Skip to main content
NCBI home page
SAGE - PMC COVID-19 Collection logoLink to SAGE - PMC COVID-19 Collection
. 2023 Jun 3;37(5):722–723. doi: 10.1177/08901171231172013

Editors’ Desk – Creating a Movement for Healthy Physical Activity at Work

Laurie Whitsel, Elizabeth Ablah, Tom Richards
PMCID: PMC10281907  PMID: 37269240
editorial Am J Health Promot. 2023 Jun 3;37(5):722–723. doi: 10.1177/08901171231172013a

Editors’ Desk – Creating a Movement for Healthy Physical Activity at Work

Laurie Whitsel, Elizabeth Ablah, Tom Richards

The COVID-19 pandemic transformed our work environments. Occupations like health care, emergency services, retail, and the food and restaurant industries were on the front lines. These employees made tremendous sacrifices to protect the health of entire communities. Early in COVID-19, some were laid off from their jobs. Many worked despite increased risks of work-related exposure. Other occupations shifted to remote and/or hybrid work environments. Regardless of the occupation or work environment, these changing dynamics impacted how people move during the workday, and employers should be paying attention.

Physical activity and physical fitness benefit employees’ health and well-being in a myriad of ways – including improved mental health, 1 increased energy, 1 increased immunity against infectious diseases like COVID-19,2-4 enhanced vaccination response, 5 improved chronic disease and weight management, 1 reduced risks of hypertension, diabetes, and other leading risk factors. 1 Physical activity can be one of the most effective “medications” or “treatments” for overall health and well-being, and it has a positive impact on productivity, focus, and creativity. 6 As business and organizational leaders prioritize employee health and well-being and aim for retention, advancement, productivity, and lower health care costs, integration of physical activity – even light physical activity to reduce sedentary behavior – benefits employees and employers!

It is time to create a movement that assures all occupations and work settings are designed to integrate healthy physical activity and decrease sedentary behavior, thereby improving our health. Business and organizational leaders should role model active living and commit to designing healthy work environments. This special issue: (1) provides the rationale for building the movement, describing why and how physical activity and fitness contribute to our well-being at work, (2) highlights a new CEO Pledge from the Physical Activity Alliance that is catalyzing change, and (3) includes interviews from leading voices on how employers and employees are adapting to changing work environments and prioritizing their health and well-being. Please help spark the movement for healthy physical activity and fitness at work, and in leisure time, to sustain health and well-being for decades to come.

References

  • 1.US Department of Health and Human Services . Physical Activity Guidelines for Americans, 2nd edition. 2018. [Google Scholar]
  • 2.Sallis R, Young DR, Tartof SY, et al. Physical inactivity is associated with a higher risk of severe COVID-19 outcomes: a study in 48,440 adult patients. Br J Sports Med. 2021;55(19):1099-1105. [DOI] [PubMed] [Google Scholar]
  • 3.Young DR, Sallis JF, Baecker A, et al. Associations of physical inactivity and COVID-19 outcomes among subgroups. Am J Prev Med. 2022. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Hamer M, Kivimäki M, Gale CR, David Batty G. Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalization: a community-based cohort study of 387,109 adults in UK. Brain Behav Immun. Published online 2020. [DOI] [PMC free article] [PubMed]
  • 5.Nieman DC, Wentz LM. The compelling link between physical activity and the body’s defense system. J Sport Heal Sci. Published online 2019. doi: 10.1016/j.jshs.2018.09.009 [DOI] [PMC free article] [PubMed]
  • 6.Hogan CL, Mata J, Carstensen LL. Exercise holds immediate benefits for affect and cognition in younger and older adults. Psychol Aging. 2013;28(2):587-594. [DOI] [PMC free article] [PubMed] [Google Scholar]
editorial Am J Health Promot. 2023 Jun 3;37(5):722–723. doi: 10.1177/08901171231172013b

Physical Activity Promotion in the Evolving Work Landscape

Laurie P Whitsel 1, Elizabeth Ablah 2, Nicolaas P Pronk 3,4,5, Frederique Huneycutt 6, Mary T Imboden 7,8, David Anderson 9, Neil E Peterson 10, Samantha Yocke 11, Chase Sterling 12, Anna L Zendell 13, Janet R Wojcik 14

Introduction

How and where we do our work is changing in the United States across industry, government, and non-profit sectors. This evolving landscape includes downsized office space, the reduction of corporate fitness centers, decreased daily commutes, increased hybrid or remote work environments, and experiments with the length of the work week. While some of these changes may prove transient, others will likely be permanent changes affecting the context of work. Some occupations require in-person work settings, especially in the health care, education, travel and food processing sectors. Many of these employees are experiencing burnout after prolonged overtime work and stressful pandemic-related work conditions. Accordingly, employers are turning their focus to employee health and well-being; productivity, retention, promotion; diversity, equity, and inclusion; re-thinking their corporate wellness programs; and prioritizing financial stability, work-life balance, mental health, and other health-promoting culture, systems and policy changes. 1

Maintaining regular physical activity is one of the most important lifestyle behaviors for physical health, mental health, and well-being. Employees who have higher physical fitness demonstrate increased productivity and work efficiency, better attention and concentration, improved mood and energy, more creativity, better stress management, and improved mental health.2-4 Thus, employers should prioritize physical activity among their employee health promotion solutions, including appropriate and safe physical activity at work as well as encouraging adequate leisure time and transportation-related physical activity (see Table 1).

Table 1.

Domains for Physical Activity Across the 24-hour Movement Cycle. 5

Physical Activity Definition
Occupational Activity done as part of one’s employment. This does not include exercise or physical activity engaged in at employer-sponsored gyms or other facilities
Leisure time Exercise, sports, and physical activity done in one’s leisure time
Commuting/Transportation-related Physical activity undertaken for the purpose of getting from one place to another, including to and from work
Open in a new tab

This article outlines why physical activity is important; what has happened to adults’ physical activity levels during the COVID-19 pandemic; how employers and employees are responding to changing work environments; potential solutions for promoting physical activity with particular focus on vulnerable employee populations; which industries, job types, and population sub-groups may be most affected; and the impact on health care costs and utilization. Given that appropriate levels of physical activity and fitness across work and in leisure time can sustain workforce health and well-being, employers should be leading the way in supporting this movement.

