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Pronk NP, Martinson B, Kessler RC, Beck AL, Simon GE, Wang P. The association between work performance and physical activity, cardiorespiratory fitness, and obesity
Abstract
The purpose of this study was to test the association between lifestyle-related modifiable health risks (physical activity, cardiorespiratory fitness, and obesity) and work performance. Data were obtained from 683 workers. Dependent variables included number of work loss days, quantity and quality of work performed, overall job performance, extra effort exerted, and interpersonal relationships. Results indicated that higher levels of physical activity related to reduced decrements in quality of work performed and overall job performance; higher cardiorespiratory fitness related to reduced decrements in quantity of work performed, and a reduction in extra effort exerted to perform the work; obesity related to more difficulty in getting along with coworkers; severe obesity related to a higher number of work loss days. It is concluded that lifestyle-related modifiable health risk factors significantly impact employee work performance.
... Multiple health risky behaviours tend to occur concurrently or complement each other [e.g., (7,8)], implying a multiplication of associated disease burdens on health and productivity, pressure on health care systems both in terms of disease incidence and associated costs of hospitalisation (9)(10)(11). Moreover, cardiovascular diseases tend to be associated with more than a single health behaviour, suggesting potential intercorrelation between these risky behaviours. ...
... This understanding is based on potential spillover effects arising when improvement in one behaviour increases the likelihood of adopting other healthier lifestyle behaviours. 7 That is; a beneficial single behaviour change may incentivize adoption of another healthy behaviour (30). ...
... This an important result suggesting that having a pre-condition may motivate healthier lifestyles (in terms of reduction in smoking and inadequate diet) in the future. It would be of 7 The idea of spillover effect here is synonymous with the concept of co-variation amongst multiple health behaviours in the literature on preventive medicine [e.g. (29)]. ...
Background
Disease incidence and premature deaths tend to be influenced by multiple health risky behaviours, including smoking, excessive alcohol consumption and unhealthy diet. Risky behaviours tend not to be independent and may have a multiplicative effect on disease incidence and healthcare cost. Thus, understanding the interrelationship between health behaviours and their effect on health outcomes is crucial in designing behavioural intervention programmes.
Objective
To examine the interrelationship between health risky behaviours and associated disease outcomes amongst Scottish adults.
Methods
We use hospitalisation episode data from the Scottish Morbidity Records, (SMR), that have been administratively linked to Scottish Health Surveys (SHeS) respondents with target disease defined by relevant ICD9 and 10 codes. We apply a recursive multivariate probit model to jointly estimate the health risky behaviours and disease incidence to adequately control for unobserved heterogeneity. The model is estimated separately by gender.
Results
Modelling health risk behaviours and disease incidence equations independently rather than jointly may be misleading. We find a clear socioeconomic gradient predicting health risky behaviours and the results differ by gender. Specifically, smoking appears to be a key driver of other health risky behaviours. Current smokers are more likely to be drinking above the recommended limit, physically inactive, and eating inadequate diet.
Conclusions
Interventions targeting current smokers to quit could spillover to other behaviours by reducing excessive drinking, improve physical activity and adequate diet. Thus, improvements in one behaviour may increase the likelihood of adopting other healthier lifestyle behaviours.
... Physical activity (PA) provides numerous health benefits, such as risk reduction for various chronic diseases, improved cardiovascular and metabolic function, and weight regulation. [1][2][3][4][5] PA engagement has also been linked to sound mental health and improved daily functioning [6][7][8][9] ; individuals who do so regularly are more likely to be productive and less likely to be depressed, anxious, or irritable on the job. 6,8,9 Yet, despite widespread public awareness of its benefits, less than a quarter of the United States (US) adult population meets national guidelines for time spent in leisure-time aerobic and muscle-strengthening activities. ...
... 10 One of the strongest associations with physical inactivity is obesity. 3,[11][12][13] An examination of the distribution of obesity rates by the employment industry shows that the health care industry has the highest rate of obesity at 32%, 3 followed by the public administration and social service industries. 3,[14][15][16] The data behind this 32% obesity rate implicate irregular work schedules, long hours, shift work, and an inadequate number of breaks as significant risk factors for weight gain and disruption in metabolic and circadian function. ...
... 10 One of the strongest associations with physical inactivity is obesity. 3,[11][12][13] An examination of the distribution of obesity rates by the employment industry shows that the health care industry has the highest rate of obesity at 32%, 3 followed by the public administration and social service industries. 3,[14][15][16] The data behind this 32% obesity rate implicate irregular work schedules, long hours, shift work, and an inadequate number of breaks as significant risk factors for weight gain and disruption in metabolic and circadian function. ...
Introduction:
Associations across self-efficacy, social support, and multiple measures of physical activity (PA) have not been thoroughly explored in hospital employees.
Methods:
Validated surveys assessed psychosocial factors; the IPAQ-long assessed PA, and mixed-effects analyses examined relations between psychosocial variables and PA in 920 employees from 6 Texas hospitals.
Results:
At P <.05, self-efficacy was significantly associated with light (β = 1.67), moderate (β = 1.63), and vigorous (β = 2.78) leisure PA; with domestic PA (β = 1.64); and with moderate commute PA (β = 0.03). At P < .05, family social-support was significantly associated with light (β = 0.94), moderate (β = 0.63), and vigorous (β = .74) leisure PA; with moderate (β = 0.46) and vigorous (β = 1.24) occupation PA; with light (β = 0.58) and moderate (β = 0.20) commute PA; and with domestic PA (β = 1.18). At P < .05, social support from friends was significantly associated with light (β = 0.74), moderate (β = 0.58), and vigorous (β = .91) leisure PA; with moderate commute (β = 0.21); and with domestic PA (β = 0.82).
Conclusion:
Interventions must emphasize self-efficacy-building strategies and the role of family support to meaningfully impact PA behaviors in this unique population.
... Physical activity improves the quality of work performed and overall job performance. Cardiorespiratory fitness improves the quality of work performed and reduces the amount of extra effort needed to perform tasks (Pronk et al., 2004). ...
... A lack of fitness and conditioning and an increased level of obesity are linked to lower work performance (Pronk et al., 2004), disability retirement, disability pension, mortality, higher work limitation, injury on duty, and increased worker's compensation claims (Ells et al., 2006;Fontaine et al., 2003;Ostbye et al., 2007;Thorlacius et al., 2006). Poor fitness and obesity are also related to increased healthcare costs, job absenteeism, early retirement, lost production time, shorter long-term disabilities among employees in an occupational setting, as well as locomotive and other disabilities (Soteriades et al., 2008). ...
In this study, we documented the value and importance of health and fitness of male and female security guards at an urban university in South Africa. We invited 84 participants to determine their health, selected fitness profiles and work readiness. We used four questionnaires, namely the physical activity readiness questionnaire, the medical history questionnaire, the lifestyle evaluation questionnaire, and the heart risk factor questionnaire. These questionnaires assisted with risk factor classification for the study cohort. Health and selected fitness parameters were also tested. Descriptive data were analysed using means and standard deviations for each variable. Comparisons between the male and female participants were made to find any statistically significant differences. A t-test was used to analyse the means between the gender groups. The correlation coefficient was used to determine the relationships between the variables. The results indicate that the female participants were less fit than the male participants; however, the fitness results were similar to the general population, which should be much higher as such occupations require higher levels of fitness. In this study, we provide recommendations for developing health and fitness protocols (for protection service personnel) in the field of health and fitness, and practical implications that can be utilised for both protective personnel and broader society. Morar, Coopoo and Noorbhai 2
... No association between self-reported physical fitness and work performance was found. Pronk et al. (2004) conducted a study that also tested the association between lifestyle-related modifiable health risks and work performance. In this study, dependent variables included number of work loss days, quantity and quality of work performed, overall job performance, extra effort exerted, and interpersonal relationships. ...
... Some studies (see Table 1) have shown interventions with positive influence on productivity (Ben-Ner et al. 2014;Carr et al. 2016;Chau et al. 2016;Pronk et al. 2004). Neuhaus et al. (2014) suggested that it is feasible to implement a multi-component intervention such as was used in Stand Up desk with high fidelity, no perceived decrease in productivity. ...
... In this case, individuals were 1.64 times more likely to report absenteeism in comparison to employees who did engage in a sufficient amount of physical exercise. By examining employees from three healthcare organisations and an airline, Pronk et al. (2004) found that engagement in moderate physical exercise was positively related to overall job performance. ...
... In this study, obese individuals reported having greater difficulties with completing physical tasks and getting work done on time. Pronk et al. (2004) also found obese employees to incur a higher number of work-loss days but, in this instance, obesity was associated with significantly greater difficulties in working effectively and getting along with co-workers. This suggests that BMI can influence work performance beyond physical tasks alone. ...
The UK is currently facing two inter-related socio-economic challenges. One is the now well-documented ‘productivity puzzle’; the crisis of persistent low productivity growth across the economy. The other is low levels in the mental and physical health of the working population, in particular. Wellbeing has been considered as a driver of higher levels of productivity and thus a means of solving the productivity puzzle. However, the relationship between productivity growth and wellbeing is complex and involves many moderating or mediating factors.
This report reviews the relationships between the different aspects of wellbeing, productivity, and productivity growth. It is the culmination of a desk-based evidence review, survey, and a mapping workshop held with experts from backgrounds including psychology, sociology, economics, and design. The focus is on wellbeing and labour productivity, although resource productivity and multi-factor productivity are also touched upon at relevant points within the report. Key findings and recommendations for further research are summarised below.
Key finding 1: Wellbeing is linked to higher levels of labour productivity.
• Individuals who have been diagnosed with a chronic physical health problem and those who engage in risky health behaviours (e.g. smoking, unhealthy diet, and lack of exercise) in the absence of any formal diagnosis both tend to report reduced labour productivity through presenteeism and absenteeism.
• Poor mental health appears to be more strongly linked with lost productivity through presenteeism (relative to absenteeism), as people are often reluctant to disclose that they are suffering from mental health problems.
• Higher levels of subjective wellbeing has been linked to greater labour productivity, and the causal nature of this link has been demonstrated in experimental studies.
• High levels of stress can lead to burnout and reduced labour productivity, but training resilience has been shown to produce positive effects on wellbeing and productivity.
• Case studies demonstrate that workplace wellness programmes can deliver benefits in terms of enhanced productivity, but this seems to be reliant on certain conditions being met (e.g. tailoring to the specific organisation and senior management support).
Key finding 2: Certain factors may be able to explain the positive relationship between levels of wellbeing and labour productivity.
• Human capital is an asset that is considered to enhance an individual’s or organisation’s productivity. At the same time it can enhance wellbeing by facilitating the satisfaction of psychological needs, greater health status and greater social mobility.
• Social capital allows for voluntary cooperation and the effective sharing of human capital, thus heightening productivity. At the same time it considered to be a determinant of higher levels of wellbeing in the workplace and everyday life.
• Certain environmental factors have been linked to both greater wellbeing and greater labour productivity. These include air quality, greenery and temperatures.
• Information and communication technology (ICT) has been considered as a key driver of productivity growth and has the potential to support wellbeing in that it facilitates communication, autonomy, and more flexible working conditions.
Key finding 3: Productivity growth may have detrimental effects on wellbeing.
• Attempts to reduce costs and increase labour productivity within the healthcare sector can lead to poorer quality care being provided and thus poorer health outcomes.
• The pursuit of productivity growth in the workplace can heighten a number of workplace factors such as job demands and job insecurity, both are associated with poorer wellbeing.
• Although the adoption of ICT can promote productivity growth, it can also blur the boundaries between work and home life and facilitate sedentary lifestyles, hence reducing wellbeing.
• Sustained productivity growth may increase carbon emissions, raise average temperatures, and deplete forms of natural capital that have been shown to be beneficial for wellbeing.
We conclude that, although wellbeing may be a determinant of higher levels of productivity, the way in which we pursue productivity growth also appears to have the potential to undermine wellbeing. Our key recommendation is therefore for research that takes a critical approach to understanding how wellbeing and productivity growth may influence each other over time and across contexts. Numerous suggestions for specific areas for future research have been made throughout the review and these are summarised in Table 1. Once we have a more nuanced understanding of the relationship between these two factors we will be better able to decide upon the value we assign to productivity growth and if and how we wish to pursue it.
... X -X 2. Employees rate work quantity, work quality, and interaction quality in previous 4 weeks on a 5-point scale; evidence of face validity [56]; higher work quantity associated with higher physical fitness (P=.045), higher work quality associated with higher moderate physical activity (P=.002), lower interaction quality associated with greater obesity (P=.02) [57]. X --3. ...
... X -X 2. Supervisors rate employees' work quantity, work quality, and interaction quality: slightly adapted from above employee version [56,57]. ...
Background:
Workplaces that provide opportunities for physical activity without requiring extra time for activity could help counteract the obesity epidemic. Desk ellipticals can contribute to activity-supportive workplace environments; however, the feasibility of engaging employees in pedaling ellipticals during simultaneous office work has not been well evaluated.
Objective:
We aim to present the rationale and methods from an ongoing randomized trial with overweight and obese employees that will evaluate (1) the effects of pedaling a compact desk elliptical on work performance and (2) the influence of different incentive types and schedules on desk pedaling quantity.
