Promoting physical activity in the workplace: A systematic meta-review

Incorporating Lifestyle Medicine Into Occupational Medicine Practice: ACOEM Guidance Statement

ABSTRACT

Lifestyle medicine (LM) utilizes evidence-based therapeutic lifestyle changes to address lifestyle factors that impact health, performance, and injury risk and recovery. By integrating LM principles into clinical care, workplace policies, and programs, along with other evidence-based methods, occupational and environmental medicine clinicians and medical directors can enhance worker health and performance, manage chronic disease, and facilitate faster recovery from injury and illness. This guidance addresses approaches that can be used in the clinic and workplace to address tobacco, substance misuse, nutrition, physical activity, overweight/obesity, sleep, mental well-being, and social connectedness.

Impact of a Self-Autonomous Evaluation Station and Personalized Training Algorithm on Quality of Life and Physical Capacities in Sedentary Adults: Randomized Controlled Trial

BACKGROUND

Physical inactivity is a major risk factor for noncommunicable diseases and a leading cause of premature death. The World Health Organization (WHO) recommends at least 150 minutes of moderate intensity physical activity (PA) weekly, regardless of age, gender, or personal habits. However, in both sports performance and clinical settings, personalized training (PT) regimens have shown superior efficacy over general guidelines.

OBJECTIVE

We hypothesized that an automatic PT program, informed by initial physical evaluations, would increase overall quality of life, quality of sleep, and physical capabilities and reduce fatigue and depression compared with adherence to WHO recommendations.

METHODS

This 5-month, randomized, single-blinded controlled trial involved 112 sedentary or minimally active participants, divided randomly into PT and free training (FT) groups. Physical capabilities and subjective measures such as quality of life, sleep, depression, and fatigue were evaluated for both groups. After 1 month, both groups were asked to perform 150 minutes of PA per week for 4 months; the PT group could either follow a "virtual coach" on a mobile app to follow some personalized PA or do what they would like, while the FT group was to follow the general PA recommendations of the WHO.

RESULTS

We did not find any group×time interaction for PA duration or intensity, physical qualities, and subjective measures. However, considering both groups together, there was a significant pretest and posttest time effect for duration of PA (18.2 vs 24.5 min/d of PA; P<.001), intensity (2.36 vs 3.11; P<.001), and workload (46.8 vs 80.5; P<.001). Almost all physical qualities were increased pretest and posttest (ie, estimated VO2max 26.8 vs 29 mL min-1 kg-1; P<.001; flexibility 25.9 vs 26.9 cm; P=.049; lower limb isometric forces 328 vs 347 N m; P=.002; reaction time 0.680 vs 0.633 s; P<.001; power output on cyclo-ergometer 7.63 vs 7.82 W; P<.003; and balance for the left and right leg 215 vs 163 mm2; P<.003 and 186 vs 162 mm2; P=.048, respectively). Finally, still considering the PT and FT groups together, there were significant pretest to posttest improvements in the mental component of quality of life using the 12-item Short Form Health Survey (41.9 vs 46.0; P<.006), well-being using the Warwick-Edinburgh Mental Well-Being Scale (48.3 vs 51.7; P<.002), depression using the Center for Epidemiologic Studies Depression Scale (15.5 vs 11.5; P=.02), and fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (37.1 vs 39.5; P=.048).

CONCLUSIONS

The individualized training was not more effective than the general recommendations. A slight increase in PA (from 18 to 24 min/d) in sedentary or poorly active people is enough for a significant increase in physical capabilities and a significant improvement in quality of life, well-being, depression, and fatigue.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04998266; https://clinicaltrials.gov/study/NCT04998266.

Effectiveness of a multicomponent intervention to promote physical activity among Japanese remote workers: a pilot open-label randomized controlled trial

OBJECTIVES

Remote work (ie, teleworking) may adversely affect physical activity (PA) among workers, but no strategies have been effectively implemented to address this issue. We aimed to test whether a multicomponent intervention program could promote the PA of remote workers.

METHODS

This study was an 8-week pilot open-label randomized controlled trial. Fifty-one participants (19 women) aged 23-58 years were recruited via an information technology company in Tokyo, Japan, and randomly assigned to the control (n = 26) or intervention (n = 25) group. The intervention group was provided a multicomponent intervention that comprised individual (lecture, print material, goal setting, feedback, and posters), sociocultural (supportive atmosphere and team building), and organizational (encouraging message from an executive) strategies. The control group only received posters. The primary outcome was an 8-week change in objectively measured moderate-to-vigorous PA (MVPA). The secondary outcomes were changes in light PA, moderate PA, vigorous PA, steps, and sedentary time. We also conducted subdomain analyses divided into working and nonworking days.

RESULTS

No significant difference was observed in MVPA changes between the 2 groups. However, the intervention group showed significant improvement in light PA by +14.0 min/d (95% CI, 1.7-26.2). Subdomain analyses also showed no significant differences in MVPA changes between the 2 groups. However, MVPA in the intervention group significantly increased by +9.4 min/d (95% CI, 2.5-16.2) on working days.

CONCLUSIONS

The present multicomponent intervention was feasible for remote workers, although some revisions are necessary to enhance the effect size.

Evaluation of an organisational-level monetary incentive to promote the health and wellbeing of workers in small and medium-sized enterprises: A mixed-methods cluster randomised controlled trial

We conducted an independent evaluation on the effectiveness of an organisational-level monetary incentive to encourage small and medium-sized enterprises (SMEs) to improve employees' health and wellbeing. This was A mixed-methods cluster randomised trial with four arms: high monetary incentive, low monetary incentive, and two no monetary incentive controls (with or without baseline measurements to examine 'reactivity' The consequence of particpant awareness of being studied, and potential impact on participant behavior effects). SMEs with 10-250 staff based in West Midlands, England were eligible. We randomly selected up to 15 employees at baseline and 11 months post-intervention. We elicited employee perceptions of employers' actions to improve health and wellbeing; and employees' self-reported health behaviours and wellbeing. We also interviewed employers and obtained qualitative data. One hundred and fifty-two SMEs were recruited. Baseline assessments were conducted in 85 SMEs in three arms, and endline assessments in 100 SMEs across all four arms. The percentage of employees perceiving "positive action" by their employer increased after intervention (5 percentage points, pp [95% Credible Interval -3, 21] and 3pp [-9, 17], in models for high and low incentive groups). Across six secondary questions about specific issues the results were strongly and consistently positive, especially for the high incentive. This was consistent with qualitative data and quantitative employer interviews. However, there was no evidence of any impact on employee health behaviour or wellbeing outcomes, nor evidence of 'reactivity'. An organisational intervention (a monetary incentive) changed employee perceptions of employer behaviour but did not translate into changes in employees' self-reports of their own health behaviours or wellbeing. Trial registration: AEARCTR-0003420, registration date: 17.10.2018, retrospectively registered (delays in contracts and identfying a suitable trial registry). The authors confirm that there are no ongoing and related trials for this intervention.