Background

The changing dynamics in our various work settings are affecting how people move throughout the day, and concurrently in their leisure time, which has a direct impact on their physical activity and cardiorespiratory fitness levels. During the pandemic, there was a significant overall decrease in physical activity, with disparities across certain geographies, ages, occupations, job types, and racial and ethnic groups. 6 Some of this reduction in physical activity levels may be attributed to stay-at-home orders, resulting in a switch to remote work, long hours by front-line responders, and closure of exercise facilities, parks and schools. 6 The downward trend in physical activity as well as the variety of other stressors during the pandemic had profound negative effects on mental health.7,8 Other chronic disease risk factors increased during the pandemic as well, including diabetes, hypertension, and obesity.9-11 All of these trends have significant negative implications for burnout, resiliency, retention, and work satisfaction as well as healthcare costs and utilization. Already stretched health systems are burdened by preventable disease. Entire communities are failing to benefit from the wider social, environmental and economic benefits associated with more people living active lives. 12

Benefits of physical activity promotion accrue not only to workers and their families but also to employers and other institutions. A review of the literature 13 noted increased productivity, more meaningful co-worker interactions, reduced injury rates, lower presenteeism, and lower excess medical care costs for employees. In addition, benefits for the employer include healthier work culture, increased company performance in the marketplace, enhanced corporate image, and improved retention of talent. 14

Meanwhile, employers continue to face soaring health care costs and health care utilization. 15 The economic burden of physical inactivity is estimated at $27 billion/year due to treatment costs for resulting non-communicable diseases and worsening mental health. 16 In one study of more than 50,000 older adults, total average healthcare expenses (including medical and pharmacy) were 16% lower for fitness program participants compared to non-participating members. Another study suggests meeting aerobic physical activity guidelines is associated with reduced healthcare utilization for inpatient, primary care, and emergency department visits. 17

Variation in Physical Activity by Race, Ethnicity and Geography

Currently, no more than 28% of the US adult population meets both the aerobic and muscle strengthening physical activity recommendations. 18 Adults in rural counties (16.1%) are less likely to meet combined physical activity guidelines compared to those in major urban centers (27.8%), while adults in the West region (28.5%) are more active than adults in the Northeast (24.4%), Midwest (23.4%), and South (22.0%). 18 Most recent data indicate notable differences in physical inactivity levels by race and ethnicity. Overall, Hispanic adults (32.1%) had the highest prevalence of aerobic physical inactivity outside of work, followed by non-Hispanic Black (30.0%), non-Hispanic American Indian/Alaskan Native (29.1%), non-Hispanic White (23.0%), and non-Hispanic Asian (20.1%) adults. 19 When the physical inactivity map is compared to other maps that display prevalence of chronic diseases, obesity, tobacco use, dietary habits, short sleep duration, or COVID-19 death rates, similar patterns emerge—the highest prevalence of unhealthy lifestyle behaviors coincides with the highest mortality rates for COVID-19. 20 Furthermore, these prevalence rates patterns are similar to other maps summarizing the proportion of people living without health insurance, living in poverty, or who are Black or non-Hispanic. 21 Therefore, depending upon the geographic location of the work setting, strategies deployed to promote physical activity in the workforce should consider the prevalence of physical activity in the larger surrounding community where the worksite or workforce is located. When deployed, this geographic strategy should ideally consider cultural sensitivities likely to differ among communities and surrounding neighborhoods of companies located in different parts of the country.

The Impact of COVID-19 on Work Settings and Physical Activity Levels

During the pandemic, physical activity levels declined due to community-level mitigation strategies, such as stay-at-home orders and business closures, which restricted access to places where adults were most able to be active. 22 For many businesses with primarily non-essential workers, organizational survival depended on successfully navigating an almost total shift to remote work. In other businesses, essential workers migrated to a hybrid schedule in which on-site exposures were minimized while still getting essential on-site work accomplished. Between 2019 and 2021, the number of employees working remotely tripled from 5.7% to 17.9%. 23 The financial, communications/information, and technical/professional service industries reported the highest proportion of remote workers. 24

With increases in remote work came increases in sedentary behavior. A study 25 from Stanford University surveyed 1316 working adults 25 and 74 years old to assess the impact of remote work on physical activity levels. On average, the results showed that working from home was associated with an additional two hours of sitting time compared to employees working entirely in person (9.2 vs 7.3 hours of sitting time, respectively). This study also reported that employees working exclusively from home were more likely to report an increase in sedentary behavior and a decrease in exercise time from their pre-COVID level compared to adults working entirely in-person.

This reduction in physical activity is a result of a variety of factors, including reductions in active transportation, changing work-life balance, decreased employer support for physical activity, and home and community-built environments that are less conducive to physical activity. The HERO Health and Well-being Best Practices Scorecard™ is a free online organization-level health and well-being scorecard designed to help companies learn about best practices for promoting workplace health and well-being and to discover opportunities to improve and measure progress over time. Data from the HERO Scorecard Version 5 (n = 246 organizations) show that organizations with a higher proportion of remote employees (more than 75% remote workforce (n = 37)) are less likely to have written policies supporting physical activity in their workforce when compared to organizations with smaller proportions of their employees working remotely (<25% remote workforce (n = 150) and 25-74% remote workforce (n = 59)). Additionally, organizations with a higher proportion of employees working from home reported their physical work environment to be less likely to support physical activity by providing amenities such as onsite fitness centers, walking trails, and standing desks. 20

A person’s employment industry determines how and when they work. Additional analyses of HERO Scorecard Version 5 data showed the technical/professional services industry had the largest proportion of employees working remotely, followed by the financial services industry. Conversely, food services, transportation, manufacturing, and healthcare all reported low percentages of employees working remotely. When organizational support for physical activity was analyzed by industry type, the retail (11.1%), healthcare (24.1%), and manufacturing (21.4%) industries were much less likely to have written policies supporting physical activity in their workforce compared to technical/professional services (50.0%), financial services (50.0%), education (50.0%), and government industries (50.0%). Further, the technical/professional services (70.6%), financial (92.3%), and education (82.1%) sectors were the most likely to report physical work environments that support physical activity options, while the retail (55.6%), communications (60.0%), and manufacturing (57.1%) sectors reported the lowest percentages. 20

