Recently, there has been an increase in chronic diseases in the working population with increasing medical expenses [1, 2]. This has an impact on the life quality of employees and their families, as well as harming the sustainability of their company's economic interests [1]. It is important to carry out health promotion and health protection intervention in the workplace [1], including disease prevention programs, for all of the employees. Workplace wellness programs supported by policies can have some advantages, such as mitigating health risks and optimizing the employees’ quality of life [3, 4].
A comprehensive setting and proper synchronization between programs, environmental supports, policies, advantages, and relations to the community are highly required to obtain maximum safety and health needs of all workers [3]. According to Berry et al. [5], a workplace wellness program is a program designed systematically and sponsored by the employer to develop healthy behaviours to minimize health risks, improve life quality, gain efficiency and effectiveness, and bring positive impacts on the organization’s bottom line.
Workplace wellness programs consist of several activities: screening actions to monitor health risks (e.g., measurement of body weight, biometric measures), preventive interventions to minimize health risks (e.g., vaccination, smoking cessation, physical activities, weight management counselling, access to fitness facilities, stress management, supportive social and physical environments, wearing personal protective equipment), health promotion to improve a healthy lifestyle (e.g., healthy food options, health education, company policies, workplace bullying), and disease management (e.g., health insurance, on-site medical health centre such as a clinic for workers with or without their families)[2, 3, 4, 6].
Emmons et al. [7] evaluated a workplace health education initiative targeting smoking, diet, and physical activity. Workers in the intervention condition developed an improved healthy diet and exercise behaviours; however, these did not affect their levels of smoking [7]. Sorensen et al. [8] found that a comprehensive workplace malignancy prevention intervention conducted at 15 manufacturing plants reduced the number of smoking stages. As a result, smoking levels dropped significantly over the two years, but a healthy diet did not improve. Golaszewski et al. [9] found that there was an improvement in the workplace environment of a U.S. government’s department for over three years. There was a decline found in the hours taken by workers for sick leaves, progress in the worksite environment, and stable employees’ risk statuses although some of them were getting older [9]. Short et al. [10] reported the results to Prudential Financial in which physically active workers had a good level of high-density lipoproteins (HDL). The workers joining a disease controlling program were also found to have a declined level of low-density lipoproteins (LDL) and cholesterol in one year matched to a group of non-participants [10]. Byrne et al. [11] presented the findings of their seven-year research (2003–2009) at Vanderbilt University, in which the application of health promotion programs had improved the physical activities of employees from 73–83%. Jackson et al. [12] reported that there was a decline in blood pressure and an increased level of awareness among the workers after the interventions through health education for 6 months (86%) [12]. Merrill et al. [13] compared the employees of Lincoln Industries with those outside Lincoln Industries in terms of four wellness indicators, namely emotional health, physical health, access to health-related services, and engagement in healthy behaviours. It was found that the employees of the Lincoln Industries were better than those outside in three of the four indicators, namely emotional health, physical health, and engagement in healthy behaviours. Neville et al. [14] carried out an 8-year study and revealed that there was an improvement in the health condition of workers with chronic diseases. Long-standing involvement was linked to Body Mass Index (BMI), adjusted blood pressure, cholesterol, and with the highest advantages discovered in the highest-risk group. Berry et al. [15] reported that a U.S. software provider, SAS Institute (The Statistical Analysis System), ran its own worksite full-service health clinics for workers and their families. The services included consultation with a dietician, allergy shots, blood tests, consultation with a psychotherapist, and physical therapy. Workers generated a connection with a primary care physician (a medical home) which guaranteed the continuity of care [15].
Not all workplace wellness programs at the worksite showed positive results on the working mothers’ wellness (e.g., mental health, physical health, less stress, depression, burnout, alcohol consumption, smoking, overweight, bullying), job satisfaction, and work-life balance. Thus, a systematic review is needed to better understand the evidence associated with the implementation of wellness programs in the workplace. [1–4, 16, 17].
Working mothers as part of the workers’ community are more vulnerable to various health problems compared men or other working women. Health risks emerge from both workplace factors and family factors, which sometimes are correlated to each other. Working mothers often have to carry out multiple responsibilities at the same time, namely as a housewife, mother raising children [5], working woman [17]. The amount of work they have at home and at work often makes them lack time, energy, physical capacity, psychological acceptance, and endurance [17, 18]. There are also many working mothers who do not receive full support from their spouses or families in terms of burden-sharing due to cultural influences. Furthermore, there is a lack of support from the workplace for them. Not many companies run workplace wellness programs specifically designed for working mothers [17, 18].
Many working mothers complain of frequent fatigues [18], headaches, back pain, circulatory disorders, poor nutritional status. They also suffer from gynaecological problems, miscarriages, premature deliveries, urinary tract infections and other diseases, sexual harassment, emotional and mental disorders. A number of health and psychological problems [18, 19] are faced by working mothers which affect their children. Babies with low birth weight or birth defects as well as adolescent children of working mothers are more delinquent [3, 18].
Some working mothers speak of how they allocated urgency to their inflexible needs, i.e., caring and work duties, rather than ‘optional’ health and wellness-promoting behaviours due to lack of time and energy [3, 20]. That is the reason why working mothers are in dire need of support from the worksite in the form of workplace wellness programs to help them maintain physical and psychological health. The opportunities and support provided to them to do physical activities, relieve stress, obtain flexible working time, healthy food, and health information should be based on the types of work they do and their work environment [21].
We have attempted to find previous research on the implementation of workplace wellness programs for working mothers; however, there was only little of it. Tucker et al. [22] reported on 58 nurses (30 interventions and 28 controls) who provided replicated measures of body composition and physical activity (steps) at baseline and after the intervention. In both groups, the average daily steps at baseline and after intervention exceeded 12,400. There were no significant results for physical activity, but significant results for fat index, fat mass, and percentage of fat (p < .03). The employer promised of targeting the wellness of working mothers [22]. Dixon [23] reported that 44 working mothers from a university in the Southwestern United States contributed to focus group inquiries concerning their physical activities, sports participation, paths they bargained for those barriers, difficulties in partaking, and suggestions for modification. The findings showed that guilt, rigid timetables, and narrow programming restricted the activity involvement with limits being varied by marital status and social class [23].
Therefore, this systematic review aims to find the workplace wellness programs that have previously been run for working mothers as well as their outcomes. There are two research questions that we aim to address: (1) What kind of workplace wellness programs have previously been run for working mothers?, and (2) What are their outputs on the working mothers?