Worksite Physical Activity Program Research Articles

Physical Activity in the Workplace – Making the Healthy Choice the Easy Choice

Background: Engaging in physical activity in the workplace is important to address to combat the negative health outcomes associated with physical inactivity and prolonged sitting.Aim: This study aims to identify efforts that increase light neuromotor physical activity in university workplaces for sedentary employees.Methods: Sub-study 1 examined 15 intervention employees and 10 control employees. MANOVA was used to examine average number of days employees did three movements at work between groups over an eight-week period. Sub-study 2 examined 56 employees and measured three beliefs towards employee intention to do the movements at work. A linear regression examined the significance of the beliefs in predicting employee intention.Results: MANOVA results showed a significant effect between groups on the average number of days employees did three movements over an eight-week period of time, F (3, 21) = 3.16; p < .05. The adjusted R-squared predicting intention from the three beliefs was .343 (p < .001). Participants' belief in how 'easy' doing the movements would be significantly predicted intention scores (β= .467; p < .001) as did the 'popular' belief (β = .371; p < .01). Conclusion: Worksite group physical activity programs can increase the frequency employees get up and move at work. Employee beliefs of how easy or popular a behavior is can significantly predict intention to do neuromotor movements in workplaces.

Evaluation of Worksite Wellness Nutrition and Physical Activity Programs and Their Subsequent Impact on Participants' Body Composition.

Background Adult obesity is globally recognized as a public health concern. As adults spend most of their weekdays at work, worksite wellness programs may include topics of nutrition education and physical activity to improve an employee's body composition. However, results are inconsistent with the impact they have on employees' body composition. Objective The purpose of this systematic review was to evaluate worksite wellness nutrition and physical activity programs and their subsequent impact on participants' body composition. Methods Extraction of articles was completed through 4 databases: PubMed, CINAHL, SCOPUS, and PsycINFO using keywords such as “nutrition and physical activity interventions/programs” and “weight.” A 9-point inclusion criterion was established. Evaluation of the articles was assessed using the Academy of Nutrition and Dietetics Evidence-Based Manual. Results A total of 962 articles were identified. Twenty-three met the inclusion criterion. Seventeen studies resulted in a change in body composition (e.g., decreased BMI (kg/m2), waist circumference, and body fat percentage), and six studies did not show any changes. Programs that had professionals frequently interact with participants, regardless if the interactions were done daily, weekly, or monthly, led to a change in body composition. Additionally, programs that incorporated a motivation theory and provided content relevant to participants' needs resulted in a change in body composition. Conclusion Evidence supports that future worksite wellness programs that are designed using a motivational theory and content that is created relevant to participants' needs and that has frequent interactions with participants may result in a change in body composition.

A worksite physical activity program and its association with biopsychosocial factors: An intervention study in a footwear factory

ObjectiveThe objective of this study was to evaluate the effect of a worksite physical activity program on psychophysiological and social factors. MethodsA worksite physical activity program included 1113 workers from a footwear factory in northeastern Brazil. The participants were classified based on their frequency of attendance in the program. The dependent variables were psychophysiological factors, including the relief of musculoskeletal pain, the improvement of physical and psychological well-being, perceived difficulty in performing tasks, and willingness to work; and social factors related to interpersonal relationships among employees. The obtained data were processed, and the analysis of the correlations between the variables was modeled using ordinal logistic regression. ResultsThe frequency of physical activity was a determining factor for the effectiveness of the intended outcomes for all analyzed variables. The participants who attended more weekly exercise sessions were twice as likely to experience relief of musculoskeletal pain, 74% more likely to report psychophysiological well-being, 30% less likely to have difficulties in performing tasks, and 87% more likely to perceive improved interpersonal relations. ConclusionsRegular physical activity is associated with consistent benefits for work dynamics and the health status of employees and effectively and rapidly improves the desired outcomes. Relevance to industryWorksite physical activity programs are used as strategies to prevent diseases and address complications caused by exposure to occupational risk factors. However, data on the effects of these interventions that consider the frequency of physical activity and work-related social factors are inconsistent.

Health and Fitness Benefits But Low Adherence Rate: Effect of a 10-Month Onsite Physical Activity Program Among Tertiary Employees.

The aim of this study was to assess the effects of a 10-month structured physical activity intervention implemented within the workplace on overall health indicators among tertiary (office workers) employees. In this quasi-experimental study, 224 employees followed a 10-month worksite physical activity program. Overall health was assessed at baseline, after 5 months, and by the end of the intervention. Fat mass percentage decreased significantly. There was a time effect favoring push-ups, abdominal strength, flexibility, heart rate postexercise, heart rate +30 seconds, and heart rate +60 seconds postexercise. Anxiety, depression, and eating habits also improved. In total, 45% of participants completed the whole intervention. Although a structured on-site physical activity program supports improved health indicators, adherence remains a concern and requires specialists to develop new strategies.

