Is work keeping us from acting healthy? How workplace barriers and facilitators impact nutrition and exercise behaviors

Healthy and successful: Health-behavior goal striving in daily work life

Health behaviors (physical activity and healthy eating) can be an essential part of everyday work life and are relevant for employees' affective states. Many worksite interventions, including goal-striving approaches, have been developed to promote health behavior at work. However, these approaches often neglect that making progress with respect to health-behavior goals necessarily takes place during workday episodes, so that work tasks are accomplished simultaneously. In our study, we aim to advance the understanding of how health-behavior goal progress is facilitated and how reflecting on it evokes affective states-taking into account simultaneous pursuit of work-task progress. We collected daily diary data from 205 employees on 1399 days. Analyses showed that goal importance positively predicted health-behavior goal progress, which in turn positively predicted pride and negatively predicted shame at the end of the workday. The negative relation between health-behavior goal progress and shame was stronger on days with low work-task progress, implying compensatory effects. Work-task progress did not moderate the relation between health-behavior goal progress and pride. We discuss the theoretical and practical relevance of integrating research on multiple goal striving when promoting health behavior in daily work life by means of goal-striving techniques.

The Use of Robots in the Workplace: Conclusions from a Health Promoting Intervention Using Social Robots

Workplace wellness programs constitute a preventive measure to help avoid healthcare costs for companies, with additional benefits for employee productivity and other organizational outcomes. Interventions using social robots may have some advantages over other conventional telemedicine applications, since they can deliver personalized feedback and counseling. This investigation focused on a health-promoting intervention within work environments, and compared the efficacy of the intervention on two distinct groups, one guided by a human agent and the other by a robot agent. Participants (n = 56) were recruited from two Portuguese organizations and led through eight sessions by the social agent, the goal being to encourage health behavior change and adoption of a healthier lifestyle. The results indicate that the group led by the robot agent revealed better post-intervention scores than the group led by the human agent, specifically with regard to productivity despite presenteeism and regard of their level of mental well-being. No effects were found concerning the work engagement level of participants in either group. By demonstrating the potential of using social robots to establish therapeutic and worth relationships with employees in their workplaces, this study provides interesting new findings that contribute to the literature on health behavior change and human-robot interaction.

"It's Been a Game Changer": Examining Treadmill Desk Use When Working from Home

Previous research has established the physical and mental benefits of using active workstations like treadmill desks in the workplace, such as reducing sedentary behavior and improving mood. However, treadmill desk use when working at home has not been examined despite significant increases in working from home during the COVID-19 pandemic. Therefore, the objectives of this study were (1) to be the first to describe how treadmill desks are used when working from home and (2) to describe perceived benefits, motivators, and barriers for treadmill desk use when working from home. Twenty participants who worked from home and used a treadmill desk were interviewed between February 2022 and April 2022. Participants reported using their treadmill desks while completing a variety of work and non-work tasks and experienced physical, mental, social, and work-related perceived benefits. Motivators for use included desires to reduce prolonged sitting and be more active, wanting to be healthier and fitter, tracking and reaching goals like daily step counts, feeling good during use, and to overcome increased sedentary behavior due to working from home during the COVID-19 pandemic. Barriers to use included the type of work being done, physical limitations, accessibility issues, social concerns, and mental barriers. Future research should investigate ways to increase treadmill desk use at home by capitalizing on motivating factors and reducing barriers to use.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41542-023-00144-0.

Rationale for participation in university worksite wellness programs

Objective: To understand the wellness needs of university employees to design more effective and inclusive worksite wellness programs (WWP) for health promotion. Methods: Cross-sectional assessment of university employees' wellness needs (online survey, n = 639). Results: Employees were most interested in physical activity (PA), nutrition, and lifestyle WWP. Principal barriers to participation were time, scheduling, location, motivation, and confidentiality concerns. Significant correlations exist between having a diagnosed health condition and the likelihood of participating in related programs. 67.1% of past participation was predicted by (1) health status today versus last year, (2) use of university recreational facilities, (3) gender, (4) general health status, (5) PA in the past month, (6) faculty/staff, and (7) age. Conclusions: Our findings contribute to building a road map of how-to better design university WWP based on understanding participation predictors, barriers/facilitators, and the influence of health status/conditions on topics of interest/participation. Tailoring WWP to meet employees' needs may increase reach, engagement and promote a health culture.