Most employers have begun bringing at least some employees back on-site, but many remain committed to continuing hybrid work schedules. This continuation of hybrid work may partially stem from the need to retain employees in a competitive market, since surveys indicate that a vast majority of workers do not want to return to the office full-time. 26 However, many employers have also reported short-term productivity gains they attributed to these more flexible work arrangements.27,28

Despite the potential of flexible hybrid or remote work arrangements to elevate work performance during the time-limited period of the pandemic, it is unclear whether such productivity gains can be sustained as the economy and job market return to normalcy. A recent Gallup survey of a nationally representative sample of more than 8000 employees reported threats to long-term productivity including the lack of access to resources and equipment, feeling of disconnection with culture, and difficulties with collaboration and developing co-worker relationships. 29

How Employers and Employees Are Evolving Worksite Health and Physical Activity Promotion

Due to the pandemic and generational transitions reshaping the workplace, a more permanent era of hybrid work for desk-based employees may be emerging, but there is still limited hybrid functionality for most frontline workers, like manufacturing and healthcare. 30 Reportedly, 58% of organizations that employ frontline workers have invested in improving their employee experience in the past year, including benefit programs. About a third of those that have not yet done so intend to in the next 12 months. 31 With a renewed focus for many employers on inclusivity, making sure the entire workforce has access to promoted health initiatives, like physical activity, is foundational for fostering successful adoption and buy-in.

Hybrid environments and remote work are shifting how employees in more sedentary positions work during the day and how employers can offer opportunities for employees to be physically active. Access to on-site facilities may be less of a priority than before the pandemic and can be replaced with incentives to take time for physical activity when working remotely. Examples include companies providing flexible work schedules to allow for physical activity during the day; subsidizing park or fitness center memberships or sessions with a health and fitness professional. Other occupations where employees have been on the front lines during COVID-19 and are moving throughout their work day such as health care, retail, and the food industry, have different needs. These employees may get more of their physical activity at work (ie, occupational physical activity) vs in leisure time, so workplace health promotion programs should prioritize the safety of their physical activity and adjust for other health and well-being priorities like work-life balance.

Employers have also shifted over the past five years from addressing primarily physical health-related initiatives to a greater emphasis on mental health, financial wellbeing, and diversity, equity, inclusion.32,33 There is a positive correlation between exercise and lower levels of stress, improved sleep, and higher overall quality of life, which carries over into the workplace.34,35 Despite this, employers are not emphasizing physical activity enough to address engagement and burnout, instead relying on flexible work schedules and mental health resources to make progress. 29 Other obstacles for employees getting adequate levels of physical activity is job roles and lack of time. Studies have shown modest results when incorporating physical activity into the workday, but barriers remain around culture, logistics, and technology adoption. 36

Employers have also pivoted on physical activity program offerings. When on-site fitness classes became restricted due to the pandemic, 47% of employers began investing more in on-demand sessions. While this trend is more commonly observed amongst large employers, small and mid-size organizations could benefit from this lower cost option that removes the need for space and equipment. 29 On-demand options allow employees to access a variety of physical activity opportunities at the time and place of their choosing. This can be especially appealing to hybrid and fully remote workers, as well as employees who may not feel comfortable participating in physical activity programs alongside their coworkers. On-demand options may also provide increased diversity in the types of physical activity programming offered, which is important to ensure that people with different abilities can participate and enjoy movement options. 37 Employers should consider working with vendors who not only have diverse instructors and physical activity options, but also provide an environment that truly welcomes and celebrates differences including size-inclusivity and ability level. 38

Potential Solutions for Integrating Physical Activity Promotion in the Evolving Work Landscape

In the evolving work landscape, Table 2 provides examples of both public policy levers and organizational level solutions to promote physical activity in workplace settings and commuting to and from work. Employee input into organization-level policy development and systems change is critical to foster co-creation, co-ownership, commitment, and sustainability. Employers are also experimenting with new approaches to work, such as the four-day work week, which may have an impact on leisure-time physical activity, mental health, and improved employee satisfaction and retention.

Table 2.

Examples of Public Policy Levers and Organizational Level Solutions to Promote Physical Activity in Workplace Settings and Commuting.39-46

