The effectiveness of using the workplace to identify and address modifiable health risk factors in deprived populations

Abbas, Syed Zakir; Pollard, Tessa M.; Wynn, Philip; Learmonth, Alyson; Joyce, Kerry; Bambra, Clare

doi:10.1136/oemed-2014-102743

Cited by 10 publications

(29 citation statements)

References 16 publications

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“…Nine studies were randomised controlled trials (RCTs) [21][22][23][24][25][26][27][28][29], and two were cluster RCTs -one involving only two worksites [30] and the other several university units [31]. There were also two non-randomised studies [32,33] three pre-and post-evaluations with no comparison group [34][35][36].…”

Section: Study Selections and Characteristicsmentioning

confidence: 99%

“…In total, 3,215 participants (of those 2045 participated in RCTs) were included in the 16 worksite PA interventions: five in the USA [22][23][24][25]31], two in the UK [27,34], and one each in Taiwan [33], Japan [32], Poland [26], Australia [35], the Netherlands [20,21], Switzerland [30], Canada [28], Sweden [29] and Italy [36].…”

Section: Participantsmentioning

confidence: 99%

“…Four interventions were delivered in academic institutions [22,26,28,31], three in hospitals or medical centres [21,25,36], and four were delivered to factory employees [27,[32][33][34]. One intervention was delivered to transport workers (drivers) [35] and three interventions were delivered to office workers [24,29,30].…”

Section: Participantsmentioning

confidence: 99%

“…Table 2 summarises intervention characteristics (for more details see Supplementary Table 1). Six studies addressed multiple cardiovascular risk factors [22,24,25,31,33,34], four targeted PA and nutrition [21,32,35,36] and six focused only on PA [23,[26][27][28][29][30]. Interventions overwhelmingly focused on aerobic PA compared to other domains relevant for older people such as balance, strength and flexibility.…”

Section: Participantsmentioning

confidence: 99%

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Effects on exercise and fitness outcomes of workplace physical activity interventions targeting older employees: A systematic review and meta-analysis

Merom¹,

Stanaway²,

Sweeting³

et al. 2019

Preprint

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Background: “Active Ageing” policy to delay retirement mean that maintaining the health and fitness of older employees has become increasingly important. This systematic review summarises the characteristics and effect on exercise and fitness outcomes of workplace physical activity (PA) interventions targeting older employees. Methods: Five online databases were searched from inception to December 2018. Eligible studies were of any experimental design, included employees aged ≥50 years, had PA as an intervention component and reported PA-related outcomes. Results: Titles and abstracts of 7470 records were screened and 16 unique interventions were included (3,215 participants). Eleven studies were RCTs. Six interventions targeted multiple risk factors (n=1,586) involving screening for cardiovascular disease risk factors, but had a non-specific description of the PA intervention. Four interventions targeted nutrition and PA (n=1,127), and six intervention (n=195) focused only on PA. Seven interventions were short –term (<15 weeks), six interventions lasted 6-9 months and three interventions were long-term (10-12 months). Interventions overwhelmingly targeted aerobic PA compared to strength, balance and flexibility. No studies involved screening for falls/injury risk. Computation of effect sizes (ES) was only possible in a maximum of three RCTs per outcome. ESs were statistically non-significant for all outcomes. ESs were medium for PA behaviour (ES=0.25 95% CI: -0.07 to 0.56), muscle strength (ES=0.27, 95%CI: -0.26- 0.80), cardiorespiratory fitness (ES=0.28, 95%CI: -22 to 0.78) and flexibility (ES=0.50, 95% CI: -0.04- 1.05) and large for balance (ES=1.29, 95% CI: -0.56- 3.15). GRADE criteria-rated quality of evidence were ‘low’ due to high risk of bias, imprecision and inconsistency. Conclusions: The effect of workplace interventions for improving fitness outcomes of older employees is uncertain. There is a need for high-quality PA interventions that takes into account the broader PA recommendations for older adults. Such interventions should incorporate strength and balance training and screening of falls/injury risk in multi risk factors approaches.