Methods:
Overweight and obese medical center employees are being recruited in dyads for a 2 (gift card type: healthier food vs Amazon) by 3 (gift card schedule: immediate incentive contingent on individual pedaling quantity; immediate incentive partially contingent on dyads' joint pedaling quantity; and delayed noncontingent pedaling incentive) cluster randomized within-subjects factorial trial. All participants receive a Bluetooth-enabled desk elliptical for 4 weeks and access to a mobile app that provides real-time pedaling feedback. The primary aims are to assess (1) change in employee work performance from pre- to postelliptical installation via employee and supervisor ratings and (2) effects of gift card type and schedule on quantity of objectively measured desk pedaling completed.
Results:
Data collection is ongoing. We expect to complete main outcome analyses in 2020.
Conclusions:
This trial represents one of the earliest attempts to assess the effects of desk pedaling and pedaling-incentive types in real-world offices. It could help bridge the research-to-practice gap by providing evidence on whether desk pedaling can be sustained without compromising work performance.
International registered report identifier (irrid):
DERR1-10.2196/16275.
... Burton, Chen, Conti, Pransky, and Edington (2004) also proved in their research that physical activities of any kind can significantly improve the job satisfaction level of the employees. While the same idea was also support by Pronk, Martinson, Kessler, et al (2004) as well. They supported that the informal or the semi-formal activities within the organization that can allow the employees to share their ideas and to enjoy their free time develops a bound between the employees. ...
... Ten studies 26,56,67,73,82,84,85,90,99,103 (18%) used a validated questionnaire such as the International Physical Activity Questionnaire (IPAQ) or the Baecke Questionnaire to measure physical activity. Twelve other studies (21%) used a single-item question like "In the past week, on how many days have you done a total of 30 minutes or more of physical activity, which was enough to raise your breathing rate?" ...
Objective
The aim of this study is to scope the literature on what is currently known between physical activity and presenteeism.
Data Source
A search strategy was conducting in six scientific databases.
Study Inclusion and Exclusion Criteria
Studies written in English about the relation between physical activity and presenteeism were considered for inclusion.
Data Extraction
Data on definitions and measurement of presenteeism and physical activity were extracted.
Data Synthesis
The data is categorized according to the understanding of presenteeism of the studies to give a better idea of how this phenomenon is studied in relation to physical activity.
Results
After screening 9773 titles and abstracts and 269 full-text articles, 57 unique articles fulfilled our eligibility criteria. The majority of the articles were published since 2010 and originated predominantly in the United States. Most studies (70%) define presenteeism as lost productivity due to health problems, according to the American line of research, whereas 19% of the studies define it as “working while ill” which refers to the European line of research. The studies that reflected the American school of thought tends to report more results that supported their hypothesis (i.e., that more physical activity is associated with less presenteeism).
Conclusion
This review has highlighted the homogeneity in how presenteeism is conceptualized and measured in studies included in our sample. Research on physical activity and presenteeism should be expanded across various disciplines in social sciences to respond to the needs that many researchers have expressed to promote healthier organizations.
... 4 Moreover, there is strong evidence suggesting that PA enhances health, 1 and good health has been suggested to have positive impact on labor market outcomes. 13 PA has also been reported to be positively associated with work ability 14 and negatively with sickness absence. 15 In economics, PA can be seen as an investment in future health and income. ...
This study investigated the association between physical activity (PA) and midlife income. The population‐based data comprised employed members of the Northern Finland Birth Cohort 1966 (N = 2797). Using binned scatterplots and polynomial regressions, we evaluated the association between accelerometer‐measured moderate PA (MPA), vigorous PA (VPA), and moderate‐to‐vigorous PA (MVPA) at 46 years old and register‐based income at 50 years old. The models were adjusted for sex, marital status, number of children, education, adolescent PA, occupational physical strenuousness, and time preference. We found MPA (p < 0.001), VPA (p < 0.05), and MVPA (p < 0.001) to associate curvilinearly with income. In subgroup analyses, a curvilinear association was found between MPA (p < 0.01) and MVPA (p < 0.01) among those with physically strenuous work, VPA among all females (p < 0.01) and females with physically light work (p < 0.01), and MPA and MVPA among all males and males with physically strenuous work (p < 0.05; p < 0.01; p < 0.05; p < 0.05, respectively) and income. The highest income benefits occurred at PA volumes higher than current PA guidelines. Linear associations between PA and income were found among females for MPA (p < 0.05) and MVPA (p < 0.05), among those with physically light work for MPA (p < 0.05), VPA (p < 0.05), and MVPA (p < 0.05), and among females with physically strenuous work for VPA (p < 0.05). We conclude that PA up to the current recommended level is associated with income, but MPA exceeding 505.4 min/week, VPA exceeding 216.4 min/week, and MVPA exceeding 555.0 min/week might have a negative association with income.
... Nutrition, PA, and sleep are each modifiable lifestyle determinants of chronic disease [23] and influence employee work performance [24]. Habitually consuming healthy nutritional patterns, engaging in sufficient PA, and obtaining adequate sleep are three lifestyle behaviors that have a positive effect on physical health and psychological wellness [25,26], significantly lower all-cause mortality, and likely mitigate numerous NCD pathogenesis processes [27,28]. ...
Background:
Airline pilots experience unique occupational demands that may contribute to adverse physical and psychological health outcomes. Epidemiological reports have shown a substantial prevalence of cardiometabolic health risk factors including excessive body weight, elevated blood pressure, poor lifestyle behaviors, and psychological fatigue. Achieving health guidelines for lifestyle behavior nutrition, physical activity, and sleep are protective factors against the development of noncommunicable diseases and may mitigate the unfavorable occupational demands of airline pilots. This narrative review examines occupational characteristics for sleep, nutrition, and physical activity and outlines evidence-based strategies to inform health behavior interventions to mitigate cardiometabolic health risk factors among airline pilots.
Methods:
Literature sources published between 1990 and 2022 were identified through electronic searches in PubMed, MEDLINE (via OvidSP), PsychINFO, Web of Science, and Google Scholar databases, and a review of official reports and documents from regulatory authorities pertaining to aviation medicine and public health was conducted. The literature search strategy comprised key search terms relating to airline pilots, health behaviors, and cardiometabolic health. The inclusion criteria for literature sources were peer-reviewed human studies, meta-analyses, systematic reviews, and reports or documents published by regulatory bodies.
Results:
The results of the review show occupational factors influencing nutrition, sleep, and physical activity behaviors and delineate evident occupational disruptions to these lifestyle behaviors. Evidence from clinical trials demonstrates the efficacy of nutrition, sleep, and physical activity interventions for enhancing the cardiometabolic health of airline pilots.
Conclusion:
This narrative review suggests that implementing evidence-based interventions focused on nutrition, physical activity, and sleep could help mitigate cardiometabolic health risk factors among airline pilots, who are particularly susceptible to adverse health outcomes due to unique occupational demands.
... The relationship between physical activity and work-related outcomes has often been inconclusive, although some evidence suggest positive effects of physical activity on work performance, reduced absenteeism, and sick leave [79]. Absenteeism has been inversely associated with the number of exercise days [80] and participation in sports activities [81], while Pronk et al. [82] reported a positive association between CRF and work performance. Moreover, an inverse dose-response relationship was reported between vigorous-intensity physical activity and the number of sick leave days, but this relationship was not present with moderate-intensity activity [83]. ...
Background
Workplace exercise interventions showed good results, but lack of time was often reported as a barrier to participation. To overcome this problem, several studies attempted to implement short high-intensity interval training (HIT) within the workplace.
Objectives
The aim of this systematic review is to explore the feasibility and effectiveness of HIT interventions within the workplace setting.
Data sources
A systematic literature search was conducted in PubMed and SPORTDiscus to identify articles related to HIT within the workplace.
Study eligibility criteria
Only interventions that consisted of HIT programmes within the workplace and tested at least one physiological, psychological, or work-related outcome were included.
Results
Seven studies (317 participants) met the inclusion criteria. HIT interventions lasted 6–12 weeks, with a frequency of 2–4 sessions/week and a duration of 8–30 min per session. Feasibility was qualitatively investigated in four studies, with key positive aspects reported for HIT time-appeal, the sense of competence driven by individual intensity, and improved intention to exercise; five studies reported adherence rates > 80%. Small-to-large effect sizes were reported for improvements in cardiorespiratory and muscular fitness. Small-to-medium effect sizes were reported for blood parameters and health-related quality of life.
Conclusions
HIT interventions in the workplace showed limited effectiveness in improving health-related outcomes, while promising results regarding feasibility were reported, mainly due to the time-efficiency and the positive post-exercise psychosocial responses. However, further high-quality studies involving more participants are still needed to make firm conclusions on HIT effectiveness and feasibility compared to other types of exercise in this context.
... Considering that workplace physical activity interventions can have positive effects on musculoskeletal pain [34] , anxiety and depression symptoms [35], and work performance outcomes [36] , there is reason to be concerned about the lack of movement and physical activity among desk-based workers [37] . It has been suggested that increasing the PA levels of desk-based employees could have significant benefits for both workplaces and individuals [38]. ...
Low back pain (LBP) is a common, disabling, and expensive condition. Sedentary work has become more common as we move into a highly-industrialized and highly robotic era. Low levels of physical activity can lead to LBP and have a negative impact on job satisfaction among desk job workers, the main objective of the study was to determine whether daily office activity is associated with low back pain. Within this study, desk job workers in Dhaka city were surveyed cross-sectionally. Randomly selected 280 respondents met the inclusion and exclusion criteria. Data was collected using a pretested, modified semi-structured questionnaire and entered into a database using SPSS software. It was found that 50.7% of respondents work in the office between 4 and 8 hours a day. Four out of five respondents didn't do exercise daily. Radiating pain was reported by 52.1% of respondents to this study. Also, most respondents use computers for about 3-6 hours per day. Desk job workers with LBP have an average age of 11-19 years and most have 11-19 years of experience. The majority of people work for 1 to 3 hours without taking a break. Respondents sat with a forward bending posture in 52.99% of all situations. Lumber support in chairs is rare among most people. A significant association has been found between gender and knowledge of negative impacts of using computers, gender and knowledge of negative impacts of long-term sitting, pain increasing time and lumber support in chair, type of pain and job experience, type of pain and trauma, type of pain and lumber support in chair, history of trauma and lumber support in chair; and the p-values were respectively 0.000, 0.018, 0.001, 0.038, 0.042, 0.004. In spite of a few clear associations between daily physical activity and low back pain among desk job workers, prospective studies are required to accurately evaluate each association. A clear definition of the causes and consequences of LBP will enable proper education and prevention methods to be developed.
... Nutrition, PA, and sleep are each modifiable lifestyle determinants of chronic disease (Gbadamosi & Tlou, 2020) and influence employee work performance (Pronk et al., 2004). ...
Cardiometabolic non-communicable diseases (NCD) and their major risk factors are associated with adverse acute and chronic health outcomes and may pose risks to flight safety and economic burden. Restorative sleep, healthy nutrition, and sufficient physical activity are powerful lifestyle behaviours that are fundamental for human health and well-being, and each are independently associated with NCD risk reduction. Although occupational preventive medicine research is increasing, airline pilots are largely underrepresented in the literature. Through a series of seven studies, this PhD thesis aimed to enhance the understanding of modifiable health risk factor status for airline pilots and to investigate evidence-based strategies for promoting positive health, wellness, and NCD risk factor mitigation among airline pilots.
To identify priority health risks among airline pilots and to serve as a foundation for further studies within the thesis, Study One systematically explored the global literature pertaining to the prevalence of cardiometabolic health risk factors among airline pilots. Study Two investigated the prevalence and distribution of subjective and objective cardiometabolic health risk factors among New Zealand airline pilots and compared these with the general population. Study Three synthesised global literature and summarised evidence-based considerations regarding the health benefits of sleep hygiene, healthy eating, and physical activity for cardiometabolic health promotion in airline pilots and further discussed evidence-based considerations for enhancing health behaviours in this occupational group. Study Four evaluated the efficacy of a 17-week, three-component personalised sleep, healthy eating, and physical activity lifestyle intervention for enhancing self-report health parameters during the coronavirus disease 2019 (COVID-19) pandemic. Subsequently, Study Five performed a 12-month follow-up investigation of the longitudinal effects of the 17-week intervention on self-report health parameters in addition to body mass and blood pressure management. Study Six further evaluated the effects of the three-component lifestyle intervention with utilisation of a wider range of objective cardiometabolic health parameters. Finally, Study Seven evaluated the efficacy of a smartphone-based app delivery of the three-component lifestyle intervention as a potentially scalable strategy for enhancing health and fitness parameters in airline pilots.
In Study One, A total of 47 studies derived from 20 different countries among a total pooled sample of 36,454 airline pilots were reviewed. The systematic review revealed substantial prevalence of > 50% for overweight and obesity, insufficient physical activity, and elevated fatigue among airline pilots globally. Further, this study highlighted the heterogeneity in methodology and lacking quality and quantity among the current literature pertaining to airline pilots, identifying the need for further research to better understand health risk factors and risk factor mitigation strategies among airline pilots.
In Study Two, the cross-sectional comparison of health risk factor prevalence between airline pilots (n = 504) and the general population (n = 2,033) identified notable and similar health risk factor prevalence between groups, with elevated prevalence of short sleep, physical inactivity, ‘at risk’ for hypertension, and lower positive self-rated health among airline pilots. Accordingly, findings called for further research to examine targeted, cost-effective intervention methods for promoting healthy body weight, managing blood pressure, and enhancing health behaviours to mitigate the risks of occupational morbidity, medical conditions causing loss of license, medical incapacity, and to support flight safety.