Public Policy Levers
• Offer tax incentives for employers who provide subsidies for active transportation/use of public transportation to work, memberships to recreational/fitness facilities, and/or supervised exercise prescription with a health and fitness professional
• Allow health savings accounts/flexible spending accounts to cover physical activity-related expenses (eg, pass legislation similar to Personal Health Investment Today Act)
• Make grants available to employers (especially small-mid-size employers) to offset costs of wellness and physical activity programming
• Fund for complete streets policies and other active living infrastructure and connectivity in community design
• Standardize and implement performance and quality measures for physical activity assessment, prescription, and referral in health care delivery with state and federal regulation and public and private health care plans
• Create appropriations for training in physical activity promotion across multiple professions
• Organizational-level strategies
• Provide subsidies for memberships to health and fitness clubs, parks, and other community recreational facilities, and/or for supervised exercise prescriptions with a health-and-fitness professional (facilitated through local partnerships)
• Offer paid time to be physically active during the workday. Encourage short activity breaks or active meetings that provide opportunities for employees to break up sitting time (by standing or moving, especially for meetings >1 hour)
• Encourage stretching before, after, and/or during shifts, especially with employees doing manual labor to decrease the risk of musculoskeletal injury or pain
• Offer flex-time policy to allow employees to shift their work schedules to incorporate physical activity into the workday
• Implement an active meeting policy that encourages movement throughout meetings
• Offer employees opportunities to wear casual, workout-friendly attire
• Encourage individual worksite behaviors that allow for additional movement, less sitting time:
• Parking farther from the worksite’s entrance
• Walking to colleagues desk instead of calling or emailing them
• Eating lunch away from desk
• Using stairs instead of elevator
• Setting timer reminders for standing
• Create and disseminate list of tips for optimizing movement and reducing sedentary behavior for teleworkers
• Incentivize and subsidize active transportation/use of public transportation to and from work (cycle mileage reimbursement, subsidized train/bus passes)
• Purchase active workstation equipment; subsidize the purchase of home-based fitness equipment, mobility-assist devices, bikes/e-bikes, portable headphones, and other active recreation devices/equipment
• Integrate and subsidize mobile technologies/wearables to support employees in their active living journey
• Educate/raise awareness on the benefits of an active lifestyle and reducing sedentary behavior:
• Employee education programs for physical activity (individualized counseling)
• Distribution of educational materials (via classes, bulletin boards, newsletters, and high-traffic locations)
• Create a nudge (eg, email, text, music) prompting employees to move
• Offer onsite or virtual fitness classes for a broad range of activity levels
• Offer social support programs (company sports teams, walking clubs, non-competitive buddy program or exercise group accessible for all activity levels)
• Implement a worksite campus design that encourages employees to be physically active and prioritizes “equitable, safe and universal access”
• Provide on-site fitness rooms, walking paths
• Encourage use of stairs and walking paths (eg, using point-of-decision signs/prompts and ensuring that these features are well-maintained and attractive)
• Provide lockers as well as safe and clean showers and changing areas
• Enhance maintenance of sidewalks/trails (including via prompt and thorough snow/ice removal)
• Enhance access to worksite for bikers, walkers, transit users
• Boost safety of physical activity environment (through provision of lighting, cameras, safety whistles, flashlights)
• Offer bicycle racks/storage, sheltered areas to help promote active transportation
• Improve ergonomics to optimize movement and posture at work (includes option to use active office furniture/equipment such as stand-up or treadmill desks, stability balls, headsets, speaker phones)
• Establish a wellness committee to:
• Inform benefit system and infrastructure improvements
• Offer resource such as maps to walking/biking trails, accessibility maps, routes to/from public transit, info on community events and clubs, ways for remote employees to incorporate physical activity
• Establish worksite sports teams and promote buddy system and affinity groups
• Coordinate physical activity events (eg, onsite classes, competitions, challenges)
• Review health risk assessment results
• Participate in pertinent policy and program design, promotion, and communication
• Educate workforce on benefit of safe physical activity
• Partner with health organizations and insurers
• Consider employee’s family in benefit design to promote and support a culture of health behavior across the employee’s family unit (gym membership subsidy; parental leave; wellness program and events open to family members)
• Work with local governments to promote physical activity around the worksite (eg, ensuring continuity/connectivity of sidewalks and bicycle paths; improving safety with the addition of speed bumps and traffic circles; enhancing the appearance of the outdoor environment through landscaping and artwork; and providing park spaces)
• Continually monitor and evaluate physical activity promotion programs
• Tailor programming to individual employee needs and desires
• Partner with local stakeholders to develop fair-shared-use policies for professionally led physical activity (open schools, parks, churches, and other facilities)
• Set organizational goals linked to relevant internal policies that promote physical activity
• Remove redundant shared resources from individual workstations and place them in common resource areas
• Encourage and support open dialogue about health and early reporting of musculoskeletal symptoms and other health issues
• Engage employees in physical activity promotion effort (appoint champions, report back to employees)
Open in a new tab

Incorporating the Employee Voice

Organizations that can create a climate of caring by collecting employee feedback and acting upon it create environments that foster better social connections between coworkers, which can lead to an increase in positive role modeling of healthy behaviors. 47 A workplace culture that values both physical activity and meaningful employee participation in design and implementation of physical activity programming can optimize solutions that address both increasingly sedentary work environments and promoting leisure-time physical activity. Robust literature suggests that offering employees a choice in how they engage in workplace wellness is pivotal.48,49 Ways to honor the employee voice include using checklists, surveys, focus groups, team meetings, and other forms of input to learn what employees want in physical activity programming and then implementing their preferences.26,27 Allowing employees to opt out of certain activities can contribute to employees feeling they have a choice in how they spend their work days and leisure time. 26 Another approach to integrate the employee voice is to frame workplace physical activity programs as responses to employee concerns, such as fatigue and stress. 26 Linking stretch breaks and walks to improved productivity and decreased muscular aches can be a way to address employees’ stated concerns while encouraging physical activity as a solution. These approaches require employers and employees to collaborate in implementing conditions favorable to employees’ perceived ability to choose physical activity as part of their workday and leisure time and assuring sustainable implementation of workplace health opportunities.26,50 Sustained communication between organizational leaders and employees can embed the importance of physical activity and health into the organization’s core values.

Community Partnerships

Community partnerships are an important way to successfully implement physical activity strategies. Leveraging community partnerships is mutually beneficial for the community and workplace. The community partner often provides structure, planning, facilities, and expertise. Forming community partnerships is an investment in the local culture and social, physical, and economic environments. These partnerships can be small, individual partnerships like local yoga instructors leading wellness sessions with employees or large scale, comprehensive partnerships that link multiple resources together like uniting local employers, schools, businesses, and parks to create a suite of physical activity opportunities for employees and community residents.51,52

Use of Digital Tools/Technology

Given the geographical and generational diversity of many employee populations, technology has become a leading solution for providing corporate wellness programming, including physical activity initiatives, and fostering sufficient engagement. The accessibility of wearables and device connectivity can reduce barriers to participation for wellness initiatives. While 84% of US adults have a smart phone with connectivity access, incorporating other methods, such as wearable giveaways and easy-to-use computer applications, are vital to elicit an inclusive program for broad participation. 53 Digitalization has allowed human resources and benefits teams to accelerate implementation of their programs while reducing the administrative burden and stress of deploying such programs. Having the right digital tools can also promote proper measurement, which is typically a barrier for manual, spreadsheet-oriented programs, making technology an integral part of meeting goals and objectives of wellness initiatives.

Digital tools and technologies can be useful aids to support engaging in physical activity or encouraging people to stand up from their desks. Mobile and computer apps, wearable activity monitors, and personalized dashboards have been in use for decades. 54 A 2019 meta-analysis was conducted on the use of digital tools to reduce sedentary behavior in office workers. 42 Forty-five technologies were described specific to workplace sedentary behavior reduction. Some of these technologies provide physical activity health information and encouraging messages, while others allow users to set and track goals. Many can sync with other systems, such as health providers and health insurers, or with other users for peer support and accountability. Many apps and dashboards can be configured to allow public viewing of key metrics on social media or through dashboard metrics, such as minutes walked and number of days walked in order to support friendly competition and offer incentives. Similarly, digital tools can be used to gamify physical activity with potential to earn badges, points, and prizes.42,55 Apps in particular can be a low-cost means to reach employees.42,43

Whereas use of apps and other digital tools can be a cost-effective and user-friendly approach to fostering engagement in workplace physical activity, there are several considerations in assuring effective use. Data security must be assured in all digital tools. Ethically, data sharing with others, particularly employers, should be a choice; ideally, shared data should be aggregated. Selection of digital tools should be purposeful, ensuring inclusion of all employees within the organization and allowing control of the technology to rest with the individual employee. Additionally, incentivizing or gamifying workplace wellness initiatives can be an effective approach, but it is important to ensure that incentives are not coercive.

