The effect of workplace lifestyle programmes on diet, physical activity, and weight-related outcomes for working women: A systematic review using the TIDieR checklist

Physical activity and healthy diets are essential for the prevention of obesity and chronic disease that disparately impact women compared with men. Given the number of women engaged in the workforce, workplace interventions could improve lifestyle behaviours and health outcomes for women. This systematic review aimed to identify intervention characteristics of lifestyle programmes or organizational policy changes in the workplace associated with improved diet, physical activity, or weight-related outcomes for working women using the template for intervention description and replication (TIDieR) checklist. Seven databases were searched for controlled studies published up to March 2019 that included a workplace diet and/or physical activity intervention. From 5,318 identified records, 20 studies (23 articles and 26 intervention arms) were included. Data were extracted on diet, physical activity, weight-related outcomes, and TIDieR components. Findings indicated that group delivery may improve physical activity outcomes, and a high number of sessions may benefit weight-related outcomes for physical activity interventions. Mixed interventions that included tailoring and input from non-healthcare professionals may also enhance physical activity. In contrast, the role of mixed interventions in improving diet and weight-related outcomes was less clear. Overall, workplace health programmes were effective at improving lifestyle behaviours for working women.

Efficacy of theory-informed workplace physical activity interventions: a systematic literature review with meta-analyses

This review aimed to assess the efficacy of workplace physical activity interventions; compare the efficacy of those that were and were not informed by behaviour change theory, and outline the effectiveness of different intervention components. A search was undertaken in Medline, Embase, PsycINFO, Ovid Emcare (previously CINAHL) and SportDiscus. Randomised, non-randomised and cluster-controlled trials with objectively measured physical activity and/or measured or predicted maximal oxygen uptake (VO_2max) as outcomes were included in the review (83 papers from 79 trials). Random-effects meta-analyses of mean differences were undertaken. Workplace physical activity programmes demonstrated positive overall intervention effects for daily step counts (814.01 steps/day; CI: 446.36, 1181.67; p < 0.01; i² = 88%) and measured VO_2max (2.53 ml kg^-1 min^-1; CI: 1.69, 3.36; p < 0.01; i² = 0%) with no sub-group differences between theory- and non-theory informed interventions. Significant sub-group differences were present for predicted VO_2max (p < 0.01), with a positive intervention effect for non-theory informed studies (2.11 ml.kg^-1 min^-1; CI: 1.20, 3.02; p < 0.01; i² = 78%) but not theory-informed studies (-0.63 ml kg^-1 min^-1; CI: -1.55, 0.30; p = 0.18; i² = 0%). Longer-term follow-ups ranged from 24 weeks to 13 years, with significant positive effects for measured VO_2max (2.84 ml kg^-1 min^-1; CI: 1.41, 4.27; p < 0.01; i² = 0%). Effective intervention components included the combination of self-monitoring with a goal, and exercise sessions onsite or nearby. The findings of this review were limited by the number and quality of theory-informed studies presenting some outcomes, and confounding issues in complex interventions. Future researchers should consider rigorous testing of outcomes of theory-informed workplace physical activity interventions and incorporate longer follow-ups.

Evaluation of health education interventions on Chinese factory workers' knowledge, practices, and behaviors related to infectious disease

BACKGROUND

Workplaces are a common location for infectious disease transmission among adults. To provide recommendations regarding appropriate health promotion programs, we evaluated the impact of three different interventions on factory workers.

METHODS

In a prospective intervention study carried out from October 2012 to June 2013, three factories were selected and each was assigned a different intervention method (i.e. self-study group, manager training group and interactional group discussion group). Participants were scored on their knowledge, behavior, and hygienic practices related to infectious disease prevention both before and after the intervention.

RESULTS

A total of 1154 participants completed the survey before the intervention and 1111 completed the survey after. The sum infectious disease knowledge score in the manager training group was higher after the intervention (9.09/12) than before (8.63/12, t=4.47, p<0.05). There was no significant difference in sum infectious disease knowledge score pre and post intervention for both the self-study group and the interactional group discussion.

