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. 2023 Feb 28;18(2):e0282118. doi: 10.1371/journal.pone.0282118

Table 3. Summary of the included studies (n = 24) grouped by main targeted health outcome.

Author, Country, Publication Year Study Details Intervention details Measured Outcomes Main findings
A. Lifestyle/ Chronic disease risk (n = 7)
Liu Z et al [22].,
China,
2015
Type: Clustered RCT
Participant: 589 staff of hospital health management centre
Company size: Not provided
Length:12-month intervention
Goal/Focus: Reduce overall CVD (cardiovascular disease) risk
Mode of Delivery
Intervention Group (IG): receive mobile phone-based lifestyle intervention including an individualised electronic prescription, follow-up 5 to 8 min phone calls and text messages targeting reducing CVD risk during the 12-month intervention.
Control Group (CG): receive usual medical examination without follow-up calls and text messages.
No theory applied.
Primary outcome: Change in 10-year CVD risk between baseline and follow-up point at 12-months, Change in components of risk score
Secondary outcome: Diastolic blood pressure (BP), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), fasting plasma glucose (FPG), waist hip ratio (WHR)
Significant difference between baseline and 12-month in CG:
1.Increased mean CVD risk, Systolic BP (p<0.001), DBP mean value (p< 0.001)
2.Decreased HDL and LDL (p<0.05), overall Diastolic BP, FPG and WHR (p<0.001)
Significant different between baseline and 12-months in IG: Decreased 10-year CVD risk (Systolic BP, TC, BMI) (p<0.05), DBP mean value (p<0.001), HDL and LDL (p<0.05)
Mobile phone-based intervention may therefore be a potential solution for reducing CVD risk in China.
Jorvand R at al. [30],
Iran,
2020
Type: Quasi-experiment
Participants: 114 healthcare workers employed in two cities
Company Size: 262 healthcare workers from two cities assessed for eligibility
Length: 2-week intervention with 6-month follow-up
Goal/Focus: Effect of Health Belief Model (HBM)-based education on exercise
Mode of delivery
IG: Workers from one network received a Telegram-based intervention and supervised exercises, receiving education packages every 2 weeks and exercise reminder messaging, discussion and interlocution and their own exercise pictures sharing.
CG: workers from the other network received uncontrolled individual exercise and self-reported.
Underlying theory: HBM
Primary outcome:
1.HBM (perceived susceptibility, severity, benefits, barriers, and self-efficacy)
2.Exercise (daily and weekly in minutes)
Secondary outcome: blood biochemical markers
Significant difference of HBM constructs mean score at pre and post intervention in IG:
1.Increased perceived severity (p = 0.000), perceived benefits (p = 0.010) and self-efficacy (p = 0.024)
2.Decreased perceived susceptibility (p = 0.018): directly related to increased preventive behaviours (doing exercise for CVDs)
Significant improvements of exercise in IG:
Daily exercise at post intervention (p = 0.001)
Weekly exercise at pre and post intervention (p = 0.001)
Educational interventions based-on Telegram messenger using HBM can improve exercise level.
Ramachandran A et al. [33],
India,
2013
Type: Prospective RCT
Participant: 537 male employees in public and private industrial units
Company size: Not provided, 8741 for eligibility screening
Length: 24-month intervention with follow-up
Goal/Focus: Effect of phone messages on lifestyle change (PA and diet) to reduce Type 2 diabetes (T2D)
Mode of delivery
IG: Frequent mobile phone messages about healthy lifestyle, (the benefits, cues to start, ways to avoid relapse and remain motivated in physical activity (PA) and healthy dietary habits)
CG: standard lifestyle modification advice at baseline only
Underlying theory: Transtheoretical Model of Behavioural Change
Primary: Incidence of T2D
Secondary: body mass index (BMI), waist circumference, systolic and diastolic BP, lipid profile, total dietary energy intake, PA score, acceptability of mobile phone messaging assessed by questionnaire
50 (18%) men in the IG developed T2D over the 2 years compared with 73 (27%) CG (absolute risk reduction 9%)
The intervention reduced the incidence of T2D during the study (β –0·447). The number needed to treat to prevent one case of T2D was 11 (95% CI 6–55).
