Research articleMove to Improve: A Randomized Workplace Trial to Increase Physical Activity
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
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