Effectiveness of work ability interventions on productivity: a systematic review

Pasi Kekkonen; Eija Savolainen; Mari Immonen; Pauliina Kangas; Elisa Rissanen; Ismo Linnosmaa

doi:10.1093/joccuh/uiaf051

. 2025 Sep 24;67(1):uiaf051. doi: 10.1093/joccuh/uiaf051

Show available content in

Effectiveness of work ability interventions on productivity: a systematic review

Pasi Kekkonen ^1,^2,^✉, Eija Savolainen ³, Mari Immonen ⁴, Pauliina Kangas ⁵, Elisa Rissanen ⁶, Ismo Linnosmaa ⁷

PMCID: PMC12490205 PMID: 40990970

Abstract

Key points:

What is already known on this topic: Previous systematic reviews have focused on workplace-based interventions, such as health promotion and physical activity programs, assessed mainly through randomized controlled trials. These reviews have shown some effectiveness on productivity outcomes, particularly within workplace settings. However, interventions outside the workplace, like those in health care or aimed at employability, and real-world evidence from register-based studies have been excluded, leaving a gap in understanding their effect on productivity.
What this study adds: This study provides the first comprehensive review of work ability interventions on productivity outcomes, regardless of setting and design, including diverse interventions and quasi-experimental studies. The findings suggest that most work ability interventions do not significantly affect productivity, although certain interventions can effectively reduce absenteeism and thereby enhance productivity.
How this study might affect research, practice, or policy: It remains challenging for society and organizations to invest in work ability interventions when there is insufficient information on evidence-based interventions that enhance productivity. This systematic review highlights the current lack of evidence regarding the effectiveness of high-quality work ability interventions on productivity. Further research is needed to address this information gap, and quasi-experimental register-based studies present a valuable opportunity to address this issue.

Keywords: absenteeism, effectiveness, intervention, presenteeism, productivity, work ability

1. Introduction

The dependency ratio is deteriorating globally due to factors such as population aging and low birth rates. It is projected that the dependency ratio will continue to decline. This poses challenges not only in terms of sufficient workforce availability but also in maintaining or improving the work ability of the working-age population and preventing disability. These challenges regarding demographic change also increase the pressure to enhance productivity. These issues have been recognized at the societal level as well as in workplaces in many European countries. Various interventions have been developed to maintain or improve the work ability of the working-age population. Work ability interventions might also influence productivity, but evidence on how these interventions affect productivity across various settings and study designs has not yet been comprehensively synthesized.

Work ability is defined in 2 ways: specific work ability and general work ability. Specific work ability concerns specific jobs that require special training, and the job-specific virtues, within an acceptable work environment. General work ability concerns the capability to perform a basic job that most people can do after minimal training, and it is dependent on a person’s general health, basic skills, and the work environment.¹ Work ability interventions can be implemented not only in workplaces but also in other settings, such as health care.

Productivity is defined as a ratio of output volume to input use volume.² Labor input reflects the quantity (eg, hours worked) and quality (eg, abilities) of the work force.³ In this article, productivity losses refer to presenteeism and absenteeism. Presenteeism is defined as reduced productivity that occurs when a worker attends work despite an illness or other condition that prevents them from fully functioning.⁴ Absenteeism is defined as an employee’s time away from work due to illness, disability, or premature death, measured as working days or work hours away from work.⁵^,⁶

Productivity costs refer to the costs related to production losses from both paid and unpaid work, as well as the costs of replacing individuals due to illness, disability, or death.⁵ Productivity costs are typically evaluated by using a human capital approach or friction cost method. In the human capital approach, all potential production lost due to an individual’s illness or premature death is calculated as a productivity loss. The friction cost method limits the calculated productivity loss to a specific time period, known as the friction period, which is the time required to replace the sick employee and train the new worker. However, there is no consensus on the preferred method for determining productivity cost estimates.⁵

Two previous systematic reviews have examined the effectiveness of workplace interventions or worksite wellness interventions on productivity, focusing on randomized controlled trials (RCTs).⁷^,⁸ The first systematic review⁷ concentrated on workplace environments where health promotion and occupational health strategies were implemented. The second systematic review⁸ examined settings where there was implementation of worksite wellness programs focused on physical activity. Additionally, a previous systematic review⁹ investigated the effectiveness of interventions for aging workers on productivity, targeting workers over 40 years of age and including quasi-experimental nonrandomized controlled trials (NRCTs) and RCTs.

Previous research has primarily focused on interventions implemented in the workplace, thereby excluding those conducted outside the workplace, such as interventions in health care or occupational health services aimed at improving the return to work or interventions that aim to improve employability. Moreover, these studies have focused on RCT settings, thereby excluding register-based real-world evidence studies. Consequently, the effectiveness of interventions designed to improve or maintain work ability on productivity, regardless of setting and design, remains unclear.

The aim of this study was to synthesize the research information of effectiveness of work ability interventions on productivity, productivity losses, and productivity costs. Therefore, the research question we explored was: What is the effectiveness of work ability interventions on productivity outcomes?

2. Methodology

Reporting of this systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA 2020 statement.¹⁰ The protocol¹¹ was pre-registered in the PROSPERO database. The variations in search strategy between the protocol and the article are detailed in the 2.3. Information sources and search strategy section.

2.1. Eligibility criteria

The inclusion criteria were based on the Population, Intervention, Comparison, and Study design (PICOS) elements, which consider the study design of the articles.¹² Studies were excluded if they failed to meet at least 1 inclusion criterion. Interventions focusing on ergonomics were excluded, since their aim is to affect the work environment rather than work ability, and they have been widely studied. Other inclusion criteria specified that studies must have been published after the year 2000, to ensure that the research findings reflect the most recent interventions. The inclusion criteria are described in Table 1.

Table 1.

Inclusion criteria for studies.

PICOS elements	Inclusion criteria
Population	The target population consists of working-age individuals as defined in the articles
Intervention	The intervention’s primary aim had to be the improvement or maintenance of work ability, and studies were excluded if they focused on ergonomics
Comparison	Comparators were mandatory, such as another intervention or no intervention
Outcomes	Outcomes had to be productivity related; eg, productivity, productivity losses, or productivity costs, and measured subjectively or objectively
Study design	Randomized controlled trials (RCTs), nonrandomized controlled trials (NRCTs), and economic evaluations

Open in a new tab

2.2. Definition of the outcomes

Two criteria were required for defining a work ability intervention to be included in this review. First, the intervention needed to aim at improving or maintaining work ability. For instance, a specified task gets easier if aerobic capacity improves. If the intervention improves this capacity, fulfilling job requirements gets easier. Additionally, the article had to provide a definition of the work ability. Interventions that primarily aimed at healing a specific disease or condition, such as medical treatments, surgical procedures, or treatments meant to heal only depression, were not considered as work ability interventions. An expert in the field of work ability was consulted if it was unclear whether an intervention could be treated as a work ability intervention.

Productivity-related outcomes included in this systematic review were productivity, productivity losses, and productivity costs. Productivity can be measured objectively, for example, from a database, and/or subjectively with a questionnaire. Productivity losses were defined as presenteeism and absenteeism.

2.3. Information sources and search strategy

Based on preliminary searches, which were conducted in March 2024, the effectiveness of work ability interventions on productivity outcomes has been studied extensively. A systematic search was conducted in December 2024 across the following databases: EBSCO, ProQuest, Scopus, Web of Science, and PubMed. The search strategy used productivity, work ability, and intervention-related words (intervention, program*, treatment) in combinations. Deviating from the protocol, we decided to include “presenteeism” and “absenteeism” in our search strategy, as these terms are relevant and appear also independently of the term “productivity”.

Another deviation from the protocol was that we decided to search for relevant references cited by the included articles and added them to the search results. This method, known as the snowball effect, is an alternative approach used to discover additional evidence that was not retrieved through a conventional search.¹³ Our search strategy is detailed in Figure S1.

2.4. Study selection

The references were imported into the web-based systematic review tool Covidence,¹⁴ where the title, abstract, and full-text screening were conducted. After removing duplicates, 2 reviewers independently screened 50 articles and discussed the inclusion and exclusion criteria based on titles and abstracts to ensure consistency. Consistency was also ensured in the same manner during the full-text screening phase. After discussing the initial 50 articles, the 2 independent reviewers assessed the remaining articles in duplicate. If consensus was not reached between the 2 reviewers, a third reviewer was involved in the decision-making process. The consistency between the reviewers was assessed using Cohen kappa.¹⁵

2.5. Quality assessment

The quality of the included studies was assessed by 2 independent reviewers. The assessment was conducted using the Cochrane Risk of Bias Tool for RCTs (RoB 2 tool),¹⁶ the Cochrane Risk of Bias Tool for Non-Randomized Studies of Interventions (ROBINS-I),¹⁷ and the extended version of the Consensus on Health Economic Criteria (CHEC-extended)¹⁸ for the economic evaluations.

Studies of low quality were excluded from further analysis. RCTs and cluster RCTs were included if the overall result was at low risk of bias or raised some concerns. Studies were excluded if the overall risk of bias was high. An article was deemed at high risk of bias if at least 1 domain was at high risk, or over 50% of the domains raised some concerns. NRCTs were included in the final review if the overall risk of bias was judged to be at least moderate. Studies were excluded if the overall risk of bias was judged to be serious or critical. A study was deemed to be at serious risk of bias if at least 1 domain was at serious risk, and it was judged to be at critical risk of bias if at least 1 domain was at critical risk. The threshold for the inclusion of the economic evaluation was a score of at least 50%.

2.6. Data extraction and analysis

Data were independently extracted from the studies into Excel worksheets by the 2 reviewers, who discussed and reached consensus on the extracted information. If consensus could not be achieved, a third reviewer was consulted. The Excel worksheets were created, and extracted data were collected using the help of the items from the RoB 2 tool¹⁶ for RCTs and cluster RCTs, the ROBINS-I tool for the NRCTs,¹⁷ and the CHEC-extended list¹⁸ for economic evaluations. The extracted data included basic information about the studies, methods, effectiveness results, and authors’ conclusions. In addition, cost data and cost results were extracted from the economic evaluation studies. Other publications from the studies were used if the information in the article was not comprehensive enough. Original monetary values and 2024 monetary values of the cost results are presented in this article. The conversion to 2024 monetary value was performed using the CCEMG-EPPI-Centre Cost Converter.¹⁹

Narrative evidence tables were created from the extracted data to describe the characteristics of the included studies and the details of the work ability interventions. Additionally, an evidence table was developed to address the review question.

3. Results

A total of 1863 articles were identified (Figure 1), comprising 1858 articles from the original search and an additional 5 articles added manually. After removing duplicates, 1081 articles remained. Based on the title and abstract screening, 958 articles were excluded. The remaining 123 articles were retrieved in full, and 68 articles were excluded due to wrong outcomes (n = 20), wrong interventions (n = 25), wrong study design (n = 22), or wrong population (n = 1). The Cohen kappa between the 2 reviewers was 0.49 (P.K., M.I.) and 0.74 (P.K., E.S.) at the title and abstract screening phase, indicating a weak and strong level of agreement.¹⁵ At the full-text review phase Cohen kappa was 0.80 (P.K., M.I.) and 0.61 (P.K., E.S.), indicating a strong and moderate level of agreement.

Prisma flow diagram of the studies included in the systematic review. Modified figure from Covidence.¹⁴

A total of 55 articles proceeded to the quality assessment stage, of which 29 articles passed the quality assessment.²⁰^-⁴⁸ Of these, 24²⁰^-²³^,²⁵^-³⁰^,³³^-⁴⁴^,⁴⁶^,⁴⁷ were RCTs and 5 were NRCTs.²⁴^,³¹^,³²^,⁴⁵^,⁴⁸ Five of the articles on RCTs conducted an economic evaluation alongside the trial,³⁵^,³⁸^,⁴⁰^-⁴² and none were excluded due to poor quality. Of the articles excluded based on quality (n = 26),⁴⁹^-⁷⁴ 18 were RCTs⁵⁰^-⁵²^,⁵⁴^-⁵⁶^,⁵⁸^,⁵⁹^,⁶²^-⁶⁴^,⁶⁶^-⁶⁹^,⁷¹^,⁷³^,⁷⁴ and 8 were NRCTs.⁴⁹^,⁵³^,⁵⁷^,⁶⁰^,⁶¹^,⁶⁵^,⁷⁰^,⁷²

3.1. Quality of the studies

All included RCTs (n = 24) were assessed as having some concerns regarding risk of bias. The total percentage score from the CHEC-list for the RCTs that also conducted economic evaluation (n = 5) ranged from 78% to 100%. The included NRCTs (n = 5) were assessed to have a moderate risk of bias. All RCTs excluded due to quality appraisal (n = 18) were assessed as having a high risk of bias. Excluded NRCTs were assessed as having either serious risk of bias (n = 4) or a critical risk of bias (n = 4). The consensus on the quality assessment of the trials between 2 independent reviewers is detailed in Table S1, Table S2, and Table S3.