A scoping review of sleep education and training for nurses

BACKGROUND

Shift work and resulting sleep impairment among nurses can increase their risk for poor health outcomes, occupational injuries, and errors due to sleep deficiencies. While sleep education and training for nurses has been recommended as part of a larger fatigue risk management system, little is known about training programs designed specifically for nurses.

OBJECTIVE

Investigate the literature for current sleep education or training programs specifically for shift working nurses, with intent to assess training content, delivery characteristics, and outcome measures.

DESIGN

A scoping review conducted October 2020 through September 2021.

METHODS

The bibliographic databases Cumulative Index of Nursing and Allied Health (CINAHL), Scopus, PubMed, and NIOSHTIC-2 were searched using words such as "nurse," "sleep hygiene," "shift work," and "education". Studies were included if they: 1) were original research; 2) discussed sleep education, training, or sleep hygiene interventions; 3) included a study population of nurses engaging in shift work; 4) focused on sleep as a primary study measure; 5) were written in English language; and 6) were published in 2000 or later.

RESULTS

Search results included 17,237 articles. After duplicates were removed, 14,620 articles were screened. Nine articles were found to meet established criteria. All studies included sleep hygiene content in the training programs, with five studies adding psychological and/or behavior change motivation training to support change in nurse sleep habits. Three studies added specific training for nurses and for managers. Delivery modes included in-person training of various lengths and frequency, mobile phone application with daily engagement, an online self-guided presentation, and daily reading material coupled with audio training. Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were the outcome measures most frequently used. Although studies demonstrated improved sleep measures, most were pilot studies testing feasibility.

CONCLUSION

Although there is a paucity of studies focused on sleep education and training for shift working nurses, we found the inclusion of sleep hygiene content was the only common characteristic of all nine studies. The variability in training content, delivery methods, and outcome measures suggests further research is needed on what constitutes effective sleep education and training for nurses.

Effectiveness of worksite wellness programs based on physical activity to improve workers' health and productivity: a systematic review

BACKGROUND

Although the scientific literature has previously described the impact of worksite programs based on physical activity (WPPAs) on employees' productivity and health in different contexts, the effect of these programs has not been analyzed based on the characteristics or modalities of physical activity (PA) performed (e.g., aerobic exercise, strength training, flexibility). In addition, studies on WPPAs usually report health and productivity outcomes separately, not integrated into a single study. Knowing the health and economic-related impacts of a WPPAs could provide useful information for stakeholders and policy development.

OBJECTIVE

The purpose of this review was as follows: (1) to analyze the effect of different modalities of WPPAs on employees' productivity and health and (2) to investigate the economic impact of WPPAs.

METHODS

This systematic review is registered in PROSPERO (CRD42021230626) and complies with PRISMA guidelines. Only randomized controlled trials from 1997 to March 2021 were included. Two reviewers independently screened abstracts and full texts for study eligibility, extracted the data, and performed a quality assessment using the Cochrane Collaboration Risk-of-Bias Tool for randomized trials. Population, instruments, comparison, and outcome (PICO) elements were used to define eligibility criteria. Eight-hundred sixty relevant studies were found through electronic searches in PubMed, Web of Science, Medline, Scopus, and SPORTDiscus databases. Once the eligibility criteria were applied, a total of 16 papers were included.

RESULTS

Workability was the productivity variable most positively impacted by WPPAs. Cardiorespiratory fitness, muscle strength, and musculoskeletal symptoms health variables improved in all the studies included. It was not possible to fully examine the effectiveness of each exercise modality because of the heterogeneity in methodology, duration, and working population. Finally, cost-effectiveness could not be analyzed because this information was not reported in most studies.

CONCLUSION

All types of WPPAs analyzed improved workers' productivity and health. However, the heterogeneity of WPPAs does not allow to identify which modality is more effective.

Socioecological Factors Associated With Physical Activity and Sedentary Behavior Among Workers: Using the PRECEDE-PROCEED Model

BACKGROUND

Physical inactivity is a major global health problem. Industrial automation has led to an increased number of workers who are sedentary at work. We examined whether three socioecological factors (i.e., predisposing, reinforcing, and enabling factors) derived from the PRECEDE-PROCEED model would be significantly associated with the physical activity and sedentary behavior among workers.

METHODS

A cross-sectional study was conducted among 539 employees at an electronic manufacturing plant in Gumi, South Korea. Physical activity variables of energy expenditure (MET-min/week) and sitting time at work (minutes/day) were measured by the International Physical Activity Questionnaire and the Workforce Sitting Questionnaire, respectively. Of the socioecological factors, a predisposing factor defined as self-determined motivation was measured by the Exercise Self-Regulation Questionnaire; a reinforcing factor defined as autonomy support was measured by the Work Climate Questionnaire; and an enabling factor defined as supportive workplace environment was measured by the Perceived Workplace Environment Scale.

FINDINGS

Self-determined motivation (i.e., autonomous and controlled forms of motivation), autonomy support, and a supportive workplace environment were all significantly associated with increased physical activity energy expenditure during leisure-time. However, they were not significantly associated with sitting time on working and non-working days.

CONCLUSION/APPLICATIONS TO PRACTICE

Three socioecological factors of the PRECEDE-PROCEED model were significantly associated with leisure-time physical activity among workers. Our findings may help occupational health nurses use a socioecological approach for designing effective workplace strategies to increase leisure-time physical activity among workers.

Multi-Component Intervention to Promote Physical Activity in Japanese Office Workers: A Single-Arm Feasibility Study

This study investigated the feasibility of a multi-component intervention to promote physical activity (PA) among Japanese office workers. It was an 8-week single-arm trial conducted in Japan in 2021, in which 76 employees aged 20 or older, from an insurance company, participated. They received a multi-component PA intervention that comprised individual (lecture, print material, goal setting, and feedback), socio-cultural (team building and supportive atmosphere), physical (poster), and organizational (encouraging message from an executive) strategies. The primary outcome was change in objectively measured moderate-to-vigorous PA (MVPA). A paired t-test was used to compare the changes between weeks 0 and 8. We also conducted a subdomain analysis of PA divided into four domains (working, non-working, commuting working, and remote working). Excluding 26 participants who could not complete valid assessments, the MVPA among participants (n = 50, age 49.6 ± 9.7) significantly increased by +7.3 min/day [95% confidence interval (CI) 0.8 to 13.8]. We also identified significant changes in MVPA by +10.0 min/day [95% CI, 3.7 to 16.3] in working days (n = 40), and by +7.1 min/day [95% CI, 0.4 to 13.7] in remote working days (n = 34). We demonstrated that multi-component PA interventions might improve MVPA among Japanese office workers.

