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Healy GN, Goode AD, Ulyate L, Abbott A, Dunstan DW, Eakin EG, Gilson ND, Gunning L, Jetann J, LaMontagne AD, Moodie M, Mulcahy S, Owen N, Shilton T, Sweeny L, Straker L, Winkler EAH. National implementation trial of BeUpstanding™: an online initiative for workers to sit less and move more. Int J Behav Nutr Phys Act 2024; 21:111. [PMID: 39350268 PMCID: PMC11441226 DOI: 10.1186/s12966-024-01652-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 09/09/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND The online BeUpstanding™ program is an eight-week workplace-delivered intervention for desk-based workers to raise awareness of the benefits of sitting less and moving more and build a supportive culture for change. A workplace representative (the "champion") delivers the program, which includes a workshop where teams collectively choose their sit less/move more strategies. A toolkit provides the champion with a step-by-step guide and associated resources to support program uptake, delivery, and evaluation. Here we report on the main findings from the Australian national implementation trial of BeUpstanding. METHODS Recruitment (12/06/2019 to 30/09/2021) was supported by five policy and practice partners, with desk-based work teams from across Australia targeted. Effectiveness was measured via a single arm, repeated-measures trial. Data were collected via online surveys, toolkit analytics, and telephone calls with champions. The RE-AIM framework guided evaluation, with adoption/reach (number and characteristics); effectiveness (primary: self-reported workplace sitting time); implementation (completion of core components; costs); and, maintenance intentions reported here. Linear mixed models, correcting for cluster, were used for effectiveness, with reach, adoption, implementation, and maintenance outcomes described. RESULTS Of the 1640 website users who signed-up to BeUpstanding during the recruitment period, 233 were eligible, 198 (85%) provided preliminary consent, and 118 (50.6%) champions consented and started the trial, with 94% (n = 111 champions) completing. Trial participation was from across Australia and across industries, and reached 2,761 staff, with 2,248 participating in the staff survey(s): 65% female; 64% university educated; 17% from a non-English speaking background. The program effectively changed workplace sitting (-38.5 [95%CI -46.0 to -28.7] minutes/8-hour workday) and all outcomes targeted by BeUpstanding (behaviours and culture), with small-to-moderate statistically-significant effects observed. All participating teams (n = 94) completed at least 5/7 core steps; 72.4% completed all seven. Most champions spent $0 (72%) or >$0-$5 (10%) per team member; most (67/70 96%) intended to continue or repeat the program. CONCLUSIONS BeUpstanding can be adopted and successfully implemented by a range of workplaces, reach a diversity of staff, and be effective at creating a supportive culture for teams of desk-based workers to sit less and move more. Learnings will inform optimisation of the program for longer-term sustainability. TRIAL REGISTRATION ACTRN12617000682347.
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Affiliation(s)
- Genevieve N Healy
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia.
