RESUMO
AIMS: To investigate the effectiveness of a 3-year worksite lifestyle intervention on cardiovascular metrics and to study whether outcomes are influenced by baseline subclinical atherosclerosis (SA) by non-invasive imaging. METHODS AND RESULTS: A randomized controlled trial was performed to compare a lifestyle intervention with standard of care in asymptomatic middle-aged subjects, stratified by SA. The intervention consisted of nine motivational interviews during the first year, followed by three further sessions between Years 1 and 3. The primary outcome was the change in a pre-specified adaptation of the Fuster-BEWAT score (Blood pressure, Exercise, Weight, Alimentation, and Tobacco) between baseline and follow-up Years 1-3. A total of 1020 participants (mean age 50 ± 4 years) were enrolled, of whom 510 were randomly assigned to the intervention and 510 to the control group. The baseline adapted Fuster-BEWAT score was 16.2 ± 3.7 points in the intervention group and 16.5 ± 3.5 points in the control group. At Year 1, the score improved significantly in intervention participants compared with controls [estimate 0.83 (95% CI 0.52-1.15) points]. However, intervention effectiveness decreased to non-significant levels at Year 3 [0.24 (95% CI -0.10 to 0.59) points]. Over the 3-year period, the intervention was effective in participants having low baseline SA [0.61 (95% CI 0.30-0.93) points] but not in those with high baseline SA [0.19 (95% CI -0.26 to 0.64) points]. CONCLUSION: In middle-aged asymptomatic adults, a lifestyle intervention was associated with a significant improvement in cardiovascular health and behavioural metrics. The effect attenuated after 1 year as the intensity of the intervention was reduced. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02561065).
Assuntos
Aterosclerose , Estilo de Vida , Adulto , Aterosclerose/prevenção & controle , Pressão Sanguínea , Exercício Físico/fisiologia , Humanos , Pessoa de Meia-Idade , Local de TrabalhoRESUMO
BACKGROUND: Large volumes of sitting time have been associated with multiple health risks. To reduce sitting time of office workers working for a Dutch insurance company, the Dynamic Work intervention was developed. The primary objective of this paper is to describe the study protocol of the Dynamic Work study, which aims to evaluate if this multicomponent intervention is (cost-)effective in reducing total sitting time on the short-term (≈3 months) and longer-term (≈12 months) compared to usual practice. METHODS/DESIGN: This two-arm cluster randomized controlled trial will recruit 250 desk-based office workers working at different locations of an insurance company in the Netherlands. After baseline measurements, departments will be matched in pairs and each pair will be randomly assigned to the control or intervention condition. The multicomponent intervention contains organizational (i.e. face to face session with the head of the department), work environmental (i.e. the introduction of sit-stand desks and cycling workstations), and individual elements (i.e. counselling and activity/sitting tracker with a self-help program booklet). The counselling involves two group intervention sessions and four on-site department consultations with an occupational physiotherapist. Sitting time (primary outcome), upright time and step counts will be assessed objectively using the activPAL activity monitor at baseline, short-term (approximately 3 months) and longer-term (12 months). Other outcomes will include: self-reported lifestyle behaviours, anthropometrics, work-related outcomes (i.e. absenteeism, presenteeism, work performance, work-related stress), health-related outcomes (i.e. vitality, musculoskeletal symptoms, need for recovery, quality of life), and costs from both company and societal perspective. The study will include economic and process evaluations. DISCUSSION: This study will assess the longer-term (cost-) effectiveness of a multicomponent workplace intervention aimed at reducing sitting time in comparison with usual practice. Furthermore, the process evaluation will provide insights in factors associated with successful implementation of this intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT03115645 ; Registered 13 April 2017. Retrospectively registered.