Mobile phone messaging is an effective and acceptable method to deliver advice and support towards lifestyle modification to prevent T2D in men at high risk.
Nurgul K et al. [36],
Turkey,
2015
Type: Descriptive and quasi experimental study
Participant: 30 Female staff from Sakarya University
Company Size:
Sakarya University (44 staff voluntary participation)
Length: 3-month intervention without follow-up
Goal/Focus: Effect of web-based education on health knowledge and behaviour
Mode of delivery
IG: 3-month web-supported health training material in ppt or audio-visual (3 modules: nutrition and health, PA, damages of smoking and stress management), available 7 days a week and 24 hours a day.
No CG or theory applied.
Primary outcome:
1.Knowledge on health promotion: assessed by multiple choice questionnaire (MCQ)
Individual’s health behaviours: assessed via 52-item health promotion lifestyle profile (HPLSP) with 6 sub-dimensions (Health Responsibility, PA, Nutrition, Self-actualization, Interpersonal support, stress management)
Significant difference (p<0.05) between pre and post intervention
1.HPLSP total points (p = 0.001)
2.HPLSP sub-scale total points (p = 0.001)
3.MCQ (p<0.001)
Web-based health education had a positive effect on healthy lifestyle behaviours of women staff working at Sakarya University and on their knowledge of health protection.
Rubinstein A et al. [38],
Argentina, Guatemala, and Peru,
2016
Type: Parallel RCT
Participant: 637 adults with prehypertension from workplaces, health care, and community centres
Company size: Not provided, 2630 for eligibility screening
Length: 12-month intervention with 6-month follow-up
Goal/Focus: Effect of mHealth on cardiometabolic profile in prehypertension people
Mode of delivery
IG: Received monthly motivational counselling calls and weekly personalised messages about diet quality and PA.
CG: Received usual care
Underlying theory: Transtheoretical Model of Behavioural Change and the Health Belief Model
Primary outcome: Change in Systolic BP (mmHg) and Diastolic BP (mmHg)
Secondary outcome: Change in weight (kg), BMI (kg/m2), WC (cm), PA (metabolic equivalent of task (METs)/ min per week), daily intake of fruits and vegetables (F&V), high fat and sugar foods
Significant changes in highly engaged participants (received ≥75% of counselling calls in IG): Body weight (-4∙85kg), WC (-3∙31cm), Daily intake of F&V (+0.66), Daily intake of high-sodium foods (-0.42), Daily intake of high fats food (-1.52)
Significant difference between IG and CG by country:
1.Body weight in Peru (IG): -1.24kg
2.Daily F&V intake in Peru (IG): +0.64
3.Daily F&V intake in Guatemala (IG): +0.04
The mHealth-based intervention was associated with a small reduction in bodyweight and some dietary habits. A dose-response effect signalling potential opportunities for larger effects from similar interventions in low-resource settings was seen.
Martinez C et al. [39],
Bolivia,
Guatemala
and
Paraguay,
2018
Type: Pre-post study
Participant: 202 hospital workers from three organisations
Company size: 1450 workers in three organization
Length: 6-month intervention with follow-up
Goal/Focus: Effect of online training in smoking behaviour
Mode of delivery
IG: received an adapted version of a 5A’s (Ask, Advise, Assess, Assist and Arrange follow-up) training program developed by the online platform e-oncologia based on in-person courses.
No CG or theory applied
Primary outcome: Cognitive and behavioural factors relating to smoking
Secondary outcome: Self-reported performance level according to 5A’s, demographics characteristic and questions suggested by experts to explore behavioural factors
Significant Increase in performance of each of the 5A components (p<0.001)
Significant improvement at post training
1. Performance score of 5A’s (p<0.001)
2. Cognitive, behavioural, and organisational factors affecting 5A’s
  • Five identified barriers (p<0.001): self-reported preparedness, drug preparedness, competency in assisting smokers to quit, using additional resources, and having positive experience.
  • Opportunities with score ≥7 (p<0.001): motivation to help patients to quit, importance of smoking cessation in job, seeking frequently for patients.
