UCLMuevete: Increasing the amount of physical activity, work-ability, and cardiorespiratory fitness capacity in university workers through active breaks

BACKGROUND

Active break programs at the workplace are a promising initiative for increasing workers' physical activity (PA) levels, health, work-ability (WA), and social relationship.

OBJECTIVE

To determine the impact of an Active Breaks workplace program based on Bandura's Social Cognitive Theory (SCT) aligned with Behavior Change Techniques (BCT) on PA levels, cardiorespiratory fitness (CRF), WA, and social relationships among university workers.

METHODS

#UCLMuévete is a quasi-experimental, 12-week intervention designed according to the TREND and TIDieR-PHP checklists. Sixty-nine university workers were recruited and placed into 17 teams of 3 to 5 people. Participants were instructed to take a 20-min active break every working day (walking, cycling, and functional training). The following variables were measured before and after the 12-week intervention: (1) Amount of PA with accelerometers, (2) CRF through the 6 Min-Walking Test (m), (3) Body composition (fat mass (gr), muscle mass (gr), and bone mineral content (g/cm3) through densitometry), (4) Stress with the BodyGuard2 device, (5) WA through Work Ability Index (WAI), and (6) Social relationships through an ad-hoc questionnaire. Part-time workers, pregnant women, and workers with physical disability were excluded.

RESULTS

Significant improvements were observed in the amount of daily moderate-to-vigorous PA (Difference (Dif)., women +8.05 and men +12.31 minutes; p < 0.05; ES = 0.224; 0.379), CRF (Dif., women +52.98 and men +25.53 meters; p < 0.05; ES = 0.578; 0.209), and (Dif., women +2.16 and men +2.39; p < 0.05; ES = 0.150; 0.177). No significant changes were observed in body composition and stress.

CONCLUSION

20 min/day of aerobic and strength active breaks, based on SCT aligned to BCTs, improves university workers' amount of PA, CRF, WAI, and social relationships.

Describing Physical Activity Patterns of Truck Drivers Using Actigraphy

Background

Truck driving is a highly sedentary occupation that places workers at risk for chronic health conditions, such as obesity and high blood pressure. The primary purpose of this study was to objectively describe truck drivers' typical physical activity (PA) patterns.

Methods

We used ∼7-10-day baseline PA actigraphy data samples from drivers in the Safety & Health Involvement For Truckers (SHIFT) study (n = 394). Driver PA patterns (e.g., average number of ≥10 minute Freedson bouts per week, time in bouts, and common days/times for PA) were summarized with descriptive analyses. We also compared objective accelerometer data to self-reports.

Results

Drivers' weekly PA averaged 14.4 minutes (SD = 37.0), and most PA occurred between 5-6 pm on Tuesdays and Wednesdays. Drivers overestimated self-reported weekly exercise by over 60 min/week compared to accelerometer data.

Conclusion

Our results suggest that objective PA assessment may be warranted over self-report when possible, and timing may be key in future PA intervention work with truck drivers.

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.

Primary Prevention of Weight Gain Among New Bus Operators: Results of the "Success & Health Impacts For Transit operators during Onboarding" (SHIFT Onboard) Pilot Study

OBJECTIVE

This study aimed to test the feasibility and efficacy of an enhanced onboarding intervention to prevent weight gain and support the early job success of new bus operators.

METHODS

Control participants ( n = 9) completed usual practice new employee training and onboarding. Intervention participants ( n = 14) completed five supplemental trainings and four online challenges during their first year. Primary outcomes were body weight, dietary behaviors, physical activity, and sleep duration/quality. Early job success was evaluated with measures of newcomer adjustment.

RESULTS

The difference between intervention and control participants in body weight change at 12-month was -6.71 lb (Cohen's d = -1.35). Differences in health behavior changes were mixed, but newcomer adjustment changes favored the intervention group.

CONCLUSIONS

Results support the feasibility of enhanced onboarding for bus operators to prevent worsening health while simultaneously advancing their success as new employees.

