Table 1.
Overview of included studies.
| First author, date (ref) country | Design/aim | Participants | Intervention and comparator/control | Outcome measures | Findings | Risk of biasc |
|---|---|---|---|---|---|---|
| Bolier, 2014 (26) Netherlands | RCTa To examine the effectiveness of an online health module targeting positive mental health | 366 nurses, allied health professionals Mean age 40.0 yrs ± 11.9 yrs 80% female | (a) Online health screening and personalized feedback module with access to online self-help interventions (b) Online health screening as waitlist control | Mental Health Continuum – Short Form, Utrecht Work Engagement Scale, WHO-5 Well-being Indexb, Brief Symptom Inventory (anxiety and depression sub-scales) | Positive mental health was significantly enhanced in the intervention group compared with the control group There was also a small but significant effect for work engagement in the intervention group | L |
| Bostock, 2016 (27) UK | RCT To evaluate a digital cognitive behavioural therapy intervention for insomnia | 270 self-reported insomniacs from a global ‘Fortune 500’ company Mean age 33.6 yrs ± 6.0 yrs 33% female | (a) dCBT (digital cognitive behavioural therapy) for insomnia including assessment, tailored feedback and online support (b) Online assessment as waitlist control | Sleep Condition Indicator, Work Productivity and Activity Impairment questionnaire | The dCBT group had significantly higher Sleep Condition Indicator scores than the control Before and after analysis of the dCBT group found significant improvements in presenteeism | L |
| Brendryen, 2017 (28) Norway | Pilot RCT To pilot the effectiveness of a previously established internet-based alcohol intervention, within a workplace setting | 80 employees from four organizations: a group of public hospitals, a county, a municipality department, a consulting company Mean age 43.0 yrs ± 11.0 yrs 52% female | (a) Web-based, intensive self-help alcohol programme with SMS support (b) e-booklet with general alcohol-related educational information and advice | Total weekly alcohol consumption as reported using a scale ranging from 0 to 10 drinks per day | Findings were inconclusive regarding the effectiveness of the intensive intervention in comparison to the brief due to recruitment issues but of survey responders, the intensive intervention group drank 5–6 less drinks a week than the brief intervention group | L |
| Cook, 2007 (29) USA | RCT To evaluate the effectiveness of a web-based health programme designed to improve diet, stress and physical activity | 419 employees from a human resources company 40.0 yrs ± 11.9 yrs 80% female | (a) Web-based health programme with substantial information and guidance on the major health promotion and wellness topics (b) Printed materials consisting of five commercially available booklets on eating, weight management, stress, fitness and alcohol | 21 online health questionnaires covering diet, weight, stress, coping, exercise and motivation assessment | The web-based group scored significantly higher than the printed materials group in areas of diet and nutrition although both groups showed improvements on most dietary measures No significant differences were found between the two groups on measures of stress or physical activity although both groups showed improvements | U |
| Cook, 2015 (30) USA | RCT To evaluate the effectiveness of a web-based health programme aimed specifically at workers 50 years and older | 278 employees from a large global IT company 67% were aged 50–68 yrs 33% female | (a) Web-based health programme with major health promotion topics of healthy ageing, diet, physical activity, stress management and tobacco use (b) Waitlist control | 16 online health questionnaires assessing diet, weight, stress, coping, exercise, motivation, tobacco use and beliefs about ageing | The programme group scored significantly better than the control group on diet, healthy eating and exercise There were no significant programme effects found on measures of stress or ageing beliefs | U |
| Deitz, 2014 (31) USA | RCT To examine whether a web-based programme reduces cardiovascular (CV) risk behaviours | 210 hospital employees with at least one known CV risk factor Range 21–72 yrs 86% female | (a) Web-based, interactive, Heart Healthy programme with tailored feedback designed to reduce cardiovascular risk reduction behaviour (b) Waitlist control | 13 online questionnaires and surveys covering CV risk attitudes and behaviour, blood pressure, heart rate, BMId | The intervention group showed significant improvements in diet, exercise, self-efficacy, stress and mood measures | U |
| Doumas, 2007 (32) USA | RCT To evaluate the efficacy of a web-based programme aimed at reducing high-risk alcohol behaviour in young adults | 124 human resources employees, aged 18–24 yrs 73% female | (a) Web-based programme with personalized drinking feedback designed to reduce high-risk drinking (b) Web-based programme with personalized drinking feedback designed to reduce high-risk drinking with 15-min motivational interview in person (c) Waitlist control | Measures of alcohol consumption: drinking quantity, peak consumption, frequency of drinking to intoxication and binge drinking, Modified Daily Drinking Questionnaire | When both interventions were combined and compared with the control group, significantly lower levels of drinking were found in the intervention group, especially in high-risk individuals The web-based alone intervention also had significantly lower drinking levels compared with the control group but there was no difference found between the web-based with interview intervention when compared with the control | U |
