Improving interprofessional coordination in Dutch midwifery and obstetrics: A qualitative study

Background: Coordination between the autonomous professional groups in midwifery and obstetrics is a key debate in the Netherlands. At the same time, it remains unclear what the current coordination challenges are. Methods: To examine coordination challenges that might present a barrie

Move more:Combining gamification and physical nudges to promote walking breaks and reduce sedentary behavior of office workers. A randomized controlled trial

Background: Sedentary behaviour (SB) and lack of physical activity (PA) have been associated with poorer health outcomes and are increasingly prevalent in individuals working in sedentary occupations, such as office jobs. Gamification and nudges have attracted attention as promising strategies to promote health behaviour change. However, most studies of effectiveness so far lacked active controls, and few studies have tested interventions combining these two strategies. Objective: This study investigated the effectiveness of an intervention combining a gamified digital intervention with physical nudges to increase PA and reduce SB in Dutch office workers. Methods: Employees of the municipality of Rotterdam (N = 298) from two office locations were randomized at the location-level to either a 10-week intervention, combining a five-week gamification phase encompassing a gamified digital intervention with social support features and a five-week physical nudges phase, or to an active control (i.e. limited digital application with self-monitoring and goal-setting). The primary outcome was daily step count objectively measured via accelerometers. Secondary outcomes were self-reported PA and SB. Mixed-effects models were used to analyse the effects of the intervention on the primary and secondary outcome measures of participants up to one month after the intervention. Results: A total of 234 participants completed the study and provided accelerometer data. During the gamification phase, participants in the intervention condition significantly increased their number of daily steps (from 10138 to 10901; 763.5 increase) compared to those in the active control (from 10403 to 10619; 215.6 increase) (p = 0.01). These improvements were not sustained during the physical nudges phase (p = 0.76) or follow-up (p = 0.88). Conclusions: A digital intervention with gamification and social support features significantly increased the step count of office workers, compared to an active control encompassing self-monitoring and goal-setting. Physical nudges in the workplace were insufficient to promote maintanence of behaviour change achieved in the gamification phase. Future research should explore how to improve the long-term effectiveness of gamified digital interventions