Purpose
The benefits of an active lifestyle are widely documented, yet studies show that only a small proportion of adults engage in sufficient levels of physical activity. The workplace presents an ...ideal avenue for delivering initiatives to promote physical activity, overcoming commonly cited barriers such as a ‘lack of time’ and providing access to a large intersection of society. The purpose of this study was to (1) explore the types of interventions workplaces implement to promote physical activity among staff, (2) describe the characteristics of those interventions, (3) understand whether these interventions positively impact on activity levels, and (4) assess the methodological quality of studies.
Methods
A systematic review of workplace physical activity interventions published up to April 2011 was conducted to identify types of interventions and their outcomes.
Results
Of the 58 studies included, the majority utilized health promotion initiatives. There were six physical activity/exercise interventions, 13 counselling/support interventions, and 39 health promotion messages/information interventions. Thirty‐two of these studies showed a statistically significant increase in a measure of physical activity against a control group at follow‐up.
Conclusions
While the studies included in this review show some evidence that workplace physical activity interventions can be efficacious, overall the results are inconclusive. Despite the proliferation of research in this area, there is still a need for more well‐designed studies to fully determine the effectiveness of workplace interventions for increasing physical activity and to identify the types of interventions that show the most promise.
Statement of contribution
What is already known on this subject?
Despite the recognized health benefits of regular physical activity, only a small proportion of adults engage in sufficient levels of physical activity.
The workplace presents an ideal avenue for the delivery of initiatives to promote physical activity.
Previous reviews have concluded that the efficacy of workplace physical activity interventions is unclear and that many published studies are of poor methodological quality.
What does this study add?
This systematic review includes more randomized controlled trials and quasi‐experimental studies than previously published reviews of workplace physical activity interventions.
While the studies included in this review do show some evidence that workplace physical activity interventions can be efficacious, overall the results are inconclusive.
This review highlights that there is still a need for further well‐designed studies to be carried out in order to evaluate the effectiveness of workplace interventions for increasing physical activity and identify the types of interventions that show the most promise.
Prior research has investigated various strategies to improve health, wellbeing and the job-related outcomes of nurses. However, the scope of this evidence is not clear and the types of intervention ...most likely to have positive outcomes are unknown.
To provide an overview and synthesis of the effectiveness of interventions conducted with the goal of improving health, wellbeing and the job-related outcomes of nurses.
A systematic database search was conducted from January 2000 to December 2018, with pre-defined criteria (Cochrane Central Register of Controlled Trials; MEDLINE and PubMed; EMBASE; CINAHL; PsycINFO; and BioMed Central). In total, 136 intervention studies with a total sample of 16,129 participants (range 9-3381) were included and evaluated. Data extraction, quality assessment and risk of bias analyses were performed.
Studies included randomised controlled trials (RCTs; n = 52, 38%), randomised crossover design studies (n = 2, 1.5%) and non-randomised pre-post studies with a control group (n = 31, 23%) and without a control group (n = 51, 37.5%). The majority of interventions focused on education, physical activity, mindfulness, or relaxation. Thirty-seven (27%) studies had a multimodal intervention approach. On average, studies had relatively small samples (median = 61; mode = 30) and were conducted predominantly in North America (USA/Canada, n = 53). The findings were mixed overall, with some studies reporting benefits and others finding no effects. Dietary habits was the most successfully improved outcome (8/9), followed by indices of body composition (20/24), physical activity (PA) (11/14), and stress (49/66), with >70% of relevant studies in each of these categories reporting improvements. The lowest success rate was for work-related outcomes (16/32). Separate analysis of RCTs indicated that interventions that focus solely on education might be less likely to result in positive outcomes than interventions targeting behavioural change.
Interventions targeting diet, body composition, PA, or stress are most likely to have positive outcomes for nurses' health and/or wellbeing. The methodologically strongest evidence (RCTs) is available for body composition and stress. Interventions relying solely on educational approaches are least likely to be effective. Organisational outcomes appear to be more challenging to change with lifestyle intervention, likely requiring more complex solutions including changes to the work environment. There is a need for more high-quality evidence since many studies had moderate or high risk of bias and low reporting quality.
