Stair Use: A workplace Stair Use: A workplace intervention to promote physical intervention to promote physical

activityactivity

Dr Holly Blake Dr Holly Blake Lecturer/Chartered Health PsychologistLecturer/Chartered Health Psychologist

School of Nursing, University of NottinghamSchool of Nursing, University of Nottingham

On behalf of the Q-Active Project TeamOn behalf of the Q-Active Project Team

A Q-Active StudyA Q-Active Study

OverviewOverview

The Q-Active Team

What is Q-Active?

How does the stair use study fit in?

How will this initiative be scientifically evaluated?

The Q-Active TeamThe Q-Active Team

An alliance between QMC, Sport England and the University of Nottingham

Dr Sandra Lee, Active Workforce Project Manager, QMC

Prof Mark Batt, Centre for Sports Medicine, QMC Mrs Pauline Hodgson, Human Resources, QMC Ms Isobel Schofield, Finance Department, QMC Mrs Ilana Freestone, Sport England

Dr Holly Blake, School of Nursing, University of Nottingham

The Q-Active ProjectThe Q-Active ProjectPrimary aim To change the health culture of QMC to

encourage increased physical activity and healthy behaviours amongst staff

Secondary aims To produce a cost-saving to QMC in terms of:

– reduced lost days due to sickness absences– Increased productivity

To improve staff physical health, psychological wellbeing and job satisfaction

To improve the perception of the organisation in the local community and amongst staff

How will we achieve How will we achieve this?this?

To improve current staff physical activity facilities and provide more opportunities to be

physically active at work– To significantly increase physical activity levels of QMC

staff To improve the nutrition facilities for QMC staff

– To significantly improve nutritional intake of staff whilst at work

To provide facilities for staff to unwind, socially interact, take breaks and to enhance their psychological wellbeing at work – To reduce stress/improve wellbeing in QMC staff

To develop Trust health policies – To affect the health culture of QMC management

Providing opportunities to Providing opportunities to be physically activebe physically active

Stair Use: A workplace intervention to promote Stair Use: A workplace intervention to promote physical activityphysical activity

The goal of this intervention is:

– to make taking the stairs the norm and not the exception by presenting stair climbing in a new way

– To meet the objectives of the Q-Active project in providing an ecological environmental intervention to increase physical activity and change the health culture of staff at QMC

Why be more physically Why be more physically active?active?

Physiological benefits of exercise– can favourably alter important cardiovascular risk

factors in previously sedentary individuals (Boreham et al, 2005)

– increases in daily energy requirements (Bunyard et al., 1998)

– reductions in body fat (Bunyard et al., 1998; Cox et al., 2001)

– decreased resting heart rate (Cox et al., 2001; Kobayashi et al, 2001)

– increased flexibility (Adams, 2001)

– reduced blood pressure (Cox et al., 2001; Moreau et al., 2001).

– helps to control changes associated with midlife and menopause :

including depression, weight gain, loss of muscle mass and bone density and risk of heart disease

(McAuley & Rudolph, 1995; Shangold & Sherman, 1998).

Why be more physically Why be more physically active?active?

Psychosocial benefits of exercise

increased self-efficacy towards exercise– (Adams, 2001; McAuley et al, 1995)

reduced physique anxiety – (McAuley et al., 1995; Sorensen et al, 1997)

decreased symptoms of depression – (Moore et al., 1999)

positively influence quality of life – (Shepherd, 1995)

Improved social well-being – (Biddle and Mutrie, 2001).

Why the stairs?Why the stairs?BENEFITS TO EMPLOYEES

Activities like stair climbing can significantly contribute to the 30 minutes of physical activity we all need… everyday, plus…

Stair climbing is easy to do in most workplaces

Moderate intensity lifestyle activities like taking the stairs may be more successfully promoted than structured vigorous intensity exercise

More benefits to More benefits to employeesemployees

Cardiovascular disease and death lower amongst regular stair users

Two flights of stairs climbed per day can lead to 2.7 kg weight loss over one year and using the stairs burns twice as many calories as walking

Taking the stairs is often the quickest way to a destination especially at peak times

Benefits to the EmployerBenefits to the EmployerQMC NHS TrustQMC NHS Trust

People spend more than one-half of their waking lives at work.