In Study Three, the narrative review outlined occupational health risks in airline pilots, summarised the evidence on health benefits of sleep hygiene, healthy eating, and physical activity as preventive medicine, and discussed evidence-based considerations for promoting health behaviours in this occupational group.
In Study Four, 38 airline pilots completed an acute 17-week personalised sleep hygiene, healthy eating, and physical activity intervention which elicited significant improvements in sleep quality and quantity, fruit and vegetable intake, and moderate-to-vigorous physical activity compared to the control group and suggested that achieving health guidelines for these behaviours promoted positive mental and physical health.
Study Five, provides further support that the personalised three-component lifestyle intervention can elicit and sustain long-term improvements in body mass and blood pressure management, health behaviours, and perceived subjective health in overweight and obese airline pilots and may support quality of life during an unprecedented global pandemic.
In Study Six, further implementation of the personalised three-component lifestyle intervention among 67 overweight airline pilots elicited significant (p = < 0.001) positive change associated with moderate to large effects sizes for objective health measures (VO2max, body mass, skinfolds, girths, blood pressure, resting heart rate, push-ups, plank isometric hold) and self-report health (weekly moderate-to-vigorous physical activity, sleep quality and quantity, fruit and vegetable intake, and self-rated health) at 4-months post-intervention, relative to the control group (n = 58).
Lastly, Study Seven utilised a randomised control trial design to deliver a smartphone-based app three-component lifestyle intervention among 94 airline pilots, which elicited positive changes associated with trivial to large effects sizes for objective health measures (Cooper’s 12-minute exercise test, resting heart rate, push-ups, plank isometric hold) and self-report health (weekly moderate-to-vigorous physical activity, sleep quality and quantity, fruit and vegetable intake, self-rated health, and perceived stress and fatigue) at 4-months post-intervention, relative to the control group (n = 92).
In summary, the studies in this thesis provide a foundation for understanding cardiometabolic health risk factor prevalence among airline pilots. Furthermore, our series of controlled clinical trials provide preliminary evidence that a personalised three-component physical activity, healthy eating, and sleep hygiene intervention can elicit short-term improvements and may promote sustained long-term positive adaptations in objective and subjective health parameters in airline pilots.
These findings are important for health care professionals and researchers to provide insight regarding the efficacy of lifestyle interventions for promoting health, and to inform practices relating to disease prevention, health promotion, and public health policy making. Furthermore, in relation to the limited literature base pertaining to health behaviour intervention research among airline pilots, our findings provide novel contributions to this field.
... In Metaanalysen (Mento, Steel & Karren, 1987;Tubbs, 1986) (Brandenburg & Marschall, 2000). Medizinische Untersuchungen zeigen, dass sich schon moderate körperliche Betätigung begünstigend auf die allgemeine berufliche Leistung auswirkt (Pronk, Martinson, Kessler, Beck, Simon & Wang, 2004). Auch im Rahmen der Rekreationsforschung wird berichtet, dass die Gesundheitsförderung durch Bewegungspausen am Arbeitsplatz zu einer Verbesserung der Arbeitsqualität und einer Verhinderung von Leistungseinbußen führt (Allmer, 2004). ...
Im eng traditionellen Sinne wird Leistung als Output einer Arbeitstätigkeit definiert, z.B. pro Zeiteinheit fehlerfrei gefertigte Anzahl von Schaltelementen (Schmidt & Kleinbeck, 2004). Leistung kann darüber hinaus als Qualität verstanden werden, die sich im Verhalten im Kontext sozialer Interaktionen zeigt (Schuler, 2004), z.B. Förderung der gewaltfreien Konfliktlösung bei Schülern. Neben Leistungen einzelner Personen ist im betrieblichen Kontext vor allem die Leistung von Arbeitsteams und -gruppen von Bedeutung. Ohne das Zusammenwirken mehrerer Organisations-mitglieder und -einheiten wären die Fertigung von Produkten sowie die Ausführung von Dienstleistungen oftmals nicht möglich.
... Repetitive commuting can in fact contribute to increasing fatigue and stress levels. In addition, most trips are made by car, which increases sedentariness and has been identified as one of the factors reducing work capacity [35,36]. ...
Objectives:
To estimate the evolution of compressible absenteeism in a hospital center and identify the professional and sociodemographic factors that influence absenteeism.
Method:
All hospital center employees have been included over a period of twelve consecutive years (2007 to 2019). Compressible absences and occupational and sociodemographic factors were analyzed using Occupational Health data. Since the distribution of the data did not follow a normal distribution, the number of days of absence was presented as a median (interquartile range (IQR): 1st quartile-3rd quartile), and comparisons were made using non-parametric tests followed by a negative binomial model with zero inflation (ZINB).
Results:
A total of 16,413 employees were included, for a total of 2,828,599 days of absence, of which 2,081,553 were compressible absences (73.6% of total absences). Overall, 42% of employees have at least one absence per year. Absent employees had a median of 15 (IQR 5-53) days of absence per year, with an increase of a factor of 1.9 (CI95 1.8-2.1) between 2007 and 2019 (p < 0.001). Paramedical staff were most at risk of absence (p < 0.001 vs. all other occupational categories). Between 2007 and 2019, the number of days of absence was multiplied by 2.4 (CI95 1.8-3.1) for administrative staff, 2.1 (CI95 1.9-2.3) for tenured, 1.7 (CI95 1.5-2.0) for those living more than 12 km from the workplace, 1.8 (CI95 1.6-2.0) among women, 2.1 (CI95 1.8-2.6) among those over 50 years of age, 2.4 (CI95 1.8-3.0) among "separated" workers, and 2.0 (CI95 1.8-2.2) among those with at least one child.
Conclusions:
Paramedical personnel are most at risk of absenteeism. Meanwhile, absenteeism is increasing steadily, and overall, the increase is major for administrative staff. The profile of an employee at risk of absenteeism is a titular employee, living at distance from work, probably female, over 50 years old, separated, and with children. Identifying professionals at risk of absenteeism is essential to propose adapted and personalized preventive measures.
... Research suggests that soldiers have low adherence to the Dietary Guidelines for Americans [5]. Obesity and poor dietary choices have been associated with poor attentiveness, reduced vision, adversarial work relationships, and reduced physical fitness [6][7][8]. ...
Approximately 17% of military service members are obese. Research involving army soldiers suggests a lack of awareness of healthy foods on post. Innovative approaches are needed to change interactions with the military food environment. Two complementary technological methods to raise awareness are geofencing (deliver banner ads with website links) and Bluetooth beacons (real-time geotargeted messages to mobile phones that enter a designated space). There is little published literature regarding the feasibility of this approach to promote healthy behaviors in retail food environments. Thus, we conducted a formative feasibility study of a military post to understand the development, interest in, and implementation of EatWellNow, a multi-layered interactive food environment approach using contextual messaging to improve food purchasing decisions within the military food environment. We measured success based on outcomes of a formative evaluation, including process, resources, management, and scientific assessment. We also report data on interest in the approach from a Fort Bragg community health assessment survey (n = 3281). Most respondents agreed that they were interested in receiving push notifications on their phone about healthy options on post (64.5%) and that receiving these messages would help them eat healthier (68.3%). EatWellNow was successfully developed through cross-sector collaboration and was well received in this military environment, suggesting feasibility in this setting. Future work should examine the impact of EatWellNow on military service food purchases and dietary behaviors.
... For example, employees who are regularly active have been shown to be more productive [8][9][10][11][12] and employers who introduce workplace physical activity initiatives report positive benefits such as improved job satisfaction and mood [8,12,13]. Conversely, low levels of physical activity in employees are associated with many poor work-related outcomes including reduced productivity (quality and quantity of work) and increased absenteeism, health care costs, disability, work impairment, and musculoskeletal problems [14][15][16]. Addressing employees' physical activity is therefore of significance not only for individual employees, but for workplaces as well. ...
Workplace step count challenges show promise with regard to increasing physical activity, with walking linked to many positive physical and mental health benefits. Few studies have investigated their effects on work-related outcomes. The aim of this study was to describe (1) the process of collecting work-related outcomes as part of a real-world workplace intervention, the Step Count Challenge, and (2) report step counts and work-related outcomes (productivity, perceived stress and work engagement) during the Step Count Challenge. This pre-post study was conducted as part of a four-week 2018 National Step Count Challenge (SCC) in Scotland, UK. A survey was administered to collect self-reported steps, productivity (HWQ), perceived stress (Cohen Perceived Stress Scale) and work engagement (UWES) on the week prior to the intervention starting (baseline), week 1 and week 4. Process data such as recruitment and response rates were monitored throughout. Of 2042 employees who signed up to the SCC, baseline data were reported for 246 (12% of total; mean age 42.5 years, 83% female). Process data suggest low uptake to the study and poor compliance between surveys time points. Preliminary data suggest positive changes in step counts (3374 steps/day by week 4), stress and productivity. No changes in work engagement were found. The findings highlight the need to integrate research more effectively into real-world interventions, including a true baseline period. The Step Count Challenge may have positive change on some work-related outcomes warranting further investigation into how robust research designs can be delivered without negatively influencing real-world interventions.
... The scale has been psychometrically validated in previous studies(Dennis et al. 2016;Papagiannidis et al. 2017), and similar scale items have been used in related contributions (e.g.,Hicks, Tinkler, and Allin 2013;Waldron 2010).We adapted scale items for PROD from the Health and Work Performance questionnaire (HPQ), developed by theWHO (Kessler et al. 2003; Kessler and Bedirhan Üstün 2004). This questionnaire has been used for the analysis of the relationship between health and performance in several studies(Okazaki et al. 2019;Pronk et al. 2004;Wang et al. 2003). Kessler and Bedirhan Üstün (2004) document the excellent reliability, validity and sensitivity to change of the HPQ measures. ...
Mental health issues are increasingly prevalent worldwide, emphasizing the need to research antecedents and consequences of well-being. Prior research shows that within organizations,
higher levels of subjective well-being (SWB) promote productivity performance. Building on this research, the authors hypothesize that recreational dance positively influences productivity through higher SWB. Survey data from Brazil, Italy, and the United Kingdom reveal that recreational dancers are more productive than non-dancers due to their higher intrinsic motivation and SWB. Dancing has an additional direct effect on productivity, beyond the mediating role of SWB. The results indicate well-being and productivity improvements in all three countries, although they show a moderating effect such that the
relationship between recreational dance and SWB is stronger when social norms are perceived to be looser. This study indicates potentially far-reaching benefits that could be achieved by including recreational dance in corporate well-being programs. International
dance organizations could market dance classes as a pathway to increase productivity at work and explore synergies with public health marketing to promote the benefits of recreational dance in joint international campaigns.
... If the participant did not respond on that day, a follow up message was sent the morning of the next working day. A similar procedure has been used to assess productivity in a workplace setting [31]. ...
Background
Office work generally consists of high amounts of sedentary behaviour (SB) which has been associated with negative health consequences. We developed the “WorktivIty” mobile app to help office workers reduce their SB through self-monitoring and feedback on sedentary time, prompts to break sedentary time, and educational facts. The aim of this paper is to report the feasibility of delivering the Worktivity intervention to desk-based office workers in the workplace setting and describe methodological considerations for a future trial.
Methods
We conducted a three-arm feasibility cluster randomised controlled pilot study over an 8-week period with full time-desk based employees. Clustered randomisation was to one of three groups: Worktivity mobile app (MA; n = 20), Worktivity mobile app plus SSWD (MA+SSWD; n = 20), or Control (C; n = 16). Feasibility was assessed using measures of recruitment and retention, intervention engagement, intervention delivery, completion rates and usable data, adverse events, and acceptability.
Results
Recruitment of companies to participate in this study was challenging (8% of those contacted), but retention of individual participants within the recruited groups was high (81% C, 90% MA + SSWD, 95% MA). Office workers’ engagement with the app was moderate (on average 59%). Intervention delivery was partially compromised due to diminishing user engagement and technical issues related to educational fact delivery. Sufficient amounts of useable data were collected, however either missing or unusable data were observed with activPAL™, with data loss increasing at each follow up time point. No serious adverse events were identified during the study. The majority of participants agreed that the intervention could be implemented within the workplace setting (65% MA; 72% MA + SSWD) but overall satisfaction with the intervention was modest (58% MA; 39% MA + SSWD).
Conclusions
The findings suggest that, in principle, it is feasible to implement a mobile app-based intervention in the workplace setting however the Worktivity intervention requires further technical refinements before moving to effectiveness trials. Challenges relating to the initial recruitment of workplaces and maintaining user engagement with the mHealth intervention over time need to be addressed prior to future large-scale implementation. Further research is needed to identify how best to overcome these challenges.
... 2) Physical Activity: We use the International Physical Activity Questionnaire (IPAQ; [44]). Physical activity affects not only physical health but also mental wellness and job performance [75]- [78]. The test-retest reliability for the IPAQ questionnaires is reported in [44]. ...