| Griffiths, 2016 (33) Australia | RCT To assess the effectiveness of an online mental health programme | 507 government employees Mean age 44.5 yrs ± 11.4 yrs 74% female | (a) Online educational programme focusing on depression and anxiety (b) Waitlist control | Depression Literacy Scale, Generalized Anxiety Literacy Scale, Depression Stigma Scale – Personal subscale, Generalized Anxiety Stigma scale – Personal subscale, Generalized Help-Seeking Questionnaire, Attitudes Towards Seeking Professional Psychological Help Scale-Short Form, help-seeking behaviour | The intervention group showed significantly greater improvements in depression and anxiety literacy, and a greater reduction of depression and anxiety personal stigma, compared with the control | U |
| Irvine, 2011 (34) USA | RCT To test a web-based intervention designed to improve physical activity of sedentary workers | 221 employees from a large manufacturing plant Mean age 45.0 yrs ± 9.7 yrs 42% female | (a) Web-based tool for health promotion and stress management including classical stress management exercises and a chat (b) Web-based tool for health promotion and stress management with no extra exercises or chat | Current Exercise Status Scale, study specific measures of depression, anxiety, stage of change, attitudes and perceived knowledge, behavioural self-efficacy and intention, barriers to PA and PA motivation | The intervention group differed significantly from the control group on 11 outcomes Large effect sizes were found for PA status and knowledge, attitudes and behavioural intention Medium effect sizes were found for perceived barriers, depressive symptoms, motivation and self-efficacy | U |
| Ketelaar, 2014 (35) Netherlands | RCT To evaluate an e-mental health (EMH) programme aimed at improving work function and mental health | 128 nurses and allied health professionals Mean age 49.0 yrs ± 12.0 yrs 77% female | (a) Website designed to offer tailored education, support and guidance for PA (b) Waitlist control | Nurses Work Functioning Questionnaire, Four-Dimensional Symptoms Questionnaire, Dutch Questionnaire on the Experience and Evaluation of Work | Significant improvements were found on work functioning and work-related fatigue for the intervention group Work functioning improved in 30% of participants with a small effect on stress found in the participants who had logged onto the EMH intervention | U |
| Khadjesar, 2014 (36) UK | RCT To determine the effectiveness of an online alcohol reduction programme as part of an online employee health check | 1066 employees in a large organization Median age 48.0 yrs 25% female | (a) Online health check with feedback on all health behaviours including specific risk advice regarding alcohol (b) Waitlist control group which received the same feedback minus alcohol advice | Online health check including health behaviours (e.g. smoking status, fruit and vegetable consumption), Alcohol Use Disorders Identification Test, EQ-5De | There was no significant difference in past week alcohol consumption between groups or on the scores of the Alcohol Use Disorders Identification Test or EQ-5D at follow-up | U |
| Mainsbridge, 2014 (37) Australia | RCT To evaluate the effect of an e-health intervention on mean arterial pressure (MAP) through reducing prolonged sitting | 29 desk-based employees from a government agency Mean age 39.5 yrs ± 11.0 yrs 83% female | (a) Interactive e-health programme designed to encourage breaks in long bouts of sitting by standing up to engage in brief physical activity with screen prompts every 45 min (b) Waitlist control | Blood pressure, stages of change questionnaire, Short Form-36 | The intervention group had a significantly decreased mean MAP after a 13-week period compared with the control group | L |
| Matano, 2006 (38) USA | Pilot RCT To pilot a web-based intervention for alcohol consumption reduction | 145 employees from a Silicon Valley work site identified as low or moderate risk for alcohol abuse Mean age 39.9 yrs ± 11.3 yrs 78% female | (a) Website providing general information about alcohol use and its effects along with full individualized feedback based on individual risk for alcohol abuse (b) Website providing general information about alcohol use and its effects with no individualized feedback | CAGE questionnaire, Alcohol Use Disorders Identification Test | Those who were classified moderate-risk in the intervention group had a significant reduction in frequency of beer bingeing Those who were classified low-risk in the intervention group had a significant reduction in frequency of beer binges and hard liquor binges | U |
| Pedersen, 2014 (39) Australia | RCT To examine the effectiveness of an e-health intervention designed to improve workday energy expenditure for desk-based employees | 34 desk-based police employees from several sectors Mean age 39.7 yrs ± 11.0 yrs 76% female | (a) e-health software program designed to reduce sitting time by prompting user on their computer to be active (stand, move, stretch) every 45 min (b) Waitlist control | Study-specific questionnaire based on the Occupational Sitting and Physical Activity Questionnaire and the Occupational Physical Activity Questionnaire | The intervention group significantly increased calories expended during the work day compared with the control group, which decreased | U |
| Querstret, 2016 (40) UK | RCT To investigate how an online mindfulness course influences occupational health | 118 employees from various organizations Mean age 40.7 yrs ± 10.5 yrs 81% female | (a) Online mindfulness course based on traditional mindfulness based stress reduction course (b) Waitlist control | The Work-Related Rumination Questionnaire, Occupational Fatigue Exhaustion Recovery scale, The Pittsburgh Sleep Quality Index, Five Facet Mindfulness Questionnaire Short form | The intervention group reported significantly improved levels of rumination, problem solving, pondering, fatigue and sleep quality compared with the control group | L |
