Article

Physical Activity Promotion in Business and Industry: Evidence, Context, and Recommendations for a National Plan

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  • HealthPartners Institute
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Abstract

The contemporary workplace setting is in need of interventions that effectively promote higher levels of occupational and habitual physical activity. It is the purpose of this paper to outline an evidence-based approach to promote physical activity in the business and industry sector in support of a National Physical Activity Plan. Comprehensive literature searches identified systematic reviews, comprehensive reviews, and consensus documents on the impact of physical activity interventions in the business and industry sector. A framework for action and priority recommendations for practice and research were generated. Comprehensive, multicomponent work-site programs that include physical activity components generate significant improvements in health, reduce absenteeism and sick leave, and can generate a positive financial return. Specific evidence-based physical activity interventions are presented. Recommendations for practice include implementing comprehensive, multicomponent programs that make physical activity interventions possible, simple, rewarding and relevant in the context of a social-ecological model. The business and industry sector has significant opportunities to improve physical activity among employees, their dependents, and the community at-large and to reap important benefits related to worker health and business performance.

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... The sedentary nature of office work has increased sitting time to the degree that prolonged sitting time has emerged as a significant health concern for office workers. 28,29 The workplace represents an important setting for the promotion of PA and reduction of SB. 10,29,30 It is the purpose of this article to highlight approaches to increase movement, PA, CRF, and reduce SB in the context of the workplace setting. ...
... The goal to reduce prolonged sitting time may be accomplished through, for example, the use of sitstand desks, by integrating activity breaks throughout the day, or a combination of the two-forcing everyone into the same choice may not work well and is unlikely to yield high participation. 29,30 In 2009, a set of criteria were proposed to promote PA as a strategic corporate priority. 30,31 These criteria were directly linked to a set of essential elements for comprehensive worksite health promotion programs and health policy initiatives and presented in the context of a socioecological model. ...
... 29,30 In 2009, a set of criteria were proposed to promote PA as a strategic corporate priority. 30,31 These criteria were directly linked to a set of essential elements for comprehensive worksite health promotion programs and health policy initiatives and presented in the context of a socioecological model. The criteria include 31 : 1) Organizing PA interventions within a framework that leverages the inter-relationships of individuals and their work environment; 2)Prioritizing the use of evidence-based and evidence-informed interventions; and 3) Aligning selected PA interventions with best practices for comprehensive, multi-component worksite health programs. ...
Chapter
This chapter describes the way the PRECEDE-PROCEED model has been applied to the workplace setting.
... To promote a physically active lifestyle, the workplace seems to be a promising setting [2,[10][11][12]. Previous research has indicated that measures promoting physical activity in the workplace can generate significant improvements in health, reduce absenteeism, psychological well-being and sick leave [13][14][15][16][17]. Furthermore, there are some indications of an increase in the level of physical activity due to workers' participating in such measures [12]. ...
... Previous research has indicated that measures promoting physical activity in the workplace can generate significant improvements in health, reduce absenteeism, psychological well-being and sick leave [13][14][15][16][17]. Furthermore, there are some indications of an increase in the level of physical activity due to workers' participating in such measures [12]. Multicomponent interventions comprising different approaches and strategies to promote physical activity seem to be especially effective [2,13,18]. Within the context of behavioural-related interventions, the utilization of physical activity-related measures in the German population is clearly higher than the utilization of measures for nutrition and relaxation, whereby participation is less for men than for women [19]. Therefore, the literature refers to the importance of gender-sensitive physical activity promotion [20] and also a target group-specific orientation in workplace health promotion (WHP) [21]. ...
... The requests of the participants towards physical activity measures in the workplace showed many parallels with previous research. Because of its effectiveness [2,13,18], in this study value was placed on multicomponent intervention design right from the beginning. Therefore the tripartite, incorporating measures of "exercise programmes", "redesigning work processes" and "creating physical activity-friendly infrastructure at work", analogous to the National Recommendations for Physical Activity and Physical Activity Promotion [2], was assumed. ...
Article
Full-text available
The untapped potential of workplace health promotion (WHP) in smaller companies and the promising approach to promote physical activity in the workplace requires application-oriented approaches. This study describes the participatory, theory-based development of a cross-company network with a multicomponent intervention for promoting physical activity in smaller companies. The BIG-Manual (from the "Movement as an Investment for Health" project, German-BIG) was the theoretical framework for developing the cross-company network. Qualitative and quantitative data sources were used to identify the requests and requirements of stakeholders (employees on site, local exercise providers, company representatives and network partners) regarding measures promoting physical activity and the cross-company network. The methods applied included two workshops (n = 13; n = 15), individual semi-structured interviews (n = 8) and a survey (n = 285). The analysis revealed that a large number of stakeholders must be taken into consideration for physical activity promotion in cross-company networks. Many similarities between the requests of employees and further stakeholders concerning a multicomponent intervention for promoting physical activity could be identified. Present gender-specific and physical activity-related differences show the importance of target group-specific intervention planning in the context of WHP. This study makes an important contribution for the development of future cross-company networks promoting physical activity and yields valuable information for the design of a multicomponent intervention promoting physical activity.
... To promote worksite health more productively, documents outlining best practices [21,22], scientific reviews [23], expert opinions [24][25][26] and individual studies [27] all advocate the use of socio-ecological models [28,29]. These models suggest that people's health behavior is influenced not only by their intrapersonal characteristics but also by a wide variety of factors in their social, environmental and policy contexts. ...
... However, so far the application of multilevel approach to health promotion and PA interventions has been limited [23,[44][45][46]. It seems that the empirical evidence on the effectiveness of multilevel interventions in relation to single-level interventions is yet unclear [44], which may be one reason for the limited use. ...
... The primary strength of the study was that it was conducted in a real-world setting. This may allow more direct translation of the results to practice and policy [23]. Also, the actions were mostly planned and implemented by the workplaces themselves, which made the intervention highly participative. ...
Article
Full-text available
Background Regular physical activity (PA) promotes and excessive sedentary behavior (SB) deteriorates health. Yet the Finnish working-aged population spends most of the day sitting. A 1-year Moving To Business (MTB) -intervention supported small and medium-size workplaces to combat sedentariness. This paper reports the changes in employees’ PA and SB from before MTB (baseline) to 1 year after baseline (follow-up). Methods Twelve workplaces with a total of 396 employees participated. Each workplace nominated a team to promote PA and reduce SB at organizational, working unit and employee level. The teams were mentored regionally through meetings, workshop and tools. Changes in PA and SB were assessed with a questionnaire and an accelerometer. Wald Confidence Interval (Cl) for a difference of proportions with matched pairs was used in the questionnaire data (%-points with 95% CI) and linear mixed model in the accelerometer data (minutes and % of wear-time with 95% CI). ResultsThe mean age of the respondents to the questionnaire (N = 296; 75%) was 42.6 (SD 10.9), 64% were women, 95% had some education after high school, 74% worked in the day shift, 71% did sedentary work and 51% were overweight. The mean number of actions implemented in the workplaces was 6.8 and the multilevel approach was fully applied in 6 workplaces. Based on the questionnaire the time spent in SB decreased from baseline to follow-up 16% (95% CI −29 to −3) in total and 22% (−41 to −3) at work. The accelerometer showed daily increases of 33.7 min (15.3 to 52.1) and 6.8% (3.1 to 10.4) in total PA, 30.9 min (15.3 to 46.5) and 6.1% (2.9 to 9.2) in light PA and 673 (209 to 1139) more steps at work. Daily SB at work decreased 44.9 min (−68.0 to −21.8) and 7.6% (−11.9 to −3.2). Daily leisure PA declined 11.0 min (−24.9 to 2.9) and 3.2% (−6.2 to −0.2). Number of levels or actions had no effect on changes. Conclusions Employees’ PA increased and SB reduced at work during the intervention. At the same time leisure PA decreased slightly. Workplaces can achieve meaningful changes in employees’ PA and SB if assisted systematically. Controlled studies are needed to confirm the present findings. Trial registrationNCT01999205, registration date 11/01/2013.
... Attempts to deal with the increasingly sedentary nature of work in the contemporary workplace may be considered a strategic priority for business and industry (Pronk and Kottke 2009;Pronk 2009a). The challenges associated with sedentary behavior at the workplace are not limited to health alone. ...
... As a complex social environment, the workplace allows many strategies to be deployed for the purpose of reducing sedentary time. Employees may be reached for extended periods of time with a high frequency of health-related interventions; multiple tools, resources, and vehicles may be mobilized to increase awareness, change behaviors, modify environments, and influence organizational policy; and companies may collaborate with each other to influence broader social policy at a local, statewide, provincial, or national level (Pronk 2009a;). Yet workplace health programs designed to change behavior are not limited to those focused on physical activity or sedentary behavior. ...
... Yet workplace health programs designed to change behavior are not limited to those focused on physical activity or sedentary behavior. In fact, systematic reviews have repeatedly shown that the most effective programs tend to be multicomponent comprehensive programs that engage as many employees as possible over extended periods of time (Pronk 2009a;Goetzel and Pronk 2010;Pronk and Goetzel 2010;Soler, Leeks, Razi, et al. 2010;Soler, Leeks, Buchanan, et al. 2010). Several benchmark studies and summary documents have derived a list of key characteristics of health programs that are associated with effective workplace programs and policies (O'Donnell 2002;Chapman 2004;Goetzel et al. 2007;Pronk 2009b;NIOSH 2008;Sparling 2010;Berry, Mirabito, and Baun 2011). ...
... Furthermore, when physical activity is a routine part of a person's daily set of activities, the benefits extend into improved management and prevention of major chronic conditions, such as diabetes, cardiovascular disease, and certain cancers, as well as improvements in mood states and mental health. These benefits have a direct influence on how people function, and function manifests itself in the workplace into factors such as productivity, interactions among team members, and relationships with customers (7,8). In addition, less illness reduces medical care costs (9). ...
... In addition, less illness reduces medical care costs (9). Thus, increasing physical activity to levels associated with health benefits can create a healthier workforce, reduce incidence of new disease, enhance management of existing disease, reduce debilitating chronic conditions, reduce sick leave and injuries at work due to disease and ill-health, enhance worker and family earnings, enhance the social relationships among coworkers, and increase productivity (4)(5)(6)(7)(8)(9)(10)(11)(12). ...
... For example, the impact of employer subsidies for public transportation on overall physical activity or a tax-benefited reimbursement for bicycling to work as a result of the Bicycle Commuter Act may be considered and studied (44). More specifically, action principles that may support the implementation of employer-sponsored physical activity programs include (a) the organization of physical activity interventions within a framework that leverages the interrelationships between individuals and their work environment (8,44,45); (b) prioritizing the use of evidence-based and evidence-informed interventions (5,8,40,41,44); and (c) the alignment of selected physical activity programs with best practices for comprehensive worksite health promotion programs (5,8,(46)(47)(48). ...
... The sedentary nature of office work has increased sitting time to the degree that prolonged sitting time has emerged as a significant health concern for office workers. 28,29 The workplace represents an important setting for the promotion of PA and reduction of SB. 10,29,30 It is the purpose of this article to highlight approaches to increase movement, PA, CRF, and reduce SB in the context of the workplace setting. ...
... The goal to reduce prolonged sitting time may be accomplished through, for example, the use of sitstand desks, by integrating activity breaks throughout the day, or a combination of the two-forcing everyone into the same choice may not work well and is unlikely to yield high participation. 29,30 In 2009, a set of criteria were proposed to promote PA as a strategic corporate priority. 30,31 These criteria were directly linked to a set of essential elements for comprehensive worksite health promotion programs and health policy initiatives and presented in the context of a socioecological model. ...
... 29,30 In 2009, a set of criteria were proposed to promote PA as a strategic corporate priority. 30,31 These criteria were directly linked to a set of essential elements for comprehensive worksite health promotion programs and health policy initiatives and presented in the context of a socioecological model. The criteria include 31 : 1) Organizing PA interventions within a framework that leverages the inter-relationships of individuals and their work environment; 2)Prioritizing the use of evidence-based and evidence-informed interventions; and 3) Aligning selected PA interventions with best practices for comprehensive, multi-component worksite health programs. ...