Prevalence and risk factors associated with poor sleep among firefighters in Taiwan: An observational study

Sleep quality is directly correlated with overall health and quality of life. Firefighters have a higher workload and injury rate than those in other occupations. This study investigated the prevalence of and risk factors for poor sleep quality among firefighters in Taiwan. This cross-sectional study was conducted between November 2019 and August 2020. Sociodemographic information of the study participants was collected using a structured self-administered questionnaire. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the subjective sleep quantity and quality of firefighters during the previous month. A t test for continuous variables and χ2 test for categorical variables were performed for univariate analysis. Logistic regression analysis was conducted for multivariate analysis. Eight hundred eighty-nine firefighters completed the questionnaire during the study period, with a response rate of 88.9%. Among them, 447 (50.3%) reported poor sleep quality. Logistic regression analysis showed that female sex, longer work duration (>5 years) for firefighters, on-call shift work, and no leisure-time physical activity (LTPA) was significantly correlated with an increased risk of poor sleep quality. Advanced analysis of partaking in LTPA revealed that high-intensity LTPA is significantly associated with higher rates of poor sleep quality. In contrast, adequate rest after LTPA correlated with lower rates of poor sleep quality. Firefighters are at higher risk of poor sleep quality. Emphasis should be placed on firefighters' regular LTPA, particularly when experiencing sleep problems.

Physical activity from young adulthood to middle age and premature cardiovascular disease events: a 30-year population-based cohort study

Background

Although physical activity is generally protective of cardiovascular disease (CVD), less is known about how young adult physical activity relates to premature CVD events. The objective of this study was to determine the association between level and change in physical activity from young adulthood to middle age and incidence of premature CVD events before age 60.

Methods

We analyzed data collected across four urban sites from nine visits over 30 years of follow-up (1985–2016) from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective community-based cohort study of 5115 Black and White women and men aged 18–30 years at baseline (1985–1986). Linear mixed models were used to develop individualized moderate-to-vigorous intensity self-reported physical activity trajectories per participant. Fatal and nonfatal coronary heart disease (CHD), heart failure, and stroke outcomes were analyzed separately and as a combined CVD event outcome.

Results

Overall, physical activity declined in young adults as they progressed through middle age. Lower physical activity scores (per 100 exercise units) in 18 year-olds were associated with higher odds of premature CHD (AOR 1.14, 95% CI 1.02–1.28), heart failure (AOR 1.21, 95% CI 1.05–1.38), stroke (AOR 1.20, 95% CI 1.04–1.39), and any CVD (AOR 1.15, 95% CI 1.06–1.24) events. Each additional annual 1-unit reduction in the physical activity score was associated with a higher annual odds of incident heart failure (1.07, 95% CI 1.02–1.13), stroke (1.06, 95% CI 1.00–1.13), and CVD (1.04, 95% CI 1.01–1.07) events. Meeting the minimum (AOR 0.74, 95% CI 0.0.57–0.96) and twice the minimum (AOR 0.55, 95% CI 0.34–0.91) Department of Health and Human Services physical activity guidelines through follow up was protective of premature CVD events.

Conclusions

Given recent trends in declining physical activity with age and associated premature CVD events, the transition from young adult to midlife is an important time period to promote physical activity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01357-2.

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.

Workplace physical activity practices in real life: a scoping review of grey literature for small- and medium-sized enterprises

Background

There is a need to scale-up effective physical activity (PA) programmes for small- and medium-sized enterprises (SMEs), where the uptake of PA interventions is low. Identifying real-life workplace practices in PA could contribute to a better understanding of what PA programmes might be most grounded in the ‘real world’. However, there is a scarcity of evidence showing what gets done. This study aimed to identify, describe and comprehensively summarize the real-life implementations of workplace PA initiatives, particularly in Europe, as a prior step to disseminating future feasible PA practices for SMEs.

Methods

A scoping review of grey literature included a systematic search in the Google advanced search platform that permuted a combination of key concepts (PA, workplace, interventions/programmes), internet domains, and search operators in six different languages (Catalan, Finnish, French, Dutch, English and Spanish) between 2015 and November 2020. The analysis process was iterative, and multiple methods were used to sort, group and categorize the initiatives.

Results

There were a total of 713 real-life workplace PA initiatives from different-sized organizations identified. These were categorized into five themes: active work and living, exercise and fitness programs, management and leadership, communication and dissemination, and facilities. Finally, feature trees showing a menu for real-life workplace PA practices were implemented.

Conclusions

Identifying real-life practice providing a state-of-the-art snapshot of current PA practices in workplaces, which is a starting point to better understand feasible practices in the context of small- and medium-sized workplaces.

Proposal of a Comprehensive and Multi-Component Approach to Promote Physical Activity among Japanese Office Workers: A Qualitative Focus Group Interview Study

Office workers spend up to two-thirds of their working hours sitting and are less physically active than other occupational groups. It is necessary to develop an effective approach to promote physical activity among office workers. We conducted a focus group interview with seven Japanese office workers to investigate the current status (topic 1) of, and their opinions on (topic 2), physical activity promotion programs in their workplace. Data were analyzed using qualitative data analysis. We classified the data from topic 1 into individual, socio-cultural, physical, and organizational environments. Most participants indicated that they spent a lot of time sitting and needed programs for a wide range of corresponding employee demands. We classified the data from topic 2 into capability, opportunity, and motivation. Most participants indicated that they wanted evidence-based information, a standing desk, and a conducive workplace environment to enhance physical activity. Thus, we proposed a comprehensive and multi-component approach comprising individual (information delivery), socio-cultural environment (team building, supportive atmosphere), physical environment (standing desk, use of poster), and organizational (incentive, encouraging message from an executive, workplace policy) strategies. Future studies should evaluate the effectiveness of this proposal.

Nudges used to promote physical activity and to reduce sedentary behaviour in the workplace: Results of a scoping review

Physical inactivity is one of the most important risk factors for non-communicable diseases. Workplace health promotion is therefore of growing interest to support an active day using nudges. The scoping review aims to (a) analyse how frequently nudges are applied in workplace health promotion to increase physical activity and/or reduce sedentary behaviour, and (b) characterise the nudges used. A systematic database search was conducted for the period 2009 to June 2020. According to predefined inclusion and exclusion criteria, studies promoting physical activity and/or reducing sedentary behaviour using nudges were included. Nudges were classified according to MINDSPACE and TIPPME. A study protocol was previously published. Of the 256 studies identified, 26 used nudges. Most studies were conducted in Europe (n = 12) and the USA (n = 8). N = 18 studies targeted physical activity and n = 8 studies targeted sedentary behaviour. In most studies promoting physical activity, prompts were given to climb stairs (n = 11). Interventions targeting sedentary behaviour were more diverse, using digital interventions or mixed approaches (n = 8). Although nudges can help increase physical activity and reduce sedentary behaviour, there are still gaps in terms of their effective and efficient use. There is a lack of long-term studies that analyse habituation and behavioural changes beyond the intervention period. In addition, the potential of digital and mixed approaches is not yet fully exploited. Further studies from low- and middle-income countries with different climates and working conditions are needed to investigate the feasibility of approaches and advance the fight against physical inactivity.

