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Caputo EL, Feter N, Alt R, da Silva MC. How do different interventions impact stair climbing? A systematic review and meta-analysis. Glob Health Promot 2022; 29:17579759221093388. [PMID: 35746857 DOI: 10.1177/17579759221093388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aimed to analyze the effect of interventions to increase stair use. STUDY DESIGN Systematic review and meta-analysis. METHODS An online search was conducted in January 2021 in five databases (Web of Science, SPORTDiscus, MedLine/PubMed, PsycINFO, and CINAHL). Experimental studies (randomized and non-randomized) conducted in adults, which provided stair use measures with pre- and post-intervention periods were included. A random-effect meta-analysis, as well as subgroup analyses were conducted to evaluate the quantitative effect of interventions on stair use. RESULTS Overall, 34 studies were included in qualitative analyses, and 15 in the meta-analysis. Most of the studies were conducted in Europe and private settings (e.g., office buildings). Overall, interventions increased stair use in adults (odds ratio (OR) 1.48; 95% confidence intervals (CI) 1.38-1.58; I2 = 99.6%). Subgroup analyses showed that interventions increased stair use regardless of the continent and observer type (manual or electronic). However, different settings (shopping malls and office buildings), as well as studies (time of intervention) and intervention characteristics (sign size and location, message characters) were associated with increased stair use. CONCLUSIONS Different interventions can increase stair use in several continents and settings. Sign and message characteristics should be considered when designing interventions or policies to promote physical activity by increasing stair use.
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Affiliation(s)
- Eduardo Lucia Caputo
- Postgraduate Program in Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil
- Neuroscience and Physical Activity Research Group, Universidade Federal de Pelotas, Brazil
| | - Natan Feter
- Postgraduate Program in Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil
- GEEAF - Physical Activity Epidemiology Research Group, Federal University of Pelotas, Brazil
- Neuroscience and Physical Activity Research Group, Universidade Federal de Pelotas, Brazil
- Centre on Research in Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Ricardo Alt
- Neuroscience and Physical Activity Research Group, Universidade Federal de Pelotas, Brazil
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Marcelo C da Silva
- Postgraduate Program in Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil
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Landais LL, Damman OC, Schoonmade LJ, Timmermans DRM, Verhagen EALM, Jelsma JGM. Choice architecture interventions to change physical activity and sedentary behavior: a systematic review of effects on intention, behavior and health outcomes during and after intervention. Int J Behav Nutr Phys Act 2020; 17:47. [PMID: 32264899 PMCID: PMC7140383 DOI: 10.1186/s12966-020-00942-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/26/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Choice architecture interventions, which subtly change the environment in which individuals make decisions, can be used to promote behavior change. This systematic review aimed to summarize studies on micro-environmental choice architecture interventions that encouraged physical activity or discouraged sedentary behavior in adults, and to describe the effectiveness of those interventions on these behaviors - and on related intentions or health outcomes - in presence of the intervention and after removal of the intervention (i.e. post-intervention, regardless of the time elapsed). METHODS We systematically searched PubMed, Embase, PsycINFO and the Cochrane Library for (quasi) experimental studies published up to December 2019 that evaluated the effect of choice architecture interventions on physical activity and sedentary behavior, as well as on intentions and health outcomes related to physical activity/sedentary behavior. Studies that combined choice architecture techniques with other behavior change techniques were excluded. All studies were screened for eligibility, relevant data was extracted and two independent reviewers assessed the methodological quality using the QualSyst tool. RESULTS Of the 9609 records initially identified, 88 studies met our eligibility criteria. Most studies (n = 70) were of high methodologic quality. Eighty-six studies targeted physical activity, predominantly stair use, whereas two studies targeted sedentary behavior, and one targeted both behaviors. Intervention techniques identified were prompting (n = 53), message framing (n = 24), social comparison (n = 12), feedback (n = 8), default change (n = 1) and anchoring (n = 1). In presence of the intervention, 68% of the studies reported an effect of choice architecture on behavior, whereas after removal of the intervention only 47% of the studies reported a significant effect. For all choice architecture techniques identified, except for message framing, the majority of studies reported a significant effect on behavioral intentions or behavior in presence of the intervention. CONCLUSIONS The results suggest that prompting can effectively encourage stair use in adults, especially in presence of a prompt. The effectiveness of the choice architecture techniques social influence, feedback, default change and anchoring cannot be assessed based on this review. More (controlled) studies are needed to assess the (sustained) effectiveness of choice architecture interventions on sedentary behavior and other types of physical activity than stair use.
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Affiliation(s)
- Lorraine L Landais
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands.
| | - Olga C Damman
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands
| | | | - Danielle R M Timmermans
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands
| | - Evert A L M Verhagen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam Collaboration on Health & Safety in Sports, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Judith G M Jelsma
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands
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Yoon A, Choi S, Mun J, Hong J, Hahn D, Kang M, Lee S. Motivational signage increases stair usage on a Hispanic serving institution. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:236-241. [PMID: 30570444 DOI: 10.1080/07448481.2018.1539000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/14/2018] [Accepted: 10/09/2018] [Indexed: 06/09/2023]
Abstract
Objective: Stair climbing is considered a good physical activity. Motivational signage has been successful in promoting stair usage in various settings. This study was to investigate the effects of motivational signage on stair usage in a Hispanic serving institution. Participants: A total of 31,067 pedestrians were observed from February to March 2013. Methods: Stair usage was monitored for 9 h per day each week at phase 1 (baseline), 2 (intervention), and 3 (post-intervention). Results: Overall, participants' stair usage was higher during phase 2 (49.0%) and phase 3 (48.0%), compared with phase 1 (39.7%). The participants during phase 2 and 3 were more likely to use the stairs compared to participants during phase 1, regardless of floor level (3-story or 4-story building), status (student or staff/faculty), and time of day (7:30-10:29, 10:30-13:29, or 13:30-16:30) (p < .001). Conclusion: Motivational signage can effectively encourage more stair usage, and hence promote healthy behavior in a predominantly Hispanic-serving institution.