Article
The purpose of this article is to highlight approaches to increase movement, physical activity (PA), and cardiorespiratory fitness, and reduce sedentary behavior (SB) in the context of the workplace. A deliberate strategy that will enable the successful promotion of movement at the workplace includes a business plan and rationale, an organizing framework, prioritization of interventions that are known to generate outcomes, and alignment of programmatic solutions with strong program design principles. Recommended principles of design include leadership, relevance, partnership, comprehensiveness, implementation, engagement, communications, being data-driven, and compliance. Specific evidence-based intervention examples are presented in the context of a socio-ecological framework including the individual, group, communications environment, physical environment, and policy domains. Increased movement at the workplace, as a result of promoting PA and reducing SB, generates important health outcomes across physical, mental, social, and economic domains and these benefits extend across the individual and organizational levels.
... The potential of workplaces to be sites for investment in setting-based health promotion is recognised particularly in countries such as the United States where there are financial incentives through health insurance schemes for employers to take an active role in their employees' health and wellbeing. Even where such incentives are absent there is still evidence for the benefits to workplaces in promoting workers' health and wellbeing including improved morale, reduced absenteeism and increased levels of productivity [1][2][3][4][5][6][7]. Carmichael and colleagues reviewed the evidence for such programs and their impact on individuals and workplaces across a range of industries [4]. ...
... Work has become more sedentary contributing to the increased incidence of obesity, and musculoskeletal and other health issues [5,7,[19][20][21][22][23][24][25]. These potentially impact on workplace productivity and are key reasons for employers to initiate workplace health promotion programs. ...
... Workplaces can provide opportunities for group activities and incentives to participate in health promotion that may not be available elsewhere. There is now a body of evidence that workplace health and wellbeing programs benefit both the individuals participating as well as the businesses for which they work [1][2][3][4][5][6][7]. Challenges remain, however, with involving individual businesses in workplace health and wellbeing programs. ...
Article
Full-text available
Background: Investments in settings-based health interventions can include workplaces, however, engaging with businesses and convincing them to take a role can be difficult. Our research investigated the potential for trade or industry associations (IAs) to have a role in promoting workplace health initiatives to their members. Methods: Seventeen semi-structured interviews were undertaken with senior executives from IAs representing industries in the mining, transport, agriculture, manufacturing, farming, hospitality, and construction sectors. Analysis of interviews identified themes around attitudes to workplace health promotion programs and the perceived, actual and potential role/s of IAs in promoting workplace wellness. Results: IA representatives believed workplaces had potential to be promoting the health and wellbeing of workers through their member organisations; however for some the extent of their role was unclear and for others there was confusion between government-mandated safety initiatives and non-mandated health and wellbeing initiatives. All reported that their IA could have a role in promoting worker health and wellbeing initiatives to member organisations. IAs with larger companies as members were more likely to recognise the importance of workplaces promoting workers' health; however, the degree of involvement considered appropriate varied. Most IAs had not discussed the topic with their member organisations although they identified resources and support that could assist them in encouraging members to undertake workplace health programs. Resources included industry-relevant business cases outlining the benefits of workplace health, and industry-appropriate worker health information. Conclusions: Our research suggests that across many industry sectors, larger IAs in particular are ready to take a more active role in workplace health initiatives and are well placed to promote these to member organisations.
... Another aspect to be taken in consideration is the fact that at present the work context itself is also conducive to the increase in workers' sedentary lifestyle due to technological advances that try to improve work efficiency, minimise redundancy of tasks, and avoid waste of resources (Pronk, 2009). As a consequence, there is an increase in prolonged periods without any PA, leading these workers to have Musculoskeletal Disorders (MSDs) and even cardiovascular problems (Mackenzie et al., 2015;Mulchandani et al., 2019). ...
... In contrast, unhealthy workers have been described as having negative mental attributes such as being stressed, having a negative attitude, lack of self-respect, and being visibly sad, leading to their being recognised for their low productivity. The effectiveness of health intervention programs that address these variables may mean that employers are increasingly adopting a policy of promoting PA at work as it is seen as an important component of an organisation's business plan to improve not only the health of the worker but also their productivity (Pronk, 2009;Shi et al., 2013;Goetzel et al., 2007). Employers are starting to have some economic interest in helping to maintain better health among their workers (Goetzel et al., 2007;Pescud et al., 2015;Hannon et al., 2012). ...
... Given the above, there is evidence that PA can improve people's perceptions of themselves by increasing their self-esteem and reducing stress (Biddle et al., 2003), aspects that according to the present study have a strong correlation with the levels of performance in the work context. These facts may lead the employers to the adoption of a policy of PA promotion at work, with double benefit for these two stakeholders (Goetzel et al., 2007;Pronk, 2009;Shi et al., 2013). ...
... In order to assess current state of health and fitness precisely, it is essential for men and women with a chronic disease to obtain medical advice or undergo a medical check before beginning a physical exercise program and before increasing their physical activity [13,20,42,44,45,60,91,114,144]. The physician should clarify, among other things, the nature and severity of the health issue and consider tests of physical functions/structures, limitations of activities and participation as well as individual context factors. ...
... Based on their analysis, multi-component approaches are most effective that involve for example providing on-site fitness facilities, reorganizing company processes to promote physical activity, encouraging "active transport" (e.g. with bicycle parking, showers) and pedometer-based interventions (i.e. that go beyond merely informative physical activity counseling) [43]. Another review of reviews comes to a similar conclusion, presenting multi-component approaches in companies as effective and recommendable [44]. ...
Book
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Always and at any age, regular physical activity can act as a powerful elixir with a beneficial effect on health and well-being. The wide variety of health effects that physical activity can have, for example on our cardiovascular system, back and joints, is scientifically well proven. At the same time, we spend most of our time sitting – at school, at the office or in the car. Our bodies, however, want to be on the move! This fundamental instinct is deeply rooted in human nature and this basic urge to move does not really suit our modern sedentary lifestyle.That is why it is important to know what kind of, and how much, physical activity is most effective in improving the health of which sectors of the population. However, we also need to know the specific ways in which we can most effectively motivate people to become physically active. For the very first time, this publication sets out National Recommendations for Physical Activity and Physical Activity Promotion for the Federal Republic of Germany. The recommendations apply to children and adolescents, adults and older persons as well as to adults with chronic diseases. In their present form, they are geared particularly to experts in different areas and institutions. The recommendations are characterized by their solid scientific grounding. Highly respected scientists from the fields of sports science, sports medicine and public health were involved in drawing them up. As with their creation, the recommendations’ further development and implementation will be accompanied closely by the working group on physical activity promotion in everyday life (“Bewegungsförderung im Alltag”) at the Federal Ministry of Health. This platform provides a forum for numerous organizations involved in health promotion, physical activity and sport in Germany and is part of the National Action Plan “IN FORM – German national initiative to promote healthy diets and physical activity”.
... The present work environment comprises plenty of tasks involving a high degree of sedentary behaviour, which develops and increases employees' health problems (Pronk, 2009). The leaders and managers of organisations are increasingly aware and concerned about the costs imposed by certain health conditions and subsequent reflection on performance (Diestel, Wegge andSchmidt, 2014 andGoetzel andOzminkowski, 2008). ...
... In the contemporary work environment, many tasks involve a high level of sedentary behaviour, which consequently exposes employees to musculoskeletal problems, pain, and other health problems (Pronk, 2009). Given such a context, physical exercise gains importance, because it may lighten illnesses and enhance the therapeutics of a large number of diseases associated with sedentary behaviour, such as depression, cancer, cardiovascular diseases, metabolic, pulmonary and musculoskeletal diseases (Sjøgaard et al., 2016), as well as provide benefits related to weight loss (Anderson et al., 2009). ...
Conference Paper
Uma das grandes preocupações dos gestores é manter bons níveis de desempenho no trabalho. As características individuais dos trabalhadores são variáveis importantes que contribuem para a competitividade das organizações. O ambiente de trabalho atual possui um elevado grau de sedentarismo, o que influi nas características dos funcionários e no seu desempenho. Este estudo investiga o efeito moderador do exercício físico na relação entre a satisfação no trabalho, a motivação e o desempenho organizacional. Este trabalho quantitativo utiliza dados recolhidos através de um questionário online. Os dados foram analisados com o uso de Modelos de Equações Estruturais e análise de moderação para determinar o efeito do exercício físico. Os resultados mostram que há relações entre a satisfação, a desmotivação, a motivação intrínseca e o desempenho para criatividade, bem como entre a satisfação, a motivação intrínseca e o desempenho para emergências. As relações são moderadas pelo nível de exercício realizado pelo colaborador.
... The present work environment comprises plenty of tasks involving a high degree of sedentary behaviour, which develops and increases employees' health problems (Pronk, 2009). The leaders and managers of organisations are increasingly aware and concerned about the costs imposed by certain health conditions and subsequent reflection on performance (Diestel, Wegge andSchmidt, 2014 andGoetzel andOzminkowski, 2008). ...
... In the contemporary work environment, many tasks involve a high level of sedentary behaviour, which consequently exposes employees to musculoskeletal problems, pain, and other health problems (Pronk, 2009). Given such a context, physical exercise gains importance, because it may lighten illnesses and enhance the therapeutics of a large number of diseases associated with sedentary behaviour, such as depression, cancer, cardiovascular diseases, metabolic, pulmonary and musculoskeletal diseases (Sjøgaard et al., 2016), as well as provide benefits related to weight loss (Anderson et al., 2009). ...
Article
Full-text available
Maintaining high levels of employee’s performance at work is a major concern among managers. Employees’ characteristics and individual performance contribute to the competitiveness of organisations. The current work environment is highly sedentary, which influences employees’ performance. This quantitative study investigates the moderating effect of physical exercise on the relationships between job satisfaction, motivation, and organisational performance. Data was collected using an online questionnaire and it was analysed using structural equation modelling and moderation analysis. The results show the existing relationships between job satisfaction, intrinsic motivation and performance regarding both dimensions of organisational performance: creativity and dealing with emergencies. Such relationships are moderated by the level of exercise performed by the employees.
... 18 Indeed, employers, health plans, and communities have started incorporating such devices and mobile apps into population-based wellness initiatives. 19 Some wearable manufacturers have dashboards that allow organizations to view population-level PA metrics such as the number of active minutes. 20 It is very important that these devices integrate the evidence-based PA Guidelines metrics 3 (ie, minutes of moderate-tovigorous intensity PA as opposed to, or in addition to, steps/day) into their algorithms. ...
... Physical activity programs tend to be most successful when they are embedded into multicomponent, comprehensive, and multidisciplinary programs that are designed according to best practice program design principles. 18,19,21 With all of these methods, the strength of the data and its utility as a population-level PA assessment method is dependent on the percentage of the employee population that participates in the data collection mechanism. ...
... 18 Indeed, employers, health plans, and communities have started incorporating such devices and mobile apps into population-based wellness initiatives. 19 Some wearable manufacturers have dashboards that allow organizations to view population-level PA metrics such as the number of active minutes. 20 It is very important that these devices integrate the evidence-based PA Guidelines metrics 3 (ie, minutes of moderate-tovigorous intensity PA as opposed to, or in addition to, steps/day) into their algorithms. ...
... Physical activity programs tend to be most successful when they are embedded into multicomponent, comprehensive, and multidisciplinary programs that are designed according to best practice program design principles. 18,19,21 With all of these methods, the strength of the data and its utility as a population-level PA assessment method is dependent on the percentage of the employee population that participates in the data collection mechanism. ...
Article
Full-text available
A convincing body of scientific literature supports the use of physical activity policies in the worksite to provide health and productivity benefits to employees and employers. Worksite policies that promote and allow opportunities for physical activity among employees may lower health-care costs, improve performance, and reduce sedentary time.
... 18 Indeed, employers, health plans, and communities have started incorporating such devices and mobile apps into population-based wellness initiatives. 19 Some wearable manufacturers have dashboards that allow organizations to view population-level PA metrics such as the number of active minutes. 20 It is very important that these devices integrate the evidence-based PA Guidelines metrics 3 (ie, minutes of moderate-tovigorous intensity PA as opposed to, or in addition to, steps/day) into their algorithms. ...
... Physical activity programs tend to be most successful when they are embedded into multicomponent, comprehensive, and multidisciplinary programs that are designed according to best practice program design principles. 18,19,21 With all of these methods, the strength of the data and its utility as a population-level PA assessment method is dependent on the percentage of the employee population that participates in the data collection mechanism. ...
... The increasingly sedentary nature of work in the contemporary workplace may be considered a significant challenge for business and industry. One way to address this is to treat physical activity as a strategic business priority (Pronk, 2009;Pronk & Kottke, 2009). Doing so will require a level of confidence that the implementation of programs or policies will be effective. ...
