Master of Science / Department of Kinesiology / Emily Mailey / Background: Many adults spend a majority of their time at work engaging in primarily sedentary behaviors. Creating a health-promotion program can increase awareness of the importance of physical activity as well as provide benefits to the employee and employers. The main purpose of this study was to compare physical activity, motivation and support levels between participants and non-participants of a workplace movement challenge. Additionally, we examined factors associated with average steps and reasons for participating and not participating in the challenge.   Methods: Information about the four-week movement challenge was sent by email to all employees. Steps were monitored by personal activity trackers (e.g. pedometer, Fitbit, etc.) and self-reported at the end of each week. Steps were averaged within departments and a departmental leader board was posted weekly to encourage competition across campus. All individuals who participated in the program were invited to complete a brief follow-up survey one month later. Non-participants of the program were invited to complete a similar survey at the same time. To analyze the data we used t-tests and correlation tests. Results:  Of the 6,798 employees who received an email about the Movement Challenge, 650 (9.6%) submitted at least one survey and 376 completed all four surveys. Results of the follow-up survey showed employees with a departmental team leader accumulated significantly more steps than employees without a team leader (p= 0.03). Additionally, average steps were significantly associated with both social support (r=.21; p<.01) and motivation subscales including identified regulation and intrinsic regulation. Those who enrolled in the program reported they liked the tracking/accountability and departmental competition best. Participants of the program reported greater total physical activity (p< .001), total social support (p< .001), introjected regulation (p< .001), identified regulation (p< .002) and intrinsic regulation (p< .01) levels compared to those who did not enroll in the program. Conclusion: Worksite wellness campaigns can increase physical activity among employees, but additional strategies are needed to increase participation. The results of this study suggest future programs should increase competition and increase contribution from team leaders. They should also include team support across departments to build support within the program.

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Employer-sponsored wellness programs are important tools for keeping employees healthy, reducing an organization's healthcare expenses, mitigating risk factors, and promoting health and well-being. Little research is available on the factors associated with employees' participation in wellness programs in rural hospitals. Pender's health promotion model was used to determine how employees who participated in a rural hospital's wellness program differed from those who did not participate in terms of demographics, perceptions of personal health, general health behaviors, health locus of control, self-motivation, and situational barriers. A descriptive, correlational replication with the Hallion and Haignere questionnaire was used to survey employees. Of the survey's 186 participants, 29% participated in the wellness program. The reasons for not participating were scheduled program times (n = 51, 33.6%) and lack of interest (n = 31, 20.4%). As shown by logistic regression analysis, overall employee wellness and employee payment status were statistically significant predictors of participation. The Pearson chi square showed a statistically significant difference between program participants and nonparticipants in terms of responsibility for children/elders (p = .047) and shift worked (p = .016). These findings suggest that, when developing and implementing a comprehensive wellness program, the characteristics and needs of employees, along with organizational culture, must be considered. The successful implementation and engagement of staff in an employer sponsored wellness plan improve health through lifestyle change and risk reduction, thus promoting positive social change and leading to healthier communities. The findings of the study were incorporated into the recommendations for the hospital's wellness program.

Abstract Employees experience workplace stress that can affect their health resulting in chronic diseases such as diabetes, stress, hypertension, and cardiovascular diseases. Stress also contributes to staff presentism, absenteeism, and high turnover rate. The employee wellness program (EWP) yoga class at a metropolitan teaching hospital has not been evaluated for its effectiveness in employee stress reduction and improvement in employee health. The practice focus question for this project explored employees' perception of the impact of a metropolitan teaching hospital's EWP yoga class on their stress reduction and health promotion activities. The theoretical framework for this project is Lazarus' transactional model of stress and coping. This model suggests that individuals assess the stressor and find strategies for coping with the stress as it relates to them and their environment. The evidence that guided this project included a comprehensive literature review and the analysis of data retrieved from semi structured interviews with 20 participants in the yoga class who responded to an open invitation. Audiotaped interviews with the participants were analyzed and coded for common themes and revealed that participating in the EWP yoga program helped to reduce their perceived stress and improve their mental and physical well-being. The findings of this project were used to inform organizational leadership and may provide opportunities to evaluate the current yoga program regarding employee stress reduction, improving healthy activities, expansion of the program to other work sites within the organization, maintaining a healthy workforce, and reducing health care costs.

The current study examined the influence of social cognitive variables on physical activity and proposed an intervention for an 8-week physical activity promotion program. Four specific components were examined: implementation intentions, goal commitment, barrier self-efficacy, and value. Participants included faculty and staff enrolled in a university Employee Wellness Program. Participants in the treatment group received goal-setting prompts focused on developing implementation intentions, identifying the value of outcome expectancies, and overcoming self-efficacy barriers. Participants in the control group did not receive goal-setting prompts. The use of goal-setting prompts did not result in significantly more minutes spent exercising. Overall, participants who received goal-setting prompts maintained their engagement in physical activity throughout the program, while participants in the control group steadily declined after week 5. For the treatment group, physical activity was dropping after the first week, but after receiving implementation-intentions prompts, physical activity increased. The use of implementation intentions should be further investigated. Additionally, the use of administering prompts throughout the complete program should be examined.

