Advertisement

Program implementation and effectiveness of a national workplace physical activity intervention: UPnGO with ParticipACTION

  • Erica Y. LauEmail author
  • Guy Faulkner
Population Health Intervention Research

Abstract

Intervention

UPnGO with ParticipACTION (UPnGO) is a 6-week workplace physical activity (PA) initiative aiming to increase habitual PA (steps) during the workday. Core intervention components included (1) self-monitoring of steps and action planning behaviours using a Web/mobile app with incentives and (2) organizational support, which included senior management’s role modeling and endorsement of the program.

Research question

What is the effectiveness and levels of implementation of the UPnGO intervention? What is the relationship between effectiveness and levels of implementation?

Methods

A single-arm, pre-/post-test study design was used. Participants were 660 employees from nine organizations who had valid step data and complete socio-demographic information at baseline. The primary outcome (mean daily steps) was assessed by Garmin VivoFit. Using the usage data from the UPnGO web-based system, a composite score for levels of implementation was calculated based on participant’s compliance with the self-monitoring component and senior management’s role modeling. Associations of interest were analyzed using linear mixed-effects models.

Results

Levels of implementation were highly variable across organizations (mean = 68.22% ± 18.75, range = 19.8 to 100%). A significant Time × Implementation (IM) status interaction effect was observed. When stratified by IM status, a significant increase in mean daily steps at week 6 was found among participants in the high (β = 540.01 ± 202.69, p = 0.011) but not low (β = − 81.54 ± 291.96, p = 0.78) implementation group.

Conclusion

Findings suggest significant intervention effects in increasing average daily steps among participants who were exposed to optimal levels of implementation (~ 70%). UPnGO may be a scalable workplace PA intervention at a national level, although this needs further verification with more rigorous study designs.

Keywords

Telemedicine Incentives Implementation of health programs 

Résumé

Intervention

UPnGO with ParticipACTION (UPnGO) est une initiative d’activité physique (AP) en milieu de travail d’une durée de 6 semaines qui vise à augmenter l’AP habituelle (le nombre de pas) durant la journée de travail. Les éléments centraux de l’intervention étaient : 1) l’autosurveillance des pas et des comportements de planification d’actions avec une appli Web/mobile assortie d’incitations et 2) un appui organisationnel incluant l’exemple de la haute direction et son appui moral au programme.

Questions de recherche

Quelle est l’efficacité et quels sont les niveaux de mise en œuvre de l’intervention UPnGO? Quelle est la relation entre l’efficacité et les niveaux de mise en œuvre?

Méthode

Un protocole d’étude pré- et post-test sur groupe unique a été utilisé. Les participants étaient 660 employés de neuf organismes pour lesquels il existait au départ des données validées sur le nombre de pas et un profil sociodémographique complet. Le résultat principal (les pas moyens quotidiens) a été calculé avec l’appareil VivoFit de Garmin. À l’aide des données d’utilisation du système en ligne UPnGO, une note composite pour le niveau de mise en œuvre a été calculée d’après la conformité des participants à l’élément d’autosurveillance et l’exemple de la haute direction. Les associations intéressantes ont été analysées à l’aide de modèles linéaires à effets mixtes.

Résultats

Les niveaux de mise en œuvre ont beaucoup varié d’un organisme à l’autre (moyenne = 68,22 % ± 18,75, intervalle = 19,8 % à 100 %). Un effet d’interaction significatif Temps x Mise en œuvre (MEO) a été observé. Après stratification selon le statut de MEO, une hausse significative des pas moyens quotidiens a été constatée la 6e semaine chez les participants du groupe de mise en œuvre élevée (β = 540,01 ± 202,69, p = 0,011), mais non dans ceux du groupe où la mise en œuvre était faible (β = −81,54 ± 291,96, p = 0,78).

Conclusion

Ces résultats indiquent que l’intervention a eu des effets sensibles en augmentant les pas moyens quotidiens des participants exposés à des niveaux optimaux de mise en œuvre (~ 70 %). UPnGO pourrait être une intervention d’AP en milieu de travail extensible à l’échelle nationale, mais cela nécessiterait de plus amples vérifications avec des protocoles d’étude plus rigoureux.

