Are workplace health promotion/wellness programs effective at improving presenteeism (on the job productivity) in workers? a systematic review and best evidence synthesis of the literature

Background: Presenteeism is highly prevalent and costly to employers. It is defined as being present at work but limited in some aspect of job performance by a health problem. Workplace health promotion (WHP) is a common strategy used to enhance on-the-job productivity. Objectives: The primary objective is to determine if WHP programs are effective in improving presenteeism. Secondary objectives include identifying the types of risk factors and health issues affecting workers who work despite health problems, and to identify characteristics of the programs successful at improving presenteeism. Study Design: Systematic search and best-evidence synthesis of the scientific literature.Data Synthesis: The scientifically admissible studies consisted of 5 (36%) randomized controlled trials (RCTs), 5 (36%) cluster RCTs, 1 (7%) interrupted time series, 1 (7%) crossover design, 1 (7%) pre-post study, and 1 (7%) quasi-experimental study. Risk factors contributing to presenteeism include being overweight, poor diet, lack of physical exercise, high stress, and poor relations with coworkers and management. Contributing health conditions include arthritis, musculoskeletal disorders, allergies, chronic pain, and depression and anxiety. There is preliminary evidence of a positive effect of some WHP programs. Successful programs offer organizational leadership, health risk screening, individually tailored programs, incentives, and a supportive workplace culture.Conclusions: The presenteeism literature is young, heterogeneous, and inconsistent, limiting the ability to draw firm conclusions. Nonetheless, the available evidence suggests that presenteeism is an important issue for employers and society. Better quality research is needed in this area. Future research would benefit from standard presenteeism metrics, studies conducted across a broad range of workplace settings and employee populations, and better reporting of studies in line with current scientific standards. Key Words: Presenteeism; Health and productivity management; Workplace health promotion; Primary prevention; Systematic review