Online education on smoking cessation is feasible and effective in improving smoking cessation interventions in these countries.
Joseph-Shehu EM et al. [42],
Nigeria,
2019
Type: Pre-post study
Participant: 22 university staff in Nigeria
Company Size: 1349 staff
Length: 12-week intervention with follow-up
Goal/Focus: Effect of information and communication technology on health promotion
Mode of delivery
IG: Adopted a nurse-client interactive Android phone app, Tertiary Staff Health Promotion App to access health promotion information, to monitor health status, increase PA, minimise sitting hours, with reminder of activities to improve health and quality of life.
CG: N/A
Underlying theory: Health promotion model
Primary outcome:
Health promoting lifestyle behaviour
Health status (BP, BMI, WHR, and fasting blood sugar)
Significant difference between pre- and post-intervention:
Increased nutrition score (p = 0.0001), PA score (p = 0.0001), health responsibility score (p = 0.0001), stress management score (p = 0.001), Interpersonal relation subscales score (p = 0.009)
Decreased BMI (p = 0.038) and diastolic BP (p = 0.04)
The health-promoting lifestyle behaviour and health status of workers and other population groups showed improvements through information and communication technology.
B. Weight management (n = 5)
He C et al. [23],
China,
2017
Type: Cohort study
Participant: 15,310 employees from 134 government agencies and enterprises
Company Size: Not provided, 15818 for eligibility screening
Length: 6-month intervention with 6-month follow-up
Goal/Focus: Effect of WeChat-based multicomponent program on weight loss
IG: Social media-promoted intervention. Participants willing to use the research team’s official WeChat account were enrolled in a WeChat group that provided feedback on weight, diet, and exercise weekly, microvideos and popular science knowledge on weight loss, community area for communication.
CG: Participants not willing to use official WeChat account given routine publicity such as slogan “take the stairs and lose weight” on weight loss
No theory applied.
Primary outcome:
Weight loss: height, weight, waist circumferences before and after intervention
Demographic characteristics: gender, age, educational level, and telephone number online registered with WeChat account
Weight loss: IG (2.09±3.43kg) > CG (1.78±2.96kg)
Effect of WeChat on weight loss (Assessed with propensity method, p<0.05):
1.Males in IG (active or inactive) had higher probability of maintaining weight with 1-2kg or > 2kg weight loss than CG (0-1kg)
2.Active participants in WeChat groups were more likely to lose weight.
The weight loss intervention campaign based on an official WeChat account focused on an occupation-based population in Shunyi District was more effective for males than females.
Yu Y et al. [24],
China,
2018
Type: RCT
Participant: 802 employees from institutions or enterprises from 4 areas, 44.9% overweight & obese, 49.6% normal weight and 0.5% underweight
Company Size: Not provided, 904 for eligibility screening
Length: 3-month intervention
Goal/Focus: Effect of pedometer-based walking and diet guidance on weight management
Mode of delivery
IG: Receive self-monitored intervention trial (exercise prescription and dietary guidance), synchronise pedometer exercise data to the Internet-based Health System Centre daily (at least weekly)
No CG or theory applied
Primary: Changes in body weight (kg) or BMI, waist circumference (cm), and BP (mmHg).
Secondary: Changes in lifestyle behaviour (scores), body fat percentage (%), fasting blood glucose/ fasting serum glucose (mmol/L), and serum lipid (mmol/L)
Normal weight participants:
1. Weight decreased 0.7% (p < 0.01).
2. Body fat percentage decreased 2.5% (p < 0.01).
3. BP and FSG decreased significantly (p<0.05)
Underweight participants:
1. Weight gain of 1.0% (p< 0.05),
Overweight participants:
1. 68.2% (208/305) experienced weight loss, with an average reduction of 3.5%, with 20.2% (42/208) of them achieving weight loss 5%.
2. BP and FSG decreased significantly (p<0.05)
The incidence of hypertension was significantly lower and lifestyle behaviour significantly improved (p < 0.05)
Abdi J et al. [28],
Iran,
2015
Type: Three-arm RCT
Participant: 435 governmental employees with overweight or obesity (BMI>25kgm/m2)
Company Size: Not provided,1200 for eligibility screening
Length: 6-month intervention with 3-month follow-up and maintenance
Goal/Focus: Effect of communication technologies and social-cognitive based education on weight loss
Mode of delivery
Two IG received lifestyle program and general brochures:
IG1 (Web-assisted group): educational content provided on a website.
