Implementation of Intelligent Physical Exercise Training at a Danish Hospital-A Qualitative Study of Employees' Barriers and Facilitators for Participation.

BACKGROUND: Exercise training at work has the potential to improve employees' productivity, health, and well-being. However, exercise interventions for healthcare workers in hospitals may be challenged by time pressure and the ongoing workflow with patient care. OBJECTIVE: The aim was to identify barriers and facilitators for participation in exercise training during work in a hospital department. METHODS: Eight semi-structured interviews of 13 individuals were conducted with hospital employees from different staff groups who participated in 12 weeks of exercise twice weekly. The data analysis was a thematic approach based on the Theoretical Domains Framework and the COM-B factors in the Behavior Change Wheel. RESULTS: Barriers and facilitators varied between different groups. Barriers included limited structure, busyness, and a discouraging culture. Facilitators included gaining a feeling of community and psychological and physical well-being. Seven contextual subthemes were vital for successful implementation of exercise in a hospital setting: sharing of knowledge and information; involvement; administration and structure; culture; individualization; purpose and objective; and incentives. CONCLUSIONS: The informants appreciated exercise training during work. Inpatient departments' informants found it difficult to participate in the intervention, whilst those with more administrative tasks found it easier. This study identified barriers and facilitators vital for a successful implementation of an exercise training intervention in a hospital department. The study explains how future interventions can improve reach, adoption, and implementation of exercise training interventions to hospital staffs.

Long Term Cardiovascular Health Effects of Intelligent Physical Exercise Training Among Office Workers-A 2 Year Follow up of a Randomized Controlled Trial.

OBJECTIVE: The aim of the study is to assess long-term effects of intelligent physical exercise training (IPET) on cardiorespiratory fitness (VO 2max ) and cardiometabolic measures. METHODS: Office workers were randomized to a control group (CG, n = 194) or a training group (TG, n = 193). The TG received 1-hour weekly IPET during paid working hours for 2 years and recommendations to perform 30-minute leisure time physical activity 6 d/wk (LPA). RESULTS: Training group compared with CG demonstrated a significantly larger increase in VO 2max of 0.13 ± 0.06 L/min and improved cardiometabolic measures at 1-year follow-up that were maintained at 2-year follow-up, with larger increases in VO 2max among high-adherence participants. CONCLUSIONS: Intelligent physical exercise training and LPA showed the potential for long-term improved VO 2max and cardiometabolic measures. These findings emphasize the effectiveness of integrating IPET during paid working hours, and the significance of adherence to training was underlined.

Exercise Training During Working Hours at a Hospital Department: A Pilot Study.

OBJECTIVES: This pilot study tested the use of an exercise offer to hospital employees during working hours and changes in work and health parameters. METHODS: Employees (n = 214) from a medical department on a Danish hospital were invited to 30 minutes' exercise training twice weekly for 12 weeks. Outcomes included health- and work-related parameters. RESULTS: Eighty employees (mean age, 44.4 [SD, 10.7] years; 81.3% women) completed the study. Intervention adherence was 36.3% (SD, 25.1%). Aerobic capacity increased from 34.6 (95% confidence interval [CI], 32.3 to 36.9) to 36.7 (95% CI, 34.1 to 39.4) mL O 2 /min per kilogram, P = 0.004. Blood pressure decreased from 120 (95% CI, 117 to 123)/79 (95% CI, 76 to 81) to 116 (95% CI, 112 to 120)/76 (95% CI, 74 to 79) mm Hg, P = 0.003. Waist circumference and musculoskeletal pain decreased. Well-being, social capital, and quality of life increased. CONCLUSIONS: Despite low training adherence, completers improved outcomes related to metabolic and self-rated health.

Attendance barriers experienced by female health care workers voluntarily participating in a multi-component health promotion programme at the workplace.