Workplace health promotion to facilitate physical activity among office workers in Sweden

Office workers spend most of their working time being sedentary, contributing to a sedentary lifestyle that increases the risk of developing disease and disability. A gradual decline in cardiorespiratory fitness among adults, along with increased rate of non-communicable diseases across developed countries, makes the workplace an important opportunity for promoting healthy behaviors. This study aimed to investigate: how office companies in Sweden organize and provide workplace health promotion services related to physical activity; the companies' vision for providing workplace health promotion; and potential facilitators and barriers. Nine informants from eight companies participated in the study, and both qualitative and quantitative data were collected by semi-structured interviews. Informants were selected through purposive sampling in collaboration with eight companies in the office market, including companies that own and develop office buildings, shared workspaces, interior design, sustainable solutions, or consult on issues related to the office sector. The framework method was used to analyze the data in a flexible and systematic way. The results showed that workplace health promotion is implemented to maintain employee health, productivity, and employee branding. Also, a significant number of financial resources, organizational support and office space are devoted to workplace health promotion. Convenience and easy access to storage and fitness facilities are key facilitators. In conclusion, this study highlights the importance of employees' engagement in developing and improving workplace health promotion and addressing work-life balance constraints that hinder a healthy lifestyle. Removing barriers on an organizational level may improve the usage of workplace health promotion related to physical activity among office employees.

Determinants of nutrition practice and food choice in UK construction workers

The workplace is considered an effective setting for health and wellbeing interventions, including programmes focusing on nutrition, and provides opportunities to tailor programmes to meet the specific needs of industry and employees. This study explored nutrition practices amongst construction workers and managers to inform the design of a nutrition intervention. Five focus groups were conducted on three construction sites: two with managers (n = 11) and three with workers (n = 27). Construction workers and managers identified several unhealthy nutrition-related behaviours, including high consumption of convenient and fast foods, excessive coffee, alcohol, energy drinks and low fruit and vegetable intake. These behaviours were often attributed to high workloads, long working hours and physically demanding jobs. Snacking and skipping meals were repeatedly reported, attributed to short breaks and poor accessibility to food outlets. The nutritional quality of meals differed between individuals (homemade vs fast food), depending on the type of sites (temporary vs permanent) and site location. Nutrition knowledge, establishing routines, meal planning and preparation were recognized as important in sustaining healthy nutrition habits. However, meal preparation depended on the facilities available, which differed between managers and workers, highlighting the complex relationship between the workplace context and eating behaviours. Construction workers were interested in learning about nutrition and improving their eating habits through nutrition intervention. However, they highlighted that better cooking and storage facilities on site, together with fewer job demands and longer break times, would enhance the sustainability of the intervention and their ability to make healthier food choices.

Shift workers’ perceptions and experiences of adhering to a nutrition intervention at night whilst working: a qualitative study

This study explored the feasibility of implementing a meal timing intervention during night shift work. Data were collected via semi-structured interviews. Interviews were coded inductively by two researchers independently, then three major themes were collaboratively developed. Subthemes from each major theme were mapped to the theoretical domains framework and the Capability Opportunity Motivation model of behaviour change. Seventeen night shift workers (rotating or permanent) aged between 25 and 65 years were interviewed. Participants predominately worked as health professionals. The feasibility of a simple meal timing intervention to avoid eating between 1 and 6 am on night shift is largely affected by three major influences (1) physical and emotional burden of shift work which drives food temptations; (2) the workplace context including the meal break environment, social and cultural context at work, and break scheduling; and (3) motivation of the individual. Facilitators to avoiding eating at night were, keeping busy, having co-worker support, management support, education of health benefits and/or belief that the intervention was health promoting. The barriers to avoiding eating at night were the emotional and physical toll of working at night leading to comfort eating and not having rest areas away from food environments. To support night shift workers with changing timing of meals, interventions at work should target both individual and organisational level behaviour change.