CONCLUSIONS

Overall, change in health behaviors and hygiene practices were not as affected compared to changes in knowledge after interventions related to infectious disease health promotion. Training managers who then interact with workers may be an effective and efficient way of educating workers on health issues.

"Blue flags", development of a short clinical questionnaire on work-related psychosocial risk factors - a validation study in primary care

Background

Working conditions substantially influence health, work ability and sick leave. Useful instruments to help clinicians pay attention to working conditions are lacking in primary care (PC). The aim of this study was to test the validity of a short “Blue flags” questionnaire, which focuses on work-related psychosocial risk factors and any potential need for contacts and/or actions at the workplace.

Methods

From the original“The General Nordic Questionnaire” (QPS_Nordic) the research group identified five content areas with a total of 51 items which were considered to be most relevant focusing on work-related psychosocial risk factors. Fourteen items were selected from the identified QPS_Nordic content areas and organised in a short questionnaire “Blue flags”. These 14 items were validated towards the 51 QPS_Nordic items. Content validity was reviewed by a professional panel and a patient panel. Structural and concurrent validity were also tested within a randomised clinical trial.

Results

The two panels (n = 111) considered the 14 psychosocial items to be relevant. A four-factor model was extracted with an explained variance of 25.2%, 14.9%, 10.9% and 8.3% respectively. All 14 items showed satisfactory loadings on all factors. Concerning concurrent validity the overall correlation was very strong r_s = 0.87 (p < 0.001).). Correlations were moderately strong for factor one, r_s = 0.62 (p < 0.001) and factor two, r_s = 0.74 (p < 0.001). Factor three and factor four were weaker, bur still fair and significant at r_s = 0.53 (p < 0.001) and r_s = 0.41 (p < 0.001) respectively. The internal consistency of the whole “Blue flags” was good with Cronbach’s alpha of 0.76.

Conclusions

The content, structural and concurrent validity were satisfactory in this first step of development of the “Blue flags” questionnaire. In summary, the overall validity is considered acceptable. Testing in clinical contexts and in other patient populations is recommended to ensure predictive validity and usefulness.

Implementation of the participatory approach for supervisors to prevent sick leave: a process evaluation

Purpose

To perform a process evaluation of a multifaceted strategy to implement the participatory approach for supervisors to prevent sick leave in three organisations.

Methods

The implementation strategy incorporated a working group meeting with stakeholder representatives, supervisor training, and optional supervisor coaching. Context, recruitment, reach, dose delivered, dose received, fidelity, and satisfaction with the strategy were assessed at organisational and supervisor level using questionnaires and registration forms.

Results

At least 4 out of 6 stakeholders were represented in the working group meetings, and 11 % (n = 116) of supervisors could be reached. The working group meetings and supervisor training were delivered and received as planned and were well appreciated within all three organisations. Three supervisors made use of coaching. At 6-month follow-up, 11 out of 41 supervisors (27 %) indicated that they had applied the participatory approach at least one time.

Conclusion

The implementation strategy was largely carried out as intended. However, reach of both supervisors and department managers should be improved. Future studies should consider targeting employees with the strategy.

A Participatory Integrated Health Promotion and Protection Worksite Intervention: A Cluster Randomized Controlled Trial

Our objective was to describe and evaluate an innovative approach to combining worksite wellness and ergonomics, with an emphasis on retention and absenteeism during the intervention. The study enrolled 280 employee participants in a 3-year cluster randomized, controlled trial conducted at The University of Iowa, 5 local businesses, and 1 regional business. Our results showed a 90% retention rate with lower estimated absenteeism (although not statistically significant) in the intervention group compared with the control group. This type of highly interactive and integrated short intervention has the capacity to result in high levels of participation with the potential to reduce absenteeism.