The Role of Physical Activity-Related Health Competence and Leisure-Time Physical Activity for Physical Health and Metabolic Syndrome: A Structural Equation Modeling Approach for German Office Workers

Office workers (OWs) are prone to insufficient physical activity (PA), which increases their risk of metabolic syndrome (MetS) and impaired physical health. The Physical Activity-related Health Competence (PAHCO) model holds the potential to facilitate a healthy physically active lifestyle. Therefore, in this study, we investigate the interplay between PAHCO, leisure-time PA, physical health, and MetS in OWs in Germany. In a cross-sectional study, OWs (N = 316, 25% female) completed self-report questionnaires along with an occupational health checkup to examine their Metabolic Syndrome Severity Score (MetSSS) values. Structural equation modeling indicated a strong positive association between PAHCO and leisure-time PA and a small positive association with physical health. PAHCO showed a considerable negative association with the MetSSS. Leisure-time PA was a positive mediator for the PAHCO-physical health association but was not a significant mediator for the association between PAHCO and the MetSSS. These findings underscore the importance of PAHCO in the context of leisure-time PA, physical health, and MetS in OWs. Furthermore, our findings highlight the health-enhancing value of the qualitative aspects of PA, such as motivational and volitional components in PA participation, with respect to physical health and MetS.

Still striding toward social justice? Redirecting physical activity research in a post-COVID-19 world

The COVID-19 crisis and parallel Black Lives Matter movement have amplified longstanding systemic injustices among people of color (POC). POC have been differentially affected by COVID-19, reflecting the disproportionate burden of ongoing chronic health challenges associated with socioeconomic inequalities and unhealthy behaviors, including a lack of physical activity. Clear and well-established benefits link daily physical activity to health and well-being—physical, mental, and existential. Despite these benefits, POC face additional barriers to participation. Thus, increasing physical activity among POC requires additional considerations so that POC can receive the same opportunities to safely participate in physical activity as Americans who are White. Framed within the Ecologic Model of Physical Activity, this commentary briefly describes health disparities in COVID-19, physical activity, and chronic disease experienced by POC; outlines underlying putative mechanisms that connect these disparities; and offers potential solutions to reduce these disparities. As behavioral medicine leaders, we advocate that solutions must redirect the focus of behavioral research toward community-informed and systems solutions.

"The Ripple Effect": The influence of social support on participation in a small workplace health promotion program

ISSUE ADDRESSED

Workplaces are key settings for health promotion. There is limited evidence pertaining to workplace health promotion [WHP] in Australian small and medium enterprises [SMEs], particularly in regional areas. This qualitative study explored employee perceptions of a pilot workplace health promotion program, LifeMAP, conducted in a small health service enterprise in regional Victoria 2014-2017, including facilitators of participation and perceived benefits of participation.

METHOD

Ten LifeMAP participants were recruited using convenience sampling. Individual semi-structured interviews (n = 7) and one focus group (n = 3) were conducted between August and September 2017. Data were analysed inductively and thematically to elicit emergent themes.

RESULTS

Social support emerged as the overarching theme influencing participation in LifeMAP, and a perceived benefit of participation. Using FitBits® and setting exercise challenges enabled social support to be fostered through role modelling, staff collegiality and community. There may be gendered differences in the experiences of role modelling in WHP.

CONCLUSIONS

This SME, and others like it, often feature high levels of employee social connectedness, with a strong workplace and community networks. Social support is a critical influence in social connectedness which needs to be considered and incorporated into the design, implementation and evaluation of WHP programs as a means of overcoming WHP recruitment and participation challenges in regional SMEs. SO WHAT?: The identification of social support as a key factor for WHP participation and employee satisfaction is a valuable finding providing insight into how similar programs may be better designed and implemented to enhance WHP program recruitment and retention.

Physical Activity and Hypertension From Young Adulthood to Middle Age

INTRODUCTION

The optimum physical activity dose to achieve during young adulthood to prevent hypertension using the 2017 American College of Cardiology/American Heart Association guidelines remains undefined. This study aims to determine the association between level and change in physical activity through the adult life course and the onset of hypertension using these 2017 definitions.

METHODS

In 2020, prospective community-based cohort data of 5,115 Coronary Artery Risk Development in Young Adults study participants were analyzed. The cohort included Black and White men and women aged 18-30 years at baseline (1985-1986) at 4 urban sites, collected through 30 years of follow-up (2015-2016). Individualized physical activity trajectories were developed for each participant using linear mixed models.

RESULTS

Black women reported the lowest physical activity levels from young adulthood through middle age. Lower physical activity score (per 100 units) at age 18 years was associated with 4% (95% CI=1%, 7%, p=0.002) higher odds of hypertension incidence. Each additional 1-unit reduction per year in physical activity score was associated with 2% (95% CI=1%, 3%, p=0.001) higher annual odds of hypertension incidence. Meeting approximately the current minimum physical activity guideline levels at age 18 years and through follow-up was not protective of hypertension incidence; however, meeting approximately twice the current minimum physical activity guideline level at age 18 years and through follow-up was protective of hypertension incidence.

CONCLUSIONS

Moderate physical activity levels may need to exceed current minimum guidelines to prevent hypertension onset using 2017 American College of Cardiology/American Heart Association definitions.

The promotion of injury and illness prevention and reporting in the fire service

BACKGROUND

Injury prevention interventions are limited in the fire service due to a lack of widespread implementation and underreporting. This creates a significant challenge to improving occupational health.

OBJECTIVE

To determine how fire chiefs are promoting reporting and the prevention of physical and mental injuries and illnesses.

METHODS

We used an open-ended, qualitative instrument to assess the presence of prevention programs and actions to promote injury and illness reporting in the fire service. The instrument contained six content validated items related to the promotion of prevention interventions and reporting.

RESULTS

A total of 54 fire chiefs (age = 51±8y; females = 4, males = 50, years of experience as fire chief = 7±6y) responded to the instrument. A majority (n = 37/54, 68.5%) of the fire chiefs indicated their department had an established health and wellness program. Most fire chiefs reported using established guidelines, education, and a supportive culture to promote prevention and reporting. The cultural stigma of being a firefighter and fear of repercussions were barriers to the promotion of reporting of illness and injury. Fire chiefs stated that they struggled to find ways to effectively promote reporting and prevention strategies.

CONCLUSIONS

The success of a fire chief's promotional efforts was greater in instances where multiple factors were addressed.