... Practical guidance to support implementation of bestpractice active workplaces should consider actions at multiple levels of influence, including the individual worker level, the team level, and the organizational and environmental levels. Furthermore, reducing sedentary behaviors should be made possible, simple, socially and financially rewarding, and personally and organizationally relevant (Pronk, 2009). ...
Article
An active workplace, operationally defined as a company that deploys an organizational strategy designed to encourage movement and minimize sedentary time during the workday, may benefit from more engaged employees and less productivity loss, providing benefits for both workers and the company. Evidence of effectiveness supports the introduction of programs that reduce prolonged sitting time and increase movement and activity. This article highlights the need for companies to intentionally address sedentary behavior at work and base the approach for doing so on best-practice design principles that will increase the chances for successful solutions.
... 18 Indeed, employers, health plans, and communities have started incorporating such devices and mobile apps into population-based wellness initiatives. 19 Some wearable manufacturers have dashboards that allow organizations to view population-level PA metrics such as the number of active minutes. 20 It is very important that these devices integrate the evidence-based PA Guidelines metrics 3 (ie, minutes of moderate-tovigorous intensity PA as opposed to, or in addition to, steps/day) into their algorithms. ...
... Physical activity programs tend to be most successful when they are embedded into multicomponent, comprehensive, and multidisciplinary programs that are designed according to best practice program design principles. 18,19,21 With all of these methods, the strength of the data and its utility as a population-level PA assessment method is dependent on the percentage of the employee population that participates in the data collection mechanism. ...
Presentation
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Conference: International Society of Behavioral Nutrition and Physical Activity, June 2019, Prague, Czech Republic
... Researchers exploring possible mechanisms behind the positive relationship between physical activity and improved mood and cognition have pointed to different biological markers, including a member of the neurotrophin family called brain-derived neurotrophic factor (BDNF) (Pronk, 2009). BDNF has been widely studied in both animal models and case control-studies and is associated with both physical activity and enhanced cognitive function and mood through its effect on hippocampal function, learning, and neuroplasticity (Duman & Monteggia, 2006;Pronk, 2009). ...
... Researchers exploring possible mechanisms behind the positive relationship between physical activity and improved mood and cognition have pointed to different biological markers, including a member of the neurotrophin family called brain-derived neurotrophic factor (BDNF) (Pronk, 2009). BDNF has been widely studied in both animal models and case control-studies and is associated with both physical activity and enhanced cognitive function and mood through its effect on hippocampal function, learning, and neuroplasticity (Duman & Monteggia, 2006;Pronk, 2009). BDNF is thought of as fertilizer for the brain, maintaining and enhancing neural connections and brain cell circuitry (Ratey & Hagerman, 2008). ...
Article
Full-text available
It is estimated that between 25-75% of physicians suffer from burnout. Symptoms of emotional exhaustion, depersonalization, and a low sense of personal accomplishment afflict physicians as early as medical school, into residency training, and throughout medical practice, with potential consequences for patient healthcare outcomes, public health, and the costs of our health system. While medical institutions can do more to support physician, trainee, and medical student self-care, physicians cannot wait for institutional change in order to pursue well-being. A construct for physician flourishing is proposed, borrowing from and building off of prior validated constructs of psychological and physical well-being. This proposed model, known as REVAMP, focuses on six elements that comprise physician flourishing. Specific interventions to improve each of these elements are proposed that may be used by the individual practitioner, in formal medical education settings, or by practicing physicians in continuing medical education programs. Waiting to intervene until physicians are burned out and suffering has high costs; proactive approaches such as those suggested within REVAMP can be adopted as early as undergraduate medical school education to help physicians-in-training cultivate optimal well-being. Flourishing physicians deliver the highest quality patient care. It is time to help our healers flourish.
... Researchers exploring possible mechanisms behind the positive relationship between physical activity and improved mood and cognition have pointed to different biological markers, including a member of the neurotrophin family called brain-derived neurotrophic factor (BDNF) (Pronk, 2009). BDNF has been widely studied in both animal models and case control-studies and is associated with both physical activity and enhanced cognitive function and mood through its effect on hippocampal function, learning, and neuroplasticity (Duman & Monteggia, 2006;Pronk, 2009). ...
... Researchers exploring possible mechanisms behind the positive relationship between physical activity and improved mood and cognition have pointed to different biological markers, including a member of the neurotrophin family called brain-derived neurotrophic factor (BDNF) (Pronk, 2009). BDNF has been widely studied in both animal models and case control-studies and is associated with both physical activity and enhanced cognitive function and mood through its effect on hippocampal function, learning, and neuroplasticity (Duman & Monteggia, 2006;Pronk, 2009). BDNF is thought of as fertilizer for the brain, maintaining and enhancing neural connections and brain cell circuitry (Ratey & Hagerman, 2008). ...
Article
Full-text available
It is estimated that between 25-75% of physicians suffer from burnout. Symptoms of emotional exhaustion, depersonalization, and a low sense of personal accomplishment afflict physicians as early as medical school, into residency training, and throughout medical practice, with potential consequences for patient healthcare outcomes, public health, and the costs of our health system. While medical institutions can do more to support physician, trainee, and medical student self-care, physicians cannot wait for institutional change in order to pursue well-being. A construct for physician flourishing is proposed, borrowing from and building off of prior validated constructs of psychological and physical well-being. This proposed model, known as REVAMP, focuses on six elements that comprise physician flourishing. Specific interventions to improve each of these elements are proposed that may be used by the individual practitioner, in formal medical education settings, or by practicing physicians in continuing medical education programs. Waiting to intervene until physicians are burned out and suffering has high costs; proactive approaches such as those suggested within REVAMP can be adopted as early as undergraduate medical school education to help physicians-in-training cultivate optimal well-being. Flourishing physicians deliver the highest quality patient care. It is time to help our healers flourish.
... Alkhajah et al. [9] found sit-stand workstations significantly reduced office workers' sitting time during work and led to reduced sedentary time at home. Sit-stand workstations were also found to reduce upper back and neck pain, improve mood states, and reduce ambulatory blood pressure [10][11]. ...
Article
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Purpose: There is growing evidence prolonged workplace sitting is associated with multiple health risks. Utilizing static and active workstations may help improve these health risks. The purpose of this investigation was to determine if providing access to a sit-stand workstation and a shared treadmill desk without a behavioural intervention could increase workplace physical activity and decrease sitting time. Methodology: Participants (N=15) were assigned to an experimental (sit-stand desk and shared treadmill desk; n=8) or control group (n=7) for seven weeks. No behavioural interventions were used to encourage participation. A physical activity questionnaire was administered at baseline and at the end of the study to assess workplace physical activity and sitting time. Participants wore an activity tracker (Fitbit One) to objectively assess daily footsteps and physically active hours. A mixed between-within subject analysis of variance was used to compare the groups (p 5000 steps/day. Practical Implications: This is the first study to examine the use of both static and active workstations to increase workplace physical activity and reduce sitting time without a behavioural intervention. Value: Combining static and active workstations with the addition of a behavioural intervention to promote and motivate the participants may produce significant improvements in workplace physical activity and reductions in sitting time.
... Workplace support is a key contextual factor that may influence both strategy uptake and behavioural outcomes. Support received from the organisation, managers, and/or colleagues has been identified as important for workplace increases in physical activity (22)(23)(24). However, evidence for the benefit of organisational, managerial, and/or collegial support for reducing sitting time is only emerging. ...
Article
Objective: To explore workers' sitting-reduction and activity-promoting strategy use following an intervention targeting these changes, and whether strategy use and perceived workplace support impacted on three-month sitting and activity outcomes. Methods: This secondary analysis in desk-based workers (n = 83) utilised data collected on questionnaire-derived strategy use and workplace support, and activPAL3-derived sitting (total; prolonged, ≥30mins) and activity (standing; stepping) at work. Results: Fourteen strategies were commonly used during the intervention. Increased usage of some strategies were significantly (p < 0.05) associated with beneficial changes in prolonged sitting or stepping only. Workplace support was significantly beneficially associated with changes in sitting, prolonged sitting, and stepping; these associations were largely independent of strategy use changes. Conclusions: Strategies were highly used, with increased use associated with some behavioural improvements. Workplace support appears essential for improving sitting and activity in the workplace.
... Sedentary behavior interventions in the workplace have shown promising effects [13]. Multi-level approaches targeting individual, social, and environmental factors have been most effective [14,15]. The most robust environmental support has been the use of sit-stand workstations, providing opportunities for workers to reduce sitting while maintaining productivity [13]. ...
Article
Background: American workers spend 70-80% of their time at work being sedentary. Traditional approaches to increase moderate-vigorous physical activity (MVPA) may be perceived to be harmful to productivity. Approaches that target reductions in sedentary behavior and/or increases in standing or light-intensity physical activity [LPA] may not interfere with productivity and may be more feasible to achieve through small changes accumulated throughout the workday METHODS/DESIGN: This group randomized trial (i.e., cluster randomized trial) will test the relative efficacy of two sedentary behavior focused interventions in 24 worksites across two states (N=720 workers). The MOVE+ intervention is a multilevel individual, social, environmental, and organizational intervention targeting increases in light-intensity physical activity in the workplace. The STAND+ intervention is the MOVE+ intervention with the addition of the installation and use of sit-stand workstations to reduce sedentary behavior and enhance light-intensity physical activity opportunities. Our primary outcome will be objectively-measured changes in sedentary behavior and light-intensity physical activity over 12months, with additional process measures at 3months and longer-term sustainability outcomes at 24months. Our secondary outcomes will be a clustered cardiometabolic risk score (comprised of fasting glucose, insulin, triglycerides, HDL-cholesterol, and blood pressure), workplace productivity, and job satisfaction DISCUSSION: This study will determine the efficacy of a multi-level workplace intervention (including the use of a sit-stand workstation) to reduce sedentary behavior and increase LPA and concomitant impact on cardiometabolic health, workplace productivity, and satisfaction. Trial registration: ClinicalTrials.gov Identifier: NCT02566317 (date of registration: 10/1/2015).
... Individuals spend more than half the day seated at work, 61 and this affords an opportunity for promoting PA and reducing sedentary time. 62 With current technology, a NEAT-promoting workstation is now feasible. 63 Researchers have demonstrated that people will use a walking workstation while performing traditional office functions. ...
Article
Obesity is linked to cardiovascular disease. The global increase in sedentary lifestyle is an important factor contributing to the rising prevalence of the obesity epidemic. Traditionally, counseling has focused on moderate- to vigorous-intensity exercise, with disappointing results. Nonexercise activity thermogenesis (NEAT) is an important component of daily energy expenditure. It represents the common daily activities, such as fidgeting, walking, and standing. These high-effect NEAT movements could result in up to an extra 2000 kcal of expenditure per day beyond the basal metabolic rate, depending on body weight and level of activity. Implementing NEAT during leisure-time and occupational activities could be essential to maintaining a negative energy balance. NEAT can be applied by being upright, ambulating, and redesigning workplace and leisure-time environments to promote NEAT. The benefits of NEAT include not only the extra calories expended but also the reduced occurrence of the metabolic syndrome, cardiovascular events, and all-cause mortality. We believe that to overcome the obesity epidemic and its adverse cardiovascular consequences, NEAT should be part of the current medical recommendations. The content of this review is based on a literature search of PubMed and the Google search engine between January 1, 1960, and October 1, 2014, using the search terms physical activity, obesity, energy expenditure, nonexercise activity thermogenesis, and NEAT. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
... Overall, studies relating to workplace interventions are of high heterogeneity concerning interventions as well as population groups and therefore rarely comparable [48]. Nevertheless, study results support the superiority of multimodal interventions including ergonomic, behavior-related and workplace-related aspects compared to single interventions [49]. Workplace-related interventions should be multimodal and tailored to the needs and the preventive competence of both, the individuals and the organizations [50]. ...