Bus Operators' Body Weight Changes During Their First 2 Years of Work: A Retrospective Survey

OBJECTIVE

To empirically assess retrospective reports of weight changes during bus operators' first years on the job, and to investigate experienced and desired training topics for new operators.

METHODS

Bus operators (n = 261) completed an online survey on topics of early weight changes and training experiences.

RESULTS

Operators reported gaining an average of 7.64 lb (SD = 16.36) during their first year. Further weight gain was not reported during the second year. Most operators reported that health-related topics were not addressed during their initial training. Stress management and healthy eating were the operators' two most desired topics to be included in their initial training.

CONCLUSION

Bus operators reported medically meaningful weight gain during their first year of work and a desire for more health-related training. Objective research to document the magnitude of this hazard, and contributing working conditions, is needed.

A Comparison of Safety, Health, and Well-Being Risk Factors Across Five Occupational Samples

Objective: The aim of this study was to present safety, health and well-being profiles of workers within five occupations: call center work (N = 139), corrections (N = 85), construction (N = 348), homecare (N = 149), and parks and recreation (N = 178). Methods: Baseline data from the Data Repository of Oregon's Healthy Workforce Center were used. Measures were compared with clinical healthcare guidelines and national norms. Results: The prevalence of health and safety risks for adults was as follows: overweight (83.2%), high blood pressure (16.4%), injury causing lost work (9.9%), and reported pain (47.0%). Young workers were least likely to report adequate sleep (46.6%). Construction workers reported the highest rate of smoking (20.7%). All of the adult workers reported significantly lower general health than the general population. Conclusion: The number of workers experiencing poor safety, health and well-being outcomes suggest the need for improved working conditions.

Process Evaluation of a Mobile Weight Loss Intervention for Truck Drivers

BACKGROUND

In a cluster-randomized trial, the Safety and Health Involvement For Truck drivers intervention produced statistically significant and medically meaningful weight loss at 6 months (-3.31 kg between-group difference). The current manuscript evaluates the relative impact of intervention components on study outcomes among participants in the intervention condition who reported for a postintervention health assessment (n = 134) to encourage the adoption of effective tactics and inform future replications, tailoring, and enhancements.

METHODS

The Safety and Health Involvement For Truck drivers intervention was implemented in a Web-based computer and smartphone-accessible format and included a group weight loss competition and body weight and behavioral self-monitoring with feedback, computer-based training, and motivational interviewing. Indices were calculated to reflect engagement patterns for these components, and generalized linear models quantified predictive relationships between participation in intervention components and outcomes.

RESULTS

Participants who completed the full program-defined dose of the intervention had significantly greater weight loss than those who did not. Behavioral self-monitoring, computer-based training, and health coaching were significant predictors of dietary changes, whereas behavioral and body weight self-monitoring was the only significant predictor of changes in physical activity. Behavioral and body weight self-monitoring was the strongest predictor of weight loss.

CONCLUSION

Web-based self-monitoring of body weight and health behaviors was a particularly impactful tactic in our mobile health intervention. Findings advance the science of behavior change in mobile health intervention delivery and inform the development of health programs for dispersed populations.

Caring for the elderly at work and home: Can a randomized organizational intervention improve psychological health?

Although job stress models suggest that changing the work social environment to increase job resources improves psychological health, many intervention studies have weak designs and overlook influences of family caregiving demands. We tested the effects of an organizational intervention designed to increase supervisor social support for work and nonwork roles, and job control in a results-oriented work environment on the stress and psychological distress of health care employees who care for the elderly, while simultaneously considering their own family caregiving responsibilities. Using a group-randomized organizational field trial with an intent-to-treat design, 420 caregivers in 15 intervention extended-care nursing facilities were compared with 511 caregivers in 15 control facilities at 4 measurement times: preintervention and 6, 12, and 18 months. There were no main intervention effects showing improvements in stress and psychological distress when comparing intervention with control sites. Moderation analyses indicate that the intervention was more effective in reducing stress and psychological distress for caregivers who were also caring for other family members off the job (those with elders and those "sandwiched" with both child and elder caregiving responsibilities) compared with employees without caregiving demands. These findings extend previous studies by showing that the effect of organizational interventions designed to increase job resources to improve psychological health varies according to differences in nonwork caregiving demands. This research suggests that caregivers, especially those with "double-duty" elder caregiving at home and work and "triple-duty" responsibilities, including child care, may benefit from interventions designed to increase work-nonwork social support and job control. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Safety and Health Support for Home Care Workers: The COMPASS Randomized Controlled Trial

