Promoting physical activity with people in different places—A Dutch perspective

Implementing workplace health promotion – role of middle managers

Purpose

The purpose of this paper is to address a missing link between top management and employees when it comes to understanding how to successfully implement and embed workplace health promotion (WHP) as a strategy within organizations: the role of the middle managers.

Design/methodology/approach

A conceptual framework based on review of theory is applied within an empirical multi-case study that is part of a health intervention research project on increased physical activity among office workers. The study involves six Danish organizations.

Findings

Middle managers play a key role in successful implementation of WHP, but feel uncertain about their role, especially when it comes to engaging with their employees. Uncertainty about their role appears to make middle managers reluctant to take action on WHP and leave further action to top management instead.

Research limitations/implications

Limitations included the middle managers’ low attendance at the half-day seminar on strategic health (50 percent attendance), the fact that they were all office workers and they were all from Denmark.

Practical implications

Middle managers ask for more knowledge and skills if they are to work with WHP in daily business.

Social implications

Implementing and embedding WHP as a health strategy raises ethical issues of interfering with employees’ health, is seen as the employee’s personal responsibility.

Originality/value

This study adds to knowledge of the difficulties of implementing and embedding WHP activities in the workplace and suggests an explicit and detailed research design.

Sick of sitting

Sitting too much kills. Epidemiological, physiological and molecular data suggest that sedentary lifestyle can explain, in part, how modernity is associated with obesity, more than 30 chronic diseases and conditions and high healthcare costs. Excessive sitting--sitting disease--is not innate to the human condition. People were designed to be bipedal and, before the industrial revolution, people moved substantially more throughout the day than they do presently. It is encouraging that solutions exist to reverse sitting disease. Work environments, schools, communities and cities can be re-imagined and re-invented as walking spaces, and people thereby offered more active, happier, healthier and more productive lives.

The predictive validity and effects of using the transtheoretical model to increase the physical activity of healthcare workers in a public hospital in South Africa

There have been studies conducted on the effectiveness of the transtheoretical model (TTM) in improving the level of physical activity at worksites worldwide, but no such studies have been conducted in South Africa. The aim of this study was to determine the predictive validity and effects of using the Transtheoretical Model to increase the physical activity of healthcare workers in a public hospital in South Africa. A quasi-experimental design in the form of a single-group, pretest–posttest model was used to examine the possible relationship between an exposure to interventions, attitude, knowledge, and an increased level of physical activity. Two hundred hospital staff members (medical and nonmedical staff) were randomly selected for participation in the study. The following variables were measured: TTM stages of physical activity, knowledge and attitudes, fitness level, body mass index, and level of exposure to the intervention. The interventions designed were based on the concept of progressing stages of physical activity in TTM stage sequences: (1) pamphlets about physical activity and health, (2) posters, fun runs, and sports day, and (3) a second set of posters, a daily radio program, and aerobic classes. Post-intervention, participants had significantly increased their stages of physical activity, attitudes, and knowledge compared with their pre-tests. Mean scores of TTM (3.70) and knowledge (3.65) were significantly (p < 0.05) greater at post-test. Overall accuracies of TTM at pre-test correctly predicted TTM at post-test by an average of 66.9%. The use of TTM to identify the stage of physical activity of healthcare workers has enabled the researcher to design intervention programs specific to the stage of exercise behavior of hospital staff. The predictors (TTM1), exposure levels, knowledge, attitudes, and processes of change have significant contributions to the outcome (TTM2).

The benefits and barriers to physical activity and lifestyle interventions for osteoarthritis affecting the adult knee

Osteoarthritis prevalence is increasing, placing greater demands on healthcare and future socioeconomic costing models. Exercise and non-pharmacological methods should be employed to manage this common and disabling disease. Expectations at all stages of disease are increasing with a desire to remain active and independent. Three key areas have been reviewed; the evidence for physical activity, lifestyle changes and motivational techniques concerning knee osteoarthritis and the barriers to instituting such changes. Promotion of activity in primary care is discussed and evidence for compliance has been reviewed. This article reviews a subject that is integral to all professionals involved with osteoarthritis care.