The randomization process and handling of missing data were well performed in the included studies. In addition, risk of bias due to deviations from the intended interventions was generally well addressed. The most common quality flaw among included RCTs was the risk of bias in outcome measurement, which received the highest number of moderate risk-of-bias judgments, followed by the risk of bias in the selection of reported results.

Of the included RCTs that also conducted an economic evaluation, 3³⁵^,⁴¹^,⁴² achieved a score of 100% on the applicable CHEC-list questions. One study³⁸ did not adopt a societal perspective nor adequately address ethical and distributional issues, resulting in a total score of 89% for the applicable questions. Another study⁴⁰ achieved a score of 78% of the total possible score. In this study the economic study design did not constitute a full economic evaluation, as costs were not appropriately valued, and incremental analysis was not conducted. Additionally, the study lacked detailed information regarding sensitivity analysis.

Among included NRCTs, biases related to participant selection, intervention classification, deviations from intended interventions and missing data were well avoided. The most common quality flaw was bias due to confounding, resulting in moderate risk of bias in all studies, followed by bias in outcome measurement.

The most common quality flaw among excluded RCTs was bias due to missing data, which received the highest number of high risk-of-bias judgments, followed by bias arising from deviations from the intended interventions. Among NRCTs, missing data were poorly handled, resulting in serious or high risk of bias in every study that provided this information.

3.2. Characteristics of the included studies

Overall, 29 studies were included in this systematic review. Most of the studies were conducted in Denmark (n = 9),²¹^,²²^,²⁵^,²⁶^,²⁸^,²⁹^,³³^,³⁶^,⁴⁶ Finland (n = 5),³¹^,³²^,³⁴^,³⁸^,³⁹ and the Netherlands (n = 5),³⁵^,⁴⁰^-⁴³ followed by Sweden (n = 3)³⁰^,⁴⁴^,⁴⁵ and Germany (n = 3).²⁷^,³⁷^,⁴⁸ Other countries included Spain (n = 2),²³^,²⁴ Iran (n = 1),⁴⁷ and Norway (n = 1),²⁰ with Iran being the only non-European country.

Of the included studies implementing work ability interventions to improve productivity-related outcomes (productivity, absenteeism, presenteeism, or productivity costs), 15 were standard RCTs,²⁰^,²¹^,²³^,²⁵^,²⁷^,²⁹^,³⁰^,³⁴^,³⁷^,³⁸^,⁴⁰^,⁴¹^,⁴³^,⁴⁶^,⁴⁷ with 2 also conducting economic evaluations.⁴⁰^,⁴¹ Eight trials were cluster RCTs²²^,²⁶^,²⁸^,³³^,³⁵^,³⁶^,⁴²^,⁴⁴ with 2 also conducting economic evaluations.³⁵^,⁴² Five studies were NRCTs.²⁴^,³¹^,³²^,⁴⁵^,⁴⁸

Some of the studies measured more than 1 productivity-related outcome. Absenteeism was measured in 26 studies,²⁰^-²⁵^,²⁷^-³²^,³⁴^-³⁸^,⁴⁰^-⁴⁸ 3 measured presenteeism,²²^,⁴²^,⁴⁴ 7 measured productivity,²⁰^,²²^,²⁵^,²⁶^,²⁹^,³³^,⁴⁴ and 4 measured productivity costs.³⁵^,³⁸^,⁴⁰^,⁴² More specific details about characteristics can be found in Table S4.

3.3. Population

The study population across individual studies ranged from 24 to 9720 participants. Among RCTs, the range was 24 to 821 participants, whereas for NRCTs it was 25 to 9720 participants. The population of the included studies was heterogeneous. Nine studies focused on health care workers,²²^,²⁴^,²⁸^,³³^,³⁴^,³⁶^,³⁷^,⁴⁴^,⁴⁵ with 3 focusing exclusively on women.²²^,³⁴^,³⁷ Five articles concentrated on construction workers,²⁵^,³⁵^,³⁸^,³⁹^,⁴³ with 1 article including only men.²⁵ Four studies focused on office workers.²³^,²⁹^,⁴²^,⁴⁷ Five studies focused on a mixed population.²⁶^,³¹^,⁴¹^,⁴⁶^,⁴⁸ Seven of the included studies²⁰^,²¹^,²⁷^,³⁰^,³²^,⁴⁰^,⁴⁷ focused on health conditions among workers, such as musculoskeletal disorders or depression.

3.4. Interventions

Among included studies, 22 studies evaluated a single intervention each, whereas 5 studies evaluated 2 interventions. In addition, for 1 intervention both assessment of effectiveness³⁸ and economic evaluation were conducted.³⁹ The total number of interventions was 33.

Eleven interventions studied the effectiveness of a physical intervention alone²³^-²⁵^,²⁹^,³⁰^,³³^,³⁴^,³⁷^,⁴⁵^,⁴⁷ and 9 interventions combined physical intervention with additional intervention.²¹^,²²^,²⁷^,²⁸^,³⁵^,³⁶^,⁴²^-⁴⁴ One intervention³⁰ studied in addition to a physical exercise intervention the effectiveness of internet-based cognitional behavioral training (ICBT), and 1 trial⁴⁴ studied the effectiveness of reduced work hours. The remaining 12 trials examined various types of interventions, such as coordination model, stress management, or reduced work hours. More detailed information about the interventions is provided in Table S4.

3.5. Comparators

The interventions were compared with care as usual (n = 11),²⁴^,²⁹^,³⁰^,³⁵^,³⁹^,⁴⁰^,⁴³^,⁴⁷ no intervention (n = 8),²³^,³¹^,³²^,³⁶^,⁴¹^,⁴⁴^,⁴⁸ or some other treatment (n = 8)²⁰^-²²^,²⁵^,²⁸^,³³^,³⁴^,⁴² such as oral lecture or health guidance. Two studies²⁶^,⁴⁵ did not provide a description of control conditions.

3.6. Effectiveness of the included interventions

Among the trials with significant effects, 2 focused on construction workers,³⁵^,³⁹ 1 targeted at health care workers,²⁸ another addressed health conditions related to mental disorders among City of Helsinki employees,³² and 1 focused on public sector workers.³¹ Four trials measured absenteeism using register data,³¹^,³²^,³⁵^,³⁹ whereas 1 trial used survey data.²⁸ Three trials were either cluster RCTs²⁸^,³⁵ or an RCT,³⁹ and 2 were NRCTs.³¹^,³² In addition, 2 trials conducted an economic evaluation from the employer’s perspective³⁵ or a health care perspective alongside the RCT.³⁸

Among the 33 included interventions, 28 were nonsignificant and 5 were significant in affecting productivity-related outcomes. Four interventions with a statistically significant effect reduced absenteeism,²⁸^,³²^,³⁵^,³⁹ whereas 1 intervention increased the risk of absenteeism.³¹ One intervention³⁵ indicated that the costs of absenteeism were reduced, and another economic evaluation³⁸ showed that the intervention, which consisted of 1 consultation with an occupational nurse and/or physician, was dominant (the intervention was more effective and less costly) compared with usual occupational care. More details about the results are provided in Table 2 and Table S5.

Table 2.

Intervention characteristics and results of the included interventions.