Assuntos
Promoção da Saúde/métodos , Saúde Ocupacional , Comportamento Sedentário , Local de Trabalho/organização & administração , Adulto , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Países Baixos , Postura , Qualidade de Vida , Postura SentadaRESUMO
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death worldwide. With atherosclerosis as the underlying cause for many CVD events, prevention or reduction of subclinical atherosclerotic plaque burden (SAPB) through a healthier lifestyle may have substantial public health benefits. OBJECTIVE: The objective was to describe the protocol of a randomized controlled trial investigating the effectiveness of a 30-month worksite-based lifestyle program aimed to promote cardiovascular health in participants having a high or a low degree of SAPB compared with standard care. METHODS: We will conduct a randomized controlled trial including middle-aged bank employees from the Progression of Early Subclinical Atherosclerosis cohort, stratified by SAPB (high SAPB n=260, low SAPB n=590). Within each stratum, participants will be randomized 1:1 to receive a lifestyle program or standard care. The program consists of 3 elements: (a) 12 personalized lifestyle counseling sessions using Motivational Interviewing over a 30-month period, (b) a wrist-worn physical activity tracker, and (c) a sit-stand workstation. Primary outcome measure is a composite score of blood pressure, physical activity, sedentary time, body weight, diet, and smoking (ie, adapted Fuster-BEWAT score) measured at baseline and at 1-, 2-, and 3-year follow-up. CONCLUSIONS: The study will provide insights into the effectiveness of a 30-month worksite-based lifestyle program to promote cardiovascular health compared with standard care in participants with a high or low degree of SAPB.
Assuntos
Aterosclerose/prevenção & controle , Doenças Cardiovasculares/prevenção & controle , Monitores de Aptidão Física , Promoção da Saúde/métodos , Entrevista Motivacional , Serviços de Saúde do Trabalhador/métodos , Comportamento de Redução do Risco , Adulto , Pressão Sanguínea , Peso Corporal , Dieta , Exercício Físico , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Postura , Comportamento Sedentário , Fumar , Abandono do Hábito de Fumar , Resultado do Tratamento , Local de TrabalhoRESUMO
BACKGROUND: To recover from work stress, a worksite health program aimed at improving physical activity and relaxation may be valuable. However, not every program is effective for all participants, as would be expected within a "one size fits all" approach. The effectiveness of how the program is delivered may differ across individuals. The aim of this study was to identify subgroups for whom one intervention may be better suited than another by using a new method called QUalitative INteraction Trees (QUINT). METHODS: Data were used from the "Be Active & Relax" study, in which 329 office workers participated. Two delivery modes of a worksite health program were given, a social environmental intervention (group motivational interviewing delivered by team leaders) and a physical environmental intervention (environmental modifications). The main outcome was change in Need for Recovery (NFR) from baseline to 12 month follow-up. The QUINT method was used to identify subgroups that benefitted more from either type of delivery mode, by incorporating moderator variables concerning sociodemographic, health, home, and work-related characteristics of the participants. RESULTS: The mean improvement in NFR of younger office workers in the social environmental intervention group was significantly higher than younger office workers who did not receive the social environmental intervention (10.52; 95 % CI: 4.12, 16.92). Furthermore, the mean improvement in NFR of older office workers in the social environmental intervention group was significantly lower than older office workers who did not receive the social environmental intervention ( -10.65; 95 % CI: -19.35, -1.96). The results for the physical environmental intervention indicated that the mean improvement in NFR of office workers (regardless of age) who worked fewer hours overtime was significantly higher when they had received the physical environmental intervention than when they had not received this type of intervention (7.40; 95 % CI: 0.99, 13.81). Finally, for office workers who worked more hours overtime there was no effect of the physical environmental intervention. CONCLUSIONS: The results suggest that a social environmental intervention might be more beneficial for younger workers, and a physical environmental intervention might be more beneficial for employees with a few hours overtime to reduce the NFR. TRIAL REGISTRATION: NTR2553.
Assuntos
Exercício Físico , Promoção da Saúde/métodos , Serviços de Saúde do Trabalhador , Seleção de Pacientes , Relaxamento , Estresse Psicológico/prevenção & controle , Local de Trabalho , Adulto , Fatores Etários , Demografia , Planejamento Ambiental , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Entrevista Motivacional , Meio Social , Fatores Socioeconômicos , Resultado do Tratamento , Carga de Trabalho , Adulto JovemRESUMO
BACKGROUND: Individual work performance is an important outcome measure in studies in the workplace. Nevertheless, its conceptualization and measurement has proven challenging. To overcome limitations of existing scales, the Individual Work Performance Questionnaire (IWPQ) was recently developed. The aim of the current study was to gain insight into the responsiveness of the IWPQ. METHODS: Data were used from the Be Active & Relax randomized controlled trial. The aim of the trial was to investigate the effectiveness of an intervention to stimulate physical activity and relaxation of office workers, on need for recovery. Individual work performance was a secondary outcome measure of the trial. In total, 39 hypotheses were formulated concerning correlations between changes on the IWPQ scales and changes on similar constructs (e.g., presenteeism) and distinct constructs (e.g., need for recovery) used in the trial. RESULTS: 260 Participants completed the IWPQ at both baseline and 12 months of follow-up. For the IWPQ scales, 23%, 15%, and 38%, respectively, of the hypotheses could be confirmed. In general, the correlations between change scores were weaker than expected. Nevertheless, at least 85% of the correlations were in the expected direction. CONCLUSIONS: Based on results of the current study, no firm conclusions can be drawn about the responsiveness of the IWPQ. Several reasons may account for the weaker than expected correlations. Future research on the IWPQ's responsiveness should be conducted, preferably in other populations and intervention studies, where greater changes over time can be expected.
