Abstract
BackgroundInactivity and sedentary lifestyle have led experts to recommend an increase in structured, workplace-based physical activity (PA) initiatives. Previous studies on workplace-based PA have only shown moderate and short-term effects. This has been attributed to the lack of clear implementation strategies and understanding of factors that may hinder or enable uptake of PA. To ensure long-term, sustainable outcomes, there is a need for a better understanding of implementation strategies, and barriers and facilitators to workplace-based PA.MethodA scoping review of studies investigating implementation approaches and factors affecting uptake of workplace-based PA was conducted. Qualitative and quantitative articles published in MEDLINE, Embase, Scopus, or PsycINFO between 2008 and 2018 evaluating the implementation of PA were included. Data on study characteristics, evaluation, and implementation methods applied were systematically extracted. Two reviewers extracted, coded, and organised factors affecting uptake using the Theoretical Domains Framework (TDF).ResultsAfter dual, blinded screening of titles and abstracts, 16 articles reporting on eight studies were included in the review. Several different methods of implementation were applied, including information meeting, kick-off events, and “change agents” as the most common. A total of 109 factors influencing implementation were identified, consisting of 57 barriers and 52 facilitators. Barriers most often related to the TDF domains Environmental Context and Resources (n = 34, 36.2%), Social influences (n = 13, 13.8%), and Social/Professional Role and Identity (n = 8, 8.5%). Likewise, facilitators most often related to the TDF domains Social influences (n = 17, 19.5%), Environmental Context and Resources (n = 16, 18.4%), and Social/Professional Role and Identity (n = 9, 10.3%).ConclusionOur review has highlighted the multilevel factors affecting the uptake of workplace-based PA and underpins the complexities in implementation of such initiatives. The published literature predominantly provides details from the employees’ perspectives on factors that need to be addressed and a lack of attention to these factors will cause them to hamper uptake of PA. The analysis of barriers and facilitators provides a theoretical foundation to guide future intervention design. However, further research is needed to fully understand the success or failure of implementation processes.
Highlights
Inactivity and sedentary lifestyle have led experts to recommend an increase in structured, workplacebased physical activity (PA) initiatives
Our review has highlighted the multilevel factors affecting the uptake of workplace-based PA and underpins the complexities in implementation of such initiatives
We consistently found that absence of these factors hindered uptake, whereas presence facilitated uptake of the intervention. This indicates that focus and action must be directed toward these factors, otherwise they will hinder the uptake when implementing PA in workplaces. We found both intrinsic factors in the individual participants, like unwillingness to participate in workplace PA as this was believed to infringe on private matters, or participants feeling exposed when exercising in front of colleagues, and extrinsic factors related to different levels in the organisation and the persons acting within the organisation
Summary
Inactivity and sedentary lifestyle have led experts to recommend an increase in structured, workplacebased physical activity (PA) initiatives. Previous studies on workplace-based PA have only shown moderate and short-term effects This has been attributed to the lack of clear implementation strategies and understanding of factors that may hinder or enable uptake of PA. Inactivity and sedentary lifestyles have been estimated to cause over 1 million deaths annually in Europe [2], which have led experts to recommend an increase in structured PA embedded in modern work activities [3]. This has changed the focus on workplaces from being an arena for work-related activities only, to becoming a potential field for implementing PA and other types of health promoting initiatives. Moderate evidence points towards a positive effect of workplace health promotion on work ability [4, 12, 13]
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