Numerous worksite health promotion program (WHPPs) have been implemented the past years to improve employees' health and lifestyle (i.e., physical activity, nutrition, smoking, alcohol use and ...relaxation). Research primarily focused on the effectiveness of these WHPPs. Whereas process evaluations provide essential information necessary to improve large scale implementation across other settings. Therefore, this review aims to: (1) further our understanding of the quality of process evaluations alongside effect evaluations for WHPPs, (2) identify barriers/facilitators affecting implementation, and (3) explore the relationship between effectiveness and the implementation process.
Pubmed, EMBASE, PsycINFO, and Cochrane (controlled trials) were searched from 2000 to July 2012 for peer-reviewed (randomized) controlled trials published in English reporting on both the effectiveness and the implementation process of a WHPP focusing on physical activity, smoking cessation, alcohol use, healthy diet and/or relaxation at work, targeting employees aged 18-65 years.
Of the 307 effect evaluations identified, twenty-two (7.2%) published an additional process evaluation and were included in this review. The results showed that eight of those studies based their process evaluation on a theoretical framework. The methodological quality of nine process evaluations was good. The most frequently reported process components were dose delivered and dose received. Over 50 different implementation barriers/facilitators were identified. The most frequently reported facilitator was strong management support. Lack of resources was the most frequently reported barrier. Seven studies examined the link between implementation and effectiveness. In general a positive association was found between fidelity, dose and the primary outcome of the program.
Process evaluations are not systematically performed alongside effectiveness studies for WHPPs. The quality of the process evaluations is mostly poor to average, resulting in a lack of systematically measured barriers/facilitators. The narrow focus on implementation makes it difficult to explore the relationship between effectiveness and implementation. Furthermore, the operationalisation of process components varied between studies, indicating a need for consensus about defining and operationalising process components.
Sedentary behavior is an independent risk factor for excess body weight and other health problems. There are no published data on sitting time at work, or how this is related to occupation and sector ...(branch of business). No published study has shown whether extended sitting at work is compensated for by sitting less during leisure time.
This study used data from a continuous cross-sectional survey, from 2000 to 2005 (N=7720). Workers were asked how many minutes they spent sitting during the preceding day, both at work and in their leisure time. To test differences in sitting times among occupational groups and sectors, descriptive analyses and analyses of variance were carried out in 2006.
On average, the Dutch working population reported sitting for 7 hours each day, one third of which was at work. Occupational groups and sectors differed significantly in sedentary behavior, mainly involving sitting periods at work. Workers spending long periods sitting at work did not compensate by sitting less during their leisure time.
Workers spend a substantial part of their waking and working time seated. Those who sat for long periods at work did not compensate for this lack of activity by adopting less-sedentary behaviors during leisure time. To prevent health problems, the best approach may be to reduce sedentary behavior at work, when traveling to and from work, and during leisure time.
Objective The goal of this review was to summarize the evidence for an effect of lifestyle-targeted interventions at the workplace on the main biological risk factors for cardiovascular disease ...(CVD). Methods We performed an extensive systematic literature search for randomized controlled trials (RCT) that met the following inclusion criteria: (i) targeted at workers; (ii) aimed at increasing physical activity and/or improving diet; and (iii) measured body weight, body fat, blood pressure, blood lipids and/or blood glucose. We used a nine-item methodological quality list to determine the quality of each study. A best-evidence system was applied, taking into account study quality and consistency of effects. Results Our review included 31 RCT, describing a diversity of interventions (eg counseling, group education, or exercise). Of these studies, 18 were of high quality. Strong evidence was found for a positive effect on body fat, one of the strongest predictors of CVD risk. Among populations "at risk", there was strong evidence for a positive effect on body weight. Due to inconsistencies in results between studies, there was no evidence for the effectiveness of interventions on the remaining outcomes. Conclusions We found strong evidence for the effectiveness of workplace lifestyle-based interventions on body fat and, in populations at risk for CVD, body weight. Populations with an elevated risk of CVD seemed to benefit most from lifestyle interventions; supervised exercise interventions appeared the least effective intervention strategy. To gain better insight into the mechanisms that led to the intervention effects, the participants' compliance with the intervention and the lifestyle changes achieved should be reported in future studies.
