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The impact of digital health interventions on health-related outcomes in the workplace: A systematic review
Open accessAbstract
Background: The impact of employee health on productivity in the workplace is generally evidenced through absenteeism and presenteeism. Multicomponent worksite health programmes, with significant online elements, have gained in popularity over the last two decades, due in part to their scalability and low cost of implementation. However, little is known about the impact of digital-only interventions on health-related outcomes in employee groups. The aim of this systematic review was to assess the impact of pure digital health interventions in the workplace on health-related outcomes. Methods: Multiple databases, including MEDLINE, EMBASE, PubMed and PsycINFO, were used to review the literature using PRISMA guidelines. Results: Of 1345 records screened, 22 randomized controlled trial studies were found to be eligible. Although there was a high level of heterogeneity across these studies, significant improvements were found for a broad range of outcomes such as sleep, mental health, sedentary behaviours and physical activity levels. Standardized measures were not always used to quantify intervention impact. All but one study resulted in at least one significantly improved health-related outcome, but attrition rates ranged widely, suggesting sustaining engagement was an issue. Risk of bias assessment was low for one-third of the studies and unclear for the remaining ones. Conclusions: This review found modest evidence that digital-only interventions have a positive impact on health-related outcomes in the workplace. High heterogeneity impacted the ability to confirm what interventions might work best for which health outcomes, although less complex health outcomes appeared to be more likely to be impacted. A focus on engagement along with the use of standardized measures and reporting of active intervention components would be helpful in future evaluations.
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“These findings align with previous research39,40, underscoring the potential for digital tools in managing chronic conditions and providing a foundation for future innovations in this field.”
From Impact of digital health interventions on glycemic control and weight management. (2025) · cites this paper as [39]
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ResultA scoping review of digital workplace wellness interventions in low- and middle-income countries
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“The inherent reachability of these applications and their sizable and sustained effects are key factors driving users toward them (Howarth et al., 2018, 2019; Lecomte et al., 2020).”
Kechagias, E. P., Papadopoulos, G. A., & Rokai, I. (2024) · Administrative Sciences · doi:10.3390/admsci14060131 · Cited by 15
“The literature has consistently shown that health matters such as absenteeism and presenteeism—employees physically at the work-place but underperforming on the job due to illness—are significantly associated with both workforce health and well-being (Howarth et al. 2018).”
BackgroundGarcía-Pérez-de-Sevilla, G., Guido, O. B., la Cruz, M. D. L. P. D., Fernández, A. B., Alejo, L. B., Martínez, M. M., & Pérez, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147510 · Cited by 19
“No randomized clinical trial has been found reporting a telematic intervention at the workplace that manages to increase PA levels [49,50] and to date, none carried out during the COVID-19 pandemic lockdown is described in the literature.”
BackgroundWebb, T. L., & de Bruin, M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.037 · Cited by 16
An umbrella review of efficacy of digital health interventions for workers
Iwakura, M., Ozeki, C., Jung, S., Yamazaki, T., Miki, T., Nohara, M., & Nomura, K. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01578-2 · Cited by 19
Blended Health Coaching for Work-linked Couples: Coaches’ Intervention Fidelity and Empathy Matter!
Busch, C., Dreyer, R., & Janneck, M. (2022) · Coaching | Theorie & Praxis · doi:10.1365/s40896-022-00065-9 · Cited by 15
Robinson, N., Connolly, J., Suddrey, G., & Kavanagh, D. J. (2023) · International Journal of Social Robotics · doi:10.1007/s12369-023-01054-5 · Cited by 15
“Digital interventions in mental healthcare have shown clinical benefits for anxiety and depression for young adults and adolescents [25, 28], as well as for specialist domains such as within the workplace [30].”
Merolli, M., Hinman, R. S., Lawford, B. J., Choo, D., & Gray, K. M. (2021) · JMIR Research Protocols · doi:10.2196/25177 · Cited by 13
“However, the authors noted the continued highly heterogeneous nature of digital health research as well as difficulties in examining digital health use because of the lack of standardized measures for reporting on key active components of DHIs [27].”
BackgroundYeager, C. M., & Benight, C. C. (2022) · JMIR Mental Health · doi:10.2196/35048 · Cited by 12
“This supports previous short-term research that failed to find a relationship between engagement and outcomes [75-77] and underscores the importance of understanding and targeting the mechanisms of action between engagement and outcomes to improve DMHI efficacy.”