Home Office, Health Behavior and Workplace Health Promotion of Employees in the Telecommunications Sector during the Pandemic

Our study aims to present the perception and experiences of employees at a large multinational telecommunications company in Hungary working in home offices, as well as their health behavior and the workplace health promotion during the SARS-CoV-2 COVID-19 outbreak. The sample consisted of the full sample of highly skilled employees at a large telecommunication multinational company (N = 46). Throughout the analysis, tests for homogeneity of variance were followed by a MANOVA test to compare the groups' means by gender, age, and job classification. The results clearly show that in the short term, workers' mental health did not deteriorate, they do not argue or fight more with their partners and are no more depressed or irritable than before. Workers are less likely to think of ways to be more effective at work than in a home office. Similarly, they do not think that employers have more expectations than before the pandemic. Our research shows the assumption about home workers being less efficient or less diligent in their daily work to be false. A supportive and flexible employer approach to health-conscious employees will be an essential aspect in the future.

Understanding how family demands impair health behaviors in working sole mothers: The role of perceived control over leisure time

Working sole mothers (i.e., nonpartnered women who work) may experience elevated family demands that impose barriers to pursuing health behaviors during their daily leisure time. We aimed to map the process through which evening family demands influence leisure-time health behaviors in this priority population of employees, in an effort to identify targets for intervention development and health disparity reduction. Conducting a 7-day daily survey study in a sample of 102 working sole mothers, we supported perceptions of control over leisure time as a key mechanism linking evening family demands to leisure-time exercise. Furthermore, we identified the individual difference of present focus (i.e., a tendency to focus on current experiences) as a key factor that alters how evening family demands affect control over leisure time, which ultimately mitigates the detrimental influence of these demands on evening exercise engagement. In contrast, we did not find evidence to support relationships of evening family demands with the health behaviors of leisure time consumption of alcohol or high sugar, high fat foods via control over leisure time. We discuss how our findings advance theory regarding how family demands influence health and inform practical efforts to reduce health disparities that working sole mothers face.

Knowledge of Heart Disease, Preventive Behavior and Source of Information in a Multi-ethnic Asian Population: A Population-Based Survey

Several population-based studies have been conducted to better understand the public knowledge of cardiovascular disease (CVD) and behavior. However, most studies have predominantly focused on Western populations. This study aimed to investigate heart disease knowledge, preventive behavior and source of information on heart disease in a multi-ethnic Asian population. We conducted a nation-wide population-based survey of 1000 participants of three ethnic groups (Chinese, Malay, Indian) in Singapore. A structured questionnaire was used to collect sociodemographics, knowledge on CVD risk factors, symptoms, emergency action, preventive health behaviors and sources of information on heart disease. Univariate and multivariate analyses were conducted to identify factors associated with the CVD knowledge and behavior. Knowledge on CVD risk factors was generally high. Knowledge on emergency actions was low particularly in younger people. More than 60% did not meet the recommended levels of physical activity, and this was more evident for individuals of overweight/obese status, lower education and workforce. Chinese were less likely to be obese/overweight compared to the Malays and Indians. Malays were less likely to seek information from internet and social media compared to their ethnic counterparts. This study highlighted heterogeneity in the levels of knowledge and health behavior across population segments, suggesting the need for a tailored approach to heart health interventions and optimal channels for information dissemination. Our findings will form the basis for contextually and culturally appropriate interventions to combat the growing CVD burden and prevent its toll on a rapidly ageing population.

Why Exercise at Work: Development of the Office Exercise Behavior Determinants Scale

The constant increase in work pressure and the penetration of labor-saving technologies have significantly reduced physical activity in office-based work routines, threatening employees’ physical and mental well-being. Encouraging physical exercises at the office seems a potential solution. However, while there is a wealth of research into occupational health and workplace exercise promotion, little is known about which factors can influence the engagement of physical exercises in the office context. It is crucial to understand these determinants, in order to support the design of office exercise promoting intervention. This study explored the determinants of office workers’ exercise behavior by proposing and developing the Office Exercise Behavior Determinants (OEBD) scale based on existing behavioral and environmental research. The OEBD scale was assessed through an online questionnaire study involving 479 office workers. The results indicated that four factors (Intrinsic Motivation, Extrinsic Motivation, Social Environment, and Work Environment) contribute to office workers’ exercise behavior. Furthermore, confirmatory factor analysis of our obtained data provided evidence for the internal validity of the OEBD scale. Thereby, this research can support increased office exercise with valid measurements for behavioral determinants.