IG2 (Telephone-assisted group): educational content provided through SMS every two weeks
CG: only receive general brochures about lifestyle and overweight
Underlying theory: Social cognitive theory (SCT)
Primary: anthropometric measures include weight (kg), waist circumference (cm) and blood pressure (mmHg)
Secondary: SCT measures
The lifestyle intervention resulted in a weight loss of: -1.08 kg in IG1, -1.92kg in IG2
IG1: mean scores of the constructs of self-efficacy (P = 0.001) and outcome expectancies (P = 0.020) increased.
IG2: mean scores of the constructs of self-efficacy (P = 0.001), environment (P = 0.001), outcome expectations (P = 0.040), and outcome expectancies (P = 0.001) increased.
A significant difference (P = 0.03) was observed in weight loss among the groups over the course of time.
Limaye T at al. [34],
India,
2017
Type: RCT
Participant: 265 young Indians of IT industry with normoglycemia and at high risk of developing diabetes.
Company Size: Not provided, 437 for eligibility screening
Length: 1-year intervention
Goal/Focus: Effect of technology-based lifestyle program on reducing T2D risk
IG: Receive lifestyle modification in Informative technology (LMIT) program
1. Mobile phone messages and emails with infographics which contain lifestyle modification information provided. No message was repeated.
2. Additional support through a website and a closed Facebook group.
CG: no intervention received
Underlying theory: goal setting
Primary outcome: prevalence of overweight/obesity (BMI ≥ 25 kg/m2)
Secondary outcomes: Change in weight, waist circumference, blood pressure, glucose, lipid, lifestyle choices, diabetes awareness score, acceptability, and cost-effectiveness of the intervention
Significant weight loss in IG (p<0.05): Overweight/obese participants decreased from 104 (78.2%) to 96 (72.2%)
Significant weight gain in CG (p<0.05): Overweight/obese participants increased from 101 (76.5%) to 110 (83.3%)
The number needed to treat/prevent one case of overweight/obesity in 1 year was 9.
A virtual assistance-based lifestyle intervention was effective, cost-effective and acceptable in reducing risk factors for diabetes in young employees in the IT industry and is potentially scalable.
Beleigoli A et al. [41],
Brazil,
2020
Type: Three-arm parallel RCT
Participant: 1,298 overweight and obese students and staff of a Brazilian university
Company Size: Not provided, 3745 for eligibility screening
Length: 24-week intervention
Goal/Focus: Effect of personalized web-based coaching on weight loss with overweight and obese people
Mode of delivery
Platform-only group (IG1): received reminder emails to report weight and habits at 12 and 24 weeks after baseline trial and get access to 24-week web-based weight loss program with personalised computer-delivered feedback.
Platform and coaching group (IG2): received 24-week web-based weight loss program with 12-week personalised dietician-delivered feedback.
CG (waitlist): received a non-personalized minimal intervention based on dietary and PA recommendations delivered through downloadable e-booklet and four 5-min videos.
Underlying theory: Behaviour Change Wheel
Primary outcome: changes in weight and BMI
Secondary outcome:
1.Changes in dietary intake: assessed by the daily F&V portions, weekly consumption of sweetened beverages and ultra-processed foods
2.Changes in PA: Moderate and vigorous PA was assessed by the Brief PA Assessment Questionnaire.