Physical Activity Assessment, Prescription and Referral in Workforce Health Promotion

With increasing health care costs for employers and increasing health care utilization, the integration of physical activity assessment, prescription and referral into workforce health promotion is critically important. Employers should consider integration of program options in coordination with prescriptions for physical activity or health from their employees’ health care clinicians. Worksite health assessment for aerobic and muscle strengthening physical activity should be consistent with those measures and related advice used in health care systems and integrated into federal and state regulations.56,57 This assures optimal and standardized assessment, as well as benchmarking and population-level monitoring. Employers can amplify and support the physical activity prescription and referral coming from an employee’s clinical visit with the strategies highlighted in Table 2. Workplaces can be supportive environments for physical activity and the originator of the physical activity prescription within health promotion/chronic disease management programming.

Conclusion

The COVID-19 pandemic amplified changes that were already beginning to reshape work in the U.S.

These changes include greater use of technology, new business models, new hiring and promotion strategies, an increased focus on mental health and financial well-being, and a renewed commitment to diversity, equity, and inclusion. Physical activity represents a well-supported strategy to counter detrimental changes to worker health that have resulted from recent shifts in the context of work. To best respond to this changing environment, employers should prioritize physical activity – addressing sedentary work environments, leisure time, as well as commuting -- in their suite of strategies to optimize employee health and well-being. Employers can be strong role models and lead a movement that promotes recommended levels of physical activity across the lifespan. That is good for workers, their families, organizations, and the community.