Assessment of individuals' job performance, personalized health and psychometric measures are domains where data-driven ubiquitous computing will have a profound impact in the near future. Existing work in these domains focus on techniques that use data extracted from questionnaires, sensors (wearable, computer, etc.), or other traits to assess well-being and cognitive attributes of individuals. However, these techniques can neither predict individuals' well-being and psychological traits in a global manner nor consider the challenges associated with processing the often incomplete and noisy data available. In this paper, we create a benchmark for the predictive analysis of individuals from a perspective that integrates physical and physiological behavior, psychological states and traits, and job performance. We develop a novel data mining framework that can extract meaningful predictors from noisy and incomplete data derived from wearable, mobile and social media sensors to predict nineteen constructs based on twelve standardized and well-validated tests. The framework can be used to build a predictive model of outcomes of interest. We validate the framework using data from 757 knowledge workers in organizations across the United States with varied work roles. Our framework and resulting model provides the first benchmark that combines these various instrument-derived variables in a single framework to understand people's behavior. The results show that our framework is reliable and capable of predicting our chosen variables better than the baselines when prediction includes the noisy and incomplete data.
... For example, deterioration in employee health due to lack of physical activity, overweight and musculoskeletal pain is associated with presenteeism 7 8 and absenteeism. 7 9 10 For organisations, employees with deteriorating health conditions (physical and mental) represent an increase in healthcare costs and a decrease in productivity. 11 12 As shown by the results of a recent study, 13 healthy behaviours, such as being physically active, may produce cost savings for the employer. ...
Introduction Considering that physical activity plays a key role in the health of workers, a growing number of researchers are studying its relationship with various workplace outcomes, such as presenteeism. Numerous scientists recognise the relevance of further studying this relationship in order to improve our understanding of it. However, studies about the association between physical activity and presenteeism show some discrepancy in the results obtained. Disparity in the way of measuring presenteeism makes it even more challenging to compare results. In addition, it remains difficult to determine the optimal frequency, intensity, duration and type of physical activity to increase the productivity benefits of physical activity. In light of these issues, clarification through a scoping review of the literature on the subject is warranted.
Method and analysis A search strategy will be conducted in six scientific databases: MEDLINE, CINAHL, PsycINFO, ABI Inform Global, Web of Science and Business Source Premier. A screening process by two independent reviewers will lead to study selection. Quantitative and qualitative studies written in English about the relation between physical activity and presenteeism will be considered for inclusion. Data on the definition and measurement of presenteeism as well as the measurement of physical activity will be extracted. Additional data will be extracted to provide a descriptive overview of studies that have examined the relationship between presenteeism and physical activity.
Ethics and dissemination As this study will be based only on published studies, ethics approval is not required. Through the manner in which the included studies will be presented (categorised by their approach to presenteeism), this scoping review has the potential to improve our understanding of some of the inconsistencies observed in the literature. This review can also identify gaps in the existing evidence base and lead to new avenues of research.
... 95% CI:1.11-1.46). Another study from Pronk NP et al. (2004) on 683 workers showed that work performance was related to obesity. The study found several reasons for this association. ...
The objective of this study was to analyze the associations between nutritional status, health status, other determining factors with work productivity of cocoa farmers. This cross-sectional study involved 58 male cocoa farmers aged 18–65 years old in two districts of Polewali Mandar. Data on food consumption and habit as well as health status were collected via structured interviews. While, blood pressure and anthropometric parameters were measured using standard equipment of blood pressure meter, weight scale, and height scale. Spearman’s test and Principal Components Regression (PCR) analysis were implemented to explore factors associated with farmers’ work productivity. There was no relationship between Body Mass Index (BMI) and work productivity. However, there was a significant positive association between central obesity with days of absent (r=0.275; p=0.037). We also found negative
association between blood pressure and the amount of cocoa picked daily (r=-0.366; p=0.005). PCR statistical analysis results showed that the amount of cocoa picked per day were significantly associated with smaller waist circumference, coffee consumption, and good exercise habit. While, decrease in consumption of fruits and vegetables was significantly associated with the number of absence days due to health problems. Thus, it can be concluded that work productivity of male cocoa farmers was associated with food consumption, physical activity, and lifestyle factors.
... 21,22 Specifically, physical activity, CRF, and obesity have been demonstrated to impact work performance, absenteeism, and presenteeism. 23 This is significant for firefighters as their recommended CRF standard of 42 mL O 2 /kg/min does not account for the age and sex of the firefighter, thus having the potential to misclassify a firefighter as fit or unfit inappropriately. 4 As such, this study, representing the initial phase of a larger observational study, aimed to address which body composition methods best correlate with CRF in firefighters. ...
Objective:
To address which body composition (BC) measures best correlate with cardiorespiratory fitness (CRF) in firefighters and develop a model for accurate CRF estimation compared to traditional methods.
Methods:
Career firefighters had body mass index (BMI) and waist circumference (WC) measured in addition to body fat percentage (FM%) by dual-energy X-ray absorptiometry (DXA). CRF as maximum oxygen uptake (VO2max) was estimated by rowing machine and measured by indirect calorimetry in a treadmill exercise test.
Results:
52 firefighters participated (92.3% male). Univariate correlations with BMI were best with WC. Univariate correlations with VO2max were best with FM%. Obesity classifications by BC measures agreed weakly at best. Multivariate analysis of several variables yielded an improved VO2max estimate (R = 0.70).
Conclusions:
Fire departments may benefit from more sophisticated measures of BC and CRF to evaluate firefighter fitness.
... The benefits of regular physical activity do not focus solely on feeling and being fit, but also on performing effectively at a cognitive level (Brisswalter, Collardeau, and Arcelin 2012). A study carried out among 683 workers in 2004 showed that physical activity was positively associated with quality of work performance and overall work performance (Pronk et al. 2004). ...
Recent research studies in translation devote increasing attention to the pivotal role that ergonomics plays in translators’ workplaces. However, there are no previous research studies that focus on how effective translators’ lifestyles are and provide results on how necessary it is to improve them. The aim of this paper is to show results from a pilot qualitative research study conducted in Spain with a focus group composed of a representative from four different professional profiles from the translation industry: a part-time employee at a translation company, a full-time employee at a translation company, a freelance translator, and an intern at a translation company. The focus group followed a non-structured interview and the list of topics ranged from changes in sleeping and eating patterns and regularity of physical activity depending on the volume of work translators had, to health problems related to these variations in their daily routines. Participants’ qualitative answers have shed light on the topic and have allowed us to develop a questionnaire that will be distributed internationally to compare data from different countries in a future study of a wider scope.
... 2) Physical Activity: We use the International Physical Activity Questionnaire (IPAQ; [44]). Physical activity affects not only physical health but also mental wellness and job performance [75]- [78]. The test-retest reliability for the IPAQ questionnaires is reported in [44]. ...
Assessment of job performance, personalized health and psychometric measures are domains where data-driven and ubiquitous computing exhibits the potential of a profound impact in the future. Existing techniques use data extracted from questionnaires, sensors (wearable, computer, etc.), or other traits, to assess well-being and cognitive attributes of individuals. However, these techniques can neither predict individual's well-being and psychological traits in a global manner nor consider the challenges associated to processing the data available, that is incomplete and noisy. In this paper, we create a benchmark for predictive analysis of individuals from a perspective that integrates: physical and physiological behavior, psychological states and traits, and job performance. We design data mining techniques as benchmark and uses real noisy and incomplete data derived from wearable sensors to predict 19 constructs based on 12 standardized well-validated tests. The study included 757 participants who were knowledge workers in organizations across the USA with varied work roles. We developed a data mining framework to extract the meaningful predictors for each of the 19 variables under consideration. Our model is the first benchmark that combines these various instrument-derived variables in a single framework to understand people's behavior by leveraging real uncurated data from wearable, mobile, and social media sources. We verify our approach experimentally using the data obtained from our longitudinal study. The results show that our framework is consistently reliable and capable of predicting the variables under study better than the baselines when prediction is restricted to the noisy, incomplete data.
... Many western workplace environments are predominantly desk-based with high levels of sitting and limited movement occurring during work hours [4][5][6]. This lack of physical activity (PA) and movement in desk-based workers is a concern given that workplace physical activity interventions can have positive effects on musculoskeletal pain [7,8], depressive symptoms and anxiety [9], and work performance outcomes [10]. Increasing PA levels of desk-based employees could provide significant benefit to both workplaces and employees themselves and contribute towards improved population health. ...
Background:
Poor physical and mental health of employees create significant problems in the workplace. Physical activity (PA) has been shown as an effective strategy for preventing and treating numerous physical and mental health issues as well as work performance outcomes. However, there are many barriers to taking part in PA (such as lack of time) with participation rates typically low. Providing PA in paid work time might be a way to overcome these issues, yet employers' and employees' opinions of this concept are unknown. The aim of this study was to explore employee and employer perspectives of PA in paid work time.
Methods:
Workplaces were recruited through existing contacts on the research team. Focus groups and interviews were conducted with employees and managers at one University and two executive non-departmental public bodies in central Scotland with mainly desk-based employees. Both managers and employees were involved to gain perspectives throughout the organisational hierarchy and were interviewed separately to reduce social desirability bias. All discussions were digitally recorded and transcribed verbatim. Data were analysed thematically for both managers and employees but due to significant overlap in themes between the groups, these are reported together in the results.
Results:
Three out of five organisations approached took part in this qualitative study. Two individual interviews were held with strategic managers, five focus groups with middle managers (n = 16) and nine with employees (n = 45). Benefits were anticipated by managers and employees for both employees themselves and the organisation and included improved mental health, productivity and more favourable perceptions of the employer. Despite these widely acknowledged benefits, significant barriers were identified and included the structure and nature of the working day (high workload, front line job requirements), workplace culture and norms (resentment from colleagues, no break culture) and organisational concerns (cost of lost time, public perceptions).
Conclusion:
This study suggests that there are significant barriers to PA in paid work time. Whilst numerous anticipated benefits were conveyed by both employees and managers, PA in paid work time is unlikely to become common place until changes in attitudes and the culture towards movement at work occur.
... (4)(5)(6) This lack of physical activity (PA) and movement in desk-based workers is a concern given that workplace physical activity interventions can have positive effects on musculoskeletal pain, (7,8) depressive symptoms and anxiety (9) and work performance outcomes. (10) Increasing PA levels of desk-based employees could provide signi cant bene t to both workplaces and employees themselves and contribute towards improved population health. ...
Background: Poor physical and mental health of employees create significant problems in the workplace. Physical activity (PA) has been shown as an effective strategy for preventing and treating numerous physical and mental health issues as well as work performance outcomes. However, there are many barriers to taking part in PA (such as lack of time) with participation rates typically low. Providing PA in paid work time might be a way to overcome these issues, yet employers’ and employees’ opinions of this concept are unknown. The aim of this study was to explore employee and employer perspectives of PA in paid work time.
Methods: Workplaces were recruited through existing contacts on the research team. Focus groups and interviews were conducted with employees and managers at one University and two executive non-departmental public bodies in central Scotland with mainly desk-based employees. Both managers and employees were involved to gain perspectives throughout the organisational hierarchy and were interviewed separately to reduce social desirably bias. All discussions were digitally recorded and transcribed verbatim. Data were analysed thematically for both managers and employees but due to significant overlap in themes between the groups, these are reported together in the results.
Results: Three out of five organisations approached took part in this qualitative study. Two individual interviews were held with strategic managers, five focus groups with middle managers (n=16) and nine with employees (n=45). Benefits were anticipated by managers and employees for both employees themselves and the organisation and included improved mental health, productivity and more favourable perceptions of the employer. Despite these widely acknowledged benefits, significant barriers were identified and included the structure and nature of the working day (high workload, front line job requirements), workplace culture and norms (resentment from colleagues, no break culture) and organisational concerns (cost of lost time, public perceptions).
Conclusion: This study suggests that there are significant barriers to PA in paid work time. Whilst numerous anticipated benefits were conveyed by both employees and managers, PA in paid work time is unlikely to become common place until changes in attitudes and the culture towards movement at work occur.
... (4)(5)(6) This lack of physical activity (PA) and movement in desk-based workers is a concern given that workplace physical activity interventions can have positive effects on musculoskeletal pain, (7,8) depressive symptoms and anxiety (9) and work performance outcomes. (10) Increasing PA levels of desk-based employees could provide signi cant bene t to both workplaces and employees themselves and contribute towards improved population health. ...
Background Increasing levels of employee stress and poor mental health are a significant concern for workplaces. Physical activity (PA) has been shown as an effective strategy for preventing and treating numerous mental health issues as well as improving mental wellbeing. However, there are many barriers to taking part in PA (such as lack of time) with participation rates typically low. Providing PA in paid work time might be a way to overcome these issues, yet employers’ and employees’ opinions of this concept are unknown. The aim of this study was to explore employee and employer perspectives of PA in paid work time.
Methods Focus groups and interviews were conducted with employees and managers at workplaces in central Scotland that had large numbers of desk based employees. All discussions were digitally recorded and transcribed verbatim. Data were analysed thematically.
Results Three out of five organisations approached took part in this qualitative study. Interviews were held with two strategic managers, and focus groups with16 middle managers and 45 employees. Barriers identified included organisational barriers (cost of lost time), the nature of the job (workload, logistical considerations) and existing workplace norms (colleague’s expectations and a no break, be at your culture). Benefits were anticipated for both employees and the organisation and included improved mental health, productivity and external more favourable employee perceptions of the employer.
Conclusion This study suggests that there are significant barriers to PA in paid work time. Whilst numerous anticipated benefits were conveyed by both employees and managers, PA in paid work time is unlikely to become common place until changes in attitudes and the culture towards movement at work occur.
