Title: The effectiveness and cost effectiveness of an employer-led intervention to increase walking during the daily commute: Cluster randomised controlled trial
Funder: Department of Health (England)

Abstract: AIM: To examine the effectiveness cost effectiveness and acceptability of an employer-led intervention to increase walking during the daily commute. INTERVENTION. Walk to Work promoters will be recruited and trained to encourage other employees to increase walking during their commute to and from work. Employees will receive Walk to Work booklets and pedometers walking routes will be identified and goals set. Encouragement will be given through 4 contacts from the Walk to Work promoter over 10 weeks. Participants living within 2 miles of the workplace will be encouraged to walk to work; those living further away will be encouraged to use public transport plus walking or park further away from their workplace and walk. Intervention costs will be covered by the DECIPHer collaboration and Living Streets.STUDY DESIGN. Cluster RCT including economic and process evaluations.SAMPLE SIZE CALCULATION. Based on findings from the feasibility study the sample size for the full-scale trial was based on an average cluster size of 8 an ICC of 0.15 and attrition of 25%. With a total sample size of 678 we have 80% power with a 5% significance level to detect a 15% increase in mean MVPA. [A sample size of 542 is required to detect a 15% increase in mean overall activity (cpm) with 80% power.]SETTING. Workplaces (n=84) will be recruited in Bath Swansea and South Gloucestershire. The intervention will be implemented in 42 workplaces; 42 similar workplaces will comprise the control arm. Workplace will be matched by size [small (up to 50 employees) medium (51-250 employees) large (250+ employees)] location and type of business.PARTICIPANTS. Employees who do not always cycle or walk to work.OUTCOME EVALUATION. Accelerometers GPS monitors and travel diaries will be used at baseline(DC1) and one year follow-up(DC3). Behavioural questionnaires will be used at DC1immediately post intervention(DC2) and DC3. PROCESS EVALUATION. The context delivery and receipt of the intervention will be examined from the perspectives of employers Walk to Work promoters and employees using evaluation forms at key stages of the trial behavioural questionnaires (DC1 DC2 DC3) and post intervention interviews with a purposive sample of employers Walk to Work promoters and employees.ECONOMIC EVALUATION. Costs of the intervention will be assessed by recording time materials and expenses used in training the promoters and implementing the intervention with employees. Costs to participants will be assessed by recording journey time household commuting costs and expenses using travel diaries (DC1 DC3). Presenteeism absenteeism and health service use will be recorded using questionnaires (DC1DC3). Overall absentee rates will also be collected from employers. Employee wellbeing will be measured using the ICECAP-A questionnaire.PRIMARY OUTCOME. Daily minutes of moderate to vigorous physical activity(MVPA) SECONDARY OUTCOME: Overall levels of physical activity (cpm); daily minutes of sedentary time; modal shift. PROCESS OUTCOMES. Facilitators and barriers to employer-led Walk to Work interventions; Facilitators and barriers to employees walking to work. Physical activity/MVPA due to walking during the journey to/from work.ECONOMIC EVALUATION OUTCOMES. Costs to employers and employees of the Walk to Work intervention; consequences for employers (absenteeism/presenteeism); consequences for employees (commuting costs wellbeing); health service use.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL