Abstract
Abstract
Background
Frontline workers experience substantial occupational demands that may affect sleep, physical activity, sedentary behavior, recovery, and mental health. Although 24-hour movement behavior (24hrMB) frameworks conceptualize these behaviors as interdependent components of a finite day, it remains unclear how extensively frontline research has adopted integrated approaches, or how evidence is distributed across behaviors, mental health domains, occupations, and measurement methods.
Objective
This study aimed to map evidence examining movement behaviors and mental health among adult frontline workers; characterize its distribution and overlap across movement and mental health domains, occupational groups, methods, and contexts; and identify gaps for future research and intervention development.
Methods
Following Joanna Briggs Institute methodology and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidance, 6 databases (PsycINFO, CINAHL, MEDLINE, SPORTDiscus, Scopus, and PubMed) were searched for peer-reviewed studies published from 2000 to 2026. The search was updated on July 30, 2026. Eligible studies included adult civilian frontline workers and examined at least 1 movement behavior in relation to at least 1 mental health domain. One reviewer (AS) screened and charted all studies, while 2 additional reviewers (GH-B and EC) independently screened and charted random subsets to assess reliability. Movement behaviors and mental health domains were coded as non–mutually exclusive. Findings were synthesized using descriptive statistics, narrative synthesis, and evidence mapping.
Results
Across the original and updated searches, 613 studies were included. Research was concentrated among health care populations (n=468, 76.3%), with studies predominantly using cross-sectional (n=451, 73.6%), association-focused (n=526, 85.8%), and self-report movement measurement approaches (n=533, 86.9%). Sleep was assessed in 538 (87.8%) studies, physical activity in 177 (28.9%) studies, and sedentary behavior in 24 (3.9%) studies. Most studies assessed 1 movement behavior (n=500, 81.6%), and only 13 (2.1%) assessed all 3 behaviors. Stress was the most frequently assessed mental health domain (n=285, 46.5%), followed by depression (n=243, 39.6%), anxiety (n=224, 36.5%), burnout (n=154, 25.1%), and well-being (n=129, 21.0%). Evidence concentrated on sleep in relation to stress (n=248, 40.5%), depression (n=226, 36.9%), and anxiety (n=208, 33.9%), while comparatively little examined mental health alongside sedentary behavior. Only 9 (1.5%) studies used objective-only movement measurement.
Conclusions
Despite a large and rapidly expanding literature, evidence remains dominated by sleep-focused, health care–based, cross-sectional, association-focused, and self-report research. Sedentary behavior, integrated 24hrMB approaches, non–health care frontline occupations, and longitudinal and objective methodologies remain underrepresented. By mapping movement and mental health domains as overlapping rather than mutually exclusive categories, this review identifies both major concentrations and substantive gaps in evidence. Future research should broaden occupational representation, use longitudinal and repeated-measures designs, and examine integrated 24hrMBs using complementary objective and subjective measures. In practice, current evidence can inform priorities for occupational monitoring and intervention development but is insufficient to support specific behavioral prescriptions.