Article
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Background: Physical activity and health literacy are topics of utmost importance in the prevention of chronic diseases. The present article describes the study protocol for evaluating a cross-provider workplace-related intervention promoting physical activity and health literacy. Methods: The RE-AIM Framework will be the conceptual framework of the AtRisk study. A controlled natural experiment and a qualitative study will be conducted. The cross-provider intervention is based on the cooperation of the German Pension Fund Rhineland and cooperating German Statutory Health Insurances. It combines two components: a behavior-oriented lifestyle intervention and the assignment of a health coach. The single-provider intervention only includes the behavior-oriented lifestyle intervention. The quantitative study (natural experiment) encompasses three measuring points (T0=start of the behavior-oriented lifestyle intervention (baseline); T1=end of the behavior-oriented lifestyle intervention (16 weeks); T2=6 month follow-up) and will compare the effectiveness of the cross-provider workplace-related intervention compared with the single provider intervention. Participants are employees with health related risk factors. ANCOVA will be used to evaluate the effect of the intervention on the outcome variables leisure time physical (primary outcome) activity and health literacy (secondary outcome). The qualitative study comprises semi-structured interviews, systematic field notes of stakeholder meetings and document analyses. Discussion: The AtRisk study will contribute towards the claim for cross-provider interventions and workplace-related approaches described in the new Preventive Health Care Act. The results of this study will inform providers, payers and policy makers about the effectiveness of a cross-provider workplace-related lifestyle intervention compared to a single-provider intervention. Beyond, the study will identify challenges for implementing cross-provider preventive interventions. With respect to the sustainability of preventive interventions the AtRisk study will give insight in the expectations and needs on health coaching from the perspective of different stakeholders. Trial registration: DRKS00010693. Keywords: Health promotion, Cross-provider, Workplace, Physical activity, Health literacy
... [7][8][9] Variations in time spent in sedentary and PA can be between 20% and 40% depending on the level of occupational PA. Workers in low PA professions such as technical/professional office work, research and development, teaching profession, and finance are at an increased risk of engaging in prolonged sitting at work. 10 However, current workplace wellness programs have primarily focused on promoting MVPA, 11,12 which is associated with substantial health benefits. 13 Many recent studies demonstrated that sedentary behavior has unique and perhaps more debilitating influences on the development of cardiometabolic risk and disorders than MVPA. ...
Article
Objective: The purpose of the study was to examine the longitudinal influence of sedentary behavior on the development of metabolic syndrome (MS) and cardiometabolic risk in professional workers. Methods: Study participants were 203 professional workers (55.6% female; mean age = 41.9, SD = 11.2,) in low physical activity occupations. Participants' height, weight, waist circumference, fasting plasma glucose, triglycerides, high-density lipoprotein, total cholesterol, and low-density lipoprotein were measured at the baseline and follow-up over 12 months. Accelerometry was used to assess the sedentary time and moderate and vigorous physical activity. Results: High level of sedentary behavior at baseline significantly predicted incident MS (odds ratio 4.07, 95% confidence interval 1.69 to 9.76) at follow-up. Similarly, the change in sedentary behavior significantly predicted the change in the cardiometabolic risk score (B = 0.12, SE = 0.06, P = 0.03) from baseline to the follow-up. Conclusion: Professional workers in low physical activity occupations were engaged in an excessive amount of sedentary behavior that predisposed them to an increased risk of developing cardiometabolic disorders.
... provides specific guidance for business and industry to enhance daily movement patterns, increase overall physical activity, and improve fitness levels for employees. 5 Implementation and progress toward the stated goals of this plan will benefit corporate America, individual workers, their families, and communities throughout the nation in both health-related and economic outcomes. ...
Article
Workforce fitness matters for the prevention of premature death, chronic diseases, productivity loss, excess medical care costs, loss of income or family earnings, and other social and economic concerns. Yet fitness levels appear to be relatively low and declining. Over the past half century obesity has doubled, physical activity levels are below par, and cardiorespiratory fitness often does not meet minimally acceptable job standards. During this time, daily occupational energy expenditure has decreased by more than 100 calories. It is recommended for employers to consider best practices and design workplace wellness programs accordingly. Regulations that protect and promote worker health, and the introduction of incentives for employers to optimize the fitness of their workforce represent important public health strategies.
... 8,9 Review studies have shown that interventions at individual, group, organization and environment levels to promote workplace physical activity have positive effects among employees including increased levels of physical activity, reduction of musculoskeletal disorders, chronic disease prevention, reduction of stress and absenteeism, increased workplace satisfaction, lower leave of absence rates, lower health care costs and increased productivity. 10 However, few studies -all conducted in high-income countries -have focused on the characteristics of workplace environment and adaptations to promote physical activity. [11][12][13][14][15][16] The workplace is a setting where employees spend most of their day. ...
Article
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Availability of physical environments and incentives for physical activity in industry companies, Pelotas, Brazil Disponibilidade de espaços físicos e incentivos à prática de atividades físicas nas indústrias de Pelotas, RS -Brasil Abstract Evidence shows that physically active individuals have lower risk of developing chronic diseases. Despite that, the rate of physical inactivity is high. Difficult access and lack of time are mostly reported as barriers to engaging in physical activity. The workplace is a key setting for physical activity promotion among employees. This study aimed to describe the physical environments and incentives for non-occupational physical activities offered to employees of local industry companies in the city of Pelotas, southern Brazil. A cross-sectional study was conducted with a sample drawn from the Pelotas Center for Businesses (CIPEL) and the Brazilian Special Guides Publisher (EBGE) databases. Companies with more than 20 employees were eligible to participate in the study. The final sample consisted of 81 companies and information was col-lected through a questionnaire applied to the participating company's business representative. It was found that 12.4% of the companies had physical environments for physical activity at the workplace, 9.9% had spaces for indoor sports, 91.4% had showering facilities and locker rooms, 12.4% offered health club discounts and 16.0% subsidized memberships to health clubs and gyms. Participation in employee team sports was reported in 37.0% of the companies; it was the most common physical activity especially among male employees. In conclusion, local Pelotas companies did not offer their employees adequate spaces for non-occupational physical activity. However, the availability of physical environments such as showering facilities and locker rooms opens up great opportunities for active commuting to work.
... Among other reasons, the introduction of technologies and work tasks that require computer use also has brought about work situations where employees sit for long durations. Indeed, prolonged sitting time has become a recognized workplace hazard (6), and it is recognized that prolonged sitting time primarily comes from three sources: television viewing, sitting at work, and time spent commuting to work. Whereas workplace wellness programs traditionally have focused on physical activity promotion during the workday, commuting to work represents another important opportunity to significantly impact the health and wellbeing of employees. ...
... Through trial and error, informal conversations with participants, and feedback from past league participant surveys, the recreational sports director has improved and grown the league for 12 years. For a work-site program involving voluntary participation to be effective, it should be simple for employees to participate, socially rewarding, and organizationally relevant (Pronk, 2009). The following recommendations are intended to produce a golf league that meets those requirements. ...
Article
Campus recreation departments have the ability to influence a wide range of students, faculty, staff, and administration. While the majority of programming will undoubtedly focus on students, events tailored to faculty and staff have the potential to strengthen the entire campus community. The purpose of this article is to discuss the logic behind instituting a faculty and staff golf league and to present an exemplar league. A general overview of the planning and administration procedures is presented, followed by a discussion of recommendations and challenges to consider when initiating a similar league.
... Many of the offers are aimed at encouraging increased physical activity among workers. Physical activity is associated with general improvements in health behaviors and lifestyles, improved productivity, improved morale among employees, reduced absenteeism and economic gains for employers (17)(18)(19)(20)(21). A common practice among Swedish companies is the provision of monetary allowances to their employees (22). ...
Conference Paper
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The workplace has an important influence on the health trajectories of individuals due to the amount of time spent in this sphere daily and over the life course. Work related factors such as injury, poor ergonomics, exposure to hazards etc. all have health implications during the course of life. The workplace is thus an important arena for population level health promotion. Recent times have seen much emphasis on ensuring healthy working lives. Examples inlude creation of many international and national policies, employers’ growing interest in work place health promotion (WPH) and large resources invested in WPH. Research however shows that utilisation of some WPH packages is relatively low. One such package is the provision of wellness subventions for employees in many Swedish workplaces. Managers are often charged with the responsibilities of WPH and have direct contact with employees. The aim of this study therefore is to investigate managers’ perspectives on barriers and facilitators of WHP package uptake among employees. Method: A qualitative method based on semistructured interview questions was used. Participants include managers at medium to large scale private companies in central Sweden. State owned companies were excluded in order to ensure homogeneity in terms of structure and policy. Not more than one manager per company was interviewed, giving rise to a total of nineteen respondents. Data was analyzed using content analysis. Results: A total of three themes and nine sub themes emerged. The first theme deals with factors at the individual level, sub themes include work-life balance, individual resources and individual attitude. In the second theme which relates to the Structure of WHP packages, sub themes including design and delivery of WHP, information flow and type of external collaborators/partners involved were identified. Company culture and leadership is the third theme, sub themes are leadership style and health perspective of management; existence of enabling environmet and support for management. Conclusion: Modifiable factors at organisational level can lead to improved design and delivery of WPH packages. These modifications may be crucial in addressing barriers at individual level with lots of potential to improve utilisation.
... These can be suitable settings for advocating an active lifestyle, improving employee productivity and reducing healthcare costs [14,15]. Contemporary workplaces are thus ideal for interventions that promote higher levels of physical activity amongst employees, to improve health and optimize performance [16]. ...
Article
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Background: Adults in urban areas spend almost 77% of their waking time being inactive at workplaces, which leaves little time for physical activity. The aim of this systematic review and meta-analysis was to synthesize evidence for the effect of workplace physical activity interventions on the cardio-metabolic health markers (body weight, waist circumference, body mass index (BMI), blood pressure, lipids and blood glucose) among working adults. Methods: All experimental studies up to March 2018, reporting cardio-metabolic worksite intervention outcomes among adult employees were identified from PUBMED, EMBASE, COCHRANE CENTRAL, CINAHL and PsycINFO. The Cochrane Risk of Bias tool was used to assess bias in studies. All studies were assessed qualitatively and meta-analysis was done where possible. Forest plots were generated for pooled estimates of each study outcome. Results: A total of 33 studies met the eligibility criteria and 24 were included in the meta-analysis. Multi-component workplace interventions significantly reduced body weight (16 studies; mean diff: - 2.61 kg, 95% CI: - 3.89 to - 1.33) BMI (19 studies, mean diff: - 0.42 kg/m2, 95% CI: - 0.69 to - 0.15) and waist circumference (13 studies; mean diff: - 1.92 cm, 95% CI: - 3.25 to - 0.60). Reduction in blood pressure, lipids and blood glucose was not statistically significant. Conclusions: Workplace interventions significantly reduced body weight, BMI and waist circumference. Non-significant results for biochemical markers could be due to them being secondary outcomes in most studies. Intervention acceptability and adherence, follow-up duration and exploring non-RCT designs are factors that need attention in future research. Prospero registration number: CRD42018094436.
... Many of the offers are aimed at encouraging increased physical activity among workers. Physical activity is associated with general improvements in health behaviors and lifestyles, improved productivity, improved morale among employees, reduced absenteeism and economic gains for employers (17)(18)(19)(20)(21). A common practice among Swedish companies is the provision of monetary allowances to their employees (22). ...
Article
Full-text available
Managers are often charged with the responsibility of overseeing Workplace health promotion (WHP) for which significant amounts of resources are laid aside yearly. While there is increasing interest by employers to include WHP policies, studies show that WHP implementation and uptake by employees still need to be improved upon. Given that managers are part of organizational decision-making and implementation of new policies, they serve as the bridge between workers and management. The aim of this study is to investigate managers' perceptions of employees' WHP uptake as well as challenges encountered by managers in the execution of their WHP-related tasks. Method: This study is based on a qualitative method using semi-structured interviews. Participants in the study were managers at medium and large-scale private companies in Northcentral Sweden. To ensure that participating companies are comparable in terms of structure and policy, only companies within the private sector were eligible to participate. Furthermore, only one manager per company was interviewed. A total of nineteen managers participated and the data generated were analyzed using content analysis. Results: A total of three themes and nine subthemes emerged. The first theme deals with factors at the individual level, subthemes include awareness of WHP, work-life balance, and attitudes. The second theme comprises of factors related to the WHP offer, subthemes were design of the WHP, supportive collaborators and financing of WHP. The third theme deals with organizational factors, subthemes were the nature of the organization's operations, management as role models and resources and support for managers. Results show that most of the challenges encountered by managers in executing WHP were mostly at the organizational level. Conclusion: Addressing modifiable factors at the individual and organizational levels and those related to the WHP may improve WHP uptake among employees.
... In this respect, workplace-related PA interventions conducted directly at the workplace and, where appropriate, also during working hours, have shown positive effects on, e.g., activity behavior, physical fitness and cardio-metabolic health, musculoskeletal disorders, and the prevention of work-related pain (9)(10)(11)(12)(13). They improve overall well-being and work ability, reduce sickness absenteeism and sick leave, and can generate a positive financial return (14)(15)(16). ...