The price is right: making workplace wellness financially sustainable

Purpose

The public health argument for developing and maintaining workplace wellness programmes in organisations is well‐documented, particularly within the healthcare sector which aims to “set the example” for workplace health. However, workplace wellness also makes good business sense, since it is established that investing in employee health can reduce absenteeism, improve job satisfaction and productivity and enhance corporate image. Organisations often place workplace wellness low in their priorities. The purpose of this paper is to present the case for an initial resource investment and top‐level support to pump‐prime a financially sustainable, and even profitable, programme.

Design/methodology/approach

A discussion is presented based on academic literature and practical applications from the authors' experiences in practice.

Findings

The authors use their own in‐house scheme, “Q‐active” as a case example based in an NHS Trust setting, to demonstrate how such schemes can be developed and successfully implemented and maintained in practice. The paper presents the use of the Business Healthcheck Tool for developing a business case for such schemes.

Originality/value

Workplace wellness schemes are financially viable and can become a vital part of a large organisations' infrastructure embedded within policies and internal “health culture”.

An office-place stepping device to promote workplace physical activity

OBJECTIVE

It was proposed that an office-place stepping device is associated with significant and substantial increases in energy expenditure compared to sitting energy expenditure. The objective was to assess the effect of using an office-place stepping device on the energy expenditure of lean and obese office workers.

METHODS

The office-place stepping device is an inexpensive, near-silent, low-impact device that can be housed under a standard desk and plugged into an office PC for self-monitoring. Energy expenditure was measured in lean and obese subjects using the stepping device and during rest, sitting and walking. 19 subjects (27+/-9 years, 85+/-23 kg): 9 lean (BMI<25 kg/m2) and 10 obese (BMI>29 kg/m2) attended the experimental office facility. Energy expenditure was measured at rest, while seated in an office chair, standing, walking on a treadmill and while using the office-place stepping device.

RESULTS

The office-place stepping device was associated with an increase in energy expenditure above sitting in an office chair by 289+/-102 kcal/hour (p<0.001). The increase in energy expenditure was greater for obese (335+/-99 kcal/hour) than for lean subjects (235+/-80 kcal/hour; p = 0.03). The increments in energy expenditure were similar to exercise-style walking.

CONCLUSION

The office-place stepping device could be an approach for office workers to increase their energy expenditure. If the stepping device was used to replace sitting by 2 hours per day and if other components of energy balance were constant, weight loss of 20 kg/year could occur.

The energy expenditure of using a "walk-and-work" desk for office workers with obesity

OBJECTIVE

For many people, most of the working day is spent sitting in front of a computer screen. Approaches for obesity treatment and prevention are being sought to increase workplace physical activity because low levels of physical activity are associated with obesity. Our hypothesis was that a vertical workstation that allows an obese individual to work while walking would be associated with significant and substantial increases in energy expenditure over seated work.

METHODS

The vertical workstation is a workstation that allows an office worker to use a standard personal computer while walking on a treadmill at a self-selected velocity. 15 sedentary individuals with obesity (14 women, one man; 43 (7.5) years, 86 (9.6) kg; body mass index 32 (2.6) kg/m(2)) underwent measurements of energy expenditure at rest, seated working in an office chair, standing and while walking at a self-selected speed using the vertical workstation. Body composition was measured using dual x ray absorptiometry.

RESULTS

The mean (SD) energy expenditure while seated at work in an office chair was 72 (10) kcal/h, whereas the energy expenditure while walking and working at a self-selected velocity of 1.1 (0.4) mph was 191 (29) kcal/h. The mean (SD) increase in energy expenditure for walking-and-working over sitting was 119 (25) kcal/h.

CONCLUSIONS

If sitting computer-time were replaced by walking-and-working, energy expenditure could increase by 100 kcal/h. Thus, if obese individuals were to replace time spent sitting at the computer with walking computer time by 2-3 h/day, and if other components of energy balance were constant, a weight loss of 20-30 kg/year could occur.