and statistical adjustment, endeavour to track and discount events coincident with the intervention).
Use more rigorous sampling methods and reporting of those methods (e.g., avoid convenience sampling, report refusal rates).
Use larger sample sizes, in particular, avoid single worksite studies for questions of effectiveness.
Design more rigorous economic evaluations.
To address the gaps in research content, the review team recommends that more attention be paid in two areas:
What are the facilitators of and barriers to OHSMS implementation and effectiveness? In answering this question, researchers should employ both quantitative and qualitative research methods.
What are the costs of OHSMS interventions?
Strengths and limitations of the review
5.2.1 Strengths of the review The volume of studies published each year is more than most practitioners or researchers can easily keep track of or synthesize. This is confirmed for the literature on OHSMSs in Figure 5.2.1. The review has clearly eliminated the huge volume of work required to find those relatively few studies of interest and to summarize their findings. The use of explicit, systematic methods ensures that this summary is relatively
Figure 5.2.1 Volume of literature retrieved in OHSMS search
Number of Articles
1000 800 600 400 200 0
Until July 2004
Institute for Work & Health