Article
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Background: The workplace is an important setting for adult health promotion including exercise training such as resistance training (RT). Since the reporting of exercise training interventions is generally inconsistent, the objective of this systematic review was to investigate the attention to principles of RT progression and variables of RT exercise prescription in workplace-related RT interventions. Methods: A systematic literature search was conducted in the databases LIVIVO, PubMed, SPORTDiscus, and Web of Science (2000–2020). Controlled trials with apparently healthy “employees” and a main focus on RT were included. RT principles and variables were extracted and rated by two reviewers (reported, not reported, or unclear). Sum scores for each RT intervention and percentages regarding each principle and variable were calculated. Results: Overall, 21 articles were included (18 primary studies, 3 protocols). Summarized narratively, the interventions showed different positive effects on strength- or performance-related and/or health- or complaint-related outcomes. The reporting of the RT principles and variables was varied (progressive overload: 94 % of the studies, specificity: 78 %, variation (periodization): 39 %, muscle action: 94 %, loading: 94 %, volume; 67 %, exercise selection: 89 %, exercise order: 47 %, rest periods between sets: 33 %, rest periods between exercises: 27 %, repetition velocity: 44 %, and frequency: 100 %). Conclusion: Several key RT principles and variables were reported inconsistently, reducing reproducibility and pointing to the need for standardized RT intervention reporting in workplace-related interventions. Exercise science and workplace promotion should be further linked, since accurate reporting is a prerequisite for transferring robust findings into practice.
... In food service establishments, providing quality of service is as important as in other service sectors, a quality dimension that cannot be underestimated. Although staff canteen is considered crucial in offering healthy and well-balanced meals in modern guidelines (Pronk, 2009), workplace dinning is associated with poor quality and bad food choices [13]. In addition, the safety of consumed meals is not fully guaranteed [14]. ...
... Despite the plentiful evidence of the positive effects of physical activity on both physical health [1,2] and general well-being [3][4][5], a significant share of the world's population is not active enough [6]. In an attempt to reach a high share of the population, public health authorities encourage employers to promote physical activity at the workplace, where most adults spend a significant amount of time [7][8][9][10]. ...
Article
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Background Attracted by the expected benefits such as reduced absenteeism and increased productivity, more and more firms decide to implement workplace health promotion programs (WHPPs). However, those programs can only be effective if employees actually participate. This study aims to (1) gain insight into the degree of enrolment rates in such programs across companies and (2) identify organizational level factors that are associated with employee participation. Building on existing theory on organizational drivers of participation in corporate wellness programs, the study’s main goal is to investigate which organizational factors determine whether employees enroll in a corporate fitness program or not. Methods A business-to-business fitness platform company provided organizational level data on 61 client firms that have recently implemented a corporate wellness program. The data contained information on the enrolment rate per company and different organizational level variables. The following potential determinants of participation were analyzed: firm size, organizational program support and employee co-payment. A random effects model was used to examine associations between potential determinants and the program enrolment rate. Results The average participation is limited (15.37%) but varies highly across companies (range 0.07–100.00%, monthly basis). Looking at the determinants of program enrolment, we find that organizational program support – the degree to which firm leadership encourages participation – positively influences the enrolment rate (β = 0.051 p < 0.001) while employee co-payment – the financial contribution employees have to make to participate – has a negative impact (β = − 0.002, p < 0.001). Furthermore, firm size has a negative relationship with firm enrolment. Conclusions Enrolment rates in WHPPs are limited, as many companies have difficulties to promote participation in WHPPs among employees. Strong organizational program support and low employee co-payment were identified as drivers of employee participation in corporate health programs. Hence, intensifying both social and financial support of employee participation may help to drive enrolment rates. Firm size was found to negatively affect the enrolment rate in WHPPs, implying that larger firms have to account for their size and corresponding complexity when implementing such a program.
... The health benefits to individuals also extends to employers, including reduced cost of health care and improved worker performance [1]. Overall, a majority of worksite physical activity interventions result in positive impacts for employees, such as providing organizational and environmental supports for AT [36]. Therefore, the goal of the present investigation was to examine the correlates of AT to work in a large organization within a cross-sectional analysis from a single year of data (2010) and report on changes in the rates of AT by conducting a repeated cross-sectional analysis over time (2010,(2012)(2013)(2014)(2015)(2016). ...
Article
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Background Despite evolving evidence of the health and economic benefits of active transportation (AT) to work, few studies have examined the determinants of AT in large organizations with multiple worksites nor how trends in commuting change over time. Methods The data were obtained from the U.S. Department of the Interior Employee Commuting Census of 2010 (n = 23,230), and 2012–2016 (n = 21,725-25,974). The respondents were grouped into four commuting categories: non-active mode, walking, biking, and mixed-mode. Multinomial logistic regression analysis was utilized to examine the correlates of choosing AT to work for the 2010 data. Next, a repeated cross-sectional analysis was completed for all six years of data. Results In 2010, AT modes were only chosen by approximately 10% of respondents. Employees who lived farther from work and did not have a public transit station within 0.5 miles from home were generally less likely to choose AT. Respondents working in non-metro workplaces were less likely to bike or take mixed-modes to work, but more likely to walk. Men were more likely to choose AT modes, particularly biking. Respondents aged ≤30 yrs. were less likely to bike than those 31 to 40 yrs., but more likely than those ≥61 yrs. In 2010, the number of respondents that walked was higher, and biked and took mixed-modes was lower when compared to 2016, while the choice to take mixed-modes was higher in 2012 and 2013 when compared to 2016. Daily commuting distances in 2016 tended to be lower than 2010 and 2012, and higher than 2013. However, overall AT choice and commute distance remained reasonably stable over time. Conclusions Respondents who lived close to their workplace and a public transportation station, worked in a metro location, were male and younger were more likely to choose AT modes to work. The results provide insight for the U.S. Department of the Interior and other large organizations to develop intervention strategies that support AT to work. Further research is warranted to understand the concurrent individual, social, and environmental barriers and facilitators for choosing AT to work.
... These are also known to be productivity and confidence boosters and also reduce absenteeism. [97][98][99][100] Workplaces surrounded by a variety of attractive and pedestrianfriendly neighbourhoods encourage walking, bicycling, and use of public transport. 101 Small changes like introducing a sit-stand device for the employees could significantly reduce sitting time by 66 minutes per day and achieve health benefits like improvement in neck and back pain. ...
Article
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The Lancet Commission on Obesity (LCO), also known as the “syndemic commission,” states that radical changes are required to harness the common drivers of “obesity, undernutrition, and climate change.” Urban design, land use, and the built environment are few such drivers. Holding individuals responsible for obesity detracts from the obesogenic built environments. Pedestrian priority and dignity, wide pavements with tree canopies, water fountains with potable water, benches for the elderly at regular intervals, access to open‐green spaces within 0.5‐km radius and playgrounds in schools are required. Facilities for physical activity at worksite, prioritization of staircases and ramps in building construction, redistribution of land use, and access to quality, adequate capacity, comfortable, and well‐networked public transport, which are elderly and differently abled sensitive with universal design are some of the interventions that require urgent implementation and monitoring. An urban barometer consisting of valid relevant indicators aligned to the sustainable development goals (SDGs), UN‐Habitat‐3 and healthy cities, should be considered a basic human right and ought to be mounted for purposes of surveillance and monitoring. A “Framework Convention on Built Environment and Physical Activity” needs to be taken up by WHO and the UN for uptake and implementation by member countries.
... The formulation of recommendations for physical activity promotion among adults was based on 45 reviews. Of those 45, 5 were reviews of reviews Heath et al. 2012;Jepson et al. 2010;Kahn et al. 2002;WHO 2009); 25 reviews analysed PA counselling and exercise programmes (Adams and White 2003;Anokye et al. 2012;Barr-Anderson et al. 2011;Bully et al. 2015;CADTH 2014;Campbell et al. 2012;Chau et al. 2010;Conn et al. 2009;Dishman et al. 1998;Engbers et al. 2005;Fry and Neff 2009;Lin et al. 2010;Malik et al. 2014;Marshall 2004;Morgan 2005;Morton et al. 2014;Orrow et al. 2012;Passon et al. 2011;Pronk 2009;Proper et al. 2003;Schroer et al. 2014;Senore et al. 2012;Shrestha et al. 2015;Stensel 2009;Wong et al. 2012), 7 reviews pertained to technology-based interventions (Broekhuizen et al. 2012;Cavill et al. 2012;Eakin et al. 2007;Maher et al. 2014;Neville et al. 2009;van den Berg et al. 2007;Vandelanotte et al. 2007), 3 reviews were pedometer-based interventions (Bravata et al. 2007;Freak-Poli et al. 2013;Kang et al. 2009), and 2 reviews addressed the topic of health equity (Cleland et al. 2013;WHO Europe 2013). The three remaining reviews dealt with different settings or specific intervention types (Matson-Koffman et al. 2005;Mitchell et al. 2013;Webel et al. 2010). ...
Article
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Aim This article describes the German recommendations for physical activity promotion. Such recommendations serve as an important stepping stone to increase physical activity prevalences on the population level. Subjects and methods The German recommendations for physical activity promotion are based on three separate reviews: (1) a systematic review of reviews to formulate recommendations on the efficacy and effectiveness of interventions for physical activity promotion, which included 213 reviews; (2) a systematic review of reviews to investigate the cost-effectiveness of interventions for the promotion of physical activity, comprising of 18 reviews; (3) a review to identify literature on quality criteria for the conceptualisation, implementation and evaluation of interventions for physical activity promotion, which encompassed 24 studies and documents. Through an expert consensus panel, findings from each review were utilised to formulate specific recommendations for Germany. Results Recommendations for physical activity promotion are provided for the following target groups: children and adolescents, adults, older adults, adults with a chronic disease and the general population. For each target group, other than the general population, the recommendations are structured by setting. Alongside recommendations on the efficacy and effectiveness of interventions, recommendations were also formulated for health equity, cost-effectiveness and quality criteria. Conclusion From a political perspective, the development of recommendations for physical activity promotion highlights an important milestone for Germany. Not only do the national recommendations describe the amount of physical activity people should engage in, but they also provide organisations with information on how to support people in becoming more active.
... Obesity and absenteeism have a complex connection to NCDs and productivity loss. Several studies have found that employing large numbers of workers with overweight, obesity, and related NCDs can reduce productivity by up to 60%, largely due to reduced work capacity and absenteeism (Pronk, 2009;Van Vilsteren et al., 2015). For example, employees who are overweight or obese may have to temporarily or https://doi.org/10.1016/j.obmed.2020.100198 ...
Article
Rapid economic growth, improved living standards, and immense urbanization in the Kingdom of Saudi Arabia (KSA) have affected nutritional habits and physical activity. Recent increases in physical inactivity, sedentary behaviours, consumption of caloric-dense diets, and sugar-sweetened beverages have led to overweight and obesity and non-communicable diseases (NCDs). This study's objectives are to 1) determine current prevalence of and risk factors for obesity, and 2) predict the probability of obesity among full-time employees of Sadara, the largest chemical company in KSA. In 2019, a written survey in both Arabic and English was administered to 505 Sadara employees randomly selected from five Sadara locations. A number of factors possibly associated with BMI were examined using Chi-Square test: age, physical activity, screen watching, childhood region, nationality, fat intake, sugar intake, family size, household income, and consumption of meal-replacement bars. Logistic regression was performed to compare the trends and predict conditional probabilities of obesity. The sample was 92% male, 61% Saudi, from the Eastern Province of KSA, with a mean age of 34 years. Employees aged 30–39 years were found to have 1.8 times greater odds for obesity than the youngest employees (below 30 years). More specifically, those aged 30–39, who grew up in the Eastern Province, who had low physical activity and long periods of watching electronic screens had the highest probability of obesity (more than 66%). Workplace wellness programs that focus on lifestyle habits could help reduce the high prevalence of overweight and obesity and associated NCDs in KSA.
Article
Fitness matters for the prevention of premature death, chronic diseases, productivity loss, excess medical care costs, loss of income or family earnings, and other social and economic concerns. The workforce may be viewed as a corporate strategic asset, yet its fitness level appears to be relatively low and declining. Over the past half-century, obesity rates have doubled, physical activity levels are below par, and cardiorespiratory fitness often does not meet minimum acceptable job standards. During this time, daily occupational energy expenditure has decreased by more than 100 calories. Employers should consider best practices and design workplace wellness programs accordingly. Particular attention should be paid to human-centered cultures. Research should address ongoing surveillance needs regarding fitness of the US workforce and close gaps in the evidence base for fitness and business-relevant outcomes. Policy priorities should consider the impact of both state and federal regulations, adherence to current regulations that protect and promote worker health, and the introduction of incentives that allow employers to optimize the fitness of their workforce through supportive legislation and organizational policies.