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Affiliation(s)
- Aram Yoon
- Department of Health & Human Performance, Albany State University, Albany, Georgia, USA
| | - Soonmi Choi
- Department of Athletic Training and Exercise Physiology, Midwestern State University, Wichita Falls, Texas, USA
| | - Junbae Mun
- Department of Health & Human Performance, Middle Tennessee State University, Murfreesboro, Tennessee, USA
| | - Junyoung Hong
- Department of Health & Human Performance, University of Houston, Houston, Texas, USA
| | - Dongwoo Hahn
- College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Minsoo Kang
- Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, Mississippi, USA
| | - Sukho Lee
- Department of Counseling, Health and Kinesiology, Texas A&M University-San Antonio, San Antonio, Texas, USA
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Rudolf K, Dejonghe LAL, Froböse I, Lammer F, Rückel LM, Tetz J, Schaller A. Effectiveness Studies in Health Promotion: A Review of the Methodological Quality of Studies Reporting Significant Effects on Physical Activity in Working Age Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050813. [PMID: 30845673 PMCID: PMC6427597 DOI: 10.3390/ijerph16050813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/18/2019] [Accepted: 03/01/2019] [Indexed: 12/13/2022]
Abstract
The methodology of intervention studies on physical activity (PA) promotion is of great importance regarding evidence development in complex interventions. The aim of this review was to provide an overview of the methodological quality of those studies which reported statistically significant effects of interventions promoting PA. PUBMED was searched for reviews on PA promotion to identify studies reporting effective interventions with participants of working age (16⁻67 years). Selected reviews were screened and data from primary studies with effective interventions were extracted to assess methodological quality. Forty-six reviews with 600 primary studies were identified, of which 33 met the inclusion criteria. Twenty-one studies were conducted as randomized controlled trials, 13 included an intervention control group, 25 measured PA by questionnaire, and 13 included objective measurements. Information on used statistics was often scarce, and long-term follow-up measurements were frequently missing. The overall methodological quality was moderate for randomized studies and low for non-randomized studies; information on methods and results was often lacking. To overcome these methodological issues, standardized guidelines for reporting study results should be considered, not only when publishing results but also when designing studies. This review provides a solid foundation for the development of practical advice for planning application-oriented studies in PA promotion.
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Affiliation(s)
- Kevin Rudolf
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Lea A L Dejonghe
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Ingo Froböse
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
- Center for Health and Physical Activity, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Florian Lammer
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Lisa-Marie Rückel
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Jessica Tetz
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Andrea Schaller
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
- IST-University of Applied Sciences, Erkrather Straße 220 a-c, 40233 Duesseldorf, Germany.
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Wolfenden L, Goldman S, Stacey FG, Grady A, Kingsland M, Williams CM, Wiggers J, Milat A, Rissel C, Bauman A, Farrell MM, Légaré F, Ben Charif A, Zomahoun HTV, Hodder RK, Jones J, Booth D, Parmenter B, Regan T, Yoong SL. Strategies to improve the implementation of workplace-based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity. Cochrane Database Syst Rev 2018; 11:CD012439. [PMID: 30480770 PMCID: PMC6362433 DOI: 10.1002/14651858.cd012439.pub2] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Given the substantial period of time adults spend in their workplaces each day, these provide an opportune setting for interventions addressing modifiable behavioural risk factors for chronic disease. Previous reviews of trials of workplace-based interventions suggest they can be effective in modifying a range of risk factors including diet, physical activity, obesity, risky alcohol use and tobacco use. However, such interventions are often poorly implemented in workplaces, limiting their impact on employee health. Identifying strategies that are effective in improving the implementation of workplace-based interventions has the potential to improve their effects on health outcomes. OBJECTIVES To assess the effects of strategies for improving the implementation of workplace-based policies or practices targeting diet, physical activity, obesity, tobacco use and alcohol use.Secondary objectives were to assess the impact of such strategies on employee health behaviours, including dietary intake, physical activity, weight status, and alcohol and tobacco use; evaluate their cost-effectiveness; and identify any unintended adverse effects of implementation strategies on workplaces or workplace staff. SEARCH METHODS We searched the following electronic databases on 31 August 2017: CENTRAL; MEDLINE; MEDLINE In Process; the Campbell Library; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Scopus. We also handsearched all publications between August 2012 and September 2017 in two speciality journals: Implementation Science and Journal of Translational Behavioral Medicine. We conducted searches up to September 2017 in Dissertations and Theses, the WHO International Clinical Trials Registry Platform, and the US National Institutes of Health Registry. We screened the reference lists of included trials and contacted authors to identify other potentially relevant trials. We also consulted experts in the field to identify other relevant research. SELECTION CRITERIA Implementation strategies were defined as strategies specifically employed to improve the implementation of health interventions into routine practice within specific settings. We included any trial with a parallel control group (randomised or non-randomised) and conducted at any scale that compared strategies to support implementation of workplace policies or practices targeting diet, physical activity, obesity, risky alcohol use or tobacco use versus no intervention (i.e. wait-list, usual practice or minimal support control) or another implementation strategy. Implementation strategies could include those identified by the Effective Practice and Organisation of Care (EPOC) taxonomy such as quality improvement initiatives and education and training, as well as other strategies. Implementation interventions could target policies or practices directly instituted in the workplace environment, as well as workplace-instituted efforts encouraging the use of external health promotion services (e.g. gym membership subsidies). DATA COLLECTION AND ANALYSIS Review authors working in pairs independently performed citation screening, data extraction and 'Risk of bias' assessment, resolving disagreements via consensus or a third reviewer. We narratively synthesised findings for all included trials by first describing trial characteristics, participants, interventions and outcomes. We then described the effect size of the outcome measure for policy or practice implementation. We performed meta-analysis of implementation outcomes for trials of comparable design and outcome. MAIN RESULTS We included six trials, four of which took place in the USA. Four trials employed randomised controlled trial (RCT) designs. Trials were conducted in workplaces from the manufacturing, industrial and services-based sectors. The sample sizes of workplaces ranged from 12 to 114. Workplace policies and practices targeted included: healthy catering policies; point-of-purchase nutrition labelling; environmental supports for healthy eating and physical activity; tobacco control policies; weight management programmes; and adherence to guidelines for staff health promotion. All implementation interventions utilised multiple implementation strategies, the most common of which were educational meetings, tailored interventions and local consensus processes. Four trials compared an implementation strategy intervention with a no intervention control, one trial compared different implementation interventions, and one three-arm trial compared two implementation strategies with each other and a control. Four trials reported a single implementation outcome, whilst the other two reported multiple outcomes. Investigators assessed outcomes using surveys, audits and environmental observations. We judged most trials to be at high risk of performance and detection bias and at unclear risk of reporting and attrition bias.Of the five trials comparing implementation strategies with a no intervention control, pooled analysis was possible for three RCTs reporting continuous score-based measures of implementation outcomes. The meta-analysis found no difference in standardised effects (standardised mean difference (SMD) -0.01, 95% CI -0.32 to 0.30; 164 participants; 3 studies; low certainty evidence), suggesting no benefit of implementation support in improving policy or practice implementation, relative to control. Findings for other continuous or dichotomous implementation outcomes reported across these five trials were mixed. For the two non-randomised trials examining comparative effectiveness, both reported improvements in implementation, favouring the more intensive implementation group (very low certainty evidence). Three trials examined the impact of implementation strategies on employee health behaviours, reporting mixed effects for diet and weight status (very low certainty evidence) and no effect for physical activity (very low certainty evidence) or tobacco use (low certainty evidence). One trial reported an increase in absolute workplace costs for health promotion in the implementation group (low certainty evidence). None of the included trials assessed adverse consequences. Limitations of the review included the small number of trials identified and the lack of consistent terminology applied in the implementation science field, which may have resulted in us overlooking potentially relevant trials in the search. AUTHORS' CONCLUSIONS Available evidence regarding the effectiveness of implementation strategies for improving implementation of health-promoting policies and practices in the workplace setting is sparse and inconsistent. Low certainty evidence suggests that such strategies may make little or no difference on measures of implementation fidelity or different employee health behaviour outcomes. It is also unclear if such strategies are cost-effective or have potential unintended adverse consequences. The limited number of trials identified suggests implementation research in the workplace setting is in its infancy, warranting further research to guide evidence translation in this setting.