BACKGROUND: Studies have shown that Workplace Health Promoting Programmes (WHPP) can facilitate healthier behaviour. Despite the benefits achieved from participating in a WHPP, a systematic review showed that only 10-50% of the employees participated and a challenge was lack of participation. Previous studies stress that understanding the barriers that prevent participants from attending WHPPs are important for designing highly effective interventions. To exploit the potential of a WHPP, it requires a deep insight into the attendance barriers experienced by the participants who voluntarily sign-up for a WHPP; and particularly those who want to stay in the programme but are prevented from participating in it regularly. Thus, the aim of this study was to identify and explore attendance barriers experienced by female Health Care Workers (HCWs) who voluntarily participated in a weekly one-hour multi-component training session, within a WHPP, over a one-year period. METHODS: This study was carried out within a RCT named FRIDOM (FRamed Intervention to Decrease Occupational Muscle pain) and was designed as a single-case study with an inductive approach for analysing the content of in-depth semi-structured qualitative interviews. Data was collected at two home care workplaces and two retirement homes in Denmark. Nine HCWs from the intervention group were selected as participants in the present study. RESULTS: The attendance barriers identified, consisted of three main themes and six related sub-themes: 1) organizational factors (work inflexibility, lack of support from team leaders), 2) intervention factors (training sessions organized outside normal work hours, incongruence between information received and reality, content and intensity of the program) and 3) individual factors (personal factors). CONCLUSION: Organizational and intervention factors are the two most important attendance barriers in future WHPPs. To overcome these barriers; training sessions should be organized within or in connection with work hours, support should be secured from team management and work shifts should be planned to enable attendance for all participants. Furthermore, the attendance barriers may be minimized by including participants in the decision-making process. This relates to both the content and intensity of the intervention, not only in the planning stage but throughout the intervention process. TRIAL REGISTRATION: ClinicalTrials.gov. NCT02843269 - 06.27.2016 - retrospectively registered.

The Effect of Intelligent Physical Exercise Training on Sickness Presenteeism and Absenteeism Among Office Workers.

OBJECTIVE: The aim of this study was to investigate the effect of individually tailored intelligent physical exercise training (IPET) on presenteeism and absenteeism among office workers. METHODS: In a 1-year randomized controlled trial (RCT), employees were allocated to a training group TG (N = 193) or control group CG (N = 194). TG received 1-hour high-intensity IPET once a week within working hours, and was recommended to perform 30 minutes of moderate-intensity physical activity (PA) 6 days a week during leisure-time. RESULTS: An intention-to-treat analysis showed no effect on absenteeism, but a significant 4% increase in workability and 9% increase in general health in TG compared with CG. A per-protocol analysis [adherence of ≥70% (N = 89)] in addition showed a significant 6% increase in productivity and a 29% reduction in absenteeism compared with CG. CONCLUSION: IPET combined with recommendations of leisure-time PA significantly improved presenteeism and decreased absenteeism if following the protocol.

Intelligent Physical Exercise Training in a Workplace Setting Improves Muscle Strength and Musculoskeletal Pain: A Randomized Controlled Trial.

PURPOSE: To assess effects of 1-year Intelligent Physical Exercise Training (IPET) on musculoskeletal health. METHODS: Office workers were randomized 1 : 1 to a training group, TG (N = 193), or a control group, CG (N = 194). TG received 1 h supervised high intensity IPET every week within working hours for 1 year and was recommended to perform 30 min of moderate intensity physical activity for 6 days a week during leisure. The IPET program was based on baseline health measures. RESULTS: No baseline differences were present. An intention-to-treat analysis showed significant between-group effect for muscle strength but not for musculoskeletal pain. However, a per-protocol analysis of those with an adherence of ≥70% demonstrated a significant between-group effect for neck pain during the past three months. Several significant within-group changes were present, where TG and TG ≥ 70% demonstrated clinically relevant pain reductions whereas minimal reductions were seen for CG. CONCLUSION: IPET and recommendations of moderate intensity physical activity demonstrated significant between-group effect on muscle strength. Interestingly, significant within-group reductions in musculoskeletal pain were seen not only in TG but also in CG. This may underlie the lack of such between-group effect and shows that a possible positive side effect of merely drawing attention can improve musculoskeletal health.

Implementing intelligent physical exercise training at the workplace: health effects among office workers-a randomized controlled trial.