Article
Objective: Do computer prompt software programs at the workplace reduce sitting time and/or increase physical activity at work? Background: Many products are promoted and being used in the workplace; however, their effectiveness and use are unknown or the evidence base that they work to change behavior is lacking. Method: We searched for relevant papers published between 2005 and 2020. The inclusion criteria were computer prompt software programs installed as behavioral change interventions; interventions implemented during work hours and delivered through a work personal computer or laptop; and measures of sedentary behavior and/or physical activity. To minimize risk of bias, three recommended best-evidence synthesis criteria were used: random assignment, sample size, and external validity. Based on these criteria, articles were selected and evaluated. Results: Six publications met the quality threshold for review. Seven articles did not meet the quality threshold. Four of the six included publications found that computer prompt software programs decreased sedentary behavior and/or increased physical activity. Two publications reported inconsistent results. Conclusions: The promising results from this systematic review indicate that there is potential for computer prompt software programs to improve the health of desk-based workers. For conclusive findings, more high-quality, scientific studies are needed. Application: The best-evidence publications in this review can serve as a guide in selecting and implementing computer prompt software programs at the workplace to decrease sedentary behavior and increase physical activity.
Thesis
Einleitung: Erwerbstätige verbringen einen Großteil ihrer Zeit am Arbeitsplatz, jeder Zweite überwiegend am Computer. Daraus kann andauernder Bewegungsmangel resultieren. Bewegungsorientierte betriebliche Gesundheitsförderung (BGF) bietet eine Möglichkeit, die körperliche Aktivität am Arbeitsplatz zu steigern. Zu deren Umsetzung in der Praxis gibt es bisher allerdings wenig Informationen. Ziel dieser Arbeit ist daher die Exploration der bewegungsorientierten betrieblichen Gesundheitsförderung in den DAX-Unternehmen. Methoden: Für die empirische Untersuchung wurden zwei Methoden verwendet. Im Zuge einer systematischen Analyse wurden von den Corporate Websites aller 30 DAX-Unternehmen Daten extrahiert. Für eine tiefergehende Analyse wurden qualitative Experteninterviews mit fünf im betrieblichen Gesundheitsmanagement (BGM) verschiedener DAX-Konzerne sowie einem im BGM eines MDAX-Konzerns beschäftigten Mitarbeitern geführt. Ergebnisse: 29 der 30 DAX-Konzerne erwähnen Sport- und Bewegungsangebote auf ihren Corporate Websites, ausführliche Informationen finden sich jedoch kaum. Die Experteninterviews zeigen, dass die befragten Unternehmen über ein vielfältiges Sport- und Bewegungsangebot verfügen. Hinsichtlich der Umsetzung der bewegungsorientierten BGF lassen sich viele Gemeinsamkeiten, aber auch erhebliche Unterschiede, vor allem in Hinblick auf Evaluation, Kommunikation und zielgruppenspezifische Angebote erkennen. Fünf der sechs befragten Unternehmen haben bereits Erfahrungen mit digitalen Angeboten in der bewegungsorientierten BGF gemacht. Diskussion: Hinsichtlich der Erwähnung von Sport- und Bewegungsangeboten zeigt sich im Vergleich zu den Ergebnissen von Prenzler (2011) ein Zuwachs um 38,1%, was auf eine gestiegene Relevanz dieser Angebote hinweist. Die im Rahmen der Experteninterviews befragten Unternehmen agieren auf allen vier Ebenen des sozio-ökonomischen Modells und handeln nach dem Mehrkomponentenansatz. Zielgruppenspezifische Angebote richten sich vor allem auf Produktions- bzw. Schichtarbeiter, in Unternehmen ohne Produktion gibt es bedeutend weniger solcher Angebote. Die größte Herausforderung sehen die Experten in der Erreichbarkeit bestimmter Zielgruppen wie Schicht- oder Außendienstmitarbeitern. Auch deshalb wird die Digitalisierung nach Aussagen der Experten eine wichtige Rolle in der Zukunft der bewegungsbezogenen BGF spielen.
Article
The aim of this thesis was to study a worksite exercise intervention for sedentary workers in China. This involved a 10-minute Qigong exercise session twice a day. Four inter-related studies examined the development, implementation, and evaluation of this intervention. First, a feasibility study demonstrated that short exercise breaks could be integrated into the workday routine for employees with sedentary job roles. Second, a pilot study was conducted to test the intervention under research processes. Third, a waitlist controlled trial study showed increases in employees’ physical activity between baseline and post-intervention for intervention (n=193) and waitlist control (n=83) participants, but no changes in work performance or sickness absence. And finally, a process evaluation using RE-AIM framework, i.e. Reach, Effectiveness, Adoption, Implementation, and Maintenance, was conducted using data from focus groups, document analysis, and exercise log reviews. In terms of reach, the exercise intervention was successfully marketed to all employees. In terms of adoption, it was considered that organisational support to implement the intervention was good. The intervention had been implemented broadly as planned. There was high exercise acceptance, but a gradual decrease in exercise adherence through the intervention period. With regard to maintenance, there was no clear management plan to sustain the programme beyond the period of study. To the author’s knowledge, this research is the first to test the effectiveness of worksite exercise in China. It is recommended in future that such interventions focus further on the study of implementation and include outcomes more proximal to the intervention such as job satisfaction and work engagement.
Article
Information technology (IT) professionals are typically sedentary and little is known about factors that influence their physical activity. Research has been limited by a lack of validated measures of workplace physical activity environments. PURPOSES: The purposes of this study were to (a) examine psychometric properties of a newly translated instrument for measuring workplace environments and (b) examine relationships among work environment (supportive workplace environments and job strain), psychosocial factors (outcome expectations and self-efficacy for physical activity), and physical activity in Taiwanese IT professionals. METHODS: This research was guided by a hypothesized model using Social Cognitive Theory, incorporating variables from the demand/control model. This was a cross-sectional survey of 576 IT professionals (467 men and 109 women; M = 33.7 years, SD = 6.08) from three IT companies in Taiwan. Three instruments were translated into Chinese using a modified committee approach. Participants completed a Chinese questionnaire that included the International Physical Activity Questionnaire-Taiwan long form, Perceived Workplace Environment Scale (PWES-C), Psychological Job Demands and Job Control Scale, Scale of Exercise Self-Efficacy, Positive and Negative Outcome Expectations Scale (PNOES-C), and Historical Physical Activity Questionnaire (HPAQ-C). Structural equation modeling (SEM) was used to test the model. RESULTS: Psychometric properties of the PWES-C demonstrated satisfactory internal consistency reliability, content and construct validity. SEM analyses showed that (a) higher levels of physical activity were associated with higher perceptions of supportive workplace environments, positive outcome expectations, and self-efficacy; (b) self-efficacy partially mediated the effects of supportive workplace environments on physical activity; (c) job strain had an indirect effect on physical activity through self-efficacy; (d) the final model accounted for 31% of the variance in physical activity; and (e) the effect of gender on our findings was not substantial in multigroup analyses. CONCLUSIONS: The PWES-C is a reliable and valid measure of perceived workplace environment in Taiwanese IT professionals. Both work environment and psychosocial factors are important. Interventions directed toward increasing individuals??? confidence in their ability to overcome barriers to physical activity and positive expected outcomes of physical activity in the context of supportive workplace environments may be useful. Study limitations, implications and future directions are discussed.
Article
Health assessment of workers of four meat processing plants in the Republic of Moldova in the 2011-2015 was carried out. The analysis of temporary disability showed the incidence the respiratory diseases (13.9±1.3 cases for 134.0±17.1 days per 100 workers) to prevail in the structure of disability), followed by the diseases of circulatory system (5.90±0.52 cases and 85.0±9.0 days per 100 workers) as well as the diseases of bone and muscular system (3.54±0.67 cases and 55.2±12.9 days per 100 workers), and diseases of digestive system (3.11±0.44 cases and 45.9±6.2 days of 100 workers) and injuries, poisonings and some other consequences of the influence of the external factors (3.02±0.40 cases and 48.8±10.3 days per 100 workers). Indices of the frequency and severity showed a tendency to fall. The index of diseases prevalence showed on average annually decreasing by 6.7 cases per 100 workers (R2 = 0.95), and an index of the duration of diseases for 77.0 days per 100 workers (R2 = 0,95). The meat processing plants suffered from economic losses because of the temporary disability of workers in the amount of 1892434.25 lei/107009.6 dollars. The obtained data indicate the need for the development and implementation of preventive measures.
Background The purpose of this study was to examine the level of physical activity (PA) and maximal aerobic capacity (VO 2max ) among office workers of the Pars Special Economic Energy Zone in Iran with different body mass indexes (BMIs). Materials and methods This research was descriptive, and a correlation of variables was applied as its execution method. Administrative staff of two centers were randomly selected from 20 to 30 administrative centers of the Pars Special Economic Energy Zone, Assaluyeh, Iran, and included 294 male employees who were willing to participate in this research and who met the inclusion criteria (being in the age range of 20–60 years, lacking specific diseases, and who had enough physical fitness to do PA) who were purposefully selected. Results The age-adjusted means for the PA score (7.93 ± 1.12) and VO 2max (48.66 ± 6.95) mL/min/kg were calculated. After adjusting for other variables, significant difference was found between BMI and age (β = 0.20; p = 0.005), BMI and VO 2max (β = 0.302; p = 0.001), as well as BMI and the total PA score (β = −0.304; p = 0.045). Conclusions The results of this study showed low levels of PA (work, exercise and leisure) and respiratory capacity in the administrative staff of the oil and gas industry, which is associated with overweight and obesity.
Article
Aims To estimate temporal and updated trends of OPA among Spanish adult population during the period between 1987 and 2017. Methods We used all available rounds of the Spanish National Health Survey (160,509 adults, mean age 44.6 years [SD 16.6], 50.3% women) and multivariate regressions to determine temporal trends of high OPA from 1987 to 2017 in the general working population of Spain. Results The highest OPA prevalence was observed for participants aged 31−49 years in the 2003 survey. The prevalence of high OPA was generally low, but increased slightly over time in the 18-30, 50-64, and 65-75 years old (p<0.001 for trend). In contrast, a general reduction in OPA was observed in the 16-17 years old (p<0.001 for trend). Men consistently showed higher OPA prevalence than women. Conclusions This study reports an increase in OPA prevalence in Spain from 1987 to 2017, which is low and significant in most socio-demographic groups, but small in absolute terms. The youngest group had a marked decreased in OPA prevalence over the course of the study. Men consistently showed higher OPA prevalence than women, but differences have become smaller in recent years. Our results may assist in the establishment of interventional strategies and future policies among specific subgroups.
Chapter
In spite of the well-documented benefits of regular physical activity, participation rates have either remained stagnant at alarmingly low levels, or have declined. Most recent estimates suggest that relatively few adults engage in regular leisure-time activity at sufficient levels to reach public health guidelines. Additionally, there is a consistent decline in activity levels with age. In this chapter, we begin with a brief overview of the physical and psychological health benefits that have been reliably associated with regular physical activity. We then provide an overview of the main findings derived from several different approaches to influencing physical activity and include detail on some exemplar studies. Where meta-analytic data are available, we report overall effect sizes determined across studies. We then provide a brief summary of what is known in terms of the theoretical mediators of physical activity, intervention approaches reviewed, and conclude by highlighting important targets for future research.
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The workplace is a powerful setting to reach large numbers of at-risk adults with effective chronic disease prevention programs. Missed preventive care is a particular problem for workers with low income and no health insurance. The costs of chronic diseases among workers--including health care costs, productivity losses, and employee turnover--have prompted employers to seek health promotion interventions that are both effective and cost-effective. The workplace offers 4 avenues for delivering preventive interventions: health insurance, workplace policies, health promotion programs, and communications. For each of the avenues, the evidence base describes a number of preventive interventions that are applicable to the workplace. On the basis of the evidence and of our work in Washington State, we present a public health approach to preventing chronic diseases via the workplace. In addition to relying on the evidence, this approach makes a compelling business case for preventive interventions to employers.