In order to stay healthy we need to find ways to incorporate physical activity into our workday

Active employees are healthier and more productive employees

Physical activities like stair climbing are a great way for employee to cope with job-related stress.

More benefits to the More benefits to the employeremployer

Economically viable– Stair climbing is less costly and more accessible than

other employee wellness programs

Effective– Stair climbing interventions typically result in a 6-15%

increase in stair use

Results– Workplaces which implement stairway physical

activity programs report improved employee relations, camaraderie and teamwork.

Furthermore…Furthermore…

No health inequalities– Using the stairs requires no special

skill, equipment or clothing

Good for the environment!– Stair climbing is a 'green' activity, the

only energy source used is what is stored in our bodies.... good for you and the environment!

Stair use as ‘incidental Stair use as ‘incidental activity’activity’

focus is now upon the accumulation of physical activity during the course of a day – (Jakicic and Wing, 1995).

Accumulating activity in this way may result in attaining the adequate level of energy expenditure across the course of a day – (Dunn et al, 1998).

focusing on incidental activities may help to target less active individuals.

Incidental activities such as stair climbing and walking are easy ways to increase activity levels by accumulating activity throughout the day

Research Design: Research Design: Scientific EvaluationScientific Evaluation

a mixed-methods study incorporating:

– an observational study with a time-series design

– a questionnaire study of self-reported stair use

– a qualitative study using staff focus groups

Data will be collected at baseline, intervention and follow-up

SettingSettingQueen’s Medical Centre NHS Trust (QMC)

Participants: all QMC Trust employees

Observational data will be collected on staff and members of the general public (incl. patients/visitors) during each phase of the study.

Self-report questionnaire data will be collected from staff working on floors C-F of the Queen’s Medical Centre building.

Focus groups will be run with a representative group of staff working on various floors at QMC from various occupational backgrounds

InterventionIntervention

The environmental intervention will consist of appropriately placed signs (point of decision prompts) conveying health messages

– eg “step up to better health”– possible Q-Active button at lifts

Phases of studyPhases of study

Following a two-week set-up period, data collection will occur in phases as below:

Baseline (weeks 3-4): Two weeks Intervention 1st phase (weeks 5-6): Two

weeks No intervention control phase one

(weeks 7-8): Two weeks Intervention 2nd phase (weeks 9-10)

Two weeks No intervention control phase two

(weeks 11-12) Two weeks

ProceduresProcedures

Observational Measures Counts of stair use during a 24-hr period on each day

during each phase of the study

Using thermal camera proximity sensors which will assess direction of stair walking in a non-obtrusive and accurate way

Questionnaire data Self-report questionnaire about stair use will be sent to

staff working on floors C-F at baseline (week 3) and following first phase intervention (week 6)

This data will allow us to further determine stair use amongst staff (as QMC is a public building and so observation will include many non-staff individuals).

ProceduresProceduresFocus GroupsStaff focus groups will be run at baseline (during week 3-4)

to explore existing staff attitudes towards physical activity and stair climbing as a method of increasing physical activity.

We can determine from this:

How active are staff at QMC already? Do they most frequently use stairs or lifts?

At the second phase of focus groups (during week 13-14) we will be able to determine:

How active are staff at QMC following intervention? Do they now most frequently use stairs or lifts? How effective/influential did they find the prompts?

A great plan! And A great plan! And scientifically valid…scientifically valid…

The proposed study is one of a number of evaluations that are planned for Q-Active

It will be the first mixed-methods study of its kind with the potential for long term follow-up

It is vital that this important study is scientifically evaluated in order to provide firm evidence to influence policy and practice

Results will contribute to Trust policy on physical activity and health

SummarySummary We need to increase physical activity in

the population for a variety of health reasons

The workplace is a good setting to target large numbers

Healthcare settings need to set the example for workplace interventions for health

By increasing stair use at QMC (added to other Q-Active interventions) we aim to do this

We need immediate funding! Any ideas?