Assuntos
Avaliação de Desempenho Profissional/estatística & dados numéricos , Inquéritos e Questionários , Adulto , Feminino , Humanos , Masculino , Atividade Motora , Países Baixos , Serviços de Saúde do Trabalhador , Ensaios Clínicos Controlados Aleatórios como Assunto , Relaxamento , Reprodutibilidade dos Testes , Local de TrabalhoRESUMO
BACKGROUND: With both a high need for recovery (NFR) and overweight and obesity being a potential burden for organizations (e.g. productivity loss and sickness absence), the aim of this paper was to examine the associations between overweight and obesity and several other health measures and NFR in office workers. METHODS: Baseline data of 412 office employees participating in a randomised controlled trial aimed at improving NFR in office workers were used. Associations between self-reported BMI categories (normal body weight, overweight, obesity) and several other health measures (general health, mental health, sleep quality, stress and vitality) with NFR were examined. Unadjusted and adjusted linear regression analyses were performed and adjusted for age, education and job demands. In addition, we adjusted for general health in the association between overweight and obesity and NFR. RESULTS: A significant positive association was observed between stress and NFR (B= 18.04, 95%CI:14.53-21.56). General health, mental health, sleep quality and vitality were negatively associated with NFR (p<0.001). Analyses also showed a significant positive association between obesity and NFR (B=8.77, 95%CI:0.01-17.56), but not between overweight and NFR. CONCLUSIONS: The findings suggest that self-reported stress is, and obesity may be, associated with a higher NFR. Additionally, the results imply that health measures that indicate a better health are associated with a lower NFR. TRIAL REGISTRATION: The trial is registered at the Dutch Trial Register (NTR) under trial registration number: NTR2553.
Assuntos
Adaptação Psicológica , Emprego/psicologia , Indicadores Básicos de Saúde , Obesidade/psicologia , Saúde Ocupacional/estatística & dados numéricos , Sobrepeso/psicologia , Estresse Psicológico/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação das Necessidades , Países Baixos , Serviços de Saúde do Trabalhador , Inquéritos e QuestionáriosRESUMO
BACKGROUND: There is strong evidence to suggest that multiple work-related health problems are preceded by a higher need for recovery. Physical activity and relaxation are helpful in decreasing the need for recovery. This article aims to describe (1) the development and (2) the design of the evaluation of a daily physical activity and relaxation intervention to reduce the need for recovery in office employees. METHODS/DESIGN: The study population will consist of employees of a Dutch financial service provider. The intervention was systematically developed, based on parts of the Intervention Mapping (IM) protocol. Assessment of employees needs was done by combining results of face-to-face interviews, a questionnaire and focus group interviews. A set of theoretical methods and practical strategies were selected which resulted in an intervention program consisting of Group Motivational Interviewing (GMI) supported by a social media platform, and environmental modifications. The Be Active & Relax program will be evaluated in a modified 2 X 2 factorial design. The environmental modifications will be pre-stratified and GMI will be randomised on department level. The program will be evaluated, using 4 arms: (1) GMI and environmental modifications; (2) environmental modifications; (3) GMI; (4) no intervention (control group). Questionnaire data on the primary outcome (need for recovery) and secondary outcomes (daily physical activity, sedentary behaviour, relaxation/detachment, work- and health-related factors) will be gathered at baseline (T0), at 6 months (T1), and at 12 months (T2) follow-up. In addition, an economic and a process evaluation will be performed. DISCUSSION: Reducing the need for recovery is hypothesized to be beneficial for employees, employers and society. It is assumed that there will be a reduction in need for recovery after 6 months and 12 months in the intervention group, compared to the control group. Results are expected in 2013. TRIAL REGISTRATION: Netherlands Trial Register (NTR): NTR2553.
