Promoting physical activity in the workplace: a stage of change approach

Regular physical activity is associated with improved physiological and psychological wellbeing, by reducing the risk of chronic illnesses such as cardiovascular disease, cancer, obesity, diabetes, osteoporosis and depression. There is a common perception that physical activity levels in the population are declining, and one of the biggest changes affecting this is occupational based activity. Since adults spend on average over 50% of their waking hours at work, work sites have the potential to be an important setting for health promotion initiatives. Cognitions and behaviours are key causal factors behind many of today s most widespread health problems and illnesses. The stage of change model has been highlighted as having intuitive appeal because it considers the dynamic nature of attitudes and behaviour change. This thesis is concerned with the application of the stage of change model to an occupational health intervention promoting physical activity. Several research studies were undertaken to explore the experiences of employees with workplace health initiatives and investigate the strategies and practices used by occupational health to promote healthy behaviours. These research studies highlighted the barriers and facilitators to successful health interventions and contributed towards the design, development and implementation of an activity promotion intervention. Additional research was also conducted to develop information materials based on the stage of change model. The stage approach was simplified and intervention materials were classified based on whether employees were thinking about making a change or not thinking about making a change to their activity levels. In order to test the materials, a twelve month intervention was implemented in ten work sites across the UK that were allocated to one of three groups. Two groups received information materials and one group received no information during the intervention period (control group). The difference between the two groups who received information was that one group received standard activity promotion information (standard group) and the second group received tailored information based on their stage of change construct (staged group). Participants in the staged intervention group demonstrated significant decreases in body mass index, fat percentage, waist circumference, blood pressure and resting heart rate following the twelve month intervention. In contrast, reductions were identified for the standard intervention group for waist circumference and diastolic blood pressure. Finally, there were no long-term significant improvements identified for the control group. However, group comparisons revealed there were no significant differences between the intervention conditions. The intervention also recorded self-reported psychological outcomes, which demonstrated variations throughout the intervention period for all groups. The potential reasons for these inconsistent outcomes are discussed. A process evaluation following the intervention demonstrated employees valued the health screenings and identified issues relating to knowledge, behaviour change and health implications that were important outputs of the intervention. Based on these findings, the research concludes there is scope to make physical activity interventions in the workplace more effective by applying the stage of change approach. Using the process of simplifying the stages and focusing on whether employees want to change their behaviours or not allows occupational health to deliver information that could be more meaningful and have a significant impact on behaviour change. By understanding employees readiness to change their activity behaviours and targeting information based on their beliefs, attitudes and intentions to change may produce significant improvements in health outcome measures compared to standard information. The results also suggest there is potential for this type of tailored intervention to be extended to other occupational health issues

Process evaluation of a tailored workplace intervention designed to promote sustainable working in a rapidly changing world

Increasing numbers of people are employed in sedentary occupations, spending large amounts of time sitting at work which is detrimental to health and wellbeing. Evidence-based guidance is required to intervene to reduce sedentary behaviour, encourage physical activity and promote sustainable working. This article presents a process evaluation of a successful workplace intervention Walking Works Wonders, shown to be effective in improving health, job satisfaction and motivation (Haslam et al. 2018). In this qualitative process evaluation employees reported an increased awareness of their sedentary time and they particularly valued the monitoring of activity using pedometers. They described changes to their working and leisure time activity to accumulate more steps. Participants reported improved physiological and psychological health outcomes, improved working relations with colleagues, changes in dietary behaviour and involving their families in physical activity. The results highlight elements of the intervention that encouraged healthy and more sustainable working practices. Practitioner summary: This study provides the employees’ perspective on the effective elements of a workplace intervention which encouraged physical activity and reduced sitting time. The results offer valuable insights for practitioners aiming to develop interventions to improve health and facilitate more sustainable working practices in a rapidly changing world of work

A survey of sitting time among UK employees

Background Sedentary behaviour is a known risk factor for a wide range of chronic diseases. This major health risk is likely to increase given the increasingly sedentary nature of work. Aims To investigate the prevalence of sedentary behaviour in a sample of UK working-aged adults, across a range of employment sectors. Methods A cross-sectional survey conducted with organizations throughout the UK in the education, government administration, retail, telecommunications and service industry sectors. The questionnaire examined employee and organizational information, self-reported domain-specific sitting time, sleep and physical activity. Results A total of 1141 employees completed the questionnaire, of which 504 completed all aspects of the Domain-Specific Sitting Time Questionnaire for work day sitting. Work time sitting accounted for more than half of the total daily sitting time on a work day (54%). Significantly more time was reported sitting on a work day than time reported sleeping (P < 0.001). Males spent more time sitting at work and using a personal computer at home compared with females. Workers in the telecommunications industry had the highest sitting times. There were significant positive associations between sitting time and body mass index. Conclusions There is a pressing need for future workplace health interventions to reduce employee sitting times

Walking works wonders: a tailored workplace intervention evaluated over 24 months

This article presents longitudinal data from 1120 participants across 10 worksites enrolled in Walking Works Wonders, a tailored intervention designed to increase physical activity and reduce sedentary behaviour. The intervention was evaluated over 2 years, using a quasi-experimental design comprising 3 conditions: tailored information; standard information and control. This study explored the impact of the intervention on objective measures (BMI, út, waist circumference, blood pressure and heart rate) and self-reported measures of physical activity, sedentary behaviour, physical and psychological health. Interventions tailored to employees' stage of change significantly reduced BMI and waist circumference compared to standard and control conditions. Employees who received either a standard or tailored intervention demonstrated significantly higher work ability, organizational commitment, job motivation, job satisfaction, and a reduction in intention to quit the organization. The results suggest that adopting a tailored approach to interventions

