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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Introduction: Adult obesity is a significant public health problem, increasing chronic disease and resulting in health and economic implications. The worksite environment provides a setting for comprehensive Worksite Health Promotion programs that can benefit employees and employers. However, the literature identifies barriers to implementation of WHP programs and achievement of positive outcomes. The purpose of this study was to determine if a DeKalb County Board of Health Employee Wellness Policy that provides work breaks during the workday for employees to engage in wellness activities has resulted in actual use of the break and employee perceived benefits. The study also examined barriers to use of the wellness break. Methods: In collaboration with the DeKalb County Board of Health, a cross-sectional study of 187 employees across eight locations was conducted. The survey instrument included both quantitative and qualitative questions and was administered electronically or in person via group administration. Results: Of survey respondents, 74% knew about the Employee Wellness Policy, 57% understood policy guidelines, and 41% had ever used wellness breaks. Respondents most often reported using wellness breaks for physical activity, most often for walking/jogging. A majority of employees using wellness breaks reported positive outcomes including: increased physical activity (64.4%), weight loss (65.2%), increased productivity (79.5%), improved work relationships (86%), increased work morale (64.4%), and increased overall positive outlook (69.9%). Barriers to utilization included: lack of time, lack of knowledge, lack of encouragement from management, and clinical setting. Management employees were significantly more likely to know about the policy and understand policy guidelines compared to non-management employees. Clinical employees were significantly less likely to ever use wellness breaks and less likely to feel their manager supports the policy. Conclusion: Sampled employees participating in wellness breaks perceive health and work-related benefits; however barriers have prevented some employees from utilizing the breaks. Quantitative and qualitative data may inform wellness policy changes for improved utilization and outcomes. Findings related to self-reported employee outcomes provide some support for a discretionary paid work break policy in the workplace.

Thesis (Ph.D. (Human Movement Science))--North-West University, Potchefstroom Campus, 2008.

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.

1. The problem and objective of study Workers in physically demanding jobs have, over the last decade, shown a high incidence of work-related injuries as well as other related physical disorders (Dempsey & Hashemi, 1999:183; Mital & Ramakrishnan, 1999:74; WHO, 1999:1; Weir & Nielson, 2001:128; Cox et al, 2003:6). This has been shown to lead to absenteeism, lost work time and poor work quality which in turn give rise to increased costs of yearly worker compensation claims, medical treatment and general loss of production (Ciriello & Snook, 1999:149; Mital, 1999:246-247; Cox et al., 2003:6). For example, the World Health Organization indicates that work related injuries and illness kill an estimated 1.1 million people worldwide every year. This is roughly equal to the number of worldwide deaths due to malaria each year (WHO, 1999:1). Research indicates that these types of injuries and/or work disability usually occur when the physical demands of the work tasks exceed the physical work capacity of the worker (Chaffin, 1974:251-254; Fraser, 1992:24; Shrey, 1997a:8). Two types of workers are usually pointed out by management in this regard, namely the older workers and females that are exposed to tasks with a high physical demand (Ayoub & Mital, 1989:9; Smith & Mustard, 2004:755; Sluiter, 2006:438). The above-mentioned problem seems to be a global concern (Mital, 1999:246; WHO, 1999:1) and forces companies to better manage the physical incapacity of workers in physical demanding jobs. The management of the electricity supply company in South Africa (hereafter the company) who realised that this problem was also prevalent in their workforce, developed minimum physical ability task requirements, that represent the physical work demands, for all the physically demanding jobs (Lubbe, 2003b:4). These minimum requirements enable the company to determine which workers do not have the physical work capacity to perform their physical work demands and to implement the necessary management process, such as a worksite wellness program, to address the problem. Hence the objective of the study were to determine the: a) role of gender on the physical work capacity profile of workers in the company based on the minimum physical ability task requirements of their job; b) role of age on the physical work capacity profile of workers in the company based on the minimum physical ability task requirements of their job; c) effect of a worksite wellness program on the physical work capacity profile of workers in the company based on the minimum physical ability task requirements of their job. 2. Summary of results a) The physical work capacity of male workers in this population are practically significant greater than that of female workers with the same job-related minimum physical ability task requirements. b) Practically significant more female workers do not have the minimum physical work capacity required by their job, than male workers. c) The physical work capacity of workers in physically demanding jobs within this company declines with aging. d) The age-related decline in physical work capacity for male workers is to such an extent that from the age of 60, the physical work demands of their job exceed their physical work capacity. e) The age-related decline in physical work capacity for female workers is to such an extent that, in general, the indication is that they will never have the required physical work capacity based on the minimum physical ability task requirements of their job, for it is predicted that from the age of 18, the physical work demands of their job exceed their physical work capacity. f) A worksite wellness program assists workers whose physical work capacity profile does not meet the minimum physical ability task requirements of their job, to regain the required physical work capacity. g) A worksite wellness program provide an alternative option to managing the physical work capacity of their workers, other than ill-health retirement, retrenchments or prolonged sick-leave. / Thesis (Ph.D. (Human Movement Science))--North-West University, Potchefstroom Campus, 2008.