The aim of the study was to ascertain the views and experiences of those working in urgent and emergency care (UEC) settings towards screening, brief intervention, and referral to treatment (SBIRT) ...for alcohol, to inform future practice. To explore i) views towards health promotion, ii) views towards and practice of SBIRT, iii) facilitators and barriers to delivering SBIRT, iv) training needs to support future SBIRT practice, and v) comparisons in views and attitudes between demographic characteristics, geographical regions, setting and occupational groups. This was an open cross-sectional international survey, using an online self-administered questionnaire with closed and open-ended responses. Participants were greater than or equal to18 years of age, from any occupational group, working in urgent and emergency care (UEC) settings in any country or region. There were 362 respondents (aged 21-65 years, 87.8% shift workers) from 7 occupational groups including physicians (48.6%), nurses (22.4%) and advanced clinical practitioners (18.5%). Most believed that health promotion is part of their role, and that SBIRT for alcohol prevention is needed and appropriate in UEC settings. SBIRT was seen to be acceptable to patients. 66% currently provide brief alcohol advice, but fewer screen for alcohol problems or make alcohol-related referrals. The most common barriers were high workload and lack of funding for prevention, lack of knowledge and training on SBIRT, lack of access to high-quality resources, lack of timely referral pathways, and concerns about patient resistance to advice. Some views and attitudes varied according to demographic characteristics, occupation, setting or region. UEC workers are willing to engage in SBIRT for alcohol prevention but there are challenges to implementation in UEC environments and concerns about workload impacts on already-burdened staff, particularly in the context of global workforce shortages. UEC workers advocate for clear guidelines and policies, increased staff capacity and/or dedicated health promotion teams onsite, SBIRT education/training/resources, appropriate physical spaces for SBIRT conversations and improved alcohol referral pathways to better funded services. Implementation of SBIRT could contribute to improving population health and reducing service demand, but it requires significant and sustained commitment of time and resources for prevention across healthcare organisations.
Encouraging office workers to break up prolonged sedentary behavior (SB) at work with regular microbreaks can be beneficial yet challenging. The Internet of Things (IoT) offers great promise for ...delivering more subtle and hence acceptable behavior change interventions in the workplace. We previously developed an IoT-enabled SB intervention, called WorkMyWay, by applying a combination of theory-informed and human-centered design approaches. According to the Medical Research Council's framework for developing and evaluating complex interventions such as WorkMyWay, process evaluation in the feasibility phase can help establish the viability of novel modes of delivery and identify facilitators and barriers to successful delivery.
This study aims to evaluate the feasibility and acceptability of the WorkMyWay intervention and its technological delivery system.
A mixed methods approach was adopted. A sample of 15 office workers were recruited to use WorkMyWay during work hours for 6 weeks. Questionnaires were administered before and after the intervention period to assess self-report occupational sitting and physical activity (OSPA) and psychosocial variables theoretically aligned with prolonged occupational SB (eg, intention, perceived behavioral control, prospective memory and retrospective memory of breaks, and automaticity of regular break behaviors). Behavioral and interactional data were obtained through the system database to determine adherence, quality of delivery, compliance, and objective OSPA. Semistructured interviews were conducted at the end of the study, and a thematic analysis was performed on interview transcripts.
All 15 participants completed the study (attrition=0%) and on average used the system for 25 tracking days (out of a possible 30 days; adherence=83%). Although no significant change was observed in either objective or self-report OSPA, postintervention improvements were significant in the automaticity of regular break behaviors (t
=2.606; P=.02), retrospective memory of breaks (t
=7.926; P<.001), and prospective memory of breaks (t
=-2.661; P=.02). The qualitative analysis identified 6 themes, which lent support to the high acceptability of WorkMyWay, though delivery was compromised by issues concerning Bluetooth connectivity and factors related to user behaviors. Fixing technical issues, tailoring to individual differences, soliciting organizational supports, and harnessing interpersonal influences could facilitate delivery and enhance acceptance.
