Evidence base of economic evaluations of workplace-based interventions reducing occupational sitting time : an integrative review

Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVE: To review the evidence on the economic evaluations of workplace-based interventions that are designed to reduce prolonged periods of occupational sitting. DESIGN: An integrative review. DATA SOURCES: The search was conducted in 11 databases, including PubMed, Scopus, PsychINFO, NHS-EED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, Cochrane library, Sportdiscus, Research Paper in Economics (RePeC), the International Health Economic Association (IHEA) and EconLit. The databases were searched for articles published from inception to January 2022. Subsequent citation searches were also conducted in Google Scholar. The items of the Consensus Health Economic Criteria (CHEC) checklist were used for quality appraisal of the included studies. RESULTS: This review included five randomised control trails, including 757 office-based workers in high-income countries. The median quality appraisal score based on the CHEC items was 14 points (a range of 9-18). The mean duration of interventions was 33 weeks (a range of 4-52 weeks). Overall, the studies reported economic benefit when implemented to reduce occupational sitting time but no effect on absenteeism. From the societal perspective, the interventions (eg, the use of a sit-stand desk) were cost-effective. CONCLUSION: The economic impact of workplace interventions implemented to reduce occupational sitting time is evident; however, the existing evidence is limited, which precludes strong conclusions. Cost-effectiveness is not often evaluated in the studies exploring workplace interventions that address occupational sitting time. Workplace interventions are still in the development and testing phase; thus, the challenge for future studies is to include economic evaluation of interventions addressing sedentary behaviour in workplaces. PROSPERO REGISTRATION NUMBER: CRD42021226275.Peer reviewe

Compositional association of 24-h movement behavior with incident major adverse cardiac events and all-cause mortality

Cardiovascular disease (CVD) causes a high disease burden. Physical activity (PA) reduces CVD morbidity and mortality. We aimed to determine the relationship between the composition of moderate-to-vigorous PA (MVPA), light PA (LPA), sedentary behavior (SB), and sleep during midlife to the incidence of major adverse cardiac events (MACE) and all-cause mortality at a 7-year follow-up. The study population consisted of Northern Finland Birth Cohort 1966 members who participated in the 46-year follow-up in 2012 and were free of MACE (N = 4147). Time spent in MVPA, LPA, and SB was determined from accelerometer data. Sleep time was self-reported. Hospital visits and deaths were obtained from national registers. Participants were followed until December 31, 2019, or first MACE occurrence (acute myocardial infarction, unstable angina pectoris, stroke, hospitalization due to heart failure, or death due to CVD), death from another cause, or censoring. Cox proportional hazards model was used to estimate hazard ratios of MACE incidence and all-cause mortality. Isotemporal time reallocations were used to demonstrate the dose–response association between time spent in behaviors and outcome. The 24-h time composition was significantly associated with incident MACE and all-cause mortality. More time in MVPA relative to other behaviors was associated with a lower risk of events. Isotemporal time reallocations indicated that the greatest risk reduction occurred when MVPA replaced sleep. Higher MVPA associates with a reduced risk of incident MACE and all-cause mortality after accounting for the 24-h movement composition and confounders. Regular engagement in MVPA should be encouraged in midlife

Effect of wrist-worn activity monitor feedback on physical activity behavior: A randomized controlled trial in Finnish young men

AbstractThe purpose of this study is to evaluate whether the use of an activity monitor providing feedback has an effect on physical activity (PA) in young men. A population-based sample of 276 conscription-aged (mean=17.9, SD=0.7years) men participated in a 3-month randomized controlled trial in Oulu in 2012. Participants were randomized to an intervention group (INT, N=137) and a control group (CON, N=139). INT received a wrist-worn monitor (Polar Active) showing daily activity, and CON received identical monitors without feedback. Main outcome was the change from baseline in objectively measured weekly time spent in moderate-to-vigorous PA (MVPA) and sedentary activity (SED), as assessed by generalized estimation equations (GEE). Other lifestyle factors were assessed by a questionnaire at baseline and at 3months. Weekly physical activity data (≥4days with ≥8h each) were obtained from 72 (53%) and 90 (65%) men in the INT and CON, respectively. Based on GEE, time spent in MVPA increased (p=0.012) and SED decreased (p=0.032) in the INT compared with the CON. During the first 7weeks, the INT spent on average 1h less sedentary than the CON (t-test, p<0.05). During the first week, the INT showed 12minutes more MVPA compared to the CON (t-test, p=0.034). Based on questionnaire data, the proportion of the most sedentary men decreased in the INT (Wilcoxon test, 28% vs. 10%, p=0.029), with no change in the CON (20% vs. 19%, p=0.546). To conclude, a wrist-worn activity monitor providing feedback had a short-term positive effect on PA and SED in young men.Trial registrationThis is a pilot study for a larger randomized controlled trial registered to the clinical trials register NCT01376986

More Physical Activity, More Work Engagement? : A Northern Finland Birth Cohort 1966 Study

