Development and evaluation of a worksite health promotion program : application of critical self-directed learing for exercise behaviour change
Creators: name: Hubball, Harry Thomas
Publisher: name: University of British Columbia
Year: 2009

description: Low participation in and poor adherence to regular exercise presents a major challenge for health promotion programs (Centers for Disease Control, 1990; Dishman, 1994). The workplace provides a unique context to reach a large proportion of society for multiple health promotion programs. Effective workplace interventions are likely those combining environmental and behavioural change models from a variety of fields, and are tailored as much as resources will allow to the needs and circumstances of the workplace culture and to individuals participating in the program (Green and Cargo 1994). Few studies in the workplace context, however, have focused on integrated programs drawn from a variety of fields to facilitate exercise behaviour change. Even less evidence exists about application of learning following worksite health promotion programs. The purpose of this study was to examine application of learning following an integrated worksite health promotion program. The aim of the program was to empower participants individually and collectively with knowledge, attitudes, skills and experiences to think critically and to self-direct exercise behaviour change. Green and Kreuter's (1991) Precede-Proceed model was used as the guiding framework for the planning and evaluation processes in a worksite setting. Twenty-six clerical employees in the University of British Columbia's Department of Housing and Conferences participated in a four-week intervention program and twenty-two clerical employees participated in a waiting-list control group. An eclectic set of quantitative and qualitative tools examined participant experiences and outcome measures pertaining to exercise behaviour change. Structural changes occurred in the workplace environment to facilitate healthful behaviours. Quantitative findings indicated that positive changes occurred for the experimental group during the program and at a three- month follow-up with respect to exercise self-efficacy, exercise stages of change and exercise behaviour (p&lt;0.05). Qualitative analysis revealed that a myriad of individual, social and other contextual factors shaped whether and how learning was applied. Motives to attend the program, previous experiences, critical thinking and self-directed learning skills, and power to influence significant others and resources in the context of application influenced exercise behaviour. Furthermore, application varied by type, frequency, intensity and duration to suit specific needs and circumstances. Learning was applied to enhance motivation for brisk walking, fitness classes, holistic health behaviours and time with significant others. Two conclusions are drawn from this study. First, a worksite health promotion program developed by integrating behaviour change models drawn from a variety of fields can be effective for exercise behaviour change. Second, in the context of application individual and social contextual strategies are required to enhance exercise behaviour. Theoretical concepts and intervention strategies to facilitate critical self-directed learning for exercise behaviour change are discussed.