Mots-clés

Télémédecine Incitations Mise en œuvre des programmes de santé 

Notes

Acknowledgements

Dr. Faulkner is a Canadian Institutes of Health Research (CIHR)-Public Health Agency of Canada (PHAC) Chair in Applied Public Health. The authors also wish to acknowledge Ms. Lisa Fender, Dr. Allana LeBlanc and the UPnGO team for their assistance in the evaluation.

Funding information

UPnGO with ParticipACTION was supported by a multi-sectoral partnership grant from the Public Health Agency of Canada, ParticipACTION, Public Inc., the British Columbia Ministry of Health, the Ontario Trillium Foundation and AstraZeneca.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Aittasalo, M., Livson, M., Lusa, S., Romo, A., Vaha-Ypya, H., Tokola, K., et al. (2017). Moving to business—changes in physical activity and sedentary behavior after multilevel intervention in small and medium-size workplaces. BMC Public Health, 17(1), 319.  https://doi.org/10.1186/s12889-017-4229-4. CrossRefPubMedPubMedCentralGoogle Scholar
  2. An, H.-S., Jones, G. C., Kang, S.-K., Welk, G. J., & Lee, J.-M. (2017). How valid are wearable physical activity trackers for measuring steps? European Journal of Sport Science, 17(3), 360–368.  https://doi.org/10.1080/17461391.2016.1255261.CrossRefPubMedGoogle Scholar
  3. Andersen, L. L., & Zebis, M. K. (2014). Process evaluation of workplace interventions with physical exercise to reduce musculoskeletal disorders. International Journal of Rheumatology, 2014, 761363.  https://doi.org/10.1155/2014/761363.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Baerg, S., Cairney, J., Hay, J., Rempel, L., Mahlberg, N., & Faught, B. E. (2011). Evaluating physical activity using accelerometry in children at risk of developmental coordination disorder in the presence of attention deficit hyperactivity disorder. Research in Developmental Disabilities, 32(4), 1343–1350.  https://doi.org/10.1016/j.ridd.2011.02.009.CrossRefPubMedGoogle Scholar
  5. Behrens, T. K., Domina, L., & Fletcher, G. M. (2007). Evaluation of an employer-sponsored pedometer-based physical activity program. Perceptual and Motor Skills, 105(3), 968–976.  https://doi.org/10.2466/pms.105.3.968-976.CrossRefPubMedGoogle Scholar
  6. Campbell, N. C., Murray, E., Darbyshire, J., Emery, J., Farmer, A., Griffiths, F., et al. (2007). Designing and evaluating complex interventions to improve health care. BMJ, 334(7591), 455–459.  https://doi.org/10.1136/bmj.39108.379965.BE.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Caperchione, C. M., Stolp, S., Bottorff, J. L., Oliffe, J. L., Johnson, S. T., Seaton, C., et al. (2016). Changes in men’s physical activity and healthy eating knowledge and behavior as a result of program exposure: findings from the workplace POWERPLAY program. Journal of Physical Activity and Health, 13(12), 1364–1371.  https://doi.org/10.1123/jpah.2016-0111.CrossRefPubMedGoogle Scholar
  8. Conn, V. S., Hafdahl, A. R., Cooper, P. S., Brown, L. M., & Lusk, S. L. (2009). Meta-analysis of workplace physical activity interventions. American Journal of Preventive Medicine, 37(4), 330–339.  https://doi.org/10.1016/j.amepre.2009.06.008.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Curran, G. M., Bauer, M., Mittman, B., Pyne, J. M., & Stetler, C. (2012). Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Medical Care, 50(3), 217–226.  https://doi.org/10.1097/MLR.0b013e3182408812.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Dobson, D., & Cook, T. J. (1980). Avoiding type III error in program evaluation: results from a field experiment. Evaluation and Program Planning, 3(4), 269–276.  https://doi.org/10.1016/0149-7189(80)90042-7.CrossRefGoogle Scholar