After 24-week intervention:
1.Primary outcome (Weight & BMI change)
  • CG: Weight = -0.66kg, BMI = -0.24kg
  • IG1: Weight = -1.08kg, BMI = -0.38kg
  • IG2: Weight = -1.57kg, BMI = -0.56kg
  • Significant overall weight loss (p = 0.001): IG1 (83/420, 19.8%) and IG2 (64/408, 15.7%) > CG (61/270, 13.0%)
2.Secondary outcome:
  • Significant increase in F&V consumption (p = 0.001): IG1 and IG2 > CG
  • Significant reduction in ultra-processed food consumption (p = 0.005): IG1 and IG2 > CG
  • Significant increase in sweetened beverage consumption (p = 0.02): IG1> IG2
C. Physical activity (PA) (n = 4)
Blake H et al. [25],
China,
2019
Type: Two-arm clustered RCT
Participant: 282 employees of IT private sector organizations in Beijing and Gaungzhou
Company size: 690 employees from two sites
Length:12-week intervention without follow-up
Goal/Focus: Effect of digital video-based exercise on PA and work performance
Mode of delivery
IG (Guangzhou): “Move-It” digital video-based worksite exercise intervention
1. Move-It website: Six 10-min Qigong exercise video clips, twice/day on working day
2. Reminder messages: The Move-it desktop icon popped up at the same time, twice/day
3. Exercise adherence info: Daily exercise logs were collected through Move-it icon
CG (Beijing, wait-list): received the same intervention after the intervention period
Underlying theory: Behaviour Change Techniques (BCTs)
PA level, weekday sitting hours and work performance Significant differences at post intervention:
1.Increased PA:
  • IG (5.80 hrs/week, p = 0.04)
  • CG (7.41 hrs/week, p = 0.00)
2.Work performance:
  • Increased in CG (+0.69 units, p = 0.01)
  • Reduced in IG (−0.03 units, p = 0.78)
3.Increased sitting hours:
I  • G (+10.34 hrs/week, p = 0.00)
  • CG (+5.68 hrs/week, p = 0.00)
  • Between groups (−4.66 h/w, p<0.01)
The intervention did not result in greater changes in the IG than in CG. Many participants perceived the Qigong exercises positively and reported positive benefits on physical and mental health including muscle relaxation, stress reduction and improved working mood.
Gu M et al. [26],
China,
2020
Type: Quasi-experiment with self-controlled design
Participant: 262 workers from 17 worksites
Company Size: Not provided, 398 employees participated in study baseline
Length: 100-day intervention with follow-up
Goal/Focus: Effect of pedometer and WeChat-based group program on PA and health-related outcome
Mode of delivery
IG: a pedometer- and group-based intervention program with 10–20 participants each in 47 groups.
1.Pedometer: to monitor the PA during waking hours and upload the data to a specific website.
2.We-Chat group: created by each group captain to share daily steps number, communicate, and motivate the participants to achieve the corresponding goals.
CG: required to complete the measures and no intervention applied.
Underlying theory: SCT
Primary outcome:
1.PA
2.Health related outcome: height (cm), weight (kg), Body Fat % (BF%), systolic diastolic BP, waist and hip circumference, BMI
Secondary outcome: Job demand and control which measured based on Karasek’s Job Content Questionnaire (JCQ)
Baseline
Significant difference between IG and CG (p<0.05): Waist and hip circumferences, BMI
Post intervention
  • Walking increased about 22% compared with baseline vigorous PA
  • Significant increase in vigorous PA (p = 0.048) and walking (p<0.01) in IG
  • Significant reduction in moderate PA in both IG (p<0.01) and CG (p<0.01)
  • Significant reduction in health-related outcomes at post intervention (p<0.05) in IG: systolic BP, waist and hip circumferences, body fat and BMI
Significant association between:
1.Gender and WHR (p<0.001): females showed larger decrease WHR
2.Age and BF% (p = 0025): age increased; BF% decreased
3.Age (p<0.027) and difference in METs for vigorous PA (p<0.001) with BF%: older and higher difference showed larger decreased BF%
4. Vigorous PA and BMI (p = 0.013): higher difference, larger decreased BMI
Pillay JD et al. [40],
South Africa,
2014
Type: Pilot study
Participant: 22 Staff members of the Faculty of Health Sciences, University of Cape Town
Company Size: Not provided, 25 employees agreed to join
Length: 10-week intervention with 2-week follow-up
Goal/Focus: Effect of pedometer-based program on PA level
Mode of delivery
IG: Received biweekly individual email feedback, motivational messages, and strategies to increase PA based on electronic receipt of pedometer data.