References

  • 1.Tarini P. Protecting employee health in tomorrow’s workplace. Robert Wood Johnson Foundation; 2022. Accessed online February 4, 2023 at Protecting Employee Health in Tomorrow’s Workplace - RWJF. [Google Scholar]
  • 2.Hogan CL, Mata J, Carstensen LL. Exercise holds immediate benefits for affect and cognition in younger and older adults. Psychol Aging. 2013;28(2):587-594. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Coulson JC, McKenna J, Field M. Exercising at work and self-reported work performance. Int J Workplace Health Manag. 2008;1(3):17. [Google Scholar]
  • 4.Brown H. Does physical activity impact on presenteeism and other indicators of workplace well-being? Sports Med. 2011;41(3):241-262. [DOI] [PubMed] [Google Scholar]
  • 5.Centers for Disease Control and Prevention . National Center for Health Statistics. National Health Interview Survey. Glossary. NHIS - Adult Physical Activity - Glossary (cdc.gov).
  • 6.Elgaddal N, Kramarow EA, Reuben C. Physical Activity Among Adults Aged 18 and over. United States; 2020. [PubMed] [Google Scholar]
  • 7.Ammar A, Trabelsi K, Brach M, et al. Effects of home confinement on mental health and lifestyle behaviours during the COVID-19 outbreak: insights from the ECLB COVID19 multicentre study. Biol Sport. 2021;38:9-21. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Barbieri PN, Giuntella O, Saccardo S, Sadoff S. Lifestyle and mental health 1 year into COVID-19. Sci Rep. 2021;11:23349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.American Psychological Association . Stress in America 2021: One Year Later: A New Wave of Pandemic Concerns; 2021. [Google Scholar]
  • 10.Centers for Disease Control and Prevention . Incidence of Newly Diagnosed Diabetes; 2022. [Google Scholar]
  • 11.Lafflin LK HW, Niles JK, Arellano AR, Bare LA, Hazen SL. Rise in blood pressure observed among US adults during the COVID-19 pandemic. Circulation. 2022;145:235-237. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Adhikari B, Global status report on physical activity 2022. Accessed online January 4, 2023 at Global status report on physical activity 2022 (phnupdates.com). [DOI] [PMC free article] [PubMed]
  • 13.Pronk NP. Implementing movement at the workplace: Approaches to increase physical activity and reduce sedentary behavior in the context of work. Prog Cardiovasc Dis. 2021;64:17-21. [DOI] [PubMed] [Google Scholar]
  • 14.Hafner M, Yerushalmi E, Phillips WD, et al. The Economic Benefits of a More Physically Active Population: An International Analysis. RAND Corporation; 2019. Accessed online April 3, 2023 at The economic benefits of a more physically active population: An international analysis | RAND. [Google Scholar]
  • 15.Cook D.The cost of long COVID to employers is skyrocketing. September 15, 2022. ALM Benefits Pro. Accessed online February 4, 2023 at The cost of long COVID to employers is skyrocketing | BenefitsPRO.
  • 16.World Health Organization . Global Status Report on Physical Activity; 2022. [Google Scholar]
  • 17.Lin CY, Ball TJ, Gentile NL, McDonald VF, Humbert AT. Associations between physical activity vital sign in patients and health care utilization in a health care system, 2018–2020. J Phys Activ Health. 2022. Published online December 08. doi: 10.1123/jpah.2022-0266 [DOI] [PubMed] [Google Scholar]
  • 18.Abildso CG, Daily SM, Umstattd Meyer MR, Perry CK, Eyler A. Prevalence of meeting aerobic, muscle-strengthening, and combined activity guidelines during leisure time among adults, by rural-urban classification and region – United States, 2020. MMWR. 2023;72(4):85-89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Centers for Disease Control and Prevention . Adult Physical Inactivity Prevalence Maps by Race/Ethnicity. 2022. https://www.cdc.gov/physicalactivity/data/inactivity-prevalence-maps/index.html. Accessed online January 6, 2023.
  • 20.Arena R, Pronk NP, Laddu D, et al. Mapping one million deaths and unhealthy lifestyle behaviors in the United States: recognizing the syndemic pattern and taking action. Am J Med. 2022;135:1288-1295. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Arena R, Pronk NP, Laddu D. COVID-19, unhealthy lifestyle behaviors and chronic disease in the United States: mapping the social injustice overlay. Prog Cardiovasc Dis. 2022. In press. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Sallis JF, Adlakha D, Oyeyemi A, Salvo D. An international physical activity and public health research agenda to inform coronavirus disease-2019 policies and practices. J Sport Health Sci. 2020;9(4):328-334. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.U.S. Census Bureau . The number of people primarily working from home tripled between 2019 and 2021. 2022. Accessed online January 29, 2023 at The Number of People Primarily Working From Home Tripled Between 2019 and 2021 (census.gov). [Google Scholar]
  • 24.Grossmeier J, Imboden MT, Johnson SS, et al. HERO health and well-being best practices scorecard in collaboration with mercer. Version 5. Available at:https://hero-health.org/wp-content/uploads/2021/02/HERO_Scorecard_V5-Editable.pdf [DOI] [PubMed]
  • 25.Streeter J, Roche M, Friedlander A. From bad to worse: the impact of work-from-home on sedentary behaviors and exercising. https://longevity.stanford.edu/wp-content/uploads/2021/05/Sedentary-Brief.pdfhttps://longevity.stanford.edu/wp-content/uploads/2021/05/Sedentary-Brief.pdf
  • 26.Ivanti . The 2022 everywhere workplace report. 2022. https://www.ivanti.com/lp/customers/assets/s1/the-2022-everywhere-workplace-report. Accessed online January 30, 2023.
  • 27.PwC . Productivity has risen with remote/hybrid working, but worker trust may pose larger challenge: PwC survey. 2021. Accessed online January 30, 2023 at.https://www.pwc.com/gx/en/news-room/press-releases/2021/pwc-future-of-work-survey-2021.html
  • 28.Zami A, Naushad M, Sulphey MM. The examination of the relationship between work-nonwork boundary and work performance using SEM. Vision: The Journal of Business Perspective. 2022. [Google Scholar]
  • 29.Wigert B, White J. The advantage and challenges of hybrid work. September 14, 2022. Gallup. Accessed online January 30, 23 at.https://www.gallup.com/workplace/398135/advantages-challenges-hybrid-work.aspx
  • 30.Parker K, Horowitz JM, Minkin R. Covid-19 pandemic continues to reshape work in America. Pew Research Center. 2022. Accessed online February 4, 2023 at COVID-19 Pandemic Continues To Reshape Work in America | Pew Research Center. [Google Scholar]
  • 31.McRae ER, Aykens P. 9 future work trends for 2023. Gartner, 2022. Accessed online February 4, 2023 at 9 Future of Work Trends For 2023 (gartner.com). [Google Scholar]
  • 32.Rethinking M.what we need from work. 2022. Accessed online February 4, 2023 at US 2022 Inside Employees Minds Report (mercer.us). [Google Scholar]
  • 33.Wellable Labs . 2022 Employee wellness industry trends report. 2022. Accessed online February 4, 2023 at 2022 Employee Wellness Industry Trends Report.pdf (hubspotusercontent30.net). [Google Scholar]
  • 34.Stamatakis E, Ahmadi MN, Gill JMR, et al. Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality. Nat Med. 2022;28:2521-2529. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 35.Yook YS. Relationship between physical activity and job stress among public office workers. J Phys Ther Sci. 2020;32(12):839-843. doi: 10.1589/jpts.32.839 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Ryde GC, Atkinson P, Stead M. Physical activity in paid work time for desk-based employees: a qualitative study of employers’ and employees’ perspectives. BMC Publ Health. 2020;20:460. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 37.Barber W. Inclusive and Accessible Physical Education for Diverse Populations. Mount Saint Vincent Press; 2017. [Google Scholar]
  • 38.Green DJ. The importance of diversity and inclusion in the fitness industry. 2021. Accessed online January 13, 2023 at.https://www.acefitness.org/resources/pros/expert-articles/7811/the-importance-of-diversity-and-inclusion-in-the-fitness-industry/
  • 39.Ablah E, Lemon SC, Pronk NP, et al. Worksite policies for promoting physical activity. Am J Health Promot. 2019;33:314-315. [DOI] [PubMed] [Google Scholar]
  • 40.Whitsel LP, Huneycutt F, Anderson DR, et al. Physical activity surveillance in the United States for work and commuting: understanding the impact on population health and well-being. J Occup Environ Med. 2021;63(12):1037-1051. [DOI] [PubMed] [Google Scholar]
  • 41.Oldridge-Turner K, Kokkorou M, et al. Promoting physical activity policy: the development of the MOVING framework. J Phys Act Health. 2021;19(4):292-315. [DOI] [PubMed] [Google Scholar]
  • 42.Centers for Disease Control and Prevention . Active People Healthy Nation: Tools for Action – Employers. March 16; 2022. Accessed online January 29, 2023 athttps://www.cdc.gov/physicalactivity/activepeoplehealthynation/everyone-can-be-involved/employers.html [Google Scholar]
  • 43.US Department of Transportation . Complete Streets. 2015. Accessed online January 29, 2023.https://www.transportation.gov/mission/health/complete-streets
  • 44.De Langen N, Peereboom K. Promoting moving and exercise at work to avoid prolonged standing and sitting. 2020. Accessed online January 29, 2023.https://osha.europa.eu/en/themes/musculoskeletal-disorders/practical-tools-musculoskeletal-disorders/promoting-moving-and-exercise-work-avoid-prolonged-standing-and-sitting
  • 45.Franklin S. Top Policy Initiatives to Encourage Physical Activity. American Council on Exercise; 2018. Accessed online January 29, 2023https://www.acefitness.org/resources/pros/expert-articles/6908/top-policy-initiatives-to-encourage-physical-activity/ [Google Scholar]
  • 46.Physical activity in the workplace: A guide for employers. Workplace Health Research Network and Johns Hopkins Bloomberg School of Public Health. 2016. Accessed online January 29, 2023 at Physical Activity in the Workplace: A Guide for Employers. Workplace Health Research Network and Johns Hopkins Bloomberg School of Public Health. jshph.edu. Published 2016. Accessed January 10, 2023.https://www.jhsph.edu/research/centers-and-institutes/institute-for-health-and-productivity-studies/_docs/archived-projects/WHRN_PA.pdf [Google Scholar]
  • 47.Saks AM. Caring human resources management and employee engagement. Hum Resour Manag. 2022;32(3):100835. [Google Scholar]
  • 48.Das BM, Mailey E, Murray K, Phillips SM, Torres C, King AC. From sedentary to active: Shifting the movement paradigm in workplaces. Work. 2016;54(2):481-487. [DOI] [PubMed] [Google Scholar]
  • 49.Centers for Disease Control and Prevention . Workplace Health Resource Center. 2019. Accessed online January 31, 2023 at Workplace Health Resource Center (cdc.gov). [Google Scholar]
  • 50.Gilson NP, Coenen D, Holterman A, Mathiassen SE, Straker L. Postpandemic hybrid work: opportunities and challenges for physical activity and public health. Br J Sports Med. 2022;6:1-3. [DOI] [PubMed] [Google Scholar]
  • 51.Bors P, Dessauer M, Bell R, Wilkerson R, Lee J, Strunk SL. The active living by design national program: community initiatives and lessons learned. Am J Prev Med. 2009;37(6):S313-S321. [DOI] [PubMed] [Google Scholar]
  • 52.Healthy Places By Design . 2023. Accessed online January 31, 2023 at Let's Partner | Healthy Places by Design.
  • 53.US Census Bureau . Computer and Internet Use in the United States, 2018; 2021. Accessed online February 4, 2023 at Computer and Internet Use in the United States, 2018 (census.gov). [Google Scholar]
  • 54.Huang Y, Benford S, Blake H. Digital interventions to reduce sedentary behaviors of office workers: scoping review. J Med Internet Res. 2019;21(2):e11079. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 55.Damen I, Brombacher H, Lallemand C, et al. A scoping review of digital tools to reduce sedentary behavior or increase physical activity in knowledge workers. Int J Environ Res Public Health. 2020;17(2):499. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 56.Whitsel LP, Bantham A, Jarrin R, Sanders L, Stoutenberg M. Physical activity assessment, prescription and referral in US healthcare: How do we make this a standard of clinical practice? Progress in Cardiovascular Diseases; 2020 [DOI] [PubMed] [Google Scholar]
  • 57.Whitsel LP, Arena R, Kaminsky LA, et al. Assessing physical activity, sedentary behavior, and cardiorespiratory fitness in worksite health promotion. Am J Health Promot. 2019;33:318-326. [DOI] [PubMed] [Google Scholar]
editorial Am J Health Promot. 2023 Jun 3;37(5):722–723. doi: 10.1177/08901171231172013c