	Work ability intervention	Resource use	Delivered by	Control	Population	Measurement and follow-up	Effectiveness estimate; P value
Aanesen et al, 2023²⁰	Motivational interviewing + usual case management (n = 170)	2 × 1 h per wk over 2 wk	Trained caseworkers	All participants were offered usual case management for people on sick leave in Norway. (n = 174)	People with musculoskeletal disorder (n = 514)	Absenteeism: national registries SA days 6 mo	−6.6 (95% CI, −15.0 to 1.8), NR, ns
	Stratified vocational advice intervention + usual case management (n = 170)	3-4 × 1 h	Physiotherapist and work and health researcher		People with musculoskeletal disorder (n = 514)	Absenteeism: national registries SA days 6 mo	−7.0 (95% CI, −15.4 to 1.4), NR, ns
Andersen et al, 2015²¹	Health guidance + tailored physical activity (n = 27)	3 × 50 min per wk over 10 wk	Trained supervisor	Health guidance for 1.5 h only (n = 27)	Health care workers with musculoskeletal troubles (n = 54)	Absenteeism: questionnaire SA days	NR, .4
Andersen et al, 2015²¹	Health guidance + tailored physical activity (n = 27)	3 × 50 min per wk over 10 wk	Trained supervisor	Health guidance for 1.5 h only (n = 27)	Health care workers with musculoskeletal troubles (n = 54)	Productivity: questionnaire 3 mo	NR, .26
Christensen et al, 2013²²	Dietary intervention + PE + CBT (n = 76)	1 h per wk for over 12 mo	Project manager and 2 employed instructors who had sports degrees	Monthly 2-h oral lecture during working hours (n = 68)	Female health care workers (n = 144)	Absenteeism: local database SA days SA spells	NR, 0.07 NR, 0.284
Christensen et al, 2013²²	Dietary intervention + PE + CBT (n = 76)	1 h per wk for over 12 mo		Monthly 2-h oral lecture during working hours (n = 68)	Female health care workers (n = 144)	Productivity: questionnaire 12 mo	NR, .589
Díaz-Benito et al, 2022²³	PE + health guidance (n = 43)	2 × 50 min per wk over 12 wk	Professionals graduated in physical activity and sports sciences	The control group was passive and continued with their normal life and both groups had telephone or similar contact with the research team and trainers during the intervention (n = 29)	Workers with sedentary tasks (n = 72)	Absenteeism: questionnaire SA days-related points in WAI 5 3 mo	NR, NR, ns
Escriche-Escuder et al, 2020²⁴	Resistance training program (n = 18)	5 × 15 min per wk over 9 wk	Physical therapist	Usual activity (n = 19)	Hospital porters working at a local hospital (University Clinic Hospital of Valencia) (n = 37)	Absenteeism: questionnaire SA days-related points in WAI 5 9 wk	0.3 (95% CI, −0.1 to 0.8); .165
Gram et al, 2012²⁵	Exercise intervention (n = 35)	3 × 20 min per wk over 12 wk The 12-wk physical exercise program was structured as 3 × 20 min per wk and was supervised regularly	Skilled instructors	1-h lecture on general health promotion (n = 32)	Male construction workers (n = 67)	Absenteeism: questionnaire SA days	−0.5 (95% CI, −1.4 to 0.4); .28
Gram et al, 2012²⁵	Exercise intervention (n = 35)		Skilled instructors	1-h lecture on general health promotion (n = 32)	Male construction workers (n = 67)	Productivity: questionnaire 3 mo	−0.1 (95% CI, −1.7 to 1.4); .91
Gupta et al, 2018²⁶	PIPPI intervention targeted all IGLO levels (n = 188)	NR	Research group	No description (n = 215)	All workers in the predetermined departments of the recruited workplaces (n = 403)	Productivity: questionnaire 12 mo	0.03 (95% CI, −0.38 to 0.44); .88
Haufe et al, 2020²⁷	PE + food diary [n (depression) = 29]; [n (anxiety) = 37]	150 min per wk over 6 mo +7-d food diary	Exercise scientist + dietitians	Waiting list [n (depression) = 24]; [n (anxiety) = 25]	Participants over the age of 18 y who had at least 3 of the 5 metabolic syndrome components according to the AHA/NHLBI criteria, and who were not participating in an ongoing occupational health program	Absenteeism: questionnaire SA days-related points in WAI 5, depression 6 mo	NR; .72
	PE + food diary [n (depression) = 29]; [n (anxiety) = 37]	150 min per wk over 6 mo +7-d food diary	Exercise scientist + dietitians	Waiting list [n (depression) = 24]; [n (anxiety) = 25]			NR; .12
Jakobsen et al, 2015²⁸	Workplace physical exercise (n = 111)	5 × 10 min per wk for 10 wk. 5 group-based coaching sessions 30-45 min and ergonomic counseling 1.5-3 h in addition	Experienced training instructors	5 × 10 min per wk for 10 wk, during leisure time, at home Ergonomic counseling 1.5-3 h in addition (n = 89)	Health care workers (n = 200)	Absenteeism: questionnaire SA days-related points in WAI 5 10 wk	0.2 (95% CI, 0.0 to 0.3); .04
Justesen et al, 2017²⁹	Intelligent physical exercise training (n = 193)	1 h per wk, for 2 y, except during holidays	Instructors, who were bachelor students in the education of sport and health	Were encouraged to maintain their lifestyle as usual (n = 194)	Office workers (n = 387)	Absenteeism: questionnaire SA days	−0.55 (95% CI, −1.29 to 0.20); .15
	Intelligent physical exercise training (n = 193)	1 h per wk, for 2 y, except during holidays			Office workers (n = 387)	Productivity: questionnaire 12 mo	0.16 (95% CI, −0.04 to 0.35); .11
Kaldo et al, 2018³⁰	PE (3 different arms) (n = 316)	3 × 60 min per wk for 12 wk	A qualified personal trainer	Primary care standard treatment for depression determined by the patient’s general practitioner (n = 312)	Primary care patients with depression (n = 945)	Absenteeism: employers’ registers 12 mo	1.4 (95% CI, 0.52 to 3.74); .50
	ICBT (n = 317)	Self-help text modules. In total, 34 modules were available	Therapist		Primary care patients with depression (n = 945)	Absenteeism: employers’ registers 12 mo	0.99 (95% CI 0.39 to 2.46); .75
Kausto et al, 2021³¹	The RTW-coordinator model (n = 4120)	NR	RTW-coordinator	No RTW-coordinator model implemented (n = 5600)	Participants were from the Finnish Public Sector (FPS) study cohort, which represents about 26% of Finnish public sector workers (n = 9720)	Absenteeism: employers’ registers Risk of SA days 12 mo	NR^a; <.001
Lahti et al, 2021³²	At least 1 OHP appointment (n = 288)	NR	OHP	No OHP appointment (n = 1998)	City of Helsinki employees with at least 1 y of consecutive employment from 2008 to 2017, and those with an ICD-10F-diagnosed sickness allowance period ending during employment (n = 2726)	Absenteeism: Social Insurance Institution of Finland register data SA days 12 mo	NR; <.01
Lidegaard et al, 2018³³	Aerobic exercise intervention (n = 59)	2 × 30 min per week over 12 mo	Member of the research team	5 × 2-h healthy living lectures during the 1-y intervention period (n = 57)	Cleaners performing mainly cleaning in day-care institutions, offices, hospitals, and schools (n = 116)	Productivity: questionnaire 12 mo	0.18 (95% CI, −0.38 to 0.73); .53
Nurminen et al, 2002³⁴	Worksite exercise program (n = 133)	26 × 60 min weekly sessions over 8-mo period + 2 × 60 min sessions	Physiotherapist	30 min of feedback on the results of the physical capacity tests and counseling for leisure time activity (n = 127)	Women with physically demanding laundry work (n = 260)	Absenteeism: personnel administration Sick leave hours 15 mo	22.5 (95% CI, −13.8 to 58.8); NR, ns
Oude Hengel et al, 2014³⁵	Worksite intervention (physical and mental health component) (n = 171)	2 × 30 min + 2 × 1-h group sessions over 6 mo	Physical therapist and empowerment trainer	Usual practice (n = 122)	Construction workers (n = 293)	Productivity costs (absenteeism) Companies’ registries HCA 12 mo	−€760 (95% CI, −€1497 to −€156), NR −€1029.70 (95% CI, −€2028.23 to −€211.36) (converted)
Rasmussen et al, 2016³⁶ ^c	PE + CBT + participatory ergonomics [n (G1) =126, n (G2) =146, n (G3) =158, n (G4) =164]	12 × 1-h (PE) + 2 × 3-h (CBT) + 2 × 3-h and 2 × 1-h (participatory ergonomics sessions)	Trained local therapists (physiotherapists and occupational therapists)	No description	Health care workers in elderly care either in nursing homes or in home care employed more than 20 h per week and aged 18-65 y; mainly nurses’ aides but also kitchen and cleaning personnel as well as janitors (service workers) belonging to the participating teams (n = 594)	Absenteeism: questionnaire 12 wk	−0.05 (95% CI, −0.21 to 0.11); .53
Stenner et al, 2020³⁷	Endurance training (PE) (n = 146)	The aim was to perform 210 min of endurance training a week (20-60-min units for at least 3 d per week) over 6 mo	Exercise physiologist	Waiting list (n = 145)	Middle-aged female hospital workers (n = 265)	Absenteeism: questionnaire 6 mo	NR, .586
Taimela et al, 2008³⁹	Intervention for high-risk (HR) group (n = 209)	1 × 90 min consultation with nurse and/or physician to plan future actions	Occupational physicians and nurses	Care as usual (n = 209)	49% construction industry, 51% repair, service, and maintenance of buildings, industrial installations, or communication networks [n (HR): 418; n (IR): 537]	Absenteeism: employer’s records 12 mo	11 (95% CI, 1 to 20), NR
	Intervention for intermediate risk (IR) group (n = 268)	Access to medical counseling over the telephone from phone advice center	Occupational physicians and nurses	Care as usual (n = 269)		Absenteeism: employer’s records 12 mo	NR, NR, ns
Taimela et al, 2008³⁸	Intervention for high-risk group (n = 209)	1 × 90 min consultation with nurse and/or physician to plan future actions	Occupational physicians and nurses	Care as usual (n = 209)	n (high-risk group): 418	Productivity costs: cost-effectiveness analysis of SA 12 mo	€17/SA day, NR €25.54/SA day^b
Tamminga et al, 2013⁴⁰	The hospital-based work support intervention (n = 65)	4 × 15 min	Hospital staff	Usual oncology care (n = 68)	Female cancer patients (n = 133)	Absenteeism: questionnaire RTW (relative risk) Median time from the initial sick leave until partial RTW Median time from initial sick leave until full RTW	1.03 (95% CI 0.84 to 1.2), NR NR, 0.9 NR, 0.52
	The hospital-based work support intervention (n = 65)	4 × 15 min	Hospital staff	Usual oncology care (n = 68)	Female cancer patients (n = 133)	Productivity costs (absenteeism): questionnaire HCA FCM 12 mo	−€2425; .72 −€3161.87^b −€438; .48 −€571.09^b
Uegaki et al, 2011⁴¹	Supervisor telephone contact	At 6 wk post-partum, supervisors conducted standardized interviews with employees to identify health issues potentially hindering RTW	Supervisors	Care as usual	Pregnant women from the companies (n = 541)	Absenteeism: questionnaire; sick leave hours	NR, NR
						Presenteeism: questionnaire; presenteeism hours	NR, NR
						Total productivity loss hours	NR, NR
						Sick leave costs	€37 (95% CI, −€252 to €334) −€52.46 (95% CI: −€357.33 to €473.60)^b, NR
						Presenteeism costs	€109 (95% CI: −€66 to €298) €154.56 (95% CI: −€93.59 to €422.55)^b, NR
						Total productivity costs: FCM 12 mo	€146 (95% CI: −€228 to €528) €207.02 (95% CI, −€323.30 to €748.69)^b, NR
Van Dongen et al, 2016⁴²	Structured physiotherapy + mindfulness training, e-coaching, and supporting elements (n = 129)	1 × 90 min per week over 8 wk	Certified trainer	Structured physiotherapy (n = 128)	Employees of 2 Dutch governmental research institutes (n = 257)	Productivity costs (absenteeism): company records, FCM	€746 (95% CI, −€14 to €1885) €999.36 (95% CI, −€18.75 to €2525.18)^b, NR
		1 × 90 min per week over 8 wk	Certified trainer	Structured physiotherapy (n = 128)		Productivity costs (presenteeism): questionnaire, FCM 12 mo	€869 (95% CI, −€325 to €3930) €1164.13 (95% CI, −€435.38 to €5264.71), NR
Viester et al, 2015⁴³	Health promotion intervention	3 × 60 min + 6 × 10-30 min	Trained personal health coaches	Care as usual	Blue-collar employees of a construction company. (n = 314)	Absenteeism: company’s register 12 m	1.19 (95% CI, 0.66 to 2.15), NR
Von Thiele and Hasson 2011⁴⁴	Reduction of weekly hours (n = 51)	RWH: employees were free to spend the same 2.5 h however they wanted 12 mo	NR	No intervention (n = 65)	Dental health care workers (n = 177)	Productivity: (quality and quantity of work: questionnaire)	NR, NR, ns
						Absenteeism: questionnaire	NR, NR, ns
						Presenteeism: questionnaire	NR, NR, ns
	Reduction of weekly hours with PE (n = 61)	PE: off-work time was split into 2 mandatory PE periods, for a total of 2.5 h				Productivity: (quality and quantity of work: questionnaire)	NR, NR, ns
						Absenteeism: questionnaire	NR, NR, ns
						Presenteeism: questionnaire 12 mo	NR, NR, ns
Von Thiele and Lindfors 2015⁴⁵	The work-based PE intervention (n = 13)	2 × 1 h per week over 1 y	Physiotherapist	No description (n = 12)	Women employed in older persons’ care (n = 25)	Absenteeism: questionnaire SA days	NR, NR, ns
	The work-based PE intervention (n = 13)	2 × 1 h per week over 1 y	Physiotherapist	No description (n = 12)	Women employed in older persons’ care (n = 25)	Absenteeism: questionnaire SA days 12 mo	NR, NR, ns
Willert et al, 2011⁴⁶	Stress management intervention (n = 51)	Each group contained 9 participants, encompassed 8 × 3 h over 3 mo	Licenced clinical psychologists, with >5 y of clinical experience and a 1-y advanced training course in cognitive behavioral therapy	Waiting list (n = 51)	Persons from the working population (18-67 years) in the municipality of Aarhus could participate in the study (n = 102)	Absenteeism: DREAM database 48 wk	NR; .07
Yaghoubitajani et al, 2022⁴⁷	Online supervised exercise (n = 12)	3 × 50-60 min over 8 wk	Qualified corrective exercise instructor supervises	No details (n = 12)	Office workers with upper crossed syndrome (n = 36)	Absenteeism:questionnaire 2 mo	NR, NR, ns
	Exercise administered at the workplace (n = 12)	3 × 50-60 min over 8 wk	Qualified corrective exercise instructor supervises	No details (n = 12)	Office workers with upper crossed syndrome (n = 36)	Absenteeism:questionnaire 2 mo	NR, NR, ns
Zieringer and Zapf, 2024⁴⁸	Employee assistance program (n = 73)	NR	Counselors are typically psychologists, medical professionals, social workers, addiction counselors, or otherwise trained professionals who practice different forms of counseling	Matched control group who did not receive employee assistance program (n = 134)	Clients came from different industries and job roles, such as manufacturing, human services, banking, chemical industry, engineering, or public service (n = 410)	Absenteeism: questionnaire 6 mo	NR, .43

Open in a new tab

Abbreviations: AHA, American Heart Association; CBT, cognitive behavioral therapy; DREAM, Danish longitudinal database; FCM, friction cost method; HCA, human capital approach; HR, high-risk; ICBT, internet-based cognitive behavioral therapy; ICD, International Classification of Diseases; IGLO, individual, group, leader, organization; IR, intermediate risk; NHLBI, The National Heart, Lung, and Blood Institute; NR, not reported; ns, nonsignificant; OHP, occupational health psychologist; PE, physical exercise; PIPPI, participatory physical and psychosocial workplace intervention; RTW, return-to-work; RWH, reduced work hours; s, significant; SA, sickness absence; WAI, work ability index.

Risk of SA days increased.

Converted to 2024 price level.

Stepped wedge cluster randomized trial.

4. Discussion

This review has synthesized the effectiveness of work ability interventions on productivity outcomes. The results suggest that the evidence for the effectiveness of work ability interventions is limited. To our knowledge, this is the first systematic literature review to examine the effectiveness of work ability interventions, regardless of setting and design, on productivity outcomes.

This systematic review included 29 articles covering a total of 33 interventions. Only 5 of these interventions had a significant effect on productivity outcomes, specifically on absenteeism. Three interventions were RCTs and 2 NRCTs. Both RCTs and NRCTs used mostly objective measures (data from registers) to measure absenteeism. Only 1 RCT used a subjective measure to measure absenteeism. Four interventions effectively reduced absenteeism, whereas 1 intervention unexpectedly increased sickness absence.

