Physical Activity Interventions
Worksite physical activity interventions

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Abstract

Background:

National objectives for public health have targeted worksites as important settings for interventions to increase physical activity. However, expert reviews reveal no scientific consensus about the effectiveness of worksite interventions for increasing physical activity or fitness.

Methods: We judged the quantity and quality of existing evidence against scientific standards for the internal and external validity of the research design and the validity of measurements. Meta-analytic methods were used to quantify the size of effects expressed as Pearson correlation coefficients (r). Variation in effect was examined in relation to several features of the studies deemed important for implementing successful worksite interventions. Pre-experimental cohort studies were excluded because they are sensitive to secular trends in physical activity.

Results: Twenty-six studies involving nearly 9,000 subjects yielded 45 effects. The mean effect was heterogeneous and small, r = 0.11 (95% CI, −0.20 to 0.40), approximating 14 S.D., or an increase in binomial success rate from 50% to 56%. Although effects varied slightly acccording to some of the study features we examined, effects were heterogeneous within levels of these features. Hence, the moderating variables examined did not explain variation in the effects (P > 0.05). The exception was that effects were smaller in randomized studies compared with studies using quasi-experimental designs (P < 0.05).

Conclusions: Our results indicate that the typical worksite intervention has yet to demonstrate a statistically significant increase in physical activity or fitness. The few studies that have used an exemplary sample, research design, and outcome measure have also yielded small or no effects. The generally poor scientific quality of the literature on this topic precludes the judgment that interventions at worksites cannot increase physical activity or fitness, but such an increase remains to be demonstrated by studies using valid research designs and measures.

Section snippets

Methods

Seventy-three studies published from 1972 through August 1, 1997, were located by searches of literature published in the English language using MEDLINE, PSYCHINFO, CURRENT CONTENTS, and BIOSIS, computer searches with worksite, corporate, fitness, exercise, adherence, physical activity, intervention, health education, and behavior modification as key words. Searches were supplemented by bibliographies from the articles retrieved and by reference lists provided by expert colleagues.

Criteria for

Results

A stem-and-leaf display of the 45 effects is presented in Figure 1. The distribution of effects was positively skewed (g1 = 1.56, P < 0.0001) and leptokurtic (g2 = 2.80, P < 0.0001). The modal effect was between 0.00 to 0.10. The mean (95% CI) value of r was 0.11 (−0.20 to 0.40). Expressed as a binomial effect size,10 the effect is equivalent to increasing success rates from an expected rate of 50% without intervention to 56% after an intervention. This is conventionally categorized75 as a

Discussion

Results from our quantitative synthesis of the literature indicate that the typical worksite intervention for increasing physical activity has yielded a small positive effect, which is not statistically different from zero. These findings are in agreement with an independently conducted quantitative analysis76 involving a smaller sample of effects (N = 33), in which the mean effect r was 0.17 (95% CI, −0.19 to 0.48). Our findings are more clear than those from a recent summary that relied on a

References (95)

  • U.S. Department of Health and Human Services, Public Health Service. Healthy People 2000: National health promotion and...
  • J.E. Fielding

    Health promotion and disease prevention at the worksite

    Ann Rev Pub Health

    (1984)
  • Stephens T, Craig, C. The well-being of Canadians: the 1988 Campbell’s survey. Ottawa: Canadian Fitness and Lifestyle...
  • C.A. Heaney et al.

    A review of health-related outcomes of multi-component worksite health promotion programs

    Am J Health Prom

    (1997)
  • R.J. Shephard

    Worksite fitness and exercise programsa review of methodology and health impact

    Am J Health Prom

    (1996)
  • R.S. Wanzel

    Decades of worksite fitness programmesprogress or rhetoric?

    Sports Med

    (1994)
  • R. Rosenthal

    Meta-analytic procedures for social research

    (1991)
  • S.G. Aldana et al.

    Mobile work site health promotion programs can reduce selected employee health risks

    J Occup Med

    (1993)
  • S.G. Aldana et al.

