JMIR Publications

ABSTRACT

Background:

Frontline workers are routinely exposed to high occupational demands, trauma, irregular schedules, and chronic stress. These occupational pressures are associated with elevated rates of burnout, anxiety, depression, post-traumatic stress symptoms, and sleep disturbance. Increasing attention has been directed towards 24-hour movement behaviours (24hrMBs), including sleep, sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity (MVPA), as potentially modifiable factors associated with mental health and occupational recovery. Advances in wearable technologies have expanded opportunities to monitor behavioural and psychophysiological indicators of stress and recovery in real-world settings. However, the evidence base remains fragmented across occupations, behavioural domains, and methodological approaches.

Objective:

This scoping review aimed to map the current evidence examining relationships between 24-hour movement behaviours and mental health outcomes among adult frontline workers. Secondary objectives were to characterise operationalisation and measurement approaches and identify methodological, occupational, and conceptual gaps.

Methods:

This scoping review followed Joanna Briggs Institute (JBI) methodology and was reported in accordance with the PRISMA-ScR checklist. Seven electronic databases (PubMed, Scopus, Web of Science, PsycINFO, CINAHL, Embase, and ScienceDirect) were searched for English-language studies published between 2000 and 2025. Eligible studies included adult frontline worker populations examining at least one movement behaviour in relation to at least one mental health outcome. Screening was conducted independently by two reviewers (AS and EC or GHB) using Rayyan, with disagreements resolved through discussion and third-reviewer adjudication (EC or GHB) where necessary. Data charting captured occupational groups, study designs, measurement approaches, psychophysiological markers, mental health outcomes, and study context.

Results:

A total of 18,067 records were identified through database and supplementary searches. Following duplicate removal, 9,874 records were retained for title screening. Of these, 3,616 records progressed to abstract screening, with 2,892 retained for full-text assessment. After full-text screening, 527 studies met the inclusion criteria and were included in the review. Included studies predominantly focused on healthcare workers and sleep-related outcomes, whereas relatively few adopted integrated 24hrMB frameworks. Objective monitoring approaches, including actigraphy, accelerometry, and wearable psychophysiological monitoring, were represented within the evidence base but remained comparatively uncommon.

Conclusions:

This scoping review demonstrates growing but methodologically heterogeneous evidence examining relationships between movement behaviours and mental health in frontline workers. Research has largely focused on sleep disruption in healthcare populations, with substantially less evidence examining sedentary behaviour or integrated 24hrMB perspectives that account for behavioural interdependence across the 24-hour day. Findings highlight the need for greater methodological consistency, increased adoption of whole-day analytical frameworks, and more longitudinal and wearable-based research to support future digital mental health monitoring and intervention development in frontline settings.