... (4)(5)(6) This lack of physical activity (PA) and movement in desk-based workers is a concern given that workplace physical activity interventions can have positive effects on musculoskeletal pain, (7,8) depressive symptoms and anxiety (9) and work performance outcomes. (10) Increasing PA levels of desk-based employees could provide significant benefit to both workplaces and employees themselves and contribute towards improved population health. ...
Background: Poor physical and mental health of employees create significant problems in the workplace. Physical activity (PA) has been shown as an effective strategy for preventing and treating numerous physical and mental health issues as well as work performance outcomes. However, there are many barriers to taking part in PA (such as lack of time) with participation rates typically low. Providing PA in paid work time might be a way to overcome these issues, yet employers’ and employees’ opinions of this concept are unknown. The aim of this study was to explore employee and employer perspectives of PA in paid work time.
Methods: Workplaces were recruited through existing contacts on the research team. Focus groups and interviews were conducted with employees and managers at one University and two executive non-departmental public bodies in central Scotland with mainly desk-based employees. Both managers and employees were involved to gain perspectives throughout the organisational hierarchy and were interviewed separately to reduce social desirably bias. All discussions were digitally recorded and transcribed verbatim. Data were analysed thematically for both managers and employees but due to significant overlap in themes between the groups, these are reported together in the results.
Results: Three out of five organisations approached took part in this qualitative study. Two individual interviews were held with strategic managers, five focus groups with middle managers (n=16) and nine with employees (n=45). Benefits were anticipated by managers and employees for both employees themselves and the organisation and included improved mental health, productivity and more favourable perceptions of the employer. Despite these widely acknowledged benefits, significant barriers were identified and included the structure and nature of the working day (high workload, front line job requirements), workplace culture and norms (resentment from colleagues, no break culture) and organisational concerns (cost of lost time, public perceptions).
Conclusion: This study suggests that there are significant barriers to PA in paid work time. Whilst numerous anticipated benefits were conveyed by both employees and managers, PA in paid work time is unlikely to become common place until changes in attitudes and the culture towards movement at work occur.
... The psychosocial influences related to applying active workplaces include positive relationships between increasing physical activity, the quality of work, and overall work performance [27]. Some researchers concluded that work stress decreased when walking on a treadmill compared to performing work in a seated position [18]. ...
Objective: This study evaluated participants' ability to assemble a computer keyboard while at a cycling workstation. Depending on task completion time, error percentage, and workload based on subjective workload ratings, subjective body discomfort, electroencephalography (EEG) and electrocardiographic (ECG) signals, human performances were compared at four different cycling conditions: no cycling, low level cycling (15 km/h), preferred level cycling, and high level cycling (25 km/h). Method: The experiment consisted of 16 participants. Each participant performed the test four times (each cycling condition) on different days. Results: The repeated measure test showed that the alpha and beta EEG signals were high during session times (post) when compared with session times (pre). Moreover, the mean interbeat (R-R) interval decreased after the participants performed the assembly while pedaling, possibly due to the physical effort of cycling. Conclusions: Pedaling had no significant effect on body discomfort ratings, task errors, or completion time.
... This item was rated on an 11-point numerical rating scale with "0" representing "the worst anyone could do" and "10" representing "the very best that top workers in a job like mine could do". 23 Because of a right-skewed distribution, work ability and work performance were dichotomized by the medians: Very best 10 versus everything else (0-9). ...
Background:
Performing surgery involves well-known risk factors for developing musculoskeletal pain. Multisite musculoskeletal pain has shown to have an even higher adverse impact on the individual. We examined prevalence and intensity of multisite musculoskeletal pain in surgeons and identified characteristics associated with two or more painful body sites.
Materials and methods:
Information on sociodemographic, work experience, work demands, health status, physical capacity, and prevalence and intensity of musculoskeletal pain were collected from an internet-based questionnaire in 284 surgeons. Descriptive statistics were used to report prevalence and intensity of musculoskeletal pain. A logistic regression model was conducted to assess the characteristics associated with multisite musculoskeletal pain.
Results:
Musculoskeletal pain was reported by 93% of the surgeons and 77% experienced multisite pain. The reported median pain intensities ranged from 2 to 4. Multisite musculoskeletal pain was significantly associated with being a female surgeon (OR: 3.4; 95% CI: 1.5-7.4), physical work demands (OR: 1.5 95% CI: 1.2-1.7), work ability (OR: 3.4; 95% CI: 1.6-7.0), and feeling a sense of heaviness in the head/headache (OR:4.8; 95% CI: 2.0-11.5). In addition, 21%-40% of the surgeons who experienced multisite pain reported that pain influenced their work, leisure time, and sleep negatively.
Conclusions:
The observed high prevalence of multisite musculoskeletal pain and high pain intensities adds new knowledge to the emerging literature on surgeons' health. In addition, several characteristics, for example, work ability, were significantly associated with multiple pain sites. This is concerning as pain could ultimately shorten a surgeon's career. Therefore, it is pertinent to develop preventive and rehabilitating strategies.
... Brown et al. (2013) find higher self-reported presenteeism among sedentary office workers. Other cross-sectional studies applied in a workplace setting also have found an inverse association between physical activity and presenteeism (Burton et al. 2005(Burton et al. , 2014Pronk et al. 2004;VanWormer et al. 2011;Williden et al. 2012). Furthermore, Walker et al. (2017) show that, in a longitudinal data sample of university employees, becoming more physically active is associated with lower levels of presenteeism. ...
Hızla gelişen teknoloji günlük yaşantıyı kolaylaştırırken, insan sağlığına hareketsizlik kaynaklı olumsuz etkileri üzerinde durulması gereken bir paradoks olarak araştırmacıların dikkatini çekmektedir. Modern insanın ataları olarak kabul edilen 600 bin yıllık Homo Sapien türünün son 10 bin yılından önce oluşturduğu avcı
toplayıcı yaşam tarzının avın aranması, kovalanması ve yakalanması ile
sonuçlanan bir dizi hareketi içerdiği ve bu aktivitelerin sürdürülmesinin yaşamsal derecede önemli olduğu açıktır.
İnsan, evriminin son on bin yılında tarım devrimi ile birlikte ihtiyaç
durumunda kullanmak üzere biriktirme, sahip çıkma, güvenlik endişesi, iş bölümü, paylaşma vb. sebeplerle toplu yaşamayı öğrenmiş, bütün bunların sonucu olarak önceki dönemlere nazaran çok daha hızlı bir şekilde kendini yoran ve daha uzun süre meşgul eden işlerden çekilmesini ve zaman artırmasını sağlayacak teknolojileri geliştirmeyi başarmıştır. İnsanın günlük hayatında işini kolaylaştıran teknolojiler, insan hayatını durağanlaştırarak, korunmakta olan ve kısa sürede değişmesi mümkün olmayan en az 590 bin yıllık genetik yapı üzerine bina edilmiş insan
vücudu üzerinde bir takım olumsuz etkiler oluşturduğu düşünülebilir. Bu olumsuzluklara dikkati çeken Dünya Sağlık Örgütü (DSÖ), sanayileşme, kalkınma ve şehirleşme nedeniyle dünya genelinde fiziksel aktivite seviyelerinin düştüğünü belirtmiştir (Roessler vd., 2012). Toplum sağlığını olumsuz etkileyen ve buna paralel olarak ciddi sağlık harcamalarına yol açan fiziksel hareketsizlik kaynaklı maliyetlerin azaltılmasında F.A.’nin düşünülmesi, kolay uygulanabilen, temel stratejilerden biri olarak görülmektedir (Yurtçiçek vd., 2018). Fiziksel aktivite alışkanlığının geliştirilmesi yoluyla bütün bu olumsuzlukların giderilebileceği çeşitli
çalışmalarda ortaya konmuştur (Erikssen, 2001).
Fiziksel Aktivite, gün içerisinde kas ve eklemler kullanılarak enerji
tüketimi ile kalp atış hızının ve solunumun artması, buna bağlı olarak değişik şiddetlerde yorgunlukla neticelenen aktivitelerdir (Bek, 2012:9). Başka bir tanıma göre ise “kaslar tarafından enerji harcanması suretiyle üretilen bütün
hareketler fiziksel aktivite”dir (Caspersen vd., 1985). Bireyler günlük yaşantılarında, evlerinde, işyerlerinde, ulaşım şekillerinde (yürümek, koşmak, bisiklete binmek, vb.) ve boş zamanlarında fiziksel anlamda aktif olmaktadırlar. Çalışan bireyler için gün içerisinde zamanın büyük çoğunluğunun geçirildiği işyerlerinde fiziksel aktivite ikliminin sağlanması yoluyla çalışanların iyi oluş hallerine olumlu katkı sağlanabileceği bu çalışmanın konusunu oluşturmaktadır.
Youth participation in sport is associated with multiple benefits to both physical and mental health and confers wide-ranging advantages that include decreased risk of obesity, prevention of chronic disease, scholastic and cognitive benefits, increased high school graduation rates, and improved future earning potential while decreasing risk of participation in activities that can negatively impact health and well-being (substance use, teen pregnancy, interpersonal violence, etc.).Athletic identity, which is an athlete’s perception of their role in sport and the role of sport in their life, is an important concept that has been underexamined in young people. Better understanding of this relationship may provide useful guidance for injury prevention and management as well as performance. These potential benefits warrant further study in this age group as well as other intersectional categories of populations to include race/ethnicity, disability, and gender identity.KeywordsSports participationAthletic identityAthlete healthSports medicine
Physical activity interventions are proven to mitigate job stress and improve work performance. However, the recommended threshold of physical activity is rarely considered when evaluating the effect of physical activity. This study adopted case study approach to investigate the moderating effect of the threshold of physical activity on the relationship between emotional exhaustion and work performance, based on the conservation of resources theory. The research site was an Asian university wherein the university developed a mHealth application as a physical activity intervention to promote Exercise-is-Medicine® On Campus. A longitudinal survey was conducted to collect quantitative data for analysis, and interviews were conducted for further insights. The results supported the hypothesis that the threshold of physical activity was an effective moderator in the exhaustion-performance relationship. This study enriches the burnout literature and substantiates literature on technology-enabled solutions for improving work performance by engaging users to do regular and sufficient physical activity.
This paper reports on a study on improving the health and fitness of office workers in Iran using a comprehensive model. The research design was a randomized controlled trial involving 294 employees. The intervention was a 6-month program to promote physical activity. The primary outcome measure was their scores on the physical activity (PA) index recorded at 3 and 6 months. A statistically significantly increase in PA was found in the intervention group over the control group. In addition, the mean values of related health and physiological indices of the intervention group demonstrated a statistically significant increase compared to the control group. The conclusions of this study support research findings in multiple countries, that the physical activity and health of office workers can be improved in a short period.
Increasing levels of sedentary behaviour and decreasing levels of physical activity have been cited as causes of rising obesity rates and pose a significant public health risk. The purpose of this ideas paper is to propose a model of lifespan development that is both relevant and beneficial to the study and promotion of physical activity for health. The proposed model is used in the examination of various community and environmental interventions for the promotion of physical activity. Following the explanation of the physical activity lifespan development model, the framework is used to assess which interventions are most likely to be beneficial to each of three age groups: childhood/early youth, adulthood, and older adulthood. A sample of existing research is then overviewed for each suggested intervention, using a modified RE-AIM framework (Estabrooks & Gyurcsik, 2003). It is concluded that the lifespan development model may be helpful in assessing which physical activity interventions are best suited to various life phases, and also in designing future interventions. Future research considering interventions as a function of life-phase is recommended and the current model of lifespan development is proposed as a useful tool in the creation and examination of physical activity interventions.
Bilimsel ve teknolojik alanlarda meydana gelen baş döndürücü gelişmelerin günlük yaşamımızı da kaçınılmaz şekilde değiştirdiği açıktır. İnsan aklının sınırsız gücü ile sağlanan ve insanın hizmetine sunulan imkanların, günlük yaşantıyı kolaylaştırdığı ve yaşam kalitesini artırdığı düşünülse de daha az hareketli sedanter bir yaşam biçimine yol açtığı göz ardı edilmemelidir. Dünya Sağlık Örgütü 2002 raporuna göre, hareketsiz yaşam dünya çapında yılda 1,9 milyon kişinin ölümüne neden olmaktadır (WHO, 2002). DSÖ NCD (bulaşıcı olmayan hastalıklar) ölüm oranları için, fiziksel hareketsizliği tütün kullanımı, hava kirliliği, sağlıksız diet, alkol kullanımı ile birlikte risk faktörü olarak saymıştır (WHO 2016,2018,2019,2020). Covit-19 salgını ile mücadele yöntemi olarak benimsenen kısıtlamalar dikkate alındığında hareketsiz yaşamın daha ciddi sonuçlarının olması beklenmelidir. Birçok araştırmacı tarafından sedanter hayatın ilacı olarak önerilen Fiziksel Aktivitenin uygulanması ile bireylerin sağlıklı bir yaşam sürecekleri, yaşlanmalarının etkilerinin yavaşlatılacağı öne sürülmektedir. Bu çalışma, FA ve ilintili literatür taranarak yapılmış, FA nin tanımı ve faydaları, işyerinde çalışanlar üzerine etkileri incelenmiştir. Derlenen konuların FA ve insan yaşamı üzerine etkileri, çalışanların performansları ve iş tatmini üzerine çalışma yapacaklara fayda sağlayacak bir bilgi birikimi sağlaması hedeflenmiştir.
