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Hargreaves SC, Ure C, Burns EJ, Coffey M, Audrey S, Ardern K, Cook PA. A mixed methods analysis evaluating an alcohol health champion community intervention: How do newly trained champions perceive and understand their training and role? HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2737-e2749. [PMID: 35040220 PMCID: PMC9546352 DOI: 10.1111/hsc.13717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 10/18/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Globally, alcohol harm is recognised as one of the greatest population risks and reducing alcohol harm is a key priority for the UK Government. The Communities in Charge of Alcohol (CICA) programme took an asset-based approach in training community members across nine areas to become alcohol health champions (AHCs); trained in how to have informal conversations about alcohol and get involved with alcohol licensing. This paper reports on the experiences of AHCs taking part in the training through the analysis of: questionnaires completed pre- and post-training (n = 93) and semi-structured interviews with a purposive sample of five AHCs who had started their role. Questionnaires explored: characteristics of AHCs, perceived importance of community action around alcohol and health, and confidence in undertaking their role. Following training AHCs felt more confident to talk about alcohol harms, give brief advice and get involved in licensing decisions. Interviews explored: AHCs' experiences of the training, barriers and facilitators to the adoption of their role, and how they made sense of their role. Four overarching themes were identified through thematic analysis taking a framework approach: (a) perceptions of AHC training; (b) applying knowledge and skills in the AHC role; (c) barriers and facilitators to undertaking the AHC role; and (d) sustaining the AHC role. Findings highlight the challenges in establishing AHC roles can be overcome by combining the motivation of volunteers with environmental assets in a community setting: the most important personal asset being the confidence to have conversations with people about a sensitive topic, such as alcohol.
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Affiliation(s)
| | - Cathy Ure
- School of Health and SocietyUniversity of SalfordSalfordUK
| | | | | | | | | | - Penny A. Cook
- School of Health and SocietyUniversity of SalfordSalfordUK
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Castillo-Paredes A, Inostroza Jiménez N, Parra-Saldías M, Palma-Leal X, Felipe JL, Págola Aldazabal I, Díaz-Martínez X, Rodríguez-Rodríguez F. Environmental and Psychosocial Barriers Affect the Active Commuting to University in Chilean Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041818. [PMID: 33668427 PMCID: PMC7918915 DOI: 10.3390/ijerph18041818] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 12/21/2022]
Abstract
Biking and walking are active commuting, which is considered an opportunity to create healthy habits. Objective: The purpose of this study was to determine the main environmental and psychosocial barriers perceived by students, leading to less Active Commuting (AC) to university and to not reaching the Physical Activity (PA) recommendations. Material and Methods: In this cross-sectional study, 1349 university students (637 men and 712 women) were selected. A self-reported questionnaire was applied to assess the mode of commuting, PA level and barriers to the use of the AC. Results: Women presented higher barriers associated with passive commuting than men. The main barriers for women were “involves too much planning” (OR: 5.25; 95% CI: 3.14–8.78), “It takes too much time” (OR: 4.62; 95% CI: 3.05–6.99) and “It takes too much physical effort “ (OR: 3.18; 95% CI: 2.05–4.94). In men, the main barriers were “It takes too much time” (OR: 4.22; 95% CI: 2.97–5.99), “involves too much planning” (OR: 2.49; 95% CI: 1.67–3.70) and “too much traffic along the route” (OR: 2.07; 95% CI: 1.47–2.93). Psychosocial barriers were found in both sexes. Conclusions: Psychosocial and personal barriers were more positively associated with passive commuting than environmental barriers. Interventions at the university are necessary to improve the perception of AC and encourage personal organization to travel more actively.
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Affiliation(s)
- Antonio Castillo-Paredes
- Grupo AFySE, Investigación en Actividad Física y Salud Escolar, Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad de Las Américas, Santiago 8370035, Chile
- Correspondence: ; Tel.: +56-988388592
| | - Natalia Inostroza Jiménez
- Área Salud, Universidad Tecnológica de Chile INACAP, La Serena 1700000, Chile;
- Magíster en Nutrición para la Actividad Física y el Deporte, Escuela de Nutrición y Dietética, Facultad de Ciencias, Universidad Mayor, Santiago 8580745, Chile
| | - Maribel Parra-Saldías
- IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaíso, Valparaíso 2374631, Chile; (M.P.-S.); (X.P.-L.); (F.R.-R.)
| | - Ximena Palma-Leal
- IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaíso, Valparaíso 2374631, Chile; (M.P.-S.); (X.P.-L.); (F.R.-R.)
| | - José Luis Felipe
- School of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (J.L.F.); (I.P.A.)
| | - Itziar Págola Aldazabal
- School of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (J.L.F.); (I.P.A.)
| | - Ximena Díaz-Martínez
- Quality of Life Research Group in Different Populations, Department of Education Sciences, Universidad del Bíobío, Chillan 3800949, Chile;
| | - Fernando Rodríguez-Rodríguez
- IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaíso, Valparaíso 2374631, Chile; (M.P.-S.); (X.P.-L.); (F.R.-R.)
