Research article
Move to Improve: A Randomized Workplace Trial to Increase Physical Activity

https://doi.org/10.1016/j.amepre.2008.09.038Get rights and content

Background

Workplaces are important settings for interventions to increase physical activity, but effects have been modest.

Purpose

To evaluate the efficacy of Move to Improve, a social–ecologic intervention delivered at the workplace to increase leisure-time physical activity.

Methods

A group-randomized 12-week intervention consisting of organizational action and personal and team goal-setting was implemented in Fall 2005, with a multi-racial/ethnic sample of 1442 employees at 16 worksites of The Home Depot, Inc. Change in physical activity was analyzed in Fall 2007 using latent growth modeling and latent transition analysis.

Results

Participants in the intervention had greater increases in moderate and vigorous physical activity and walking compared to participants in a health education control condition. The proportion of participants that met the Healthy People 2010 recommendation for regular participation in either moderate or vigorous physical activity remained near 25% at control sites during the study but increased to 51% at intervention sites. During the last 6 weeks of the study, intervention participants exceeded 300 weekly minutes of self-reported moderate-to-vigorous physical activity and 9000 daily pedometer steps.

Conclusions

The results support the feasibility and efficacy of the Move to Improve intervention and the role of goal-setting for attaining increased physical activity levels.

Introduction

Despite intervention,1, 2, 3 physical activity among U.S. adults is below levels recommended for health promotion.4 Although three of four adults say they engaged in leisure-time physical activity during the past month,5 fewer than half participated at the recommended level of moderate activity for at least 30 minutes 5 or more days per week or vigorous activity for at least 20 minutes 3 or more days per week.6, 7

Workplaces are important settings for interventions to increase physical activity,2 but systematic reviews did not conclude that past interventions were successful.8, 9 Nonetheless, the modest cumulative effect of physical activity interventions at workplaces is likely an underestimate of the potential impact of a well-implemented theory-based intervention applied with sound research design and methodology.9

Goal-setting is a powerful approach to changing the direction, regulation, and persistence of effort.10 However, previous goal-setting interventions applied to physical activity had several methodologic limitations,11 including the use of non-experimental12, 13, 14 and quasi-experimental15, 16 designs or the use of proxy, or poorly validated, measures of physical activity. A few RCTs of goal-setting used pedometers to provide a concurrent, objective measure of physical activity17, 18, 19; however, it wasn't clear whether the goal-setting was consistent with theory.10 There also is agreement that environmental factors are associated with choices to be physically active,20 and the use of environmental prompts and organizational efforts to support and involve employees is established in workplace health promotion.21, 22 However, few physical activity interventions at the workplace included environmental action.8, 23

This article reports on the efficacy of a group-randomized, controlled trial of a 12-week intervention that increased moderate-to-vigorous physical activity (MVPA) among employees by targeting features of the workplace environment and employee motivation using personal and team goal-setting. Based on management theory,24 employee ratings of perceived management support and employee involvement were assesses to confirm implementation and impact of the organizational action component of the intervention.

Section snippets

Subjects and Setting

The investigation was a collaborative effort with the Building Better Health (BBH) program of The Home Depot, Inc., which offers health promotion programs at approximately 1700 Home Depot locations. Participants in the study were 1442 employees (aged 19–64 years; 36.2±9.8) of The Home Depot, Inc., without overt cardiovascular, pulmonary, or metabolic disease, who signed a consent form approved by the IRB on December 1, 2004. Participants were predominantly female (69%). Racial percentages were:

Results

Among intervention participants, large increases in MVPA occurred during the first 2 weeks of the intervention and exceeded 300 minutes per week after Week 6 (Figure 2). Pedometer steps increased throughout the intervention, exceeding 9000 steps per day after Week 5 (Figure 3). Intraclass correlation (ICC-2) stability coefficients across weeks were 0.96 for minutes of MVPA and 0.92 for pedometer steps. The mean scores and standard deviations for the measures of physical activity across the

Discussion

The results support the efficacy of the Move to Improve intervention and the usefulness of goal-setting for attaining increased physical activity consistent with current public health recommendations.4, 42, 43 The increase from 31% to 51% in the proportion of participants in the intervention who were regularly active in either moderate or vigorous physical activity during the last 6 weeks of the intervention would be meaningful for public health if it could be sustained. National estimates of

References (50)

  • B.H. Marcus et al.

    Physical activity intervention studies: what we know and what we need to know: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity); Council on Cardiovascular Disease in the Young; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research

    Circulation

    (2006)
  • E.A. Locke et al.

    Building a practically useful theory of goal setting and task motivation

    Am Psychol

    (2002)
  • M.K. Shilts et al.

    Goal setting as a strategy for dietary and physical activity behavior change: a review of the literature

    Am J Health Prom

    (2004)
  • G. Cole et al.

    Using “stages of behavioral change” constructs to measure the short-term effects of a worksite-based intervention to increase moderate physical activity

    Psychol Rep

    (1998)
  • B.B. Green et al.

    Active for Life: a work-based physical activity program

    Prev Chron Dis

    (2007)
  • C.A. McCarty et al.

    Lessons learned from employee fitness programs at the Marshfield clinic

    Wisc Med J

    (2005)
  • J.E. Martin et al.

    Behavioral control of exercise in sedentary adults: studies 1 through 6

    J Consult Clin Psychol

    (1984)
  • D.A. Harrison et al.

    Promoting regular exercise in organizational fitness programs: health-related differences in motivational building blocks

    Personnel Psychol

    (1994)
  • C.R. Richardson et al.

    A randomized trial comparing structured and lifestyle goals in an Internet-mediated walking program for people with type 2 diabetes

    Int J Behav Nutr Phys Act

    (2007)
  • L.A. Talbot et al.

    A home-based pedometer-driven walking program to increase physical activity in older adults with osteoarthritis of the knee: a preliminary study

    J Am Geriatr Soc

    (2003)
  • M.G. Wilson et al.

    Maximizing participation and adherence in health promotion programs

  • K.R. McLeroy et al.

    An ecological perspective on health promotion programs

    Health Educ Q

    (1988)
  • C. Foster et al.

    Changing the environment to promote health-enhancing physical activity

    J Sports Sci

    (2004)
  • E.E. Lawler

    The ultimate advantage: creating the high-involvement organization

    (1992)
  • I. Boutron et al.

    CONSORT GroupExtending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration

    Ann Intern Med

    (2008)
  • Cited by (110)

    View all citing articles on Scopus
    View full text