Perspectives on empowerment programs, and interventions in maritime settings: A systematic review

Background: Evidence on workplace safety and health promotion interventions shows that the interventions have failed to demonstrate substantial benefits for seafarers. It is therefore important to explore what is the evidence of interventions with empowering elements regarding seafarers ' safety and health. This study aims to examine what is known about health promotion interventions in a maritime setting and whether they include an empowerment perspective. And secondly, what were the effects of these efforts. Methods: We systematically searched PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information/Web of Science (ISI/WOS), and SCOPUS up to July 2022 by using standard keywords including empowerment in the maritime setting. Data extraction was done by three independent reviewers. The quality of included studies was assessed by using the critical appraisal checklists from Joanna Briggs institute. Results: From 3313 studies initially identified, 10 articles met the inclusion criteria and were included in this review. Interventions covered a wide range of topics such as educational interventions on safety, first aid training, weight management, healthy eating, sexual harassment, alcohol abuse, and cancer prevention training. None of the studies applied a specific theory or definitions of empowerment even though their aim was to increase seafarers ' empowerment in these areas. Conclusion: The studies focused on improving the safety and health status of the seafarers, however, they had no explicit focus on participation and empowerment. Increasing research with an empowerment approach in maritime sector is recommended to enhance the feasibility and success of the programs in this hard-to-reach occupation.