Self-Efficacy and Planning as Predictors of Physical Activity in the Context of Workplace Health Promotion

Effectiveness of warm-up interventions on work-related musculoskeletal disorders, physical and psychosocial functions among workers: a systematic review

OBJECTIVES

The aim of this systematic review was to identify from published literature the available evidence regarding the effects of warm-up intervention implemented in the workplace on work -related musculoskeletal disorders (WMSDs) and physical and psychosocial functions.

DESIGN

Systematic review.

DATA SOURCES

The following four electronic databases were searched (from inception onwards to October 2022): Cochrane Central Register of Controlled Trials (CENTRAL), PubMed (Medline), Web of Science and Physiotherapy Evidence Database (PEDro).

ELIGIBILITY CRITERIA

Randomised and non-randomised controlled studies were included in this review. Interventions should include a warm-up physical intervention in real-workplaces.

DATA EXTRACTION AND SYNTHESIS

The primary outcomes were pain, discomfort, fatigue and physical functions. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used the Grading of Recommendations, Assessment, Development and Evaluation evidence synthesis. To assess the risk of bias, the Cochrane ROB2 was used for randomised controlled trial (RCT) and the Risk Of Bias In Non-randomised Studies-of Interventions was used for the non-RCT studies.

RESULTS

Three studies met the inclusion criterion, one cluster RCT and two non-RCTs. There was an important heterogeneity in the included studies principally concerning population and warm-up intervention exercises. There were important risks of bias in the four selected studies, due to blinding and confounding factors. Overall certainty of evidence was very low.

CONCLUSION

Due to the poor methodological quality of studies and conflicting results, there was no evidence supporting the use of warm-up to prevent WMSDs in the workplace. The present findings highlighted the need of good quality studies targeting the effects of warm-up intervention to prevent WMSDs.

PROSPERO REGISTRATION NUMBER

CRD42019137211.

"A reinstilled hope that they can change": Facilitator perspectives on a self-care and health promotion peer group program for veterans

Introduction

This study assessed the relevance, value, and effectiveness of "Taking Charge of My Life and Health" (TCMLH), a patient wellbeing peer group program for U.S. veterans focused on empowering them to identify what really matters in their lives and to work toward health goals that align with their mission, aspirations, or purpose in life. The potential of TCMLH to empower veterans to engage in self-care behaviors, make health behavior changes, and participate in health care decision making is important, as veterans are more likely than the general population to suffer from multiple chronic conditions that require ongoing self-management.

Methods

We conducted individual semi-structured interviews with 19 TCMLH facilitators serving in eight U.S. Veteran's Health Administration medical centers. Data were analyzed using an inductive approach to identify salient themes in facilitators' experiences.

Results

Facilitators reported that TCMLH participants demonstrated positive attitude changes (e.g., greater confidence and hope) and behavior changes (e.g., making healthcare appointments and implementing self-care practices) by program completion. Further, findings show that mindful awareness practices, the peer group setting, Whole Health assessment tools, and goal setting tools were perceived as the most impactful program elements leading to positive health behavior change.

Conclusion

Overall, findings suggest that this non-clinical peer group program can enhance patient wellbeing, and that there are certain program elements of TCMLH that are driving key attitudinal and behavioral changes.

Effects of middle-aged and elderly people's self-efficacy on health promotion behaviors: Mediating effects of sports participation

Objective

This study explores the relationship between self-efficacy, sports participation, and health promotion behavior for middle-aged and elderly people. Therefore, it provides a theoretical reference for improving the quality of life for middle-aged and elderly adults and promoting a healthy lifestyle for the elderly.

Methods

A total of 591 (men: 36.2%; women: 63.8%; age: above 50 years) middle-aged and elderly adults from five cities of Henan Province were selected as the research objects by convenient sampling. The self-efficacy, sports participation, and health promotion behavior scales were used for the questionnaire survey. Amos24.0 was used to test the structural equation model, intermediary function test, and bootstrap analysis. Results: The self-efficacy of middle-aged and elderly people positively impacted health promotion behavior. The path coefficient was 0.439. Sports participation played a partial intermediary role between self-efficacy and health promotion behavior (χ 2/df = 1.785, root mean square error of approximation = 0.036, root mean square residual = 0.021, goodness-of-fit index = 0.967, comparative fit index = 0.976, Tucker-Lewis Index = 0.971) The proportion of intermediary effect was 26.34% (0.100, 0.225).