OBJECTIVES

To determine the effectiveness of the COMmunity of Practice And Safety Support (COMPASS) Total Worker Health intervention for home care workers.

METHODS

We randomized 16 clusters of workers (n = 149) to intervention or usual-practice control conditions. The 12-month intervention was scripted and peer-led, and involved education on safety, health, and well-being; goal setting and self-monitoring; and structured social support. We collected measures at baseline, 6 months, and 12 months, which included workers' experienced community of practice (i.e., people engaged in a common activity who interact regularly for shared learning and improvement). Implementation occurred during 2013 and 2014 in Oregon.

RESULTS

In an intent-to-treat analysis, relative to control, the intervention produced significant and sustained improvements in workers' experienced community of practice. Additional significant improvements included the use of ergonomic tools or techniques for physical work, safety communication with consumer-employers, hazard correction in homes, fruit and vegetable consumption, lost work days because of injury, high-density lipoprotein cholesterol, and grip strength. Consumer-employers' reports of caregiver safety behaviors also significantly improved.

CONCLUSIONS

COMPASS was effective for improving home care workers' social resources and simultaneously impacted both safety and health factors.

Weight Control Intervention for Truck Drivers: The SHIFT Randomized Controlled Trial, United States

OBJECTIVES

To evaluate the effectiveness of the Safety and Health Involvement For Truckers (SHIFT) intervention with a randomized controlled design.

METHODS

The multicomponent intervention was a weight-loss competition supported with body weight and behavioral self-monitoring, computer-based training, and motivational interviewing. We evaluated intervention effectiveness with a cluster-randomized design involving 22 terminals from 5 companies in the United States in 2012 to 2014. Companies were required to provide interstate transportation services and operate at least 2 larger terminals. We randomly assigned terminals to intervention or usual practice control conditions. We assessed participating drivers (n = 452) at baseline and 6 months.

RESULTS

In an intent-to-treat analysis, the postintervention difference between groups in mean body mass index change was 1.00 kilograms per meters squared (P < .001; intervention = -0.73; control = +0.27). Behavioral changes included statistically significant improvements in fruit and vegetable consumption and physical activity.

CONCLUSIONS

Results establish the effectiveness of a multicomponent and remotely administered intervention for producing significant weight loss among commercial truck drivers.

The COMmunity of Practice And Safety Support (COMPASS) Total Worker Health™ study among home care workers: study protocol for a randomized controlled trial

BACKGROUND

Home care workers are a high-risk group for injury and illness. Their unique work structure presents challenges to delivering a program to enhance their health and safety. No randomized controlled trials have assessed the impact of a Total Worker Health™ program designed for their needs.

METHODS/DESIGN

The COMPASS (COMmunity of Practice And Safety Support) study is a cluster randomized trial being implemented among Oregon's unionized home care workers. Partnering with the Oregon Home Care Commission allowed recruiting 10 pairs of home care worker groups with 8 participants per group (n = 160) for balanced randomization of groups to intervention and control conditions. Physiologic and survey evaluation of all participants will be at enrollment, 6 months and 12 months. Primary outcomes are to increase health promoting (for example, healthy nutrition and regular physical activity) and health protecting (that is, safety) behaviors. In addition to assessing outcomes adjusted for the hierarchical design, mediation analyses will be used to deconstruct and confirm the program's theoretical underpinnings and intervention processes. Intervention groups will participate in a series of monthly 2-hour meetings designed as ritualized, scripted peer-led sessions to increase knowledge, practice skills and build support for healthy actions. Self-monitoring and individual and team level goals are included to augment change. Because generalizability, reach and achieving dissemination are priorities, following initial wave findings, a second wave of COMPASS groups will be recruited and enrolled with tailoring of the program to align with existing Home Care Commission educational offerings. Outcomes, process and mediation of those tailored groups will be compared with the original wave's findings.

