The effectiveness of physical activity monitoring and distance counseling in an occupational setting - results from a randomized controlled trial (CoAct).

BACKGROUND: Lack of physical activity (PA) is a known risk factor for many health conditions. The workplace is a setting often used to promote activity and health. We investigated the effectiveness of an intervention on PA and productivity-related outcomes in an occupational setting. METHODS: We conducted a randomized controlled trial of 12 months duration with two 1:1 allocated parallel groups of insurance company employees. Eligibility criteria included permanent employment and absence of any condition that risked the participant's health during PA. Subjects in the intervention group monitored their daily PA with an accelerometer, set goals, had access to an online service to help them track their activity levels, and received counseling via telephone or web messages for 12 months. The control group received the results of a fitness test and an information leaflet on PA at the beginning of the study. The intervention's aim was to increase PA, improve work productivity, and decrease sickness absence. Primary outcomes were PA (measured as MET minutes per week), work productivity (quantity and quality of work; QQ index), and sickness absence (SA) days at 12 months. Participants were assigned to groups using block randomization with a computer-generated scheme. The study was not blinded. RESULTS: There were 544 randomized participants, of which 521 were included in the analysis (64% female, mean age 43 years). At 12 months, there was no significant difference in physical activity levels between the intervention group (n = 264) and the control group (n = 257). The adjusted mean difference was -206 MET min/week [95% Bayesian credible interval -540 to 128; negative values favor control group]. There was also no significant difference in the QQ index (-0.5 [-4.4 to 3.3]) or SA days (0.0 [-1.2 to 0.9]). Of secondary outcomes, body weight (0.5 kg [0.0 to 1.0]) and percentage of body fat (0.6% [0.2% to 1.1%]) were slightly higher in the intervention group. An exploratory subgroup analysis revealed no subgroups in which the intervention affected physical activity. No adverse events were reported. CONCLUSIONS: The intervention was not found effective, and this study does not provide support for the effectiveness of the workplace PA intervention used here. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00994565.

The effectiveness of physical activity monitoring and distance counselling in an occupational health setting--a research protocol for a randomised controlled trial (CoAct).

BACKGROUND: The CoAct (Cocreating Activity) study is investigating a novel lifestyle intervention, aimed at the working population, with daily activity monitoring and distance counselling via telephone and secure web messages. The main purpose of this study is to evaluate the effectiveness of lifestyle counselling on the level of physical activity in an occupational health setting. The purposes include also analysing the potential effects of changes in physical activity on productivity at work and sickness absence, and healthcare costs. This article describes the design of the study and the participant flow until and including randomization. METHODS/DESIGN: CoAct is a randomised controlled trial with two arms: a control group and intervention group with daily activity monitoring and distance counselling. The intervention focuses on lifestyle modification and takes 12 months. The study population consists of volunteers from 1100 eligible employees of a Finnish insurance company. The primary outcomes of this study are change in physical activity measured in MET minutes per week, work productivity and sickness absence, and healthcare utilisation. Secondary outcomes include various physiological measures. Cost-effectiveness analysis will also be performed. The outcomes will be measured by questionnaires at baseline, after 6, 12, and 24 months, and sickness absence will be obtained from the employer's registers. DISCUSSION: No trials are yet available that have evaluated the effectiveness of daily physical activity monitoring and distance counselling in an occupational health setting over a 12 month period and no data on cost-effectiveness of such intervention are available. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00994565.

The influence of selective participation in a physical activity intervention on the generalizability of findings.

OBJECTIVE: To evaluate factors that characterize employees who did not participate in a physical activity intervention in an occupational setting and assess how selective participation affects inferences from the data. METHODS: Employees were asked to complete a health risk appraisal. The respondents were invited to participate in a physical activity intervention. We compared predictors of sickness absence (register data) among all respondents and those who participated in the intervention, using Bayesian regression analysis. RESULTS: Of 1116 employees, 817 (73%) responded, of whom 544 (67%) participated in the intervention. Participants had better health behaviors and fewer health problems than those who did not participate. The predictors of sickness absence in all respondents differed from those who participated in the intervention. CONCLUSIONS: Selective participation may reduce the potential benefit of interventions and limit generalizability of findings.