Conclusion

(1) Self-efficacy can significantly and positively affect health promotion behavior for middle-aged and elderly people; (2) sports participation plays a partial intermediary role between self-efficacy and health promotion behavior. From this point of view, we can enhance the self-efficacy of middle-aged and elderly people and improve their healthy life behavior by advancing sports participation. Thus, it provides theoretical support and practical guidance for promoting national health.

Dyadic reciprocal associations between self-efficacy and planning predict sedentary behaviour

OBJECTIVES

There are two alternative hypotheses regarding bidirectional associations between self-efficacy and planning in predicting health behaviour change: self-efficacy may establish planning (cultivation hypothesis) or planning may enable the formation of self-efficacy (enabling hypothesis). This study investigates the order in which these two social cognitions are linked in adult-adult dyads in the context of sedentary behaviours (SB).

DESIGN

A longitudinal study with 4 measurement points, spanning 8 months.

METHODS

A total of 320 dyads (age: 18-90 years) were enrolled. Dyads included a focus person (who received the recommendation to reduce SB and intended to change their SB), and their partners, who were willing to support the focus persons and intended to reduce their own SB as well. Data were collected at Time 1 (T1), Time 2 (1 week later, T2), Time 3 (T3, 2 months after T1) and Time 4 (T4, 8 months after T1). SB was measured with accelerometers at (T1 and T4). Mediation models with individual and dyadic reciprocal effects were tested with path analyses.

RESULTS

Only one indirect effect was found: A higher level of partners' SB reduction-specific self-efficacy at T2 was related to the focus person's more frequent planning to reduce SB at T3, which, in turn, predicted lower SB time among partners at T4.

CONCLUSIONS

The findings provide partial support for the cultivation model (self-efficacy prompting planning) and for dyadic reciprocal associations in the context of SB time reduction among adult dyads.

Study protocol for the description and evaluation of the "Habit Coach" - a longitudinal multicenter mHealth intervention for healthy habit formation in health care professionals

BACKGROUND

The adoption of a healthy lifestyle plays a crucial role for the health and well-being of health care professionals. Previous e- and mHealth interventions relied on deliberative psychological processes (e.g., intention, planning) to target lifestyle changes, while revealing mixed efficacy. The additional potential of non-deliberative, automatic processes (i.e., habits) for behavior change has been understudied in interventions so far. The Habit Coach mHealth intervention combines deliberative and non-deliberative processes to support health care professionals in forming healthy physical activity, nutrition and mindfulness habits in daily life. The aim of this paper is to outline the study protocol including a detailed description of the mHealth intervention, evaluation plan, and study design. The purpose of this trial is to understand healthy habit formation in health care professionals over time.

METHODS

A one-arm, multicenter mHealth intervention study will be conducted. Behavioral and psychosocial predictors will be collected via within-app questionnaires across a 100-day period at baseline, post, as well as at weekly assessments. To understand habit formation across time, linear mixed models will be used.

DISCUSSION

This trial aims to unravel the role of motivational and volitional determinants for healthy habit formation across multiple health behaviors in health care professionals embedded in a mHealth intervention.

TRIAL REGISTRATION

This trial is registered in the German Clinical Trials Register, DRKS-ID DRKS00027156. Date of registration 17 November 2021.

