Screening, staffing, and emergency preparedness at worksite wellness facilities.

PURPOSE: The purpose of this survey was to examine compliance of worksite health and fitness facilities with the American Heart Association/American College of Sports Medicine (AHA/ACSM) recommendations for cardiovascular screening, staffing, and emergency policies for health and fitness facilities. METHODS: A survey was developed and sent to 529 worksite health and fitness facilities. RESULTS: A total of 221 surveys were returned (42% response rate). Twelve percent of facilities had no staff supervision. Among facilities with staff, 12% were not certified in basic life support, and 6% had no national professional certification. Ninety-two percent of facilities followed a health history screening policy although 13% of these facilities administered it irregularly or not at all. Of a total 187 responding facilities, 122 (65%) defined "at risk" as two or more risk factors for heart disease. Of these, 97% either required or recommended new members obtain physician clearance before participation. Four (3%) responding facilities did not require physician clearance. Twenty-five percent of facilities experienced at least one emergency that required ambulance support in the previous year. CONCLUSION: Although this was a low response rate, most responding worksite health and fitness facilities appear to be in compliance with the AHA/ACSM recommendations yet have inconsistencies in some specific practices. There appears to be a need for further consistent implementation of these recommendations into worksite settings.

The integration of studio cycling into a worksite stress management programme.

High stress is a prevalent problem in the worksite. To reduce stress, improve productivity, reduce absenteeism, and lower healthcare costs, many companies offer exercise classes or stress management programmes. Although physical activity is an important component of stress management, few worksites have integrated physical activity into their comprehensive stress reduction programmes. The purpose of this single-arm pilot project was to examine the potential effectiveness of an integrated exercise (studio cycling) and cognitive-behavioural stress management programme. Eighty-four adults, 75% female, mostly aged 40+ years, participated in an integrated 12-week cycling studio and cognitive-behavioural stress management programme. Participants experienced a significant and clinically meaningful reduction on the Perceived Stress Scale (p < 0.01), rating of current stress level and confidence to manage stress at the programme's end and at a 1-month follow-up. Participants also reported having significantly improved overall health, improved nutritional habits, higher physical activity level, greater confidence in their ability to follow a healthy diet, higher spiritual well-being, improved sleep, receiving more support for maintaining healthy living and improved quality of life at the completion of the 12-week programme and 1-month follow-up. These findings provide further support for an integrated exercise and stress management programme.

Motivational improvements for health behavior change from wellness coaching.

OBJECTIVES: To identify client priorities prior to wellness coaching, and examine motivational improvements for health behaviors on follow-up. METHODS: Clients completed a wellness questionnaire at baseline (before coaching) and at a 3-month follow-up. Overall, 177 participants (92% female, average age 42.9 (SD 11.2) years) were included in the analysis. Clients indicated priorities for coaching, and levels of importance, confidence, and readiness to change within each domain were compared between baseline and follow-up. RESULTS: Participants identified weight management as their top priority and successfully reduced their BMI. Participants also demonstrated significant improvements in motivation and confidence in most health behavior domains. CONCLUSIONS: These results provide further support for the effectiveness of wellness coaching for weight management and for improving motivational readiness for behavior change.

Is usage of a wellness center associated with improved quality of life?

PURPOSE: There is limited documentation regarding the potential quality of life (QOL) benefits associated with use of a worksite wellness center. Therefore, the aim of this study was to examine the relationship between potential QOL change and use of a worksite wellness center during a 12-month period. DESIGN: Analysis of an annual QOL wellness center member survey and wellness center use during a 12-month time period. SETTING: A worksite wellness center. PARTICIPANTS: A total of 1151 employee wellness center members, average age of 39.5 years, 69.7% female, and 43.5% reported being overweight. INTERVENTION: Members of the worksite wellness center have access to a range of fitness options, including exercise classes, water aerobics, an indoor track, strength training, and aerobic conditioning equipment. Additionally, nutritional classes are offered, and there is a wellness café. For resiliency, members can participate in wellness coaching or a stress-reduction group program. METHOD: Participants completed a baseline QOL survey and a second QOL survey 1 year later. An electronic entry system tracked use of the wellness center. RESULTS: Participants were divided into four wellness center use quartiles: low users (less than once every 2 weeks), below-average users, above-average users, and high users (two to three visits per week). High users reported experiencing improvements in their physical QOL (p < .0001) compared with the low users. Additionally, low users experienced a greater decline in their mental QOL (p = .05) compared with high users. CONCLUSION: In a large sample of employees, use of a wellness center during a 12-month period was associated with benefits for physical QOL. QOL is an important domain of wellness; therefore, in addition to measuring physiologic changes, examining potential QOL changes may be another important outcome measure for wellness centers.

Stress level, health behaviors, and quality of life in employees joining a wellness center.

PURPOSE: Examine the relationship between stress level and quality of life at a worksite wellness center. DESIGN: A survey completed when joining the wellness center. Setting . Employee wellness center. SUBJECTS: Survey that inquired about stress, health behaviors, and quality of life of more than 13,000 employees joining a wellness center. MEASURES: A series of questions about current health status and health behaviors. ANALYSIS: Two-sample t-tests assuming unequal variances. RESULTS: A total of 2147 of these employees reported having high stress levels. Employees with high stress levels had statistically significant lower quality of life, more fatigue, and poorer health compared with employees with low stress levels. In terms of their ability and motivation to participate in wellness programs, the high-stress employees were also less active and had less healthy nutritional habits, less support, and less confidence in their ability to be active. They also reported having more health problems, including high blood pressure, high blood sugar, high cholesterol, and overweight. CONCLUSIONS: It appears that employees with high stress levels--those who might most benefit from participation in wellness programs--may experience the greatest difficulty participating actively in wellness programs because of their lack of support, low confidence, and numerous health problems. Perhaps offering tailored stress reduction programs for these employees would be beneficial.

Validity of weight loss to estimate improvement in body composition in individuals attending a wellness center.

The accuracy of weight loss in estimating successful changes in body composition (BC), namely fat mass (FM) loss, is not known and was addressed in our study. To assess the correlation between change in body weight and change in FM, fat% and fat-free mass (FFM), 465 participants (41% male; 41 ± 13 years), who met the criteria for weight change assessment at a wellness center, underwent air-displacement plethysmography (ADP). Body weight and BC were measured at the same time. We categorized the change in body weight, FM and FFM as an increase if there was >1 kg gain, a decrease if there was >1 kg loss and no change if the difference was ≤1 kg. We estimated the diagnostic performance of weight change to identify improvement in BC. After a median time of 132 days, there was a mean weight change was 2.4 kg. From the 255 people who lost >1 kg of weight, 216 (84.7%) had lost >1 kg of FM, but 69 (27.1%) had lost >1 kg of FFM. Of the 143 people with no weight change, 42 (29.4%) had actually lost >1 kg of FM. Of the 67 who gained >1 kg of weight at follow-up, in 23 (34.3%) this was due to an increase in FFM but not in FM. Weight change had a NPV of 73%. Our results indicate that favorable improvements in BC may go undetected in almost one-third of people whose weight remains the same and in one-third of people who gain weight after attending a wellness center. These results underscore the potential role of BC measurements in people attempting lifestyle changes.