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30 Years of technology use in workplace health interventions

Rikke Magnussenrmgu@steno.dkResearcher, Steno Health Promotion Center,Novo NordiskCopenhagen, DK

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Types of games I develop/study:Science games with mixed physical and computer-based activities

Types of games I develop/study:Game-like technology innovation education

Overview• Review

– Part of a longer study: selected articles reviewed from 3 perspectives– 1) health psychology, 2) management and organization, 3) technology use– Reviewing technology use in the largest workplace health studies 1980 - 2010

• Purpose– To understand where the new possibilities are in using games and health promotion

technologies in workplace health projects– As inspiration for two large health promotion projects in Copenhagen

• Methods– search, selection criteria,

• Results – model– Model– Examples of categories of tech use

• Future perspectives – which type of games, projects and technologies could be developed in future projects?– Use two projects as examples

• Innovative health promotion exhibitions engaging families in local communities• Participant development of health activities in multiple local settings of

advantaged and disadvantaged families• Possible settings: neighborhoods, workplaces, schools• Game and health promotion technologies linking the various settings

Project: Changing bus drivers health• Bus drivers – a group with high risk behavior - smoking, overweight ect.• 3 year long research and development project• focus on how education and workplace structural changes can motivate drivers to take action on changing

their lifestyle• How can we use technologies such as games or self monitoring technologies to create changes?

What creates sustainable health changes in large groups of participants?

• Projects that takes place in the multiple settings of peoples everyday life– schools, workplaces, family homes

• Multiple approaches and multiple types of interventions– designing physical activities, environmental changes etc.

• Projects that involves many local stakeholders– schools, local authorities…

• Community-based projects– neighborhoods, local sports organizations…– Projects that people also benefit socially from

• Algazy et al., 2010, Green & Tones, 2010, Poland et al., 2000; Jensen, 2009b; Naidoo & Wills, 2009

Review Methods

• Search criteria's and data sources: – identification of central studies through their mention in

WPH reviews from the past 30 years– aim to get a versatile – though not exhaustive – overview

as opening for a WPH project – databases: HSELINE, CISDOC, NIOSHTI, Cochcrane,

Occupational health field…– key search words: work (worksite or workplace) AND

“health promotion” AND review in title, keywords and abstract + published between 1980 – 2010

– 1030 review articles

Review methods – study selection

• Selection process resulted in: 71 cases and 127 articles

Selected studies• IBM - A Plan for life (Fielding J. E (1984))

• UK Heart Disease Prevention Project (Rose et al , 1985)

• Johnson and Johnson (Breslow et al, (1990))

• Dutch Worksite wellness (Maes et al, 1998)

• CitiBank (Ozminkowski RJ et al (2000))

• Heartbeat Award/Challenge (Holdsworth,2004)

Review process: reading between the lines • Aim was to analyze a broader trend of tech use in major WPH programs -

not to detect single studies with focus on tech use– Focus on technology use in implementations and not as analytical tool

• “How has computer-based technology and electronic media been used in WP health interventions during the past 30 years”– 30 years of technology use – inclusion of electronic media, video films,

telephones ect.

• Lack of detailed descriptions of specific use of technology– Eg.: Education or information campaigns?

• Very little method reflection on use of technologies– Aim with using technologies, purposes they were used for, why one

technology was used instead of another etc.

Results: Categorizing tech useTechnology use categorized into classic types of WPH interventions :

1. Education• As a tool used for educational purposes:

• smoking stop classes, education in nutrition etc.• Video films, emails, websites• Individualized education based on computerized HRA's (health risk

assessments)

2. Information • As a tool for:

• Providing general Information on health risk behavior• Recruitment of participants• Promotion of health programs or services

• Mass media, radio, video films, emails, websites• Individualized information based on computerized HRA's

Results: Categorizing tech use3. Counseling & follow up

• As a tool used in counseling • Nutritional issues, changing daily habit, raise level of physical activity

• Two groups of uses:• Computer generated individual health reports (HRA's) with screening results, individual health risks and

suggestions for lifestyle changes “women's magazine”• Remote counselling, hotlines

4. Supporting organization of physical activity• Few but interesting examples of tech use

• web-based wellness program - combination of use of pedometers and a web-based program where participants can compare progression and compete on results of physical activity

• Use of electronic media in participant planning of exercise classes

5. Environmental changes• Changing the environment or facilities at workplace• Few not so interesting examples

• video information installations• Electronic media used for educating participants in how to change the social and physical environment by

changing individual behaviour and worksite norms to e.g. smoking.

Cross-over tech use.

As a virtual setting and/or tool for participant planning and sharing of information on own physical activity and/or other health activities30, 44

For creating awareness of heath activities in working environment. 22, 27

For advising participants on, or create awareness of, program services or components5i, 14ii, 19ii

For individualizing information on health condition and health risks (computer generated HRA reports)15viii, 21, 32, 33, 35

For interventions aimed at changing the social and physical environment by changing individual behavior and worksite norms to eg. Smoking9iii

For health education in working environment7iii

For individualizing counseling (HRA, computer generated survey results) 4iii, 15viii, 34, 50, 62

For recruiting participants or introducing to health program content 3ii, 22, 27, 51,70

For health education, nutrition, anti-smoking etc.2vii, 4iii, 7i, 7iv, 9iii, 9vi, 11iv, 15i, 17ii, 51, 64

For assisting participation in co-design of physical activities 4i

Physical activityEnvironmental changes

Education Counselling

Technology in workplace health promotion interventions

Information

For distribution of health information in working environment4i, 4iii

For remote counselling or consultations2vii, 5i, 14ii, 15i, 15iv, 15vi, 23, 30, 39, 43,, 56, 59

For distribution of health information and/or promote health behavior2vii, 9iv, 11i, 11ii, (18ii), 26, 30, 66, 69

As counselling tool17i

For individualizing information on health condition and health risks with an educational aim25, 34

As a virtual setting and/or tool for individualized education44

Overall results• Most frequent use of computer based technology and electronic media

have been in interventions that involve – education, – information distribution– counseling.

• Fewer studies where technology is used as a tool in– structural changes of working environment– physical activities

• Little methodological reflection on what these tech tools contribute with

• Great potential in thinking in new types of categories.

Perspectives• What can games and play technologies contribute with?

• Which type of games, projects and technologies could be developed in future projects?

– new versions of old approaches eg. remote counseling– cross- category technologies?

• Suggestion to up scale of the health promotion technology field: understanding how we can use games to link the many settings of peoples everyday life.

– Understanding how games and technologies can be used to create new types of settings

• Think in game and play technologies for both broad and narrow health promotion/prevention interventions

• broad development and networking tools + small games for education or physical activity

Possible games and play technologies

Results