Socio-Ecological Natural Experiment with Randomized Controlled Trial to Promote Active Commuting to Work: Process Evaluation, Behavioral Impacts, and Changes in the Use and Quality of Walking and Cycling Paths.

Minna Aittasalo,Henri Vähä-Ypyä,Johanna Tiilikainen,Sylvia Titze,Kari Tokola,Pasi Metsäpuro,Jaana Suni,Harri Sievänen,Charlie Foster,Timo Seimelä,Tommi Vasankari

doi:10.3390/ijerph16091661

Abstract

Active commuting to work (ACW) has beneficial effects on health, traffic, and climate. However, more robust evidence is needed on how to promote ACW. This paper reports the findings of a multilevel natural experiment with a randomized controlled trial in 16 Finnish workplaces. In Phase 1, 11 workplaces (1823 employees) from Area 1 were exposed to environmental improvements in walking and cycling paths. In Phase 2, five more workplaces (826 employees) were recruited from Area 2 and all workplaces were randomized into experimental group (EXP) promoting ACW with social and behavioral strategies and comparison group (COM) participating only in data collection. Process and impact evaluation with questionnaires, travel diaries, accelerometers, traffic calculations, and auditing were conducted. Statistics included Wilcoxon Signed Ranks Test, Mann-Whitney U-test, and after-before differences with 95% confidence intervals (95% CI). After Phase 1, positive change was seen in the self-reported number of days, which the employees intended to cycle part of their journey to work in the following week (p = 0.001). After Phase 2, intervention effect was observed in the proportion of employees, who reported willingness to increase walking (8.7%; 95% CI 1.8 to 15.6) and cycling (5.5%; 2.2 to 8.8) and opportunity to cycle part of their journey to work (5.9%; 2.1 to 9.7). To conclude, the intervention facilitated employees’ motivation for ACW, which is the first step towards behavior change.

Highlights

Regular physical activity enhances physical and mental health and improves quality of life [1].Active commuting to work (ACW) by walking or cycling increases the total amount of physicalInt
This paper reports the findings of such study by embedding a randomized controlled design within the context of natural experiment in a Finnish worksite setting
After social and behavioral strategies, a statistically significant positive effect was discovered in experimental group (EXP) in the proportion of participants, who reported willingness to increase walking (8.7%; 95% confidence intervals (95% CI) 1.8 to 15.6) and bicycling (5.5%; 95% CI 2.2 to 8.8) and in the proportion of participants, who reported having an opportunity to bicycle at least part of their work journey (5.9%; 95% CI 2.1 to 9.7) (Table 4)

Summary

Methods

A brief summary of the study materials and methods is provided here. More detailed description can be found from the protocol article [24].The study was approved by the Ethics Committee of the Tampere Region (running number20/2014). A brief summary of the study materials and methods is provided here. More detailed description can be found from the protocol article [24]. The study was approved by the Ethics Committee of the Tampere Region The participants gave their consent to participate in the study by agreeing to complete the measurements after being fully informed in writing about the ethical principles and data protection. Written informed consent was not obtained because no sensitive data were collected, and the study did not intervene physical integrity of the participants.

Results

Discussion

Conclusion