DISCUSSION

The COMPASS trial will assess a novel program to enhance the safety and health of a vulnerable, rapidly expanding group of isolated caregivers, whose critical work allows independent living of frail seniors and the disabled.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT02113371, first registered 11 March 2014.

Reliability and validity of the Home Care STAT (Safety Task Assessment Tool)

Home care workers are a priority population for ergonomic assessment and intervention, but research on caregivers' exposures to hazards is limited. The current project evaluated the reliability and validity of an ergonomic self-assessment tool called Home Care STAT (Safety Task Assessment Tool). Participants (N = 23) completed a background survey followed by 10-14 days of self-monitoring with the STAT. Results showed that the most frequent task was house cleaning, and that participants regularly performed dangerous manual client moving and transferring tasks. Researcher in-home observations of 14 workers (duration ≤ 2 h) demonstrated that workers' self-assessments were moderately reliable. Correlational and multi-level analyses of daily self-assessment data revealed that several task exposures were significantly related to daily fatigue and/or pain. Other associations have implications for Total Worker Health™; for example, daily stress was positively associated with both pain and consumption of high calorie snacks. Findings support the STAT as a reliable and potentially valid tool for measuring home care workers' exposures to physically demanding tasks.

The effects of target behavior choice and self-management skills training on compliance with behavioral self-monitoring

PURPOSE

The purpose of this study was to evaluate two potential methods for increasing participant compliance with behavioral self-monitoring (BSM).

DESIGN

A randomized 2 × 2 factorial design was used to evaluate the effects of target behavior choice (choice vs. assigned) and self-management skills training (training vs. no-training) on BSM compliance. In the choice manipulation, participants either chose or were assigned one of seven types of healthful or safe behaviors to self-monitor. In the training manipulation, participants either completed computer-based self-management skills training or received no training. Participants were then asked to complete daily BSM for 2 weeks.

SETTING

The study was conducted at a university and teaching hospital.

SUBJECTS

Participants (N=60) were predominantly university and hospital employees.

MEASURES

The primary dependent measure was percent compliance with BSM.

ANALYSIS

A factorial analysis of variance of compliance scores was performed.

RESULTS

Mean compliance with prescribed BSM was 52.6% (SD=31.8). The main effect for choice was significant, with choice participants showing 18% higher BSM compliance than those in no-choice conditions (d=.59; p<.05). The effects of self-management skills training and the interaction term were both nonsignificant.

CONCLUSION

Although self-management skills training did not appear to affect BSM compliance, offering individuals a choice in target behavior substantially increased both BSM compliance and self-reported behavior change.

An examination of serotonin and psychological variables in the relationship between exercise and mental health

Research has revealed that exercise is effective for reducing symptoms of depression and anxiety. The mechanisms by which these reductions occur, however, have not been widely studied. To examine several potential theories, a prospective, randomized, 7-week exercise intervention was conducted. Untrained participants were randomly assigned to an aerobic exercise group or to a stretching-control group. Participants completed several questionnaires to assess psychological variables, including measures of depression and anxiety, and blood was drawn at pre- and post-test to measure serum serotonin levels. A mixed-design ANOVA revealed that the exercise group had lower levels of depression than the stretching-control group after the intervention. The exercise group also showed a larger percentage decrease in serotonin than the stretching-control group. This reduction in blood serotonin after exercise is similar to the effects of selective serotonin reuptake inhibitors. Additionally, percent change in serotonin was found to partially mediate the relationship between exercise and depression.