It is acceptable and feasible to deliver an SB intervention with an IoT system that involves a wearable activity tracking device, an app, and a digitally augmented everyday object (eg, cup). More industrial design and technological development work on WorkMyWay is warranted to improve delivery. Future research should seek to establish the broad acceptability of similar IoT-enabled interventions while expanding the range of digitally augmented objects as the modes of delivery to meet diverse needs.
We aimed to explore university students' perceptions and experiences of SARS-CoV-2 mass asymptomatic testing, social distancing and self-isolation, during the COVID-19 pandemic. This qualitative ...study comprised of four rapid online focus groups conducted at a higher education institution in England, during high alert (tier 2) national COVID-19 restrictions. Participants were purposively sampled university students (
25) representing a range of gender, age, living circumstances (on/off campus), and SARS-CoV-2 testing/self-isolation experiences. Data were analysed using an inductive thematic approach. Six themes with 16 sub-themes emerged from the analysis of the qualitative data: 'Term-time Experiences', 'Risk Perception and Worry', 'Engagement in Protective Behaviours', 'Openness to Testing', 'Barriers to Testing' and 'General Wellbeing'. Students described feeling safe on campus, believed most of their peers are adherent to protective behaviours and were positive towards asymptomatic testing in university settings. University communications about COVID-19 testing and social behaviours need to be timely and presented in a more inclusive way to reach groups of students who currently feel marginalised. Barriers to engagement with SARS-CoV-2 testing, social distancing and self-isolation were primarily associated with fear of the mental health impacts of self-isolation, including worry about how they will cope, high anxiety, low mood, guilt relating to impact on others and loneliness. Loneliness in students could be mitigated through increased intra-university communications and a focus on establishment of low COVID-risk social activities to help students build and enhance their social support networks. These findings are particularly pertinent in the context of mass asymptomatic testing programmes being implemented in educational settings and high numbers of students being required to self-isolate. Universities need to determine the support needs of students during self-isolation and prepare for the long-term impacts of the pandemic on student mental health and welfare support services.
Background
The impact of emotion regulation (ER) interventions on mental health and wellbeing has been extensively documented in the literature, although only recently have digital technologies been ...incorporated in intervention design. The aim of this review is to explore available published literature relating to the efficacy, barriers and facilitators of digital technologies in enhancing emotion/mood regulation skills.
Methods
A review of the literature was performed to explore the effectiveness of digital technology in enhancing ER skills. MEDLINE, CINAHL, PsycINFO and Web of Science databases were searched from inception to 31st August 2020. In addition, the first 10 pages of Google Scholar were examined for relevant articles. The following MeSH term and key words were used to identify relevant articles: “emotion regulation OR mood regulation” AND “intervention OR treatment OR program$ OR therap$” AND “digital technologies OR web-based OR mobile application OR App.” Reference lists of retrieved papers were hand searched to identify additional publications. Findings were summarized narratively.
Results
Titles and abstracts were reviewed by one reviewer in two phases, and confirmed by a second reviewer; discrepancies were resolved through discussion. First, the retrieved titles and abstracts were reviewed to identify relevant studies. Full texts of retrieved studies were then read to determine eligibility. The search resulted in 209 studies of which 191 citations were identified as potentially meeting the inclusion criteria. After reviewing the title and abstract of the 191 papers, 33 studies were identified as potentially meeting the inclusion criteria. Following full-text review, 10 studies met the inclusion criteria. Findings indicated the potential effectiveness of online, text-messaging, and smartphone interventions for enhancing ER skills.
Conclusion
There is encouraging evidence that digital technologies may be beneficial for enhancing ER skills and providing personalized care remotely. Digital technologies, particularly the use of smartphones, were instrumental in facilitating assessments and delivering online self-help interventions such as cognitive behavioral therapy. Continued research is required to rigorously evaluate the effectiveness of digital technologies in ER skills and carefully consider risks/benefits while determining how emerging technologies might support the scale-up of ER skills and mental health treatment.