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Affiliation(s)
- Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Sharni Goldman
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Fiona G Stacey
- University of Newcastle, Hunter Medical Research Institute, Priority Research Centre in Health Behaviour, and Priority Research Centre in Physical Activity and NutritionSchool of Medicine and Public HealthCallaghanNSWAustralia2287
| | - Alice Grady
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Melanie Kingsland
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Christopher M Williams
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - John Wiggers
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Andrew Milat
- NSW Ministry of HealthCentre for Epidemiology and EvidenceNorth SydneyNSWAustralia2060
- The University of SydneySchool of Public HealthSydneyAustralia
| | - Chris Rissel
- Sydney South West Local Health DistrictOffice of Preventive HealthLiverpoolNSWAustralia2170
| | - Adrian Bauman
- The University of SydneySchool of Public HealthSydneyAustralia
- Sax InstituteThe Australian Prevention Partnership CentreSydneyAustralia
| | - Margaret M Farrell
- US National Cancer InstituteDivision of Cancer Control and Population Sciences/Implementation Sciences Team9609 Medical Center DriveBethesdaMarylandUSA20892
| | - France Légaré
- Université LavalCentre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL‐UL)2525, Chemin de la CanardièreQuebecQuébecCanadaG1J 0A4
| | - Ali Ben Charif
- Centre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL‐UL)Université Laval2525, Chemin de la CanardièreQuebecQuebecCanadaG1J 0A4
| | - Hervé Tchala Vignon Zomahoun
- Centre de recherche sur les soins et les services de première ligne ‐ Université LavalHealth and Social Services Systems, Knowledge Translation and Implementation Component of the SPOR‐SUPPORT Unit of Québec2525, Chemin de la CanardièreQuebecQCCanadaG1J 0A4
| | - Rebecca K Hodder
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Jannah Jones
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Debbie Booth
- University of NewcastleAuchmuty LibraryUniversity DriveCallaghanNSWAustralia2308
| | - Benjamin Parmenter
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Tim Regan
- University of NewcastleThe School of PsychologyCallaghanAustralia
| | - Sze Lin Yoong
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
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Raney M, Van Zanten E. Self-Care Posters Serve as a Low-Cost Option for Physical Activity Promotion of Hospital Nurses. Health Promot Pract 2018; 20:354-362. [PMID: 29566577 DOI: 10.1177/1524839918763585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hospital nurses play an important role in the nation's short- and long-term patient care. At the same time, nurses often experience high levels of occupational stress and participate in low levels of physical activity (PA). The purpose of this study was to examine the impact of self-monitoring and a poster campaign on the PA behaviors of hospital nurses. Motivational and instructional exercise posters were hung in break rooms of experimental units and replaced biweekly for 8 weeks. A total of 26 nurses (control: n = 13; experimental: n = 13) wore accelerometers for 3 workdays pre-, mid-, and postintervention. Participants were provided a step counter at baseline and a PA report at each stage. Moderate to vigorous PA (MVPA) and step count (SC) increased pre- to midintervention for control (MVPA: 14.8 ± 7.6%; SC: 19.1 ± 7.8%) and experimental (MVPA: 26.7 ± 18.5%, SC: 17.6 ± 8.3%) participants. Physical activity levels returned to baseline postintervention for control ( p > .05) and increased mid- to postintervention for experimental (MVPA: 16.2 ± 5.2%, SC: 10.7 ± 4.7%, p < .05) participants. In conclusion, a low-cost, self-care poster campaign may increase PA levels of hospital nurses when combined with personalized PA feedback.
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Huei Phing C, Abu Saad H, Barakatun Nisak M, Mohd Nasir M. Effectiveness of physical activity intervention among government employees with metabolic syndrome. J Exerc Sci Fit 2017; 15:55-62. [PMID: 29541133 PMCID: PMC5812876 DOI: 10.1016/j.jesf.2017.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/31/2017] [Accepted: 07/31/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND/OBJECTIVE Our study aimed to assess the effects of physical activity interventions via standing banners (point-of-decision prompt) and aerobics classes to promote physical activity among individuals with metabolic syndrome. METHODS We conducted a cluster randomized controlled intervention trial (16-week intervention and 8-week follow-up). Malaysian government employees in Putrajaya, Malaysia, with metabolic syndrome were randomly assigned by cluster to a point-of-decision prompt group (n = 44), an aerobics group (n = 42) or a control group (n = 103) based on sample size calculation formula. Step counts were evaluated by Lifecorder e-STEP accelerometers for all participants. Metabolic syndrome was defined according to the 'harmonizing' definition, in which individuals who have at least three of the five metabolic risk factors (waist circumference, high-density lipoprotein cholesterol, triglycerides, fasting glucose levels, systolic and diastolic blood pressure) will be classified as having metabolic syndrome. A total of 80% of the enrolled government employees with metabolic syndrome completed the programme. Data were analyzed using SPSS for Windows (version 20, SPSS, Chicago, IL). RESULTS There were significantly higher step counts on average in the aerobics group compared to the control group over assessments. Assessments at baseline, post-intervention and follow-up showed a significant difference in step counts between the intervention and control groups. The greatest reductions in the proportions of individuals with metabolic syndrome were observed in the aerobics group with a reduction of 79.4% in the post-intervention assessment compared to the assessment at baseline. CONCLUSION The findings of this study suggest that physical activity intervention via aerobics classes is an effective strategy for improving step counts and reducing the prevalence of metabolic syndrome.
