The Effect of a Physical Activity Education Programme in the Hospital Workplace Setting

Sohun, R., MacDonncha C., Breen, A. & Neeson, B.

13th International Health Promotion Conference, Dublin May 18th-20th 2005 Mid-Western Area

University of Limerick

O L L S C O I L L U I M N I G H

Parallel Sessions IV: Friday, May 20, 2005, Session IV

Health promotion for hospital staff - Coping with work related risks and developing health promoting lifestyles

INTRODUCTION

Sedentary behaviour is a leading contributor to chronic health problems (European Heart Network, 1999)

The workplace has been identified as a setting for health promotion intervention

Physical activity participation rates of young women are low (National Health & Lifestyle Surveys, 1998 & 2002)

1998 2002– Participation in Mild Physical Activity: 25% 17%

– Participation in Moderate Physical Activity: 44% 41%

– Participation in Strenuous Physical Activity 8% 8%

– No participation in Physical Activity: 14% 21%

Success of Physical Activity Programmes is Dependent on a Number of Factors

Personal Factors

Interpersonal Factors

Institutional Factors

Environmental Factors

Policy/Legislation

Success of physical activity

programme

Access to Education

OBJECTIVE

To examine the effectiveness of a 10-week

educational physical activity intervention called

“ACTIVE WAYS” on the physical activity behaviour of sedentary young female staff in a

hospital setting

METHODOLOGY

Distribution of a Physical Activity Lifestyle Survey to females (18-40 years) in 2 hospitals (n=719 Regional Hospital, n=150 Maternity Hospital)

Overall Response Rate : 38%

Respondents categorised according to:– Willingness/Interest to attend a PA programme– Suitablility according to the PAR-Q (Health Screen)– Physical Activity Stage of Change Model

Physical Activity Lifestyle Survey

INCLUDED

Physical Activity Stage of Change Model (Marcus et al, 1992)

Proposes 5 stages of readiness for adopting physical activity

– Pre-Contemplators

– Contemplators

– Preparation

– Action

– Maintenance

SAMPLE

Intervention Group – 62 invited to participate (fit criteria)– 27 signed up– 23 began the programme (mean age 32.9±5.4 years)

– Received the intervention

Control Group – 24 invited to participate – 9 participated (mean age 29.4±5.3 years)

– Received no intervention

INTERVENTION• 10-week programme

• 1hr weekly in the hospital

• Supported by hospital mgmt

• Participant Workbook•Time management

•Activity Types

•Barriers to Physical Activity

•Measuring Progress (included PA)

•Social Support

•Goal Setting

•Healthy Eating X 2

• Assistance with planning PA

• Pedometer

INTERVENTION MEASURES

Body Mass Index Stage of Change Physical Activity History Mediators of Physical Activity

– Processes of Change– Self-Efficacy– Decisional Balance– Outcome Expectations for Exercise– Enjoyment of Exercise

Pre, Post, 6 month time points (Intervention Group)Pre, Post (Control Group)

RESULTS – POST INTERVENTION

INTERVENTION GRP– 78% PA by 1-2 stages

– Attendance at 50% sessions (> change)

– Improvement in Mediators of Physical Activity:

8 of 10 Processes of Change

Decisional Balance Self-Efficacy Outcome Exp for PA Enjoyment for PA (p0.05)

CONTROL GRP– 45% PA by 1 stage

– No significant differences in control group on Mediators of Physical Activity

QUALITATIVE ANALYSIS

Primary Theme SUSTAINING PHYSICAL ACTIVITY

Challenges

Supports

Methodology– Field Notes from Informal Interviews (post intervention)– Inductive analysis for Primary Themes

Sustaining Physical Activity

Barriers to Attending the Programme

Physical Activity Levels on Entry to Programme

Challenges to Sustaining PA

“I just don’t have time [to exercise]. I have to wait until my husband comes home. He works nights and sometimes shift work” (Debbie)

“Weather and time are my big problems” (Ann)

“I had a lovely ring route I used to walk, but now there are a few dogs on the route…so I can’t use it”

(Sinead)

Supports for Physical Activity

“I always ask my sister to come walking with me and my other sister”

(Joanne)

“By going to the walking series…… I found out about other walks”

“I have a work colleague ….she asks me [to walk with her] and is brilliant to motivate us”

(Clare)

Physical Activity Levels on Entry to Programme

“As a person with a weight issue and being very big, it was very disconcerting and de-motivating on day 1 to have people reporting that they were active 2-3 days per week. I was doing nothing….It was horrible to compare myself. When I did manage to attend, I found myself lying as the group standard was far higher [than what I was doing].”

(Mary)

RESULTS – 6 MONTHS POST (INTERVENTION GROUP ONLY n=21)

14% moved positively by 1 or 2 stages

19% retained their positive change

10% remained unchanged in contemplative stage

57% regressed by 1 or 2 stages

Improvement in self-efficacy and 2 processes of change (p0.05)

Regression on 8 processes of change, decisional balance & enjoyment for PA (p0.05)

No significant regression from pre-intervention to 6-month follow up occurred. Positive trends overall.

CONCLUSION

Intervention was successful at changing physical activity behaviour of sedentary female hospital employees.

To maintain change additional support may be required.

Recommendations & Considerations– Size of the workplace (adequate sample)– Time of programme (consideration for shift patterns)– Support from Hospital Management is essential– Inclusion of Physical Activity during Programme– Physical Activity Goal (individual or group) on finishing

programme