Sarah Spence

HLTH 634
2/5/17

Literature Review
Introduction

There are more than 80 percent of adults that do not meet the guidelines for both aerobic
and muscle-strengthening activities. The physical activity objectives for 2020 state that physical
activity levels are positively affected by: structural environment, such as the availability of
sidewalks, bike lanes, trails, parks, and legislative policies that improve access to facilities.
Physical activity is important because it can improve the health and quality of life of Americans
of all ages, regardless of the presence of a chronic disease or disability.1 Many adults today do
not have the time to exercise due to working long shifts and having no energy, motivation or
drive to exercise after work, and especially those that have children find it difficult to set aside
time to exercise after work because they have to cook or take care of other important things such
as family events.

Promoting physical activity in the workplace will allow employees to understand the
importance of physical activity, engage in workplace physical activities, receive the necessary
support and to commit to living an active lifestyle. Physical activity can lower the risk of:
depression, early death, falls, coronary heart disease, breast and colon cancer, stroke, type 2
diabetes, and high blood pressure.1 Fit n Work will allow employees to engage in physical
activities at work, educate them on the importance of physical activity, create exercise plans
specific to employees, and teach them the basics on pursuing and living an active lifestyle while
partnering with a local YMCA. The organization of this review will be explained in three parts:
This Introduction, next the Body of Evidence, and lastly, the Summary and Conclusions. The
selection criteria that were used to include in this review were: Workplace interventions for
physical activity or diet conducted in a workplace setting, references that have primary outcome
data, adequate statistical information, and reported outcomes of an intervention study that were
designed to increased energy expenditure.2

Body of Evidence

The references chosen for this review were: Reviews and theoretical articles. The reviews
had the following in common: The goals of these reviews were to increase physical activity in
the workplace whether it be through health education the use of pedometers, accelerometers,
installing treadmill workstations in offices, stair case use promotion, work recreation teams
created in the workplace, on site gyms in the workplace, and exercise classes, The articles chosen
in the review also showed effort to promote physical activity in the workplace. In Physical
Activity in Office Workers The Inphact Treadmill Study, the findings were: Using an
accelerometer and inclinometer to obtain valid measurements to see ow active a person was,
parameters such as cognitive function, and stress hormones were also explored.2 Findings also
consisted of the analysis of showing if the intervention with active workstations had any effects
on sedentary time and activity levels at work.2 The Workplace nutrition and Physical Activity
promotion at Liverpool Hospital article had the following findings: Encouragement from
colleagues, as well as the pedometer, and the 10,000 steps website were the two main motivating
factors to keep people going during this challenge, and the pedometer increased the level of
physical activity for 84.2% of participants at the worksite.

Findings also showed that the Liverpool Hospital Team Challenge was successful in
increasing participants physical activity level and healthy eating habits.3 In The effect of a
multi-strategy Workplace Physical Activity Intervention Promoting Pedometer Use and Step
Count Increase, the findings were: This effort could be unrealistic and unaffordable in a public
health promotion perspective, the intervention effects for the daily step counts were actually
significant, but one could doubt the importance for health and well-being of a reduced seasonal
step count decline. Also, the intervention did not result in increased physical activity in total
sample, but the project awareness was very high and the employees had a good to very good
evaluation of the intervention strategies.4 Findings of article Evaluation of a Workplace
Treadmill Desk Intervention were: findings suggested that a shared-treadmill desk paradigm
implemented in a real-world office workplace and coupled with structured behavioral support
strategies, can be effective in promoting positive changes in Physical Activity behaviors among
overweight and obese office workers. Findings also suggested that changes cannot be used to
justify using treadmill desks as a replacement for exercise as promoted in public health
recommendations.5 This study was similar to the Inphact Treadmill Study because treadmill
workstations were also installed in offices, physical activity and sedentary activity was
measured, and accelerometers were both used to track measurements.