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Affiliation(s)
- Chee Huei Phing
- Faculty of Science, Universiti Tunku Abdul Rahman, 31900, Kampar, Perak Darul Ridzuan, Malaysia
| | - Hazizi Abu Saad
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor Darul Ehsan, Malaysia
- Sports Academy, Universiti Putra Malaysia, 43400, Serdang, Selangor Darul Ehsan, Malaysia
| | - M.Y. Barakatun Nisak
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor Darul Ehsan, Malaysia
| | - M.T. Mohd Nasir
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor Darul Ehsan, Malaysia
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Bauman A, Milton K, Kariuki M, Fedel K, Lewicka M. Is there sufficient evidence regarding signage-based stair use interventions? A sequential meta-analysis. BMJ Open 2017; 7:e012459. [PMID: 29183924 PMCID: PMC5719260 DOI: 10.1136/bmjopen-2016-012459] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The proliferation of studies using motivational signs to promote stair use continues unabated, with their oft-cited potential for increasing population-level physical activity participation. This study examined all stair use promotional signage studies since 1980, calculating pre-estimates and post-estimates of stair use. The aim of this project was to conduct a sequential meta-analysis to pool intervention effects, in order to determine when the evidence base was sufficient for population-wide dissemination. DESIGN Using comparable data from 50 stair-promoting studies (57 unique estimates) we pooled data to assess the effect sizes of such interventions. RESULTS At baseline, median stair usage across interventions was 8.1%, with an absolute median increase of 2.2% in stair use following signage-based interventions. The overall pooled OR indicated that participants were 52% more likely to use stairs after exposure to promotional signs (adjusted OR 1.52, 95% CI 1.37 to 1.70). Incremental (sequential) meta-analyses using z-score methods identified that sufficient evidence for stair use interventions has existed since 2006, with recent studies providing no further evidence on the effect sizes of such interventions. CONCLUSIONS This analysis has important policy and practice implications. Researchers continue to publish stair use interventions without connection to policymakers' needs, and few stair use interventions are implemented at a population level. Researchers should move away from repeating short-term, small-scale, stair sign interventions, to investigating their scalability, adoption and fidelity. Only such research translation efforts will provide sufficient evidence of external validity to inform their scaling up to influence population physical activity.
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Affiliation(s)
- Adrian Bauman
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Karen Milton
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Nuffield Department of Population Health, British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, University of Oxford, Oxford, UK
| | - Maina Kariuki
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- NSW Ministry of Health Biostatistics Training Officer Program, NSW Health, North Sydney, New South Wales, Australia
| | - Karla Fedel
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Mary Lewicka
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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Åvitsland A, Solbraa AK, Riiser A. Promoting workplace stair climbing: sometimes, not interfering is the best. Arch Public Health 2017; 75:2. [PMID: 28078084 PMCID: PMC5220617 DOI: 10.1186/s13690-016-0170-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 12/11/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Stair climbing is a vigorous activity and can lead to several health benefits. Studies seeking to increase stair climbing in various public locations have shown positive effects, while results from similar studies conducted in the workplace are inconclusive. This study examined stair climbing in the workplace, and monitored effects from a single- and a combined intervention. Interventions were inspired by nudging, the libertarian method of influencing behavior. METHODS By quasi-experimental design, stair- and elevator traffic in two office buildings was monitored preceding-, during- and following interventions with stair leading footprints alone, and combined with stair-riser banners. Chi square tests were applied to determine differences between baseline and the subsequent periods. Web-based questionnaires were distributed after follow-up period. RESULTS Elevators and stairs were used 45 237 times, of which 89.6% was stair use. Intervention site stair climbing at baseline (79.0%) was significantly reduced with footprints (-5.1%, p < 0.001), and footprints with stair-riser banners (-5.7%, p < 0.001) while baseline stair climbing at the control site (94.2%) remained stable (p > 0.027). CONCLUSIONS Stair climbing was significantly reduced during the intervention periods. Use of stair leading footprints alone, or combined with stair-riser banners in an attempt to influence stair climbing may be ineffective, or cause a negative reaction, when applied in a workplace with a pre-existing high amount of stair climbing.
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Affiliation(s)
- Andreas Åvitsland
- Sogn og Fjordane University College, Faculty of Teacher Education and Sport, Box 133 – N 6851 Sogndal, Norway
| | - Ane Kristiansen Solbraa
- Sogn og Fjordane University College, Faculty of Teacher Education and Sport, Box 133 – N 6851 Sogndal, Norway
| | - Amund Riiser
- Sogn og Fjordane University College, Faculty of Teacher Education and Sport, Box 133 – N 6851 Sogndal, Norway
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Jennings CA, Yun L, Loitz CC, Lee EY, Mummery WK. A Systematic Review of Interventions to Increase Stair Use. Am J Prev Med 2017; 52:106-114. [PMID: 27720340 DOI: 10.1016/j.amepre.2016.08.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 07/12/2016] [Accepted: 08/01/2016] [Indexed: 10/20/2022]
Abstract
CONTEXT Stair climbing is an accessible activity that can be incorporated into one's daily lifestyle to increase physical activity levels and provide health benefits. This review summarizes the effectiveness of stair interventions and explores key differences that may influence intervention effectiveness. EVIDENCE ACQUISITION Interventions to increase stair use published from January 1990 to July 2015 were identified in PubMed, Sport Discus, Web of Science, Environment Complete, CINAHL, Trial Register of Promoting Health Interventions, Embase, Scopus, and PsycINFO. Eligibility criteria included original studies, published in peer-reviewed journals, targeting adult samples, and clearly describing intervention design and results. Studies were also required to measure the use of stairs compared with an elevator, escalator, or moving stairway at baseline and during at least one timepoint when the intervention was in effect. Studies were required to provide data to determine if the intervention resulted in significant changes in stair use/climbing. EVIDENCE SYNTHESIS The search results yielded 2,136 articles in total; 54 articles met the criteria, which resulted in a final sample of 67 studies included in the analyses. Interventions settings included public sites (75%), worksites (21%), or a combination of both (4%). For Phase 1 results, 72% of studies reported significant improvements in stair use (n=10 of 14) and stair climbing (n=38 of 53). CONCLUSIONS Evidence from the review demonstrates support for the effectiveness of interventions to increase stair use and stair climbing. Although evidence supports the effectiveness of stair interventions in public settings, less support is provided for worksites.