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Dutheil F, Pélangeon S, Duclos M, Vorilhon P, Mermillod M, Baker JS, Pereira B, Navel V. Protective Effect on Mortality of Active Commuting to Work: A Systematic Review and Meta-analysis. Sports Med 2020; 50:2237-2250. [PMID: 33034873 DOI: 10.1007/s40279-020-01354-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sedentary behaviour is a major risk of mortality. However, data are contradictory regarding the effects of active commuting on mortality. OBJECTIVES To perform a systematic review and meta-analysis on the effects of active commuting on mortality. METHODS The PubMed, Cochrane Library, Embase, and Science Direct databases were searched for studies reporting mortality data and active commuting (walking or cycling) to or from work. We computed meta-analysis stratified on type of mortality, type of commuting, and level of commuting, each with two models (based on fully adjusted estimates of risks, and on crude or less adjusted estimates). RESULTS 17 studies representing 829,098 workers were included. Using the fully adjusted estimates of risks, active commuting decreased all-cause mortality by 9% (95% confidence intervals 3-15%), and cardiovascular mortality by 15% (3-27%) (p < 0.001). For stratification by type of commuting, walking decreased significantly all-cause mortality by 13% (1-25%), and cycling decreased significantly both all-cause mortality by 21% (11-31%) and cardiovascular mortality by 33% (10-55%) (p < 0.001). For stratification by level of active commuting, only high level decreased all-cause mortality by 11% (3-19%) and both intermediate and high level decreased cardiovascular mortality. Low level did not decrease any type of mortality. Cancer mortality did not decrease with walking or cycling, and the level of active commuting had no effect. Low level walking did not decrease any type of mortality, intermediate level of walking decreased only all-cause mortality by 15% (2-28%), and high level of walking decreased both all-cause and cardiovascular mortality by 19% (8-30%) and by 31% (9-52%), respectively. Both low, intermediate and high intensities of cycling decreased all-cause mortality. Meta-analysis based on crude or less fully adjusted estimates retrieved similar results, with also significant reductions of cancer mortality with cycling (23%, 5-42%), high level of active commuting (14%, 4-24%), and high level of active commuting by walking (16%, 0-32%). CONCLUSION Active commuting decreases mainly all-cause and cardiovascular mortality, with a dose-response relationship, especially for walking. Preventive strategies should focus on the benefits of active commuting.
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Affiliation(s)
- Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Université Clermont Auvergne, Witty Fit, 63000, Clermont-Ferrand, France. .,Faculty of Health, School of Exercise Science, Melbourne, Australia2 General Medicine, AMUAC, Australian Catholic University, 63000, Clermont-Ferrand, France.