Among RCTs, the prevention program that included physical and mental health components for construction workers³⁵ significantly decreased sickness absence by 8.5 days compared with the control group. This reduction in sickness absences, quantified and valued using a human capital approach, resulted in financial savings despite considerable uncertainty in the estimates. The workplace physical exercise intervention (WORK) combined with ergonomic counseling²⁸ led to an increase in the Work Ability Index (WAI) item 5 compared with the home-based physical exercise intervention (HOME) with ergonomic counseling among female health care workers, indicating a reduction in sickness absence. It is noteworthy that the effect was small, and the follow-up period was only 10 weeks. The occupational health intervention³⁹ for the construction workers at high risk of sickness absence reduced sickness absence days by 11 days compared with usual care. In addition, the intervention turned out to be cost-effective³⁸ compared with usual care, indicating that well-designed interventions can be economically beneficial. However, the wide CIs and the subjectively gathered costs related to service use call for a cautious interpretation.

In a weighted matched sample, individuals with at least 1 occupational health care psychologist (OHP) appointment for mental disorders³² showed that the intervention group had a mean of 11.4 sickness absence days whereas the control group (no OHP appointment) had 20.2 days. In the full sample, the intervention group had 11.1 sickness absence days, compared with 18.9 days for the control group. OHP consultation for employees with mental disorders significantly reduced sickness absence days, reinforcing the importance of mental health support in occupational settings.

The return-to-work (RTW)–coordination model³¹ showed an increase in the risk of sickness absence from the pre-intervention to the post-intervention period, 3 years after implementing the RTW-coordinator model, compared with 3 years prior. The adjusted model indicated that the risk increased by 1.26-fold among cases and by 1.03-fold among controls in the total population. Although the intervention increased sickness absence compared with the control, controls had a 2.0-fold higher risk of disability retirement compared with cases in the total population [hazard ratio (HR) = 0.49]. This suggests that although the intervention may have negative short-term effects, it could offer long-term benefits in terms of workforce retention. It is also possible that when the intervention aims to keep individuals with poor work ability employed, sickness absences may increase, as those in poorer condition in the control group may leave the workforce.

Seven original studies²²^,³¹^,³³^,³⁴^,³⁶^,³⁷^,⁴⁶ conducted subgroup analyses. Most studies had very small populations, limiting their ability to perform subgroup analyses. One RCT²² demonstrated that productivity improved statistically significantly for the entire population after 3 months, but the effect did not persist for 12 months. Subgroup analyses for overweight female health care workers did not yield statistically significant productivity outcomes at either 3-month or 12-month follow-up. Five RCTs³¹^,³⁴^,³⁶^,³⁷^,⁴⁶ conducted subgroup analyses but they did not alter the results regarding productivity variables. Among these, Kausto et al³¹ included individuals with reduced work ability (n = 683) in their subgroup analysis, finding that whereas absenteeism remained unchanged following the intervention, controls had approximately a 2.9-fold higher risk of disability retirement compared with cases (HR = 0.34; 95% CI, 0.12-0.99). Nurminen et al³⁴ performed subgroup analyses based on sickness absence days at baseline (less than 10 days, over 10 days, and 10-30 days). Rasmussen et al³⁶ focused on nurses’ aides (n = 527) in their subgroup analysis. Stenner et al³⁷ conducted subgroup analyses based on baseline WAI score: poor (WAI 1, 7-36 points, n = 83), good (WAI 2, 37-43 points, n = 136), and excellent (WAI 3, 44-49 points, n = 46). Willert et al⁴⁶ conducted analyses based on employment status (n = 40) and part- or full-time sick leave (n = 61). One study³³ performed subgroup analyses stratified by age: younger participants (45 or younger, n = 58) and older participants (over 45, n = 53), with significant productivity improvements favoring the younger group at both 4-month (mean difference: 0.99 ± 0.37; 95% CI, 0.26-1.72; P = .009) and 12-month follow-up (1.27 ± 0.38; 95% CI, 0.52-2.03; P = .001); similar effects were not observed among older participants, indicating that younger individuals may benefit more from aerobic exercise interventions. Two articles²⁷^,³⁰ were secondary analyses from the original study and they conducted subgroup analyses. These original studies are not included in this review as they did not report productivity outcomes. Overall, the findings suggest that most work ability interventions were unable to affect productivity. Subgroup analyses of the original studies did not alter the results, except for 1 study.³³ In this study, the intervention did not have a statistically significant effect on productivity when considering the entire population, but subgroup analysis showed that it increased productivity in the younger age group. Certain interventions can effectively reduce absenteeism thereby enhancing productivity. However, the results should be interpreted with caution because the results are not generalizable across all settings or populations due to heterogeneity.

It is crucial for work ability interventions to improve employees’ health and work ability, but it is also important to enhance productivity to justify investments from societal or organizational perspective. In the long term, a healthy employee may also become more productive, as personal resources are sufficient, and production losses decrease. However, capturing these effects in research can be challenging due to short follow-up periods and difficulties in measuring productivity outcomes.

It is noteworthy that most included studies evaluated productivity solely from the perspective of absenteeism. Although some studies used questionnaires to assess perceived productivity and presenteeism, only a limited number simultaneously measured absenteeism, productivity, and presenteeism. One reason for this focus on absenteeism might be its association with an individual’s health and the ease of objective measurement. In contrast, perceived productivity and presenteeism are more subjective and challenging to quantify. However, absenteeism alone does not fully reflect overall productivity. A more robust evaluation should include assessments of presenteeism and productivity at the individual and/or organizational levels to yield a more comprehensive understanding.

The practical relevance of absenteeism depends on the nature of the work and the availability of replacement labor. In manual labor, the impact of absenteeism can differ from information work because manual tasks may require urgent completion to maintain organizational productivity. In contrast, information workers can typically resume their tasks upon returning from sick leave, unless there is a prolonged absence. In manual labor, a substitute might be found within the organization or from the labor market, whereas in information work finding a replacement may be challenging, delaying task completion (compensation mechanisms).⁵ Presenteeism, like absenteeism, reflects productivity losses, whereas perceived productivity reflects how productive an individual feels without necessarily involving illness. Presenteeism and perceived productivity might partially overlap or become conflated.

Productivity is possible to measure objectively, at least at the organizational level, by documenting measurable parameters that can be obtained from company databases. Micro-level productivity analysis examines individual and organizational productivity whereas macro-level analysis examines productivity from a societal perspective. It is notable that individual and organizational outcome variables can differ. From an organizational and societal perspective, average productivity is more important rather than productivity of individual employees, suggesting organizational and macro-level analysis is more sensible in the broader view.

Only 3 studies measured productivity costs using a human capital approach,³⁵ a friction cost method,⁴² or both.⁴⁰ This suggests that productivity costs are not frequently included in the evaluation of work ability interventions, and the appropriate method for such evaluation remains uncertain. It would be beneficial to measure productivity costs using both the human capital approach and friction cost method, as there is ongoing debate regarding which method is superior.

Multiplier effects and unpaid labor are also linked to productivity through productivity losses. The multiplier effect refers to a situation where the absence of one employee’s input prevents the entire team from functioning. For instance, if a surgeon is not able to perform surgery, the whole operating team is unable to function. From a societal perspective, unpaid labor such as volunteer work also plays an important role when measuring productivity.⁵

Productivity outcome variables are prone to publication bias. For instance, presenteeism may be easily overlooked or unreported due to its complexity compared with absenteeism. Consequently, absenteeism may skew results and provide a misleading picture of overall productivity. Therefore, it is crucial to consider as many productivity-related variables as possible to obtain a more realistic picture of overall productivity. If register data are available productivity losses can be measured with disability pensions and employment status, in addition to absenteeism, when considering a societal perspective. Depending on the chosen perspective, combining objective productivity from registry data, absenteeism, disability pensions, employment status, and survey data on presenteeism and volunteer work can offer a more comprehensive view of productivity.

Implementing work ability interventions using an experimental design appears to be challenging. Conducting a double-blind study in this context is difficult, as the person administering the intervention is usually aware of whether the participant belongs to the experimental or control group. Moreover, dividing participants into 2 groups, where 1 group is likely to receive a more effective intervention, poses ethical concerns or entails a lack of motivation for participation. It might also be difficult to enlist enough participants to the study (small sample size), which results in low statistical power.⁷⁵ The feasibility and scalability of work ability interventions are also challenging, as they encounter various real-world problems, such as resource constraints, operational disruptions, workplace diversity, and the adaptability of interventions.

A register-based quasi-experimental design is a good alternative for measuring the effectiveness of work ability interventions on productivity (particularly on sickness absence), assuming the register data are robust and comprehensive. This approach allows for a large sample size, as demonstrated by 2 studies.³¹^,³² In a quasi-experimental design, a well-matched sample ensures that groups are highly comparable with respect to covariates despite lack of randomization.⁷⁶ Follow-up times can also be wider than in a traditional RCT. Another way to address the challenges regarding work ability interventions in diverse occupational settings could be dissemination and implementation (D&I) research by focusing on effectiveness, feasibility, and scalability. D&I research frameworks typically consider contextual and multi-level barriers and facilitators that impact the adoption and use of evidence-based interventions across various real-world settings.⁷⁷ Effective implementation is essential for accurately measuring outcome effectiveness. The feasibility of an intervention addresses whether it is realistic or worthwhile to implement within real-world constraints,⁷⁸ whereas scalability examines if expanding the intervention maintains its effectiveness.⁷⁹ Previously mentioned frameworks can help ensure that interventions are well suited and applicable in real-world settings. Thus, D&I research could bridge the gap between the development of work ability interventions and their real-world applications.

4.1. Strengths and limitations of the included studies

All the studies used self-reported data to measure productivity or presenteeism. However, subjectively measured outcomes can introduce bias and limit significantly the reliability of the findings. Most studies also relied on self-reported data to measure absenteeism, although some employed register-based measurements. Notably, there is strong agreement between self-reported and register-based absenteeism data.⁸⁰ The strength of the included studies was that almost all studies with significant effects used objective measures of absenteeism.

Some of the RCTs were limited by very small sample sizes, which affects the reliability of the findings. However, most RCTs had sample sizes of over 200, indicating that both the intervention and control groups had over 100 participants, aligning with recommendations.⁸¹ All but 1 RCT with a positive effect had a sufficient sample size, enhancing the reliability of the findings. Two NRCTs²⁴^,³⁶ were limited by very small sample sizes (n = 25-37), which may affect the robustness of the findings. One NRCT⁴⁸ had a larger sample size of 410 participants. Two NRCTs³¹^,³² with significant effects had a substantial number of participants (n = 2726-9720), which enhances the reliability of their findings.

A limitation of work ability interventions is their implementation within specific settings or populations, which limits their generalizability to other contexts. Additionally, the heterogeneity of work ability interventions and productivity-related outcomes poses challenges in summarizing results and drawing generalizable conclusions.

4.2. Strengths and limitations of this review

This systematic review has several strengths, including the wide inclusion criteria and a comprehensive search strategy that ensured a wide range of studies were considered. It included studies identified through the snowball effect and included both RCT and NRCT studies, enhancing the scope and depth of the analysis. All studies featured a comparison group, which is inevitable when assessing the effectiveness of interventions.

However, inclusion criteria may have excluded some important studies, and the absence of “performance” in the search strategy may weaken its comprehensiveness. Additionally, the specific definitions of work ability and work ability interventions could have led to the omission of relevant research, resulting in the exclusion of wellness programs implemented in workplaces. These programs have been studied, for instance, in the United States.⁸² The review did not explore gray literature, potentially missing unpublished studies, and there is a risk of publication bias, as studies with undesired or statistically nonsignificant results are less likely to be published. The kappa statistic value indicated that the level of agreement was weak (P.I., M.I.) and moderate (P.K., E.S.) at the title and abstract screening phase. This indicates that 25% (P.I., M.I.) and 60% (P.K., E.S.) of the data are reliable. At the full-text review phase, Cohen kappa was 0.80 (P.K., M.I.) and 0.61 (P.K., E.S.), indicating that 64% (P.K., M.I.) and 34% (P.K., E.S.) of the data are reliable, respectively.¹⁵ Another limitation of this review is that we could not perform a meta-analysis due to the heterogeneity of the work ability interventions and outcomes. For the same reasons we did not conduct subgroup analyses.