Health Promotion for Outpatient Careworkers in Germany

Due to ongoing demographic changes, the need for care is increasing in Germany. The number of outpatient care services is also rising, and with it, the number of employees in outpatient care, who are also continuously becoming older. Workplace health promotion (WHP) becomes relevant in this context, as it can reduce negative strain reactions and promote employees’ health. The aim of this study was (1) to reveal implemented WHP interventions in German outpatient care services; (2) to examine the potential challenges regarding a successful implementation of WHP measures; and (3) to illuminate further requests and needs experienced by outpatient careworkers. In qualitative field research, 30 semi-structured individual interviews were conducted with German caregivers, using the problem-centered interview method. The collected data were deductively and inductively evaluated and interpreted, using qualitative content analysis according to Mayring. Outpatient caregivers reported various WHP measures known from their workplaces, such as the provision of fruit baskets, programmes to increase physical activity, or a subsidy for a personal gym. They further reported WHP, such as back training, known from other care services. However, the respondents spoke of the challenges regarding the implementation or the use of WHP interventions in general. The most frequently named barriers were a lack of time after work and interventions that were only offered in their leisure time. In the same course, the participants still needed offers to increase physical activity, joint activities, or relaxation techniques. However, respondents highlighted that they preferred the interventions to take place during working hours. This way, they would also be more likely to take advantage of the interventions. The results of this study provide an insight into various WHP measures that already exist, or that are desirable for implementation with regard to caregivers’ needs. Subjectively perceived challenges for a successful implementation of WHP measures represent the importance of adjustments in the work organization of caregivers. It becomes clear that WHP is not yet established in the ambulant care sector, although it appears to be imperative for keeping caregivers healthy. Considering the different needs of employees, the results can provide a basis for the development of needs-based health promotion measures for caregivers.

Workplace interventions for increasing physical activity in employees: A systematic review

Background

There is scattered evidence of the impact of workplace interventions in improving employees' physical activity. This systematic review was performed to evaluate the strategies of workplace interventions and their effectiveness, as reported in primary studies.

Method

Primary experimental trials, both randomized controlled trials (RCTs) and non‐RCTs, which examined interventions to increase healthy adult employees' physical activity were included in this review. Studies in English or Persian published between 2009 and 2019 with access to full text of resources were considered. Google Scholar, PubMed, Web of Science, Scopus and Cochrane Library, ProQuest (Thesis) and World Health Organization Clinical Trial Registration Databases and Persian databases such as SID, Magiran, IranMedex, Irandoc were searched. All the stages of review were conducted based on PRISMA. RoB and ROBINS‐I were used to assess the risk of bias of the primary studies.

Results

Thirty‐nine studies, with a total of 18 494 participants, met the inclusion criteria. Of these, 22 were RCTs, 17 were non‐RCTs. Effective interventions were reported in 15 RCTs and 14 non‐RCTs. Four main strategies of interventions were identified, consisting of motivation and support; monitoring and feedback; information and education; and activity. Thirteen different behavior change techniques (BCT) were identified with self‐determination theory (SDT) being the most frequent behavior change theory used.

Conclusion

It seems that a multi‐strategy intervention that one of the strategies of which is physical activity in the workplace (Activity), the use of behavioral change theories, especially SDT, may be indicative of a more effective intervention. It is recommended that BCTs be considered when designing physical activity interventions.

Hand Washing and Related Cognitions Following a Brief Behavior Change Intervention During the COVID-19 Pandemic: a Pre-Post Analysis

Background

Effective hand washing (for at least 20 s, with water and soap) is one of the health behaviors protecting against infection transmissions. Behavior change interventions supporting the initiation and maintenance of hand washing are crucial to prevent infection transmissions. Based on the Health Action Process Approach, the aim of this research was to conduct a pre-post analysis of hand washing and related cognitions (i.e., intention, self-efficacy, self-monitoring), measured up to 100 days following an intervention.

Methods

A convenience sample of N = 123 participants (age: M = 23.96 years; SD = 5.82; 80% women) received a brief intervention (key behavior change techniques: information about health consequences of hand washing; action planning) and responded to daily diaries and questionnaires up to a 100-day follow-up. Two-level models were used to analyze data of n = 89 participants who provided longitudinal data.

Results

Hand washing and self-monitoring increased, whereas intention and self-efficacy decreased over time. Only self-monitoring was a consistent positive correlate of hand washing on a between-person level.

