{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:18:52Z","timestamp":1787768332797,"version":"build-2784847793"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ERDF Hamburg","award":["72000948"],"award-info":[{"award-number":["72000948"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The unique occupational conditions of seafaring are associated with increased physical and psychological stress and significantly complicate common approaches to health promotion and prevention. Digital health technologies are therefore considered promising alternatives that can better address barriers to access, infrastructural shortcomings and cultural diversity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim is to provide a comprehensive overview of scientific evidence about digital measures used for health promotion and prevention among seafarers and crew members on merchant ships (cargo\/passenger). As secondary study aim, digital practical programs established to promote health at sea will also be presented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This scoping review was conducted in accordance with the updated methodological guidelines from the Joanna Briggs Institute (JBI) and the PRISMA-ScR checklist. The protocol was prospectively registered in the Open Science Framework (OSF). The literature search was conducted systematically in Scopus, Web of Science, PubMed, and LIVIVO, and study selection was carried out based on the selection criteria. In addition, a targeted web search for digital practical programs was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1,711 sources were identified, 68 full-text articles were screened, and 9 studies were included in the qualitative analysis. The evidence base is highly heterogeneous, consisting of various study designs ranging from pilot studies to one randomized controlled trial (RCT). Only articles on digital health promotion and prevention were identified. No studies were found that examined digital health literacy. All included studies focused exclusively on seafarers working on cargo ships. Four studies investigated behavioral approaches, while two studies focused on structural approaches and the remaining three studies dealt with blended concepts. Thematic focus varies, addressing topics such as nutrition, mental health, skin cancer prevention, and digital prediction models. In addition, six digital practical programs on topics such as physical activity, mental health, sleep and stress management, and nutrition were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An overview of the current state of research and practical applications regarding digital health promotion and prevention among seafarers on merchant ships was provided. The topic has been scarcely addressed in the shipping industry to date. Concurrently, the heterogeneity of the evidence, the restricted number of relevant studies, and the variable quality of the studies indicate a necessity for further research. Academic research should also address the topic of digital health literacy and the demands of crew members on passenger ships. Based on the findings, it is recommended that shipping companies take responsibility for promoting the health of seafarers on board their ships by empowering their crews.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0356798","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:30:09Z","timestamp":1787765409000},"page":"e0356798","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Digital health promotion, prevention and health literacy measures among seafarers and crews on cargo and passenger ships: A scoping review"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0494-7813","authenticated-orcid":true,"given":"Chiara","family":"Reck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Belz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2788-5529","authenticated-orcid":true,"given":"Dorothee","family":"Dengler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora Maria","family":"Puls","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Harth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Oldenburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"pone.0356798.ref001","volume-title":"Seafarer mental health study","author":"RY Lefkowitz","year":"2019"},{"key":"pone.0356798.ref002","volume-title":"The working and living conditions of seafarers on cargo ships in the period 2011-2016","author":"H Sampson","year":"2018"},{"issue":"1","key":"pone.0356798.ref003","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/BF03195154","article-title":"Maritime security and seafarers\u2019 welfare: towards harmonization","volume":"8","author":"CAE Graham","year":"2009","journal-title":"WMU J Marit Aff"},{"key":"pone.0356798.ref004","doi-asserted-by":"crossref","DOI":"10.21677\/250326","volume-title":"Shore leave: rare, brief and in danger of extinction","author":"M Carrera-Arce","year":"2025"},{"key":"pone.0356798.ref005","volume-title":"Seafarer\u2019s mental health and wellbeing","author":"H Sampson","year":"2019"},{"issue":"2","key":"pone.0356798.ref006","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/s00038-009-7067-z","article-title":"Seafaring stressors aboard merchant and passenger ships","volume":"54","author":"M Oldenburg","year":"2009","journal-title":"Int J Public Health"},{"key":"pone.0356798.ref007","doi-asserted-by":"crossref","first-page":"469580231206264","DOI":"10.1177\/00469580231206264","article-title":"Exploration of seafarers\u2019 mobile proficiency as a prerequisite for possible health app-based health promotion on board","volume":"60","author":"LC Arslan","year":"2023","journal-title":"Inquiry"},{"key":"pone.0356798.ref008","first-page":"9389286","article-title":"Requirements, challenges, and key components to improve onboard medical care using maritime telemedicine: narrative review","volume":"2023","author":"N Mohammadzadeh","year":"2023","journal-title":"Int J Telemed Appl"},{"key":"pone.0356798.ref009","volume-title":"WHO guideline recommendations on digital interventions for health system strengthening: evidence and recommendations","author":"World Health Organization","year":"2019"},{"key":"pone.0356798.ref010","volume-title":"Global strategy on digital health 2020-2025","author":"World Health