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Physical inactivity is associated with the increased risk of many chronic diseases. Such risks decrease with increases in physical activity. This study assessed the cost-effectiveness of population-wide strategies to promote physical activity in adults and followed disease incidence over a lifetime. A lifetime cost-effectiveness analysis from a societal perspective was conducted to estimate the costs, health gains, and cost-effectiveness (dollars per quality-adjusted life year [QALY] gained, relative to no intervention) of seven public health interventions to promote physical activity in a simulated cohort of healthy U.S. adults stratified by age, gender, and physical activity level. Interventions exemplifying each of four strategies strongly recommended by the Task Force on Community Preventive Services were evaluated: community-wide campaigns, individually adapted health behavior change, community social-support interventions, and the creation of or enhanced access to physical activity information and opportunities. Each intervention was compared to a no-intervention alternative. A systematic review of disease burden by physical activity status was used to assess the relative risk of five diseases (coronary heart disease, ischemic stroke, type 2 diabetes, breast cancer, and colorectal cancer) across a spectrum of physical activity levels. Other data were obtained from clinical trials, population-based surveys, and other published literature. Cost-effectiveness ratios ranged between $14,000 and $69,000 per QALY gained, relative to no intervention. Results were sensitive to intervention-related costs and effect size. All of the evaluated physical activity interventions appeared to reduce disease incidence, to be cost-effective, and--compared with other well-accepted preventive strategies--to offer good value for money. The results support using any of the seven evaluated interventions as part of public health efforts to promote physical activity.
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During the past 20 years there has been a dramatic increase in societal interest in preventing disability and death in the United States by changing individual behaviors linked to the risk of contracting chronic diseases. This renewed interest in health pro motion and disease prevention has not been without its critics. Some critics have accused proponents of life-style interventions of promoting a victim-blaming ideology by neglecting the importance of social influences on health and disease. This article proposes an ecological model for health promotion which focuses atten tion on both individual and social environmental factors as targets for health promo tion interventions. It addresses the importance of interventions directed at changing interpersonal, organizational, community, and public policy, factors which support and maintain unhealthy behaviors. The model assumes that appropriate changes in the social environment will produce changes in individuals, and that the support of individ uals in the population is essential for implementing environmental changes.
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PURPOSE: To assess organizational and employee participation during three community-wide worksite exercise competitions in two communities. DESIGN: A one-group, posttest-only design was used. Lack of controls, exercise baseline, and the short-term nature of the interventions were limitations. SETTING: The Minnesota Heart Health Program conducted annual exercise campaigns between 1982 and 1989 within three intervention communities to reduce behavioral risk for cardiovascular disease. The Shape Up Challenge was a worksite exercise competition designed, in conjunction with other campaign activities, to increase levels of physical activity. SUBJECTS: A total of 119 participating companies in two Minnesota communities, and 17,626 employees within these worksites, composed the subjects in this study. INTERVENTION: Eligible worksites were invited to participate in a month-long competition during which employees recorded minutes spent daily in aerobic activities. Incentives were established to promote intragroup cooperation and intergroup competition. Companies competed for awards that were based on average minutes of exercise per employee versus per participant. MEASURES: Numbers of companies recruited and participating, campaign activities, minutes of exercise, and costs were recorded on implementation logs. Companies completed surveys describing business type, number and sex of employees, existing health promotion programs, and perceived benefits of participation. RESULTS: Of the 365 companies invited to participate, 33% participated (range 15% to 50%). Participating companies were more likely than nonparticipating companies to offer other health promotion programs and perceived greater benefits from participation. Women and smaller companies had significantly greater participation rates than men and larger companies. Average employee participation rates ranged from as high as 84% in smaller organizations to as low as 16% as organization size increased. CONCLUSIONS: Community-based worksite exercise competitions appear to be a viable strategy for promoting employee exercise, particularly in smaller companies. Group-based contingencies applied in natural work units may facilitate employee participation. Further research is needed to assess the relative efficacy of this approach, compare alternative incentives, and identify strategies to enhance exercise maintenance after the intervention has ceased.
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The fourth in a series of critical reviews, this study examines the clinical and cost outcome evaluations of 10 worksite health promotion programs that were comprehensive, multifactorial, and directed at risk management. The studies, conducted between 1994 and 1998, indicate favorable clinical and cost outcomes and suggest characteristics of worksite interventions that may be critical for effectiveness.
Article
The workplace is a powerful setting to reach large numbers of at-risk adults with effective chronic disease prevention programs. Missed preventive care is a particular problem for workers with low income and no health insurance. The costs of chronic diseases among workers - including health care costs, productivity losses, and employee turnover - have prompted employers to seek health promotion interventions that are both effective and cost-effective. The workplace offers 4 avenues for delivering preventive interventions: health insurance, workplace policies, health promotion programs, and communications. For each of the avenues, the evidence base describes a number of preventive interventions that are applicable to the workplace. On the basis of the evidence and of our work in Washington State, we present a public health approach to preventing chronic diseases via the workplace. In addition to relying on the evidence, this approach makes a compelling business case for preventive interventions to employers.
Article
Purpose. To assess the relationship between modifiable health risks and total health care expenditures for a large employee group. Design. Risk data were collected through voluntary participation in health risk assessment (HRA) and worksite biometric screenings and were linked at the individual level to health care plan enrollment and expenditure data from employers' fee-for-service plans over the 6-year study period. Setting. The setting was worksite health promotion programs sponsored by six large private-sector and public-sector employers. Subjects. Of the 50% of employees who completed the HRA, 46,026 (74.7%) met all inclusion criteria for the analysis. Measures. Eleven risk factors (exercise, alcohol use, eating current and former tobacco use, depression, stress, blood pressure, cholesterol, weight, and blood glucose) were dichotomized into high-risk and lower-risk levels. The association between risks and expenditures was estimated using a two-part regression model, controlling for demographics and other confounders. Risk prevalence data were used to estimate group-level impact of risks on expenditures. Results. Risk factors were associated with 25% of total expenditures. Stress was the most costly factor, with tobacco use, overweight, and lack of exercise also being linked to substantial expenditures. Conclusions. Modifiable risk factors contribute substantially to overall health care expenditures. Health promotion programs that reduce these risks may be beneficial for employers in controlling health care costs.
Article
Purpose To assess the relationship between modifiable health risks and total health care expenditures for a large employee group. Design Risk data were collected through voluntary participation in health risk assessment (HRA) and worksite biometric screenings and were linked at the individual level to health care plan enrollment and expenditure data from employers' fee-for-service plans over the 6-year study period. Setting The setting was worksite health promotion programs sponsored by six large private-sector and public-sector employers. Subjects Of the 50% of employees who completed the HRA, 46,026 (74.7%) met all inclusion criteria for the analysis. Measures Eleven risk factors (exercise, alcohol use, eating, current and former tobacco use, depression, stress, blood pressure, cholesterol, weight, and blood glucose) were dichotomized into high-risk and lower-risk levels. The association between risks and expenditures was estimated using a two-part regression model, controlling for demographics and other confounders. Risk prevalence data were used to estimate group-level impact of risks on expenditures. Results Risk factors were associated with 25% of total expenditures. Stress was the most costly factor, with tobacco use, overweight, and lack of exercise also being linked to substantial expenditures. Conclusions Modifiable risk factors contribute substantially to overall health care expenditures. Health promotion programs that reduce these risks may be beneficial for employers in controlling health care costs.
Article
Background:Because most adults in industrialized countries do not meet physical activity guidelines, population-wide interventions are needed. Environmental and policy interventions are based on ecological models of behavior and have the potential to influence entire populations. Ecological models are particularly applicable to physical activity because the behavior must be done in specific physical settings. Cross-sectional data indicate that environmental and policy variables are associated with physical activity behaviors of young people and adults.Method: Seven published evaluations of environmental and policy interventions to increase physical activity were reviewed.Results: Two studies showed that placing signs encouraging stair use can be effective. Quasi-experimental evaluations provided limited evidence that broad environmental changes can be effective. Large-scale policy interventions are currently being conducted in several countries.Proposed Model: A model describing the development of policy and environmental interventions is proposed, in the hope of stimulating more research in this area. Advocacy or planning groups identify and work with agencies that control policies and environments that can be altered to increase physical activity. Educational and policy/environmental interventions are seen as complementary.Conclusion: Lack of conceptual models and the inherent difficulties of evaluation have hampered research on environmental and policy interventions. Further research is needed, and practitioners and researchers should work together to evaluate programs.
Article
This paper systematically reviews the literature on the effectiveness of physical activity programs at worksites with respect to work-related outcomes. A computerized literature search, a reference search, and a manual search of personal databases were performed using the following inclusion criteria: randomized controlled or controlled trial, working population, worksite intervention program to promote physical activity or physical fitness, and work-related outcomes. The study quality was evaluated using nine methodological criteria. Conclusions were based on a 5-level rating system of evidence. Eight studies (4 randomized controlled trials and 4 controlled trials) were identified, but their methodological quality was generally poor. The outcomes were absenteeism, job satisfaction, job stress, productivity, and employee turnover. The evidence of an effect was limited for absenteeism, inconclusive for job satisfaction, job stress and employee turnover, and nil for productivity. The scientific evidence on the effectiveness of physical activity programs at worksites is still limited. Because of the few high-quality randomized controlled trials, it is strongly suggested that this type of study be carried out. Future randomized controlled trials should pay special attention to the description of randomization, inclusion criteria, compliance, and analyses according to intention to treat.
Article
The increasingly sedentary nature of work and its impact on health and productivity indicators demands the promotion of physical activity at the worksite. This paper aims to present considerations for broad-scale application of corporate strategies designed to promote physical activity among employees and their families through employer-sponsored initiatives. The benefits of physical activity are multifold, including health and wellbeing and productivity related outcomes. The workplace setting may be leveraged to promote physical activity levels through frequent and sustained exposures to effective interventions that reach employees and, indirectly, their families. Furthermore, employers represent a powerful stakeholder group that should leverage its influence on health policy initiatives designed to create supportive environments inside the workplace as well as the broader community. Specific principles, recommendations for action, and considerations for the prioritization of initiatives are provided based on essential elements for comprehensive programs and health policy initiatives and in the context of a social-ecological model and supportive research. Physical activity promotion at the worksite should be an integrated initiative that measurably improves worker health and enhances business performance.
Article
Workplaces are important settings for interventions to increase physical activity, but effects have been modest. To evaluate the efficacy of Move to Improve, a social-ecologic intervention delivered at the workplace to increase leisure-time physical activity. A group-randomized 12-week intervention consisting of organizational action and personal and team goal-setting was implemented in Fall 2005, with a multi-racial/ethnic sample of 1442 employees at 16 worksites of The Home Depot, Inc. Change in physical activity was analyzed in Fall 2007 using latent growth modeling and latent transition analysis. Participants in the intervention had greater increases in moderate and vigorous physical activity and walking compared to participants in a health education control condition. The proportion of participants that met the Healthy People 2010 recommendation for regular participation in either moderate or vigorous physical activity remained near 25% at control sites during the study but increased to 51% at intervention sites. During the last 6 weeks of the study, intervention participants exceeded 300 weekly minutes of self-reported moderate-to-vigorous physical activity and 9000 daily pedometer steps. The results support the feasibility and efficacy of the Move to Improve intervention and the role of goal-setting for attaining increased physical activity levels.
Article
The aim of this systematic literature analysis was to study the association between work health promotion and job well-being, work ability, absenteeism, and early retirement. This systematic review is a part of a large research project studying multiple workplace factors and interventions that may affect workers' health and well-being. Original articles published in 1970 to 2005 were searched in Medline and PsycINFO databases, the main search terms being health promotion, well-being, work ability, sick leave, and disability pension. Out of 1312 references and 35 potentially eligible publications, 10 studies were included in the analysis. Other sources producing 36 eligible studies, 46 studies in total were included in the analysis. There is moderate evidence that work health promotion decreases sickness absences (risk ratio [RR], 0.78; range, 0.10 to 1.57) and work ability (RR, 1.38; range, 1.15 to 1.66). It also seems to increase mental well-being (RR, 1.39; range, 0.98 to 1.91), but not physical well-being. There is no evidence on disability pension. Exercise seems to increase overall well-being (RR, 1.25; range, 1.05 to 1.47) and work ability (RR, 1.38; range, 1.15 to 1.66), but education and psychological methods do not seem to affect well-being or sickness absences. Sickness absences seem to be reduced by activities promoting healthy lifestyle (RR, 0.80; range, 0.74 to 0.93) and ergonomics (RR, 0.72; range, 0.13 to 1.57). Work health promotion is valuable on employees' well-being and work ability and productive in terms of less sickness absences. Activities involving exercise, lifestyle, and ergonomics are potentially effective. On the other hand, education and psychological means applied alone do not seem effective. Work health promotion should target both physical and psychosocial environments at work.