CG: Received general motivational message biweekly without pedometer feedback
Underlying theory: Theoretical model of behavioural change
Primary outcome:1.
Participants’ perceptions: false, appeal, support and benefits of the intervention assessed through questionnaire during follow-up period.
Secondary outcome:
1.PA level = measured at baseline and follow-up
  • Steps per day: recorded by pedometer
Biometric and clinical measure, including waist circumferences (cm), body fat (%), BMI (kg/m2), systolic and diastolic blood pressure (mmHg)
IG at 2-week follow up period after intervention:
1.Average daily aerobic steps: decreased (-54±2746 steps)
2.Daily aerobic time (min): Increased (+0.9±23.0)
3.Daily steps: increased (+996±1748 steps)
CG at 2-week follow up period after intervention:
1.Daily steps: increased (+97±750 steps)
This pilot study provides useful information on the potential for PA improvements through pedometry in an employed, adult group.
Ganesan A et al. [44],
Asia (India), Europe, Africa, North America, South America, Australia, and New Zealand,
2016
Type: Prospective cohort study
Participant: 26,562 Indian employees from private and public sector organizations
Company Size: Not provided, 69,219 employees completed pre-event questionnaire
Length:100-day intervention annual program without follow-up
Goal/Focus: Effect of mHealth on PA, sitting and weight
Mode of delivery
IG: Stepathlon workplace-based pedometer program
1.Pedometer: for step count challenge.
2.Stepathlon website (desktop and mobile version): provides personalized tools, educational content, and online community platform.
3.Daily encouraging emails: PA and nutrition messages, entertaining quizzes, and competitions to encourage online interface interaction
No CG or theory applied.
PA measures:
Change in step count, sitting duration and weight (kg)
Post program showed significant improvements (p<0.0001) in:
1.Recorded step count (+3,519 steps/day)
2.Exercise days (+0.89 days)
3.Sitting duration (-0.74 h)
4.Weight loss (-1.45 kg)
Improvements occurred in women and men, in all geographic regions, and in both high and lower-middle income countries.
D. Job Performance (n = 2)
Guo YF et al. [27],
China,
2020,
Type: RCT
Participant: 73 clinical nurses from Chinese tertiary general hospital
Company Size: 197 nurses
Length: 6-month intervention without follow-up
Goal/Focus: Effect of WeChat-based psychotherapy on job performance and self-efficacy of people suffering burnout.
Mode of delivery
IG: WeChat-based 3GT-positive psychotherapy.
1.WeChat: to record three good things that were impressive each day and answer 2 questions: “Why did these good things happen?” and “What was your role in bringing them about?” in their WeChat circle
2.Reminder messages for recording 3 good things: sent to all the nurses at 8 pm by the researcher to remind them to increase the adherence of 3GT
CG: No intervention received
Underlying theory: Self Efficacy
Primary outcome: job performance measured by a 16-item scale
Second outcome: Self-efficacy was measured by the 10-item GSS
Tertiary outcome: burnout was measured by MBI-GS
Significant main intervention effect (p<0.05) and interactions (p<0.05) in both IG and CG on job performance and self-efficacy.
Significant difference (p<0.05) between post-intervention scores for job performance and self-efficacy between IG and CG.
Significant difference (p<0.05) between scores for job performance and self-efficacy of the IG before and after.
Three Good Things are recommended to be included into the management systems to improve nurses’ physical and mental health and work outcomes over the long term.
Sasaki N et al. [43],
Vietnam,
2021
Type: Three-arm RCT
Participant: 951 nurses from national public tertiary hospital
Company Size: 1256 nurses
Length: 7-month intervention with follow-up
Goal/Focus: Effect of phone-based stress management program on work engagement
Mode of delivery
IG: Two 6-module CBT programs using ABC Stress Management app. Program A with free-choice multi-module, Program B with fixed-sequential order multi-module, both receive weekly messages and access to informal group chat (via social media apps such as Vober, Zalo, FB messenger) to receive intensive technical support
CG (waitlist):
1.Free to use any other mental health services as usual treatment during the intervention period.
2.Received intervention after the 7-month intervention period
No theory applied.
