Objective: This study aimed to determine the influence of participatory workplace environmental improvement program on reducing job stress and workers’ psychological distress at small enterprises (i.e., less than 10 employees). Furthermore, this study aimed to clarify important factors for success of this program as well. Methods: The model program was tested in a small enterprise with eight employees between October 2014 and January 2017. Moreover, five employees participated in the annual work environment improvement workshops for two consecutive years. During both years, the New Brief Job Stress Questionnaire (80-item version) was used to measure work-related stress before (baseline) and after (post-three months and post-12 months) the workshops. To assess the extent of an intervention effect, the questionnaire data were analyzed using the Friedman test and the multiple comparison test annually. In addition, continuous data were analyzed during the two years. The statistical significance of the differences across time was determined at the p < .10 cutoff value because the number of participants was small. The effect size was also calculated. The participants were interviewed regularly. Results: For both years, the employees implemented action plans within one month of completing the workshops. In the first year, the data for the Friedman test indicated a significant change in role conflict, job resources (workgroup-level), respect for individuals, fair personnel evaluations, work-self balance (positive), workplace social capital, and job satisfaction. In the multiple comparison test, significant changes manifested in role conflict and workplace social capital. In the second year, significant changes were found regarding role conflict and fair personnel evaluations for the Friedman test, demonstrating significant changes in role conflict in the multiple comparison test. As per the two-year survey results, the Friedman test indicated significant changes in role conflict, respect for individuals, and fair personnel evaluations, while the multiple comparison test demonstrated no significant changes. Over time, favorable changes were found regarding role conflict in the first year; however, undesirable changes were found regarding the other statistically significant items. The interviews revealed both positive and negative opinions. Conclusions: This study found the effects of the participatory workplace environment improvement program to be limited. Thus, the program should be improved to reduce its adverse effects as well as the participants’ negative opinions.

Objective: To examine Japanese workers’ acceptance and perceptions of the work-treatment balance system proposed by the Japanese Government. Methods: A questionnaire survey was conducted among 120,000 Japanese workers. Participants were asked about their acceptance of the work-treatment balance system and their attitudes toward disclosing health problems and seeking support in the workplace. Results: Only 7% and 27% of participants accepted the work-treatment balance system and a consultation desk for employees having difficulties at the workplace, respectively. The proportion of those who preferred not to disclose a health problem in the workplace (31%) exceeded those who preferred to do so (15%). Multiple logistic regression analysis indicated that acceptance of the work-treatment balance system and a consultation desk at the workplace was significantly associated with attitudes toward disclosing health problems. Those who worked in smaller workplaces (less than 300 employees) and were employed in sales/customer service, manufacturing, and driving/delivery were significantly less likely to indicate a willingness to disclose a health problem in the workplace. Conclusion: Most workers have little understanding of the work-treatment balance system. Further knowledge of the work-treatment balance system must be promoted by both the Government and companies.