Obesity is presently one of the leading preventable causes of mortality and is an increasing issue that affects the workplace. This pilot study investigates the effects of a multidisciplinary obesity management program on employees within a community hospital setting. The purpose of this study is to assess the outcome factors of the intervention and to detect an association between the participants’ biological factors, psychological status, eating behaviors, and lifestyle components to that of their current body weight status. Methods. An evaluation of a tailored obesity management program was conducted in a corporate setting with employees of a large community hospital. The evaluation sought to determine if this program could be efficiently and effectively implemented in this corporate setting. This program also allowed an exploration of those sociological, biological, and behavioral factors that were associated with weight loss. An employee health outcomes assessment visit was used to identify, recruit and enroll overweight employees into a quasi-experimental study designed to evaluate potential impacts of a tailored weight management program. The 6-month intervention included medical assessments, nutritional coaching, activity counseling, and behavioral therapy. The following specific aims were proposed for this dissertation research: Specific Aim 1 sought to evaluate the effectiveness of the multidisciplinary weight loss program to change a series of modifiable health risk factors, body composition, clinical indicators, and biological markers from baseline to 6 months for overweight participants. Specific Aim 2 evaluated factors associated with achieving weight loss and patterns of attrition from the program. Weight and lifestyle factors included onset of obesity, family history, weight loss history, weight loss goals, self-perceptions, physical activity factors, and eating habits/patterns. Within Specific Aim 3, we determined if body composition measurements [body mass index (BMI), weight, basal metabolic rate, fat mass, percent fat, fat free mass, and total body water] correlated with standing or supine measurements of waist, hip, or thigh circumferences. We also investigated if there was a significant difference between recording measurements made in both positions. This aim sought to determine if both sets of position measurements needed to be included for subsequent weight management studies. Results. Forty-six (46) employees, with a mean age of 48.6 +/- 10.9 years and predominately female (91.3%), consented to participate in the pilot intervention, with 26 participants completing the 6 months (response = 50.9%). Statistically significant changes from baseline were seen at 6 months in the 44 participants that continued in the study after enrollment. In the intent to treat analysis, the participants, regardless of completion status, had a clinically significant (p<.0001) mean percent weight loss of 4.1% and a total weight loss of 9.3 pounds, with a corresponding 5.6% mean weight loss in those participants that completed the program. When analyzing predictors of attrition from the program, models indicated significant associations between overall program attrition and an increase in baseline systolic blood pressure (p=0.02), along with decreased compliance with eating three meals per day (p=0.04). Primary attrition (dropout < 3 months) was statistically associated with an increase in baseline systolic blood pressure (p=0.02) and decreased compliance with eating three meals per day (p=0.01). Secondary attrition (dropout between 3-6 months) was associated with decreased compliance with eating three meals per day (p=0.05) and an increase in weight loss expectations during the intervention (p=0.05). The mean absolute difference between the two techniques (standing vs. supine) was 4.14 inches for waist, hip, and thigh measurements combined. An increase in body mass index was associated with a greater magnitude of discrepancy in the measurement between the two techniques for waist circumference (p=0.02). Conclusions. The changes seen following this multidisciplinary intervention were clinically significant and advantageous for the participants. These substantial results suggest that the use of multidisciplinary weight management programs merits further investigation in larger, randomized, controlled trials.

Obesity and type 2 diabetes (T2DM) has increased greatly in incidence in the United States over the past decade. Diagnosis of T2DM is typically preceded by insulin resistance, which is typically indicated by increases in fasting blood sugar and called pre-diabetes. The Diabetes Prevention Program (DPP) is a group-based program focused on improving diet and maintaining consistent exercise towards a lower body weight. It has been found that minimum weight loss and 150 minutes of moderate exercise is more effective at preventing T2DM than medication-based treatment. Therefore, the DPP has potential in preventing T2DM however currently faces obstacles concerning recruitment and retention. Unfortunately, only 1-5% of individuals who would benefit from the program actually sign up. In order to address this, researchers obtained RDC funding and partnered with YMCA to determine barriers and motivators to the DPP. Individuals were invited to an on-campus, pilot DPP aimed towards employees in a single building. All employees received an invitation to give feedback in 1 of 3 focus groups: 1 with those who joined the program and 2 with employees who did not join. There were 4 individuals in the focus group for DPP participants and 18 total who attended the other focus groups (one group of 5, and one group of 13). The focus group for current participants was scheduled during the time of a normal weekly meeting, while the group for non-DPP participants was during lunchtime. Questions centered around individuals' perceptions on wellness programs, barriers to participation, and recommendations. Thematic analysis was done on notes taken at each focus group. Motivators found in the focus group with DPP participants included family history of diabetes, weight loss, desire to take control of lifestyle, hearing success stories, and support from others. A challenge faced by individuals going through the program included unsupportive family members or home environment. Themes found among the non-DPP participant focus groups gave greater insight in the negatives and barriers to wellness programs. Themes emphasized included importance of convenience, variability, coworker support, and appealing to individual interests. Overlapping themes included convenience, coworker support, and the importance of steering away from the 'diabetes' or 'prediabetic' labels. This study has significant impact especially in Tennessee where the DPP has become a covered benefit under insurance. In order to ensure strong recruitment and retention of these programs across the state and nation, researching further and addressing the motivators and barriers identified is key. With the DPP having such great potential in reducing risk of diabetes and obesity, a strong, intentional recruitment plan is necessary.