1. The problem and objective of study Workers in physically demanding jobs have, over the last decade, shown a high incidence of work-related injuries as well as other related physical disorders (Dempsey & Hashemi, 1999:183; Mital & Ramakrishnan, 1999:74; WHO, 1999:1; Weir & Nielson, 2001:128; Cox et al, 2003:6). This has been shown to lead to absenteeism, lost work time and poor work quality which in turn give rise to increased costs of yearly worker compensation claims, medical treatment and general loss of production (Ciriello & Snook, 1999:149; Mital, 1999:246-247; Cox et al., 2003:6). For example, the World Health Organization indicates that work related injuries and illness kill an estimated 1.1 million people worldwide every year. This is roughly equal to the number of worldwide deaths due to malaria each year (WHO, 1999:1). Research indicates that these types of injuries and/or work disability usually occur when the physical demands of the work tasks exceed the physical work capacity of the worker (Chaffin, 1974:251-254; Fraser, 1992:24; Shrey, 1997a:8). Two types of workers are usually pointed out by management in this regard, namely the older workers and females that are exposed to tasks with a high physical demand (Ayoub & Mital, 1989:9; Smith & Mustard, 2004:755; Sluiter, 2006:438). The above-mentioned problem seems to be a global concern (Mital, 1999:246; WHO, 1999:1) and forces companies to better manage the physical incapacity of workers in physical demanding jobs. The management of the electricity supply company in South Africa (hereafter the company) who realised that this problem was also prevalent in their workforce, developed minimum physical ability task requirements, that represent the physical work demands, for all the physically demanding jobs (Lubbe, 2003b:4). These minimum requirements enable the company to determine which workers do not have the physical work capacity to perform their physical work demands and to implement the necessary management process, such as a worksite wellness program, to address the problem. Hence the objective of the study were to determine the: a) role of gender on the physical work capacity profile of workers in the company based on the minimum physical ability task requirements of their job; b) role of age on the physical work capacity profile of workers in the company based on the minimum physical ability task requirements of their job; c) effect of a worksite wellness program on the physical work capacity profile of workers in the company based on the minimum physical ability task requirements of their job. 2. Summary of results a) The physical work capacity of male workers in this population are practically significant greater than that of female workers with the same job-related minimum physical ability task requirements. b) Practically significant more female workers do not have the minimum physical work capacity required by their job, than male workers. c) The physical work capacity of workers in physically demanding jobs within this company declines with aging. d) The age-related decline in physical work capacity for male workers is to such an extent that from the age of 60, the physical work demands of their job exceed their physical work capacity. e) The age-related decline in physical work capacity for female workers is to such an extent that, in general, the indication is that they will never have the required physical work capacity based on the minimum physical ability task requirements of their job, for it is predicted that from the age of 18, the physical work demands of their job exceed their physical work capacity. f) A worksite wellness program assists workers whose physical work capacity profile does not meet the minimum physical ability task requirements of their job, to regain the required physical work capacity. g) A worksite wellness program provide an alternative option to managing the physical work capacity of their workers, other than ill-health retirement, retrenchments or prolonged sick-leave. / Thesis (Ph.D. (Human Movement Science))--North-West University, Potchefstroom Campus, 2008.

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.