| | - Ana D Goode
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Lisa Ulyate
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Alison Abbott
- Work Health Design (retired), Workplace Health and Safety Qld, Office of Industrial Relations, Queensland, Australia
| | - David W Dunstan
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Australia
| | - Elizabeth G Eakin
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Nicholas D Gilson
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Lynn Gunning
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Jodie Jetann
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Anthony D LaMontagne
- Deakin University, Institute for Health Transformation, Determinants of Health Unit, Melbourne, Australia
| | - Marj Moodie
- Deakin University, Institute for Health Transformation, Determinants of Health Unit, Melbourne, Australia
| | - Samantha Mulcahy
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Neville Owen
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Trevor Shilton
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Leanne Sweeny
- Work Health Design (retired), Workplace Health and Safety Qld, Office of Industrial Relations, Queensland, Australia
| | - Leon Straker
- School of Public Health, Curtin University, Kent Street, Bentley, Australia
- School of Allied Health, Curtin University, Kent Street, Bentley, Australia
| | - Elisabeth A H Winkler
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
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Adjognon OL, Cohen-Bearak A, Kaitz J, Bokhour BG, Chatelain L, Charns MP, Mohr DC. Factors affecting the implementation of employee whole health in the veterans health administration: a qualitative evaluation. BMC Health Serv Res 2023; 23:600. [PMID: 37291554 DOI: 10.1186/s12913-023-09450-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 04/26/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND There is increasing recognition of the need to focus on the health and well-being of healthcare employees given high rates of burnout and turnover. Employee wellness programs are effective at addressing these issues; however, participation in these programs is often a challenge and requires large scale organizational transformation. The Veterans Health Administration (VA) has begun to roll out their own employee wellness program-Employee Whole Health (EWH)-focused on the holistic needs of all employees. This evaluation's goal was to use the Lean Enterprise Transformation (LET) model for organizational transformation to identify key factors-facilitators and barriers-affecting the implementation of VA EWH. METHODS This cross-sectional qualitative evaluation based on the action research model reflects on the organizational implementation of EWH. Semi-structured 60-minute phone interviews were conducted in February-April 2021 with 27 key informants (e.g., EWH coordinator, wellness/occupational health staff) knowledgeable about EWH implementation across 10 VA medical centers. Operational partner provided a list of potential participants, eligible because of their involvement in EWH implementation at their site. The interview guide was informed by the LET model. Interviews were recorded and professionally transcribed. Constant comparative review with a combination of a priori coding based on the model and emergent thematic analysis was used to identify themes from transcripts. Matrix analysis and rapid turnaround qualitative methods were used to identify cross-site factors to EWH implementation. RESULTS Eight common factors in the conceptual model were found to facilitate and/or hinder EWH implementation efforts: [1] EWH initiatives, [2] multilevel leadership support, [3] alignment, [4] integration, [5] employee engagement, [6] communication, [7] staffing, and [8] culture. An emergent factor was [9] the impact of the COVID-19 pandemic on EWH implementation. CONCLUSIONS As VA expands its EWH cultural transformation nationwide, evaluation findings can (a) enable existing programs to address known implementation barriers, and (b) inform new sites to capitalize on known facilitators, anticipate and address barriers, and leverage evaluation recommendations through concerted implementation at the organization, process, and employee levels to jump-start their EWH program implementation.
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Affiliation(s)
- Omonyêlé L Adjognon
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA
| | - Adena Cohen-Bearak
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System , Bedford, MA, USA
| | | | - Barbara G Bokhour
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System , Bedford, MA, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Leslie Chatelain
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA
| | - Martin P Charns
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA
| | - David C Mohr
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA.
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA.
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Pereira MA, Mullane SL, Toledo MJL, Larouche ML, Rydell SA, Vuong B, Feltes LH, Mitchell NR, de Brito JN, Hasanaj K, Carlson NG, Gaesser GA, Crespo NC, Oakes JM, Buman MP. Efficacy of the 'Stand and Move at Work' multicomponent workplace intervention to reduce sedentary time and improve cardiometabolic risk: a group randomized clinical trial. Int J Behav Nutr Phys Act 2020; 17:133. [PMID: 33109190 PMCID: PMC7592578 DOI: 10.1186/s12966-020-01033-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/01/2020] [Indexed: 12/20/2022] Open