The Mediator Roles of Problematic Internet Use and Perceived Stress Between Health Behaviors and Work-Life Balance Among Internet Users in Germany and China: Web-Based Cross-Sectional Study

Background

Work-life balance is associated with health behaviors. In the face of digitalization, understanding this link requires a theory-based investigation of problematic internet use and perceived stress, which are so far unknown.

Objective

On the basis of the compensatory carry-over action model, this study aimed to determine whether problematic internet use and perceived stress mediate the relationship between health behaviors and work-life balance in two groups of internet users from different environments (residents in Germany and China). We also investigated whether the place of residence was a moderator.

Methods

An online questionnaire (N=877) was administered to residents from Germany (n=374) and China (n=503) in 3 languages (German, English, and Chinese). Moderated mediation analyses were run with health behaviors as the independent variable, work-life balance as the dependent variable, problematic internet use and perceived stress as the mediator variables, and place of residence as a potential moderator.

Results

On a mean level, individuals in Germany reported less problematic internet use and more health behaviors than individuals in China; however, they also had lower work-life balance and higher perceived stress. Results showed that health behaviors seem to be directly related to work-life balance in both groups. Among the residents of Germany, a partial mediation was revealed (β=.13; P=.01), whereas among the residents of China, a full mediation was found (β=.02; P=.61). The mediator role of perceived stress was compared with problematic internet use in all the serial models and the parallel model. Residence moderated the relationship between health behaviors and work-life balance: The interrelation between health behaviors and work-life balance was stronger in Germany (β=.19; P<.001) than in China (β=.11; P=.01) when controlling for other variables.

Conclusions

The findings of this study are in line with the compensatory carry-over action model. To promote work-life balance, individuals should perform health behaviors to help overcome problematic internet use and perceived stress. Both problematic internet use and perceived stress mediated health behaviors and work-life balance partially in German study participants and fully in Chinese study participants.

Decomposition of Gender Differences in Body Mass Index in Saudi Arabia using Unconditional Quantile Regression: Analysis of National-Level Survey Data

Understanding gender differences in body mass index (BMI) between males and females has been much debated and received considerable attention. This study aims to decompose gender differentials in the BMI of people of the Kingdom of Saudi Arabia. The study decomposed the BMI gender gap into its associated factors across the entire BMI distribution by using counterfactual regression methods. The main method of analysis was newly developed unconditional quantile regression-based decomposition, which applied Blinder-Oaxaca decomposition using data from the Saudi Health Interview Survey. Gender differentials were found in the BMI, with females showing a higher BMI than males. The aggregate decomposition showed that both the covariate effect and the structural effect were significant at the 25th and 50th quantiles. Detailed decomposition indicated that income level and employment status as well as soda consumption and the consumption of red meat were significantly correlated in explaining gender differentials in BMI across various quantiles, but the magnitude varied by quantile. Our study suggests the government should consider introducing programs that specifically target women to help them reduce BMI. These programs could include organizing sporting events at the workplace and at the national level. Furthermore, the effect of soda consumption could be reduced by levying a tax on beverages, which might reduce the demand for soda due to the increased price.

Perceived Facilitators and Barriers to Nigerian Nurses' Engagement in Health Promoting Behaviors: A Socio-Ecological Model Approach

Nurses make up the single largest healthcare professional group in the Nigerian healthcare system. As frontline healthcare providers, they promote healthy lifestyles to patients and families. However, the determinants of Nigerian nurses’ personal health promoting behaviors (HPBs) remain unknown. Utilizing the socio-ecological model (SEM) approach, this study aimed to explore the perceived facilitators and barriers to Nigerian nurses’ engagement in HPBs. HPBs were operationalized to comprise of healthy dietary behaviors, engagement in physical activity, low-risk alcohol consumption, and non-smoking behaviors. Our study was carried out in a large sub-urban tertiary health facility in Nigeria. Data collection was via face-to-face semi-structured interviews and participants were registered nurses (n = 18). Interview data were transcribed verbatim and analyzed thematically to produce nine themes that were mapped onto corresponding levels of influence on the SEM. Findings show that in Nigeria, nurses perceive there to be a lack of organizational and policy level initiatives and interventions to facilitate their engagement in HPBs. The determinants of Nigerian nurses’ HPBs span across all five levels of the SEM. Nurses perceived more barriers to healthy lifestyle behaviors than facilitators. Engagement in healthy behaviors was heavily influenced by: societal and organizational infrastructure and perceived value for public health; job-related factors such as occupational stress, high workload, lack of protected breaks, and shift-work; cultural and religious beliefs; financial issues; and health-related knowledge. Organizations should provide facilities and services to support healthy lifestyle choices in Nigeria nurses. Government policies should prioritize the promotion of health through the workplace setting, by advocating the development, implementation, regulation, and monitoring of healthy lifestyle policies.