5. Conclusions

The analysis of work ability interventions showed that most of them were ineffective in increasing productivity-related outcomes, whereas only a few interventions affected these outcomes, specifically absenteeism. Among these, 4 interventions effectively reduced absenteeism, whereas 1 trial increased the risk of absenteeism. Notably, 1 trial indicated a reduction in costs related to absenteeism, and another showed that the intervention was more effective and less costly than usual occupational care. It remains challenging for society and organizations to invest in work ability interventions when there is insufficient information on evidence-based interventions that enhance productivity. This systematic review highlights the current lack of evidence regarding the effectiveness of high-quality work ability interventions on productivity. Further research is needed to fill the information gap concerning work ability interventions that affect productivity. Quasi-experimental register-based studies are a good opportunity to address this issue.

Supplementary Material

Web_Material_uiaf051

web_material_uiaf051.zip^{(78.3KB, zip)}

Contributor Information

Pasi Kekkonen, Department of Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland; Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland.

Eija Savolainen, Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland.

Mari Immonen, Department of Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland.

Pauliina Kangas, Department of Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland.

Elisa Rissanen, Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland.

Ismo Linnosmaa, Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland.

Author contributions

P.K. contributed to the planning of the study, conducted screening and data extraction, analyzed the data, and wrote the initial manuscript. E.S. conducted screening and data extraction. E.R., P.K., and I.L. contributed to the planning of the study and revised the manuscript. M.I. conducted screening.

Supplementary material

Supplementary material is available at Journal of Occupational Health online.

Funding

This study was funded by the Social Insurance Institution of Finland.

Conflicts of interest

All authors declared that they have no conflicts of interest.

Data availability

The datasets supporting the conclusions of this article are included within the article and its supplementary material.