Abstract
Background Sedentary time is associated with chronic disease and premature mortality. We tested a multilevel workplace intervention with and without sit-stand workstations to reduce sedentary time and lower cardiometabolic risk. Methods Stand and Move at Work was a group (cluster) randomized trial conducted between January 2016 and December 2017 among full-time employees; ≥18 years; and in academic, industry/healthcare, and government worksites in Phoenix, Arizona and Minneapolis/St. Paul, Minnesota, USA. Eligible worksites were randomized to (a) MOVE+, a multilevel intervention targeting reduction in sedentary time and increases in light physical activity (LPA); or (b) STAND+, the MOVE+ intervention along with sit-stand workstations to allow employees to sit or stand while working. The primary endpoints were objectively-measured workplace sitting and LPA at 12 months. The secondary endpoint was a clustered cardiometabolic risk score (blood pressure, glucose, insulin, triglycerides, and HDL-cholesterol) at 12 months. Results Worksites (N = 24; academic [n = 8], industry/healthcare [n = 8], and government [n = 8] sectors) and employees (N = 630; 27 ± 8 per worksite; 45 ± 11 years of age, 74% female) were enrolled. All worksites were retained and 487 participants completed the intervention and provided data for the primary endpoint. The adjusted between arm difference in sitting at 12 months was − 59.2 (CI: − 74.6,-43.8) min per 8 h workday, favoring STAND+, and in LPA at 12 months was + 2.2 (− 0.9,5.4) min per 8 h workday. Change in the clustered metabolic risk score was small and not statistically significant, but favored STAND+. In an exploratory subgroup of 95 participants with prediabetes or diabetes, the effect sizes were larger and clinically meaningful, all favoring STAND+, including blood glucose, triglycerides, systolic blood pressure, glycated hemoglobin, LDL-cholesterol, body weight, and body fat. Conclusions Multilevel workplace interventions that include the use of sit-stand workstations are effective for large reductions in sitting time over 12 months. Among those with prediabetes or diabetes, clinical improvements in cardiometabolic risk factors and body weight may be realized. Trial registration ClinicalTrials.gov Identifier: NCT02566317. Registered 2 October 2015, first participant enrolled 11 January 2016.
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Affiliation(s)
- Mark A Pereira
- University of Minnesota, School of Public Health, 1300 South Second Street, Minneapolis, MN, 55455, USA.
| | - Sarah L Mullane
- Arizona State University, College of Health Solutions, 500 North 3rd Street, Phoenix, AZ, 85004, USA
| | | | - Miranda L Larouche
- Arizona State University, College of Health Solutions, 500 North 3rd Street, Phoenix, AZ, 85004, USA
| | - Sarah A Rydell
- University of Minnesota, School of Public Health, 1300 South Second Street, Minneapolis, MN, 55455, USA
| | | | | | - Nathan R Mitchell
- University of Minnesota, School of Public Health, 1300 South Second Street, Minneapolis, MN, 55455, USA
| | - Junia N de Brito
- University of Minnesota, School of Public Health, 1300 South Second Street, Minneapolis, MN, 55455, USA
| | - Kristina Hasanaj
- Arizona State University, College of Health Solutions, 500 North 3rd Street, Phoenix, AZ, 85004, USA
| | - Neil G Carlson
- University of Minnesota, School of Public Health, 1300 South Second Street, Minneapolis, MN, 55455, USA
| | - Glenn A Gaesser
- Arizona State University, College of Health Solutions, 500 North 3rd Street, Phoenix, AZ, 85004, USA
| | | | - J Michael Oakes
- University of Minnesota, School of Public Health, 1300 South Second Street, Minneapolis, MN, 55455, USA
| | - Matthew P Buman
- Arizona State University, College of Health Solutions, 500 North 3rd Street, Phoenix, AZ, 85004, USA.
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Terry PE. The "Best of 2019 List" of Health Promotion Researchers. Am J Health Promot 2020; 34:127-131. [PMID: 31931597 DOI: 10.1177/0890117119899249] [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
Each year, the editorial team of the American Journal of Health Promotion selects our "Best of List" of health promotion science from the prior year. This editorial features the Editor's picks, the Editor in Chief's favorites, and other award categories for the research and writing published in 2019 in this journal. Our criteria for selection include such factors as: whether the study addresses a topic of timely importance in health promotion, the research question is clearly stated and the methodologies used are well executed, whether the paper is often cited and downloaded, whether the study findings offer a unique contribution to the literature, and whether the paper is well written and enjoyable to read. Awardees in 2019 shared study findings that demonstrated the vital role of health policies in affecting behaviors and offered new insights into how to engage voices from communities, how intervention dose and reach impact outcomes, and how to better engage the most difficult to reach.
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Affiliation(s)
- Paul E Terry
- Editor in Chief, the American Journal of Health Promotion, Senior Fellow, The Health Enhancement Research Organization (HERO)
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