Objective: Individual work performance is differently conceptualized and operationalized in different disciplines. The aim of the current review was twofold: (1) identifying conceptual frameworks of ...individual work performance and (2) integrating these to reach a heuristic conceptual framework. Methods: A systematic review was conducted in medical, psychological, and management databases. Studies were selected independently by two researchers and included when they presented a conceptual framework of individual work performance. Results: A total of 17 generic frameworks (applying across occupations) and 18 job-specific frameworks (applying to specific occupations) were identified. Dimensions frequently used to describe individual work performance were task performance, contextual performance, counterproductive work behavior, and adaptive performance. Conclusion: On the basis of the literature, a heuristic conceptual framework of individual work performance was proposed. This framework can serve as a theoretical basis for future research and practice.
Evidence shows that prolonged sitting is associated with an increased risk of mortality, independent of physical activity (PA). The aim of the study was to identify correlates of sedentary time (ST) ...in different age groups and day types (i.e. school-/work day versus non-school-/non-work day).
The study sample consisted of 1895 Dutch children (4-11 years), 1131 adolescents (12-17 years), 8003 adults (18-64 years) and 1569 elderly (65 years and older) who enrolled in the Dutch continuous national survey 'Injuries and Physical Activity in the Netherlands' between 2006 and 2011. Respondents estimated the number of sitting hours during a regular school-/workday and a regular non-school/non-work day. Multiple linear regression analyses on cross-sectional data were used to identify correlates of ST.
Significant positive associations with ST were observed for: higher age (4-to-17-year-olds and elderly), male gender (adults), overweight (children), higher education (adults ≥ 30 years), urban environment (adults), chronic disease (adults ≥ 30 years), sedentary work (adults), not meeting the moderate to vigorous PA (MVPA) guideline (children and adults ≥ 30 years) and not meeting the vigorous PA (VPA) guideline (4-to-17-year-olds). Correlates of ST that significantly differed between day types were working hours and meeting the VPA guideline. More working hours were associated with more ST on school-/work days. In children and adolescents, meeting the VPA guideline was associated with less ST on non-school/non-working days only.
This study provides new insights in the correlates of ST in different age groups and thus possibilities for interventions in these groups. Correlates of ST appear to differ between age groups and to a lesser degree between day types. This implies that interventions to reduce ST should be age specific. Longitudinal studies are needed to draw conclusions on causality of the relationship between identified correlates and ST.
The prevalence of overweight and elevated cardiovascular disease (CVD) risk among workers in the construction industry is relatively high. Improving lifestyle lowers CVD risk and may have ...work-related benefits. The purpose of the study was to evaluate the effects on physical activity (PA), diet, and smoking of a lifestyle intervention consisting of individual counseling among male workers in the construction industry with an elevated risk of cardiovascular disease (CVD).
In a randomized controlled trial including 816 male blue- and white-collar workers in the construction industry with an elevated risk of CVD, usual care was compared to a 6-month lifestyle intervention. The intervention consisted of individual counseling using motivational interviewing techniques, and was delivered by an occupational physician or occupational nurse. In three face to face and four telephone contacts, the participant's risk profile, personal determinants, and barriers for behavior change were discussed, and personal goals were set. Participants chose to aim at either diet and PA, or smoking. Data were collected at baseline and after six and 12 months, by means of a questionnaire. To analyse the data, linear and logistic regression analyses were performed.
The intervention had a statistically significant beneficial effect on snack intake (β-1.9, 95%CI -3.7; -0.02) and fruit intake (β 1.7, 95%CI 0.6; 2.9) at 6 months. The effect on snack intake was sustained until 12 months; 6 months after the intervention had ended (β -1.9, 95%CI -3.6; -0.2). The intervention effects on leisure time PA and metabolic equivalent-minutes were not statistically significant. The beneficial effect on smoking was statistically significant at 6 (OR smoking 0.3, 95%CI 0.1;0.7), but not at 12 months (OR 0.8, 95%CI 0.4; 1.6).
Beneficial effects on smoking, fruit, and snack intake can be achieved by an individual-based lifestyle intervention among male construction workers with an elevated risk of CVD. Future research should be done on strategies to improve leisure time PA and on determinants of maintenance of changed behavior. Considering the rising prevalence of unhealthy lifestyle and CVD, especially in the aging population, implementation of this intervention in the occupational health care setting is recommended.