Assuntos
Promoção da Saúde/métodos , Atividade Motora , Relaxamento , Local de Trabalho , Adulto , Análise Custo-Benefício , Feminino , Grupos Focais , Humanos , Masculino , Entrevista Motivacional , Países Baixos , Comportamento Sedentário , Mídias Sociais , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Sedentary behaviour increases the risk for morbidity. Our primary aim is to determine the proportion and factors associated with objectively measured total and occupational sedentary time in three work settings. Secondary aim is to study the proportion of physical activity and prolonged sedentary bouts. METHODS: Data were obtained using ActiGraph accelerometers from employees of: 1) a financial service provider (n = 49 men, 31 women), 2) two research institutes (n = 30 men, 57 women), and 3) a construction company (n = 38 men). Total (over the whole day) and occupational sedentary time, physical activity and prolonged sedentary bouts (lasting ≥30 minutes) were calculated by work setting. Linear regression analyses were performed to examine general, health and work-related factors associated with sedentary time. RESULTS: The employees of the financial service provider and the research institutes spent 76-80% of their occupational time in sedentary behaviour, 18-20% in light intensity physical activity and 3-5% in moderate-to-vigorous intensity physical activity. Occupational time in prolonged sedentary bouts was 27-30%. Total time was less sedentary (64-70%), and had more light intensity physical activity (26-33%). The employees of the construction company spent 44% of their occupational time in sedentary behaviour, 49% in light, and 7% in moderate intensity physical activity, and spent 7% in sedentary bouts. Total time spent in sedentary behavior was 56%, 40% in light, and 4% in moderate intensity physical behaviour, and 12% in sedentary bouts. For women, low to intermediate education was the only factor that was negatively associated with occupational sedentary time. CONCLUSIONS: Sedentary behaviour is high among white-collar employees, especially in highly educated women. A relatively small proportion of sedentary time was accrued in sedentary bouts. It is recommended that worksite health promotion efforts should focus on reducing sedentary behaviour through improving light intensity physical activity.
Assuntos
Academias e Institutos , Indústria da Construção , Comportamento Sedentário , Adulto , Estudos Transversais , Feminino , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Local de TrabalhoRESUMO
OBJECTIVES: The aim of this study was to examine the longitudinal relationship between job satisfaction and total productivity-related costs, and between job satisfaction and absenteeism and presenteeism costs separately. A secondary aim was to explore whether these relationships differed across job types. METHODS: Linear generalized estimating equation analyses were used to explore the longitudinal relationships. To explore whether the relationships differed across job types, stratified analyses were performed. RESULTS: A significant relationship was found between job satisfaction and total productivity-related costs [ßâ=â&OV0556;-273; 95% confidence interval (95% CI): -407 to -200] and between job satisfaction and presenteeism costs (ßâ=â&OV0556;-276; 95% CI: -367 to -235), but not between job satisfaction and absenteeism costs. These relationships differed across job types. CONCLUSIONS: Higher levels of job satisfaction were longitudinally related to lower total productivity-related costs and presenteeism costs, but not to lower absenteeism costs. These relationships seem to differ across job types.
Assuntos
Eficiência , Satisfação no Emprego , Absenteísmo , Adulto , Custos e Análise de Custo , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Presenteísmo/economia , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
BACKGROUND: Research is needed to better understand the associations between during-work and after-work-hours physical activity and relaxation and need for recovery (NFR), so a study of these variables in office workers at a financial service provider was undertaken. METHODS: Self-reported baseline data of 412 employees (mean age = 41.3 y; 39.6% women) were used. Linear regression analyses were performed to test associations of physical activity, relaxation, detachment, and breaks at work with NFR. RESULTS: A lower NFR was significantly positively associated with standing, stair climbing, active lunch break, relaxation at work, detachment at work, physical detachment at work, relaxation at home, and detachment at home. In the multiple model, a lower NFR was independently positively associated with frequency of stair climbing, minutes spent in leisure activities, detachment at work, physical detachment at work, and relaxation and detachment at home (P < .05). Significant effect modification indicated that the positive association between relaxation at home and NFR was stronger with high job demands. CONCLUSION: Although prospective evidence is necessary to confirm the causal relationships, our findings suggest that engaging in stair climbing, leisure activities, (physical) detachment at work, relaxation and detachment after work is associated with a lower NFR. For future work site health promotion initiatives, interventions might be targeted at improving physical activity and relaxation.