Work engagement scores Work engagement scores in both IG: Increased from baseline to 3-month follow-up but decreased at the 7-month follow-up
At 3-month follow-up:
1.Program A showed a non-significant trend (P = 0.07) toward improved engagement.
2.Program B showed a significant intervention effect on improving work engagement (P = 0.049) with a small effect size.
7-month follow up: neither program achieved effectiveness.
A fixed order (program B) delivery of a smartphone-based stress management program improving work engagement in nurses in Vietnam effectively but with temporary and small effect.
E. Other health outcome such as stress (n = 3), sleep (n = 2), ergonomic condition (n = 1)
Aliakbari R et al. [29],
Iran,
2020
Type: Quasi-experimental study
Participant: 63 general dentists and dental specialists in Bojnourd city
Company Size: 90 general dentists
Length: 3-month intervention without follow-up
Goal/Focus: Effect of digital-based education to improve occupational health and ergonomic condition
Mode of delivery
IG: educational intervention developed based on predictive constructs using modern media.
Messages: Receive 1–2 per day for a month about changing behaviour, share knowledge in a Telegram group to improve musculoskeletal conditions, and receive access to online educational material
CG: received software package consisting of several applications, articles and corrective trainings as IG but not involved in Telegram group.
Underlying theory: Theory of Planned Behaviour
Primary outcome: evaluated by a questionnaire about
1.Health condition: personal info, daily activities, and exercise
2.Knowledge and constructs of behavioural intention model
Ergonomics condition: measured by Nordic questionnaire and Rapid Upper Limb Assessment (RULA)
Significant difference of mean scores of constructs between IG and CG at pre-intervention: Perceived control (p = 0.04)
Significant difference of mean scores of constructs in IG at post-intervention: Attitude score (p = 0.03)
Subjective norms, perceived control, attitude, and behavioural intention had the highest predictive power in improving the health and ergonomic position of dentists, respectively.
Nourian M et al. [31],
Iran,
2021
Type: RCT
Participant: 41 nurses working in 2 COVID-19 care wards in hospital.
Company Size: 44 nurses in 2 COVID-19 care wards
Length: 7-week intervention
Goal/Focus: Effect of WhatsApp-based training program on sleep quality
Mode of delivery
IG: Mindfulness-based stress reduction training program via WhatsApp group. Training content included educational media files of mediation, yoga exercise, speeches delivered by professionals
CG: completed 2 questionnaires on Porsline website, received music and training file without WhatsApp application.
No theory applied.
Sleep quality measured by Pittsburgh Sleep Quality Index tool (Score of 5 or higher indicates poor sleep quality) Significant improvement on sleep quality score in IG: Subjective sleep quality (p<0.05), Sleep latency (p<0.05), Habitual sleep efficiency (p<0.05)
Significant improvement on sleep quality score in CG: Subjective sleep quality (p<0.05), Daytime drowsiness (p<0.05), Total sleep quality score (p = 0.001)
Significant difference on sleep quality score between IG and CG: Sleep latency (p<0.05), Subjective sleep quality (p<0.001)
The total sleep quality did not change among the participants in the IG at pre- and post-intervention but increased significantly in the CG. The MBSR program may be effective in improving the sleep quality of nurses.
Pendse et al. [32],
India,
2012
Type: Pilot study with part 1 (P1) survey and part 2 (P2) intervention
Participant: Service sector employees: 81 (P1) and 10 (P2)
Company Size: Not provided
Length: 2-week intervention without follow-up
Goal/Focus: Effect of web-based intervention on work life quality and mental well-being
Mode of delivery
IG: receive two 20–40 seconds stimuli in the forms of pictures, videos, and text through official emails every day for 10 working days.