Conclusions

Hand washing and self-monitoring considerably increased over several weeks following the intervention. Future research testing the intervention against a control condition is needed to rule out that changes in behavior and cognitions might have been prompted by completing the daily diaries.

Trial Registration

German Clinical Trials Register; https://www.drks.de; registration number: DRKS00022067.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12529-021-10042-w.

Start moving - benefits of an onsite workplace health program in the age of digitalization

Background

The process of digitization should simplify our work and improve related processes (i.e. quality, transparency). Moreover, it enables the home office, which is greatly expanded due to the current pandemic. Regarding workplace health, it should be noted that with increasing digitization, physical activity decreases, and as a result, the number of work-related diseases will increase. On the other hand, increasing digitization also offers promising opportunities for new approaches to workplace health promotion. With these positive as well as negative effects in mind, we designed a workshop to increase physical activity at work. This protocol describes our approach to a live workshop concept.

Methods

We use a randomized controlled trial with two intervention groups: a live workshop with and without additional reminders. The workshop intervention design consists of a baseline measurement, two workshops, and one follow-up measurement. Each workshop takes place in small groups (n < 11). We use a randomized allocation to both groups. To control for health-related effects and the expected behavior change we examine (i) physical activity (i.e. active time, taken steps, etc.) by a tracking device (ii) physical wellbeing, motivation, and volition by an online questionnaire, and (iii) participants also report physical activity by a diary. All measurements are taken one week before the respective workshop and 24 weeks after the initial baseline measures.

Discussion

A live workshop offers advantages such as very personal interactions and a low technical effort. However, during the current pandemic, there are some limitations (i.e. small groups, pay attention to hygienic guidelines). Based on the upcoming experiences of this workshop, a web-based approach might offer some advantages (i.e. easier daily implementation, independent from a participant’s location) regarding home office workplaces and the increasing digitization. On the other hand, there are also mandatory requirements as a stable internet connection and technical equipment (i.e. webcam, microphone). Overall, a step by step development of a web-based workshop, based on the experience of the live workshop, can be regarded as advantageous.

Trial registration

Since this article reports a health promotion intervention concept with human participants, we registered it in the German Clinical Trials Register (DRKS). Number:DRKS00021512, Date:30.10.2020.

Development and Validation of the Workplace Decisional Balance Scale for Exercise (WDBex) in a French Sample

OBJECTIVE

Despite positive effects of physical activity programs in the workplace, an appropriate measurement instrument to capture employees' decisional balance to exercise is lacking. This study sought to develop and validate a decisional balance scale for exercise adapted to the workplace.

METHODS

Four complementary studies were carried out, with a total sample of 2398 French volunteer employees, to develop a preliminary version and examine its dimensionality, temporal stability, and construct validity.

RESULTS

The Workplace Decisional Balance scale for Exercise (WDBex) consists of 21 items with two subfactors, respectively composed of 12 items (facilitators) and nine items (barriers); for each subfactor, three dimensions (ie, physical, psychological, and logistic) were distinguished and presented satisfactory psychometric properties.

CONCLUSIONS

This instrument constitutes a reliable and valid instrument for studying the psychosocial determinants of physical activity engagement in the workplace and for developing health promotion strategies.

Immediate effects of a very brief planning intervention on fruit and vegetable consumption: A randomized controlled trial

Action planning interventions can effectively promote fruit and vegetable (FV) consumption, but not much is known about the day-to-day translation of intervention planning into action. In this randomized controlled trial, immediate intervention effects of a very brief planning intervention on FV consumption during the following 13 days were investigated. After a 13-day pre-intervention diary, N = 206 participants (aged 19-66 years) were randomly allocated to a waiting-list control condition or a planning condition, where they formed one FV plan. Participants from both conditions completed a 13-day post-intervention diary. Self-reported daily FV consumption, FV-specific self-efficacy, and action control were assessed. Segmented linear mixed models estimating a discrete change (i.e. "jump") between diary phases showed a positive "jump" of FV intake and self-efficacy in the planning condition when compared to the control condition. For action control, such effects were not observed. Changes in study variables throughout the post-intervention phase did not differ between both conditions. Present findings extend previous evidence on action planning interventions by showing that increases in self-regulatory (i.e. self-efficacy) and behavioral (i.e. FV intake) outcomes can occur very rapidly and already on the first day for which behavioral increases were planned.

