The Impact of Web-Based Feedback on Physical Activity and Cardiovascular Health of Nurses Working in a Cardiovascular Setting: A Randomized Trial

Abstract

A disconcerting proportion of Canadian nurses are physically inactive and report poor cardiovascular health. Web-based interventions incorporating feedback and group features may represent opportune, convenient, and cost-effective methods for encouraging physical activity (PA) in order to improve the levels of PA and cardiovascular health of nurses. The purpose of this parallel-group randomized trial was to examine the impact of an intervention providing participants with feedback from an activity monitor coupled with a web-based individual, friend or team PA challenge, on the PA and cardiovascular health of nurses working in a cardiovascular setting.Methods: Nurses were randomly assigned in a 1:1:1 ratio to one of the following intervention “challenge” groups: (1) individual, (2) friend or (3) team. Nurses wore a Tractivity® activity monitor throughout a baseline week and 6-week intervention. Height, body mass, body fat percentage, waist circumference, resting blood pressure (BP) and heart rate were assessed, and body mass index (BMI) was calculated, during baseline and within 1 week post-intervention. Data were analyzed using descriptive statistics and general linear model procedures for repeated measures.Results: 76 nurses (97% female; age: 46 ± 11 years) participated. Weekly moderate-to-vigorous intensity PA (MVPA) changed over time (F = 4.022, df = 4.827, p = 0.002, η2 = 0.055), and was greater during intervention week 2 when compared to intervention week 6 (p = 0.011). Daily steps changed over time (F = 7.668, df = 3.910, p < 0.001, η2 = 0.100), and were greater during baseline and intervention weeks 1, 2, 3, and 5 when compared to intervention week 6 (p < 0.05). No differences in weekly MVPA or daily steps were observed between groups (p > 0.05). No changes in body mass, BMI or waist circumference were observed within or between groups (p > 0.05). Decreases in body fat percentage (−0.8 ± 4.8%, p = 0.015) and resting systolic BP (−2.6 ± 8.8 mmHg, p = 0.019) were observed within groups, but not between groups (p > 0.05).Conclusions: A web-based intervention providing feedback and a PA challenge initially impacted the PA, body fat percentage and resting systolic BP of nurses working in a cardiovascular setting, though increases in PA were short-lived. The nature of the PA challenge did not differentially impact outcomes. Alternative innovative strategies to improve and sustain nurses' PA should be developed and their effectiveness evaluated.

Effectiveness of Lifestyle Health Promotion Interventions for Nurses: A Systematic Review

“…A further six studies reported no significant change in health or physical symptoms [75,126,130,131,147,168], as measured by Short Form-36 [130,147,168], SCL-90 [147], health complaints [75], GHQ [126], or cardiovascular health (i.e., resting blood pressure, [131]). Of the six studies reporting no changes in measures of health or physical symptoms, three were RCTs [75,130,131], and three were non-randomised controlled studies [126,147,168]. The interventions failing to demonstrate positive outcomes used PA [130,131], PA with mindfulness [126], PA with stress education [75], mindfulness [147] and art-based relaxation [168].…”

“…Thirty-five studies included some form of PA [60,69,75,76,78,83,88,96,98,. The PA interventions included walking [83,88,96,113,115,119,123,127,131,133,136], standing [119], aerobics [60,75], aerobics and resistance exercise [118], yoga [116,122,125,126,132,135], Tai-Chi [130], endurance training [117], muscle strength promotion [117,128], stretching [119,134,137], daily exercise [78,121], physiotherapy exercise [76], exercises with equipment (stair-stepper: [114], treadmill, Wii TM : [96,115], elastic bands and kettlebells [120,137,138], back muscle exercises [98,…”

“…[ii] Body Composition: The most often included measures were BMI [67,83,97,[112][113][114][115][116][117]123,128,131], fat mass [97,115,131], and waist circumference [113,116,123,128,131]. Only one study included the measure of dual-energy X-ray absorptiometry [96].…”

“…A small number of studies used objective measures of PA (see below). The objective measures included activity trackers (pedometers [96,112,115,123,131], or accelerometers [113]); the UKK walking test [75], or aerobic capacity using the VO 2max test [117,118]. [v] Smoking Behaviour: The measures included abstinence [141], number of cigarettes smoked, number of nurses smoking, nicotine dependence, confidence to resist smoking [142], carbon monoxide (CO) level, and smoking cessation status [143].…”

“…Of the six studies reporting no changes in measures of health or physical symptoms, three were RCTs [75,130,131], and three were non-randomised controlled studies [126,147,168]. The interventions failing to demonstrate positive outcomes used PA [130,131], PA with mindfulness [126], PA with stress education [75], mindfulness [147] and art-based relaxation [168]. None of the studies reported other clinical outcomes.…”