Scoping review meets expert interviews: Key issues of multimodal programs for workplace health promotion in long-term care facilities -

Background: Long-term care facility employees' workload escalation intensifies negative risk for (nursing) staff health, residents, and the economy. Workplace health promotion (WHP) has emerged as a vital approach with positive impacts on employee well-being. This Scoping Review focuses on multimodal WHP programs in long-term care facilities, emphasizing barriers, facilitators, and the integration of complementary and integrative medicine (CIM). Methods: Following the PRISMA-ScR guidelines, a systematic search strategy from February to April 2023 in Medline (PubMed), EMBASE (Ovid), and CINAHL (EBSCOhost) yielded 506 hits. Findings were enriched through semi-structured expert interviews. All data were analyzed with a deductive-inductive qualitative content analysis. Results: Eleven publications met inclusion criteria and eight experts were interviewed based on key topics of the included publications. The integration of the results showed that primary obstacles highlight structural challenges (time, finances, hierarchies) and team dynamics (lack of support, communication issues, low motivation), while effective communication, support from the management, and participatory engagement enhance program success. CIM approaches are not explicitly referenced as such, despite widespread use. Conclusion: An exclusive CIM-focus, with multimodal WHP programs for long-term care facilities is missing and should highlight the necessity of a multimethod approach intervention. While the need for further research about the specific topic of multimodal, CIM-based WHO programs in long-term care facilities - including cross-cultural and international comparisons - is apparent, an appropriate evaluation of complex interventions is challenging given the nature of multimodal WHP programs. A multi-method approach is therefore recommended as standard for further research in this area.