This thesis focused on the development of a curriculum guide for a cancer awareness program for older men. The background of the problem -- a lack of programs for older men -- and the methods used in developing the guide are detailed in Chapter One. The second chapter consists of current information on disease prevention, aging and cancer with the emphasis on age-related changes and learning needs of older adult men. Chapter Three is the completed instructor's curriculum guide, and the final chapter includes recommendations on implementing the program as part of a community wellness program. The guide could also be used in senior centers, hospital educational programs, or adapted for use in staff inservices.

Bakgrund: Arbetsgivare kan stödja de anställdas hälsa genom att erbjuda friskvårdsbidrag. Flera faktorer påverkar individer till att välja hälsorelaterade beteenden. Self-efficacy är en sådan faktor vilket innebär individens tilltro sin egen förmåga att klara en uppgift. Syfte: Studiens syfte var att undersöka relationen mellan self-efficacy och nyttjande av friskvårdsbidrag. Vidare undersöktes fysisk aktivitetsnivå och upplevt hälsotillstånd relaterat till dessa två faktorer. Metod: Undersökningen genomfördes med en enkät som skickades ut genom ett tillverkningsföretags intern-epost.  Korrelationsanalyser, chitvå-test och t-test användes för att utforska relationen mellan variablerna. Resultat: Enkäten skickades till 2019 anställda varav 1022 besvarade enkäten. Mellan self-efficacy och nyttjande av friskvårdsbidrag kunde inget signifikant samband påvisas. Self-efficacy och nyttjande av friskvårdsbidrag var båda korrelerade till både fysisk aktivitetsnivå och upplevt hälsotillstånd. Slutsats: Genom att initiera interventioner på arbetsplatser som fokuserar på att höja self-efficacy och öka nyttjande av friskvårdsbidrag kan anställdas fysiska aktivitetsnivå och upplevda hälsotillstånd förbättras. / Background: The employer can support their employees by proving work site wellness programs. “Friskvårdsbidrag[E1] ” is a wellness subsidy that many work sites in Sweden provides. Whether an individual will choose to engage in a health related behavior may be affected by different factors. Self-efficacy is one of these factors and implies the individual’s confidence in his own ability to complete a task. Aim: The aim of this study was to examine the relationship between self-efficacy and the use of “friskvårdsbidrag”. Further was physical activity level and perceived health status also examined. Method: The study was carried out by sending out a questionnaire using a manufacturing company’s internal email. Correlation analyzes chi-square tests and t-tests were used to explore the relationships between the variables. Results: The questionnaire was sent to 2019 employees and 1022 of these were answered. Self-efficacy and the use of “friskvårdsbidrag” were not correlated. Both self-efficacy and the use of “friskvårdsbidrag” were correlated with physical activity level and perceived health status. Conclusion: By initiating interventions in the work sites that are focusing on enhancing self-efficacy and the use of “friskvårdsbidrag”, the employee´s level of physical activity and perceived health status can be increased.

Workplace wellness programs (WWP) were developed to support employees’ health behaviors and well-being. Although physical activity is incorporated into the definition of wellness and is a modifiable behavior that can both reduce the risk for chronic disease and lifestyle-related diseases and enhance health and well-being, performance of physical activity is often overlooked within WWP and the workplace in general. Rather than investigating organizational aspects of the WWP, this grounded theory-based study explored employees’ perceptions concerning how their organization facilitated their participation in physical activity within WWP. To provide a theoretical framework, Self-Determination Theory (SDT) from Ryan and Deci (2000) offered the lens to understand the employees’ motivation to participate in physical activity and Social Ecological Model (SEM) by Bronfenbrenner (1977) described the multiple levels of interaction between the employee and their organizational environment. The employees’ perceptions elucidated their decision-making process. The emergent themes were time management, advantageousness, need for movement, supervisor ambivalence, social / “gregarious” connection, messages from leadership, limited awareness, culture of health, and incentives and reimbursements. Three levels (individual, relational, and organizational) and three facets (barriers, bolsters, and facilitators) illustrated the relationships among these themes. These themes, levels, and facets are exemplified in the grounded theory model. Consequently, six implications for practice were illuminated for organizations to employ for encouraging their employees to join and actively participate in physical activity in the WWP and in the workplace in general, providing better health outcomes for employees and improving the organizations’ bottom line. / Kinesiology