Background
Physical inactivity and health
Walking as active travel
Measuring physical activity
Costs and benefits of walking as active travel
Aim and objectives of the current study
Methods
Trial design
Sample size
Recruitment and eligibility
Consent procedures
Physical activity measures and outcomes
Initialising | Accelerometers initialised to start recording on day after distribution and to store data for 7 days including a weekend. |
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Data collection points | Baseline, 1-year follow-up |
Protocol | Single Actigraph GT3X+ monitor, worn around the waist over the same hip during waking hours (except when swimming/bathing/showering). |
Wear time | Waking hours (usually 6.00 am – midnight but this will be modified, for example, for shift workers) |
Valid length of day | ≥10 h (600 min) |
Days required | 3 days |
Epoch length | 10 s |
Zero counts | Bouts of 60 min of continuous/consecutive zero counts excluded |
Spurious data | > 15,000 cpm |
Missing data | No imputation |
Activity cut-points | Sedentary < 100 cpm; MVPA ≥1952 cpm [19] |
Outcomes | i) Moderate to vigorous physical activity (MVPA) ii) Sedentary time iii) Overall physical activity, mean counts per minutes (cpm) |
Health economic costs and outcomes
Randomisation procedures
The walk to work intervention
Walk to work promoter recruitment and training
Participant booklets and newsletters
Information and ideas for employers
Process evaluation
Statistical methods
Results
Recruitment and retention
Intervention (n = 44) | Control (n = 43) | |
---|---|---|
n (%) | n (%) | |
Location | ||
Swansea (including Newport and Neath Port Talbot) | 13 (30%) | 13 (30%) |
Bath (including Swindon) | 8 (18%) | 6 (14%) |
Bristol (including South Gloucestershire) | 23 (52%) | 24 (56%) |
Size of business | ||
Micro (5–9 employees) | 4 (9%) | 6 (14%) |
Small (10–49 employees) | 21 (48%) | 14 (33%) |
Medium (50–250 employees) | 9 (20%) | 13 (30%) |
Large (250+ employees) | 10 (23%) | 10 (23%) |
Most often used method of travel to work by employees | ||
Car or motorised transport | 32 (73%) | 31 (72%) |
Public transport | 1 (2%) | 1 (2%) |
Walk or cycle | 1 (2%) | 0 (0%) |
Unknown | 10 (23%) | 11 (26%) |
Proportion of employees that walk or cycle all the way to work | ||
None or hardly any | 13 (30%) | 12 (28%) |
Less than half | 23 (52%) | 21 (49%) |
Most | 1 (2%) | 0 (0%) |
All | 1 (2%) | 0 (0%) |
Unknown | 6 (14%) | 10 (23%) |
UK Standard Industrial Classification (SIC) Categories 2007 | ||
C: Manufacturing | 4 (9%) | 2 (5%) |
D: Electricity, gas, steam & air conditioning supply | 0 (0%) | 1 (2%) |
F: Construction | 1 (2%) | 0 (0%) |
G: Wholesale & retail trade; repair of motor vehicles & motor cycles | 4 (9%) | 2 (5%) |
H: Transport & storage | 0 (0%) | 1 (2%) |
K: Financial & insurance activities | 2 (5%) | 2 (5%) |
M: Professional, scientific & technical activities | 10 (23%) | 11 (26%) |
N: Administrative & support service activities | 5 (11%) | 3 (7%) |
O: Public administration & defence; compulsory social security | 4 (9%) | 4 (9%) |