Factors influencing employees' eating behaviours in the office-based workplace: A systematic review

Employees spend a large proportion of their time at work and typically consume a third of their total calories during the working day. Research suggests that the workplace environment can affect employees' eating behaviours, leading to various related health consequences. This systematic review aimed to identify and synthesize the evidence surrounding factors influencing eating behaviours within an office-based workforce. The literature search was restricted to studies published in English between January 2008 and April 2018. A total of 5,017 articles were screened and assessed for eligibility, of which 22 articles (n=23 studies) were included in the review. All included studies were subjected to quality assessment and were summarized into groups (themes) of "factors" affecting any aspect of eating behaviour at work. The findings revealed a number of factors influencing eating behaviours at work relating to the job role, workplace food environment, and social aspects of the office-based workplace. Most of the existing research implies the office-based workplace has a negative influence on eating behaviours. The findings of this review provide an evidence based, comprehensive summary of the possible determinants of eating behaviours in the workplace, which may help researchers to identify factors that are potential targets for intervention.

A qualitative study of facilitators and barriers to implementing worksite policies that support physical activity

BACKGROUND

Physical inactivity is associated with several chronic diseases that are costly to society, employers, and individuals. Workplaces are a common location for physical activity (PA) initiatives because of the amount of time individuals who are employed full time spend at work. This research examined a statewide worksite wellness program, the Healthiest Maryland Businesses (HMB) program, to fill an important gap regarding the facilitators for and barriers to implementing workplace policies that support PA.

METHODS

Individual telephone interviews were conducted in December 2015 with six HMB Coordinators and their supervisor, and from August through October 2016 with a purposeful sample of 15 businesses of various sizes from across Maryland, to learn about the role of leadership, and successes and challenges of implementing PA programs and policies. The sample of businesses was intentionally selected to capture perspectives from a range of businesses. Interviews were recorded and professionally transcribed. Descriptive coding was used to identify dominant themes that addressed the study aims and research questions.

RESULTS

PA was not described as a priority for several large and small businesses. To garner more support for PA, interviewees emphasized associating PA initiatives with measures the businesses care about, such as health care costs from claims data. Small businesses also described having a need for PA programming yet reported having significant resource constraints. There was a strong interest in developing guidance for implementing PA break policies, which was mentioned as a critical support for workplace PA promotion. More commitment and investment of resources from leadership, and an engaged wellness committee with company representation at all levels and roles, were identified as vital for impactful programs.

CONCLUSIONS

Most businesses are implementing PA programs with limited policy supports, which was mentioned as a barrier. Successful implementation of workplace wellness programs broadly, and PA initiatives specifically, are achievable through leadership buy-in, employee input, and policy supports, along with highlighting the economic benefits for businesses.

Understanding how outcomes are measured in workplace physical activity interventions: a scoping review

Background

An inverse relationship exists between physical activity and many non-communicable diseases, such as obesity. Given the daily time spent, a logical domain to reach an adult population for intervention is within and around the workplace. Many government bodies, including the World Health Organization (WHO), include worksite health promotions (WHPs) targeted at increasing physical activity as a public health intervention. The aim of this scoping review was to determine what was measured (outcomes) and how they were measured (evaluation tools) during workplace physical activity interventions in order to identify gaps and implications for policies and practice.