Organization","year":"2021"},{"key":"pone.0356798.ref011","volume-title":"Ottawa charter for health promotion","author":"World Health Organization","year":"1986"},{"key":"pone.0356798.ref012","volume-title":"Health promotion glossary","author":"World Health Organization","year":"1998"},{"key":"pone.0356798.ref013","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/1471-2458-12-80","article-title":"Health literacy and public health: a systematic review and integration of definitions and models","volume":"12","author":"K S\u00f8rensen","year":"2012","journal-title":"BMC Public Health"},{"issue":"11","key":"pone.0356798.ref014","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0310440","article-title":"Possibilities, usage and needs of an app-based health prevention among seafarers","volume":"19","author":"L Arslan","year":"2024","journal-title":"PLoS One"},{"key":"pone.0356798.ref015","author":"International Seafarers Welfare Assistance Network (ISWAN)","year":"2026"},{"key":"pone.0356798.ref016","author":"Sailors Society"},{"issue":"1","key":"pone.0356798.ref017","first-page":"1","article-title":"Pilot study on the development of digitally supported health promotion for seafarers on sea","volume":"76","author":"L Scheit","year":"2025","journal-title":"Int Marit Health"},{"issue":"1","key":"pone.0356798.ref018","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s12889-020-09893-x","article-title":"Can adopting skin cancer preventive behaviors among seafarers be increased via a theory-based mobile phone-based text message intervention? A randomized clinical trial","volume":"21","author":"E Heydari","year":"2021","journal-title":"BMC Public Health"},{"key":"pone.0356798.ref019","article-title":"Empowering Seafarers as agents of their mental health: the role of information and communication technology in seafarers\u2019 well-being","volume":"60","author":"S Abila","year":"2023","journal-title":"Inquiry"},{"issue":"1","key":"pone.0356798.ref020","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s12995-024-00412-x","article-title":"Seafarers\u2019 attitudes and chances to improve the nutrition on merchant ships from the crews\u2019 and cooks\u2019 perspective","volume":"19","author":"FA Neumann","year":"2024","journal-title":"J Occup Med Toxicol"},{"issue":"10","key":"pone.0356798.ref021","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.11124\/JBIES-20-00167","article-title":"Updated methodological guidance for the conduct of scoping reviews","volume":"18","author":"MDJ Peters","year":"2020","journal-title":"JBI Evid Synth"},{"issue":"7","key":"pone.0356798.ref022","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation","volume":"169","author":"AC Tricco","year":"2018","journal-title":"Ann Intern Med"},{"key":"pone.0356798.ref023","unstructured":"Reck C, Belz L, Dengler D, Harth V, Puls N, Oldenburg M. Digital health promotion, prevention and health literacy measures among seafarers and crews on cargo and passenger ships: a scoping review protocol. 2025."},{"issue":"1","key":"pone.0356798.ref024","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan-a web and mobile app for systematic reviews","volume":"5","author":"M Ouzzani","year":"2016","journal-title":"Syst Rev"},{"issue":"4","key":"pone.0356798.ref025","doi-asserted-by":"crossref","first-page":"285","DOI":"10.3233\/EFI-180221","article-title":"The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers","volume":"34","author":"QN Hong","year":"2018","journal-title":"EFI"},{"key":"pone.0356798.ref026","volume-title":"AACODS Checklist for appraising grey literature","author":"J Tyndall","year":"2010"},{"key":"pone.0356798.ref027","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"MJ Page","year":"2021","journal-title":"BMJ"},{"issue":"3","key":"pone.0356798.ref028","doi-asserted-by":"crossref","first-page":"180","DOI":"10.5603\/IMH.2019.0028","article-title":"Development of physical training smartphone application to maintain fitness levels in seafarers","volume":"70","author":"G Battineni","year":"2019","journal-title":"Int Marit Health"},{"issue":"10","key":"pone.0356798.ref029","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.3390\/healthcare13101176","article-title":"Feasibility of wearable digital healthcare devices among Korean male seafarers: a pilot study","volume":"13","author":"D-R Kim","year":"2025","journal-title":"Healthcare (Basel)"},{"key":"pone.0356798.ref030","author":"C Herkommer","year":"2023","journal-title":"Smooth sailing: An exploratory study navigating the acceptance of digital health solutions and the impact on seafarer well-being"},{"key":"pone.0356798.ref031","doi-asserted-by":"crossref","first-page":"335","DOI":"10.3390\/systems13050335","article-title":"Human digital healthcare engineering for enhancing the health and well-being of seafarers and offshore workers: a comprehensive review","volume":"13","author":"MX Cui","year":"2025","journal-title":"Systems"},{"key":"pone.0356798.ref032","author":"Sea Health & Welfare"},{"key":"pone.0356798.ref033","author":"WellAtSea Limited"},{"key":"pone.0356798.ref034","author":"Institute for Occupational and Maritime Medicine UMHH-E"},{"key":"pone.0356798.ref035","author":"The Mission to Seafarers"},{"issue":"2","key":"pone.0356798.ref036","doi-asserted-by":"crossref","first-page":"102","DOI":"10.5603\/IMH.2017.0019","article-title":"The design of health promotion strategies for seafarers","volume":"68","author":"T Carter","year":"2017","journal-title":"Int Marit Health"},{"issue":"3","key":"pone.0356798.ref037","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1111\/jep.12884","article-title":"Improving the usefulness of a tool for appraising the quality of qualitative, quantitative and mixed methods studies, the Mixed Methods Appraisal Tool (MMAT)","volume":"24","author":"QN Hong","year":"2018","journal-title":"J Eval Clin Pract"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0356798","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:30:15Z","timestamp":1787765415000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0356798"}},"subtitle":[],"editor":[{"given":"Fatemeh","family":"Zarei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":37,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0356798","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]}}}