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0 -1.955 TD (literature review)Tj /TT0 1 Tf ( )Tj 0 -1.637 TD ( )Tj 0 -1.318 TD (This report addresses the question 'Do work-environment )Tj 0 -1.955 TD (improvements have any effects?' The aim was to produce a )Tj T* (summary of knowledge that includes the methodological )Tj 0 -1.955 TD (problems of measuring and evaluating effects, as well as )Tj 0 -1.955 TD (literature reviews of effects from work environment )Tj 0 -1.955 TD (improvement efforts on musculoskeletal health, health )Tj 0 -1.955 TD (promotion, and economy. )Tj 0 -1.636 TD ( )Tj 0 -1.318 TD (Results show that published literature reviews do not give )Tj 0 -1.955 TD (unambiguous support for health benefits of interventions )Tj 0 -1.955 TD (against musculoskeletal problems, when only studies using )Tj 0 -1.955 TD (natural science criteria with experimental or quasi-)Tj 0 -1.955 TD (experimental design are included. There are, on the other )Tj 0 -1.955 TD (hand, many case studies in the so called 'grey' literature that )Tj 0 -1.955 TD (report positive effects. Further, results show that health )Tj T* (promotion interventions, and especially physical activity, have )Tj 0 -1.955 TD (a positive effect on low back pain. Workplace interventions to )Tj 0 -1.955 TD (increase physical activity are effective and lead to increased )Tj 0 -1.955 TD (physical activity amongst employees. More studies are needed, )Tj 0 -1.955 TD (however, at the organisational level. )Tj 0 -1.636 TD ( )Tj 0 -1.318 TD (There is some support for the profitability of work-environment )Tj 0 -1.955 TD (investments at the organisational level; even though there are )Tj T* (few studies and methodological problems. The review also )Tj 0 -1.955 TD (indicates that the financial benefits come mostly from quality )Tj 0 -1.955 TD (and productivity improvements and, to a lesser extent from )Tj 0 -1.955 TD (reductions in costs related to sickness absenteeism. )Tj 0 -1.955 TD (While more recent literature reviews of the effects of health )Tj 0 -1.955 TD (promotion interventions seem to show a stronger effect than )Tj 0 -1.955 TD (older studies, comparisons of older versus more recent studies )Tj 0 -1.955 TD (of interventions against musculoskeletal problems give a more )Tj 0 -1.955 TD (ambiguous picture. 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q 0 18 612 756 re W* n 0 0 0 rg BT /TT0 1 Tf 8.8115 0 0 8.8115 159.4084 755.3766 Tm (study design with less priority on the quality of the )Tj 0 -1.955 TD (interventions themselves. )Tj 0 -1.636 TD ( )Tj 0 -1.318 TD (Multifactorial interventions are particularly difficult to evaluate. )Tj 0 -1.955 TD (At the same time, many studies and research reviews )Tj 0 -1.955 TD (emphasise the need for multifactorial approaches as necessary )Tj 0 -1.955 TD (for successful intervention. )Tj 0 -1.636 TD ( )Tj 0 -1.318 TD (Inclusion criteria in literature reviews that only consider )Tj 0 -1.955 TD (experimental designs in organisational interventions exclude )Tj 0 -1.955 TD (studies with good interventions that can't be evaluated with )Tj 0 -1.955 TD (traditional experimental methods. Difficulties in proving the )Tj 0 -1.955 TD (effectiveness of interventions depends on views of what )Tj 0 -1.955 TD (constitutes good scientific quality in the studies. This shows a )Tj 0 -1.955 TD (need for a critical examination of the assumptions used for )Tj T* (knowledge generation in this area. )Tj 0 -1.636 TD ( )Tj 0 -1.318 TD (Conclusions are that work-environment improvement efforts )Tj 0 -1.955 TD (have effects that are clear in some cases but are difficult to )Tj 0 -1.955 TD (show in others. Effect evaluation poses large methodological )Tj 0 -1.955 TD (challenges. These difficulties are considered to be an important )Tj 0 -1.955 TD (cause of the lack of clear evidence, especially in the area of )Tj 0 -1.955 TD (interventions against musculoskeletal problems. 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