Effect of a 5-Month Worksite Physical Activity Program on Tertiary Employees Overall Health and Fitness.

This pilot study questions the effects of a worksite physical activity program on health and fitness in tertiary employees. Ninety-five employees were randomly assigned to Control (CON); Novice (NOV); Experienced group (EXP). The NOV and EXP groups followed a 5-month worksite physical activity program (at least two sessions/week). Body composition, physical activity level and physical fitness, eating habits, health perception, sleep quality, pain, and quality of life were assessed. Fat mass decreased in NOV and EXP; the distance covered during the 6-minute walking test, push-ups, squat jump increased for NOV and EXP group. Physical activity level, health perception, quality of sleep, and eating habits were improved in NOV. This study underlines for the first time the beneficial effects of such worksite programs among tertiary employees on overall health and the feasibility of its design.

A Review of the Importance of Physical Fitness to Company Performance and Productivity

The purpose of this study is to illustrate and investigate the importance of physical fitness to company performance and productivity, by comparing previous researches on this area. This study focuses on the importance of physical fitness and its effect on employee health, performance and productivity in organizations. The number of health promotion programs in workplace settings has continued to grow. Although employers' rationales vary, health promotion programs may yield economic benefits such as reduced absenteeism, presentism, employee health care costs and employee turnover. The data for the study is collected from various sources namely articles from 1969 to 1999 and 2000 to 2015. The methodology adopted is qualitative and the findings are based on reliable data with respect to the economic impact of worksite physical fitness activity programs. Most, if not all, researches in this field have been performed in developed and high-income countries. This research recommends improvements and further studies on physical fitness on company performance and offers some suggestions for further research.

A Simulation Modeling Framework to Optimize Programs Using Financial Incentives to Motivate Health Behavior Change.

While increasingly popular among mid- to large-size employers, using financial incentives to induce health behavior change among employees has been controversial, in part due to poor quality and generalizability of studies to date. Thus, fundamental questions have been left unanswered: To generate positive economic returns on investment, what level of incentive should be offered for any given type of incentive program and among which employees? We constructed a novel modeling framework that systematically identifies how to optimize marginal return on investment from programs incentivizing behavior change by integrating commonly collected data on health behaviors and associated costs. We integrated "demand curves" capturing individual differences in response to any given incentive with employee demographic and risk factor data. We also estimated the degree of self-selection that could be tolerated: that is, the maximum percentage of already-healthy employees who could enroll in a wellness program while still maintaining positive absolute return on investment. In a demonstration analysis, the modeling framework was applied to data from 3000 worksite physical activity programs across the nation. For physical activity programs, the incentive levels that would optimize marginal return on investment ($367/employee/year) were higher than average incentive levels currently offered ($143/employee/year). Yet a high degree of self-selection could undermine the economic benefits of the program; if more than 17% of participants came from the top 10% of the physical activity distribution, the cost of the program would be expected to always be greater than its benefits. Our generalizable framework integrates individual differences in behavior and risk to systematically estimate the incentive level that optimizes marginal return on investment.

Abstract P145: Using an Activity Monitor to Motivate Physical Activity among Healthy Employees: A Randomized Controlled Trial

Background: Worksite physical activity programs have the potential to reduce sedentary behavior of large populations of employees. Activity monitors are promising tools for motivating individuals to increase physical activity, but it is unknown whether this is an effective strategy for a relatively healthy employee population. Methods: We conducted a 2-phase trial to assess the effectiveness of providing 102 internal medicine residents with an activity monitor for 12 weeks. The first phase (6 weeks) was a randomized controlled trial (RCT) with half of the residents randomized to wear a monitor with visible feedback (steps, calories, activity level) and half the residents randomized to wear a blinded monitor (control). The second phase (6 weeks) was a team competition (TC), and all residents were unblinded and divided into 3 teams (interns, juniors, seniors) that competed on weekly steps. To increase compliance over 12 weeks, we conducted a weekly lottery for two $10 gift cards among subjects who wore the monitor for at least 5 of 7 days. Pedometer use (defined as > 500 steps/day) was compared across groups using chi-squared tests. We compared mean daily steps on days when pedometer was worn between control and intervention groups using generalized linear mixed models with participant as a random effect. Results: Baseline demographics and weight did not differ between control and intervention. Mean age was 29, 54% were female, and mean BMI was 24.2. Mean daily steps at baseline (week 1) were 8,084 (SD 3565). During the RCT phase (6 weeks), control and intervention groups did not differ in mean daily steps, but over the entire study (12 weeks), the intervention group logged 403 more steps per day than control (p<.001). During the 6- week TC phase, subjects logged 297 more steps per day than during the 6-week RCT (p=.001). A similar proportion of subjects from both groups wore the pedometer during the 6-week RCT (75%), but despite unblinding during the second 6 weeks (TC), pedometer usage was lower in the control group compared to intervention (55% vs. 63%, p<.001). Conclusions: Compliance with using an activity monitor in this young employee population was relatively high but started to decrease after 6 weeks. Although the effect size was small, providing an activity monitor and creating a team competition was effective for motivating employees to increase activity over the short term. Future study is needed to evaluate long-term effectiveness among a more sedentary population.