References

1. Tengland P-A. The concept of work ability. J Occup Rehabil. 2011;21(2):275-285. 10.1007/s10926-010-9269-x [DOI] [PubMed] [Google Scholar]
2. OECD . OECD Manual: Measurement of Aggregate and Industry-Level Productivity Growth. OECD Publishing; 2001. [Google Scholar]
3. Zhang W, Bansback N, Anis AH. Measuring and valuing productivity loss due to poor health: a critical review. Soc Sci Med. 2011;72(2):185-192 [DOI] [PubMed] [Google Scholar]
4. Widera E, Chang A, Chen HL. Presenteeism: a public health hazard. J Gen Intern Med. 2010;25(11):1244-1247. 10.1007/s11606-010-1422-x [DOI] [PMC free article] [PubMed] [Google Scholar]
5. Krol M, Brouwer W, Rutten F. Productivity costs in economic evaluations: past, present, future. PharmacoEconomics. 2013;31(7):537-549. 10.1007/s40273-013-0056-3 [DOI] [PubMed] [Google Scholar]
6. Schultz AB, Chen C-Y, Edington DW. The cost and impact of health conditions on presenteeism to employers. PharmacoEconomics. 2009;27(5):365-378. 10.2165/00019053-200927050-00002 [DOI] [PubMed] [Google Scholar]
7. Marin-Farrona M, Wipfli B, Thosar SS, et al. Effectiveness of worksite wellness programs based on physical activity to improve workers’ health and productivity: a systematic review. Syst Rev. 2023;12(1):87. 10.1186/s13643-023-02258-6 [DOI] [PMC free article] [PubMed] [Google Scholar]
8. Tarro L, Llauradó E, Ulldemolins G, Hermoso P, Solà R. Effectiveness of workplace interventions for improving absenteeism, productivity, and work ability of employees: a systematic review and meta-analysis of randomized controlled trials. Int J Environ Res Public Health. 2020;17(6):1901. 10.3390/ijerph17061901 [DOI] [PMC free article] [PubMed] [Google Scholar]
9. Cloostermans L, Bekkers MB, Uiters E, Proper KI. The effectiveness of interventions for ageing workers on (early) retirement, work ability and productivity: a systematic review. Int Arch Occup Environ Health. 2015;88(5):521-532. 10.1007/s00420-014-0969-y [DOI] [PubMed] [Google Scholar]
10. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. 10.1136/bmj.n71 [DOI] [PMC free article] [PubMed] [Google Scholar]
11. Kekkonen Pasi RE, Kangas P, Linnosmaa I. The effectiveness of work ability interventions on productivity – a systematic review protocol. PROSPERO. 2024;CRD42024541404. [DOI] [PMC free article] [PubMed] [Google Scholar]
12. Methley AM, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014;14(1):579. 10.1186/s12913-014-0579-0 [DOI] [PMC free article] [PubMed] [Google Scholar]
13. Choong MK, Galgani F, Dunn AG, Tsafnat G. Automatic evidence retrieval for systematic reviews. J Med Internet Res. 2014;16(10):e223. 10.2196/jmir.3369 [DOI] [PMC free article] [PubMed] [Google Scholar]
14.Homepage. Covidence systematic review software. Veritas Health Innovation. www.covidence.org
15. McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22(3):276-282. 10.11613/BM.2012.031 [DOI] [PMC free article] [PubMed] [Google Scholar]
16. Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:14898. 10.1136/bmj.l4898 [DOI] [PubMed] [Google Scholar]
17. Sterne JA, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. 10.1136/bmj.i4919 [DOI] [PMC free article] [PubMed] [Google Scholar]
18. Evers S, Goossens M, de Vet H, van Tulder M, Ament A. Criteria list for assessment of methodological quality of economic evaluations: consensus on health economic criteria. Int J Technol Assess Health Care. 2005;21(2):240-245. 10.1017/S0266462305050324 [DOI] [PubMed] [Google Scholar]
19.CCEMG-EPPI-Centre Cost Converter. Version 1.6. The Campbell and Cochrane Economics Methods Group (CCEMG) and the Evidence for Policy and Practice Information and Coordinating Centre (EPPI-Centre), 2019. https://eppi.ioe.ac.uk/costconversion/
20. Aanesen F, Grotle M, Rysstad TL, et al. Effectiveness of adding motivational interviewing or a stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders: the MI-NAV randomised controlled trial. Occup Environ Med. 2023;80(1):42-50. 10.1136/oemed-2022-108637 [DOI] [PMC free article] [PubMed] [Google Scholar]
21. Andersen LN, Juul-Kristensen B, Roessler KK, Herborg LG, Sørensen TL, Søgaard K. Efficacy of 'tailored physical activity' on reducing sickness absence among health care workers: a 3-months randomised controlled trial. Man Ther. 2015;20(5):666-671. 10.1016/j.math.2015.04.017 [DOI] [PubMed] [Google Scholar]
22. Christensen JR, Overgaard K, Hansen K, Søgaard K, Holtermann A. Effects on presenteeism and absenteeism from a 1-year workplace randomized controlled trial among health care workers. J Occup Environ Med. 2013;55(10):1186-1190. 10.1097/JOM.0b013e31829b2816 [DOI] [PubMed] [Google Scholar]
23. Díaz-Benito VJ, Moro MIB, Vanderhaegen F, et al. Intervention of physical exercise in the workplace on work ability, depression, anxiety and job satisfaction in workers with sedentary tasks. WORK. 2022;72(3):921-931. 10.3233/WOR-210300 [DOI] [PubMed] [Google Scholar]
24. Escriche-Escuder A, Calatayud J, Andersen LL, Ezzatvar Y, Aiguadé R, Casaña J. Effect of a brief progressive resistance training program in hospital porters on pain, work ability, and physical function. Musculoskelet Sci Pract. 2020;48:102162. 10.1016/j.msksp.2020.102162 [DOI] [PubMed] [Google Scholar]
25. Gram B, Holtermann A, Bültmann U, Sjøgaard G, Søgaard K. Does an exercise intervention improving aerobic capacity among construction workers also improve musculoskeletal pain, work ability, productivity, perceived physical exertion, and sick leave?: a randomized controlled trial. J Occup Environ Med. 2012;54(12):1520-1526. 10.1097/JOM.0b013e318266484a [DOI] [PubMed] [Google Scholar]
26. Gupta N, Wåhlin-Jacobsen CD, Abildgaard JS, Henriksen LN, Nielsen K, Holtermann A. Effectiveness of a participatory physical and psychosocial intervention to balance the demands and resources of industrial workers: a cluster-randomized controlled trial. Scand J Work Environ Health. 2018;44(1):58-68. 10.5271/sjweh.3689 [DOI] [PubMed] [Google Scholar]
27. Haufe S, Kahl KG, Kerling A, et al. Employers with metabolic syndrome and increased depression/anxiety severity profit most from structured exercise intervention for work ability and quality of life. Front Psychiatry. 2020;11:562. 10.3389/fpsyt.2020.00562 [DOI] [PMC free article] [PubMed] [Google Scholar]
28. Jakobsen MD, Sundstrup E, Brandt M, Jay K, Aagaard P, Andersen LL. Physical exercise at the workplace prevents deterioration of work ability among healthcare workers: cluster randomized controlled trial. BMC Public Health. 2015;15:1174. [DOI] [PMC free article] [PubMed] [Google Scholar]
29. Justesen JB, Sogaard K, Dalager T, Christensen JR, Sjogaard G. The effect of intelligent physical exercise training on sickness presenteeism and absenteeism among office workers. J Occup Environ Med. 2017;59(10):942-948. 10.1097/JOM.0000000000001101 [DOI] [PubMed] [Google Scholar]
30. Kaldo V, Lundin A, Hallgren M, et al. Effects of internet-based cognitive behavioural therapy and physical exercise on sick leave and employment in primary care patients with depression: two subgroup analyses. Occup Environ Med. 2018;75(1):52-58. 10.1136/oemed-2017-104326 [DOI] [PMC free article] [PubMed] [Google Scholar]
31. Kausto J, Oksanen T, Koskinen A, et al. ‘Return to work’ coordinator model and work participation of employees: a natural intervention study in Finland. J Occup Rehabil. 2021;31(4):831-839. 10.1007/s10926-021-09970-x [DOI] [PMC free article] [PubMed] [Google Scholar]
32. Lahti J, Harkko J, Nordquist H, et al. Seeing an occupational health psychologist reduces sickness absence due to mental disorders: a quasi-experimental study. Prev Med. 2021;149:106611. 10.1016/j.ypmed.2021.106611 [DOI] [PubMed] [Google Scholar]
33. Lidegaard M, Søgaard K, Krustrup P, Holtermann A, Korshøj M. Effects of 12 months aerobic exercise intervention on work ability, need for recovery, productivity and rating of exertion among cleaners: a worksite RCT. Int Arch Occup Environ Health. 2018;91(2):225-235. 10.1007/s00420-017-1274-3 [DOI] [PMC free article] [PubMed] [Google Scholar]
34. Nurminen E, Malmivaara A, Ilmarinen J, et al. Effectiveness of a worksite exercise program with respect to perceived work ability and sick leaves among women with physical work. Scand J Work Environ Health. 2002;28(2):85-93. 10.5271/sjweh.652 [DOI] [PubMed] [Google Scholar]
35. Oude Hengel KM, Bosmans JE, Van Dongen JM, Bongers PM, Van der Beek AJ, Blatter BM. Prevention program at construction worksites aimed at improving health and work ability is cost-saving to the employer: results from an RCT. Am J Ind Med. 2014;57(1):56-68. 10.1002/ajim.22267 [DOI] [PubMed] [Google Scholar]
36. Rasmussen CDN, Holtermann A, Jørgensen MB, Ørberg A, Mortensen OS, Søgaard K. A multi-faceted workplace intervention targeting low back pain was effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence: stepped wedge cluster randomised trial. Scand J Public Health. 2016;44(6):560-570. 10.1177/1403494816653668 [DOI] [PubMed] [Google Scholar]
37. Stenner HT, Eigendorf J, Kerling A, et al. Effects of six month personalized endurance training on work ability in middle-aged sedentary women: a secondary analysis of a randomized controlled trial. J Occup Med Toxicol. 2020;15(1):8. 10.1186/s12995-020-00261-4 [DOI] [PMC free article] [PubMed] [Google Scholar]
38. Taimela S, Justén S, Aronen P, et al. An occupational health intervention programme for workers at high risk for sickness absence. Cost effectiveness analysis based on a randomised controlled trial. Occup Environ Med. 2008;65(4):242-248. 10.1136/oem.2007.033167 [DOI] [PMC free article] [PubMed] [Google Scholar]
39. Taimela S, Malmivaara A, Justén S, et al. The effectiveness of two occupational health intervention programmes in reducing sickness absence among employees at risk. Two randomised controlled trials. Occup Environ Med. 2008;65(4):236-241. 10.1136/oem.2007.032706 [DOI] [PMC free article] [PubMed] [Google Scholar]
40. Tamminga SJ, Verbeek JHAM, Bos MMEM, et al. Effectiveness of a hospital-based work support intervention for female cancer patients—a multi-centre randomised controlled trial. PLoS One. 2013;8(5):e63271. 10.1371/journal.pone.0063271 [DOI] [PMC free article] [PubMed] [Google Scholar]
41. Uegaki K, Stomp-Van Den Berg SGM, De Bruijne MC, et al. Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in the Netherlands: results of an economic evaluation alongside a randomized controlled trial. BMC Public Health. 2011;11(1):57. 10.1186/1471-2458-11-57 [DOI] [PMC free article] [PubMed] [Google Scholar]
42. Van Dongen JM, Van Berkel J, Boot CRL, et al. Long-term cost-effectiveness and return-on-investment of a mindfulness-based worksite intervention. J Occup Environ Med. 2016;58(6):550-560. 10.1097/JOM.0000000000000736 [DOI] [PubMed] [Google Scholar]
43. Viester L, Verhagen EALM, Bongers PM, van der Beek AJ. The effect of a health promotion intervention for construction workers on work-related outcomes: results from a randomized controlled trial. Int Arch Occup Environ Health. 2015;88(6):789-798. 10.1007/s00420-014-1007-9 [DOI] [PubMed] [Google Scholar]
44. Von Thiele SU, Hasson H. Employee self-rated productivity and objective organizational production levels: effects of worksite health interventions involving reduced work hours and physical exercise. J Occup Environ Med. 2011;53(8):838-844. 10.1097/JOM.0b013e31822589c2 [DOI] [PubMed] [Google Scholar]
45. Von Thiele SU, Lindfors P. Improved fitness after a workbased physical exercise program. Int J Workplace Health Manag. 2015;8(1):61-74. 10.1108/IJWHM-10-2013-0038 [DOI] [Google Scholar]
46. Willert MV, Thulstrup AM, Bonde JP. Effects of a stress management intervention on absenteeism and return to work—results from a randomized wait-list controlled trial. Scand J Work Environ Health. 2011;37(3):186-195. 10.5271/sjweh.3130 [DOI] [PubMed] [Google Scholar]
47. Yaghoubitajani Z, Gheitasi M, Bayattork M, Andersen LL. Corrective exercises administered online vs at the workplace for pain and function in the office workers with upper crossed syndrome: randomized controlled trial. Int Arch Occup Environ Health. 2022;95(8):1703-1718. 10.1007/s00420-022-01859-3 [DOI] [PMC free article] [PubMed] [Google Scholar]
48. Zieringer RC, Zapf D. The effects of an employee assistance program on productivity at work, workability, absenteeism, and smartphone measures of heart rate and heart rate variability. J Occup Health Psychol. 2024;29(4):280-298. 10.1037/ocp0000380 [DOI] [PubMed] [Google Scholar]
49. Aili K, Hellman T, Svartengren M, Danielsson K. Including a three-party meeting using the demand and ability protocol in an interdisciplinary pain rehabilitation programme for a successful return to work process. Int J Environ Res Public Health. 2022;19(24):16614. 10.3390/ijerph192416614 [DOI] [PMC free article] [PubMed] [Google Scholar]
50. Asplund RP, Asplund S, von Buxhoeveden H, et al. Work-focused versus generic internet-based interventions for employees with stress-related disorders: randomized controlled trial. J Med Internet Res. 2023;25:e34446. 10.2196/34446 [DOI] [PMC free article] [PubMed] [Google Scholar]
51. Asplund RP, Carvallo F, Christensson H, et al. Learning how to recover from stress: results from an internet-based randomized controlled pilot trial. Internet Interv. 2023;34:100681. 10.1016/j.invent.2023.100681 [DOI] [PMC free article] [PubMed] [Google Scholar]
52. Axén I, Sennehed CP, Eek F, Stigmar K. Can a workplace dialogue impact the perceived influence of neck and/or backpain on everyday activities and performance at work? A secondary analysis from the randomized controlled trial WorkUp. BMC Musculoskelet Disord. 2022;23(1):861. 10.1186/s12891-022-05812-w [DOI] [PMC free article] [PubMed] [Google Scholar]
53. Behrens-Wittenberg E, Wedegaertner F. A return-to-work intervention for prematurely retired depression or anxiety disorder patients. Front Psychiatry. 2021;12:662158. 10.3389/fpsyt.2021.662158 [DOI] [PMC free article] [PubMed] [Google Scholar]
54. Contreras C, Hellhammer J, Gerhards F, Hellhammer DH. Neuropattern, a translational tool to reduce stress at work—a pilot study. Occup Health Sci. 2018;2(4):385-407. 10.1007/s41542-018-0025-5 [DOI] [Google Scholar]
55. Dalager T, Bredahl TGV, Pedersen MT, Boyle E, Andersen LL, Sjøgaard G. Does training frequency and supervision affect compliance, performance and muscular health? A cluster randomized controlled trial. Man Ther. 2015;20(5):657-665. 10.1016/j.math.2015.01.016 [DOI] [PubMed] [Google Scholar]
56. Frederiksen P, Indahl A, Andersen LL, Burton K, Hertzum-Larsen R, Bendix T. Can group-based reassuring information alter low back pain behavior? A cluster-randomized controlled trial. PLoS One. 2017;12(3):e0172003. 10.1371/journal.pone.0172003 [DOI] [PMC free article] [PubMed] [Google Scholar]
57. Geukes M, Anema JR, Vermeer M, van Aalst MP, Oosterhof H. Evaluation of a workplace educational intervention on menopause: a quasi-experimental study. Maturitas. 2023;174:48-56. 10.1016/j.maturitas.2023.05.005 [DOI] [PubMed] [Google Scholar]
58. Hange D, Ariai N, Kivi M, Eriksson MCM, Nejati S, Petersson E-L. The impact of internet-based cognitive behavior therapy on work ability in patients with depression—randomized controlled study. Int J Gen Med. 2017;10:151-159. 10.2147/IJGM.S129710 [DOI] [PMC free article] [PubMed] [Google Scholar]
59. Haynes NJ, Vandenberg RJ, Wilson MG, DeJoy DM, Padilla HM, Smith ML. Evaluating the impact of the Live Healthy, Work Healthy program on organizational outcomes: a randomized field experiment. J Appl Psychol. 2022;107(10):1758-1780. 10.1037/apl0000977 [DOI] [PMC free article] [PubMed] [Google Scholar]
60. Hultberg EL, Lönnroth K, Allebeck P, Hensing G. Effects of co-financed interdisciplinary teamwork on sick leave for people with musculoskeletal disorders. Work. 2006;26(4):369-377. 10.3233/WOR-2006-00532 [DOI] [PubMed] [Google Scholar]
61. Koolhaas W, Groothoff JW, De Boer MR, Van Der Klink JJL, Brouwer S. Effectiveness of a problem-solving based intervention to prolong the working life of ageing workers. BMC Public Health. 2015;15(1):76. 10.1186/s12889-015-1410-5 [DOI] [PMC free article] [PubMed] [Google Scholar]
62. Muschalla B, Linden M, Jöbges M. Work-anxiety and sickness absence after a short inpatient cognitive behavioral group intervention in comparison to a recreational group meeting. J Occup Environ Med. 2016;58(4):398-406. 10.1097/JOM.0000000000000678 [DOI] [PubMed] [Google Scholar]
63. Noben C, Evers S, Jv G, Nijhuis F, de Rijk A. Improving a web-based employability intervention for work-disabled employees: results of a pilot economic evaluation. Disabil Rehabil. Assist Technol. 2017;12(3):280-289 [DOI] [PubMed] [Google Scholar]
64. Notenbomer A, Roelen C, Groothoff J, van Rhenen W, Bültmann U. Effect of an eHealth intervention to reduce sickness absence frequency among employees with frequent sickness absence: randomized controlled trial. J Med Internet Res. 2018;20(10):e10821. 10.2196/10821 [DOI] [PMC free article] [PubMed] [Google Scholar]
65. Näsman O, Ahonen G. The DRUVAN-project: a major increase in Occupational Health Service based on the Metal Age method in a Finnish municipality improved the work ability and gave significant financial return. Paper presented at: Promotion of Work Ability Towards Productive Aging—Third International Symposium on Work Ability; 2007. 22-24 October; Hanoi, Vietnam. [Google Scholar]
66. Saha S, Grahn B, Gerdtham UG, Stigmar K, Holmberg S, Jarl J. Structured physiotherapy including a work place intervention for patients with neck and/or back pain in primary care: an economic evaluation. Eur J Health Econ. 2019;20(2):317-327. 10.1007/s10198-018-1003-1 [DOI] [PMC free article] [PubMed] [Google Scholar]
67. Sennehed CP, Holmberg S, Axén I, et al. Early workplace dialogue in physiotherapy practice improved work ability at 1-year follow-up—WorkUp, a randomised controlled trial in primary care. Pain. 2018;159(8):1456-1464. 10.1097/j.pain.0000000000001216 [DOI] [PMC free article] [PubMed] [Google Scholar]
68. Shaw WS, McLellan RK, Besen E, et al. A worksite self-management program for workers with chronic health conditions improves worker engagement and retention, but not workplace function. J Occup Rehabil. 2022;32(1):77-86. 10.1007/s10926-021-09983-6 [DOI] [PMC free article] [PubMed] [Google Scholar]
69. Sprūdža D, Kozlova L, Lakiša S, et al. The impact of metal age training programme on the well-being of Latvian office workers. Proc Latv Acad Sci. 2016;70(5):315-324. 10.1515/prolas-2016-0048 [DOI] [Google Scholar]
70. van de Ven D, Schuring M, Kouwenhoven-Pasmooij TA, Blom P, Burdorf A, Robroek SJW. Reach and effectiveness of a worksite health promotion program combining a preventive medical examination with motivational interviewing; a quasi-experimental study among workers in low socioeconomic position. BMC Public Health. 2023;23(1):2130. 10.1186/s12889-023-16908-w [DOI] [PMC free article] [PubMed] [Google Scholar]
71. Van Holland BJ, Reneman MF, Soer R, Brouwer S, de Boer MR. Effectiveness and cost-benefit evaluation of a comprehensive workers’ health surveillance program for sustainable employability of meat processing workers. J Occup Rehabil. 2018;28(1):107-120. 10.1007/s10926-017-9699-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
72. Von Thiele SU, Augustsson H, Hasson H, Stenfors-Hayes T. Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study. J Occup Environ Med. 2015;57(2):217-225. 10.1097/JOM.0000000000000344 [DOI] [PubMed] [Google Scholar]
73. Wall A, Henriksson M, Nyberg J, et al. Exercise and health-related quality of life and work-related outcomes in primary care patients with anxiety disorders—a randomized controlled study. J Affect Disord. 2024;360:5-14. 10.1016/j.jad.2024.05.092 [DOI] [PubMed] [Google Scholar]
74. Östlind E, Eek F, Stigmar K, Sant’Anna A, Hansson EE. Promoting work ability with a wearable activity tracker in working age individuals with hip and/or knee osteoarthritis: a randomized controlled trial. BMC Musculoskelet Disord. 2022;23(1):112. 10.1186/s12891-022-05041-1 [DOI] [PMC free article] [PubMed] [Google Scholar]
75. Button KS, Ioannidis JPA, Mokrysz C, et al. Power failure: why small sample size undermines the reliability of neuroscience. Nat Rev Neurosci. 2013;14(5):365-376. 10.1038/nrn3475 [DOI] [PubMed] [Google Scholar]
76. Stuart EA. Matching methods for causal inference: a review and a look forward. Stat Sci. 2010;25(1):1-21. 10.1214/09-STS313 [DOI] [PMC free article] [PubMed] [Google Scholar]
77. Shelton RC, Lee M, Brotzman LE, Wolfenden L, Nathan N, Wainberg ML. What is dissemination and implementation science?: an introduction and opportunities to advance behavioral medicine and public health globally. Int J Behav Med. 2020;27(1):3-20. 10.1007/s12529-020-09848-x [DOI] [PubMed] [Google Scholar]
78. Arain M, Campbell MJ, Cooper CL, Lancaster GA. What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Med Res Methodol. 2010;10(1):67. 10.1186/1471-2288-10-67 [DOI] [PMC free article] [PubMed] [Google Scholar]
79. Milat AJ, Bauman A, Redman S. Narrative review of models and success factors for scaling up public health interventions. Implement Sci. 2015;10(1):113. 10.1186/s13012-015-0301-6 [DOI] [PMC free article] [PubMed] [Google Scholar]
80. Voss M, Stark S, Alfredsson L, Vingård E, Josephson M. Comparisons of self-reported and register data on sickness absence among public employees in Sweden. Occup Environ Med. 2008;65(1):61-67. 10.1136/oem.2006.031427 [DOI] [PubMed] [Google Scholar]
81. Althubaiti A. Sample size determination: a practical guide for health researchers. J Gen Fam Med. 2023;24(2):72-78. 10.1002/jgf2.600 [DOI] [PMC free article] [PubMed] [Google Scholar]
82. Jones D, Molitor D, Reif J. What do workplace wellness programs do? Evidence from the Illinois workplace wellness study. Q J Econ. 2019;134(4):1747-1791. 10.1093/qje/qjz023 [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Web_Material_uiaf051

web_material_uiaf051.zip^{(78.3KB, zip)}

Data Availability Statement

The datasets supporting the conclusions of this article are included within the article and its supplementary material.