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Factors associated with parental recognition of a child's overweight status - a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Very few studies have evaluated the association between a child's lifestyle factors and their parent's ability to recognise the overweight status of their offspring. The aim of this study was to analyze the factors associated with a parent's ability to recognise their own offspring's overweight status.</p> <p>Methods</p> <p>125 overweight children out of all 1,278 school beginners in Northern Finland were enrolled.</p> <p>Weight and height were measured in health care clinics. Overweight status was defined by BMI according to internationally accepted criteria. A questionnaire to be filled in by parents was delivered by the school nurses. The parents were asked to evaluate their offspring's weight status. The child's eating habits and physical activity patterns were also enquired about. Factor groups of food and physical activity habits were formed by factor analysis. Binary logistic regression was performed using all variables associated with recognition of overweight status in univariate analyses. The significant risk factors in the final model are reported using odds ratios (ORs) and their 95% confidence intervals (CIs).</p> <p>Results</p> <p>Fifty-seven percent (69/120) of the parents of the overweight children considered their child as normal weight. Child's BMI was positively associated with parental recognition of overweight (OR 3.59, CI 1.8 to 7.0). Overweight boys were less likely to be recognised than overweight girls (OR 0.14, CI 0.033 to 0.58). Child's healthy diet (OR 0.22, CI 0.091 to 0.54) and high physical activity (OR 0.29, CI 0.11 to 0.79) were inversely related to parental recognition of overweight status.</p> <p>Conclusions</p> <p>Child's healthy eating habits and physical activity are inversely related to parental recognition of their offspring's overweight. These should be taken into account when planning prevention and treatment strategies for childhood obesity.</p

More Physical Activity, More Work Engagement? : A Northern Finland Birth Cohort 1966 Study

Objective To examine the role of physical activity (PA) and sedentary behavior (SED) for work engagement. Methods We used data from Northern Finland Birth Cohort 1966 Study (n = 3046 to 4356) to analyze self-reported weekly leisure-time physical activity (LTPA), daily leisure-time sitting time (LTST) and work engagement. PA and SED 24-hour were also measured with accelerometer for 14 days. The data were analyzed using linear regression analyses. Results High self-reported LTPA and sports participation were associated with higher work engagement and its subdimensions. High self-reported ST was associated with lower work engagement, vigor, and absorption. Accelerometer-measured light PA was associated with higher work engagement and vigor, and accelerometermeasured steps were linked to higher vigor. Accelerometer-measured SED was associated with lower work engagement, vigor, and dedication. Conclusions Self-reported and accelerometer-measured PA and SED may play a role in people's work engagement.Peer reviewe

Physical activity, residential greenness, and cardiac autonomic function

Purpose: This population-based study examines the associations between physical activity (PA), residential environmental greenness, and cardiac health measured by resting short-term heart rate variability (HRV). Methods: Residential greenness of a birth cohort sample (n=5433) at 46 years was measured with normalized difference vegetation index (NDVI) by fixing a 1km buffer around each participant's home. Daily light PA (LPA), moderate PA (MPA), vigorous PA (VPA), and the combination of both (MVPA) were measured using a wrist-worn accelerometer for 14days. Resting HRV was measured with a heart rate monitor, and generalized additive modeling (GAM) was used to examine the association between PA, NDVI, and resting HRV. Results: In nongreen areas, men had less PA at all intensity levels compared to men in green areas. Women had more LPA and total PA and less MPA, MVPA, and VPA in green residential areas compared to nongreen areas. In green residential areas, men had more MPA, MVPA, and VPA than women, whereas women had more LPA than men. GAM showed positive linear associations between LPA, MVPA and HRV in all models. Conclusions: Higher LPA and MVPA were significantly associated with increased HRV, irrespective of residential greenness. Greenness was positively associated with PA at all intensity levels in men, whereas in women, a positive association was found for LPA and total PA. A positive relationship of PA with resting HRV and greenness with PA was found. Residential greenness for promoting PA and heart health in adults should be considered in city planning

Did the Finnish depression of the early 1990s have a silver lining? The effect of unemployment on long-term physical activity

This paper studies the impact of long-term unemployment on physical activity. We examined the effects 6 and 15 years following a severe business cycle downturn in Finland over the period 1991-1994. The study sample comprised residents of Northern Finland. The unemployed individuals were 23-26 years old during the downturn. Physical activity, measured by MET minutes and meeting WHO guidelines, was higher 15 years later among those people who experienced the longest periods of unemployment in 1991-1994. Physical activity was somewhat lower among people with relatively shorter periods of unemployment

Accelerometer-measured physical activity is associated with knee breadth in middle-aged Finns - a population-based study

Background: Articular surface size is traditionally considered to be a relatively stable trait throughout adulthood. Increased joint size reduces bone and cartilage tissue strains. Although physical activity (PA) has a clear association with diaphyseal morphology, the association between PA and articular surface size is yet to be confirmed. This cross-sectional study aimed to clarify the role of moderate-to-vigorous PA (MVPA) in knee morphology in terms of tibiofemoral joint size. Methods: A sample of 1508 individuals from the population-based Northern Finland Birth Cohort 1966 was used. At the age of 46, wrist-worn accelerometers were used to monitor MVPA (≥3.5 METs) during a period of two weeks, and knee radiographs were used to obtain three knee breadth measurements (femoral biepicondylar breadth, mediolateral breadth of femoral condyles, mediolateral breadth of the tibial plateau). The association between MVPA and knee breadth was analyzed using general linear models with adjustments for body mass index, smoking, education years, and accelerometer weartime. Results: Of the sample, 54.8% were women. Most individuals were non-smokers (54.6%) and had 9-12 years of education (69.6%). Mean body mass index was 26.2 (standard deviation 4.3) kg/m2. MVPA was uniformly associated with all three knee breadth measurements among both women and men. For each 60 minutes/day of MVPA, the knee breadth dimensions were 1.8-2.0% (or 1.26-1.42 mm) larger among women (p < 0.001) and 1.4-1.6% (or 1.21-1.28 mm) larger among men (p < 0.001). Conclusions: Higher MVPA is associated with larger tibiofemoral joint size. Our findings indicate that MVPA could potentially increase knee dimensions through similar biomechanical mechanisms it affects diaphyseal morphology, thus offering a potential target in reducing tissue strains and preventing knee problems. Further studies are needed to confirm and investigate the association between articulation area and musculoskeletal health.Peer reviewe