Predicting psychological factors affecting regular physical activity in hypertensive patients: Application of health action process approach model

Aim

The aim of this study was to determine the factors affecting the behaviour of regular physical activity in patients with hypertension using the health action process approach (HAPA) model.

Design

This cross-sectional study was conducted on 176 hypertension patients, in Astaneh-e-Ashrafiyeh, Guilan, Iran, 2018-2019.

Methods

Data collection tools included demographic characteristics, medical history, the short form of International Physical Activity Questionnaire (IPAQ) and scales related to the HAPA model. The data were analysed using chi-square, independent t test, one-way ANOVA, Pearson's correlation coefficient and path analysis on AMOS, version 23.0.

Results

Action self-efficacy (β = 0.59), outcome expectancy (β = 0.20) and risk perception (β = 0.18) had a statistically significant effect on intention. Moreover, the path coefficient between intention (β = 0.35) and coping self-efficacy (β = 0.29) with physical activity was statistically significant. The results revealed that HAPA constructs were able to describe 45% of the variance in intention and 31% of the variance in physical activity behaviour.

Conclusion

The HAPA model is a useful framework for describing the factors affecting physical activity in hypertension patients.

An 8-Week Study on Social-Cognitive Variables for Physical Activity and Fruit and Vegetable Intake: Are there Stage Transitions?

BACKGROUND

Health behavior change can be modelled in terms of stages, and outcomes of transitions between stages can be categorized into progression, regression, and stagnation. Based on the Health Action Process Approach this study tested whether changes in social-cognitive variables are associated with transitions between stages regarding physical activity (PA) and fruit and vegetable intake (FVI).

METHODS

N = 132 participants (M = 50.86 years, SD = 13.17, 61.4% women) were assessed at baseline and 8 weeks later. Data were analysed using multivariate analyses of variance (MANOVA) and post-hoc comparisons.

RESULTS

Changes in motivational self-efficacy (η²  = 0.081), maintenance self-efficacy (η²  = 0.119), and recovery self-efficacy (η²  = 0.049) as well as positive outcome expectancies (η²  = 0.070), negative outcome expectancies (η²  = 0.055), and coping planning (η²  = 0.065) were associated with FVI stage progression. For PA, changes were not associated with stage progression.

CONCLUSION

To facilitate behavior change effectively, at least for FVI, it is essential to consider underlying mechanisms such as several aspects of self-efficacy in performing the desired health behaviors, outcome expectations, and planning how to overcome barriers. Additionally, the adoption of a stage approach may be a useful starting point to develop stage-matched interventions.

Efficacy of path-oriented psychological self-help interventions to improve mental health of empty-nest older adults in the Community of China

BACKGROUND

China has the world's largest aging population and the number of empty-nest older adults is on the rise. In comparison to the aging population in general, empty-nest older adults have a lower level of subjective well-being and poorer mental health status due to a lack of emotional support from their children. The aim of this study is to conduct an empirical study to evaluate the efficacy of the 'Path-oriented Psychological Self-help Intervention' (P-oPSI) led by nurses on the mental health of empty-nest older adults in the community, to provide a scientific foundation for improving their quality of life.

METHODS

A Quasi-Experimental controlled intervention study was conducted from 2015 to 2017. A total of 76 empty-nest older adults from 2 districts were recruited using a convenience sampling and assigned to 2 groups based on their residential communities in the city of Chifeng in the Inner Mongolia Autonomous Region, China. The wait list control group participated in a mental health lecture to gain knowledge and learn techniques of mental health promotion. The intervention group additionally received 1 month of training in a nurse-led 'P-oPSI' for a month. Both groups were followed-up for 3 months. Mental health status, coping styles, and psychological self-help ability of the participating empty nest older adults were assessed at the baseline, 1 month, and 3-months follow up, respectively. Two-way analysis of variance and a simple effect test were used to analyse the differences of the two groups.