Men's Physical Activity and Sleep Following a Workplace Health Intervention: Findings from the POWERPLAY STEP Up challenge

The workplace provides an important delivery point for health promotion, yet many programs fail to engage men. A gender-sensitive 8-week team challenge-based intervention targeting increased physical activity was delivered at a petrochemical worksite. The purpose of this study was to examine men's pre-post physical activity and sleep following the intervention, as well as to explore program acceptability and gather men's recommendations for health promotion. Pre-post surveys assessed physical activity, sleep, program exposure, acceptability, and suggestions for continued support. Overall, 328 men completed baseline surveys and 186 (57%) completed follow-up surveys. Walking increased by 156.5 min/week, 95% confidence interval (61.2, 251.8), p = .001. Men with higher program exposure increased moderate and vigorous activity 49.4 min more than those with low exposure (p = .026). Sleep duration and quality were higher postintervention, though changes were modest. Program acceptability was high as was intention to maintain physical activity. Men's suggestions to enable physical activity involved workplace practices/resources, reducing workload, and leadership support. These findings suggest that a gender-sensitive physical activity workplace intervention showed promise for improving physical activity and sleep among men. The men's suggestions reflected workplace health promotion strategies, reinforcing the need for employers to support ongoing health promotion efforts.

"Occupational sitting kills; but who cares?": Quantitative analysis of barriers and facilitators of sedentary behavior in Indian white-collar workers

The knowledge, attitude and practices of employees and employers toward reducing sedentary behavior (SB) and improving physical activity (PA) at Indian workplaces remain unclear. A bespoke questionnaire assessing barriers and facilitators of occupational SB and PA practices as informed by the theoretical framework and behavioral change wheel model was adapted. Two hundred and three white-collar workers (both employees and managers) from eight corporate sectors were inquired about the SB, and PA practices at workplaces. The dichotomous variables of barriers and facilitators were analyzed by nonparametric tests. Excessive sitters had good knowledge (>75%), good attitude (>85%) but poor workplace SB and PA practice (>90%). Workplace SB, or PA practices differed between employers and employees. Low practice of workplace PA or SB interventions may be due to lack of workplace policies for SB interventions.

Using nudges to promote physical activity and to reduce sedentary behaviour in the workplace: a scoping review protocol

INTRODUCTION

Physical inactivity and sedentary behaviour are associated with numerous health problems and increasing risks of premature morbidity and mortality. Workplace health promotion with a focus on increasing physical activity (PA) and reducing sedentary behaviour is of growing interest. The concept of choice architecture with the use of nudges is a promising approach to influence decision making regarding health behaviours. It can help to understand why people often fail to act in their best interest, to follow well-informed preferences or to achieve their set goals. Nudges, the way the choice is presented, can help to overcome these challenges by using the same habits, biases or boundaries to alter our decision-making in favour of the more preferred behaviour. Aims of the scoping review will be to analyse (a) to what extent the concept of choice architecture is used in workplace health promotion to promote PA and/or to reduce sedentary behaviour and (b) which instruments (nudges) are used to archive that.

METHODS AND ANALYSES

Medline, PsychInfo, Web of Science and CINHAL will be searched from 2009 until June 2020. Applying a two-level screening process, title and abstracts will be screened according to a set of predetermined inclusion and exclusion criteria. Included articles will be screened a second time to determine the extent to which choice architecture has been used. Analyses for publication year, location, setting and target group will be provided. Interventions will be analysed presenting the instruments used, number of studies per instrument, combinations of instruments and alteration of the environment. Outcome measures and results will be reported as they occur.

ETHICS AND DISSEMINATION

Due to the nature of the scoping review, ethical concerns are minimal. No patient data will be included. Results are published in peer-review journals.

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.

WHIRL Study: Workplace Health Interprofessional Learning in the Construction Industry

Interprofessional learning (IPL) is essential to prepare healthcare trainees as the future public health workforce. WHIRL (Workplace Health InteRprofessional Learning) was an innovative IPL intervention that engaged volunteer healthcare trainees (n = 20) in multi-professional teams to deliver health checks (n = 464), including tailored advice and signposting, to employees in the UK construction industry (across 21 events, 16 sites, 10 organisations) as part of an ongoing research programme called Test@Work. Volunteers undertook a four-part training and support package of trainer-led education, observations of practice, self-directed learning and clinical supervision, together with peer mentoring. In a one-group post-test only design, IPL outcomes were measured using the Inventory of Reflective Vignette-Interprofessional Learning (IRV-IPL), and the psychometric properties of the IRV-IPL tool were tested. WHIRL demonstrably improved healthcare trainees' interprofessional skills in all five areas of collaboration, coordination, cooperation, communication, and commendation. The IRV-IPL tool was found to be a valid and reliable measure of interprofessional competencies across three scenarios; before and after health promotion activities, and as a predictor of future health promotion competence. This industry-based workplace IPL programme resulted in the attainment of health check competencies and bridged the gap between research, education and clinical practice.

Motivation Predicts Change in Nurses' Physical Activity Levels During a Web-Based Worksite Intervention: Results From a Randomized Trial

Background

Low physical activity levels can negatively affect the health of nurses. Given the low physical activity levels reported by nurses, there is a clear need for brief and economical interventions designed to increase physical activity levels in this population. We developed a web-based intervention that used motivational strategies to increase nurses’ physical activity levels. The intervention provided the nurses with feedback from an activity monitor coupled with a web-based individual, friend, or team physical activity challenge.

Objective

In this parallel-group randomized trial, we examine whether nurses’ motivation at baseline predicted changes in objectively measured physical activity levels during the 6-week intervention.

Methods

The participants were 76 nurses (n=74, 97% female; mean age 46, SD 11 years) randomly assigned to 1 of 3 physical activity challenge conditions: (1) individual, (2) friend, or (3) team. The nurses completed a web-based questionnaire designed to assess motivational regulations for physical activity levels before the intervention and wore a Tractivity activity monitor before and during the 6-week intervention. We analyzed data using multilevel modeling for repeated measures.

Results

The nurses’ physical activity levels increased (linear estimate=10.30, SE 3.15; P=.001), but the rate of change decreased over time (quadratic estimate=−2.06, SE 0.52; P<.001). External and identified regulations (ß=−2.08 to 11.55; P=.02 to .04), but not intrinsic and introjected regulations (ß=−.91 to 6.29; P=.06 to .36), predicted changes in the nurses’ physical activity levels.

Conclusions

Our findings provide evidence that an intervention that incorporates self-monitoring and physical activity challenges can be generally effective in increasing nurses’ physical activity levels in the short term. They also suggest that drawing solely on organismic integration theory to predict changes in physical activity levels among the nurses participating in web-based worksite interventions may have been insufficient. Future research should examine additional personal (eg, self-efficacy) and occupational factors (eg, shift length and shift type) that influence physical activity levels to identify potential targets for intervention among nurses.

