A workplace-based intervention to increase levels of daily physical activity: the Travel to Work cluster RCT

Abstract

Background There may be opportunities for working adults to accumulate recommended physical activity levels (≥ 150 minutes of moderate-intensity physical activity in bouts of ≥ 10 minutes throughout the week) during the commute to work. Systematic reviews of interventions to increase active transport indicate that studies are predominantly of poor quality, rely on self-report and lack robust statistical analyses. Objectives To assess the effectiveness, cost and consequences of a behavioural intervention to increase walking during the commute to work. Design A multicentre, parallel-arm, cluster randomised controlled trial incorporating economic and process evaluations. Physical activity outcomes were measured using accelerometers and GPS (Global Positioning System) receivers at baseline and the 12-month follow-up. Setting Workplaces in seven urban areas in south-west England and south Wales. Participants Employees (n = 654) in 87 workplaces. Interventions Workplace-based Walk to Work promoters were trained to implement a 10-week intervention incorporating key behaviour change techniques. Main outcome measures The primary outcome was the daily number of minutes of moderate to vigorous physical activity (MVPA). Secondary outcomes included MVPA during the commute, overall levels of physical activity and modal shift (from private car to walking). Cost–consequences analysis included employer, employee and health service costs and consequences. Process outcomes included barriers to, and facilitators of, walking during the daily commute. Results There was no evidence of an intervention effect on MVPA at the 12-month follow-up [adjusted difference in means 0.3 minutes, 95% confidence interval (CI) –5.3 to 5.9 minutes]. The intervention cost was on average, £181.97 per workplace and £24.19 per participating employee. In comparison with car users [mean 7.3 minutes, standard deviation (SD) 7.6 minutes], walkers (mean 34.3 minutes, SD 18.6 minutes) and public transport users (mean 25.7 minutes, SD 14.0 minutes) accrued substantially higher levels of daily MVPA during the commute. Participants who walked for ≥ 10 minutes during their commute were more likely to have a shorter commute distance (p < 0.001). No access to a car (p < 0.001) and absence of free workplace car parking (p < 0.01) were independently related to walking to work and using public transport. Higher quality-of-life scores were observed for the intervention group in a repeated-measures analysis (mean 0.018, 95% CI 0.000 to 0.036; scores anchored at 0 indicated ‘no capability’ and scores anchored at 1 indicated ‘full capability’). Conclusions Although this research showed that walking to work and using public transport are important contributors to physical activity levels in a working population, the behavioural intervention was insufficient to change travel behaviour. Broader contextual factors, such as length of journey, commuting options and availability of car parking, may influence the effectiveness of behavioural interventions to change travel behaviour. Further analyses of statistical and qualitative data could focus on physical activity and travel mode and the wider determinants of workplace travel behaviour. Trial registration Current Controlled Trials ISRCTN15009100. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 11. See the NIHR Journals Library website for further project information. Living Streets, a UK charity promoting everyday walking, provided funding for the intervention booklets and free pedometers for distribution to participants in the intervention group.

New Self-Report Measures of Commuting Behaviors to University and Their Association with Sociodemographic Characteristics

“…Consequently, choosing one active mode of commuting to and from university can make a large difference in the annual energy expenditure, as concluded in [ 26 ]. The current data concur with a study carried out in an English adult population that showed that active and public mode of commuting to work were important contributors to PA levels [ 54 ]. In addition, a study in university students from The United States showed that an increase of the energy expenditure per day, week, and year may result in gradual and sustained long-term improvements in cardiometabolic health [ 55 ].…”

An Evaluation of Physical Activity Levels amongst University Employees

“…Therefore, it is suggested that appropriate interventions are implemented to enhance MVPA within the university workplace, to ensure employees are provided with opportunities to be active during working hours. For example, some of the commonly applied and existing interventions focus on walking using step counters (Chomistek et al, 2017), encouraging stair use (Engelen, Gale, Chau, & Bauman, 2018), and active travel to work (e.g., cycle to work scheme or walk to work) (Audrey et al, 2019;Bauman, Crane, Drayton, & Titze, 2017) to improve employees PA engagement in the workplace (Ryde & Brown, 2017).…”

Effects of the COVID‐19 pandemic on recruitment for the working women walking program

“…To Consistent with prior studies (Audrey et al, 2019;Carriedo et al, 2020;Foster et al, 2011;Shaw et al, 2007;Wilbur et al, 2006Wilbur et al, , 2013, our study provided for multiple recruitment strategies, inperson and electronic, that were developed with thorough planning before the onset of the COVID-19 pandemic. Not surprisingly, the percentage of potential participants who heard about the study inperson from program staff went down while institutional emails went up post-COVID-19 onset.…”

“…Therefore, to facilitate recruitment of potential participants with added flexibility and convenience (Carroll et al, 2011 ; Foster et al, 2011 ; Wilbur et al, 2006 ) we planned to incorporate electronic recruitment strategies. We used emails associated with women's employment at the institution, which has been found to be an effective recruitment strategy at workplace settings (Audrey et al, 2019 ). We collaborated with key stakeholders (e.g., human resources, clinicians, and staff) to receive input regarding wording for study description, color, logos, and photographs used for recruitment (Foster et al, 2011 ; Wilbur et al, 2006 , 2013 ).…”