  11. Dunstan, D. W., Howard, B., Healy, G. N., & Owen, N. (2012). Too much sitting—a health hazard. Diabetes Research and Clinical Practice, 97(3), 368–376.  https://doi.org/10.1016/j.diabres.2012.05.020.CrossRefPubMedGoogle Scholar
  12. Durlak, J. A. (1998). Why program implementation is important. Journal of Prevention & Intervention in the Community, 17(2), 5–18.  https://doi.org/10.1300/J005v17n02_02.CrossRefGoogle Scholar
  13. Durlak, J., & DuPre, E. (2008). Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41(3–4), 327–350.  https://doi.org/10.1007/s10464-008-9165-0.CrossRefPubMedGoogle Scholar
  14. Durstine, J. L., Gordon, B., Wang, Z., & Luo, X. (2013). Chronic disease and the link to physical activity. Journal of Sport and Health Science, 2(1), 3–11.  https://doi.org/10.1016/j.jshs.2012.07.009.CrossRefGoogle Scholar
  15. Employement and Social Development Canada. (2015). Indicators of well-being in Canada. http://well-being.esdc.gc.ca/misme-iowb/d.4m.1.3n@-eng.jsp?did=3. Accessed 09-04-2018.
  16. Exercise Society for Exercise Physiology. (2012). The physical activity questionnaire for everyone.Google Scholar
  17. Faghri, P. D., Omokaro, C., Parker, C., Nichols, E., Gustavesen, S., & Blozie, E. (2008). E-technology and pedometer walking program to increase physical activity at work. The Journal of Primary Prevention, 29(1), 73–91.  https://doi.org/10.1007/s10935-007-0121-9. CrossRefPubMedGoogle Scholar
  18. Gilson, N. D., Puig-Ribera, A., McKenna, J., Brown, W. J., Burton, N. W., & Cooke, C. B. (2009). Do walking strategies to increase physical activity reduce reported sitting in workplaces: a randomized control trial. International Journal of Behavioral Nutrition and Physical Activity, 6(1), 43.  https://doi.org/10.1186/1479-5868-6-43.CrossRefPubMedGoogle Scholar
  19. Greaves, C. J., Sheppard, K. E., Abraham, C., Hardeman, W., Roden, M., Evans, P. H., et al. (2011). Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health, 11(1), 119.  https://doi.org/10.1186/1471-2458-11-119. CrossRefPubMedPubMedCentralGoogle Scholar
  20. Indig, D., Lee, K., Grunseit, A., Milat, A., & Bauman, A. (2017). Pathways for scaling up public health interventions. BMC Public Health, 18(1), 68.  https://doi.org/10.1186/s12889-017-4572-5. CrossRefPubMedPubMedCentralGoogle Scholar
  21. Innovation Science and Economic Development Canada. (2016). Key small business statistics.Google Scholar
  22. Janssen, I. (2012). Health care costs of physical inactivity in Canadian adults. Applied Physiology, Nutrition, and Metabolism, 37(4), 803–806.  https://doi.org/10.1139/h2012-061.CrossRefPubMedGoogle Scholar
  23. Malik, S. H., Blake, H., & Suggs, L. S. (2014). A systematic review of workplace health promotion interventions for increasing physical activity. British Journal of Health Psychology, 19(1), 149–180.  https://doi.org/10.1111/bjhp.12052.CrossRefPubMedGoogle Scholar
  24. Mason, M. R., Ickes, M. J., Campbell, M. S., & Bollinger, L. M. (2018). An incentivized, workplace physical activity intervention preferentially increases daily steps in inactive employees. American Journal of Health Promotion, 32(3), 638–645.  https://doi.org/10.1177/0890117117723803.CrossRefPubMedGoogle Scholar
  25. Medical Research Council. (2000). A framework for the development and evaluation of RCTs for complex interventions to improve health. London: MRC.Google Scholar
  26. Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implementation Science, 6(1), 42.  https://doi.org/10.1186/1748-5908-6-42. CrossRefPubMedGoogle Scholar
  27. Mirolla, M. (2004). The cost of chronic diseases in Canada.Google Scholar
