A scoping review of digital workplace wellness interventions in low- and middle-income countries

PLOS ONE RESEARCH ARTICLE A scoping review of digital workplace wellness interventions in low- and middle-income countries Yi Chiann Thai1, Deanna Sim2, Tracy A. McCaffrey2*, Amutha Ramadas1, Hema Malini3, Jessica L. Watterson ID1* a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 1 Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia, 2 Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia, 3 Faculty of Nursing, Universitas Andalas, West Sumatra, Indonesia * (JLW); (TAM) Abstract Introduction Citation: Thai YC, Sim D, McCaffrey TA, Ramadas A, Malini H, Watterson JL (2023) A scoping review of digital workplace wellness interventions in lowand middle-income countries. PLoS ONE 18(2): e0282118. https://doi.org/10.1371/journal. pone.0282118 Digital technology-based interventions have gained popularity over the last two decades, due to the ease with which they are scalable and low in implementation cost. Multicomponent health promotion programmes, with significant digital components, are increasingly being deployed in the workplace to assess and promote employees’ health behaviours and reduce risk of chronic diseases. However, little is known about workplace digital health interventions in low- and middle- income countries (LMICs). Editor: Ali A. Weinstein, George Mason University, UNITED STATES Methods OPEN ACCESS Received: June 21, 2022 Accepted: February 7, 2023 Published: February 28, 2023 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0282118 Copyright: © 2023 Thai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All data is available in existing library databases that we searched. Our methodology is outlined in the article to allow others to reproduce the search. Various combinations of keywords related to “digital health”, “intervention”, “workplace” and “developing country” were applied in Ovid MEDLINE, EMBASE, CINAHL Plus, PsycINFO, Scopus and Cochrane Library for peer-reviewed articles in English language. Manual searches were performed to supplement the database search. The screening process was conducted in two phases and a narrative synthesis to summarise the data. The review protocol was written prior to undertaking the review (OSF Registry:10.17605/OSF.IO/QPR9J). Results The search strategy identified 10,298 publications, of which 24 were included. Included studies employed the following study designs: randomized-controlled trials (RCTs) (n = 12), quasi-experimental (n = 4), pilot studies (n = 4), pre-post studies (n = 2) and cohort studies (n = 2). Most of the studies reported positive feedback of the use of digital wellness interventions in workplace settings. Conclusions This review is the first to map and describe the impact of digital wellness interventions in the workplace in LMICs. Only a small number of studies met the inclusion criteria. Modest evidence was found that digital workplace wellness interventions were feasible, cost-effective, PLOS ONE | https://doi.org/10.1371/journal.pone.0282118 February 28, 2023 1 / 25 PLOS ONE Funding: The author(s) received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist. Digital workplace wellness interventions in LMICs and acceptable. However, long-term, and consistent effects were not found, and further studies are needed to provide more evidence. This scoping review identified multiple digital health interventions in LMIC workplace settings and highlighted a few important research gaps. Introduction According to the World Health Organisation (WHO), 3.5 billion people, nearly half of the world’s population, are employees. On average, a full-time employee spends more than onethird of his or her days, five days a week at their workplace. Due to the large population and long hours spent at work, the workplace has been a favourable setting to implement health promotion programs, motivating employee health behaviour change. WHO has estimated that 2.1% of all deaths and 2.7% of the global disease burden are attributed to quantified occupation risks [1]. Of these, employees in low-and middle-income countries (LMICs) have contributed to the largest portions of deaths and disability in the workplace settings. Evidence has suggested a rising need for WWPs in LMICs [2]. WWPs are typically designed to reduce medical spending, increase employee’s productivity and enhance their well-being [3]. Research explored the link between employee health and work productivity [4, 5]. Besides absenteeism as an indicator for work productivity, there is also an extent of limitation due to health problems even when employees are present at work. For example, obese workers may experience greater challenges at work compared to normal weight workers [6]. Both absenteeism and presenteeism are strongly associated with poor employee’s status and behaviours, including obesity, insomnia, depression or physical inactive which have been proven to cause detrimental burden to organizations’ economic [7–11]. This poor workplace performance which is caused by physical or mental health issues is often underestimated by the organisation. Thus, it is essential to build a healthy work environment and address employee’s health issues. Studies have grown exponentially in a short time as digital health is progressing rapidly due to advances in technology and applications. Multicomponent design which involves various support from healthcare professionals, employees support groups, telephone-based coaching and more recently web and mobile-delivered programs, has been proven to be the most effective approach in addressing occupational health issues [12–17]. Digital technology-based intervention is increasingly being deployed in the workplace due in part to their scalability to a large population and cost-effective approach when compared with traditional health intervention used. Additionally, the COVID-19 pandemic has accelerated the digital transformation and brought more people on the digital health journey. The remote work model might affect the implementation of WWPs and thus, digital intervention may be more feasible and practical in this new norm. Also, digital workplace wellness allows all employees to access the health promotion content from anywhere at any time with the help of technology. Nonetheless, it is worth discovering whether digital workplace wellness is effective in modifying healt (...truncated)