A systematic review of the cost-effectiveness of worksite physical activity and/or nutrition programs

The aim of this study was to appraise and summarize the evidence on the cost-effectiveness of worksite physical activity and/or nutrition programs. We searched EMBASE, MEDLINE, SportDiscus, PsycInfo, NIOSHTIC-2, NHSEED, HTA, and Econlit for studies published up to 14 January 2011. Additionally, we searched for articles by reviewing references, searching authors' databases, and contacting authors of included studies. Two researchers independently selected articles. Articles had to include a cost-effectiveness and/or cost-utility analysis comparing a worksite physical activity and/or nutrition program to usual care or an abridged version of the program. Data were extracted on study characteristics and results. Two researchers independently assessed the risk of bias using the Consensus on Health Economic Criteria list (CHEC-list). Ten studies (18 programs) were included. More than 50% of the studies fulfilled 11 (58%) of the 19 CHEC-list items. From various perspectives, worksite nutrition and worksite physical activity and nutrition programs (N=6) were more costly and more effective in reducing body weight than usual care. When only intervention costs were considered, most worksite nutrition (N=4/5) and worksite physical activity and nutrition programs (N=5/6) were more costly and more effective in reducing cholesterol level and cardiovascular disease risks, respectively. The cost-effectiveness of more costly and more effective programs depends on the "willingness to pay" for their effects. It is unknown how much decision-makers are willing to pay for reductions in body weight, cholesterol level, and cardiovascular disease risks. Therefore, conclusions about the cost-effectiveness of worksite physical activity and/or nutrition programs cannot be made. There is substantial need for improvement of the methodological quality of studies and particular emphasis should be placed on the handling of uncertainty.

Participation and cardiovascular risk reduction in a voluntary worksite nutrition and physical activity program

ObjectiveIn a cohort of employees participating in a worksite nutrition and physical activity program, we compared program completion and changes in cardiovascular risk factors by baseline body mass index. MethodsIn 2007, 774 employees enrolled in a 10week program at a hospital in Boston, Massachusetts. Program completion and change in weight, cholesterol, and blood pressure were compared between obese (body mass index≥30), overweight (body mass index=25–29.9), and normal weight (body mass index<25) participants. ResultsAt baseline, 63% were obese or overweight and had higher blood pressure and cholesterol compared to normal weight participants. Program completion was 82% and did not differ by body mass index. Mean weight loss was 1.9kg at end of program (p<0.001) and 0.4kg at 1year (p=0.002). At end of program, participants with body mass index≥30 lost 3.0% body weight vs. 2.7% for body mass index=25–29.9 and 1.7% for body mass index<25 (p<0.001), but weight loss at 1year did not differ by body mass index. Mean cholesterol and blood pressure were lower at end of program and 1year (all, p<0.005) but did not differ by body mass index. ConclusionsWorksite programs can successfully initiate cardiovascular risk reduction among employees, but more intensive interventions are needed to make significant improvements in the health of higher risk obese employees.