PURPOSE: The aim was to assess 1-year cardiovascular health effects of Intelligent Physical Exercise Training, IPET. METHODS: Office workers from six companies were randomized 1:1 to a training group, TG (N = 194) or a control group, CG (N = 195). TG received 1-h supervised high intensity IPET every week within working hours for 1 year, and was recommended to perform 30-min of moderate intensity physical activity 6 days a week during leisure. The training program was based on baseline health check measures of cardiorespiratory fitness (CRF), body composition, blood pressure, blood profile, and musculoskeletal health. RESULTS: There were no baseline differences between groups. CRF assessed as VO2max in absolute values and relative to body weight was (mean ± SD): 3.0 ± 0.8 l/min and 35.4 ± 10.9 ml/min/kg for females, 3.9 ± 1.0 l/min and 37.9 ± 11.79 ml/min/kg for males. Intention to treat analysis demonstrated a significant almost 5 % increase in VO2max in TG compared with CG. A per protocol analysis of those with an adherence of ≥70 % demonstrated a significant increase in CRF of more than 10 % compared with CG, and a significant reduction in systolic blood pressure (-5.3 ± 13.7 mm Hg) compared with CG. CONCLUSION: High intensity IPET combined with the recommendations of moderate intensity physical activity demonstrated significant clinical relevant improvements in CRF and systolic blood pressure. This underlines the effectiveness of health promotion by implementing physical exercise training at the workplace.

Exercise is more than medicine: The working age population's well-being and productivity.

BACKGROUND: Physical activity (PA) includes muscle activity during exercise, manual work, and leisure time activities including sport. Conflicting results exist regarding health effects of PA that may deteriorate with manual work and elite sports, but improve when performed in moderation in accordance with international guidelines and may additionally enhance well-being and productivity. METHODS: In Denmark 15 randomized controlled trials have been conducted, introducing exercise at the workplace enrolling >3500 workers. The interventions lasted from 10 to 52 weeks and offered ~1 h weekly supervised exercise during working hours according to the concept of intelligent physical exercise training (IPET) that is based on evidenced sports sciences training principles and tailored to work exposure, employee health status, and physical capacity. Questionnaire surveys and health checks including blood and muscle sampling were performed at baseline and follow-up. The job groups included: office and computer workers, dentists, industrial technicians, cleaning personnel, health care workers, construction workers, and fighter/helicopter pilots. RESULTS: In all job groups significant improvements were documented regarding health outcomes. These were job group specific: neck pain was reduced among office and computer workers, dentists, industrial laboratory technicians, health care workers as well as fighter pilots. Cardio-respiratory fitness-a health risk indicator for cardio-metabolic diseases-was improved among office and computer workers, health care workers, and construction workers. Additionally, other improvements were evidenced such as increased muscle strength and balance control. Importantly, productivity increased with improved muscle strength and decreased body mass index. CONCLUSION: IPET does enhance health if an exercise program with evidenced efficacy is implemented by expert trainees with support of the employer. Accordingly, in every study group outcomes of improved health were documented and the effect sizes were of clinical relevance. Cost effectiveness estimates indicate acceptable cost relative to savings on health expenses and lost productivity.

A conceptual model for worksite intelligent physical exercise training--IPET--intervention for decreasing life style health risk indicators among employees: a randomized controlled trial.

BACKGROUND: Health promotion at the work site in terms of physical activity has proven positive effects but optimization of relevant exercise training protocols and implementation for high adherence are still scanty. METHODS/DESIGN: The aim of this paper is to present a study protocol with a conceptual model for planning the optimal individually tailored physical exercise training for each worker based on individual health check, existing guidelines and state of the art sports science training recommendations in the broad categories of cardiorespiratory fitness, muscle strength in specific body parts, and functional training including balance training. The hypotheses of this research are that individually tailored worksite-based intelligent physical exercise training, IPET, among workers with inactive job categories will: 1) Improve cardiorespiratory fitness and/or individual health risk indicators, 2) Improve muscle strength and decrease musculoskeletal disorders, 3) Succeed in regular adherence to worksite and leisure physical activity training, and 3) Reduce sickness absence and productivity losses (presenteeism) in office workers. The present RCT study enrolled almost 400 employees with sedentary jobs in the private as well as public sectors. The training interventions last 2 years with measures at baseline as well as one and two years follow-up. DISCUSSION: If proven effective, the intelligent physical exercise training scheduled as well as the information for its practical implementation can provide meaningful scientifically based information for public health policy. TRIAL REGISTRATION: ClinicalTrials.gov, number: NCT01366950.