| | | | - Martine Duclos
- INRA, UMR 1019, CRNH-Auvergne, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Sport Medicine and Functional Explorations, Université Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Philippe Vorilhon
- Université Clermont Auvergne, UPU ACCePPT, 63000, Clermont-Ferrand, France
| | - Martial Mermillod
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France.,Institut Universitaire de France, Paris, France
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Bruno Pereira
- CHU Clermont-Ferrand, Clinical Research and Innovation Direction, University Hospital of Clermont Ferrand, 63000, Clermont-Ferrand, France
| | - Valentin Navel
- CNRS, INSERM, GReD, Translational Approach To Epithelial Injury and Repair, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Ophthalmology, Université Clermont Auvergne, 63000, Clermont-Ferrand, France
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Freak-Poli RLA, Cumpston M, Albarqouni L, Clemes SA, Peeters A. Workplace pedometer interventions for increasing physical activity. Cochrane Database Syst Rev 2020; 7:CD009209. [PMID: 32700325 PMCID: PMC7389933 DOI: 10.1002/14651858.cd009209.pub3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The World Health Organization (WHO) recommends undertaking 150 minutes of moderate-intensity physical activity per week, but most people do not. Workplaces present opportunities to influence behaviour and encourage physical activity, as well as other aspects of a healthy lifestyle. A pedometer is an inexpensive device that encourages physical activity by providing feedback on daily steps, although pedometers are now being largely replaced by more sophisticated devices such as accelerometers and Smartphone apps. For this reason, this is the final update of this review. OBJECTIVES To assess the effectiveness of pedometer interventions in the workplace for increasing physical activity and improving long-term health outcomes. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Occupational Safety and Health (OSH) UPDATE, Web of Science, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform from the earliest record to December 2016. We also consulted the reference lists of included studies and contacted study authors to identify additional records. We updated this search in May 2019, but these results have not yet been incorporated. One more study, previously identified as an ongoing study, was placed in 'Studies awaiting classification'. SELECTION CRITERIA We included randomised controlled trials (RCTs) of workplace interventions with a pedometer component for employed adults, compared to no or minimal interventions, or to alternative physical activity interventions. We excluded athletes and interventions using accelerometers. The primary outcome was physical activity. Studies were excluded if physical activity was not measured. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. When studies presented more than one physical activity measure, we used a pre-specified list of preferred measures to select one measure and up to three time points for analysis. When possible, follow-up measures were taken after completion of the intervention to identify lasting effects once the intervention had ceased. Given the diversity of measures found, we used ratios of means (RoMs) as standardised effect measures for physical activity. MAIN RESULTS We included 14 studies, recruiting a total of 4762 participants. These studies were conducted in various high-income countries and in diverse workplaces (from offices to physical workplaces). Participants included both healthy populations and those at risk of chronic disease (e.g. through inactivity or overweight), with a mean age of 41 years. All studies used multi-component health promotion interventions. Eleven studies used minimal intervention controls, and four used alternative physical activity interventions. Intervention duration ranged from one week to two years, and follow-up after completion of the intervention ranged from three to ten months. Most studies and outcomes were rated at overall unclear or high risk of bias, and only one study was rated at low risk of bias. The most frequent concerns were absence of blinding and high rates of attrition. When pedometer interventions are compared to minimal interventions at follow-up points at least one month after completion of the intervention, pedometers may have no effect on physical activity (6 studies; very low-certainty evidence; no meta-analysis due to very high heterogeneity), but the effect is very uncertain. Pedometers may have effects on sedentary behaviour and on quality of life (mental health component), but these effects were very uncertain (1 study; very low-certainty evidence). Pedometer interventions may slightly reduce anthropometry (body mass index (BMI) -0.64, 95% confidence interval (CI) -1.45 to 0.18; 3 studies; low-certainty evidence). Pedometer interventions probably had little to no effect on blood pressure (systolic: -0.08 mmHg, 95% CI -3.26 to 3.11; 2 studies; moderate-certainty evidence) and may have reduced adverse effects (such as injuries; from 24 to 10 per 100 people in populations experiencing relatively frequent events; odds ratio (OR) 0.50, 95% CI 0.30 to 0.84; low-certainty evidence). No studies compared biochemical measures or disease risk scores at follow-up after completion of the intervention versus a minimal intervention. Comparison of pedometer interventions to alternative physical activity interventions at follow-up points at least one month after completion of the intervention revealed that pedometers may have an effect on physical activity, but the effect is very uncertain (1 study; very low-certainty evidence). Sedentary behaviour, anthropometry (BMI or waist circumference), blood pressure (systolic or diastolic), biochemistry (low-density lipoprotein (LDL) cholesterol, total cholesterol, or triglycerides), disease risk scores, quality of life (mental or physical health components), and adverse effects at follow-up after completion of the intervention were not compared to an alternative physical activity intervention. Some positive effects were observed immediately at completion of the intervention periods, but these effects were not consistent, and overall certainty of evidence was insufficient to assess the effectiveness of workplace pedometer interventions. AUTHORS' CONCLUSIONS Exercise interventions can have positive effects on employee physical activity and health, although current evidence is insufficient to suggest that a pedometer-based intervention would be more effective than other options. It is important to note that over the past decade, technological advancement in accelerometers as commercial products, often freely available in Smartphones, has in many ways rendered the use of pedometers outdated. Future studies aiming to test the impact of either pedometers or accelerometers would likely find any control arm highly contaminated. Decision-makers considering allocating resources to large-scale programmes of this kind should be cautious about the expected benefits of incorporating a pedometer and should note that these effects may not be sustained over the longer term. Future studies should be designed to identify the effective components of multi-component interventions, although pedometers may not be given the highest priority (especially considering the increased availability of accelerometers). Approaches to increase the sustainability of intervention effects and behaviours over a longer term should be considered, as should more consistent measures of physical activity and health outcomes.
