The impact of worksite interventions promoting healthier food and/or physical activity habits among employees working 'around the clock' hours: a systematic review

We conducted a systematic review of randomised studies on the impact of worksite interventions to promote healthier food and/or physical activity among people who work irregular hours 'around the clock', that is, outside of ordinary daytime working hours. The population-intervention-comparator-outcomes-study (PICOS) design format was used. Data sources were PubMed and CINAHL. An updated search was conducted on October 2017 using Google Scholar and the related articles function in PubMed on initially included studies to identify additional studies. Risk of bias was used to assess study quality. A total of seven studies (reports published in 14 papers) were included in the systematic review: Two interventions with a broader lifestyle approach, three focusing on physical exercise and two on providing healthier food or meal options. The studies had sample sizes from 30 to 1,000 and targeted a mixture of occupations, including both male- and female-dominated occupational groups. The interventions lasted from 2 to 12 months. Only one had an extended follow-up. In general, the studies showed small-to-moderate effect sizes on several measures, including dietary and/or physical activity measures, suggesting acceptable effectiveness for interventions involving community-level behaviour change. Our findings highlight a need to further develop and implement well-designed health promotion interventions with comparable outcome measures and effect size reports. A mixture of health promotion strategies is recommended for future practice in this target population, including individually tailored programmes, improving the food and physical activity environment and using broader lifestyle approaches including the use of participatory and empowerment strategies. While more research is needed in this field, the existing knowledge base on effective approaches awaits translation into practice.