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Section: Study Selections and Characteristicsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

See 2 more Smart Citations

Effects on exercise and fitness outcomes of workplace physical activity interventions targeting older employees: A systematic review and meta-analysis

Merom¹,

Stanaway²,

Sweeting³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Thus, early screening for CVD risk factors and risk modification are crucial in reducing complications and deaths. Various modes of CVD risk screening are available, ranging from door-to-door (Wee et al , 2013; US Office of Disease Prevention and Health Promotion (ODPHP), 2019), healthcare facility-based (Baker et al , 2018), workplace-based (Abbas et al , 2015), to outreach program (Zhang et al , 2017). However, a low SES has also been shown to be a barrier to CVD risk screening.…”

Section: Introductionmentioning

confidence: 99%

Association between access to health-promoting facilities and participation in cardiovascular disease (CVD) risk screening among populations with low socioeconomic status (SES) in Singapore

Lim

Kwan

et al. 2019

Prim Health Care Res Dev

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Background: Low socioeconomic status (SES) is a barrier for cardiovascular disease (CVD) risk screening and a determinant of poor CVD outcomes. This study examined the associations between access to health-promoting facilities and participation in a CVD risk screening program among populations with low SES residing in public rental flats in Singapore. Methods: Data from Health Mapping Exercises conducted from 2013 to 2015 were obtained, and screening participation rates of 66 blocks were calculated. Negative binomial regression was used to test for associations between distances to four nearest facilities (i.e., subsidized private clinics, healthy eateries, public polyclinics, and parks) and block participation rate in CVD screening. We also investigated potential heterogeneity in the association across regions with an interaction term between distance to each facility and region. Results: The analysis consisted of 2069 participants. The associations were only evident in the North/North-East region for subsidized private clinic and park. Specifically, increasing distance to the nearest subsidized private clinic and park was significantly associated with lower [incidence rate ratio (IRR) = 0.88, 95% confidence interval (CI): 0.80–0.98] and higher (IRR = 1.93, 95%CI: 1.15–3.25) screening participation rates respectively. Conclusions: Our findings could potentially inform the planning of future door-to-door screenings in urban settings for optimal prioritization of resources. To increase participation rates in low SES populations, accessibility to subsidized private clinics and parks in a high population density region should be considered.

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Factors responsible for healthcare avoidance among rural adults in the Eastern Region of North Carolina

Burch

2022

J Community Health

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Purpose Previous research has identified three common reasons for healthcare avoidance, cost, complexity, and privacy. This study extends prior work by examining the antecedents to these barriers and determining the extent to which they contribute to healthcare avoidance in a rural population. Methods A cross-sectional, regional survey of rural residents from Eastern North Carolina was conducted with questions focused on self-perceived health, healthcare utilization, and healthcare avoidance. Bivariate logistic regression was employed to investigate the predictors of cost, complexity, and privacy-related avoidance. Results Among 946 respondents, a quarter of the sample (N = 240) had not visited a doctor within the past year. Respondents who were uninsured were almost 6-times more likely to endorse avoiding healthcare due to cost (OR = 5.98) and those who had a chronic illness were 3-times as likely to report cost-related avoidance (OR = 3.01). Complexity-related avoidance was predicted by having a chronic illness (OR = 3.77) and a low perception of healthcare value (OR = 2.80). Lastly, privacy-related avoidance was related to being in fair/poor health (OR = 2.61), having a chronic illness (OR = 2.63), reporting low healthcare value (OR = 2.72), and having an external locus of control (OR = 2.96). Conclusions Among avoidant individuals, those with a chronic illness, who could benefit most from continuity of healthcare, are 3-times more likely to avoid healthcare due to cost, complexity, and privacy. The perceived value of healthcare is also associated with complexity- and privacy-related healthcare avoidance. Utilizing alternative methods of healthcare delivery, such as telemedicine and free or reduced cost mobile health clinics, could improve continuity of medical care for rural residents.

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The effectiveness of using the workplace to identify and address modifiable health risk factors in deprived populations

Cited by 10 publications

References 16 publications

Effects on exercise and fitness outcomes of workplace physical activity interventions targeting older employees: A systematic review and meta-analysis

Effects on exercise and fitness outcomes of workplace physical activity interventions targeting older employees: A systematic review and meta-analysis

Association between access to health-promoting facilities and participation in cardiovascular disease (CVD) risk screening among populations with low socioeconomic status (SES) in Singapore

Factors responsible for healthcare avoidance among rural adults in the Eastern Region of North Carolina

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