Trial Registration

ClinicalTrials.gov NCT04524572; https://clinicaltrials.gov/ct2/show/NCT04524572

Effects of Occupational and Leisure-Time Physical Activities on Insomnia in Korean Firefighters

Studies have been conducted on the association between physical activity (PA) and sleep, but to the best of our knowledge, a simultaneous analysis of the effects of occupational PA (OPA) and leisure time PA (LTPA) on South Korean firefighters’ sleep has never been conducted. This study aims to analyze how OPA and LTPA affect these individuals’ risk of suffering from insomnia with-in this specific population of subjects. The study includes data from an online self-report survey in which 9788 South Korean firefighters participated. The survey used the Insomnia Severity Index and the OPA- and LTPA-related characteristics were investigated. The independent two-sample t-test, χ² test, and multiple logistic regression analysis were performed. Subgroup logistic regression analyses were also completed in accordance with the OPA level. Among 9788 participants, 890 (9.1%) suffered from insomnia. A logistic regression analysis revealed that higher levels of feeling of job loading (FoJL), rising levels of physical strength utilization rate (PSUR), greater frequency levels of occupational activities, and high-intensity LTPA were significantly correlated with an increased risk of insomnia, while execution of LTPA and getting enough rest after LTPA was correlated with a decreased risk. However, the subgroup analysis showed that high-intensity LTPA was correlated with a significantly increased the risk in the group with high OPA, but this did not apply to the group with low OPA. Although the risk of suffering from insomnia was overall significantly higher in the high OPA group, the risk was significantly lower in groups getting enough rest after partaking in LTPA, regardless of the OPA level. Thus, the intensity of exercise programs pre-scribed to groups with high OPA and individuals with higher risks of suffering from insomnia, such as firefighters, police officers, and soldiers, should be considered.

Developing healthy cities with urban facility management

Purpose

Most people live in cities and work in offices, two contexts offering many lifestyle-related and environmental health risks. To advance their health, this paper aims to introduce an analogy between urban design and facility design to explore whether health-directed design interventions in cities and facilities are related and to look for applicable cross-overs and opportunities to develop the facility management (FM) profession on the urban level.

Design/methodology/approach

The principles of abductive reasoning as a first phase of scientific investigation were followed, by introducing a new idea and attentively observing phenomena in the communities of FM and urban design. The method was desk research, in the context of discovery.

Findings

Many possible cross-overs exist which offer opportunities for urban planners and facility managers to reinforce each other and interesting market opportunities for the further development of urban FM. However, more systematic research is needed on efficacious and effective interventions. Furthermore, experiences and capacities of the FM sector should be unlocked and applied within a city context, as the knowledge and experiences of facility managers and urban planners can create synergy.

Practical implications

The findings are directly applicable to facility and urban design practices and to FM education by involving students in city design practices.

Originality/value

Cross-overs between facilities and cities are new and can inspire both facility managers and urban planners to work together more closely for the benefit of citizens and employees.

Workers' Healthcare Assistance Model (WHAM): Development, Validation, and Assessment of Sustainable Return on Investment (S-ROI)

The present study aimed to present and validate the Worker´s Healthcare Assistance Model (WHAM), which includes an interdisciplinary approach to health risk management in search of integral and integrated health, considering economic sustainability. Through the integration of distinct methodological strategies, WHAM was developed in the period from 2011 to 2018, in a workers' occupational health centre in the oil industry in Bahia, Brazil. The study included a sample of 965 workers, 91.7% of which were men, with a mean age of 44.9 years (age ranged from 23 to 73 years). The Kendall rank correlation coefficient and hierarchical multiple regression analysis were used for the validation of WHAM. The assessment of sustainable return on investment (S-ROI) was made using the WELLCAST ROI™ decision support tool, covering workers with heart disease and diabetes. WHAM can be considered an innovative healthcare model, as there is no available comparative model. WHAM is considered robust, with 86% health risk explanatory capacity and with an 85.5% S-ROI. It can be concluded that WHAM is a model capable of enhancing the level of workers' health in companies, reducing costs for employers and improving the quality of life within the organization.

Effects of a Workplace-Based Virtual-Run Intervention Among University Employees

Virtual runs (real running or walking activities using online recording platforms) have been popular in the digital age and could have the potential to promote physical activity (PA) in workplaces. We investigated the effects of a virtual-run intervention (VRI) on PA and body compositions among university employees. A three-phase intervention was conducted over 6 months: 0 (pre-intervention), 1 (during intervention), and 2 (post-intervention). Exercise stages of change were assessed in phases 0 and 2. Body compositions (body weight, body mass index, fat mass, percentage of fat mass, fat-free mass, and percentage of fat-free mass) were assessed in phases 0, 1, and 2. Running and walking times were recorded through a mobile application. Forty-seven participants completed the VRI. The number of participants at the maintenance stage increased from 34.04% in phase 0 (n = 16) to 63.83% in phase 2 (n = 30). None of the changes in body compositions were significant (p > 0.05). The median running and walking time among participants at the maintenance stage was 151.85 (interquartile range, 109.15) min/week. Future research should focus on approaches to improve the efficacy of VRIs and their effects on health outcomes.

Health-Related Physical Fitness Benefits in Sedentary Women Employees after an Exercise Intervention with Zumba Fitness®

Background: The protective properties of high physical fitness levels on health are manifest independently of age, sex, fatness, smoking, alcohol consumption, and other clinical factors. However, women are less active than men, which contributes to low physical fitness and a high risk of CVD. Thus, the objective of this study is to analyze the effect of two exercise interventions on health-related physical fitness in sedentary employed females. Methods: A total of 98 physically inactive adult women were randomly assigned to 3 study groups: the control group (CG) = 31, the endurance training group based on Zumba Fitness^® classes (ET; n = 39), and the concurrent training group that had an extra muscle-strengthening workout after the Zumba Fitness^® class (CnT; n = 28). Body composition (BMI, waist circumference), motor fitness (one-leg stand test), musculoskeletal fitness (shoulder–neck mobility, handgrip strength test, jump and reach test, and dynamic sit-up test), and cardiorespiratory fitness (2-km test and estimated VO₂ max) were assessed with the ALPHA-Fit test battery for adults. Results: Both interventions showed a significant improvement in the majority of health-related fitness and body composition variables/test (waist circumference: ET = −2.275 ± 0.95, p = 0.02, CnT = −2.550 ± 1.13, p = 0.03; one-stand leg test: ET = 13.532 ± 2.65, p < 0.001; CnT = 11.656 ± 2.88, p < 0.001; shoulder–neck mobility: ET = 1.757 ± 0.44, p < 0.001, CnT = 2.123 ± 0.47, p < 0.001; handgrip test: 0.274 ± 0.08, p < 0.001, CnT = 0.352 ± 0.08, p < 0.001; dynamic sit-up: ET = 1.769 ± 0.45, p < 0.001, CnT = −1.836 ± 0.49, p < 0.001; 2-km test time: −1.280 ± 0.25, p < 0.001, CnT = −1.808 ± 0.28, p < 0.001; estimated VO₂ max: ET = 1.306 ± 0.13, p < 0.001, CnT = 1.191 ± 0.15, p < 0.001). There were no significant differences after the intervention between the two exercise intervention groups. Conclusions: Exercise interventions based on Zumba fitness^® or Zumba fitness^® combined with an extra muscle-strengthening workout based on bodyweight training exercises are effective strategies to improve the health-related physical fitness in sedentary women employees.