Work environment is becoming global, rapidly changing and competitive. With Industry
4.0, we get new technology, innovative processes, large databases, nanotechnology,
robotisation, artificial intelligence, information and communication technology,
changing employment practice, and increased age diversity. Traditional and new health
issues are emerging: chronic diseases, mental health, musculoskeletal diseases, and
disability (ENWHP, 2018).
Employees can cope with stressful work environment (physiological and psychological)
only with regular and appropriate physical activity. This has a positive effect on the
biological, psychological and sociological condition of the employees. The balance of the
factors contributes to better employee health and leads to lower absenteeism, which
proves to be a good investment for the employer, as it brings lower labor costs, higher
productivity, development and it also improves the company's competitive position at
the market.
Employers can promote a balanced lifestyle by investing in workplace health promotion.
Any investment in a workplace health promotion program can be profitable – reduced
absenteeism, lower health costs (Wolfgang & Kramer, 2008), (Stergar & Urdih Lazar,
2012), but only with a systematic approach and analysis of real data, information and
facts. It is necessary to find the optimal connection between a healthy lifestyle and
employee efficiency (Sports Union of Slovenia, 2020a).
In the master's thesis, we determined the impact of physical activity on the sickness (non)
absence of the previous year and the interrelation between the assessment of fitness and
the assessment of health status. We presented the time when it is reasonable to
introduce the model of a programmed recreational break into the business process
(employee productivity share), and how long it should last. Based on scientific findings,
70 % of working skills can be restored in a short time. This is feasible only with the
participation of the experts from various fields (ergonomics, cybernetics, robotics,
informatics, occupational medicine, occupational psychology, the sociology of work,
kinesiology, communication, occupational safety and others). However, recreational
breaks should not affect the quality and quantity of the production.
Background:
Occupations might influence the employees' psychophysical conditions and an important issue is the human activity mechanization, which favors a hypokinetic work status and leads to several chronic diseases. One of the most hypokinetic occupations is the supermarket cashier, in which the individual may spend many hours a day in the same body position.
Objective:
The goal of this study was to evaluate the association between cardiovascular risk, quality of life and physical activity level in supermarket cashiers.
Methods:
This is a cross-sectional study which included 200 supermarket cashiers aged 20 to 41 years from São Paulo, Brazil. The following cardiovascular risk factors were evaluated: overweight, obesity, hypertension, diabetes mellitus, and tobacco smoking. Physical activity level and quality of life were assessed with the short-form of the International Physical Activity Questionnaire (IPAq) and World Health Organization Quality of Life (WHOQOL), respectively. Student t test and Chi-square were carried out to evaluate mean gender comparations and frequency, respectively. Logistic regression models were applied to determine the association between cardiovascular risk factors and physical activity level.
Results:
The prevalence for all cardiovascular risk factors was significantly high in the cashiers with a low physical activity level. However, there was a significant reduction in several risk factors in the groups with moderate and high physical activity levels. The odds ratio values were significantly reduced for the association between the cardiovascular risk factors and the moderate and high physical activity levels. The cashiers with moderate and high physical activity levels showed significantly higher quality of life scores for the social and environmental domain.
Conclusions:
A high physical activity level is positively related to quality of life in supermarket cashiers.
La práctica de actividad física y su relación con el empleado saludable y el potencial creativo Resumen Las organizaciones más vanguardistas están tomando medidas con el objetivo final de mejorar la calidad de vida de los empleados y en consecuencia la productividad de la empresa. Engagement, optimismo, resiliencia, autoeficacia, emociones positivas o potencial creativo, son algunas de las características con las que se identifica al empleado saludable. El objetivo de este estudio fue el de conocer la relación entre la práctica de actividad física y las variables anteriormente citadas en los empleados de una organización dedicada a la fabricación de sofás. La muestra fueron 102 trabajadores que contestaron de forma anónima y voluntaria al cuestionario IPAQ para determinar la práctica de actividad física de cada uno de ellos. Para observar la relación entre el tipo de actividad física y las variables, se empleó el cuestionario Healthy and Resilient Organization (HERO). Además, se integró la adaptación española de la escala de Potencial Creativo y de la Creatividad Practicada (CPPC-17) en el trabajo y en la organización. Los resultados mostraron que prácticamente todas las variables estudiadas (salvo dos) presentan índices más elevados en aquellos empleados que practicaba actividad física alta o moderada. Las conclusiones de este estudio determinan que la práctica de actividad física, influye positivamente en la mayoría de las variables estudiadas. Abstract The most avant-garde organizations are taking measures with the ultimate goal of improving the quality of life of employees and consequently the productivity of the company. Engagement, optimism, resilience, self-efficacy, positive emotions or creative potential are some of the characteristics with which the healthy employee is identified. The objective of this study was to know the relationship between the practice of physical activity and the variables previously mentioned in the employees of an organization dedicated to the manufacture of sofas. The sample was 102 workers who answered anonymously and voluntarily to the IPAQ questionnaire to determine the physical activity practice of each one of them. The Healthy and Resilient Organization (HERO) questionnaire was used to observe the relationship between the type of physical activity and the variables. In addition, the Spanish adaptation of the scale of Creative Potential and Practical Creativity (CPPC-17) was integrated into the work and organization. The results showed that practically all the variables studied (except two) had higher rates in those employees who engaged in high or moderate physical activity. The conclusions of this study determine that the practice of physical activity positively influences most of the variables studied. Fecha de recepción:
This study has been conducted to identify the effect of employees' engagement, physical fitness including their style (behaviour) on job performance and absenteeism from work in Saudi Arabia. This is a significant study due to the fact that absenteeism from the work has a direct effect on productivity and organisations' performance. Absenteeism is a continuous pattern of absence from duty without a reasonable excuse and leads to poor performance. The study encompasses an investigation on the impact of the above three independent variables through empirical research and data analysis. This study is carried out by the survey method and is empirical in nature. The tool used in this study for analysis is the regression model developed by Sir Francis Galton. The results show a positive relationship between independent variables (employee engagement and healthy behaviour) and the dependent variables (job performance). However, there is not a strong relationship between the third independent variable (physical health) and job performance. The second dependent variable which is absenteeism and result shows no relationship with any independent variables (employee engagement, physical fitness and healthy behaviour).
Las organizaciones más vanguardistas están tomando medidas con el objetivo final de mejorar la calidad de vida de los empleados y en consecuencia la productividad de la empresa. Engagement, optimismo, resiliencia, autoeficacia, emociones positivas o potencial creativo, son algunas de las características con las que se identifica al empleado saludable. El objetivo de este estudio fue el de conocer la relación entre la práctica de actividad física y las variables anteriormente citadas en los empleados de una organización dedicada a la fabricación de sofás. La muestra fueron 102 trabajadores que contestaron de forma anónima y voluntaria al cuestionario IPAQ para determinar la práctica de actividad física de cada uno de ellos. Para observar la relación entre el tipo de actividad física y las variables, se empleó el cuestionario Healthy and Resilient Organization (HERO). Además, se integró la adaptación española de la escala de Potencial Creativo y de la Creatividad Practicada (CPPC-17) en el trabajo y en la organización. Los resultados mostraron que prácticamente todas las variables estudiadas (salvo dos) presentan índices más elevados en aquellos empleados que practicaba actividad física alta o moderada. Las conclusiones de este estudio determinan que la práctica de actividad física, influye positivamente en la mayoría de las variables estudiadas.
Importance
Exercise intolerance is associated with increased risk for morbidity and mortality in childhood cancer survivors. However, an association between exercise intolerance and psychosocial outcomes has not been fully explored.
Objective
To examine the associations between exercise intolerance and emotional distress, attainment of social roles, and health-related quality of life in childhood cancer survivors.
Design, Setting, and Participants
A cross-sectional study including 1041 adult survivors of childhood cancer and 286 community controls in the St Jude Lifetime Cohort was conducted at St Jude Children’s Research Hospital. The study was performed from April 1, 2012, to March 15, 2020.
Exposures
Exercise intolerance was defined as relative peak oxygen uptake less than 85% of age- and sex-estimated levels from maximal cardiopulmonary exercise testing.
Main Outcomes and Measures
Emotional distress was measured with the 18-item Brief Symptom Inventory-18, which includes overall Global Severity Index and depression, anxiety, and somatization subscales. Participants with T scores greater than or equal to 63 were classified as having elevated levels of distress. Social attainment was evaluated using patient-reported educational, employment, and marital status. Health-related quality of life was examined with the Medical Outcomes Survey Short Form-36. Participants with T scores less than or equal to 40 were classified as reporting poor health-related quality of life.
Results
Of the 1041 participants, 528 were women (50.7%). The prevalence of exercise intolerance among survivors (mean [SD] age, 35.5 [9.2] years) was higher than that among controls (age, 34.5 [10.0] years) (survivors: 634 [60.9%] vs controls: 75 [26.2%], P < .001). After adjusting for age at diagnosis and cardiopulmonary exercise testing, sex, race/ethnicity, smoking, physical activity, and exercise intolerance were associated with an increased risk for anxiety (prevalence rate ratio [PRR], 1.95; 95% CI, 1.20-3.16), somatization (PRR, 1.86; 95% CI, 1.23-2.80), and unemployment (PRR, 1.76; 95% CI, 1.23-2.52); an inverse association was noted with having a college degree (PRR, 0.67; 95% CI, 0.50-0.88). Exercise intolerance was associated with an increased the risk for scoring less than or equal to 40 on the physical component summary of the Medical Outcomes Survey Short Form-36 (PRR, 3.69; 95% CI, 2.34-5.84). These associations persisted when either cancer treatment exposures or chronic health conditions were added to the model.
Conclusions and Relevance
The findings of this study suggest that exercise intolerance is independently associated with emotional distress, attainment of social roles, and health-related quality of life of long-term survivors of childhood cancer. The results also suggest that improving physiologic capacity may benefit general health and wellness, as well as emotional health, ability to participate in social roles, and health-related quality of life.
Many individuals are passionate for physical activity such as cycling, running, and soccer. Drawing from the dualistic model of passion, the purpose of the present study was to examine the direct and indirect relationships between passion (harmonious and obsessive) for physical activity, life satisfaction, performance, and innovativeness in organisational settings. Survey data were gathered from 272 cyclists who also occupied employment roles beyond their cycling pursuits. Data were analysed using structural equation modelling. Results indicated a direct positive relationship between harmonious passion and both performance and innovativeness at work. Moreover, results indicated that perceived life satisfaction indirectly influenced the relationships between harmonious passion and both performance and innovativeness at work. No significant relationships were found between obsessive passion for cycling and either organisational performance outcome. In sum, these findings suggest that passion for physical activity directly and indirectly (through life satisfaction) enhance organisational performance outcomes but only for harmonious passion.
Background:
It is assumed that conventional laparoscopy (LAP) and robotic-assisted laparoscopic surgery (RALS) differ in terms of the surgeon's comfort. This study compared muscle workload, work posture and perceived physical exertion of surgeons performing LAP or RALS.
Methods:
Colorectal surgeons with experience in advanced LAP and RALS performed one of each operation. Bipolar surface electromyography (EMG) recordings were made from forearm, shoulder and neck muscles, and expressed relative to EMG maximum (%EMGmax ). The static, median and peak levels of muscle activity were calculated, and an exposure variation analysis undertaken. Postural observations were carried out every 10 min, and ratings of perceived physical exertion before and after surgery were recorded.
Results:
The study included 13 surgeons. Surgeons performing LAP showed higher static, median, and peak forearm muscle activity than those undertaking RALS. Muscle activity at peak level was higher during RALS than LAP. Exposure variation analysis demonstrated long-lasting periods of low-level intensity muscle activity in the shoulders for LAP, in the forearms for RALS, and in the neck for both procedures. Postural observations revealed a greater need for a change in work posture when performing LAP compared with RALS. Perceived physical exertion was no different between the surgical modalities.
Conclusion:
Minimally invasive surgery requires long-term static muscle activity with a high physical workload for surgeons. RALS is less demanding on posture.
In 2010, The National Association of Kinesiology in Higher Education (NAKHE) began a summer program to develop leadership in kinesiology professionals. The Leadership Development Workshop (LDW) was designed to help young academic professionals develop skills for leadership advancement in higher education. In 2017, NAKHE decided to host the LDW in Flagstaff, AZ, on a campus known for promoting outdoor activities. During early discussion and planning, the steering committee decided to try something new and shift the focus of the LDW to outdoor leadership that can influence professional development and productivity. This idea was suggested, in part, because of new and emerging research on improved brain function related to learning when people are physically active. The 2018 LDW attendees across all kinesiology disciplines worked side-by-side to solve group initiatives, adventure course activities, and geocaching challenges on top of supporting one another to brainstorm solutions to complex leadership challenges. This paper will describe a leadership workshop that combined leadership topics with outdoor activities that encouraged participants to “think outside the box” when dealing with common administrative concerns. Planning, implementation, and assessment of this workshop will be addressed in the hopes that this model can serve as a “Best Practice” for future professional meetings.