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Affiliation(s)
- Rosanne LA Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Miranda Cumpston
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Loai Albarqouni
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Stacy A Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Anna Peeters
- Institute for Health Transformation, Deakin University, Geelong, Australia
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Ek A, Alexandrou C, Söderström E, Bergman P, Delisle Nyström C, Direito A, Eriksson U, Henriksson P, Maddison R, Trolle Lagerros Y, Bendtsen M, Löf M. Effectiveness of a 3-Month Mobile Phone-Based Behavior Change Program on Active Transportation and Physical Activity in Adults: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e18531. [PMID: 32510462 PMCID: PMC7308910 DOI: 10.2196/18531] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Active transportation (AT; ie, walking and cycling as a mode for transportation) has been associated with decreased morbidity and mortality; however, low-cost and scalable intervention programs are lacking. OBJECTIVE The goal of the research was to determine the effectiveness of a 3-month behavior change program delivered via a mobile phone app to promote AT (TravelVu Plus) on time spent in moderate-to-vigorous physical activity (MVPA). METHODS For this 2-arm parallel randomized controlled trial, we recruited a population-based sample of 254 adults from Stockholm County who were aged 20 to 65 years and had access to a smartphone. On completion of 1-week baseline measures, the 254 participants were randomized to either the control or intervention group (1:1 ratio). Both groups had access to the standard TravelVu app (Trivector AB) for monitoring their AT for 6 months. The intervention group also received a 3-month behavior change program to promote AT (TravelVu Plus app). Assessors of outcomes were blinded to group allocation. Outcomes were objectively measured MVPA at 3 (primary) and 6 months. Secondary outcomes were AT, attitudes toward AT, and health-related quality of life at 3 and 6 months. RESULTS No effect on MVPA was observed after 3 months (P=.29); however, at 6 months the intervention group had a greater improvement in MVPA than the controls (6.05 minutes per day [95% CI 0.36 to 11.74; P=.04]). A Bayesian analyses showed that there was a 98% probability that the intervention had any effect at 6 months, and a 63% probability that this effect was >5 minute MVPA per day. CONCLUSIONS No effect on MVPA immediately after the intervention period (at 3 months) was observed; however, there was a delayed effect on MVPA (6 minutes per day) at 6 months, which corresponds to approximately 30% of the weekly MVPA recommendation. Our findings suggest that a behavior change program promoting AT delivered via an app may have a relevant effect on PA. TRIAL REGISTRATION ClinicalTrials.gov NCT03086837; https://clinicaltrials.gov/ct2/show/NCT03086837. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12889-018-5658-4.
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Affiliation(s)
- Anna Ek
- Department of Clinical Science Intervention and Technology, Karolinska Institutet, Huddinge, Sweden
| | | | - Emmie Söderström
- Department of Health, Medicine and Caring Sciences, Linköping, Sweden
| | - Patrick Bergman
- eHealth Institute, Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
| | | | - Artur Direito
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping, Sweden
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Ylva Trolle Lagerros
- Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
- Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping, Sweden
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
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Assemi B, Zahnow R, Zapata-Diomedi B, Hickman M, Corcoran J. Transport-related walking among young adults: when and why? BMC Public Health 2020; 20:244. [PMID: 32070313 PMCID: PMC7029445 DOI: 10.1186/s12889-020-8338-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 02/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The existing smartphones' technology allows for the objective measurement of a person's movements at a fine-grained level of geographic and temporal detail, and in doing so, it mitigates the issues associated with self-report biases and lack of spatial details. This study proposes and evaluates the advantages of using a smartphone app for collecting accurate, fine-grained, and objective data on people's transport-related walking. METHODS A sample of 142 participants (mostly young adults) was recruited in a large Australian university, for whom the app recorded all their travel activities over two weekdays during August-September 2014. We identified eight main activity nodes which operate as transport-related walking generators. We explored the participants' transport-related walking patterns around and between these activity nodes through the use of di-graphs to better understand patterns of incidental physical activity and opportunities for intervention to increase incidental walking. RESULTS We found that the educational node - in other samples may be represented by the workplace - is as important as the residential node for generating walking trips. We also found that the likelihood of transport-related walking trips is larger during the daytime, whereas at night time walking trips tend to be longer. We also showed that patterns of transport-related walking relate to the presence of 'chaining' trips in the afternoon period. CONCLUSIONS The findings of this study show how the proposed data collection and analytic approach can inform urban design to enhance walkability at locations that are likely to generate walking trips. This study's insights can help to shape public education and awareness campaigns that aim to encourage walking trips throughout the day by suggesting locations and times of the day when engaging in these forms of exercise is easiest and least intrusive.