BackgroundOlaya, B., Feltz-Cornelis, C. M. V. D., Roijen, L. H., Merecz‐Kot, D., Sinokki, M., Naumanen, P., Shepherd, J., van Krugten, F. C. W., de Mul, M., Staszewska, K., et al. (2022) · Digital Health · doi:10.1177/20552076221131145 · Cited by 13
Critical and Qualitative Approaches to Behavior Change
Chamberlain, K., & Lyons, A. C. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.030 · Cited by 13
Virgillito, D., & Ledda, C. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1718474 · Cited by 17
Maximizing User Engagement with Behavior Change Interventions
Yardley, L., Morrison, L. G., Müller, I., & Bradbury, K. J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.025 · Cited by 11
Effectiveness of a Water Intake Program at the Workplace in Physical and Mental Health Outcomes
Luo, Y., Hsu, C. C., Lin, K. J., Fu, S., Chen, J. R., & Lai, C. (2022) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/00469580221085778 · Cited by 12
“Nonetheless, studies implementing interventions in the workplace designed to manipulate health-related behaviors have often demonstrated well-being status improvements and further reductions in absenteeism and improved presenteeism among participants.(13) Modern equipment, such as digital interventions and application…”
BackgroundHerold, M., Simbula, S., & Gallucci, M. (2024) · Current Psychology · doi:10.1007/s12144-024-06534-z · Cited by 13
“At the same time, digital technologies are embracing our everyday life (Howarth et al., 2018 ; Liesa-Orús et al., 2020 ), and organizations have profited from digital technologies in various ways, such as reducing labour and production costs (Skoumpopoulou et al., 2018 ), a more remarkable ability…”
Digital Health Education for Chronic Lung Disease: Scoping Review
Sun, C., Dai, H., van der Kleij, R., Li, R., Wu, H.-P., Hallensleben, C., Willems, S. H., & Chavannes, N. H. (2025) · Journal of Medical Internet Research · doi:10.2196/53142 · Cited by 12
Benefits and Limitations of Implementing Mental Health Apps Among the Working Population
Jones, N. M., Johnson, M., Sathappan, A. V., & Torous, J. B. (2021) · Psychiatric Annals · doi:10.3928/00485713-20210112-01 · Cited by 11
Yeh, P. T., Kennedy, C. E., Minamitani, A., Baggaley, R. C., Shah, P., Verster, A. D., Luhmann, N., Mello, M. B., & Macdonald, V. (2022) · Journal of Medical Internet Research · doi:10.2196/40150 · Cited by 11
“These findings are broadly similar to those of other systematic reviews of digital health interventions with diverse health topics and populations [41-43].”
Digi-Exist: Eine digitale Plattform zur Gesundheitsförderung für junge Unternehmen
Ducki, A., Behrendt, D., Boß, L., Brandt, M., Janneck, M., Jent, S., Kunze, D., Lehr, D., Nissen, H., & Wappler, P. (2019) · Springer eBooks · doi:10.1007/978-3-662-59044-7_22 · Cited by 11
Brodie, A. M., Pavey, T., Newton, C. J., & Sendall, M. C. (2021) · PLoS ONE · doi:10.1371/journal.pone.0255225 · Cited by 11
“Of particular relevance to the time-pressured road transport industry, the burgeoning availability of smartphone technology and wireless internet access means digital technologies such as apps can be easily integrated into tools already used by the workplace and adapted to workers’ current state and context [33, 34].”
Background
Metadata
- Authors
- Howarth, A., Quesada, J., Silva, J., Judycki, S., & Mills, P. R.
- Affiliations
- St George's, University of London (GB)
- Cigna (United States) (US)
- Cigna, Global Well-being Solutions Ltd, UK
- Whittington Hospital (GB)
- Corresponding author
- Howarth, Ana
- Venue
- DIGITAL HEALTH
- Publisher
- SAGE Publications
- Published
- 2018-01
- Volume
- 4
- Pages
- 2055207618770861-2055207618770861
- ISSN
- 2055-2076 (ISSN-L)
- PMC
- PMC6016571
- OpenAlex
- W2800263550
- Cited by
- 240
- References
- 64
- Citations by year
- 2026: 16 · 2025: 40 · 2024: 33 · 2023: 27 · 2022: 36 · 2021: 18 · 2020: 63 · 2019: 7
- FWCI
- 3.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Digital Health (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- digital health interventions, workplace health, employee health, absenteeism, presenteeism, sleep, mental health, sedentary behavior, physical activity, user engagement, attrition
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