Feasibility and preliminary effects of a peer-led motivationally-embellished workplace walking intervention: A pilot cluster randomized trial (the START trial)

Abstract

Walking interventions can be effective in increasing physical activity amongst physically inactive employees. However, despite their promising potential regarding sustainability and scalability, peer-led workplace walking interventions have not been tested. We evaluated a peer-led workplace group walking intervention designed to engage physically inactive employees. A 16-week pilot cluster randomized controlled trial consisted of enhanced ( 5worksites; n=50 participants) and minimal treatment (3 worksites; n=47) conditions. All participants were provided with a Fitbit Zip and information on health benefits of walking.Enhanced treatment participants had access to a mobile phone app incorporating behavior change techniques, were trained on principles of autonomous motivation, and had a peer leader trained in a motivationally supportive communication style. Feasibility assessments included recruitment and drop-out rates, assessment completion rates, training acceptability (walkers and peer leaders), and intervention acceptability (walkers only). Outcomes assessed included movement-related behaviors (assessed via activPAL devices), cardio-metabolic risk factors, motivation to walk, and well-being, and these measures were taken at baseline and post-intervention. The results supported intervention feasibility. Preliminary efficacy evidence was mixed. Markers of cardio-metabolic risk improved in the enhanced treatment only. Autonomous motivation increased in both conditions. There were no changes in step counts, standing, and sitting time, or well-being. Further fine tuning is needed before a definitive RCT.Australian and New Zealand Clinical Trials Registry: ACTRN12618000807257.

A scoping review of workplace health promotion interventions for chronic diseases in Australia

“…While a vast range of physiological outcomes were measured, blood pressure was the most common and was evaluated in 10 articles 29–31,34,42,47,52,59–61 . Waist and/or hip measurements were the most commonly used anthropometric outcomes 28–32,34,42,47,52,62,63 . This was followed by weight which was measured in 10 articles 28,29,31,32,34,41,42,47,52,59 and BMI that was measured in nine 28,29,31,34,41,42,47,56,62 .…”

“…Other physiological measures and their tools included; BGLs, lipid value, renal function, hs‐CRP via venepuncture, CRF via cycle ergometer tests, upper body strength with the use of a dynamometer or one repetition maximum bench press, lower limb strength via isokinetic dynameter or repetition maximum leg press, insulin via electrochemiluminescence immunoassay and aerobic endurance via two‐minute walk test. Waist and or/hip measurements were obtained via use of a tape measure in six articles 28–32,63 . Weight was measured using electric scales in four articles 28,29,31,32 and via bio‐impedance analysis scale in Healy et al 52 Other anthropometric measures and their tools included; fat mass and fat‐free mass via bio‐impedance analysis scale, total fat and mean mass using a whole‐body dual‐energy X‐ray scan and in one article 62 the measurement tool used to record body mass was not stated.…”

“…[29][30][31]34,42,47,52,[59][60][61] Waist and/ or hip measurements were the most commonly used anthropometric outcomes. [28][29][30][31][32]34,42,47,52,62,63 This was followed by weight which was measured in 10 articles 28,29,31,32,34,41,42,47,52,59 and BMI that was measured in nine. 28,29,31,34,41,42,47,56,62 Other outcomes included fat mass, fat free mass, total fat, lean mass, body mass, and waist-to-height ratio.…”

“…Objective measurement tools included the use of activity monitors or pedometers, sitting pads, manual and infrared observations of stair versus elevator usage, and computer software to record sit-stand desk usage and time away from the desk. [28][29][30][31][32]63 Weight was measured using electric scales in four articles 28,29,31,32 and via bio-impedance analysis scale in Healy et al 52 Other anthropometric measures and their tools included; fat mass and fatfree mass via bio-impedance analysis scale, total fat and mean mass using a whole-body dual-energy X-ray scan and in one article 62 the measurement tool used to record body mass was not stated. Four articles 30,32,41,56 included subjective measurement tools (e.g., self-reported height and weight to calculate BMI).…”

Leading the way together: a cluster randomised controlled trial of the 5R Shared Leadership Program in older adult walking groups

“…Recent work suggests that the influence of peer leaders on team identification might even be greater than that of the coach [ 28 ]. While the promising impact of peer leaders on participants’ group identification has largely been ignored in exercise contexts, several studies illustrate the important role that peer leaders can occupy in exercise groups [ 39 , 40 ]. Peer-delivered interventions were even found to be as effective as professionally-led interventions in increasing physical activity levels [ 41 , 42 ].…”