Do intervention fidelity and dose influence outcomes? Results from the Move to Improve worksite physical activity program

The purpose of this paper is to evaluate the implementation of the Move to Improve worksite physical activity program using a four step framework that includes the following: (i) defining the active ingredients, (ii) using good methods to measure implementation, (iii) monitoring implementation and (iv) relating implementation to outcomes. The intervention active ingredients consisted of a goal setting behavior change program, a team competition and environmental supports. Intervention fidelity and dose were measured by surveys administered to site co-ordinators, team captains and employees. Implementation was monitored by the use of biweekly assessments that tracked individual physical activity levels and through weekly reports of the project director and site co-ordinators. Latent growth modeling was conducted to determine whether intervention outcomes were affected by site implementation (i.e. fidelity) and/or participation by employees (i.e. dose). Results showed high levels of intervention fidelity, moderate to high levels of intervention dose delivered and moderate levels of the intervention dose received. Level of implementation affected the degree of change in vigorous physical activity (Mean = 5.4 versus 2.2; chi(2) = 4.9, df = 1), otherwise outcome measures were unaffected by fidelity and dose. These findings suggest that practitioners should focus more energy assuring that the core components are fully implemented and be less concerned about the level of participation.

Barriers and Enabling Factors for Work-Site Physical Activity Programs: A Qualitative Examination

Work sites offer a productive setting for physical activity (PA) promoting interventions. Still, PA participation remains low. Thus, the purpose of this study was to examine the reasoning behind commonly reported barriers and enabling factors to participation in PA programs in a work-site setting. Employees from a large city government were recruited to participate in focus groups, stratified by white- and blue-collar occupations. Responses from open-ended questions about factors influencing participation in PA programs were audio recorded and transcribed verbatim. Resulting data were analyzed with open and axial coding. The sample consisted of 60 employees composing 9 focus groups. Although time was the most common barrier between both groups, white-collars workers responded that scheduling and work conflicts were the most common barrier concerning time. Blue-collar workers indicated shift work as their most common barrier. In addition, health was a significant enabling factor for both occupational categories. White-collar workers were much more concerned with appearances and were more highly motivated by weight loss and the hopefulness of quick results than were blue-collar workers. These findings are important in the understanding of PA as it relates to the reasoning behind participation in work-site programs in regard to occupational status.

Blood Lipid Changes after a 10-Week Unsupervised Worksite Physical Activity Program

PURPOSE: Promoting physical activity is an important public health issue. Estimates suggest that 40 percent of adults do not engage in any leisure time physical activity. The worksite is an environment which may be conducive to promoting physical activity. The purpose of this study was to see whether a relatively unstructured approach to promoting physical activity and health at the worksite using pedometers and incentives would improve blood lipids. METHODS: All 72 employees of a small private corporation at three separate worksites were given the opportunity to take part in the 10-week intervention. Blood lipids of the 30 subjects who agreed to participate were measured before and after the intervention. Each subject was given a pedometer (New Lifestyles SW-200) and instructed on proper use, and weekly log sheets to track their daily step total. To encourage adherence each week subjects who turned in their weekly logs were rewarded with incentives. Each weekday subjects were also sent a daily e-mail health tip. The intervention also consisted of three 30-minute educational seminars. These seminars focused on the importance of physical activity, healthy nutrition, and stress management. RESULTS: Thirty subjects (24 females and 6 males) with a mean (+ SD) age of 44.53 + 9.74 years participated in the intervention. Paired samples t-tests showed that mean (+ SD) total cholesterol declined from 208.07 + 51.88 to 199.68 + 48.10 mg/dL (p<0.145); LDL-C declined significantly from 122.12 + 41.09 to 110.81 + 39.81 mg/dL (p<0.010); HDL-C increased significantly from 58.16 + 20.23 to 64.51 + 21.44 mg/dL (p<0.000); and as a consequence the ratio of TC:HDL-C declined from 4.17 + 3.31 to 3.20+ 1.04 (p<0.09).TG declined from 132.39+85.46 to 127.29 + 121.78 mg/dL (p<0.728). For the 10 weeks each subject averaged 5,134.8 + 3,287.9 steps per day. A significant correlation (r2 =0.414, p<0.028) existed between each subject's pre - post difference in HDL-C and the total number of steps completed. CONCLUSIONS: The results of this worksite intervention indicate that significant changes in lipid profiles may occur in adults with a relatively easy to implement and inexpensive short-term physical activity intervention.

The effectiveness of a pragmatic worksite physical activity program on maximal oxygen consumption and the physical activity level in healthy people

Summary Background and purpose: The primary aim of this study is to investigate the effect of a workplace physical activity program on maximal oxygen consumption and the physical activity level in healthy people. Subjects: One hundred and thirty-one subjects (80 men and 51 women) in a group of company employees were randomly assigned into the experimental group. Methods: A prospective unblinded clinical trial. Maximal oxygen consumption (VO 2max ) was predicted from a cycle ergometer test. Physical activity level was conducted from a self-reporting questionnaire. The experimental group was given an individual pragmatic program to increase the everyday physical activity level based on motivation and opportunity. Results: The VO 2max increased significantly ( P 0.001 ) with a significant ( P 0.001 ) increase in the overall physical activity level. The body mass index (BMI) did not increase significantly. Discussion and conclusion: A worksite physical activity program, with an individual pragmatic approach, may increase the physical activity level and hence VO 2max in a group of company employees.