[ref1] 1. Tengland P-A. The concept of work ability. J Occup Rehabil. 2011;21(2):275-285. 10.1007/s10926-010-9269-x [DOI] [PubMed] [Google Scholar]

[ref2] 2. OECD . OECD Manual: Measurement of Aggregate and Industry-Level Productivity Growth. OECD Publishing; 2001. [Google Scholar]

[ref3] 3. Zhang W, Bansback N, Anis AH. Measuring and valuing productivity loss due to poor health: a critical review. Soc Sci Med. 2011;72(2):185-192 [DOI] [PubMed] [Google Scholar]

[ref4] 4. Widera E, Chang A, Chen HL. Presenteeism: a public health hazard. J Gen Intern Med. 2010;25(11):1244-1247. 10.1007/s11606-010-1422-x [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref5] 5. Krol M, Brouwer W, Rutten F. Productivity costs in economic evaluations: past, present, future. PharmacoEconomics. 2013;31(7):537-549. 10.1007/s40273-013-0056-3 [DOI] [PubMed] [Google Scholar]

[ref6] 6. Schultz AB, Chen C-Y, Edington DW. The cost and impact of health conditions on presenteeism to employers. PharmacoEconomics. 2009;27(5):365-378. 10.2165/00019053-200927050-00002 [DOI] [PubMed] [Google Scholar]

[ref7] 7. Marin-Farrona M, Wipfli B, Thosar SS, et al. Effectiveness of worksite wellness programs based on physical activity to improve workers’ health and productivity: a systematic review. Syst Rev. 2023;12(1):87. 10.1186/s13643-023-02258-6 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref8] 8. Tarro L, Llauradó E, Ulldemolins G, Hermoso P, Solà R. Effectiveness of workplace interventions for improving absenteeism, productivity, and work ability of employees: a systematic review and meta-analysis of randomized controlled trials. Int J Environ Res Public Health. 2020;17(6):1901. 10.3390/ijerph17061901 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref9] 9. Cloostermans L, Bekkers MB, Uiters E, Proper KI. The effectiveness of interventions for ageing workers on (early) retirement, work ability and productivity: a systematic review. Int Arch Occup Environ Health. 2015;88(5):521-532. 10.1007/s00420-014-0969-y [DOI] [PubMed] [Google Scholar]

[ref10] 10. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. 10.1136/bmj.n71 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref11] 11. Kekkonen Pasi RE, Kangas P, Linnosmaa I. The effectiveness of work ability interventions on productivity – a systematic review protocol. PROSPERO. 2024;CRD42024541404. [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref12] 12. Methley AM, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014;14(1):579. 10.1186/s12913-014-0579-0 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref13] 13. Choong MK, Galgani F, Dunn AG, Tsafnat G. Automatic evidence retrieval for systematic reviews. J Med Internet Res. 2014;16(10):e223. 10.2196/jmir.3369 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref14] 14.Homepage. Covidence systematic review software. Veritas Health Innovation. www.covidence.org

[ref15] 15. McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22(3):276-282. 10.11613/BM.2012.031 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref16] 16. Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:14898. 10.1136/bmj.l4898 [DOI] [PubMed] [Google Scholar]

[ref17] 17. Sterne JA, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. 10.1136/bmj.i4919 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref18] 18. Evers S, Goossens M, de Vet H, van Tulder M, Ament A. Criteria list for assessment of methodological quality of economic evaluations: consensus on health economic criteria. Int J Technol Assess Health Care. 2005;21(2):240-245. 10.1017/S0266462305050324 [DOI] [PubMed] [Google Scholar]

[ref19] 19.CCEMG-EPPI-Centre Cost Converter. Version 1.6. The Campbell and Cochrane Economics Methods Group (CCEMG) and the Evidence for Policy and Practice Information and Coordinating Centre (EPPI-Centre), 2019. https://eppi.ioe.ac.uk/costconversion/

[ref20] 20. Aanesen F, Grotle M, Rysstad TL, et al. Effectiveness of adding motivational interviewing or a stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders: the MI-NAV randomised controlled trial. Occup Environ Med. 2023;80(1):42-50. 10.1136/oemed-2022-108637 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref21] 21. Andersen LN, Juul-Kristensen B, Roessler KK, Herborg LG, Sørensen TL, Søgaard K. Efficacy of 'tailored physical activity' on reducing sickness absence among health care workers: a 3-months randomised controlled trial. Man Ther. 2015;20(5):666-671. 10.1016/j.math.2015.04.017 [DOI] [PubMed] [Google Scholar]

[ref22] 22. Christensen JR, Overgaard K, Hansen K, Søgaard K, Holtermann A. Effects on presenteeism and absenteeism from a 1-year workplace randomized controlled trial among health care workers. J Occup Environ Med. 2013;55(10):1186-1190. 10.1097/JOM.0b013e31829b2816 [DOI] [PubMed] [Google Scholar]

[ref23] 23. Díaz-Benito VJ, Moro MIB, Vanderhaegen F, et al. Intervention of physical exercise in the workplace on work ability, depression, anxiety and job satisfaction in workers with sedentary tasks. WORK. 2022;72(3):921-931. 10.3233/WOR-210300 [DOI] [PubMed] [Google Scholar]

[ref24] 24. Escriche-Escuder A, Calatayud J, Andersen LL, Ezzatvar Y, Aiguadé R, Casaña J. Effect of a brief progressive resistance training program in hospital porters on pain, work ability, and physical function. Musculoskelet Sci Pract. 2020;48:102162. 10.1016/j.msksp.2020.102162 [DOI] [PubMed] [Google Scholar]

[ref25] 25. Gram B, Holtermann A, Bültmann U, Sjøgaard G, Søgaard K. Does an exercise intervention improving aerobic capacity among construction workers also improve musculoskeletal pain, work ability, productivity, perceived physical exertion, and sick leave?: a randomized controlled trial. J Occup Environ Med. 2012;54(12):1520-1526. 10.1097/JOM.0b013e318266484a [DOI] [PubMed] [Google Scholar]

[ref26] 26. Gupta N, Wåhlin-Jacobsen CD, Abildgaard JS, Henriksen LN, Nielsen K, Holtermann A. Effectiveness of a participatory physical and psychosocial intervention to balance the demands and resources of industrial workers: a cluster-randomized controlled trial. Scand J Work Environ Health. 2018;44(1):58-68. 10.5271/sjweh.3689 [DOI] [PubMed] [Google Scholar]

[ref27] 27. Haufe S, Kahl KG, Kerling A, et al. Employers with metabolic syndrome and increased depression/anxiety severity profit most from structured exercise intervention for work ability and quality of life. Front Psychiatry. 2020;11:562. 10.3389/fpsyt.2020.00562 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref28] 28. Jakobsen MD, Sundstrup E, Brandt M, Jay K, Aagaard P, Andersen LL. Physical exercise at the workplace prevents deterioration of work ability among healthcare workers: cluster randomized controlled trial. BMC Public Health. 2015;15:1174. [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref29] 29. Justesen JB, Sogaard K, Dalager T, Christensen JR, Sjogaard G. The effect of intelligent physical exercise training on sickness presenteeism and absenteeism among office workers. J Occup Environ Med. 2017;59(10):942-948. 10.1097/JOM.0000000000001101 [DOI] [PubMed] [Google Scholar]

[ref30] 30. Kaldo V, Lundin A, Hallgren M, et al. Effects of internet-based cognitive behavioural therapy and physical exercise on sick leave and employment in primary care patients with depression: two subgroup analyses. Occup Environ Med. 2018;75(1):52-58. 10.1136/oemed-2017-104326 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref31] 31. Kausto J, Oksanen T, Koskinen A, et al. ‘Return to work’ coordinator model and work participation of employees: a natural intervention study in Finland. J Occup Rehabil. 2021;31(4):831-839. 10.1007/s10926-021-09970-x [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref32] 32. Lahti J, Harkko J, Nordquist H, et al. Seeing an occupational health psychologist reduces sickness absence due to mental disorders: a quasi-experimental study. Prev Med. 2021;149:106611. 10.1016/j.ypmed.2021.106611 [DOI] [PubMed] [Google Scholar]

[ref33] 33. Lidegaard M, Søgaard K, Krustrup P, Holtermann A, Korshøj M. Effects of 12 months aerobic exercise intervention on work ability, need for recovery, productivity and rating of exertion among cleaners: a worksite RCT. Int Arch Occup Environ Health. 2018;91(2):225-235. 10.1007/s00420-017-1274-3 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref34] 34. Nurminen E, Malmivaara A, Ilmarinen J, et al. Effectiveness of a worksite exercise program with respect to perceived work ability and sick leaves among women with physical work. Scand J Work Environ Health. 2002;28(2):85-93. 10.5271/sjweh.652 [DOI] [PubMed] [Google Scholar]

[ref35] 35. Oude Hengel KM, Bosmans JE, Van Dongen JM, Bongers PM, Van der Beek AJ, Blatter BM. Prevention program at construction worksites aimed at improving health and work ability is cost-saving to the employer: results from an RCT. Am J Ind Med. 2014;57(1):56-68. 10.1002/ajim.22267 [DOI] [PubMed] [Google Scholar]

[ref36] 36. Rasmussen CDN, Holtermann A, Jørgensen MB, Ørberg A, Mortensen OS, Søgaard K. A multi-faceted workplace intervention targeting low back pain was effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence: stepped wedge cluster randomised trial. Scand J Public Health. 2016;44(6):560-570. 10.1177/1403494816653668 [DOI] [PubMed] [Google Scholar]

[ref37] 37. Stenner HT, Eigendorf J, Kerling A, et al. Effects of six month personalized endurance training on work ability in middle-aged sedentary women: a secondary analysis of a randomized controlled trial. J Occup Med Toxicol. 2020;15(1):8. 10.1186/s12995-020-00261-4 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref38] 38. Taimela S, Justén S, Aronen P, et al. An occupational health intervention programme for workers at high risk for sickness absence. Cost effectiveness analysis based on a randomised controlled trial. Occup Environ Med. 2008;65(4):242-248. 10.1136/oem.2007.033167 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref39] 39. Taimela S, Malmivaara A, Justén S, et al. The effectiveness of two occupational health intervention programmes in reducing sickness absence among employees at risk. Two randomised controlled trials. Occup Environ Med. 2008;65(4):236-241. 10.1136/oem.2007.032706 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref40] 40. Tamminga SJ, Verbeek JHAM, Bos MMEM, et al. Effectiveness of a hospital-based work support intervention for female cancer patients—a multi-centre randomised controlled trial. PLoS One. 2013;8(5):e63271. 10.1371/journal.pone.0063271 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref41] 41. Uegaki K, Stomp-Van Den Berg SGM, De Bruijne MC, et al. Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in the Netherlands: results of an economic evaluation alongside a randomized controlled trial. BMC Public Health. 2011;11(1):57. 10.1186/1471-2458-11-57 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref42] 42. Van Dongen JM, Van Berkel J, Boot CRL, et al. Long-term cost-effectiveness and return-on-investment of a mindfulness-based worksite intervention. J Occup Environ Med. 2016;58(6):550-560. 10.1097/JOM.0000000000000736 [DOI] [PubMed] [Google Scholar]

[ref43] 43. Viester L, Verhagen EALM, Bongers PM, van der Beek AJ. The effect of a health promotion intervention for construction workers on work-related outcomes: results from a randomized controlled trial. Int Arch Occup Environ Health. 2015;88(6):789-798. 10.1007/s00420-014-1007-9 [DOI] [PubMed] [Google Scholar]

