Active Workplace Study

Study Overview
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Brief Summary
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Exposure to sedentary work is an occupational hazard with significant health and safety consequences. Sedentary behavior is an independent predictor of heart disease, diabetes, early mortality, and accounts for the majority of the increase in obesity in the US. Prolonged sitting, common in modern sedentary work environments, contributes to increases in musculoskeletal pain, injuries, and detrimental changes in physiological functioning. Call center employees, who are among the most sedentary workers in the US, area priority population for Total Worker Health interventions. This project is designed to substantially improve health, safety, and well-being in call center employees, including physiological outcomes that contribute to chronic diseases.The study tests whether a Total Worker Health oriented intervention is more effective than usual practices for increasing the utilization of health and safety resources and improving worker health and safety. Study results will have implications for over 30 million sedentary workers in the US.

Detailed Description
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The purpose of this study is to evaluate how a Total Worker Health intervention targeting sedentary behavior among call center employees improves the health, safety, and well-being of sedentary workers. Our primary hypothesis is that a multilevel integrated intervention that follows the Total Worker Health approach will have a stronger impact on primary outcomes (sedentary time and light physical activity at work, musculoskeletal pain, time lost due to injury or illness) compared to a control condition that matches typical worksite practices. To test our hypothesis, we will 1) tailor Total Worker Health intervention components to the call center environment, 2) determine the effects of a 6-month intervention, and 3) measure the durability of intervention effects at 12-month follow-up. The study will use a randomized control trial design with two conditions: a control condition and a Total Worker Health intervention condition that includes organizational and individual intervention components. Study participants will include employees and supervisors from up to eight call centers. The call centers will be randomly assigned to the two conditions prior to the start of the study. During the study, we will conduct a baseline assessment; implement a six-month intervention; conduct a post-intervention assessment; and conduct a follow-up assessment at twelve months. During each assessment period, study participants in both conditions will complete a survey, physical measures, hemoglobin A1c measurement, and seven days of physical activity data collection with accelerometers. Study participants in both conditions could additionally be asked to complete a measurement for endothelial function during each assessment. The baseline assessment will occur directly after participant enrollment and consent at each worksite. Both conditions will be given access to portable pedal stands. The intervention condition will have additional environmental alterations including hanging signs throughout the work environment that promote health and safety behaviors; and replacing high calorie and high sugar food and drink options in vending machines and break rooms with fresh fruits, vegetables, and other healthier choices. Participants in the intervention condition will begin intervention activities. Intervention activities that participants could be asked to complete include: computer based training, goal setting and behavioral self-monitoring, scripted team-based health and safety discussions, and team competitions with pedal stands. Supervisor participants could additionally be asked to complete additional computer based training, goal setting and behavioral self-monitoring of supportive behaviors, and inter-supervisor observations. Participants in the control condition will receive no additional support beyond the provision of pedal stands. Repeated measures will be collected at baseline, six months, and 12 months. Our primary hypotheses are that the intervention condition will produce greater reductions in sedentary behavior, increases in light physical activity, and reductions in musculoskeletal pain and sick day use than the control condition. To test these hypotheses, we will employ an intent-to-treat strategy using generalized estimating equations in order to use all available data to evaluate group differences in the magnitude of change over time in primary outcomes. The effect of interest for each outcome will be the interaction of condition X time. We will statistically control for confounders by measuring a wide range of demographic and psychological variables that could impact study outcomes. We will test for baseline differences between conditions on these variables using one-way ANOVAs (continuous variables) or chi-squares tests (categorical variables). Variables that differ significantly between groups at baseline will be included as covariates in the generalized estimating equation models of intervention effects over time.

Official Title
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Active Workplace Study

Conditions
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Sedentary Lifestyle, Occupational Exposure, Health Behavior, Safety Issues

Intervention / Treatment
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* Behavioral: Total Worker Health
* Other: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years of age or older Currently working in a participating organization Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: There are two study conditions: intervention and control. Organizations will be randomized to conditions.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Total Worker Health Intervention<br> | Behavioral: Total Worker Health<br>* The intervention combines organizational and individual level strategies. Participants will be given access to pedal stands, health and safety messaging, and other environmental modifications. Intervention activities that participants could be asked to complete include: computer based training, goal setting and behavioral self-monitoring, scripted team-based health and safety discussions, and team competitions with pedal stands. Supervisor participants could additionally be asked to complete additional computer based training, goal setting and behavioral self-monitoring of supportive behaviors, and inter-supervisor observations. The intervention is six-months in duration.<br>|
| Active Comparator: Control<br> | Other: Control<br>* Usual practice control<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sedentary behavior | Sedentary behavior at work measured via accelerometry | Change from baseline at 6 months and 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Height | Height | Baseline, 6-months, and 12-months | 
| Body weight | Directly measured body weight | Change from baseline at 6 months and 12 months | 
| Percent body fat | Directly measured percent body fat via bioelectric impedence | Change from baseline at 6 months and 12 months | 
| Blood pressure | Direct measurement | Change from baseline at 6 months and 12 months | 
| Resting heart rate | Direct measurement | Change from baseline at 6 months and 12 months | 
| Hemoglobin A1c | Direct measurement with Siemens DCA Vantage Analyzer | Change from baseline at 6 months and 12 months | 
| Endothelial functioning | Direct measurement with EndoPat software and hardware | Change from baseline at 6 months and 12 months | 
| Depression symptoms | CES-D Short Form Scale | Change from baseline at 6 months and 12 months | 
| Job Stress | Stress in General Scale | Change from baseline at 6 months and 12 months | 
| Work Family Conflict | Work Family Conflict Scale | Change from baseline at 6 months and 12 months | 
| General Life Stress | Perceived Stress Scale | Change from baseline at 6 months and 12 months | 
| Job satisfaction | Michigan Organizational Assessment Questionnaire job satisfaction scale | Change from baseline at 6 months and 12 months | 
| Global Health | PROMIS Global Health Scale | Change from baseline at 6 months and 12 months | 
| Support at work | Survey measure of perceived support from supervisors at work | Change from baseline at 6 months and 12 months | 
| Dietary behaviors | Frequency of high-calorie food and drink consumption | Change from baseline at 6 months and 12 months | 
| Physical Activity survey | Healthy Physical Activity Scale | Change from baseline at 6 months and 12 months | 
| Sleep Quality | Pittsburgh Sleep Quality Index | Change from baseline at 6 months and 12 months | 
| Sleep Distrubance | PROMIS Sleep Disturbance Scale | Change from baseline at 6 months and 12 months | 
| Sleep Impairment | PROMIS Sleep Impairment Scale | Change from baseline at 6 months and 12 months | 
| Safety climate | Safety Climate Scale | Change from baseline at 6 months and 12 months | 
| Musculoskeletal pain | Survey measure of musculoskeletal pain (Nordic Musculoskeletal Symptoms Questionnaire) | Change from baseline at 6 months and 12 months | 
| Lost work time | Sick days, tardiness, time lost due to injury and illness, and other work absences | Change from baseline at 6 months and 12 months | 
| Physical activity accelerometer | Physical activity measured via accelerometry | Change from baseline at 6 months and 12 months | 
| Occupational Sitting | Occupational Sitting and Physical Activity Questionnaire | Change from baseline at 6 months and 12 months | 
| Job Turnover Intentions | Job Turnover Intentions Scale | Change from baseline at 6 months and 12 months | 
| Lost Work Time | Days missed at work due to illness and injury | Change from baseline at 6 months and 12 months |