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Affiliation(s)
- Cally A Jennings
- Faculty of Physical Education and Recreation, University of Alberta, Alberta, Canada.
| | - Lira Yun
- Faculty of Physical Education and Recreation, University of Alberta, Alberta, Canada
| | - Christina C Loitz
- Faculty of Physical Education and Recreation, University of Alberta, Alberta, Canada
| | - Eun-Young Lee
- Faculty of Physical Education and Recreation, University of Alberta, Alberta, Canada
| | - W Kerry Mummery
- Faculty of Physical Education and Recreation, University of Alberta, Alberta, Canada
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Melton BF, Bland HW, Marshall ES, Bigham LE. The Effectiveness of a Physical Activity Educational Campaign in a Rural Obstetrics and Gynecology Office. Matern Child Health J 2016; 20:2112-20. [DOI: 10.1007/s10995-016-2039-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Lippke S, Corbet JM, Lange D, Parschau L, Schwarzer R. Intervention Engagement Moderates the Dose-Response Relationships in a Dietary Intervention. Dose Response 2016; 14:1559325816637515. [PMID: 27069440 PMCID: PMC4811006 DOI: 10.1177/1559325816637515] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Behavioral interventions could lead to changes in behavior through changes in a mediator. This dose–response relationship might only hold true for those participants who are actively engaged in interventions. This Internet study investigated the role of engagement in a planning intervention to promote fruit and vegetable consumption in addition to testing the intervention effect on planning and behavior. A sample of 701 adults (mean = 38.71 years, 81% women) were randomly assigned either to a planning intervention (experimental group) or to one of 2 control conditions (untreated waiting list control group or placebo active control group). Moderated mediation analyses were carried out. Significant changes over time and time × group effects revealed the effectiveness of the intervention. The effect of the intervention (time 1) on changes in behavior (time 3; 1 month after the personal deadline study participants set for themselves to start implementing their plans) was mediated by changes in planning (time 2; 1 week the personal deadline). Effects of planning on behavior were documented only at a moderate level of intervention engagement. This indicates an inverse U-shaped dose–response effect. Thus, examining participants’ intervention engagement allows for a more careful evaluation of why some interventions work and others do not.
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Affiliation(s)
| | | | | | | | - Ralf Schwarzer
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia; University of Social Sciences and Humanities, Wroclaw, Poland
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13
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Workplace health programme among individuals with metabolic syndrome. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2015. [DOI: 10.1108/ijwhm-09-2014-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to ascertain the effect of a physical activity intervention using a combination of Facebook and standing banners on improvements in metabolic syndrome.
Design/methodology/approach
– In all, 120 (82.8 per cent) government employees with metabolic syndrome completed the programme. A Lifecorder e-STEP accelerometer (Suzuken Company Limited, Nagoya, Japan) was utilized to quantify physical activity. Metabolic syndrome was defined according to “Harmonized” definition at baseline, post-intervention and follow-up.
Findings
– There were significantly higher step counts in the intervention group as compared to the control group over time. There were significant within-group differences in the step count at the baseline, post-intervention and follow-up assessments (p
<
0.001) in both the intervention and control groups. The step count of the intervention group increased by 4,522 steps in the post-intervention assessment compared to the assessment at baseline. The step count of the intervention group in the follow-up assessment was lower than in the post-intervention assessment, but it was still 2,126 steps higher than at baseline. For control group, the difference between the post-intervention assessment and the assessment at baseline was 520 steps per day, while the difference between the follow-up assessment and assessment at baseline was 379 steps per day. The greatest decrease in the percentage of metabolic syndrome was observed in the intervention group, with a reduction of 88.6 per cent in the post-intervention assessment as compared to that at baseline.
Research limitations/implications
– Future studies should incorporate measures which will be of interest to employers. Greater understanding and assessment of desirable employer-related outcomes are warranted, such as decreased job stress, turnover, absenteeism and improved job satisfaction, productivity and exploration of how these associated with physical activity.
Practical implications
– The findings show that delivering information on physical activity through an easily implemented and low-cost physical activity intervention via a combination of Facebook and standing banners was successful in improving step counts and metabolic parameters among individuals with metabolic syndrome.
Social implications
– The findings draw on supporting evidence for advocacy, which is about influencing the larger environment of public policy, and raising awareness of a single programme is insufficient to create lasting social change. Public policy must be shaped in a way that will sustain change across institutions.
Originality/value
– Despite the well-documented health benefits of physical activity, a growing number of people not achieving the recommended levels of physical activity necessary for good health. Importantly, the study provides a new insight on lifestyle-based physical activity interventions capable of improving step counts and metabolic parameters.
