Workplace wellness programmes to improve health
Authors: Luke Wolfenden, Sze Lin Yoong
Journal: The Lancet Public Health (2021)

The workplace has been a recommended setting for interventions to improve heart health for decades.1WHOGlobal strategy for health for all by the year 2000. World Health Organization, Geneva1981https://www.who.int/publications/i/item/9241800038Date accessed: July 22, 2021Google Scholar Research regarding the effectiveness of workplace interventions has accelerated in the past 10 years. One of the largest reviews to date, reported by José Peñalvo and colleagues2Peñalvo JL Sagastume D Mertens E et al.Effectiveness of workplace wellness programmes for dietary habits, overweight, and cardiometabolic health: a systematic review and meta-analysis.Lancet Public Health. 2021; 6: e648-e660Summary Full Text Full Text PDF Scopus (5) Google Scholar in The Lancet Public Health, consolidates this evidence base by providing evidence to support the role of workplace interventions in improving a range of dietary, anthropometric, and cardiometabolic outcomes. The systematic review and meta-analysis included 121 interventional studies (82 with randomised designs) and supports previous reviews by concluding that such interventions can yield modest but important effects, particularly when considered from a population health perspective. For most outcomes, there was considerable statistical heterogeneity that could not be explained by subgroup analysis of a range of characteristics, including intervention strategies. The evidence was also largely generated from research done in high-income countries, and it was not possible to assess the long-term sustainability of such interventions. These are important caveats, particularly for end users responsible for delivering health promotion interventions. The contextual factors of individual studies should be considered, in addition to averaged effects reported in meta-analysis, when designing or selecting interventions to deliver in the real world. Additionally, it is crucial to highlight the importance of future research in low-income and middle-income workplace environments, research that enables more granularity in identifying effective components of workplace interventions, and studies that assess their sustained effects. There are several opportunities to improve cardiovascular health in workplace settings. The substantial shifts in the working environments of many industries as a result of the global pandemic are likely to be transformational to workplace health promotion efforts. The greater integration of technology-based systems may offer opportunities to facilitate behaviour change, including in home environments. However, the adverse effects of being connected to technology, and how to expand workplace interventions into the home for many employees, remain largely unknown.3Oakman J Kinsman N Stuckey R Graham M Weale V A rapid review of mental and physical health effects of working at home: how do we optimise health?.BMC Public Health. 2020; 201825Crossref PubMed Scopus (49) Google Scholar Perhaps the most pressing need for research if we are to ensure that effective workplace interventions benefit the cardiovascular health of the community is to identify strategies to support their implementation. The 121 studies included in the review by Peñalvo and colleagues contrasts with just six trials identified in a Cochrane review of strategies to implement chronic disease prevention programmes in the workplace setting.4Wolfenden L Goldman S Stacey FG et al.Strategies to improve the implementation of workplace-based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity.Cochrane Database Syst Rev. 2018; 11CD012439PubMed Google Scholar The Cochrane review found no evidence of benefit of implementation support in improving policy or practice implementation of these programmes in workplaces. This finding leaves the field in the uncomfortable position of having a range of effective interventions but potentially no effective means of implementing them. While not without its limitations, the systematic review by Peñalvo and colleagues demonstrates that the evidence regarding the effects of workplace interventions on cardiovascular risks is now convincing. The attention of the field should now be directed at getting this evidence implemented into practice. LW receives salary support from a National Health and Medical Research Council Career Development Fellowship (grant APP 1197022). SLY receives salary support from an Australian Research Council Discovery Early Career Research Award (DE170100382). LW and SLY declare no other potential competing interests. Effectiveness of workplace wellness programmes for dietary habits, overweight, and cardiometabolic health: a systematic review and meta-analysisWorkplace wellness programmes are associated with improvements in specific dietary, anthropometric, and cardiometabolic risk indicators. The heterogeneity identified in study designs and results should be considered when using these programmes as strategies to improve cardiometabolic health. Full-Text PDF Open Access