Supported wellbeing centres established during the COVID-19 pandemic provided high quality rest spaces and access to peer-to-peer psychological first aid for healthcare workers (HCWs). The centres ...were well accessed and valued by HCWs, but their relationship with wellbeing and job-related factors is not well established. The aim of this study was to explore the relationship between wellbeing centre use, HCWs wellbeing and job-related factors (job stressfulness, job satisfaction, presenteeism, turnover intentions).
Secondary analysis of data from 819 HCWs from an acute hospital trust who completed an online survey in April-July 2020, as part of the COVID-Well study. Measures included the Warwick Edinburgh Mental Wellbeing Scale, and four single-item global measures of job stressfulness, job satisfaction, presenteeism and turnover intentions. ANCOVA models and regression analyses were conducted on these data.
HCWs who had not accessed the wellbeing centres had lower wellbeing (β = 0.12, p < .001), higher job stressfulness (β = - 0.22, p < .001), lower job satisfaction (β = 0.39, p < .001), higher presenteeism (β = - 0.22, p < .001) and were of younger age (β = 0.09, p = .002). Centre use was associated with wellbeing irrespective of job stressfulness. Those reporting presenteeism and who accessed the centre (M = 3.30, SE = 0.04) had higher wellbeing than those who accessed the centre but did not report presenteeism (M = 3.06, SE = 0.04) (F(1, 791) = 18.65, p < .001, η
= 0.02). Centre use was not significantly associated with turnover intentions (B = - 0.30, p = .13; Wald = 2.26; odds = 0.74), while job stress and job satisfaction showed significant effects.
Accessing wellbeing centres was associated with higher wellbeing of HCWs, particularly for those reporting presenteeism. Therefore, the centres may have provided greatest respite and restoration for those present at work but not in optimal health. Younger workers were disproportionately affected in terms of wellbeing, and targeted support for this population is needed. Strategies to decrease presenteeism and maximise job satisfaction are urgently required. Healthcare organisations should provide rest spaces and psychological support to HCWs for the long-term, as part of a systems-wide approach to improving workforce health and wellbeing.
ObjectivesChildren in China have low levels of physical activity. We developed a school-based behaviour change intervention to increase their physical activity levels. The study aimed to determine ...the feasibility of undertaking a cluster randomised controlled trial (RCT) in the future. This future cluster RCT will evaluate the effectiveness of the intervention.DesignFeasibility cluster non-RCT design.SettingTwo public schools (one intervention and one control) in Yangzhou, China.ParticipantsChildren aged 10–12 years and their parents.InterventionThe 16-week school-based behaviour change intervention to increase physical activity levels consisted of three components (a) health education (physical education), (b) family involvement and (c) school environment support.Outcomes measuresWe estimated important parameters that are needed to design the future cluster RCT, such as SD of the primary outcome (ie, 7-day steps in children), intracluster correlation coefficient (ICC), recruitment of child–parent dyads, follow-up of children, completion of and time needed for data collection among children and intervention attendance.ResultsSixty-four children and their parents participated in the study (32 per study group). The SD of the primary outcome was 34 519 steps. The ICC was 0.03. The recruitment and follow-up rates were 100%. The completion of data collection was 100% (except for the 7-day steps at baseline—one child lost the step log in the intervention group and two children lost their pedometer in the control group). The time needed to complete the self-reported questionnaire by children was around 15 min per study group, and the measurement of their anthropometric parameters took around 40 min per study group. The intervention attendance was 100%.ConclusionsBased on the promising recruitment, follow-up, completion of and time needed for data collection and intervention attendance, it would be feasible to undertake the future cluster RCT in China.Trial registration numberChiCTR1900026865.
