Effect of the National Stress Check Program on mental health among workers in Japan: A 1-year retrospective cohort study

Kotaro Imamura, Yumi Asai, Kazuhiro Watanabe, Akizumi Tsutsumi, Akihito Shimazu, Akiomi Inoue, Hisanori Hiro, Yuko Odagiri, Toru Yoshikawa, Etsuko Yoshikawa, Norito Kawakami

Research output: Contribution to JournalArticleAcademicpeer-review


OBJECTIVES: This retrospective cohort study evaluated the impact of the Stress Check Program, a recently introduced national policy and program aimed at reducing psychological distress among Japanese workers.

METHODS: A baseline survey was conducted from November 2015 to February 2016, the period when Japan began enforcing the Stress Check Program. A one-year follow-up survey was conducted in December 2016. In the follow-up survey, two exposure variables were collected: having taken the annual stress survey, and experiencing an improvement in the psychosocial work environment. Psychological distress was assessed using the Brief Job Stress Questionnaire (BJSQ) at baseline and 1-year follow-up. The two exposure variables were used to define four groups: "Neither", "Stress survey (SS) only", "Psychosocial work environment improvement (WI) only", and "Both". BJSQ results were analyzed using repeated measures general linear modeling (GLM).

RESULTS: The study included 2,492 participants: 1,342 in the "Neither" group, 1,009 in the "SS only" group, 76 in the "WI only" group, and 65 in the "Both" group. Overall time-group interaction effects were not significant. The "Both" group showed significantly greater improvements in psychological distress than the "Neither" group (p = 0.02) at the 1-year follow-up, although the effect size was small (d = -0.14).

CONCLUSIONS: Combination of the annual stress survey and improvement in psychosocial work environment may have been effective in reducing psychological distress in workers, although the effect size was small.

Original languageEnglish
Pages (from-to)298-306
Number of pages9
JournalJournal of occupational health
Issue number4
Publication statusPublished - 25 Jul 2018


FundersFunder number
Japan Society for the Promotion of Science17K15849, 15J04085, 18K10554


    • Adolescent
    • Adult
    • Female
    • Follow-Up Studies
    • Health Surveys
    • Humans
    • Japan
    • Male
    • Mental Health
    • Middle Aged
    • Occupational Health
    • Occupational Stress/diagnosis
    • Program Evaluation
    • Retrospective Studies
    • Workplace/psychology
    • Young Adult


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