  28. ParticipACTION. (2016). Sitting and restless: It’s time to take a stand against ‘meeting culture’ in Canada.Google Scholar
  29. Rongen, A., Robroek, S. J., van Lenthe, F. J., & Burdorf, A. (2013). Workplace health promotion: a meta-analysis of effectiveness. American Journal of Preventive Medicine, 44(4), 406–415.  https://doi.org/10.1016/j.amepre.2012.12.007. CrossRefPubMedGoogle Scholar
  30. Saunders, R. (2016). Implementation monitoring and process evaluation. Sage Publication, Inc..Google Scholar
  31. Shiell, A., Hawe, P., & Gold, L. (2008). Complex interventions or complex systems? Implications for health economic evaluation. BMJ, 336(7656), 1281–1283.  https://doi.org/10.1136/bmj.39569.510521.AD.CrossRefPubMedPubMedCentralGoogle Scholar
  32. Statistics Canada. (2015). Table 117-0019—distribution of the household population meeting/not meeting the Canadian physical activity guidelines, by sex and age group, occasional (percentage). Accessed 24-08-2018.Google Scholar
  33. To, Q. G., Chen, T. T., Magnussen, C. G., & To, K. G. (2013). Workplace physical activity interventions: a systematic review. American Journal of Health Promotion, 27(6), e113–e123.  https://doi.org/10.4278/ajhp.120425-LIT-222.CrossRefPubMedGoogle Scholar
  34. Tones, K. (2000). Evaluating health promotion: a tale of three errors. Patient Education and Counseling, 39(2–3), 227–236.CrossRefGoogle Scholar
  35. Tudor-Locke, C., & Bassett, D. R., Jr. (2004). How many steps/day are enough? Preliminary pedometer indices for public health. Sports Medicine, 34(1), 1–8.CrossRefGoogle Scholar
  36. Tudor-Locke, C., Burkett, L., Reis, J. P., Ainsworth, B. E., Macera, C. A., & Wilson, D. K. (2005). How many days of pedometer monitoring predict weekly physical activity in adults? Preventive Medicine, 40(3), 293–298.  https://doi.org/10.1016/j.ypmed.2004.06.003.CrossRefPubMedGoogle Scholar
  37. Verwey, R., van der Weegen, S., Spreeuwenberg, M., Tange, H., van der Weijden, T., & de Witte, L. (2016). Process evaluation of physical activity counselling with and without the use of mobile technology: a mixed methods study. International Journal of Nursing Studies, 53, 3–16.  https://doi.org/10.1016/j.ijnurstu.2015.10.008.CrossRefPubMedGoogle Scholar
  38. Warburton, D. E., Nicol, C. W., & Bredin, S. S. (2006). Health benefits of physical activity: the evidence. Canadian Medical Association Journal, 174(6), 801–809.  https://doi.org/10.1503/cmaj.051351.CrossRefPubMedGoogle Scholar
  39. Wilson, M. G., Basta, T. B., Bynum, B. H., DeJoy, D. M., Vandenberg, R. J., & Dishman, R. K. (2010). Do intervention fidelity and dose influence outcomes? Results from the move to improve worksite physical activity program. Health Education Research, 25(2), 294–305.  https://doi.org/10.1093/her/cyn065.CrossRefPubMedGoogle Scholar
  40. Wollesen, B., Menzel, J., Drögemüller, R., Hartwig, C., & Mattes, K. (2017). The effects of a workplace health promotion program in small and middle-sized companies: a pre–post analysis. Journal of Public Health, 25(1), 37–47.  https://doi.org/10.1007/s10389-016-0763-2. CrossRefGoogle Scholar
  41. Woods, W. G., Bernstein, M., & Lemieux, B. (1999). Randomized controlled trials in population-based intervention studies are not always feasible. Medical and Pediatric Oncology, 33(4), 360–361.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2019

Authors and Affiliations

  1. 1.Vancouver Coastal Health Research CentreCentre for Hip Health and MobilityVancouverCanada
  2. 2.Department of Family PracticeUniversity of British ColumbiaVancouverCanada
  3. 3.School of KinesiologyUniversity of British ColumbiaVancouverCanada

Personalised recommendations