P: Education | 5 (11%) | 6 (14%) |
Q: Human health & social work activities | 6 (14%) | 5 (12%) |
R: Arts, entertainment & recreation | 1 (2%) | 4 (9%) |
S: Other service activities | 2 (5%) | 2 (5%) |
Intervention | Control | |||
---|---|---|---|---|
n | n (%) | n | n (%) | |
Participant Demographics | ||||
Total participants | 331 | 323 | ||
Gender: Male | 331 | 143 (43%) | 323 | 140 (43%) |
Age (years) | 321 | 41.2 (11.4) | 314 | 42.0 (11.3) |
BMI: | ||||
Underweight and normal | 331 | 149 (45%) | 323 | 144 (45%) |
Overweight | 99 (30%) | 92 (28%) | ||
Obese | 53 (16%) | 52 (16%) | ||
Missing | 30 (9%) | 35 (11%) | ||
Household income: | ||||
Up to £10,000 | 313 | 1 (< 1%) | 305 | 3 (1%) |
£10,001 - £20,000 | 14 (4%) | 25 (8%) | ||
£20,001 - £30,000 | 39 (12%) | 39 (13%) | ||
£30,001 - £40,000 | 51 (16%) | 49 (16%) | ||
£40,001 - £50,000 | 67 (21%) | 53 (17%) | ||
More than £50,000 | 118 (38%) | 117 (38%) | ||
Don’t know | 23 (7%) | 19 (6%) | ||
Ethnicity: | ||||
White British | 317 | 288 (91%) | 310 | 279 (90%) |
White other | 15 (5%) | 14 (5%) | ||
Mixed ethnic group | 4 (1%) | 3 (1%) | ||
Asian or British Asian | 3 (1%) | 6 (2%) | ||
Black or Black British | 7 (2%) | 5 (2%) | ||
Chinese | 0 (0%) | 3 (1%) | ||
Education: | ||||
Higher degree, degree or equivalent | 315 | 195 (62%) | 309 | 182 (59%) |
A-levels or equivalent | 74 (23%) | 79 (26%) | ||
GCSEs or equivalent | 41 (13%) | 43 (14%) | ||
No formal qualifications | 5 (2%) | 5 (2%) | ||
Current method of travel to work (by journeys) | ||||
Car | 327 | 217 (66%) | 313 | 205 (65%) |
Public transport | 44 (13%) | 32 (10%) | ||
Walk | 32 (10%) | 42 (13%) | ||
Cycle | 34 (10%) | 34 (11%) | ||
Distance between workplace and home (km) | ||||
2 km or less | 319 | 35 (11%) | 307 | 30 (10%) |
Over 2 km | 280 (88%) | 277 (90%) | ||
Current occupation | ||||
Sedentary | 315 | 239 (76%) | 299 | 237 (79%) |
Standing | 60 (19%) | 42 (14%) | ||
Manual | 15 (5%) | 20 (7%) | ||
Heavy manual work | 1 (< 1%) | 0 (0%) |
Intervention delivery
Adverse events
Outcomes and estimation
Outcome | Intervention mean (SD) N | Controlmean (SD) N | Adjusted difference in meansa (95% CI) | P-valuea | ||
---|---|---|---|---|---|---|
Baseline | Follow-up | Baseline | Follow-up | |||
Primary | ||||||
i) Daily minutes of moderate to vigorous physical activity (MVPA) | 55.0 (24.9) 142 | 53.3 (23.7) 142 | 57.7 (37.0) 180 | 53.9 (27.6) 180 | 0.3 (−5.3, 5.9) | 0.917 |
Secondary | ||||||
ii) Overall physical activity (counts per minute) | 390.5 (144.2) 142 | 387.6 (148.5) 142 | 417.1 (267.4) 180 | 392.7 (168.8) 180 | 3.5 (−30.3, 37.4) | 0.838 |
iii) Sedentary time (minutes per day) | 585.5 (63.3) 141 | 580.0 (97.0) 141 | 581.9 (80.1) 178 | 585.4 (108.6) 178 | 1.0 (−11.7, 13.6) | 0.882 |
iv) Daily minutes of MVPA during commute | 13.9 (14.1) 183 | 13.8 (14.0) 183 | 13.3 (15.1) 213 | 16.2 (19.0) 213 | −3.1 (−6.0, −0.2) | 0.036 |
Sensitivity analyses of primary outcome | ||||||
Daily minutes of MVPA: 1 day of valid data | 52.6 (25.0) 189 | 51.1 (23.7) 189 | 55.5 (35.1) 217 | 52.6 (28.1) 217 | −0.4 (−5.3, 4.5) | 0.876 |