| Schell, 2008 (41) Sweden | RCT To evaluate the effect of a web-based stress programme on back, neck and shoulder pain and pain-related stress | 226 news media employees Mean age 44.0 yrs Age range 23–61 yrs 45% female | (a) Web-based tool for health promotion and stress management including classical stress management exercises and a chat (intervention group) (b) Web-based tool for health promotion and stress management with no extra exercises or chat (reference group) (c) Control with no intervention | Study-specific self-reported pain and pain-related stress questionnaire | There were no significant differences between groups at any point Some significant differences were found within groups, but they were inconsistent and varied according to pain localization | L |
| Shimazu, 2005 (42) Japan | RCT To examine the effects of a web-based programme on self-efficacy, problem-solving behaviour, stress responses and job satisfaction | 212 white collar employees Mean age 43.0 yrs ± 11.4 yrs 28% female | (a) Online self-paced employee programme aimed at enhancing coping abilities (b) Waitlist control | The Self-efficacy scale, study-specific problem-solving behaviour measure, Brief Job Stress Questionnaire, Single item job satisfaction measure | Job satisfaction changes pre to post intervention were marginal but significant compared with the control group | U |
| Solenhill, 2016 (43) Sweden | RCT To evaluate the effect of a web-based health programme with or without the option of telephone coaching | 981 transport employees Mean age 44.0 yrs ± 10.2 yrs 23% female | (a) Health risk assessment and tailored feedback (b) Health risk assessment and tailored feedback and telephone coaching option (c) Health assessment with no feedback | BMI, Alcohol Use Disorders Identification Test, Karolinska Sleep Questionnaire, self-reported activity levels, usage of telephone helplines, healthy eating behaviours, self-perceived health, motivation to change ratings | No significant differences were found between any groups in relation to reported health behaviours At baseline, the intervention groups reported significantly higher motivation to improve dietary and physical activity behaviour compared with the control | U |
| Umanodan, 2014 (44) Japan | Cluster RCT To evaluate the effectiveness of a computer-based stress management training programme | 263 employees from a manufacturing company Mean age 38.9 yrs ± 11.4 yrs 7% female | (a) Online stress management training consisting of behavioural, communication and cognitive techniques (b) Waitlist control | Brief Job Stress Questionnaire, Utrecht Work Engagement Scale, World Health Organization Health and Work Performance Questionnaire, Brief Scales for Coping Profile | There was a significant effect found for increase in ‘knowledge about stress management’ in the intervention group | L |
| Van den Heuvel, 2003 (45) Netherlands | RCT To evaluate the effects of a software program that promotes extra activity for workers with neck and upper-limb complaints | 268 computer worker employees Age range 18–50 yrs | (a) Software program that prompts a 5-min break on screen for every 35 min of computer use with physical exercise recommendations (b) Software program that prompts a 5-min break on screen for every 35 min of computer use with no physical exercise recommendations (c) Control | Recovery rate from complaints questionnaire, frequency and severity of complaints, self-reported sick leave, productivity by the mean number of key strokes a day | There were no differences between pre and post intervention score comparisons between groups Self-reported recovery was significantly higher in the intervention groups compared with the control | U |
| Westrup, 2003 (46) USA | RCT To assess the impact of a website-based intervention aimed at reducing high-risk drinking | 187 employees Mean age 40.9 yrs ± 11.5 yrs 77% female | (a) Website for alcohol and coping behaviour with limited individualized feedback (b) Website for alcohol and coping behaviour with full individualized feedback | Social Readjustment Rating Scale, modified version of Brief COPEf Inventory, daily website usage in minutes | There was no significant difference between groups for average daily minutes of website use Significant differences were found in average daily use related to alcohol dependence risk level with those at the high-risk level using the website more than those in the moderate or low-risk group | U |
| Zhang, 2017 (47) Singapore | Pilot RCT To pilot Smartphone-Based Coronary Heart Disease (CHD) Prevention programme aimed at improving awareness and knowledge of CHD, perceived stress and cardiac-related lifestyle behaviours | 80 employees without CHD not working in heart-related organizations or institutes Age range 21–40 yrs65% female | (a) Smartphone app with heart-related educational programme (b) Health promotion website access | Awareness of CHD, Heart Disease Fact Questionnaire, Perceived Stress Scale, Behavioural Risk Factor Surveillance System questionnaire | The intervention group had higher CHD awareness and knowledge than the control group as well as one better coronary behaviour (i.e. blood cholesterol control) | U |
a
Randomized controlled trial (RCT).
b
WHO-5 Well-being Index (World Health Organization 5-item well-being index).
c
L: low risk of bias; U: unclear risk of bias.
d
BMI (body mass index).
e
EQ-5D (European Quality of Life-5 Dimensions).
f
COPE (Coping Inventory).