Background: Poor beverage consumption habits pose significant health concerns. Delivering health behavior change interventions via social media is an emerging area of health research and may provide a promising way to minimize barriers such as cost, intervention delivery time, and access. However, there is limited research on online social support health behavior change delivered through Instagram. Objectives: 1) Assess the validity and reproducibility of the updated BEVQ-15, a beverage intake questionnaire; 2) Review the current literature on the availability and effectiveness of mobile phone interventions targeting sugar-sweetened beverage (SSB) consumption; and 3) Use the updated BEVQ-15 to conduct the Healthy Beverage Habits pilot study, which is an online social networking worksite intervention aimed at improving Healthy Beverage Index (HBI) scores. Methods: The Healthy Beverage Habits study was an online randomized controlled pilot trial with an 8-week intervention and a 4-week maintenance period delivered through Instagram. The materials were adapted from the in-person SIPsmartER SSB reduction intervention. Data analysis included RM-ANOVAs to test for differences in beverage intake between the Instagram intervention group and the E-mail control group. Results: For the Healthy Beverage Habits trial, no significant between group over time differences were found. However, the Instagram group demonstrated a significant reduction in total beverage kcal (mean difference±SE=-156±48; p=0.049), and increase in total HBI scores (mean difference±SE= 11.9±2.3; p=0.025) from baseline to the end of the maintenance period. No within group differences were demonstrated for the E-mail control group over the intervention or maintenance period. The study retention rate was 38%, with 39 participants initially enrolled and 15 participants completing all study visits through maintenance. Results for the validity and reproducibility of the updated BEVQ-15 and a review of the availability and effectiveness of mobile phone interventions targeting SSB consumption are presented. Conclusions: Mobile phone-delivered interventions may be a promising method for improving beverage intake quality. Technologically-based interventions targeting beverage consumption should consider utilizing multiple forms of mobile-phone contact methods. The preliminary findings from the Healthy Beverage Habits trial highlight the need for more rigorous studies that determine which technology and intervention components are most effective for mobile-delivered beverage consumption interventions. / Doctor of Philosophy / Background: Poor beverage consumption habits pose significant health concerns. Delivering health behavior change interventions via social media is an emerging area of health research and may provide a promising way to minimize barriers such as cost, intervention delivery time, and access. However, there is limited research on online social support health behavior change delivered through Instagram. Objectives: 1) Assess the validity and reproducibility of the updated BEVQ-15, a beverage intake questionnaire which estimates habitual average daily intake of 15 beverage categories as well as total sugar-sweetened beverages (SSB) and total beverages. 2) Review the current literature of the availability and effectiveness of mobile phone interventions targeting SSB consumption. 3) Use the updated BEVQ-15 to conduct The Healthy Beverage Habits pilot study, which is an online social networking worksite intervention aimed at improving Healthy Beverage Index (HBI) scores. Methods: The updated BEVQ-15 was assessed for agreement between the BEVQ-15 and dietary recalls. Researchers compared beverage intake between two BEVQ-15 administrations. The Healthy Beverage Habits pilot study was an 8-week intervention with a 4-week maintenance period. Data analysis included testing for differences in beverage intake between the Instagram group and the E-mail group. Results: The updated BEVQ-15 demonstrated moderate agreement between the BEVQ-15 and dietary recalls for total SSB intake and total beverage intake. All beverage variables were significantly correlated. For the systematic review, 11 of the 17 studies (65%) were successful in reducing SSB consumption through mobile phone delivery. The successful studies used multiple types of technology. There were no significant differences for any beverage variable between the Instagram and E-mail groups over time. However, for within group changes, Instagram significantly reduced total beverage kcals and improved total HBI score, while the E-mail group did not demonstrate any significant changes. Conclusions: Mobile phone-delivered interventions may be a promising method for improving beverage intake quality. Technologically-based interventions targeting beverage consumption should consider utilizing multiple forms of mobile-phone contact methods. The preliminary findings from the Healthy Beverage Habits pilot trial highlight the need for more rigorous studies that determine which technology and intervention components are most effective for mobile-delivered beverage consumption interventions.

Cardiovascular disease (CVD) is responsible for approximately 600,000 deaths in the United States each year, with African Americans (AAs) disproportionately affected. Individual-level approaches to reducing CVD remain ineffective, mobilizing a movement that advocates for population-based solutions. Workplace wellness programs (WWPs) have gained considerable traction as a viable strategy for ameliorating CVD burden among workers in general. However, no studies have looked at the efficacy of WWPs in ameliorating CVD specifically among AA employees--a knowledge gap that this investigation aimed to close. Based on the health belief model and the social cognitive theory, this retrospective cohort study used de-identified secondary data to evaluate the racial differences in the mean change in CVD biomarkers between 163 AAs and 228 Caucasians civilian workers participating in a U.S. Marine Corp self-directed WWP. The 4 CVD biomarkers evaluated were systolic blood pressure (SBP), diastolic blood pressure (DBP), and waist-to-hip ratio. Repeated measures MANCOVA analysis was used to establish the contribution of the independent variable (race) to SBP, DBP, LDL cholesterol, and waist-to-hip ratio. Results showed an overall significant main effect of time for changes in SBP and DBP even after controlling for race, sex, age, and days from baseline. However, there was no overall main effect of time for changes in LDL cholesterol or waist-to-hip ratio. Further research using randomization, a comprehensive health risk appraisal, and a larger sample size may yield additional benefits to AAs. Implications for positive social change include reduction of the extraordinarily high CVD disease burden and disparity among AAs.