Current Controlled Trials ISRCTN60545588
OBJECTIVE:The aim of this study was to explore the longitudinal relationship between sitting time on a working day and vitality, work performance, presenteeism, and sickness absence.
METHODS:At the ...start and end of a five-month intervention program at the workplace, as well as 10 months after the intervention, sitting time and work-related outcomes were measured using a standardized self-administered questionnaire and company records. Generalized linear mixed models were used to estimate the longitudinal relationship between sitting time and work-related outcomes, and possible interaction effects over time.
RESULTS:A significant and sustainable decrease in sitting time on a working day was observed. Sitting less was significantly related to higher vitality scores, but this effect was marginal (b = −0.0006, P = 0.000).
CONCLUSIONS:Our finding of significant though marginal associations between sitting time and important work-related outcomes justifies further research.
Abstract Objective To study the association between commuter cycling and all-cause sickness absence, and the possible dose–response relationship between absenteeism and the distance, frequency and ...speed of commuter cycling. Method Cross-sectional data about cycling in 1236 Dutch employees were collected using a self-report questionnaire. Company absenteeism records were checked over a one-year period (May 2007–April 2008). Propensity scores were used to make groups comparable and to adjust for confounders. Zero-inflated Poisson models were used to assess differences in absenteeism between cyclists and non-cyclists. Results The mean total duration of absenteeism over the study year was more than 1 day shorter in cyclists than in non-cyclists. This can be explained by the higher proportion of people with no absenteeism in the cycling group. A dose–response relationship was observed between the speed and distance of cycling and absenteeism. Compared to people who cycle a short distance (≤ 5 km) three times a week, people who cycle more often and longer distances are absent for fewer days on average. Conclusion Cycling to work is associated with less sickness absence. The more often people cycle to work and the longer the distance travelled, the less they report sick.
OBJECTIVE:To examine the construct validity of the Individual Work Performance Questionnaire (IWPQ).
METHODS:A total of 1424 Dutch workers from three occupational sectors (blue, pink, and white ...collar) participated in the study. First, IWPQ scores were correlated with related constructs (convergent validity). Second, differences between known groups were tested (discriminative validity).
RESULTS:First, IWPQ scores correlated weakly to moderately with absolute and relative presenteeism, and work engagement. Second, significant differences in IWPQ scores were observed for workers differing in job satisfaction, and workers differing in health.
CONCLUSION:Overall, the results indicate acceptable construct validity of the IWPQ. Researchers are provided with a reliable and valid instrument to measure individual work performance comprehensively and generically, among workers from different occupational sectors, with and without health problems.
To critically review the literature with respect to the effectiveness of worksite physical activity programs on physical activity, physical fitness, and health.
A search for relevant English-written ...papers published between 1980 and 2000 was conducted using MEDLINE, EMBASE, Sportdiscus, CINAHL, and Psychlit. The key words used involved a combination of concepts regarding type of study, study population, intervention, and outcome measure. In addition, a search was performed in our personal databases, as well as a reference search of the studies retrieved.
The following criteria for inclusion were used: 1) randomized, controlled trial or nonrandomized, controlled trial; 2) working population; 3) worksite intervention program to promote employees' physical activity or physical fitness; and 4) physical activity, physical fitness, or health-related outcomes.
Two reviewers independently evaluated the quality of relevant studies using a predefined set of nine methodological criteria. Conclusions regarding the effectiveness of a worksite physical activity programs were based on a rating system consisting of five levels of evidence.
Fifteen randomized, controlled trials and 11 nonrandomized, controlled trials met the criteria for inclusion and were reviewed. Six randomized, controlled trials and none of the nonrandomized, controlled trials were of high methodological quality. Strong evidence was found for a positive effect of a worksite physical activity program on physical activity and musculoskeletal disorders. Limited evidence was found for a positive effect on fatigue. For physical fitness, general health, blood serum lipids, and blood pressure, inconclusive or no evidence was found for a positive effect.
To increase the level of physical activity and to reduce the risk of musculoskeletal disorders, we support implementation of worksite physical activity programs. For the other outcome measures, scientific evidence of the effectiveness of such a program is still limited or inconclusive, which is mainly the result of the small number of high-quality trials. Therefore, we recommend performing more randomized, controlled trials of high methodological quality, taking into account criteria such as randomization, blinding, and compliance.
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