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Affiliation(s)
- Behrang Assemi
- School of Built Environment, Queensland University of Technology (QUT), Gardens Point, 2 George St, Brisbane, QLD, 4000, Australia.
| | - Renee Zahnow
- School of Social Science, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Belen Zapata-Diomedi
- School of Global, Urban & Social Studies, RMIT University, 124 La Trobe Street, Melbourne, VIC, 3000, Australia
| | - Mark Hickman
- School of Civil Engineering, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Jonathan Corcoran
- School of Earth and Environmental Sciences, University of Queensland, St Lucia, QLD, 4072, Australia
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Audrey S, Fisher H, Cooper A, Gaunt D, Metcalfe C, Garfield K, Hollingworth W, Procter S, Gabe-Walters M, Rodgers S, Gillison F, Davis A, Insall P. A workplace-based intervention to increase levels of daily physical activity: the Travel to Work cluster RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background
There may be opportunities for working adults to accumulate recommended physical activity levels (≥ 150 minutes of moderate-intensity physical activity in bouts of ≥ 10 minutes throughout the week) during the commute to work. Systematic reviews of interventions to increase active transport indicate that studies are predominantly of poor quality, rely on self-report and lack robust statistical analyses.
Objectives
To assess the effectiveness, cost and consequences of a behavioural intervention to increase walking during the commute to work.
Design
A multicentre, parallel-arm, cluster randomised controlled trial incorporating economic and process evaluations. Physical activity outcomes were measured using accelerometers and GPS (Global Positioning System) receivers at baseline and the 12-month follow-up.
Setting
Workplaces in seven urban areas in south-west England and south Wales.
Participants
Employees (n = 654) in 87 workplaces.
Interventions
Workplace-based Walk to Work promoters were trained to implement a 10-week intervention incorporating key behaviour change techniques.
Main outcome measures
The primary outcome was the daily number of minutes of moderate to vigorous physical activity (MVPA). Secondary outcomes included MVPA during the commute, overall levels of physical activity and modal shift (from private car to walking). Cost–consequences analysis included employer, employee and health service costs and consequences. Process outcomes included barriers to, and facilitators of, walking during the daily commute.
Results
There was no evidence of an intervention effect on MVPA at the 12-month follow-up [adjusted difference in means 0.3 minutes, 95% confidence interval (CI) –5.3 to 5.9 minutes]. The intervention cost was on average, £181.97 per workplace and £24.19 per participating employee. In comparison with car users [mean 7.3 minutes, standard deviation (SD) 7.6 minutes], walkers (mean 34.3 minutes, SD 18.6 minutes) and public transport users (mean 25.7 minutes, SD 14.0 minutes) accrued substantially higher levels of daily MVPA during the commute. Participants who walked for ≥ 10 minutes during their commute were more likely to have a shorter commute distance (p < 0.001). No access to a car (p < 0.001) and absence of free workplace car parking (p < 0.01) were independently related to walking to work and using public transport. Higher quality-of-life scores were observed for the intervention group in a repeated-measures analysis (mean 0.018, 95% CI 0.000 to 0.036; scores anchored at 0 indicated ‘no capability’ and scores anchored at 1 indicated ‘full capability’).
Conclusions
Although this research showed that walking to work and using public transport are important contributors to physical activity levels in a working population, the behavioural intervention was insufficient to change travel behaviour. Broader contextual factors, such as length of journey, commuting options and availability of car parking, may influence the effectiveness of behavioural interventions to change travel behaviour. Further analyses of statistical and qualitative data could focus on physical activity and travel mode and the wider determinants of workplace travel behaviour.
Trial registration
Current Controlled Trials ISRCTN15009100.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 11. See the NIHR Journals Library website for further project information. Living Streets, a UK charity promoting everyday walking, provided funding for the intervention booklets and free pedometers for distribution to participants in the intervention group.
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Affiliation(s)
- Suzanne Audrey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Harriet Fisher
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ashley Cooper
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Daisy Gaunt
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Chris Metcalfe
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kirsty Garfield
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - William Hollingworth
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sunita Procter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Sarah Rodgers
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Adrian Davis
- Faculty of Business and Law, University of the West of England, Bristol, UK
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