Workplace-based interventions to promote healthy lifestyles in the NHS workforce: a rapid scoping and evidence map

Background

The health and well-being of staff working in the NHS is a significant issue for UK health care. We sought to identify research relevant to the promotion of healthy lifestyles among NHS staff on behalf of NHS England.

Objectives

To map existing reviews on workplace-based interventions to promote health and well-being, and to assess the scope for further evidence synthesis work.

Design

Rapid and responsive scoping search and evidence map.

Participants

Adult employees in any occupational setting and in any role.

Interventions

Any intervention aimed at promoting or maintaining physical or mental health and well-being. Early intervention initiatives and those addressing violence against staff, workplace bullying or harassment were also included.

Main outcome measures

Any outcome related to the effectiveness, cost-effectiveness or implementation of interventions.

Data sources

A scoping search of nine databases was conducted to identify systematic reviews on health and well-being at work. Searches were limited by publication date (2000 to January/February 2019).

Review methods

The titles and abstracts of over 8241 records were screened and a total of 408 potentially relevant publications were identified. Information on key characteristics were extracted from the titles and abstracts of all potentially relevant publications. Descriptive statistics (counts and percentages) for key characteristics were generated and data from reviews and ‘reviews of reviews’ were used to produce the evidence map.

Results

Evidence related to a broad range of physical and mental health issues was identified across 12 ‘reviews of reviews’ and 312 other reviews, including 16 Cochrane reviews. There also exists National Institute for Health and Care Excellence guidance addressing multiple issues of potential relevance. A large number of reviews focused on mental health, changing lifestyle behaviour, such as physical activity, or on general workplace health/health promotion. Most of the reviews that focused only on health-care staff addressed mental health issues, and stress/burnout in particular.

Limitations

The scoping search process was extensive and clearly effective at identifying relevant publications, but the strategy used may not have identified every potentially relevant review. Owing to the large number of potentially relevant reviews identified from the scoping search, it was necessary to produce the evidence map using information from the titles and abstracts of reviews only.

Conclusions

It is doubtful that further evidence synthesis work at this stage would generate substantial new knowledge, particularly within the context of the NHS Health and Wellbeing Framework[NHS England. Workforce Health and Wellbeing Framework. 2018. URL: www.nhsemployers.org/-/media/Employers/Publications/Health-and-wellbeing/NHS-Workforce-HWB-Framework_updated-July-18.pdf (accessed 10 January 2019)] published in 2018. Additional synthesis work may be useful if it addressed an identifiable need and it was possible to identify one of the following: (1) a specific and focused research question arising from the current evidence map; it may then be appropriate to focus on a smaller number of reviews only, and provide a more thorough and critical assessment of the available evidence; and (2) a specific gap in the literature (i.e. an issue not already addressed by existing reviews or guidance); it may then be possible to undertake further literature searching and conduct a new evidence review.

Funding

This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 18. See the NIHR Journals Library website for further project information.

Office-based physical activity: mapping a social ecological model approach against COM-B

BACKGROUND

There are growing concerns over the health impacts of occupational sedentary behaviour on office-based workers and increasing workplace recognition of the need to increase physical activity at work. Social ecological models provide a holistic framework for increasing opportunities for physical activity at work. In this paper we propose a social ecological model of office-based physical activity and map it against the Capability Motivation Opportunity (COM-B) framework to highlight the mechanisms of behaviour change that can increase levels of physical activity of office-based workers.

DISCUSSION

The paper proposes a social ecological model of physical activity associated with office-based settings. The model considers opportunities for both incidental and discretionary activities, as well as macro and micro factors on both socio-cultural and physical dimensions. The COM-B framework for characterising behaviour change interventions is used to highlight the underlying mechanisms of behaviour change inherent in the model. The broad framework provided by social ecological models is important for understanding physical activity in office-based settings because of the non-discretionary nature of sedentary behaviour of office-based work. It is important for interventions not to rely on individual motivation for behaviour change alone but to incorporate changes to the broader social ecological and physical context to build capability and create opportunities for more sustainable change.

Effects of Bluetooth-Enabled Desk Ellipticals on Office Work Performance: Rationale, Design, and Protocol for a Randomized Trial With Overweight and Obese Adults

Background

Workplaces that provide opportunities for physical activity without requiring extra time for activity could help counteract the obesity epidemic. Desk ellipticals can contribute to activity-supportive workplace environments; however, the feasibility of engaging employees in pedaling ellipticals during simultaneous office work has not been well evaluated.

Objective

We aim to present the rationale and methods from an ongoing randomized trial with overweight and obese employees that will evaluate (1) the effects of pedaling a compact desk elliptical on work performance and (2) the influence of different incentive types and schedules on desk pedaling quantity.

Methods

Overweight and obese medical center employees are being recruited in dyads for a 2 (gift card type: healthier food vs Amazon) by 3 (gift card schedule: immediate incentive contingent on individual pedaling quantity; immediate incentive partially contingent on dyads’ joint pedaling quantity; and delayed noncontingent pedaling incentive) cluster randomized within-subjects factorial trial. All participants receive a Bluetooth-enabled desk elliptical for 4 weeks and access to a mobile app that provides real-time pedaling feedback. The primary aims are to assess (1) change in employee work performance from pre- to postelliptical installation via employee and supervisor ratings and (2) effects of gift card type and schedule on quantity of objectively measured desk pedaling completed.

Results

Data collection is ongoing. We expect to complete main outcome analyses in 2020.

Conclusions

This trial represents one of the earliest attempts to assess the effects of desk pedaling and pedaling-incentive types in real-world offices. It could help bridge the research-to-practice gap by providing evidence on whether desk pedaling can be sustained without compromising work performance.

International Registered Report Identifier (IRRID)

DERR1-10.2196/16275

Effect of workplace physical activity interventions on the cardio-metabolic health of working adults: systematic review and meta-analysis

Background

Adults in urban areas spend almost 77% of their waking time being inactive at workplaces, which leaves little time for physical activity. The aim of this systematic review and meta-analysis was to synthesize evidence for the effect of workplace physical activity interventions on the cardio-metabolic health markers (body weight, waist circumference, body mass index (BMI), blood pressure, lipids and blood glucose) among working adults.

