The review “Effectiveness of workplace interventions for health promotion” addresses a significant gap in the literature by providing a comprehensive, quality-informed horizontal analysis of the effectiveness of a broad range of workplace health interventions. This publication, authored by Marianna Virtanen and colleagues, synthesizes findings from 88 reviews and 339 meta-analysed effect estimates published between 2011 and 2024.
Rationale for Workplace Health Promotion: Workplaces are recognized as an important and strategic setting for health promotion. This is due to several key advantages:
- They offer established infrastructure.
- They provide daily access to large populations.
- They create opportunities to engage groups that are often under-represented in health initiatives.
- Workplace factors significantly influence major public health concerns such as work stress, mental health problems, musculoskeletal disorders, and cardiometabolic risks, which contribute to absenteeism, reduced productivity, and increased health-care costs for individuals, employers, and society. For instance, a high percentage of workers in the EU and USA spend most of their working hours seated, and a large portion of daily food intake occurs during working hours.
Scope and Methodology of the Review: The review systematically evaluated interventions targeting several key health areas:
- Mental health and stress reduction (most frequently studied, 36% of targets).
- Weight management and cardiometabolic health (25%).
- Health-related behaviours (22%).
- Musculoskeletal disorders and pain (17%).
The authors conducted a systematic horizontal review of previous meta-analyses, using explicit criteria for relevance and bias assessment, focusing on interventions aimed directly at health promotion, such as workplace wellness programs. They applied the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework to assess the quality of evidence for each intervention and outcome estimate. This assessment considered the risk of bias in original intervention studies, inconsistency (heterogeneity), and small-study effects (publication bias).
Key Findings on Effectiveness and Quality of Evidence: The review’s findings highlight both the potential and the limitations of current workplace health promotion efforts:
- Overall Quality of Evidence: The quality of evidence was generally low or very low, with none classified as high quality. Out of 339 meta-analysed effect estimates, only 71 (21%) provided evidence of moderate quality. The highest possible rating was moderate because more than 40% of the original studies in the included meta-analyses had a high risk of bias.
- Mental Health and Stress Reduction:
- Mindfulness showed effectiveness across multiple stress and mental health outcomes, including stress reduction, burnout symptoms, improving subjective health, resilience, and enhancing mindfulness skills. It also demonstrated some stronger effects on stress, burnout, and anxiety relief.
- Cognitive behavioural techniques (CBT-based) and other psychological methods were effective in reducing stress, depression, and anxiety symptoms, whether delivered traditionally or via e-health platforms.
- Stress management and physically oriented methods (like relaxation exercises) also showed some effectiveness in reducing stress symptoms.
- Psychological skills training could prevent depression and anxiety in police personnel.
- Cardiometabolic Health:
- Multicomponent interventions had small but measurable effects on weight loss (0.52–1.19 kg or 0.12–0.34 BMI units) and glucose levels (improving glycated haemoglobin).
- Physical activity interventions effectively improved cardiorespiratory fitness.
- Mindfulness practices could enhance cardiovascular or autonomic functioning.
- However, multicomponent interventions were not effective in improving blood triglyceride levels, and e-health interventions showed no effect on weight management.
- Health-Related Behaviours:
- Environmental interventions were effective in reducing sedentary time at work (by approximately 64 minutes per day), with behavioral and multicomponent interventions also showing reductions (up to 28 min and 41 min, respectively).
- Multicomponent interventions proved successful in increasing fruit intake (a fifth portion’s increase) and seasonal influenza vaccination uptake among healthcare personnel.
- Physical activity programs, including e-health approaches, generally improved employees’ overall physical activity.
- Workplace interventions had a small effect on alcohol consumption, particularly for those with higher consumption levels.
- Musculoskeletal Disorders and Pain: The evidence for interventions aimed at preventing musculoskeletal disorders and pain was uncertain, as only one meta-analysis remained in the final analytic sample. Previous overviews suggested workplace modifications, assistive devices, education, and exercise could be effective for back pain.
- E-health and Mobile-health (m-health) Interventions: These solutions present a potential novel pathway, especially with the rise of remote work. They provided small-to-strong effects on depressive, anxiety, and stress symptoms, and physical activity. However, their suitability as a sole intervention needs further investigation.
Limitations and Future Directions: The review notes several limitations, including the reliance on author-reported publication bias and study quality, and the challenge of study overlap across meta-analyses. Despite addressing study overlap qualitatively, the generalizability of some findings is limited due to interventions targeting specific groups.
The authors propose directions for future research to address existing limitations and enhance the field:
- Conducting larger, multicentre randomized controlled trials (RCTs) with long follow-ups in workplace settings.
- Assessing the role of organizational culture, which has been largely overlooked.
- Focusing on under-represented populations, such as workers with low socioeconomic positions, those in low- and middle-income countries (LMICs), young workers, shift workers, and employees in small and medium-sized enterprises.
- Evaluating interventions targeting the psychosocial work environment, shift work schedules, and economic aspects (e.g., return on investment).
- Examining sensitive aspects of workplace health promotion, such as confidentiality and disclosure of health information.
- Addressing publication bias (small-study effects) by publishing all study results and identifying unpublished data.
- Requiring longer follow-up periods to assess long-term benefits, as most existing trials have short follow-ups.
In conclusion, while the review supports the positive effects of some workplace-based health promotion strategies, it also underscores the substantial limitations in the quality of existing evidence, necessitating more rigorous and comprehensive research to draw firm conclusions about their overall effectiveness and contribution to public health.
Reference: Virtanen, M., Lallukka, T., Elovainio, M., Steptoe, A., & Kivimäki, M. (2025). Effectiveness of workplace interventions for health promotion. The Lancet Public Health, 10(6), e512-e530.