These studies differed in that the Inphact Treadmill study was for 13 months and the other
study for 3 months, and one study says that structured behavior strategies will be successful for
future interventions, and the other study suggests active workstations being useful for the future.
Article Office-Based Physical Activity & Nutrition Intervention: Barriers, Enablers, and
Preferred Strategies for Workplace Obesity Prevention showed findings that preferred
intervention strategies were: stretching programs at office desks, group classes offered at the
worksite, and participation in corporate gym memberships, and intervention strategy preferences
demonstrated employee support for health promotion in the workplace.6 This article had some
similarities to another article Enhancing Workplace Wellness Efforts to Reduce Obesity: A
Qualitative Study of Low-Wage Workers in St. Louis, Missouri which were: findings that
several successful initiatives were an on-site gym, exercise classes, and two weight loss
challenges each year. According to the Office-Based Article referenced earlier, findings
suggested that more emphasis should be placed on educating employees about the health benefits
of physical activity, and that group exercise classes provided a socially supportive environment
and an effective key to encourage physical activity. 6 Now referencing the Enhancing Workplace
Wellness Efforts Article, findings suggested also, that social support and accountability to
coworkers could improve their ability to initiate and maintain healthy behaviors, and that
workplace participatory programs are a promising approach to engage workers in, and some
differences within this article are: incentives within programs need to be ongoing to have
maximum impact, because behavioral effects tend to be short-lived after incentives are removed.7
Opportunities for Increased Physical Activity in the Workplace and A systematic review of
workplace health promotion Interventions for increasing Physical Activity articles were also
similar in that employees were given pedometers to wear and in the Opportunities for Increased
P.A. article, the walking protocol that encouraged walking and raised levels of physical activity
in the workplace was needed to counter the negative health effects of sedentary behavior.8

In the Systematic Article, the intervention that allowed employees to take an active role
in designing and implementing health promotion activities was more effective in improving
exercise habits than a standard self-help program on physical activity. The article also suggested
that there was a need for more well-designed studies to fully determine the effectiveness of
workspace interventions for increasing physical activity, and the firm recommendations about the
effectiveness of workplace interventions for increasing physical activity or the types of
interventions that show the most promise are still not possible.9 In the article Improving
Nutrition and Physical Activity in the Workplace: A Meta-Analysis of Intervention Studies,
findings were: Most support for workplace interventions that used motivation enhancement such
as motivational interviewing or the use of rewards.10 Another finding of this study was that when
the focus was on one area of behavior change, it was associated with a larger effect size than
those focused on more than one health behavior. The study also found that randomized controlled
trials were associated with larger effects.10 Lastly, in the article, Improved fitness after a work-
based physical exercise program, findings were: Individual fitness was increased within one
year over time in terms of test scores and perceived exertion, and these findings also do not
follow conceptual models linking individual improvements in fitness to productivity.11

Summary and Conclusions

The main contributions of some references to knowledge about the priority population,
problem, and evidence supporting the purpose stated earlier are: The most successful
interventions included an on-site gym, exercise classes, and the social support of the
participating employees. Many references also had focus groups that discussed worksite factors
that supported healthy eating and physical activity and also barriers of participation in worksite
programs. Reaching the population was also an important contribution of the references, and in
order to do so, some employees took surveys before they began the program. The surveys
consisted of questions that allowed employees to give a background of their physical activity and
what interested them and what they were looking forward to improving regarding their physical
activity lifestyle.

Another main contribution of the references is that people do not have a lot of time to
engage in physical activity outside of work, and also for the employer, improved health
outcomes associated with successful interventions may also lead to reduced absenteeism and sick
leave and as a result, increased productivity, so there are health benefits for the employee being
able to engage in physical activity at the workplace, and it also benefits the employer.10 There
were some differences in conclusions among the studies chosen. Majority of the references
worked and were beneficial, but there were also some studies that could not reach a clear
conclusion. Some flaws of the research was there being no control group, biased results of the
survey due to exaggeration, and the pedometer only being able to detect subtle behavior, which
isnt captured in surveys. Some areas for future research of the references were: investigations
comparing shared and dedicated use of treadmill stations at office desks, find solutions that can
target sedentary behavior while at work, research is needed to evaluate the development process
and effectiveness of programs, and more workplace interventions are needed to show positive
improvements of physical activity. In the research there was also a gap in evidence regarding the
workplace health promotion article stating that there was inconclusive evidence regarding the
efficacy of tailoring interventions to particular stages of change.9 There is a great need for
physical activity in the workplace. Studies show that this is very important and that employees
greatly benefit from it, especially when they are receiving social support through their workouts.
Fit n Work would be a great intervention to help employees stay on top of their daily physical
activity, and enjoy themselves at the same time.