Impact of a pedometer-based physical activity challenge on behavioral, biomedical, anthropometric and psychological outcomes in hospital employees: An interventional study

Background Health promotion programmes often incorporate the use of a pedometer to increase physical activity (PA). Although many studies have examined the influence of the pedometer on PA at the workplace, very few have directly targeted hospital employees and the anthropometric, biomedical, psychological, and behavioral benefits they could experience following a pedometer-based PA intervention. The aim of the present study was to examine the anthropometric, biomedical, psychological and behavioral benefits associated with the use of a pedometer in a PA challenge with a wide range of hospital employees. Methods A total of 310 employees of a university-affiliated multi-site healthcare centre in Canada, from 24 to 70 years of age and of different types of jobs and work schedules, were voluntarily enrolled in an eight–week pedometer-based PA programme aimed at increasing PA as well as improving fruit and vegetable consumption. Data were collected at baseline and after the eight-week challenge using clinical measurements and questionnaires that were classified into five categories: socio-demographic, anthropometric, biomedical, psychological, and behavioral. Paired sample t-tests were conducted on the baseline and post-programme data to detect significant differences between the measurement points. Further analyses, including univariate analyses of covariance, were conducted on the post-programme scores to detect significant differences in the study variables between pedometer-determined PA groups. Results Behavioral, biomedical, anthropometric and psychological benefits were associated with the PA intervention. Hospital employees also exhibited significant changes in anthropometric measures, such as lower weight and body mass index which is in line with previous studies. The present intervention also led to an increase in moderate PA and to a decrease in time spent sitting, to improvements in biomedical and psychological outcomes. Conclusion The results highlight that the use of a pedometer is associated with significant increases in PA and significant decreases in weight, BMI, blood pressure and cholesterol as well as in stress, fatigue and sleep problems. This underscores the importance of such interventions in the hospital setting. Impact of a pedometer-based physical activity challenge on behavioral, biomedical, anthropometric and psychological outcomes in hospital employees: An interventional study Editorial Office, WHO-CC • Clinical Health Promotion Centre • Bispebjerg / Frb University Hospital, Denmark Copyright © Clinical Health Promotion Research and Best Practice for patients, staff and community, 2013 Research and Best Practice C L I N I C A L • H E A L T H • P R O M O T I O N • s t a ff c o m p e t e n c i e s e vi de nc e ent pefer e n c e s C L I N I C A L • L T R O M O T I O N • s t a ff c o m p e t e n c i e s e vi de nc e ti t pefer e n c e s Volume 3 | Issue 1 www.clinhp. org May/June | 2013 | Page 6 Editorial Office, WHO-CC • Clinical Health Promotion Centre • Bispebjerg / Frb University Hospital, Denmark Copyright © Clinical Health Promotion Research and Best Practice for patients, staff and community, 2013 further screened by a health professional. Candidates who were pregnant, had a cardiovascular disease, or a serious orthopaedic problem that could be made worse with exercise, needed clearance from a physician. Intervention The “Wellness Challenge” intervention comprised a one-hour on-site lunch lecture, 30-minute one-on-one preand post-evaluations during work hours and the eight-week pedometer activity challenge (September 19 to November 13, 2011). The activity challenge involved tracking step counts, step equivalents of other physical activities, as well as tracking fruit and vegetable consumption on a website. The lunch-hour lecture provided information on PA and nutrition as well as instructions on proper pedometer use. A goal of 10,000 steps and a goal of being the first site to cross Canada virtually as a group was used as motivators. The website allowed participants to see their progress as individuals, as a team and as an entire group (measurement of how many times they walked around the world). The website developed by the CHIP (Complete Health Improvement Program) team (comprised of trained and licensed facilitators) also provided health risk assessments and educational modules on various health factors—including cardiovascular disease, blood pressure, cholesterol, smoking, sleep, stress, depression, exercise, weight loss, and nutrition. Participants were invited to register with partners or as small groups, with colleagues from their department, to enhance social support. All eligible participants received a pedometer at the lecture and a code to access the programme website. Assessments Data were collected at baseline and after the eight-week challenge using questionnaires completed by participants (by mail and in person) as well as clinical measurements collected by trained staff during the preand post-screening evaluations at the workplace. Clinical measurements and questionnaires were classified into five categories (15): socio-demographic, anthropometric, biomedical, psychological and behavioral. Socio-demographic Date of birth, gender, smoking status, presence of cardiovascular disease (CVD) and diabetes, family history of CVD and diabetes, and current medications were collected at the preand post-screening evaluations Anthropometric Trained staff measured weight, waist circumference and height at baseline and at the end of the programme. improved efficiency and productivity, increased job satisfaction, more staff interaction, and better workplace morale (4-6). Health promotion programmes often incorporate the use of a pedometer to increase PA. The pedometer, or step counter, is a small, light, electronic device that is generally clipped to an individual’s clothing at the hip. It is a measurement tool which estimates distance traveled by foot by recording the number of steps taken. Pedometers are ideal for health promotion interventions because they are inexpensive, costing US$20 to US$35 apiece. As pedometers provide an approximate calculation of distance travelled by an individual, they are a simple and efficient way to measure PA. Health promotion programmes often set a goal of 10,000 daily steps to encourage increased PA (6). Pedometer programmes are often combined with motivational reminders, such as internet-based motivational messages, motivational interviewing or challenges to encourage a successful in-