The effectiveness of worksite physical activity programs on physical activity, physical fitness, and health.

To critically review the literature with respect to the effectiveness of worksite physical activity programs on physical activity, physical fitness, and health. A search for relevant English-written papers published between 1980 and 2000 was conducted using MEDLINE, EMBASE, Sportdiscus, CINAHL, and Psychlit. The key words used involved a combination of concepts regarding type of study, study population, intervention, and outcome measure. In addition, a search was performed in our personal databases, as well as a reference search of the studies retrieved. The following criteria for inclusion were used: 1) randomized, controlled trial or nonrandomized, controlled trial; 2) working population; 3) worksite intervention program to promote employees' physical activity or physical fitness; and 4) physical activity, physical fitness, or health-related outcomes. Two reviewers independently evaluated the quality of relevant studies using a predefined set of nine methodological criteria. Conclusions regarding the effectiveness of a worksite physical activity programs were based on a rating system consisting of five levels of evidence. Fifteen randomized, controlled trials and 11 nonrandomized, controlled trials met the criteria for inclusion and were reviewed. Six randomized, controlled trials and none of the nonrandomized, controlled trials were of high methodological quality. Strong evidence was found for a positive effect of a worksite physical activity program on physical activity and musculoskeletal disorders. Limited evidence was found for a positive effect on fatigue. For physical fitness, general health, blood serum lipids, and blood pressure, inconclusive or no evidence was found for a positive effect. To increase the level of physical activity and to reduce the risk of musculoskeletal disorders, we support implementation of worksite physical activity programs. For the other outcome measures, scientific evidence of the effectiveness of such a program is still limited or inconclusive, which is mainly the result of the small number of high-quality trials. Therefore, we recommend performing more randomized, controlled trials of high methodological quality, taking into account criteria such as randomization, blinding, and compliance.

Use of the Surgeon Generals Report on Physical Activity and Health among CHES

The primary purpose of this study was to determine awareness and use of the Surgeon General's Report on Physical Activity and Health (SGR) among Certified Health Education Specialists (CHES). A secondary purpose was to determine whether use of the SGR varied by physical activity level of the respondents. A total of 540 CHES completed a survey that included open- and closed-ended items regarding their awareness and use of the SGR and questions about their participation in physical activity. Twenty-five incomplete surveys were excluded from analyses, which resulted in a final sample of 515. The majority of CHES (78.3%, n = 403) had heard of the SGR. Of the 403 who were aware of the report, 52.8% (n = 208) had used the information from the report in their work setting. In addition, CHES who engaged in regular vigorous physical activity were more likely to use the report in their work setting than less active CHES (χ2 = 15.39, df = 3, p = .002). It is encouraging that a large number of CHES are using the SGR information within their own worksite physical activity programs.

“March Into May”: Worksite Physical Activity Program

In 1996, the U.S. Surgeon General's Report on Physical Activity and Health stated that physical inactivity is a serious national health problem. Each year up to 250,000 American deaths are attributed to a lack of regular physical activity. Studies have shown that inactive people generate about 8 percent higher health claim costs than active people. Using the U.S. Centers for Disease Control and Prevention's Physical Activity Challenge as a model, the Illinois Department of Public Health (IDPH) organized a worksite physical activity program: “March Into May.” Its primary goal was to promote regular, moderate physical activity through a planned 10-week program. Participant motivation relied on a team incentive, as well as on a personal-based behavioral contract. Participants set personal goals for regular activity, ranging from moderate activities like yard work to more intense ones like running and swimming. Using a simple self-reporting point system, they recorded daily physical activity in 10-minute blocks of time with the goal to be active at least 30 minutes most days (Surgeon General's recommendation). Incentives, prizes and awards were given at various intervals throughout the 10-week program. Teams were created within work units to encourage in-house competition and awards. The event was promoted via E-mail, flyers and weekly fitness activities. A database utilizing a spreadsheet format was created to record goals, points achieved, percent goals achieved and stage of change information obtained from pre- and post-survey forms. Nonparticipants also were invited to complete a survey form to collect stage of change data. The program and data collected were part of a national pilot campaign to help Americans increase their physical activity level and move toward the Healthy People 2010 physical activity goals. IDPH plans to expand the program next year to include both physical activity and Five-a- Day goals and stage of change data.