Sedentary behaviour and health at work: an investigation of industrial sector, job role, gender and geographical differences

This article presents baseline data from 1120 employees across 10 worksites enrolled in a workplace physical activity intervention. The study provides new data on physical activity, sedentary behaviour and health and highlights gender, geographical, job type and industrial sector differences. Sitting at work accounted for more than 60% of participants' total daily sitting time on work days. Weekly and monthly hours worked, body mass index (BMI) and waist circumference were significantly higher for workers in the private sector compared to the public sector. Employees in sales and customer services had significantly higher BMI scores and significantly lower scores for workability index (WAI), job satisfaction, organisational commitment and job motivation, compared to other groups. This study provides further evidence that work is a major contributor to sedentary behaviour and supports the pressing need for interventions particularly targeting private sector industries and sales and customer service sectors

Proactive occupational safety and health management: promoting good health and good business

This research assessed the impact of organisational approaches to occupational safety and health (OSH) management on organisational performance, safety climate, employee attitudes, health and well-being. Interviews with health and safety personnel, company directors and worker representatives were used to categorise the organisations according to their approaches to OSH management, using the Continuous Improvement Cycle model (Budworth and Khan, 2003). A cross-sectional survey of 2067 employees from these organisations examined the impact of company size, industrial sector and approach to OSH management on indicators of organisational performance and employee outcomes. A structured questionnaire assessed demographic characteristics, organisation and job tenure, job satisfaction, organisational commitment, intention to quit and job motivation, safety climate, self-reported absence, performance and work-related ill-health. Organisations were also asked to provide data on profit, performance, accidents and absence indices. Organisations adopting a proactive approach to OSH management reported higher profit margins and lower accident rates, however these differences were not statistically significant. Organisations classified as ‘very good’ were found to show significantly more positive safety climate perceptions across eight out of the nine safety climate dimensions. Employees in proactive organisations were significantly more committed to their organisations and showed greater job satisfaction than employees in organisations categorised as ‘yet to be fully engaged/-complier’. Positive safety climate perceptions and organisational attitudes were associated with better self-reported physical and mental health. The findings add to the validation of the CIC model as an assessment and learning tool which may support the transition of organisations from reactive to proactive safety culture

Working late: strategies to enhance productive and healthy environments for the older workforce

It is predicted that by 2025 there will be twice as many workers aged 50 and over than those aged 25 years and younger in the EU (Ilmarinen, 2001). Demographic changes, together with changes in pension policy, life expectancy and employment practices, are contributing to the increasing age of our workforce. Consequently, improved older worker integration and employment outcomes look set to be the key means through which economies can adjust to the pressures of an ageing population (Banks, 2006). The ageing workforce presents new challenges not only for government, occupational health services, and employers, but also for employees and their families. [Continues...

Associations of mutually exclusive categories of physical activity and sedentary time with markers of cardiometabolic health in English adults: a cross-sectional analysis of the Health Survey for England

BACKGROUND: Both physical activity and sedentary behaviour have been individually associated with health, however, the extent to which the combination of these behaviours influence health is less well-known. The aim of this study was to examine the associations of four mutually exclusive categories of objectively measured physical activity and sedentary time on markers of cardiometabolic health in a nationally representative sample of English adults. METHODS: Using the 2008 Health Survey for England dataset, 2131 participants aged ≥18 years, who provided valid accelerometry data, were included for analysis and grouped into one of four behavioural categories: (1) 'Busy Bees': physically active & low sedentary, (2) 'Sedentary Exercisers': physically active & high sedentary, (3) 'Light Movers': physically inactive & low sedentary, and (4) 'Couch Potatoes': physically inactive & high sedentary. 'Physically active' was defined as accumulating at least 150 min of moderate-to-vigorous physical activity (MVPA) per week. 'Low sedentary' was defined as residing in the lowest quartile of the ratio between the average sedentary time and the average light-intensity physical activity time. Weighted multiple linear regression models, adjusting for measured confounders, investigated the differences in markers of health across the derived behavioural categories. The associations between continuous measures of physical activity and sedentary levels with markers of health were also explored, as well as a number of sensitivity analyses. RESULTS: In comparison to 'Couch Potatoes', 'Busy Bees' [body mass index: -1.67 kg/m(2) (p < 0.001); waist circumference: -1.17 cm (p = 0.007); glycated haemoglobin: -0.12 % (p = 0.003); HDL-cholesterol: 0.09 mmol/L (p = 0.001)], 'Sedentary Exercisers' [body mass index: -1.64 kg/m(2) (p < 0.001); glycated haemoglobin: -0.11 % (p = 0.009); HDL-cholesterol: 0.07 mmol/L (p < 0.001)] and 'Light Movers' [HDL-cholesterol: 0.11 mmol/L (p = 0.004)] had more favourable health markers. The continuous analyses showed consistency with the categorical analyses and the sensitivity analyses indicated robustness and stability. CONCLUSIONS: In this national sample of English adults, being physically active was associated with a better health profile, even in those with concomitant high sedentary time. Low sedentary time independent of physical activity had a positive association with HDL-cholesterol