    The effectiveness of a mobile worksite health promotion program in lowering employee health risk

    Am J Health Prom

    (1994)
  • J.G. Allen et al.

    Influence of a hospital-based wellness program on employee fitness

    Health Values

    (1987)
  • R.J. Barnard et al.

    Effect of health maintenance programs on Los Angeles city firefighters

    J Occup Med

    (1980)
  • L.A. Bjurstrom et al.

    A program of heart disease intervention for public employees

    J Occup Med

    (1978)
  • S.M. Blake et al.

    The shape-up challengea community-based worksite exercise competition

    Am J Health Prom

    (1996)
  • J. Bobalik et al.

    Alterations in pre-exercise versus post-exercise data after four months of supervised exercise

    Fitness Business

    (1986)
  • L.D. Cady et al.

    Program for increasing health and physical fitness of fire fighters

    J Occup Med

    (1985)
  • B.A. Dalton et al.

    A comprehensive approach to corporate health management

    J Occup Med

    (1991)
  • J.M. Eddy et al.

    Impact of a physical fitness program in a blue-collar workforce

    Health Values

    (1990)
  • J.C. Erfurt et al.

    Health promotion in small businesswhat works and what doesn’t work

    J Occup Med

    (1991)
  • K. Garofalo

    Worksite wellnessrewarding healthy behaviors

    AAOHN J

    (1994)
  • R.Z. Goetzel et al.

    An evaluation of Duke University’s Live for Life health promotion program and its impact on employee health

    Am J Health Prom

    (1996)
  • J. Henritze et al.

    LIFECHECKa successful, low touch, low tech, in-plant, cardiovascular disease risk identification and modification program

    Am J Health Prom

    (1992)
  • M. Jette et al.

    The benefits and challenges of a fitness and lifestyle enhancement program for correctional officers

    Can J Pub Health

    (1991)
  • G.F. Knadler et al.

    “Mountain Climb Month,” a low-cost exercise intervention program at a high-rise worksite

    Fitness Business

    (1987)
  • B.L. Marks et al.

    Can employees successfully manage their own fitness program?

    Am J Health Prom

    (1997)
  • C.A. Owen et al.

    Longitudinal evaluation of an exercise prescription intervention program with periodic ergometric testinga ten-year appraisal

    J Occup Med

    (1980)
  • J.T. Pauly et al.

    The effect of a 14-week employee fitness program on selected physiological and psychological parameters

    J Occup Med

    (1982)
  • G. Shore et al.

    A cost-effective fitness program

    Fitness Business

    (1989)
  • M.C. Yang et al.

    The effects of wellness program attendance on physiologic measures, health practices and diet habits

    Health Ed Res

    (1988)
  • P.M. Yarvotte et al.

    Organization and evaluation of a physical fitness program in industry

    J Occup Med

    (1974)
  • R.S. Zimmerman et al.

    Health promotion in contextThe effects of significant others on health behavior change

    Health Ed Quart

    (1989)
  • P. Leatt et al.

    Seven-year follow up of employee fitness programme

    Can J Publ Health

    (1988)
  • R.J. Shephard et al.

    The impact of changes in fitness and lifestyle upon health care utilization

    Can J Pub Health

    (1983)
  • R.J. Shephard et al.

    Fitness program participationits effect on worker performance

    J Occup Med

    (1981)
  • B.E. Stoffelmayr et al.

    A program model to enhance adherence in work-site-based fitness programs

    J Occup Med

    (1992)
  • J. Walker et al.

    Analysis of lipid profiles after long-term exposure to a corporate fitness program

    Can J Sport Sci

    (1989)
  • M. Cox et al.

    Influence of an employee fitness programme upon fitness, productivity and absenteeism

    Ergonomics

    (1981)
  • R.J. Shephard

    Twelve years experience of a fitness program for the salaried employees of a Toronto life assurance company

    Am J Health Prom

    (1992)
  • View full text