[ref44] 44. Von Thiele SU, Hasson H. Employee self-rated productivity and objective organizational production levels: effects of worksite health interventions involving reduced work hours and physical exercise. J Occup Environ Med. 2011;53(8):838-844. 10.1097/JOM.0b013e31822589c2 [DOI] [PubMed] [Google Scholar]

[ref45] 45. Von Thiele SU, Lindfors P. Improved fitness after a workbased physical exercise program. Int J Workplace Health Manag. 2015;8(1):61-74. 10.1108/IJWHM-10-2013-0038 [DOI] [Google Scholar]

[ref46] 46. Willert MV, Thulstrup AM, Bonde JP. Effects of a stress management intervention on absenteeism and return to work—results from a randomized wait-list controlled trial. Scand J Work Environ Health. 2011;37(3):186-195. 10.5271/sjweh.3130 [DOI] [PubMed] [Google Scholar]

[ref47] 47. Yaghoubitajani Z, Gheitasi M, Bayattork M, Andersen LL. Corrective exercises administered online vs at the workplace for pain and function in the office workers with upper crossed syndrome: randomized controlled trial. Int Arch Occup Environ Health. 2022;95(8):1703-1718. 10.1007/s00420-022-01859-3 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref48] 48. Zieringer RC, Zapf D. The effects of an employee assistance program on productivity at work, workability, absenteeism, and smartphone measures of heart rate and heart rate variability. J Occup Health Psychol. 2024;29(4):280-298. 10.1037/ocp0000380 [DOI] [PubMed] [Google Scholar]

[ref49] 49. Aili K, Hellman T, Svartengren M, Danielsson K. Including a three-party meeting using the demand and ability protocol in an interdisciplinary pain rehabilitation programme for a successful return to work process. Int J Environ Res Public Health. 2022;19(24):16614. 10.3390/ijerph192416614 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref50] 50. Asplund RP, Asplund S, von Buxhoeveden H, et al. Work-focused versus generic internet-based interventions for employees with stress-related disorders: randomized controlled trial. J Med Internet Res. 2023;25:e34446. 10.2196/34446 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref51] 51. Asplund RP, Carvallo F, Christensson H, et al. Learning how to recover from stress: results from an internet-based randomized controlled pilot trial. Internet Interv. 2023;34:100681. 10.1016/j.invent.2023.100681 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref52] 52. Axén I, Sennehed CP, Eek F, Stigmar K. Can a workplace dialogue impact the perceived influence of neck and/or backpain on everyday activities and performance at work? A secondary analysis from the randomized controlled trial WorkUp. BMC Musculoskelet Disord. 2022;23(1):861. 10.1186/s12891-022-05812-w [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref53] 53. Behrens-Wittenberg E, Wedegaertner F. A return-to-work intervention for prematurely retired depression or anxiety disorder patients. Front Psychiatry. 2021;12:662158. 10.3389/fpsyt.2021.662158 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref54] 54. Contreras C, Hellhammer J, Gerhards F, Hellhammer DH. Neuropattern, a translational tool to reduce stress at work—a pilot study. Occup Health Sci. 2018;2(4):385-407. 10.1007/s41542-018-0025-5 [DOI] [Google Scholar]

[ref55] 55. Dalager T, Bredahl TGV, Pedersen MT, Boyle E, Andersen LL, Sjøgaard G. Does training frequency and supervision affect compliance, performance and muscular health? A cluster randomized controlled trial. Man Ther. 2015;20(5):657-665. 10.1016/j.math.2015.01.016 [DOI] [PubMed] [Google Scholar]

[ref56] 56. Frederiksen P, Indahl A, Andersen LL, Burton K, Hertzum-Larsen R, Bendix T. Can group-based reassuring information alter low back pain behavior? A cluster-randomized controlled trial. PLoS One. 2017;12(3):e0172003. 10.1371/journal.pone.0172003 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref57] 57. Geukes M, Anema JR, Vermeer M, van Aalst MP, Oosterhof H. Evaluation of a workplace educational intervention on menopause: a quasi-experimental study. Maturitas. 2023;174:48-56. 10.1016/j.maturitas.2023.05.005 [DOI] [PubMed] [Google Scholar]

[ref58] 58. Hange D, Ariai N, Kivi M, Eriksson MCM, Nejati S, Petersson E-L. The impact of internet-based cognitive behavior therapy on work ability in patients with depression—randomized controlled study. Int J Gen Med. 2017;10:151-159. 10.2147/IJGM.S129710 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref59] 59. Haynes NJ, Vandenberg RJ, Wilson MG, DeJoy DM, Padilla HM, Smith ML. Evaluating the impact of the Live Healthy, Work Healthy program on organizational outcomes: a randomized field experiment. J Appl Psychol. 2022;107(10):1758-1780. 10.1037/apl0000977 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref60] 60. Hultberg EL, Lönnroth K, Allebeck P, Hensing G. Effects of co-financed interdisciplinary teamwork on sick leave for people with musculoskeletal disorders. Work. 2006;26(4):369-377. 10.3233/WOR-2006-00532 [DOI] [PubMed] [Google Scholar]

[ref61] 61. Koolhaas W, Groothoff JW, De Boer MR, Van Der Klink JJL, Brouwer S. Effectiveness of a problem-solving based intervention to prolong the working life of ageing workers. BMC Public Health. 2015;15(1):76. 10.1186/s12889-015-1410-5 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref62] 62. Muschalla B, Linden M, Jöbges M. Work-anxiety and sickness absence after a short inpatient cognitive behavioral group intervention in comparison to a recreational group meeting. J Occup Environ Med. 2016;58(4):398-406. 10.1097/JOM.0000000000000678 [DOI] [PubMed] [Google Scholar]

[ref63] 63. Noben C, Evers S, Jv G, Nijhuis F, de Rijk A. Improving a web-based employability intervention for work-disabled employees: results of a pilot economic evaluation. Disabil Rehabil. Assist Technol. 2017;12(3):280-289 [DOI] [PubMed] [Google Scholar]

[ref64] 64. Notenbomer A, Roelen C, Groothoff J, van Rhenen W, Bültmann U. Effect of an eHealth intervention to reduce sickness absence frequency among employees with frequent sickness absence: randomized controlled trial. J Med Internet Res. 2018;20(10):e10821. 10.2196/10821 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref65] 65. Näsman O, Ahonen G. The DRUVAN-project: a major increase in Occupational Health Service based on the Metal Age method in a Finnish municipality improved the work ability and gave significant financial return. Paper presented at: Promotion of Work Ability Towards Productive Aging—Third International Symposium on Work Ability; 2007. 22-24 October; Hanoi, Vietnam. [Google Scholar]

[ref66] 66. Saha S, Grahn B, Gerdtham UG, Stigmar K, Holmberg S, Jarl J. Structured physiotherapy including a work place intervention for patients with neck and/or back pain in primary care: an economic evaluation. Eur J Health Econ. 2019;20(2):317-327. 10.1007/s10198-018-1003-1 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref67] 67. Sennehed CP, Holmberg S, Axén I, et al. Early workplace dialogue in physiotherapy practice improved work ability at 1-year follow-up—WorkUp, a randomised controlled trial in primary care. Pain. 2018;159(8):1456-1464. 10.1097/j.pain.0000000000001216 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref68] 68. Shaw WS, McLellan RK, Besen E, et al. A worksite self-management program for workers with chronic health conditions improves worker engagement and retention, but not workplace function. J Occup Rehabil. 2022;32(1):77-86. 10.1007/s10926-021-09983-6 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref69] 69. Sprūdža D, Kozlova L, Lakiša S, et al. The impact of metal age training programme on the well-being of Latvian office workers. Proc Latv Acad Sci. 2016;70(5):315-324. 10.1515/prolas-2016-0048 [DOI] [Google Scholar]

[ref70] 70. van de Ven D, Schuring M, Kouwenhoven-Pasmooij TA, Blom P, Burdorf A, Robroek SJW. Reach and effectiveness of a worksite health promotion program combining a preventive medical examination with motivational interviewing; a quasi-experimental study among workers in low socioeconomic position. BMC Public Health. 2023;23(1):2130. 10.1186/s12889-023-16908-w [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref71] 71. Van Holland BJ, Reneman MF, Soer R, Brouwer S, de Boer MR. Effectiveness and cost-benefit evaluation of a comprehensive workers’ health surveillance program for sustainable employability of meat processing workers. J Occup Rehabil. 2018;28(1):107-120. 10.1007/s10926-017-9699-9 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref72] 72. Von Thiele SU, Augustsson H, Hasson H, Stenfors-Hayes T. Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study. J Occup Environ Med. 2015;57(2):217-225. 10.1097/JOM.0000000000000344 [DOI] [PubMed] [Google Scholar]

[ref73] 73. Wall A, Henriksson M, Nyberg J, et al. Exercise and health-related quality of life and work-related outcomes in primary care patients with anxiety disorders—a randomized controlled study. J Affect Disord. 2024;360:5-14. 10.1016/j.jad.2024.05.092 [DOI] [PubMed] [Google Scholar]

[ref74] 74. Östlind E, Eek F, Stigmar K, Sant’Anna A, Hansson EE. Promoting work ability with a wearable activity tracker in working age individuals with hip and/or knee osteoarthritis: a randomized controlled trial. BMC Musculoskelet Disord. 2022;23(1):112. 10.1186/s12891-022-05041-1 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref75] 75. Button KS, Ioannidis JPA, Mokrysz C, et al. Power failure: why small sample size undermines the reliability of neuroscience. Nat Rev Neurosci. 2013;14(5):365-376. 10.1038/nrn3475 [DOI] [PubMed] [Google Scholar]

[ref76] 76. Stuart EA. Matching methods for causal inference: a review and a look forward. Stat Sci. 2010;25(1):1-21. 10.1214/09-STS313 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref77] 77. Shelton RC, Lee M, Brotzman LE, Wolfenden L, Nathan N, Wainberg ML. What is dissemination and implementation science?: an introduction and opportunities to advance behavioral medicine and public health globally. Int J Behav Med. 2020;27(1):3-20. 10.1007/s12529-020-09848-x [DOI] [PubMed] [Google Scholar]

[ref78] 78. Arain M, Campbell MJ, Cooper CL, Lancaster GA. What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Med Res Methodol. 2010;10(1):67. 10.1186/1471-2288-10-67 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref79] 79. Milat AJ, Bauman A, Redman S. Narrative review of models and success factors for scaling up public health interventions. Implement Sci. 2015;10(1):113. 10.1186/s13012-015-0301-6 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref80] 80. Voss M, Stark S, Alfredsson L, Vingård E, Josephson M. Comparisons of self-reported and register data on sickness absence among public employees in Sweden. Occup Environ Med. 2008;65(1):61-67. 10.1136/oem.2006.031427 [DOI] [PubMed] [Google Scholar]

[ref81] 81. Althubaiti A. Sample size determination: a practical guide for health researchers. J Gen Fam Med. 2023;24(2):72-78. 10.1002/jgf2.600 [DOI] [PMC free article] [PubMed] [Google Scholar]

[ref82] 82. Jones D, Molitor D, Reif J. What do workplace wellness programs do? Evidence from the Illinois workplace wellness study. Q J Econ. 2019;134(4):1747-1791. 10.1093/qje/qjz023 [DOI] [PMC free article] [PubMed] [Google Scholar]

PERMALINK

Effectiveness of work ability interventions on productivity: a systematic review

Pasi Kekkonen

Eija Savolainen

Mari Immonen

Pauliina Kangas

Elisa Rissanen

Ismo Linnosmaa

Abstract

Abstract

1. Introduction

2. Methodology

2.1. Eligibility criteria

Table 1.

2.2. Definition of the outcomes

2.3. Information sources and search strategy

2.4. Study selection

2.5. Quality assessment

2.6. Data extraction and analysis

3. Results

Figure 1.

3.1. Quality of the studies

3.2. Characteristics of the included studies

3.3. Population

3.4. Interventions

3.5. Comparators

3.6. Effectiveness of the included interventions

Table 2.

4. Discussion

4.1. Strengths and limitations of the included studies

4.2. Strengths and limitations of this review

5. Conclusions

Supplementary Material

Contributor Information

Author contributions

Supplementary material

Funding

Conflicts of interest

Data availability

References

Associated Data

Supplementary Materials

Data Availability Statement

ACTIONS

PERMALINK

RESOURCES

Similar articles

Cited by other articles

Links to NCBI Databases