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.

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.

A crescente epidemia de obesidade tem incentivado profissionais da saúde a procurar por intervenções que possam atingir um grande número de indivíduos de maneira custo-efetiva. Os Programas de Qualidade de Vida no Trabalho vêm sendo apontados como ferramentas importantes para a promoção da saúde e qualidade de vida. Neste contexto, o Coaching em Saúde e Bem Estar vem despontando como um componente promissor nas intervenções desenvolvidas nestes programas, de modo a atingir resultados positivos e permanentes para mudança de comportamento para um estilo de vida saudável. Desta forma, o propósito desta revisão é verificar o efeito do Coaching em Saúde e Bem Estar sobre o peso corporal, nível de atividade física e consumo de frutas, legumes e vegetais de trabalhadores. Para tanto, foi conduzida uma busca nas bases de dados PubMed, CINAHL, EMBASE, LILACS e Cochrane Library. Onze ensaios clínicos randomizados atenderam aos critérios de elegibilidade, aos quais foi aplicado o instrumento de avaliação de risco de viés da Colaboração Cochrane e extraídas as informações relevantes de cada estudo. Encontrou-se associação de efeito na direção esperada para peso corporal, atividade física e consumo de frutas, legumes e vegetais. No entanto, 72,7% dos estudos (n=8) apresentaram alto risco de viés. Assim, conclui-se que as evidências para responder à pergunta desta revisão são limitadas e, portanto, sugere-se que mais estudos sejam realizados, considerando-se a transparência no relato das evidências e o rigor metodológico recomendado para sua execução. / The expanding outbreak of obesity has stimulated health professionals to search for interventions capable to encompass a large number of individuals in a cost-effective manner. Worksite Wellness Programs have been pointed out as important tools for the promotion of workers\' health and quality of life. In this context, Health and Wellness Coaching is emerging as a promising component of the interventions developed in such programs, leveraging achievement of positive and permanent results on behavior change for a healthy lifestyle. Under such perspective the purpose of this review is to verify the effect of Health and Wellness Coaching on workers\' body weight, physical activity and consumption of fruits and vegetables. Therefore, a survey was conducted in PubMed, CINAHL, EMBASE, LILACS and Cochrane Library databases. Eleven studies met the selection criteria of this research. The risk of bias analysis tool developed by Cochrane collaboration was applied, and the relevant data were extracted from each study The analysis of results of such studies demonstrated association of positive effect for the increase of workers\' physical activity, body weight and fruits and vegetables intake. Nevertheless, 72,8% of the studies (n=8) showed a high risk of bias. So the conclusion is that the evidences found are not enough to answer the proposed question. Further studies are necessary in order to gather consistent data raised with the required methodological rigor.

A crescente epidemia de obesidade tem incentivado profissionais da saúde a procurar por intervenções que possam atingir um grande número de indivíduos de maneira custo-efetiva. Os Programas de Qualidade de Vida no Trabalho vêm sendo apontados como ferramentas importantes para a promoção da saúde e qualidade de vida. Neste contexto, o Coaching em Saúde e Bem Estar vem despontando como um componente promissor nas intervenções desenvolvidas nestes programas, de modo a atingir resultados positivos e permanentes para mudança de comportamento para um estilo de vida saudável. Desta forma, o propósito desta revisão é verificar o efeito do Coaching em Saúde e Bem Estar sobre o peso corporal, nível de atividade física e consumo de frutas, legumes e vegetais de trabalhadores. Para tanto, foi conduzida uma busca nas bases de dados PubMed, CINAHL, EMBASE, LILACS e Cochrane Library. Onze ensaios clínicos randomizados atenderam aos critérios de elegibilidade, aos quais foi aplicado o instrumento de avaliação de risco de viés da Colaboração Cochrane e extraídas as informações relevantes de cada estudo. Encontrou-se associação de efeito na direção esperada para peso corporal, atividade física e consumo de frutas, legumes e vegetais. No entanto, 72,7% dos estudos (n=8) apresentaram alto risco de viés. Assim, conclui-se que as evidências para responder à pergunta desta revisão são limitadas e, portanto, sugere-se que mais estudos sejam realizados, considerando-se a transparência no relato das evidências e o rigor metodológico recomendado para sua execução. / The expanding outbreak of obesity has stimulated health professionals to search for interventions capable to encompass a large number of individuals in a cost-effective manner. Worksite Wellness Programs have been pointed out as important tools for the promotion of workers\' health and quality of life. In this context, Health and Wellness Coaching is emerging as a promising component of the interventions developed in such programs, leveraging achievement of positive and permanent results on behavior change for a healthy lifestyle. Under such perspective the purpose of this review is to verify the effect of Health and Wellness Coaching on workers\' body weight, physical activity and consumption of fruits and vegetables. Therefore, a survey was conducted in PubMed, CINAHL, EMBASE, LILACS and Cochrane Library databases. Eleven studies met the selection criteria of this research. The risk of bias analysis tool developed by Cochrane collaboration was applied, and the relevant data were extracted from each study The analysis of results of such studies demonstrated association of positive effect for the increase of workers\' physical activity, body weight and fruits and vegetables intake. Nevertheless, 72,8% of the studies (n=8) showed a high risk of bias. So the conclusion is that the evidences found are not enough to answer the proposed question. Further studies are necessary in order to gather consistent data raised with the required methodological rigor.