Effects of Changing Work Environments on Employer Support for Physical Activity During COVID-19

Elizabeth Ablah 1,✉, Matthew P Buman 2, Liz Petersen 3, Chia-Chia Chang 4, Ann Wyatt 5, Sarah Ziemer 6, Mary T Imboden 7, Janet R Wojcik 8, Neil E Peterson 9, Anna Zendell 10, David R Anderson 11, Laurie P Whitsel 12

Introduction

COVID-19 dramatically accelerated evolving changes in the way we define the “work environment” in the United States. In response to COVID-19, many employers have offered increased flexibility for where employees work, including remote (an employee’s workstation is at home) and hybrid work (an employee works both at the employer worksite and remotely, on pre-determined schedules). Accordingly, worksite physical activity (PA) and sedentary behaviors (SB) such as extended sitting time (ST) may have changed.1,2 However, little is known about whether these work arrangements are associated with changes in employer support for PA. Interviews were conducted to assess this gap in understanding. Because little is known about employer support for equity with respect to PA and SB, this study sought to identify potential strategies to assure equity in PA opportunities across work environments.

The Experts

The Physical Activity Policy Research and Evaluation Network (PAPREN) and National Physical Activity Plan (NPAP) Business/Industry Work Group convened a group of five experts in workforce health to serve as panelists (Table 1). During a Zoom meeting on Friday, December 16, the experts were asked to respond to eight questions that had been developed by the PAPREN/NPAP Work Group.

Table 1.

Panelists’ Positions and Expertise.

Panelist Position Expertise
Dr. Matthew Buman Professor, college of health solutions at Arizona State University Developing and implementing evidence-based interventions to reduce sitting and increase PA in workplaces
Ms. Chia-Chia Chang Coordinator, total worker Health® at Centers for Disease Control and Prevention (CDC)’s National Institute for Occupational Safety and Health (NIOSH) Healthy work design and well-being
Ms. Liz Petersen Quality manager, human resources knowledge center at society for human resource management (SHRM) Human resources research
Ms. Ann Wyatt Chief client success leader at HealthFitness Creating strong communities of health by engaging people on-site and online
Ms. Sarah Ziemer Senior vice president, corporate sales at Wellbeats Corporate health and wellbeing sales, strategy, and leadership
Open in a new tab

What We Learned

As COVID-19 has Evolved, so Have employers’ Policies About Acceptable Work Arrangements. How has COVID-19 Changed employees’ Working Environments?

Ms. Wyatt: “We have a great opportunity to look across a variety of companies that we…provide services for, and I think ‘flexibility’ is probably the number one thing I hear. There are so many companies that now offer hybrid work. Coming into the ‘workplace’ may look very different by worksite. A vast majority do two-to-three days on site, and people can set their hours. Typically, they have core hours - that’s brought a lot of flexibility. So many are embracing working from home, but I’m starting to hear a trend of companies wanting their employees to come back on site. I’m curious to see how that’s going to start to evolve over this next year. We’re still, of course, seeing a lot of COVID-19 cases.”

Ms. Ziemer: “Employees are resistant to employers asking them to ‘come back at all,’ especially when employees have been productive remotely. One large employer surveyed their employees; with greater than 90% response, employees most frequently describe returning to an office as ‘pointless.’ “So even if it is feasible for them to go back, they really don’t want to.”

Ms. Petersen: “In 2020, 78% of employers reported offering expanded remote work options and benefits for socially distanced employees (e.g. expanded leave to care for family). 3 Additionally, 63% of organizations had hybrid work opportunities for most employees, so that’s a good indication of how prevalent the hybrid workforce has become. 4 Several occupations are most likely able to offer flexible work arrangements, including information technology, finance, sales, marketing, and human resources.”

Ms. Chang: “Frontline workers, such as health care workers, service, retail, manufacturing, and production are occupational groups that have largely been unable to work remotely.”

