BackgroundThe 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.MethodsMultiple databases, including MEDLINE, EMBASE, PubMed and PsycINFO, were used to review the literature using PRISMA guidelines.ResultsOf 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.ConclusionsThis 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.

Objectives Traditional mindfulness-based interventions (MBIs) have been applied successfully across many populations. The time commitment for these programs is often a barrier, and while brief MBIs have become popular, the impact of these on healthrelated outcomes is unclear as they have not yet been reviewed. Methods A search of databases, including Medline, Embase, and PsycINFO, was conducted with qualitative and case studies being excluded. Findings were summarized using a narrative approach for all studies that met the inclusion criteria. Results With one exception, all 85 studies that were included were randomized controlled trials and were relatively robust methodologically. Seventy-nine reported significant positive effects on at least one health-related outcome and over a quarter targeted a clinical population. The majority of studies focused on psychological outcomes, such as anxiety and depression, as well as emotion regulation, stress, and cognitive outcomes. Conclusions Despite heterogeneity of outcomes across studies, there is evidence that brief MBIs can impact numerous healthrelated outcomes, after only one session and with interventions as brief as 5 min. These interventions have the potential to be the initial steps leading to sustainable and positive health outcomes. Keywords Mindfulness. Brief interventions. Systematic review. Health outcomes Mindfulness can be defined as an approach to experiencing everyday life by turning attention and awareness to the present moment without judgment (Kabat-Zinn 2006). Despite its Buddhist origins, mindfulness is now often a secular practice and is easily accessible to many, whether practiced in an individual's home or by attending a class (Hyland 2016). Mindfulness encompasses the key therapeutic concepts of acceptance, compassion, and detachment (Bogosian et al. 2016; Desrosiers et al. 2013; Pinto-Gouveia et al. 2014). As a therapy, the practice of mindfulness is predominately based on a chronic illness program that was originally Bformalized^as mindfulnessbased stress reduction (MBSR), a treatment for illness-related stress. More recently, the more cognitive treatment of mindfulness-based cognitive therapy (MBCT) has emerged (Teasdale et al. 2000), principally as a treatment for depression. Over the years, mindfulness-based therapies (most commonly MBSR and MBCT) have been applied successfully to a range of clinical populations (Gotink et al. 2015) including patients recovering from cancer, patients with low back pain, and patients with general anxiety disorders (Cherkin et al. 2016; Evans 2016; Johns et al. 2015). This research has cumulated into a solid foundation of evidence supporting the use of mindfulness for clinical health conditions, as well as for the management of non-clinical conditions such as everyday stress and mood disturbances (

ObjectiveThe first wave of the COVID-19 pandemic had a major impact on healthcare utilisation. The aim of this retrospective review was to quantify how utilisation of non-COVID care changed during this time so as to gain insight and inform planning of future services during potential second and subsequent waves.Methods and analysisA longitudinal design was used to analyse anonymous private UK health insurer datasets covering the period of January 2018 to August 2020. Taken as a measure of healthcare utilisation in the UK, incidence rates of claims broken down by service area and condition were calculated alongside overall monthly totals and costs. Pre-COVID-19 years were compared with the current year.ResultsHealthcare utilisation during the first wave of COVID-19 decreased by as much as 70% immediately after lockdown measures were implemented. After 2 months, the trend reversed and claims steadily began to increase, but did not reach rates seen from previous years by the end of August 2020. Assessment by service and diagnostic category showed that most areas, especially those highly reliant on in-person treatment, reflected the same pattern (ie, rapid drop followed by a steady recovery). The provision of mental health services differed from this observed trend, where utilisation increased by 20% during the first wave of COVID-19, in comparison to pre-COVID-19 years. The utilisation of maternity services and the treatment of existing cancers also stayed stable, or increased slightly, during this time.ConclusionsHealthcare utilisation in a UK-based privately insured population decreased dramatically during the first wave of the COVID-19 pandemic, being over 70% lower at its height. However, mental health services remained resilient during this time, possibly due to greater virtualisation of diagnostics and care.

BackgroundHealth risk assessments (HRA) are used by many organisations as a basis for developing relevant and targeted employee health and well-being interventions. However, many HRA’s have a western-centric focus and therefore it is unclear whether the results can be directly extrapolated to those from non-western countries. More information regarding the differences in the associations between country status and health risks is needed along with a more global perspective of employee health risk factors and well-being overall. Therefore we aimed to i) quantify and compare associations for a number of health risk factors based on country status, and then ii) explore which characteristics can aid better prediction of well-being levels and in turn workplace productivity globally.MethodsOnline employee HRA data collected from 254 multi-national companies, for the years 2013 through 2016 was analysed (n = 117,274). Multiple linear regression models were fitted, adjusting for age and gender, to quantify associations between country status and health risk factors. Separate regression models were used to assess the prediction of well-being measures related to productivity.ResultsOn average, the developing countries were comprised of younger individuals with lower obesity rates and markedly higher job satisfaction compared to their developed country counterparts. However, they also reported higher levels of anxiety and depression, a greater number of health risks and lower job effectiveness. Assessment of key factors related to productivity found that region of residency was the biggest predictor of presenteeism and poor pain management was the biggest predictor of absenteeism.ConclusionsClear differences in health risks exist between employees from developed and developing countries and these should be considered when addressing well-being and productivity in the global workforce.Electronic supplementary materialThe online version of this article (doi:10.1186/s40557-017-0172-1) contains supplementary material, which is available to authorized users.

BackgroundChronic illness is the leading cause of death in the UK and worldwide. Psychological therapies to support self-management have been shown to play an important role in helping those with chronic illness cope; more recently, the therapeutic benefits of mindfulness approaches have become evident for managing depression and other distressing emotions. Brief guided mindfulness interventions, are more convenient than intensive traditional programmes requiring regular attendance but have been less explored. This study assessed views on a brief (i.e., 10 min) mindfulness intervention for those with specific long-term illnesses.MethodsSemi-structured interviews and focus groups were conducted with chronic illness patient groups (i.e., chronic obstructive pulmonary disease, chronic pain and cardiovascular disease), designed to capture the acceptability and feasibility of the intervention. The interviews were conducted after use of a mindfulness based audio in clinic and, one week later, after use in the patient’s own environment. Interviews were recorded, transcribed and analysed using thematic analysis.ResultsIn total, a combination of 18 interviews and focus groups were conducted among 14 patients. Recruitment was most successful with chronic pain patients. All patients reported benefits such as feelings of relaxation and improved coping with symptoms. While the wording and content of the audio were generally well received, it was suggested that the length could be increased, as it felt rushed, and that more guidance about the purpose of mindfulness, and when to use it, was needed.ConclusionsA brief mindfulness intervention was well accepted among patients with long-term illness. The intervention may benefit by being lengthened and by offering further guidance on its use.Electronic supplementary materialThe online version of this article (doi:10.1186/s40359-016-0163-y) contains supplementary material, which is available to authorized users.