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

1. University of Limerick O L L S C O I L L U I M N I G H Mid-Western Area Parallel Sessions IV: Friday, May 20, 2005, Session IV Health promotion for hospital staff - Coping with work related risks and developing health promoting lifestyles 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

2. 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%

3. Personal Factors Interpersonal Factors Psychological Theory Success of physical activity programme Institutional Factors Environmental Factors Policy/Legislation Behavioural Intervention Methods Success of Physical Activity Programmes is Dependent on a Number of Factors Access to Education

4. 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

5. METHODOLOGY Physical Activity Lifestyle Survey • 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

6. INCLUDED EXCLUDED 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

7. 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

8. 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

9. 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)

10. 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 (p0.05) CONTROL GRP 45%  PA by 1 stage No significant differences in control group on Mediators of Physical Activity RESULTS – POST INTERVENTION

11. 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

12. “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) Challenges to Sustaining PA

13. “I always ask my sister to come walking with me and my other sister” “By going to the walking series…… I found out about other walks” (Joanne) “I have a work colleague ….she asks me [to walk with her] and is brilliant to motivate us” (Clare) Supports for Physical Activity

14. “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) Physical Activity Levels on Entry to Programme

15. 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 (p0.05) • Regression on 8 processes of change, decisional balance & enjoyment for PA (p0.05) • No significant regression from pre-intervention to 6-month follow up occurred. Positive trends overall.

16. 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