Insufficient physical activity (PA) and extensive sedentary behavior (SB) are major global health threats. Workplace interventions, especially the impacts of physical environments, have received limited attention compared to the growing literature linking residential environments with PA/SB. This systematic review examines this understudied topic and proposes a comprehensive conceptual framework for future research and practice.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 87 relevant articles (2000–2017) were identified and reviewed. The results revealed evidence supporting environmental impacts on employees' PA/SB from three spatial scales. At the workstation scale, sit-stand desks, treadmill desks, and stationary high desks were found to reduce SB and increase standing. Work building scale is relatively understudied, and reported correlates include staircase design, overall building design combining multiple PA-friendly strategies, and specific PA amenities (e.g., exercise facilities). On the work neighborhood scale, important correlates include work commute distance and corresponding route characteristics, parking availability and cost, and surrounding neighborhood environments. Assessment of the study quality showed limitations related to selection bias, confounders, difficulty of blinding, and lack of control groups and long-term assessments. The research base is still nascent as to how the workplace environment as a whole, including all three scales, influence PA/SB throughout the workday.
This review provides promising support for the potential of promoting active lifestyles through workplace environmental interventions. Future research and practice will be enhanced by a more holistic approach that integrates multiple environmental scales and considers personal and social factors.
In response to the growing rate of severe obesity and its consequences, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) funded the development of the Longitudinal Assessment of Bariatric Surgery (LABS) consortium to address some of the many questions related to the safety and efficacy of bariatric surgery. Comprised of six clinical centers and one data coordinating center with a governing body, LABS was a multicenter, observational cohort study with strategically designed protocols for data collection and maintenance. Three phases of the LABS study (LABS-1, LABS-2, and LABS-3) assessed the short- and longer-term risks and benefits of bariatric surgery and its associated outcomes and also examined several underlying mechanisms of effect in more detail. Ancillary studies include Teen-LABS and other approved protocols utilizing this extensive 7-year biospecimen and dataset.
For reasons of cost and ease of implementation, mail surveys are more frequently used for social research than are either telephone or face-to-face interviews. In this chapter, the last two decades of research aimed at improving mail survey methods are examined. Discussion of this research is organized around progress made in overcoming four important sources of error: sampling , noncoverage, measurement, and nonresponse. Progress has been especially great in improving response rates as a means of reducing nonresponse error. Significant progress has also been made in finding means of overcoming measurement error. Because mail surveys generally present few, if any, special sampling error problems, little research in this area has been conducted. The lack of research on noncoverage issues is a major deficiency in research to date , and noncoverage error presents the most significant impediment to the increased use of mail surveys. The 1990s are likely to see increased research on mail surveys, as efforts ar...
The reliability and concurrent validity of a simple questionnaire to assess leisure time physical activity has been investigated on 306 self-selected healthy adults of both sexes (163 M; 143 F). Values of body fat (BF) and maximum oxygen intake (VO2 max) expressed as percentiles of appropriate age and sex categories were used as criteria of validity for the questionnaire. BF and VO2 max were predicted from the Durnin and Womersley skinfold equations, and the laboratory version of the Canadian Home Fitness Test respectively. The strongest correlation was between VO2 max (percentile) and reported strenuous exercise (r = 0.35). The optimum discriminant function for VO2 max was based on a combination of reported strenuous and light activity. This yielded a correct 2-way classification of 69% of the subjects. A combination of sweat-inducing and moderate exercise yielded a correct 2-way classification of BF for 66% of subjects. The reliability coefficients for the optimum discriminant functions classifying VO2 max and BF were 0.83 and 0.85 respectively. We conclude that this simple instrument has potential value for the assessment of leisure time exercise behavior, offering the possibility of examining changes in behavior following the implementation of health and physical fitness promotion programmes in the community.
We analyzed data from two national surveys to estimate the short-term work disability associated with thirty-day major depression. Depressed workers were found to have between 1.5 and 3.2 more short-term work-disability days in a thirty-day period than other workers had, with a salary-equivalent productivity loss averaging between $182 and $395. These workplace costs are nearly as large as the direct costs of successful depression treatment, which suggests that encouraging depressed workers to obtain treatment might be cost-effective for some employers.
This report was prepared by the Center for Disease Prevention and Health Promotion in the Institute for Health and Productivity Management as part of an effort to improve understanding of the connection between employee health and performance and to begin to identify new strategies through which treating health as an investment in human capital can lead to greater business success. Computer database searches of peer-reviewed literature published between 1993 and 1998 and manual reviews of 20 journals were used to identify research on the link between employee health and performance. Data was extracted to summarize the overall findings on the magnitude of health problems addressed by health promotion and disease prevention programs, and the impact of interventions on improving health risk, reducing medical care cost, and improving worker performance. From this summary, major conclusions on early detection of disease, the impact of behavior change programs, and appropriate care-seeking were drawn. This systematic review is supplemented with summaries of 15 seminal articles and descriptions of five leading-practices programs. The influence of developments in work/family issues, complementary and alternative medicine, and quality of care and health outcomes research are briefly discussed. Finally, a conceptual framework for studying the impact of health and productivity is described.
This report describes the World Health Organization Health and Work Performance Questionnaire (HPQ), a self-report instrument designed to estimate the workplace costs of health problems in terms of reduced job performance, sickness absence, and work-related accidents-injuries. Calibration data are presented on the relationship between individual-level HPQ reports and archival measures of work performance and absenteeism obtained from employer archives in four groups: airline reservation agents (n = 441), customer service representatives (n = 505), automobile company executives (n = 554), and railroad engineers (n = 850). Good concordance is found between the HPQ and the archival measures in all four occupations. The paper closes with a brief discussion of the calibration methodology used to monetize HPQ reports and of future directions in substantive research based on the HPQ.
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.
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.
This report is the first report of the Surgeon General on physical activity and health. For more than a century, the Surgeon General of the Public Health Service has focused the nation's attention on important public health issues. Reports from Surgeons General on the adverse health consequences of smoking triggered nationwide efforts to prevent tobacco use. Reports on nutrition, violence, and HIV/AlDS - to name but a few - have heightened America's awareness of important public health issues and have spawned major public health initiatives. This new report, which is a comprehensive review of the available scientific evidence about the relationship between physical activity and health status, follows in this notable tradition. Scientists and doctors have known for years that substantial benefits can be gained from regular physical activity. The expanding and strengthening evidence on the relationship between physical activity and health necessitates the focus this report brings to this important public health challenge. Although the science of physical activity is a complex and still-developing field, we have today strong evidence to indicate that regular physical activity will provide clear and substantial health gains. In this sense, the report is more than a summary of the science - it is a national call to action.
This study uses a sample of over 1000 MBA graduates from a Middle Atlantic University to test for sex differences in perceived discrimination and for the actual effects of various physical characteristics and background factors on the starting salaries and later (1983) salaries of these men and women managers. Women more often reported experiencing discrimination, and they typically identified this as general discrimination against women. Fewer men perceived any discrimination. Those men who did claimed to be the victims of affirmative action programs favoring women and blacks over them. Salary data indicated that women did earn less than men, even when controlling for work experience. Evidence for other forms of discrimination was also found. Controlling for prior work experience and year of first professional employment, age and height had a positive effect on men's starting salaries and being overweight, a negative effect. For women, starting salaries were significantly and positively affected by social class. For 1983 income, taller, non-overweight, and older men earned more, as did those who grew up in a higher social class. For women, a positive salary correlate was again being from a higher social class. Areas for future research are discussed.
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.
The impact of behavioral risk factors on absenteeism and health-care costs was analyzed among 45,976 employees in a large, diversified industrial work force. A cross-sectional design was used to evaluate health risk appraisal and physical-examination data collected from 1984 through 1988. Employees with any of six behavioral risks had significantly higher absenteeism (range = 10% to 32%) compared with those without risks. These differences led to significantly higher illness costs (defined as compensation, health care, and non-health care benefits) for those with risks compared with those without risks. Annual excess illness costs per person at risk were smoking, $960; overweight, $401; excess alcohol, $389; elevated cholesterol, $370; high blood pressure, $343; inadequate seatbelt use, $272; and lack of exercise, $130. Only one factor, lack of exercise, was not significant after adjusting for age, education, pay category, and the six other behavioral risks. The total cost to the company of excess illness was conservatively estimated at $70.8 million annually. These findings suggest that the cost of key behavioral risks provides an opportunity to manage health-care cost increases through health promotion, financial incentives for healthy lifestyle, and environmental changes that affect health behaviors.
The effects of having diabetes or obesity on simulated job decisions was evaluated in a two (qualifications, high v. marginal) by three (diabetes, mildly obese, or normal) design. Subjects were 295 adults, averaging 5.02 years of full-time employment in white-collar settings, recruited in advanced level graduate or undergraduate business classes. Each subject examined a job description and a resume of the 'applicant' and viewed a 5-minute videotape. The applicant's face was never seen and an off-camera voice, constant across all conditions, was dubbed in for the applicant's responses to the interviewer's questions. Subjects were then asked to rate the applicant's qualification level and demeanor during the interview and to recommend whether or not to hire the individual. Subjects were also asked to make ratings about the applicant's work habits, work reliability and absenteeism, and interpersonal skills (e.g. emotional problems, likeability). Results indicated that level of quantification affected decisions to hire the applicant in the predicted direction. However, the obese applicant was rated as less qualified for the job, and both the diabetic and obese applicant were less likely to be hired, although they were rated similarly on personal appearance, attitude during the interview, and communication skills. Additionally, both the obese and the diabetic applicant were viewed as having poorer work habits. The diabetic was rated as much more likely to have medically-related job absences, whereas the obese applicant was rated as more likely to have other absences (e.g. abusing company privileges by feigning illness) and to have emotional and interpersonal problems.(ABSTRACT TRUNCATED AT 250 WORDS)
Twenty-six physical performance variables were assessed on 100 professional fire fighters and correlated against timed measures of five sequentially performed fire fighting tasks and against fractionated heart rates collected during performance of the fire fighting tasks via Holter monitoring of the ECG. Canonical correlation analysis revealed that two factors, physical work capacity and resistance to fatigue, accounted for the fractionated time and heart rate data. The first factor, influenced heavily by the average intra-task heart rate (L = 0.94) and by the approximately equal weights for the five simulated tasks (-0.53 less than L less than -0.36), reflected the fact that relatively high muscular strength and endurance, coupled with a near maximal aerobic capacity effort, were required to complete the simulated tasks. The battery of physical performance variables best predicting the first factor (R2 = 0.63) included maximal heart rate, sit-ups, grip strength, age, and submaximal oxygen pulse. The second factor (R2 = 0.39), most heavily loaded by the simulated rescue (L = 0.70) and chopping tasks (L = 0.42), appeared to represent an ability to complete all tasks quickly by exhibiting a resistance to fatigue brought on by the demands of the earlier tasks. The battery of physical performance variables best predicting the second factor included lean body weight, maximal heart rate, final treadmill grade, age, and percent fat. This study demonstrated that physiological factors related to the performance of occupational tasks can be identified and measured.
There is a growing trend toward using preemployment tests to select employees for physically demanding jobs. Women are, in increasing numbers, entering physically demanding occupations that were traditionally dominated by men. Under current Federal employment law, it is illegal to disqualify an employee for a job because of race, color, religion, sex, national origin, and with the recent passage of the American Disabilities Act (ADA), handicap. Because of gender differences in strength, body composition, and VO2max, preemployment tests for physically demanding jobs tend to screen out more females than males. Employers are using preemployment tests not only to enhance worker productivity, but also to minimize the threat of litigation for discriminatory hiring practices and to reduce the risk of musculoskeletal injuries. The primary ergonomic methods used in industry to reduce the risk of back injuries are preemployment testing and job redesign. When a test results in adverse impact, the validity of the test must be established. Validity in this context means that the test represents or predicts the applicant's capacity to perform the job. Criterion-related, content, and construct validation studies are the means used to establish validity. The validity of preemployment hiring practices for physically demanding jobs has been decided in the courts. The most common reason for ruling an employment practice invalid is the failure to show that the test measured important job behaviors. Much of this litigation has involved height and weight requirements for public safety jobs. The courts have generally ruled that using height and weight standards as a criteria for employment is illegal because they were not job related. If fitness tests comprise part or all of the preemployment test, it is essential to demonstrate that the fitness component is related to job performance. Although there are many factors to consider when establishing a cut score, there is a growing trend toward establishing the cut score on the basis of the job's physical demands, defined by VO2max and strength. This literature is limited because most validation studies are not published. They more typically take the form of a technical report to the governmental agency or company that funded the project. There are published preemployment validation studies for outdoor telephone craft jobs involving pole-climbing tasks; firefighters; highway patrol officers; steel workers; underground coal miners; chemical plant workers; electrical transmission lineworkers; and various military jobs.
To describe the pattern of sick-leave and disability pension in an obese sample and to estimate the Incremental, indirect cost due to sick-leave and early retirement for the obese fraction of the Swedish female population.
A retrospective study of sick-leave and disability pension in health examined obese subjects was performed. The indirect cost of obesity in Sweden was estimated from reported and recorded sick-leave and disability pension in the sample and from the estimated prevalence of obesity in the country.
1298 obese persons aged 30-59 y. The mean age was 46 years. The mean body mass Index was 39 kg/m2 (range 28-68).
The obese subjects were recruited from eight counties in Sweden.
As compared to the general Swedish population the obese subjects had 1.5-1.9 times higher sick-leave during one year. Twelve percent of the obese women had disability pension while the corresponding figure in the general population was 5%. The incremental cost of sick-leave and disability pensions attributable to obesity was 3.6 billion SEK during one year, which is equivalent to about 300 million USD per million female adult population. The total cost for sick-leave and disability pension due to absence from work for the obese fraction of the Swedish female population was 10.5 billion SEK during one year.
