Abstract
A disconcerting proportion of Canadian nurses are physically inactive and report poor cardiovascular health. Web-based interventions incorporating feedback and group features may represent opportune, convenient, and cost-effective methods for encouraging physical activity (PA) in order to improve the levels of PA and cardiovascular health of nurses. The purpose of this parallel-group randomized trial was to examine the impact of an intervention providing participants with feedback from an activity monitor coupled with a web-based individual, friend or team PA challenge, on the PA and cardiovascular health of nurses working in a cardiovascular setting.Methods: Nurses were randomly assigned in a 1:1:1 ratio to one of the following intervention “challenge” groups: (1) individual, (2) friend or (3) team. Nurses wore a Tractivity® activity monitor throughout a baseline week and 6-week intervention. Height, body mass, body fat percentage, waist circumference, resting blood pressure (BP) and heart rate were assessed, and body mass index (BMI) was calculated, during baseline and within 1 week post-intervention. Data were analyzed using descriptive statistics and general linear model procedures for repeated measures.Results: 76 nurses (97% female; age: 46 ± 11 years) participated. Weekly moderate-to-vigorous intensity PA (MVPA) changed over time (F = 4.022, df = 4.827, p = 0.002, η2 = 0.055), and was greater during intervention week 2 when compared to intervention week 6 (p = 0.011). Daily steps changed over time (F = 7.668, df = 3.910, p < 0.001, η2 = 0.100), and were greater during baseline and intervention weeks 1, 2, 3, and 5 when compared to intervention week 6 (p < 0.05). No differences in weekly MVPA or daily steps were observed between groups (p > 0.05). No changes in body mass, BMI or waist circumference were observed within or between groups (p > 0.05). Decreases in body fat percentage (−0.8 ± 4.8%, p = 0.015) and resting systolic BP (−2.6 ± 8.8 mmHg, p = 0.019) were observed within groups, but not between groups (p > 0.05).Conclusions: A web-based intervention providing feedback and a PA challenge initially impacted the PA, body fat percentage and resting systolic BP of nurses working in a cardiovascular setting, though increases in PA were short-lived. The nature of the PA challenge did not differentially impact outcomes. Alternative innovative strategies to improve and sustain nurses' PA should be developed and their effectiveness evaluated.
Highlights
Nurses are the largest professional group within the health care workforce
Nurses were categorized as being overweight, normotensive, with a lowrisk waist circumference according to the American College of Sports Medicine (ACSM) guidelines (American College of Sports Medicine, 2017)
Providing web-based feedback from wearable devices is acceptable and can increase the physical activity (PA) levels of inactive overweight and obese women (Cadmus-Bertram et al, 2015a,b). Our work extends these findings to nurses and provides support for the use of e-health interventions to target PA and cardiovascular outcomes in nurses working in a cardiovascular setting as revealed by the good compliance with the intervention and initial effects on behavior and health outcomes
Summary
Nurses are the largest professional group within the health care workforce. Several investigators in varied settings have assessed the self-reported and objective physical activity (PA) levels of nurses and shown low levels of PA (Kaewthummanukul et al, 2006; Sveinsdottir and Gunnarsdottir, 2008; Ratner and Sawatzky, 2009; James et al, 2013; Babiolakis et al, 2015; Perry et al, 2015; Reed et al, 2018). The irrefutable evidence demonstrating the effectiveness of regular PA in the prevention and management of cardiovascular disease and associated risk factors (Warburton et al, 2006, 2010; Haskell et al, 2007; Reed and Pipe, 2016) highlights the opportunity afforded by targeted PA interventions to promote positive behavior change within this unique and large professional population. As adults worldwide embrace modern technologies, webbased innovations may represent opportune, convenient, and cost-effective methods to target suboptimal PA levels and poor cardiovascular health of nurses. Several reviews have shown that web-based interventions can increase PA levels and reduce body mass, waist circumference and blood pressure in adults (van den Berg et al, 2007; Liu et al, 2013; Joseph et al, 2014; Seo and Niu, 2015; Direito et al, 2017; Sorgente et al, 2017)
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