RESULTS

The P-oPSI yielded a greater benefit for the mental health status, coping styles, and psychological self-help ability of the participants in the intervention group. Combined with a simple effect test, the scores of the mental health status, positive coping style, and psychological self-help ability of those in the intervention group significantly increased at 1 month after the baseline (F _{mental health status} = 7.59, F _{positive coping style} = 7.24, F _{psychological self-help ability} = 7.07); and the sustainable effect of this program lasted for 3 months after the intervention (F _{mental health status} = 13.24, F _{positive coping style} = 10.42, F _{psychological self-help ability} = 10.45), which reached statistical significance (P < 0.01).

CONCLUSIONS

The P-oPSI program significantly improved the level of mental health of empty-nest older adults in China. This intervention provides a new approach of self-management to improve mental health of older adults in community settings.

TRIAL REGISTRATION

chictr.org.cn: ChiCTR1900025552. Retrospectively registered 1 September 2019.

The Role of Positive Emotion and Ego-Resilience in Determining Men's Physical Activity Following a Workplace Health Intervention

Men are a hard-to-reach group in the promotion of modifiable behaviors such as physical activity. Examining the individual differences among men that might predict positive behavior changes could support customization of health promotion programs. This study examined the role of emotional outlook, positive emotion, and ego-resilience in determining men’s physical activity and health-related quality of life following implementation of a gender-sensitive workplace health intervention. Using a pre–post within-subjects design, computer-assisted telephone interviewing (CATI) was used to collect measures of emotion and ego-resilience along with physical activity and health-related quality of life (using the 12-item short form [SF-12]) at baseline (n = 139) and after 6 months (n = 80) from adult men (M_age = 43.7, SD = 12.5). Baseline emotional outlook and ego-resilience were both positively related to increased physical activity at follow-up among men. Emotional outlook and positive emotion were positively related to ego-resilience, and ego-resilience mediated the relationship between these and the physical component of health-related quality of life. Workplace health interventions that incorporate the promotion of personal resources hold potential for greater impacts.

Worksite Physical Activity Barriers and Facilitators: A Qualitative Study Based on the Transtheoretical Model of Change

Background: Many of the studies on worksite physical activity (PA) have investigated either the effectiveness of PA programs for employees and the work-related outcomes or health promotion interventions to increase PA. However, studies on barriers and enabling factors for participation are scarce and have generally not been theoretically grounded. The purpose of this qualitative study was to identify worksite PA barriers and facilitators from the perspective of the transtheoretical model of change (TTM). Methods: Thirty employees (15 females and 15 males; M_age = 44.70; SD = 5.20) were recruited to participate in semi-structured interviews lasting from 60 to 90 min. Participants came from several organizations that offered PA programs and were at different exercise stages of change. They were invited to describe: (a) general information on the place of PA in their daily lives and in the workplace, and the reasons for (b) worksite PA participation or (c) non-participation. The interview transcripts were analyzed both inductively and deductively with reference to the exercise stages of change. Results: Three categories of barriers and facilitators related to physical, psychological and environmental dimensions were identified. For all exercise stages of change combined, psychological and environmental barriers were significantly more reported than physical barriers, whereas physical and psychological facilitators were more cited than environmental facilitators. Further qualitative analysis suggested that these categories differed with the exercise stage of change. At the precontemplative and contemplative stages, all types of barriers predominated (e.g., physical constraints due to the workstation, fear of management disapproval, time constraints). At the preparation stage, physical, and psychological needs emerged in relation to worksite PA (e.g., need to compensate for sedentary work, stress regulation). At the action and maintenance levels, physical, psychological, and environmental facilitators were reported (e.g., enhanced physical condition, workplace well-being, social ties). At the relapse stage, specific life changes or events broke the physically active lifestyle dynamics. Conclusion: This study identified the contribution of different types of worksite PA barriers and facilitators according to the exercise stage of change. The identified facilitators are consistent with the general TTM processes of change, while being specific to the workplace. Practical strategies are discussed.