Obesity represents a major health problem with significant economic implications for the society. Approximately 10 percent of the total cost of loss of productivity due to sick-leave and disability pensions in women may be related to obesity and obesity-related diseases.
Results from a prospective illness-absence surveillance of refinery and petrochemical workers from 1986 through 1994 are presented. Illness absence data for this study were extracted from the morbidity section of the Shell Oil Company's Health Surveillance System, which includes records of all illness absences in excess of 5 days. The majority of employees (59%) had no illness absence during the 9-year period studied. The 13% of the population who had three or more absences accounted for 63% of the total illness absence episodes and 62% of the total work days lost. Frequency rate and duration of absence increased with increasing age. The increased illness absence was associated with the presence of known health risk factors, such as smoking, elevated blood pressure, high cholesterol, and obesity. For example, obese women had a twofold increased illness absence rate compared with nonobese women and the rate for male smokers doubled that of nonsmoking men. These health risk factors are also more common among employees with three or more absences than those with fewer or no absences. The goal of this analysis is to quantify the impact of illness absence to develop disease prevention strategies to maximize good health in employees and to minimize both the frequency and duration of illness absence.
Common mental disorders are often not identified in primary care settings.
To evaluate the validity and clinical utility of a telephone-assisted computer-administered version of Primary Care Evaluation of Mental Disorders (PRIME-MD), a brief questionnaire and interview instrument designed to identify psychiatric disorders in primary care patients.
Comparison of diagnoses obtained by computer over the telephone using interactive voice response (IVR) technology vs those obtained by a trained clinician over the telephone using the Structured Clinical Interview for DSM-IV [Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition] Diagnosis (SCID). A subsample also received the clinician-administered version of PRIME-MD.
Outpatients (N=200) from 4 primary care clinics, an eating disorders clinic, an alcohol treatment facility, psychiatric outpatients, and community controls.
Interviews conducted by telephone, except for face-to-face administration of PRIME-MD, which was conducted at either the primary care clinic or a research clinic.
Prevalence rates for any psychiatric disorder were similar between diagnoses made by the computer and those made by a mental health professional using the SCID (60.0% vs 58.5%). Prevalence rates for individual diagnoses were generally similar across versions. However, primary care patients reported twice as much alcohol abuse on the computer (15.0%) as on either the SCID (7.5%) or the clinician-administered PRIME-MD (7.5%). Using the SCID as the criterion, both the computer- and clinician-administered versions of PRIME-MD demonstrated high and roughly equivalent levels of sensitivity and specificity. Overall agreement (K) for any diagnosis was 0.67 for the computer-administered PRIME-MD and 0.70 for the clinician-administered PRIME-MD.
The computer-administered PRIME-MD appears to be a valid instrument for assessing psychopathology in primary care patients. Interactive voice response technology allows for increased availability, and provides primary care physicians with information that will increase the quality of patient care without additional physician time and at minimal expense.
This study was undertaken to determine if a progressive correlation exists between body mass index (BMI), health care costs, and absenteeism and to identify an economically optimal BMI. We studied 3,066 First Chicago NBD employees by using health risk appraisals and personnel data. Analysis was completed for those employees with and without a risk for BMI. People at risk for BMI are more likely to have additional health risks, short-term disability and illness absence, and higher health care costs than those not at risk for BMI. A "J-shaped" curve between health care costs and BMI exists, with the low point occurring at about 25 to 27 kg/m2. We concluded that indirect and direct costs to an employer increase with increasing BMI. Employers may benefit from helping employees achieve a healthy weight. The initial target population should be those who are at highest risk of complications from obesity.
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.
This study was conducted to determine the extent of the relationship between obesity and absenteeism due to illness. A secondary objective was to ascertain the extent to which age, gender, family income, length of workweek, and cigarette smoking influenced the obesity-absenteeism association.
A cross-sectional design was used. Data regarding obesity, absenteeism, and the potential confounding factors were collected during the same time period.
Data were collected within workplaces throughout the U.S., and at the headquarters of Health Advancement Services, Inc. (HAS).
Subjects were 10,825 employed men and women who participated in an ongoing wellness screening program administered by HAS.
The three-site skinfold technique was used to estimate body fat percentage. Absenteeism due to illness and the potential confounding variables were assessed using a structured paper-pencil questionnaire.
Without controlling for any potential confounders, obese employees were more than twice as likely to experience high-level absenteeism (seven or more absences due to illness during the past 6 months), and 1.49 times more likely to suffer from moderate absenteeism (three to six absences due to illness during the last 6 months) than were lean employees. With all of the potential confounders controlled simultaneously, obese employees were 1.74 and 1.61 times more likely to experience high and moderate levels of absenteeism, respectively, than were lean individuals.
Obese employees tend to be absent from work due to illness substantially more than their counterparts.
Obesity and low levels of physical fitness are independently associated with a variety of diseases and disorders. These conditions are modifiable and affect health care utilization. The degree to which these health risks are modifiable is directly related to the readiness of individuals to change the underlying behaviors. This study analyzes the relationship between health care costs, obesity, physical fitness, and willingness to communicate. In addition, we tested the hypothesis that willingness to communicate is directly associated with an individual's readiness to change behavior.
Multiple regression was used to estimate the relationship between adverse behavioral health outcomes, willingness to communicate, and annualized health care costs incurred over a period of 33 months before the completion of a health risk assessment survey in an employed population enrolled in a Midwestern managed care organization (N = 8822).
High body mass index (BMI), low physical fitness (predicted VO2max), and greater willingness to communicate were directly and significantly (P < 0.05) associated with higher health care costs. Relative to low-risk, annualized health care costs for each of the high-risk factors were 8% higher for BMI (rate ratio, 1.08; 95% confidence interval, 1.01-1.15), 10% higher for low predicted VO2max (rate ratio 1.10, 95% confidence interval, 1.02-1.18), and 22% higher for willingness to communicate (rate ratio, 1.22, 95% confidence interval, 1.14-1.30). The association between these health risks and health care costs was independent of age, sex, age-sex interaction, role-mental and role-physical limitations, and nine chronic conditions. Furthermore, willingness to communicate was directly related to a greater readiness to change behavior.
The prevalence of obesity and low physical fitness is high, and these health risks are directly related to health care costs. Willingness of health plan members to communicate around health improvement opportunities appears greatest among those who incur higher costs, and these patients also have more favorable readiness to change profiles. Effective, proactive population-based health improvement efforts appear to have significant potential for positive economic impact.
If physical inactivity, obesity, and smoking status prove to contribute significantly to increased health care charges within a short period of time, health plans and payers may wish to invest in strategies to modify these risk factors. However, few data are available to guide such resource allocation decisions.
To examine the relationship of modifiable health risks to subsequent health care charges after controlling for age, race, sex, and chronic conditions.
Cohort study of a stratified random sample of 5689 adults (75.5% of total sample of 7535) aged 40 years or older who were enrolled in a Minnesota health plan and completed a 60-item questionnaire.
Resource use as measured by billed health care charges from July 1, 1995, to December 31, 1996, compared by health risk (physical activity, body mass index [BMI], and smoking status).
The mean annual per patient charge in the total study population was $3570 (median, $600), and 15% of patients had no charges during the study period. After adjustment-for age, race, sex, and chronic disease status, physical activity (4.7% lower health care charges per active day per week), BMI (1.9% higher charges per BMI unit), current smoking status (18% higher charges), and history of tobacco use (25.8% higher charges) were prospectively related to health care charges over 18 months. Never-smokers with a BMI of 25 kg/m2 and who participated in physical activity 3 days per week had mean annual health care charges that were approximately 49% lower than physically inactive smokers with a BMI of 27.5 kg/m2.
Our data suggest that adverse health risks translate into significantly higher health care charges within 18 months. Health plans or payers seeking to minimize health care charges may wish to consider strategic investments in interventions that effectively modify adverse health risks.
This literature review demonstrates that the health risks and failure of employees to participate in fitness and health promotion programs are associated with higher rates of employee absenteeism. When determining how to manage absenteeism, employers should carefully consider the impact that health promotion programs can have on rates of absenteeism and other employee-related expenses.
This article discusses the impact of depression on work productivity and the potential for improved work performance associated with effective treatment. We undertook a review of the literature by means of a computer search using the following key terms: cost of illness, work loss, sickness absence, productivity, performance, and disability. Published works were considered in four categories: (1) naturalistic cross-sectional studies that found greater self-reported work impairment among depressed workers; (2) naturalistic longitudinal studies that found a synchrony of change between depression and work impairment; (3) uncontrolled treatment studies that found reduced work impairment with successful treatment; and (4) controlled trials that usually, but not always, found greater reduction in work impairment among treated patients. Observational data suggest that productivity gains following effective depression treatment could far exceed direct treatment costs. Randomized effectiveness trials are needed before we can conclude definitively that depression treatment results in productivity improvements sufficient to offset direct treatment costs.
Although work performance has become an important outcome in cost-of-illness studies, little is known about the comparative effects of different commonly occurring chronic conditions on work impairment in general population samples. Such data are presented here from a large-scale nationally representative general population survey. The data are from the MacArthur Foundation Midlife Development in the United States (MIDUS) survey, a nationally representative telephone-mail survey of 3032 respondents in the age range of 25 to 74 years. The 2074 survey respondents in the age range of 25 to 54 years are the focus of the current report. The data collection included a chronic-conditions checklist and questions about how many days out of the past 30 each respondent was either totally unable to work or perform normal activities because of health problems (work-loss days) or had to cut back on these activities because of health problems (work-cutback days). Regression analysis was used to estimate the effects of conditions on work impairments, controlling for sociodemographics. At least one illness-related work-loss or work-cutback day in the past 30 days was reported by 22.4% of respondents, with a monthly average of 6.7 such days among those with any work impairment. This is equivalent to an annualized national estimate of over 2.5 billion work-impairment days in the age range of the sample. Cancer is associated with by far the highest reported prevalence of any impairment (66.2%) and the highest conditional number of impairment days in the past 30 (16.4 days). Other conditions associated with high odds of any impairment include ulcers, major depression, and panic disorder, whereas other conditions associated with a large conditional number of impairment days include heart disease and high blood pressure. Comorbidities involving combinations of arthritis, ulcers, mental disorders, and substance dependence are associated with higher impairments than expected on the basis of an additive model. The effects of conditions do not differ systematically across subsamples defined on the basis of age, sex, education, or employment status. The enormous magnitude of the work impairment associated with chronic conditions and the economic advantages of interventions for ill workers that reduce work impairments should be factored into employer cost-benefit calculations of expanding health insurance coverage. Given the enormous work impairment associated with cancer and the fact that the vast majority of employed people who are diagnosed with cancer stay in the workforce through at least part of their course of treatment, interventions aimed at reducing the workplace costs of this illness should be a priority.
The purpose of this review is to summarize the literature on the ability of health promotion programs to reduce employee-related health care expenditures and absenteeism. SEARCH PROCESS: Using key words in a literature-searching program, a comprehensive search was conducted on the following databases: MEDLINE, Embase, HealthSTAR. SPORTDiscus, PsycINFO, SciSearch, ERIC, and ABI Inform.
All data-based studies that appeared in peer reviewed journals in the English language. Theses, dissertations, or presentation abstracts that were not published in peer reviewed journals were excluded. The initial search identified 196 studies, but only 72 met the inclusion criteria and were included in the review.
Summary tables were created that include design classification, subject size, results, and other key information for each study.
Both the nature of the findings and the overall quality of the literature were evaluated in an attempt to answer two questions: Do individuals or populations with high health risks have worse financial outcomes than individuals or populations with low health risks? Do health promotion programs improve financial outcomes?
There are good correlational data to suggest that high levels of stress, excessive body weight, and multiple risk factors are associated with increased health care costs and illness-related absenteeism. The associations between seat belt use, cholesterol, diet, hypertension, and alcohol abuse and absenteeism and health care expenditures are either mixed or unknown. Health promotion programs are associated with lower levels of absenteeism and health care costs, and fitness programs are associated with reduced health care costs.
Expanded health risk appraisal (HRA) surveys can help employers target chronic conditions for outreach or disease management interventions by providing data on the prevalences of conditions and their effects on work performance. However, concerns exist about the accuracy of this data because most HRAs have low response rates. We evaluated these concerns by examining the prevalences and work impairments associated with chronic conditions across four HRA subsamples that differed in intensity of recruitment effort.
Two thousand five hundred thirty-nine working people were invited to complete an expanded HRA survey that included questions about chronic conditions, work impairments, and demographics. Condition prevalences and associations between conditions and work impairment were compared across subsamples who responded after a single mailing, after two mailings, and in a telephone interview after the mailings either with or without a 20 dollars incentive.
Consistent with previous research, response rates varied dramatically across the four subsamples (from 20.1% with only one mailing to 67.7% with telephone administration and a financial incentive). However, the estimated prevalences of chronic conditions, levels of work impairment, and effects of chronic conditions on work impairment did not differ with intensity of recruitment effort.
Expanded HRAs can provide useful data on the prevalences and work impairments associated with chronic conditions even if response rates are low. Confirmation of these results is required, however, in new samples. Additional research is also needed on innovative and cost-effective strategies to improve HRA response rates.
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