Methods

A scoping review was executed in April 2017 via PubMed, SPORTDiscus, EBSCOhost and the Cochrane Library. This search included articles published between January 2008 to February 2017 in order to coincide with the WHO’s Global Plan of Action on Worker’s Health. Extracted information was arranged into data collection grids. Cross-analysis of measured outcomes with their corresponding evaluation tools was completed. A quality assessment based on study design was executed.

Results

Identification of 732 records was made and ultimately 20 studies and reviews that met criteria were selected. Researchers themed 9 primary measured outcomes. Studies utilized various forms of both objective and subjective evaluation methods. Three primary evaluation methods were categorized: biologic, electronic and declarative tools. The researchers discovered 92 unique tools: 27 objective and 65 subjective, within these parameters.

Conclusion

Study quality, measurement tools and data collection were heterogeneous making analysis of effect comparisons problematic and unreliable. Much of the published research does not employ robust statistical analysis making effects difficult to ascertain. Considering the variety of both measured outcomes and evaluation tools, only educated inferences can be made as to the effectiveness and efficiency of WHPs. More standardized measurement practices are therefore suggested for assessment efficiency.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5980-x) contains supplementary material, which is available to authorized users.

Enablers and barriers to improving worksite canteen nutrition in Pudong, China: a mixed-methods formative research study

OBJECTIVE

To identify individual-level and organisation-level enablers and barriers to the provision and consumption of healthier foods at worksite canteens in China and to develop a theoretical framework and evidence-based, specific, practical intervention strategies.

DESIGN

Mixed-methods formative research, with in-depth interviews, focus group discussions and quantitative questionnaires.

SETTING

Two community health centres (CHCs) in Pudong, Shanghai, China.

PARTICIPANTS

In-depth interviews with three CHC administrators and three canteen managers and staff. Six focus groups with a total of 19 male and 36 female employees, aged 25-67 years.

RESULTS

Three subthemes were identified as important for influencing individual food choice: the cultural perception of 'eating well', the need to balance taste preferences and nutrition, and the emphasis on food safety in healthfulness. At the organisation level, two related subthemes emerged: the balance of canteen budget and food safety with the variety and quality of offerings, and the interplay between key stakeholders. Key barriers included cost, poor communication between employees and management, individuals' emphasis on taste over healthfulness, variation in individual preferences and discordance between perceived and actual weight status, particularly among men. Key enablers included strong, positive food culture in China and trust in canteen food. An ecological framework to describe determinants of worksite food environment in Shanghai was developed and intervention strategies were mapped onto this framework.

CONCLUSIONS

A balancing act occurs at multiple levels and ultimately determines the worksite food environment and employee food choice at CHCs in Shanghai of China. There is a need to implement these findings and evaluate their impact on diet and health.

Understanding perceived determinants of nurses' eating and physical activity behaviour: a theory-informed qualitative interview study

BACKGROUND

Unhealthy eating and physical activity behaviours are common among nurses but little is known about determinants of eating and physical activity behaviour in this population. The present study used a theoretical framework which summarises the many possible determinants of different health behaviours (the Theoretical Domains Framework; TDF) to systematically explore the most salient determinants of unhealthy eating and physical activity behaviour in hospital-based nurses.

METHODS

Semi-structured qualitative interviews based on the TDF were conducted with nurses (n = 16) to explore factors that behavioural theories suggest may influence nurses' eating and physical activity behaviour. Important determinants of the target behaviours were identified using both inductive coding (of categories emerging from the data) and deductive coding (of categories derived from the TDF) of the qualitative data.

RESULTS

Thirteen of the fourteen domains in the TDF were found to influence nurses' eating and physical activity behaviour. Within these domains, important barriers to engaging in healthy eating and physical activity behaviour were shift work, fatigue, stress, beliefs about negative consequences, the behaviours of family and friends and lack of planning. Important factors reported to enable engagement with healthy eating and physical activity behaviours were beliefs about benefits, the use of self-monitoring strategies, support from work colleagues, confidence, shift work, awareness of useful guidelines and strategies, good mood, future holidays and receiving compliments.

CONCLUSIONS

This study used a theory-informed approach by applying the TDF to identify the key perceived determinants of nurses' eating and physical activity behaviour. The findings suggest that future efforts to change nurses' eating and physical activity behaviours should consider targeting a broad range of environmental, interpersonal and intrapersonal level factors, consistent with a socio-ecological perspective.