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Zentrale Einflussfaktoren der betrieblichen Gesundheitsförderung. PRAVENTION UND GESUNDHEITSFORDERUNG 2015. [DOI: 10.1007/s11553-015-0488-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Nomura T, Katayama K, Kashiwa T, Akezaki Y, Sato A. Maintenance of the Rate of Stair Use over a Long‐term Period Using a Stair Climbing Campaign. J Occup Health 2015; 56:511-8. [DOI: 10.1539/joh.13-0223-fs] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Takuo Nomura
- Department of Rehabilitation SciencesKansai University of Welfare SciencesJapan
| | | | - Tomoyuki Kashiwa
- Department of Physical TherapyKochi Rehabilitation InstituteJapan
| | - Yoshiteru Akezaki
- Department of Rehabilitation SciencesKansai University of Welfare SciencesJapan
| | - Atushi Sato
- Faculty of NutritionUniversity of KochiJapan
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Bellicha A, Kieusseian A, Fontvieille AM, Tataranni A, Charreire H, Oppert JM. Stair-use interventions in worksites and public settings - a systematic review of effectiveness and external validity. Prev Med 2015; 70:3-13. [PMID: 25449692 DOI: 10.1016/j.ypmed.2014.11.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 10/30/2014] [Accepted: 11/02/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We performed a literature review with the main aims to propose an updated overview of the effectiveness of stair-use interventions and to determine the most effective type of intervention. METHODS We systematically searched stair-use interventions performed in worksites or public settings, published up to mid 2013. We used a harvest plot approach to visualize the findings in addition to a quantitative synthesis. We also assessed external validity using the Reach, Efficacy, Adoption, Implementation, Maintenance (RE-AIM) framework. RESULTS Of 8571 articles identified, 50 were included. In worksites (25 studies) and public settings (35 studies), an increase in stair climbing was found during the intervention period in 64% and 76% of studies, respectively. Combining motivational and directional signs in worksites or conducting a second intervention phase in public settings increased stair climbing in 83% and 86% of studies, respectively. Elements of external validity were overall largely under-reported. CONCLUSION There is evidence that stair-use interventions are effective to increase stair climbing in public settings, but evidence of such effect is limited in worksites. Issues regarding the best sequencing of interventions or the potential importance of environmental interventions should be addressed in future studies. Process evaluation should be an integral part of interventions.
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Affiliation(s)
- Alice Bellicha
- Institute of Cardiometabolism and Nutrition (ICAN), University Pierre et Marie Curie - Paris 6, Paris, France
| | - Aurélie Kieusseian
- Institute of Cardiometabolism and Nutrition (ICAN), University Pierre et Marie Curie - Paris 6, Paris, France
| | | | | | - Hélène Charreire
- Department of Geography, Lab-Urba, Urbanism Institute of Paris, University Paris-Est, Créteil, France
| | - Jean-Michel Oppert
- Institute of Cardiometabolism and Nutrition (ICAN), University Pierre et Marie Curie - Paris 6, Paris, France; Department of Nutrition, Pitie-Salpetriere University Hospital (AP-HP), University Pierre et Marie Curie - Paris 6, Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Paris, France.
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Holtz B, Krein SL, Bentley DR, Hughes ME, Giardino ND, Richardson CR. Comparison of Veteran experiences of low-cost, home-based diet and exercise interventions. ACTA ACUST UNITED AC 2014; 51:149-60. [DOI: 10.1682/jrrd.2013.04.0088] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 07/11/2013] [Indexed: 11/05/2022]
Affiliation(s)
- Bree Holtz
- Center for Clinical Management Research, Department of Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, MI
| | - Sarah L. Krein
- Center for Clinical Management Research, Department of Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, MI
| | - Douglas R. Bentley
- Center for Clinical Management Research, Department of Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, MI
| | - Maria E. Hughes
- Center for Clinical Management Research, Department of Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, MI
| | | | - Caroline R. Richardson
- Center for Clinical Management Research, Department of Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, MI;Department of Family Medicine, University of Michigan, Ann Arbor, MI
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Economic Evaluation of an Occupational Health Care Guideline for Prevention of Weight Gain Among Employees. J Occup Environ Med 2013; 55:1100-9. [DOI: 10.1097/jom.0b013e31829b279a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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19
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Smith JD. Single-case experimental designs: a systematic review of published research and current standards. Psychol Methods 2012; 17:510-50. [PMID: 22845874 PMCID: PMC3652808 DOI: 10.1037/a0029312] [Citation(s) in RCA: 287] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article systematically reviews the research design and methodological characteristics of single-case experimental design (SCED) research published in peer-reviewed journals between 2000 and 2010. SCEDs provide researchers with a flexible and viable alternative to group designs with large sample sizes. However, methodological challenges have precluded widespread implementation and acceptance of the SCED as a viable complementary methodology to the predominant group design. This article includes a description of the research design, measurement, and analysis domains distinctive to the SCED; a discussion of the results within the framework of contemporary standards and guidelines in the field; and a presentation of updated benchmarks for key characteristics (e.g., baseline sampling, method of analysis), and overall, it provides researchers and reviewers with a resource for conducting and evaluating SCED research. The results of the systematic review of 409 studies suggest that recently published SCED research is largely in accordance with contemporary criteria for experimental quality. Analytic method emerged as an area of discord. Comparison of the findings of this review with historical estimates of the use of statistical analysis indicates an upward trend, but visual analysis remains the most common analytic method and also garners the most support among those entities providing SCED standards. Although consensus exists along key dimensions of single-case research design, and researchers appear to be practicing within these parameters, there remains a need for further evaluation of assessment and sampling techniques and data analytic methods.
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Affiliation(s)
- Justin D Smith
- Child and Family Center, University of Oregon, Eugene, OR 97401-3408, USA.
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20
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Kahn-Marshall JL, Gallant MP. Making Healthy Behaviors the Easy Choice for Employees. HEALTH EDUCATION & BEHAVIOR 2012; 39:752-76. [DOI: 10.1177/1090198111434153] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As employers look for ways to reduce rising health care costs, worksite health promotion interventions are increasingly being used to improve employee health behaviors. An alternative approach to traditional worksite health promotion programs is the implementation of environmental and/or policy changes to encourage employees to adopt healthier behaviors. This review examines the evidence for the effectiveness of worksite health promotion programs using environmental and/or policy changes either alone or in combination with individually focused health behavior change strategies. A review of the relevant literature, published between 1995 and 2010, identified 27 studies that met all inclusion criteria. Limited evidence was found for the effectiveness of environmental and/or policy changes alone ( n = 11) to change employee behavior, but more promising results were identified with multicomponent interventions ( n = 16). There is a strong need for improvement in the design and evaluation of future health promotion programs focusing solely on environmental and/or policy changes at the worksite.
