Do worksite health promotion programs (WHPP) influence presenteeism among employees? A systematic review1

Abstract

BACKGROUND: Worksite health promotion programs (WHPP) aiming to reduce presenteeism are rapidly increasing. However, program-efficacy seems impaired by lack of conceptual understanding and theoretical frameworks related to presenteeism. OBJECTIVES: To study (1) the concept of presenteeism, (2) causes of the phenomenon and (3) which WHPP affect presenteeism. METHODS: We followed the PRISMA 2020 guidelines mapping relevant literature in seven databases. The main search-terms were “worksite”, “WHPP”, “presenteeism”, “employee productivity” and “interventions”. Reviews and review of reviews were included and analysed according to research questions and ecological theory. RESULTS: Of 2196 studies identified, 14 reviews were included, comprising 1390 single studies. Conceptually, presenteeism was poorly defined, mostly related to productivity/performance limitations due to ill health. Factors causing presenteeism addressed individual health or lifestyle (78%), to a lesser extent work and organisational factors (management/job stress) (22%). Forty-five highly diverse WHPP were identified, about 90% focusing health outcomes. 22/45 WHPP affected presenteeism/productivity positively. Multi-component WHPP implemented at multi levels accounted for 55%. Single-component programs, implemented at individual level, were mostly targeting health-risk subgroups. No specific WHPP seems preferable. Methodological quality seems highly associated with worksite intervention-efficacy. CONCLUSION: Increased telework opportunities due to COVID-19 experiences has affected working conditions worldwide, for better and worse, requiring adaptions at employee, management, organisational and socio-cultural level. Our results showed high program diversity, several adaptable to future needs (e.g., digital solutions), however hampered by narrow focus on individual health. Future research should focus on theory based high quality multilevel WHPP comprising contextual, work, and organisational factors.