Methods

All experimental studies up to March 2018, reporting cardio-metabolic worksite intervention outcomes among adult employees were identified from PUBMED, EMBASE, COCHRANE CENTRAL, CINAHL and PsycINFO. The Cochrane Risk of Bias tool was used to assess bias in studies. All studies were assessed qualitatively and meta-analysis was done where possible. Forest plots were generated for pooled estimates of each study outcome.

Results

A total of 33 studies met the eligibility criteria and 24 were included in the meta-analysis. Multi-component workplace interventions significantly reduced body weight (16 studies; mean diff: − 2.61 kg, 95% CI: − 3.89 to − 1.33) BMI (19 studies, mean diff: − 0.42 kg/m², 95% CI: − 0.69 to − 0.15) and waist circumference (13 studies; mean diff: − 1.92 cm, 95% CI: − 3.25 to − 0.60). Reduction in blood pressure, lipids and blood glucose was not statistically significant.

Conclusions

Workplace interventions significantly reduced body weight, BMI and waist circumference. Non-significant results for biochemical markers could be due to them being secondary outcomes in most studies. Intervention acceptability and adherence, follow-up duration and exploring non-RCT designs are factors that need attention in future research.

Prospero registration number: CRD42018094436.

What Do Workers Do to Reduce Their Sitting Time? The Relationships of Strategy Use and Workplace Support With Desk-Based Workers' Behavior Changes in a Workplace-Delivered Sitting-Reduction and Activity-Promoting Intervention

OBJECTIVE

To explore workers' sitting-reduction and activity-promoting strategy use following an intervention targeting these changes, and whether strategy use and perceived workplace support impacted on 3-month sitting and activity outcomes.

METHODS

This secondary analysis in desk-based workers (n = 83) utilized data collected on questionnaire-derived strategy use and workplace support, and activPAL3-derived sitting (total; prolonged, ≥30 minutes) and activity (standing; stepping) at work.

RESULTS

Fourteen strategies were commonly used during the intervention. Increased usage of some strategies were significantly (P < 0.05) associated with beneficial changes in prolonged sitting or stepping only. Workplace support was significantly beneficially associated with changes in sitting, prolonged sitting, and stepping; these associations were largely independent of strategy use changes.

CONCLUSIONS

Strategies were highly used, with increased use associated with some behavioral improvements. Workplace support appears essential for improving sitting and activity in the workplace.

Measuring hospital qualities. A preliminary investigation on Health Impact Assessment possibilities for evaluating complex buildings

BACKGROUND AND AIM OF THE WORK

World Health Organization states that is possible evaluating projects' qualities via Health Impact Assessment (HIA) but there are not specific HIA tools on hospital buildings assessment. Researchers show significant relationships between built environment and health. The research purpose is investigating how existing tools for healthcare building assessment are encouraging the development of possible hospital HIA evaluation.

METHODS

Based on previous works, 13 assessment tools have been included and a comparison of the criteria has been conducted to understand which the most prevalent topics are. The tools have been analyzed through literature, technical manuals and official websites. The authors identified 12 thematic categories where criteria from different tools have been clustered and discussed.

RESULTS

The most prevalent criteria are related to Indoor Environmental Quality (IEQ) (20%). In the oldest tools the evaluation was mainly on technical features while in recent instruments several indicators are related to Architectural features and innovation (48%), Education (23%) and Food (11%).

CONCLUSIONS

There is growing interest in tools capable of addressing healthy hospitals encouraging IEQ, physical activity and healthy food provision related to occupants' health outcomes. This preliminary study set the basis for further development on hospital facility HIA tools.

Effects of a Worksite Group Intervention to Promote Physical Activity and Health: The Role of Psychological Coaching

BACKGROUND

This study investigates whether a worksite physical activity (PA) promotion program consisting of both a "practical" PA component and a "theoretical" (psychological) coaching component (PA+C) is more effective than the same "practical" PA component alone.

METHODS

N = 213 employees were assigned to two groups by cluster-randomisation: one group received the "MoVo-work" program including a PA component and a coaching component (PA+C group). The other group received only the PA component (PA group). Assessment of PA and health was conducted at five time points.

RESULTS

Six weeks after program completion the percentage of physically active participants was significantly higher in the PA+C group compared to the PA group (68% vs. 45%; p = .01). At 12-month follow-up, the PA+C group showed a higher percentage of physically active participants and a better health status than the PA group on the descriptive level, but these differences did not reach statistical significance.

CONCLUSIONS

Results suggest that a PA promotion program including a psychological coaching component is more effective in evoking behavior change than a practical PA program alone. However, booster interventions are required to maintain the additional effects.

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.

Effects of a Multi-Component Workplace Intervention Program with Environmental Changes on Physical Activity among Japanese White-Collar Employees: a Cluster-Randomized Controlled Trial

PURPOSE

This study aimed to investigate effects of a flexible multi-component workplace intervention program for improving physical activity among Japanese white-collar employees in a cluster randomized controlled trial design.

METHODS

A total of 208 worksites and nested employees were approached. Any worksite interested in a 3-month physical activity promotion intervention and white-collar workers aged 18 years or older were eligible. The worksites were randomly assigned to an intervention or a control, stratified by worksite size. The intervention worksites were offered an intervention program that allows these worksites to select intervention components from a set of options, including environmental changes. The control worksites were offered feedback and basic occupational health services. Physical activity level was measured using a self-reported questionnaire at baseline and at 3 and 6 months of follow-up.

RESULTS

Three worksites (92 employees) were allocated to the intervention and five worksites (98 employees) to the control worksites. The overall physical activity level in the intervention worksites significantly increased compared with the control worksites (Coeff = 0.45, SE = 0.19, p = 0.018). For subgroup analyses, the intervention effect on the overall physical activity level was significant among medium- and large-sized worksites but not among small-sized worksites.

CONCLUSION

This trial showed a significant and positive effect of the intervention program on physical activity. The program is unique because of its flexibility and feasibility. However, small worksites might receive less benefit from the program, indicating a need for further support and/or new technologies.

TRIAL REGISTRATION

UMIN Clinical Trials Registry (ID=UMIN000024069).

Employees' adherence to worksite physical activity programs: Profiles of compliers versus non-compliers

While worldwide public health policies have emphasized the necessity to create a culture that favors regular physical activity, stakeholders and health institutions keep looking for new strategies and opportune settings. Workplaces have been identified since employees spent a considerable part of their time at work and several worksite interventions have been developed lately. While the actual scientific literature clearly points out the beneficial effects of physical activity programs implemented within companies on employees overall health, available evidences however seem to question their adherence to such interventions. Based on previously published results and new observations, this paper discusses the adherence rate during workplace physical activity programs and suggests new strategies to favor increased physical activity among employees, considering their dropouters or finishers' profiles.