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Affiliation(s)
- Jennifer L. Kahn-Marshall
- Cornell Cooperative Extension, Schenectady County, and Schenectady County Public Health Services, Schenectady, NY, USA
| | - Mary P. Gallant
- University at Albany, State University of New York, Albany, NY, USA
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21
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Sugiyama S, Okuda M, Kinoshita T, Inada K, Tateishi H, Uehara M, Hobara T. Association between visual message and health knowledge in a 4-month follow-up study at worksites. J Occup Health 2011; 53:465-72. [PMID: 21996931 DOI: 10.1539/joh.11-0156-fs] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study evaluated a simple workplace intervention that used visual messages to create awareness of two highly specific recommendations for good health. METHODS Four worksites were recruited in Iwakuni, Japan. The 4-month intervention used three promotional media-A2-size posters, A4-size flyers and displays on the company intranet. The visual messages were designed with silhouettes, pictograms and slogans. Knowledge acquisition concerning the two recommendations (daily vegetable intake of 350 g and 23 exercises weekly) was evaluated using questionnaires. In addition, recall of media and attitudes toward health behavior were assessed. RESULTS Of the 2,322 workers, 827 responded to both the pre- and postintervention surveys. Correct responses at the four worksites increased from initial levels of 36-48% to 38-73% for the vegetable intake questions and from 7-14% to 7-59% for the physical activity questions. Media recall results were 35-73% for posters, 20-43% for flyers and 19% for intranet. The workers who recalled the posters and flyers had more correct answers on knowledge questions than those who did not recall the posters or flyers (p<0.01). In multivariate analyses, seeing the visual messages was associated with a positive change in response to physical activity questions (odds ratio=1.49-2.03), and the number of media recalled was also significant (odds ratio=1.16-1.17). CONCLUSIONS Interventions with a combination of media and simple visual messages should be considered for health promotion among general populations at worksites.
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22
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Process Evaluation of an Occupational Health Guideline Aimed at Preventing Weight Gain Among Employees. J Occup Environ Med 2011; 53:722-9. [DOI: 10.1097/jom.0b013e318222af9b] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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23
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Olander EK, Eves FF. Effectiveness and Cost of Two Stair-Climbing Interventions—Less is More. Am J Health Promot 2011; 25:231-6. [DOI: 10.4278/ajhp.090325-quan-119] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. The current study compared two interventions for promotion of stair climbing in the workplace, an information-based intervention at a health information day and an environmental intervention (point-of-choice prompts), for their effectiveness in changing stair climbing and cost per employee. Design. Interrupted time-series design. Setting. Four buildings on a university campus. Subjects. Employees at a university in the United Kingdom. Interventions. Two stair-climbing interventions were compared: (1) a stand providing information on stair climbing at a health information day and (2) point-of-choice prompts (posters). Measures. Observers recorded employees' gender and method of ascent (n = 4279). The cost of the two interventions was calculated. Analysis. Logistic regression. Results. There was no significant difference between baseline (47.9% stair climbing) and the Workplace Wellbeing Day (48.8% stair climbing), whereas the prompts increased stair climbing (52.6% stair climbing). The health information day and point-of-choice prompts cost $773.96 and $31.38, respectively. Conclusion. The stand at the health information day was more expensive than the point-of-choice prompts and was inferior in promoting stair climbing. It is likely that the stand was unable to encourage stair climbing because only 3.2% of targeted employees visited the stand. In contrast, the point-of-choice prompts were potentially visible to all employees using the buildings and hence better for disseminating the stair climbing message to the target audience. (Am J Health Promot 2011;25[4]:231–236.)
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Vuillemin A, Rostami C, Maes L, Van Cauwenberghe E, Van Lenthe FJ, Brug J, De Bourdeaudhuij I, Oppert JM. Worksite physical activity interventions and obesity: a review of European studies (the HOPE project). Obes Facts 2011; 4:479-88. [PMID: 22249000 PMCID: PMC6444861 DOI: 10.1159/000335255] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Our aim was to review the effectiveness of physical activity promotion interventions in the worksite setting in Europe in order to identify those studies that had measured obesity-related outcomes and to evaluate how external validity of the findings had been assessed. METHODS We conducted a review of studies conducted in Europe, published up to December 2009. We assessed levels of evidence regarding effectiveness and analysed external validity using the RE-AIM framework. RESULTS Studies included (n = 33) were divided in 6 intervention categories. Moderate evidence of effectiveness was found for physical fitness outcomes with exercise training interventions and for physical activity outcomes with active commuting interventions. There was no or inconclusive evidence for obesity-related outcomes for all intervention categories. For external validity, elements receiving the least attention (<20%) were representativeness of participants, setting-level inclusion/exclusion criteria and representativeness, characteristics regarding intervention staff, implementation of intervention, costs, long-term effects and programme sustainability. CONCLUSIONS Active commuting and exercise training appear as promising approaches to promote physical activity or fitness in the workplace. The effect of interventions on obesity-related outcomes remains to be further investigated. There is a need to better report elements of generalizability and dissemination for translation into practice of worksite physical activity interventions.