Article
We developed a new evaluation method to identify promising practices for promoting healthy weight among employees at small and medium-sized worksites. We used a structured rating and selection process to select 9 worksites with approximately 100 to 3,000 employees from a pool of worksites with health promotion programs reputed to be exemplary. A site visit over 2 sequential half-days at each site included interviews with senior management, program staff, vendors, and wellness committees; observation guided by a written environmental assessment; and structured review of program data on health outcomes of wellness program participants. The team corroborated findings from interviews, observations, and reviews of aggregate data on health outcomes of participants. Using the site visit reports, the project team and a separate panel of experts identified worksite health promotion practices that were promising, innovative, feasible to implement in a variety of settings, sustainable, and relevant for public health. Innovative practices included peer coaching, wellness screening coupled with motivational interviewing and follow-up, free access to fitness facilities, and incentives such as days of paid leave for participation in wellness programs. Introduction of incentives was associated with higher participation rates. To build the business case for their programs, staff at several worksites used aggregate data on decreases in high blood pressure, serum cholesterol concentrations, and body weight in longitudinal samples of program participants. The evaluation method identified promising practices implemented at small and medium-sized worksites to promote healthy weight and related favorable health outcomes.
Article
Physically inactive people are expected to use more healthcare services than active people. This inactivity imposes costs on the collectively funded health insurance programs. In this paper, excess utilization of healthcare services due to physical inactivity is examined using count data models and the Canadian Community Health Survey. The aim of the paper is to estimate utilization of healthcare services associated with inactivity and to estimate its impact on the Canadian healthcare system. The results suggest that physical inactivity increases hospital stays, and use of physician and nurse services. On average, an inactive person spends 38% more days in hospital than an active person. S/he also uses 5.5% more family physician visits, 13% more specialist services, and 12% more nurse visits than an active individual. The subsequent social cost of inactivity for the healthcare system is substantial.
Article
Many early work-site exercise programs had a unique fitness focus. More recently, modular programs have addressed many facets of lifestyle. Their stated objective has often been to boost corporate morale or employee health rather than to have direct economic benefits, and evaluation has frequently been in terms of process rather than a cost-benefit or a cost-effectiveness analysis. Nevertheless, a growing number of authors have claimed fiscal dividends from such programs. A full economic evaluation must consider such issues as the transfer of benefits between various sectors of the economy, opportunity costs to participants, marginal costs and benefits, inflation, discounting, and the choice between cost-benefit and cost-effectiveness analyses. Suggested benefits include an improvement of corporate image, a decrease of employee turnover, gains of productivity, reduced absenteeism and medical costs, an improved employee lifestyle, and a decrease of industrial injuries. In practice, the corporate impact of a program is greatly attenuated, depending on prevalence of need, participation rate, program response of recruits, and continued employment of such individuals within a company. Costs to the corporation include promotion, facilities, equipment, and professional leadership. However, such items are often small relative to the opportunity costs incurred by the participant. For this reason, activities that can be built into the normal day of the employee (for example, walking or cycling to and from work) may prove more acceptable and more cost-effective than formal work-site classes.
This chapter examines the role of exercise in increasing human and organizational effectiveness. First, the integration of health promotion and physical fitness interventions into human resource strategies is reviewed. This is followed by a review of the significance of exercise within general health promotion, of the impact of exercise on individual health parameters, of the carryover of individual health benefits to the organization, and, finally, by a commentary on current trends.
Article
Ideally this article should begin with a mathematical model--an equation. On the left we should put together contributions and expenditures in terms of hours, money and effort. On the right we should enter the profits in terms of years of life, money and quality of life. Unfortunately it is not that easy. The literature is comprehensive but also not complete. At the request of the British Department of Social Welfare, Fentem & Bassey went through the literature on exercise and health--1 334 references (4), and were unable to draw up any conclusion in the form of a mathematical equation. They could only make a declaration which they called "The case for exercise" (10). Lack of scientific proof should not stop us from drawing probable conclusions. In the article below we set out our reasons for the conclusions we have arrived at. In brief, the conclusion should be: "exercise is healthy and health is profitable".
Article
Physical activity has considerable health-enhancing potential. It will be realized, however, only if large number of people participate in adequate activity. This summary report describes the main results of four studies aimed to find out whether physically active commuting to work (PACW) meets the requirements of health and fitness enhancing activity. Three successive mail inquiries (N = 2014) indicated that PACW provided habitual exercise to one-third of employed urban population, and that more than one-fifth expressed willingness and being able to increase PACW. A randomized controlled trial on 68 inactive middle-aged men and women revealed that PACW (1 h daily for 10 wk) increased VO2max by 4.5% (P = 0.02), maximal treadmill time by 10.3% (P = 0.0007), and HDL cholesterol by 5% (P = 0.06). A demonstration project in a large industrial plant showed that PACW can be successfully promoted by low cost measures. In conclusion, these studies suggest that PACW may offer substantial potential as health and fitness enhancing measure provided that it can be practiced safely.
Article
Academic scrutiny has been directed at North American worksite fitness programmes, within broader health promotion programmes, for approximately a quarter of a century. Studies proclaiming the positive benefits of worksite fitness programmes for both the employer and employee have constantly been reported in the literature and presented at conferences. Many believe that health and fitness promotion at the worksite is firmly accepted by all concerned. Others believe that only healthcare cost containment interests allow these programmes to survive. Of concern is the low participation rate in programmes when the entire employee population is considered. As well, government commitment, while positively demonstrated in many ways, has been hampered by political priority setting and infrastructure duplication. In addition, neither a collective voice for the health movement has emerged nor has the movement actively sought to learn from those holding contradictory opinions. Corporate commitment to health promotion has not been overwhelmingly positive across varied socioeconomic employee populations. Several societal priorities may cause health promotion programmes to lose whatever attractiveness they presently hold as alternative benefit options develop. It is time for health promotion proponents to challenge themselves to examine the movement’s issues and concerns and plan appropriate strategies for the future.
Article
This investigation estimates the impact of ten modifiable health risk behaviors and measures and their impact on health care expenditures, controlling for other measured risk and demographic factors. Retrospective two-stage multivariate analyses, including logistic and linear regression models, were used to follow up 46,026 employees from six large health care purchasers for up to 3 years after they completed an initial health risk appraisal. These participants contributed 113,963 person-years of experience. Results show that employees at high risk for poor health outcomes had significantly higher expenditures than did subjects at lower risk in seven of ten risk categories: those who reported themselves as depressed (70% higher expenditures), at high stress (46%), with high blood glucose levels (35%), at extremely high or low body weight (21%), former (20%) and current (14%) tobacco users, with high blood pressure (12%), and with sedentary lifestyle (10%). These same risk factors were found to be associated with a higher likelihood of having extremely high (outlier) expenditures. Employees with multiple risk profiles for specific disease outcomes had higher expenditures than did those without these profiles for the following diseases: heart disease (228% higher expenditures), psychosocial problems (147%), and stroke (85%). Compared with prior studies, the results provide more precise estimates of the incremental medical expenditures associated with common modifiable risk factors after we controlled for multiple risk conditions and demographic confounders. The authors conclude that common modifiable health risks are associated with short-term increases in the likelihood of incurring health expenditures and in the magnitude of those expenditures.
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Because most adults in industrialized countries do not meet physical activity guidelines, population-wide interventions are needed. Environmental and policy interventions are based on ecological models of behavior and have the potential to influence entire populations. Ecological models are particularly applicable to physical activity because the behavior must be done in specific physical settings. Cross-sectional data indicate that environmental and policy variables are associated with physical activity behaviors of young people and adults. Seven published evaluations of environmental and policy interventions to increase physical activity were reviewed. Two studies showed that placing signs encouraging stair use can be effective. Quasi-experimental evaluations provided limited evidence that broad environmental changes can be effective. Large-scale policy interventions are currently being conducted in several countries. PROPOSED MODEL: A model describing the development of policy and environmental interventions is proposed, in the hope of stimulating more research in this area. Advocacy or planning groups identify and work with agencies that control policies and environments that can be altered to increase physical activity. Educational and policy/environmental interventions are seen as complementary. Lack of conceptual models and the inherent difficulties of evaluation have hampered research on environmental and policy interventions. Further research is needed, and practitioners and researchers should work together to evaluate programs.
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National objectives for public health have targeted worksite as important settings for interventions to increase physical activity. However, expert reviews reveal no scientific consensus about the effectiveness of worksite interventions for increasing physical activity or fitness. We judged the quantity and quality of existing evidence against scientific standards for the internal and external validity of the research design and the validity of measurements. Meta-analytic methods were used to quantify the size of effects expressed as Pearson correlation coefficients (r). Variation in effect was examined in relation to several features of the studies deemed important for implementing successful worksite interventions. Pre-experimental cohort studies were excluded because they are sensitive to secular trends in physical activity. Twenty-six studies involving nearly 9,000 subjects yielded 45 effects. The mean effect was heterogeneous and small, r = 0.11 (95% CI, -0.20 to 0.40), approximating 1/4 S.D., or an increase in binomial success rate from 50% to 56%. Although effects varied slightly according to some of the study features we examined, effects were heterogeneous within levels of these features. Hence, the moderating variables examined did not explain variation in the effects (P > 0.05). The exception was that effects were smaller in randomized studies compared with studies using quasi-experimental designs (P < 0.05). Our results indicate that the typical worksite intervention has yet to demonstrate a statistically significant increase in physical activity or fitness. The few studies that have used an exemplary sample, research design, and outcome measure have also yielded small or no effects. The generally poor scientific quality of the literature on this topic precludes the judgment that interventions at worksites cannot increase physical activity or fitness, but such an increase remains to be demonstrated by studies using valid research designs and measures.
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Editor Note: This is the third in a series of articles written by Dr. Kenneth R. Pelletier summarizing the results of studies examining the impact of comprehensive health promotion programs on health and cost. We received more than i0,000 reprint requests for these articles, which is far more than we have received for any other article we have published. Dr. Pelletier updated the summary because of the tremendous response it received and because additional studies have been published since the first two summaries were printed. Our intention is to continue publishing updated summaries of the impact of comprehensive health promotion programs on health and financial outcome measures periodically and to include all studies published in rigorous peer-reviewed journals. If we have missed a study, please send us a copy to include in the next update. At the request of Dr. Pelletier, this article is dedicated to Dr. Andrea Foote for her innovative and enduring impact on worksite health promotion that recognized the value of the individual worker and the power of the worksite as an ad hoc community to improve individual and organizational health.
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In summary, employees' flexibility and mood showed modest improvements following the implementation of a plant-wide, 10-minute, daily flexibility and strength program. The initial six-week pilot study, administered prior to the plant-wide program implementation, successfully assessed program feasibility, assessed the efficiency of program implementation, identified administrative and logistical concerns, and generated pilot data needed to secure managerial support. Despite the noted significant increases in grip strength in the pilot study, no increases were observed following the six months of plant-wide implementation. This may be related to the differences in low average pretest grip strength for the pilot study compared to the higher scores for the main study population. The pilot study subjects may have received a sufficient exercise stimulus to increase grip strength over the course of six weeks. In contrast, this may not have been the case for the main study subjects due to their higher initial mean grip strength. An increased number of exercises designed to directly impact grip strength may be needed to improve this parameter.
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To examine the methodology of worksite fitness and exercise programs and to assess their effect on health-related fitness, cardiac risk factors, life satisfaction and well-being, and illness and injury. The 52 studies reviewed cover English-language literature for the period from 1972 to 1994, as identified by a search of the Cumulative Index Medicus, Medline, the Canadian Sport Documentation Centre's "Sport Discus," computerized bibliography, and my own files. Reports were divided into five controlled experimental studies, 14 quasi-experimental studies with matched controls (one reported in abstract), and 33 other interventions of varied quality. Methodologic problems include difficulty in allowing for Hawthorne effects, substantial sample attrition, and poor definition of the intervention (exercise or broad-based health promotion). Findings are analyzed by specific fitness and health outcomes. Program participants show small but favorable changes in body mass, skinfolds, aerobic power, muscle strength and flexibility, overall risk-taking behavior, systemic blood pressure, serum cholesterol, and cigarette smoking. Claims of improved mood state are based heavily on uncontrolled studies. Quasi-experimental studies suggest reduced rates of illness and injury among participants, but seasonal and year-to-year differences in health weaken possible conclusions. Participation in worksite fitness programs can enhance health-related fitness and reduce risk-taking behavior, but population effect is limited by low participation rates.