Outcome | Intervention mean (SD) n | Control mean (SD) n | Adjusted difference in means between control and intervention within subgroup* (95% CI) | Interaction test P-value* | ||
---|---|---|---|---|---|---|
Baseline | Follow-up | Baseline | Follow-up | |||
Daily minutes of moderate to vigorous physical activity (MVPA) | ||||||
Age (<median) | 55.2 (23.2) 61 | 56.3 (24.7) 61 | 63.2 (46.7) 77 | 60.6 (26.8) 77 | −1.9 (−9.8, 6.0) | |
Age (≥median) | 54.9 (26.3) 81 | 51.0 (22.8) 81 | 53.6 (27.2) 103 | 48.9 (27.2) 103 | 1.6 (−5.5,8.6) | 0.496 |
Sex (Male) | 58.1 (24.8) 57 | 56.4 (23.7) 57 | 61.8 (50.1) 71 | 56.0 (31.3) 71 | 1.5 (−6.8, 9.9) | |
Sex (Female) | 53.0 (24.9) 85 | 51.1 (23.6) 85 | 55.0 (24.9) 109 | 52.6 (25.0) 109 | −0.8 (−7.7, 6.2) | 0.664 |
Household income (below £30,000 or missing) | 52.4 (24.2) 32 | 54.4 (23.2) 32 | 54.6 (25.5) 41 | 53.8 (24.6) 41 | 2.6 (−8.3, 13.5) | |
Household income (above £30,000) | 55.8 (25.2) 110 | 52.9 (24.0) 110 | 58.6 (39.8) 139 | 54.0 (28.5) 139 | −0.4 (−6.6, 5.8) | 0.628 |
Distance from work (2 km or less) | 58.7 (26.3) 20 | 57.2 (25.4) 20 | 59.9 (22.7) 12 | 64.5 (34.0) 12 | −6.8 (−23.2, 9.7) | |
Distance from work (more than 2 km) | 54.7 (24.7) 121 | 52.9 (23.4) 121 | 57.3 (38.0) 164 | 53.1 (27.1) 164 | 0.4 (−5.5, 6.3) | 0.419 |
Economic evaluation
Workplace sizea | Intervention materials costs (£)b | Promoter training | Total cost per workplace (£) | Cost per employee (£) | |
---|---|---|---|---|---|
Training delivery cost (£)c | Promoter cost(£)d | ||||
Micro | 31.58 | 130.50 | 20.69 | 182.77 | 43.01 |
Small | 42.78 | 97.86 | 19.05 | 159.68 | 25.60 |
Medium | 44.55 | 134.19 | 29.12 | 207.86 | 34.01 |
Large | 73.26 | 107.08 | 24.83 | 205.16 | 16.03 |
All | 49.05 | 110.35 | 22.57 | 181.97 | 24.19 |
Intervention mean (SD) n | Control mean (SD) n | Adjusted difference in means (95% CI)b | P-valueb | |||
---|---|---|---|---|---|---|
Post-intervention | Follow-up | Post-intervention | Follow-up | |||
Productivity | ||||||
Self-assessed productivity | 2.230 | 2.262 | 2.563 | 2.853 | −0.406 | 0.019 |
(1.872) | (1.827) | (2.173) | (2.450) | (−0.744 to −0.067) | ||
200 | 195 | 263 | 231 | |||
Self-reported days of work missed | 1.005 | 2.013 | 1.441 | 1.709 | −0.142 | 0.733 |
(2.795) | (6.111) | (5.125) | (4.579) | (−0.961 to 0.677) | ||
199 | 194 | 262 | 232 | |||
Lost earnings | ||||||
Based on self-assessed productivity | £701.32 | £719.30 | £891.04 | £1056.44 | -£231.35 | 0.019 |
(£1067.41) | (£1041.80) | (£1238.79) | (£1397.15) | (−£424.77 to -£37.92) | ||
200 | 195 | 263 | 231 | |||
Based on self-reported days of work missed | £88.16 | £176.57 | £126.39 | £149.92 | -£12.50 | 0.733 |
(£245.15) | (£536.05) | (£449.57) | (£401.70) | (−£84.34 to £59.33) | ||
199 | 194 | 262 | 232 | |||
Quality of life | ||||||
ICECAP-A | 0.852 | 0.840 | 0.825 | 0.823 | 0.018 | 0.056 |
(0.136) | (0.134) | (0.143) | (0.152) | (0.000 to 0.036) | ||
197 | 196 | 264 | 228 | |||
Commuting to work | ||||||
Commute costsa | £9.32 | £10.99 | -£1.15 | 0.245 | ||
(£7.67) | (£12.19) | (−£3.10 to £0.79) | ||||
140 | 131 |