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Affiliation(s)
- Anne Vuillemin
- Nutritional Epidemiology Unit, UMR U557 Inserm, U1125 Inra, Cnam, Université Paris 13, CRNH IdF, Bobigny
- Nancy-University, University Paul Verlaine Metz, University Paris Descartes, EA 4360 Apemac, Nancy, France
| | - Cyrus Rostami
- Nutritional Epidemiology Unit, UMR U557 Inserm, U1125 Inra, Cnam, Université Paris 13, CRNH IdF, Bobigny
| | | | | | | | - Johannes Brug
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | | | - Jean-Michel Oppert
- Nutritional Epidemiology Unit, UMR U557 Inserm, U1125 Inra, Cnam, Université Paris 13, CRNH IdF, Bobigny
- Department of Nutrition, University Pierre et Marie Curie, Pitie-Salpêtriere Hospital (AP-HP), Centre for Research on Human Nutrition Ile-de-France (CRNH IdF), Paris, France
- *Prof. Dr. Jean-Michel Oppert, Department of Nutrition, Pitié-Salpêtrière Hospital (AP-HP), 83, Boulevard de l’Hôpital, 75013 Paris, France, Tel. +33 1 42 1779-48, Fax -63,
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Colonoscopy yields fewer polyps as the day progresses despite using social influence theory to reverse the trend. Gastrointest Endosc 2010; 72:1233-40. [PMID: 21111873 DOI: 10.1016/j.gie.2010.08.034] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Accepted: 08/20/2010] [Indexed: 12/23/2022]
Abstract
BACKGROUND We previously reported that fewer polyps are detected by colonoscopy as the day progresses, a phenomenon that could be modified with "social influence theory" by using auditing and feedback. OBJECTIVE To measure the impact of a social influence informational poster on the relationship between time of day and colonoscopy yield. DESIGN Controlled before-and-after study comparing the polyp yield and time of day relationship in a historical cohort versus a 3-month intervention period. SETTING University-based Veterans Affairs medical center. PATIENTS Patients undergoing outpatient screening, surveillance, or diagnostic colonoscopies. INTERVENTION Placement of informational posters in endoscopy rooms within view of operators and nurses. The poster depicted a bar graph of the previously documented hour-by-hour decreases in polyp yield coupled with prominent text: "What Time Is It Now?" MAIN OUTCOME MEASUREMENT Polyp yield, including secondary end point limited to adenoma detection. We performed regression to measure the effect of start time on polyp yield. RESULTS There were 477 and 301 patients in the control and intervention periods, respectively. There was a negative relationship between start time and polyp yield, including adenoma detection, for both periods (P = .001). Start time remained negatively predictive of polyp and adenoma yield after adjusting for poster exposure and confounders (P = .01). LIMITATIONS Nonrandomized study design. CONCLUSION An informational poster did not alter the relationship between colonoscopy start time and polyp yield. This strengthens the previous finding that start time may affect polyp yield and suggests that passive use of social influence theory is inadequate to modify this effect. Shortening endoscopy shifts and active auditing with feedback may be necessary.
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Kwak L, Kremers SP, Candel MJ, Visscher TL, Brug J, van Baak MA. Changes in skinfold thickness and waist circumference after 12 and 24 months resulting from the NHF-NRG In Balance-project. Int J Behav Nutr Phys Act 2010; 7:26. [PMID: 20370934 PMCID: PMC2858095 DOI: 10.1186/1479-5868-7-26] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 04/07/2010] [Indexed: 11/17/2022] Open
Abstract
Background More knowledge is needed regarding the effectiveness of weight gain prevention programmes. The present study tested the 12-and 24-month effectiveness of the 'Netherlands Research programme weight Gain prevention' (NHF-NRG)-In Balance-project, a worksite-based intervention aimed at the prevention of weight gain. Methods Twelve worksites (n = 553 participants) were matched and assigned to either intervention or control group. The worksites and employees of the intervention group received individual (i.e. pedometer, computer-tailored advice) and environmental (i.e. changes in worksite canteen) interventions, directed at physical activity and food intake over 1-year. Differences between the intervention and control group in changes in body weight, BMI, skinfold thickness and waist circumference at 12 and 24 months were examined using multilevel linear regression analyses adjusting for various baseline characteristics (age, gender, BMI, marital status, education and smoking status). Results A significant greater reduction in skinfold thickness was found in the intervention group than in the control group, both after 12-and 24 months (Unstandardized regression coefficients (B) = -2.52, 95% C.I. -4.58, -0.45; p = 0.018; B = -4.83, 95% C.I. 6.98, -2.67; p < 0.001 respectively). Significant differences were also observed for changes in waist circumferences both at 12 months (B = -1.50, 95% C.I. -2.35, -0.65; p < 0.001) and at 24 months (B = -1.30, 95% C.I. -2.18, -0.42; p = 0.005). No significant changes were observed for weight and BMI. Conclusions The project was effective with regard to changes in skinfold thickness and waist circumference both at 12 and 24 months. It supports the usefulness of worksite-based prevention, especially regarding maintenance of behavioral changes.
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Affiliation(s)
- Lydia Kwak
- Unit for Preventive Nutrition, Department of Biosciences, Karolinska Institutet, Huddinge, Sweden.
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Behavioral and cognitive effects of a worksite-based weight gain prevention program: the NHF-NRG in balance-project. J Occup Environ Med 2010; 51:1437-46. [PMID: 19952793 DOI: 10.1097/jom.0b013e3181bd895a] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Examine the effectiveness of the worksite-based weight gain prevention program Netherlands Heart Foundation-Netherlands Research program weight Gain prevention In Balance, with regard to behavioral changes and corresponding cognitive determinants. METHODS A nonrandomized pretest-repeated posttest control group design was applied in 12 worksites. Intervention groups received individual and environmental interventions, directed at physical activity and food intake. Measurements were executed at baseline and after 12 and 24 months. RESULTS Nearly all behaviors in the intervention group improved more than in the control group, even though improvements in behaviors were often too small to reach statistical significance. No positive intervention effects were observed for the cognitive factors. CONCLUSION Differential changes between the intervention and control group were observed for several important dietary and physical activity behaviors. Valuable information is gained regarding the implementation of weight gain prevention programs in worksites.
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Boen F, Maurissen K, Opdenacker J. A simple health sign increases stair use in a shopping mall and two train stations in Flanders, Belgium. Health Promot Int 2010; 25:183-91. [DOI: 10.1093/heapro/daq001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rohrer JE, Barnes DE, Adamson SC, Altrichter PM, Yapuncich VP. Limited stair-climbing ability and weight control in family medicine patients. Chronic Illn 2008; 4:183-7. [PMID: 18796507 DOI: 10.1177/1742395308089060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the association between self-assessed stair-climbing limitation and weight control among family medicine patients, after adjustment for age, gender, marital status, body mass index (BMI), and co-morbidity. METHODS This study was a retrospective analysis of a cohort of 840 adult family medicine patient records drawn from a large family medicine department in Rochester, Minnesota. Weight control was measured as no change or decline in BMI over approximately 1 year. RESULTS Adjusting for co-morbidity and other confounders using multiple logistic regression analysis revealed that limited stair-climbing ability was unrelated to weight control over approximately 1 year. Instead, patients with BMI > or = 30 were more likely to control their weight (p<0.01), and age exhibited a non-linear relationship with weight control. The odds of weight control were lower for patients between the ages of 36 and 45 years than for those aged 18-35 years (p<0.01). CONCLUSIONS In our sample of family medicine patients, self-assessed stair-climbing limitations did not preclude weight control. Weight gain prevention programmes might be targeted at patients who are entering middle age.
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Affiliation(s)
- James E Rohrer
- Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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