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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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BackgroundAutonomy-Supportive Interventions
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Effectiveness of a Blended Web-Based Intervention to Raise Sleep Awareness at Workplace
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BackgroundImplementation Science and Translation in Behavior Change
Łuszczyńska, A., Łobczowska, K., & Horodyska, K. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.023 · Cited by 10
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“25,26 However, Abd-Alrazaq et al. 45 found that there is still insuf fi cient evidence to prove the effectiveness and safety, and recommended that further studies are required to draw solid conclusions that their effect is clinically important.”
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BackgroundThe role of internal CSR in guiding the digitalisation of work
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“Programmes such as “Exertime” and “Get Moving” (Howarth et al., 2018, p. 15), which aim to activate employees, were particularly successful in terms of engagement and health improvements.”
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“%) showing positive impact on presenteeism/productivity, were multicomponent programs implemented at two or more levels [35, 36, 38, 42, 43, 48, 50].”
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“A systematic review of 22 randomized controlled trials found that digital health interventions in the workplace create a positive impact on health-related workplace outcomes such as diet, exercise, mental health, and job satisfaction [22].”
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“…is often provided digitally (43%), which is greatly in line with the findings of Mauch et al. [3] and can be attributed to the fact that digital interventions (wearables, apps, etc.) have become increasingly accepted and utilized in occupational health management in recent years [75,78–81].”
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“Sample sizes ranged for students (from ‘‘not reported’’ to 4808) and schools (1-193) making meaningful comparison equally challenging.”
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Kasrineh, M. R., Sharifzadeh, N., Soodejani, M. T., & Tabatabaei, S. M. (2023) · Physiology and Pharmacology · doi:10.61186/phypha.27.3.234 · Cited by 4
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“Also, the applicability of DWHP is broad and can cover all aspects of health [30,31], e.g., physical activity [32], medical checks [33], mental health [34] and eating habits [35].”
BackgroundMethodInfluentialLeveraging Trauma Informed Care for Digital Health Intervention Development in Opioid Use Disorder
Venkatasubramanian, K., Appleton, J., Ranalli, T.-M., Mankodiya, K., Solanki, D., & Carreiro, S. (2024) · Journal of Medical Toxicology · doi:10.1007/s13181-024-01040-x · Cited by 2
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“These studies have explored technical, infra-structural, and policy-related barriers to implementation [26, 27] and have assessed the impact of digital health on healthcare efficiency and patient outcomes [28–30].”
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“Additional research suggests that a successful approach to addressing digital health interventions is through a multicomponent design [13], using features such as tailored messages, reporting of thoughts, feelings, or behaviors [31]; relaxations features [5]; integrated therapist contact and other…”
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“…effort allowed us to move beyond prior reviews that examine a specific type of programme or treatment (Bartlett et al., 2019; Carolan et al., 2017; Fuentes et al., 2019; Howarth et al., 2018), enabling our work to draw conclusions about the extent to which paradoxes exist and in what circumstance.”
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Behavior Change in Community Contexts
Trickett, E. J., & Paterson, S. E. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.028 · Cited by 2
Kuhlberg, H., Kujala, S., Hörhammer, I., & Koskela, T. (2021) · JMIR Research Protocols · doi:10.2196/27668 · Cited by 2
“There have been studies on online health checks and internet-based risk assessments of subgroups such as the employed, but there have been few studies focusing on online health checks for the unemployed [20].”
BackgroundKulkarni, H., Chong, C., & Lam, M. (2023) · Springer eBooks · doi:10.1007/978-981-99-2613-8_6 · Cited by 2
Cost-Effectiveness Evaluations of Behavior Change Interventions
Wang, T., Downes, M., Byrnes, J., & Scuffham, P. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.026 · Cited by 1
Development of a responsive website to promote behavior changes in computer users
Filho, E. C. G., Vieira, L. M. S. M. D. A., & Sato, T. D. O. (2022) · Fisioterapia e Pesquisa · doi:10.1590/1809-2950/22001129032022en · Cited by 2
Wong, C. C.-K., Kwok, R. C.-W., & Zhang, S. (2023) · Journal of Information Technology Case and Application Research · doi:10.1080/15228053.2023.2186673 · Cited by 2
“Physical activity and wellness programs, such as aerobic, strength, and flexibility exercises, have been commonly used in the workplace to stress management and reduce stress symptoms (Buckingham et al., 2019; Howarth et al., 2018; Quick et al., 1997).”
BackgroundCoda, A., Hawke, F., Santos, D., Stevenson, E., Gironès, X., Ruiz, X., Escalona‐Marfil, C., Sanson‐Fisher, R., & Fellas, A. (2025) · Discover Education · doi:10.1007/s44217-025-00450-5 · Cited by 1
“This information is essential for providing continuity of care and ensuring that patients receive the best possible treatment [37, 46].”
May, N., Kasten, S., Schwan, T., Scharle, M., Tautz, A., Letzel, S., & Dietz, P. (2025) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-025-02145-8 · Cited by 1
“However, the scientific database on this issue is under-researched, and it can be assumed that the acceptance of digital workplace health promotion differs according to sociodemographic characteristics (Howarth et al. 2018; Robroek et al. 2021).”