Abstract
Background
Late diagnosis of HIV remains a challenge, despite improved testing and treatment. Testing is often targeted at high-risk groups; workplace events might normalise testing and ...allow access to a wider population. The construction workforce has a number of risk factors for HIV. In the Test@Work study, HIV tests were delivered within general health checks to construction employees, with high uptake and acceptability. This paper reports on the experiences of construction managers and health professionals involved in Test@Work and explores the suitability of construction worksites as a venue for opt-in HIV testing.
Methods
Qualitative interviews (
n
= 24) were conducted with construction managers who had facilitated health check/HIV testing (
n
= 13), and delivery partners (
n
= 11) including i) healthcare volunteers who had delivered general health checks (
n
= 7) and, ii) HIV professionals who had conducted HIV testing (
n
= 4) at 21 Test@Work events held on construction sites. Interviews explored their experiences of these events and views towards HIV testing in the workplace. Exit questionnaires (
n
= 107) were completed by delivery partners after every event, providing qualitative data identifying facilitators and barriers to effective delivery. Thematic analysis identified themes that were mapped against a socioecological framework.
Results
Delivery partners reported high engagement of construction workers with workplace HIV testing, peer-to-peer encouragement for uptake, and value for accessibility of onsite testing. HIV professionals valued the opportunity to reach an untested population, many of whom had a poor understanding of their exposure to HIV risk. Managers valued the opportunity to offer workplace health checks to employees but some identified challenges with event planning, or provision of private facilities.
Conclusions
The construction sector is complex with a largely male workforce. Providing worksite HIV testing and education to an untested population who have poor knowledge about HIV risk helped to normalise testing, encourage uptake and reduce HIV-related stigma. However, there are practical barriers to testing in the construction environment. Rapid testing may not be the most suitable approach given the challenges of maintaining confidentiality on construction worksites and alternatives should be explored.
Patients with coronary heart disease often do not follow prescribed physical activity recommendations. The aim of this study was to assess the efficacy of a behavioural intervention to increase ...physical activity in patients with coronary heart disease not attending structured cardiac rehabilitation programmes.
Parallel randomised controlled trial comparing 6-month multi-component behavioural change intervention (n = 71) with usual care (n = 85) was conducted in two hospitals in Jordan, Middle East. Intervention included one face-to-face individualised consultation, 6 telephone support calls (for goal-setting, feedback and self-monitoring) and 18 reminder text messages. Patients were randomly allocated to the two groups by opening opaque sealed sequence envelopes. The patients and the researcher who provided the intervention and assessed the outcomes were not blinded. Outcomes were assessed at baseline and 6 months. Primary outcome was physical activity level, secondary outcomes were blood pressure, body mass index, exercise self-efficacy for exercise and health-related quality of life.
Intervention and control groups were comparable at baseline. Moderate physical activity significantly increased in the intervention group compared with control group (mean change (SD) of frequency: 0.23 (0.87) days/week versus -.06 (0.40); duration: 15.53 (90.15) minutes/week versus -3.67 (22.60) minutes/week; intensity: 31.05 (105.98) Metabolic equivalents (METs) versus 14.68 (90.40) METs). Effect size was 0.03 for moderate PA frequency, 0.02 for moderate PA duration and 0.01 for moderate PA intensity. Walking significantly increased in the intervention group compared with control group (mean change (SD) of frequency: 3.15 (2.75) days/week versus 0.37 (1.83) days/week; duration: 150.90 (124.47) minutes/week versus 24.05 (195.93) minutes/week; intensity: 495.12 (413.74) METs versus14.62 (265.06) METs). Effect size was 0.36 for walking frequency, 0.05 for walking duration, 0.32 for walking intensity and 0.29 for total PA intensity. Intervention participants had significantly lower blood pressure, lower body mass index, greater exercise self-efficacy and better health-related quality of life at 6 months compared with controls.
Multi-component behavioural intervention increases physical activity, and improves body composition, physiological and psychological outcomes in CHD patients not attending structured rehabilitation programmes.
Current Controlled Trials retrospectively registered in 21-03-2012. ISRCTN48570595 .
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