CG: No intervention received
Underlying theory: Influential theory
Questionnaire in P1: measure career and job satisfaction, perceived absence of work stress
Questionnaire in P2: measure affect balance and emotion/worry
Happiness positively and significantly related to
1.Quality of Work Life (R = 0.378, P<0.01)
2.Resilience (R = 0.365, P<0.05)
CG on affect balance significantly lower than the gain scores of IG (U = 14, P<0.05)
Web-based interventions show promise for enhancing employee’s’ happiness but this study was limited by there’s limitation on small sample size
Divya K et al. [35],
India,
2021
Type: Pilot study with single arm pre-post design
Participant: 92 healthcare providers (HCPs)
Company Size: 7597 HCPs from different states
Length: 40-day intervention with follow-up
Goal/Focus: Effect of online video-based education on mental wellbeing
Mode of delivery
IG: received a 4-day online breath and meditation workshop, Sudarshan Kriya Yoga (SKY) delivered by trained instructors with a 2-hour session/ day through video conference. Participants also learnt the 35-min home practice, including Pranayama, Bhastrika and SKY breathing to be practised at home daily.
No CG or theory applied.
Primary outcome:
1.Depression and Anxiety: measured by self-reported Depression, Anxiety and Stress Scale (DASS-21).
2.Sleep Quality: measured by Pittsburgh Sleep Quality Index (PSQI).
3.Resilience: measured by self-rated Connor-Davidson Resilience Scale.
Life satisfaction: measured by a 5-item Satisfaction with Life Scale.
Significant differences in the scale scores:
1.Depression, anxiety, and stress: reduced scores for all at post-intervention (p<0.001)
2.Resilience: Increased resilience at post-intervention (p<0.001) and greater increase at follow-up phase (p = 0.015).
3.Life satisfaction: increased life satisfaction at post-intervention (p<0.001) and greater increase at follow-up phase (p< 0.001).
4.Quality of sleep: reduced scores immediately after the program (p<0.001)
SKY breathing technique had a positive impact on the well-being of healthcare professionals during the pandemic. Participants experienced improved quality of sleep, enhanced satisfaction with life, and increased resilience after SKY.
Dincer B and Inangil D [37],
Turkey,
2021
Type: RCT
Participant: 72 nurses caring for COVID-19 patients in a university hospital
Company Size: Not provided, 80 nurses met criteria
Length: Not provided, without follow-up
Goal/Focus: Effect of online group emotional freedom techniques (EFT) treatment on reducing stress, anxiety, and burnout level
Mode of delivery
IG: received a 20-mins guided online group EFT treatment by showing the participants a picture of the acupressure points and ways to apply pressure tap.
CG: no EFT treatment received between the completion of 2 subjective units of distress (SUD) and burnout tests.
No theory applied.
Primary outcome:
1.Stress levels: measured by SUD scale
2.Anxiety levels: measure the State Anxiety Scale
3.Burnout levels: measured by a 21-item Burnout Scale
Significant differences in IG at post intervention (p < .001):
1. Stress levels: Reduced mean SUD score
2.Anxiety levels Reduced anxiety score
3.Burnout levels: Reduced burnout score
CG showed no statistically significant changes on these measures (p > .05)
Montagni I et al. [45],
China, France, Spain, UK,
2019
Type: Pilot study
Participant: 291 employees (T1) of eight company sites in four countries
Company Size: Not provided, 834 employees in (T0)
Length: Two phase (T0 and T1) intervention of 5 days each. Follow-up (T1) after 6 months
Goal/Focus: Effect of blended tablet-based survey to raise sleep awareness
Mode of delivery
IG: asked to use WarmUapp tablet application which consist of 27 screens (23 screens for questions, 3 screens for partial survey answers, 1 screen for survey results and personalised recommendations to improve sleep quality)
No CG or theory applied
Primary outcome:
1.Change in sleep status which measured total sleep duration, sleep efficiency, sleep debt, insomnia, sleepiness
2.WarnUappTM effectiveness: measured user satisfaction, feedbacks and ideas through structured interview composed of 3 open-ended questions
Significant difference in sleep status at post intervention (follow-up phase):
1.Increased total sleep duration (p = 0.046)
2.Decreased sleep debt (p = 0.019), sleep difficulties between two phases (p<0.001), sleepiness (p = 0.026)
3.Sleep problem: females 2 times more likely to suffer in both phases (p = 0.006)
Satisfaction with WarnUappTM: All interviewees were satisfied of the intervention
Interventions blending face-to-face and web-based approaches show promise for effective promotion of sleep awareness at the workplace.