Effectiveness of a workplace wellness program for adolescents and young adults
Griffin, K. W., WILLIAMS, C. R., & Botvin, G. J. (2025) · Journal of Workplace Behavioral Health · doi:10.1080/15555240.2025.2533995 · Cited by 1
“For example, interventions that are made available in online formats offer more flexibility and could increase employee engagement (Howarth et al., 2018).”
Osei, E., Asante, L. S., Ampon-Wireko, S., & Abdulai, P. M. (2025) · Digital Health · doi:10.1177/20552076251379770 · Cited by 1
Frazier, M. C., Pullin, M. J., & Harden, S. M. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1634264 · Cited by 1
“Virtual interventions are particularly promising for improving CHE health and wellbeing (17).”
Addanki, S., Macedo, L., MacDermid, J. C., & Moll, S. E. (2026) · JMIR mhealth and uhealth · doi:10.2196/57046 · Cited by 1
du Prel, J., & Borchart, D. (2026) · BMC Health Services Research · doi:10.1186/s12913-026-14398-1 · Cited by 1
“In addition, there is a greater variety of services if DiHPO are provided along-side face-to-face programmes [17].”
InfluentialKillian, C. M., D’Agostino, E. M., Urtel, M. G., Long, B., Arangio, O., & Webster, C. A. (2026) · Journal of School Health · doi:10.1111/josh.70143 · Cited by 1
Collective Action for Wellness in the Malaysian Workplace: Protocol for a Feasibility Study
Thai, Y. C., McCaffrey, T. A., Ramadas, A., Chandrasekara, D., Koh, S. G. M., Choi, T. S. T., Malini, H., Xie, J., Olivier, P. L., Zain, A. Z. M., et al. (2022) · JMIR Research Protocols · doi:10.2196/39238 · Cited by 3
“Over the past 2 decades, growing research has been conducted to evaluate the effectiveness and feasibility of digital health interventions in the workplace context of many countries [13-15], but relatively few studies have been conducted in low- and middle-income countries (LMICs).”
BackgroundPosenau, A., Leinweber, J., & Barthel, M. (2022) · Springer Reference Pflege, Therapie, Gesundheit · doi:10.1007/978-3-662-65219-0_80 · Cited by 1
Recursos digitais na promoção da saúde mental de trabalhadores: Protocolo de revisão sistemática
Jacques, J. P. B., Pinhatti, E. D. G., Aroni, P., Leachi, H. F. L., & Ribeiro, R. P. (2023) · Enfermería actual en Costa Rica · doi:10.15517/ca2ffh57 · Cited by 1
Kowalski, L., Finnes, A., Koch, S., Stenling, A., & Bujacz, A. (2024) · BMC Digital Health · doi:10.1186/s44247-024-00120-w · Cited by 1
Theobald, P., Herold, F., Gronwald, T., & Müller, N. G. (2024) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-024-00985-4 · Cited by 1
“…limitations (e.g., requiring digital infrastructure and digital skills) [4, 16, 17], several studies [18–22] have shown that digital health applications, for instance, can be used to deliver physical training interventions [19, 23–26] and behavioural therapies in younger and older adults [21, 27].”
BackgroundKervinen, E., Vähätalo, L., Siukola, A., Reho, T., Winell, K., & Sauni, R. (2025) · Digital Health · doi:10.1177/20552076241297409 · Cited by 1
Fragmented care in lupus: Patient experiences and insights
Bam, A. (2025) · African Journal of Disability · doi:10.4102/ajod.v14i0.1562 · Cited by 2
Böttcher, N., & Kauffeld, S. (2025) · Gruppe Interaktion Organisation Zeitschrift für Angewandte Organisationspsychologie (GIO) · doi:10.1007/s11612-025-00795-3 · Cited by 1
“Behavioral interventions may benefit from face-to-face elements, which provide immediate feedback, facilitate interpersonal interactions, and offer structured support to help participants translate intentions into actions (see also Howarth et al., 2018).”
Musakuro, R. N. (2025) · International Journal of Business Ecosystem and Strategy (2687-2293) · doi:10.36096/ijbes.v7i2.698 · Cited by 1
“The use of e-health tools enables DMHS delivery in the workplace by impacting how mental health services are designed and accessed, but more importantly how mental health services are delivered in a formal and informal workplace setting (Howarth et al., 2018).”
InfluentialAl‐Jabr, H., Salt, E., Stephenson, J. R., Hamdan, E., & Helliwell, T. (2025) · JMIR Research Protocols · doi:10.2196/67675 · Cited by 1
“DH plays a significant role in health care, and it can be seen in many medical specialties [6,7].”
Hayvon, J. C. (2025) · Howard Journal of Communications · doi:10.1080/10646175.2025.2535604 · Cited by 1
“To illustrate with more concreteness, the following discussions draw upon the field of health media or digital health (Howarth et al., 2018; Widmer et al., 2015), in which a variety of both non-fictional and creative works have been created to meet key marginalized health needs.”
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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