Assuntos
Promoção da Saúde , Atividades de Lazer/psicologia , Atividade Motora/fisiologia , Descanso/psicologia , Trabalho/psicologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Local de TrabalhoRESUMO
OBJECTIVE: To investigate the effectiveness of a worksite social and physical environment intervention on need for recovery (i.e., early symptoms of work-related mental and physical fatigue), physical activity and relaxation. Also, the effectiveness of the separate interventions was investigated. METHODS: In this 2 × 2 factorial design study, 412 office employees from a financial service provider participated. Participants were allocated to the combined social and physical intervention, to the social intervention only, to the physical intervention only or to the control group. The primary outcome measure was need for recovery. Secondary outcomes were work-related stress (i.e., exhaustion, detachment and relaxation), small breaks, physical activity (i.e., stair climbing, active commuting, sport activities, light/moderate/vigorous physical activity) and sedentary behavior. Outcomes were measured by questionnaires at baseline, 6 and 12 months follow-up. Multilevel analyses were performed to investigate the effects of the three interventions. RESULTS: In all intervention groups, a non-significant reduction was found in need for recovery. In the combined intervention (n = 92), exhaustion and vigorous physical activities decreased significantly, and small breaks at work and active commuting increased significantly compared to the control group. The social intervention (n = 118) showed a significant reduction in exhaustion, sedentary behavior at work and a significant increase in small breaks at work and leisure activities. In the physical intervention (n = 96), stair climbing at work and active commuting significantly increased, and sedentary behavior at work decreased significantly compared to the control group. CONCLUSION: None of the interventions was effective in improving the need for recovery. It is recommended to implement the social and physical intervention among a population with higher baseline values of need for recovery. Furthermore, the intervention itself could be improved by increasing the intensity of the intervention (for example weekly GMI-sessions), providing physical activity opportunities and exercise schemes, and by more drastic environment interventions (restructuring entire department floor). TRIAL REGISTRATION: Nederlands Trial Register NTR2553.
Assuntos
Promoção da Saúde/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Estresse Psicológico/prevenção & controle , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Terapia de Relaxamento/métodos , Apoio Social , Caminhada , Local de TrabalhoRESUMO
OBJECTIVE: To investigate the effectiveness of a combined social and physical environmental intervention as well as the effectiveness of both separate interventions. METHODS: In a 2 × 2 factorial design, 412 office employees were allocated to the combined social and physical environmental intervention, to the social environmental intervention only, to the physical environmental intervention only, or were part of the control group. Data on presenteeism, absenteeism, work performance, and work engagement were obtained with questionnaires at baseline, 6, and 12 months. Multilevel analyses were performed. RESULTS: The combined intervention showed a decrease in contextual performance and dedication. The social environmental intervention showed an improvement in task performance. The physical environmental intervention revealed an improvement in absorption. CONCLUSION: Although the study showed some promising results, it is not recommended to implement the current interventions.
Assuntos
Absenteísmo , Comércio , Planejamento Ambiental , Entrevista Motivacional , Trabalho/psicologia , Adulto , Atitude , Avaliação de Desempenho Profissional , Feminino , Humanos , Decoração de Interiores e Mobiliário , Masculino , Pessoa de Meia-Idade , Motivação , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Local de TrabalhoRESUMO
OBJECTIVE: To evaluate the process of implementation of a social and physical environmental intervention and to explore differences regarding this process between both interventions. METHODS: Context, recruitment, dose delivered, fidelity, reach, dose received, satisfaction, and implementation barriers were investigated. RESULTS: Reach for the social and physical environmental interventions ranged from 45% to 76%. Mean satisfaction for the social environmental intervention was 6.0 and for the physical environmental intervention was 7.0. Generally, the results were higher for team leaders than for employees. Furthermore, the implementation of the physical intervention was better at the departments that additionally received the social intervention. CONCLUSION: Both interventions were better implemented on the level of the team leader than that of the employees. Furthermore, the combined interventions received higher evaluation scores. To increase satisfaction and participation, attention should be paid to both employees and team leaders during implementation.