Ms. Petersen: “I would also add hospitality, transportation, utilities, and child and elder care as occupations least likely to offer flexible work arrangements.”

Ms. Chang: “I think a lot of the people who are paid less and who do not have the flexibility in where and when they work, are the ones who are not getting the full benefits of the remote work. Moreover, in 2020, some of these places needed to be closed because of potential COVID-19 exposures, which meant that many of those employees were unpaid and/or no longer employed.”

Where do Increased Physical Activity and Decreased Sedentary Behavior rank as Priorities for employers? How has That Prioritization Evolved Throughout COVID-19?

Dr. Buman: “There is some recognition that sitting time has increased incredibly since COVID-19. 5

Ms. Chang: “Despite this, we have not heard that physical activity has become more of a priority during COVID. People have been concerned about COVID and changes related to going hybrid or remote. There has been more concern about mental health and isolation from increased remote work.”

Dr. Buman: “I agree. Many worksites are still indicating they would love to offer a physical activity program to their employees, but right now, they have 100 other issues to deal with, including mental health, as major concerns. Employers are looking for how they can offer an additional benefit to their employees. This is an opportunity for employers to connect to concerns about employees’ well-being.”

We Know More About Stress Because of COVID-19. Do employers Value Mental Health and Well-being? Are employers Using Physical Activity as a tool to Address Well-being/reduce Stress?

Ms. Petersen: “In 2022, 42% of companies reported that wellness benefits were extremely or very important benefit categories. 4 Compare this to 2020 and 2021, when it was up to 62%.”

Ms. Ziemer: “Clients were coming here as a place to address fitness and nutrition, but then they quickly routed themselves over to mindfulness-type activities. Many companies were promoting five-to-10-minute classes employees can do at their workstations to combat stress, anxiety, depression related to COVID-19. Now employers are seeing the connections to mental health, fitness, nutrition, mindfulness.”

Ms. Chang: “Because of COVID-19, there has been greater attention paid to mental health in the workplace. Talk has been mostly about individual resilience, which puts responsibility on the workers. Slowly, more employers are identifying how workplace policies can promote health. How can cultures, leadership, and management get rid of toxic work environments and make work environments more supportive? Now, employers are attending to employees’ mental health and giving them time to take care of their health; that can include physical activity.”

How Have Employers/vendors Encouraged Physical Activity And/or Discouraged Sedentary Behavior During COVID-19?

Ms. Wyatt: “Early on, when employers offered hybrid work arrangements, and people were coming back to the workplace, it was so meeting-heavy that people just did not have time for anything else; that was certainly detracting from people participating in physical activity. Employees started sharing, ‘You have this great gym here for me, but I can’t use it. I’m in meetings from the time I step in the door until the time I’m done. You’re even bringing lunch in so that I do not need to leave. You’re creating some great efficiencies, but you’re also not allowing me to do everything I need to be able to do.’ We started to see more requests for things like stretch breaks or mindfulness activities during meetings. One manager brought his whole team into the fitness center to work out. When they are being intentional, they are really having some great success.”

Ms. Petersen: “It is best for employers to offer as many different options as possible to encourage a community of motion. The more that leaders can show what they are doing, leading by example, the better. Encourage the use of adjustable desks or other active workstations. My boss is pedaling underneath her desk. In the middle of our meeting, her employees say, ‘Oh, you’re pedaling!’ Calling out those things, it makes you wonder – ‘What activity have I done today?’ Hosting one-on-one meetings on a walk if you are in-person, or if you’re not in-person, both be on your cell phones. ‘Let’s go for a walk in our own neighborhoods and have that conversation.’ Other effective strategies to prompt PA and/or decrease SB include well bots - something that pops up to remind you on your computer screen, ‘Hey! You’ve been on the screen [X amount of time]. Here’s this quick exercise you can do!' It’s a good thing to see those reminders and offer them as many ways as possible. Additional strategies include gaining support from management, having access to exercise facilities, paid gym memberships, and offering PA programs that include social support.”

Ms. Ziemer: “It can be beneficial to promote a philanthropic cause. For instance, ‘People who complete at least 80% of this challenge will get a donation to their charity of choice,’ where they can benefit a cause that is meaningful to them.”

What Are Barriers to employers Encouraging PA And/or Discouraging Sedentary Behavior Through the Worksite? Are These Barriers Specific to COVID-19? How can These Barriers Be Overcome?

Panelists described multiple barriers associated with employers encouraging PA and/or discouraging SB during COVID-19.

Dr. Buman: “Due to flexible work environments, we have to offer hybrid types of physical activity and sedentary programs. From a researcher perspective, we lack knowledge about the necessary interventions and how to deliver them in these spaces. We had a program that was highly evidence-based to reduce sitting, prior to COVID. It’s no longer evidence-based when we have workers who are now not in the office or are in hybrid settings. We have to scramble now to develop and build that evidence, which we are doing. As a field, that is where we are. We have these great programs that work, but they do not necessarily work in the contexts in which many of us now live.”

Ms. Ziemer: “Employers may not fully support wellness initiatives in workplace culture. It’s alarming how many employers say, ‘Well, we’d love to offer this benefit, but can we turn it off during the workday?’” She also described how workplaces are navigating workforce reductions and asking for more output from fewer employees. “To implement fitness is sometimes frustrating to employees, because ‘I don't even have time to eat, let alone work out!’” To address these barriers, she indicated that workplaces need to prioritize and integrate wellness into their culture.

Ms. Petersen: “Generally, it’s a matter of the business executives deciding what they want their work culture to be like, and do they want to make sure that they’re attracting and retaining high-quality talent. Employers’ initial responses to COVID-19 have allowed them the opportunity to determine whether remote can work for them. But now, what do they want their work culture to be? Is the culture going to be flexible, or is the culture going to have a set expectation of everyone? The more flexible the workplace is in allowing employees to decide what works for them, the easier it is to recruit. The more companies want a fixed everyone-in-the-office mentality, the more resistance they may receive from employees and high-quality candidates.”

Ms. Wyatt: “People are still having trouble setting their boundaries around what their workday at home looks like, which then leads to employees not focusing on their self-care. Leaders need to set an expectation of when it is inappropriate for employees to work. ‘You should not send that e-mail at 8 pm unless that is your normal shift.’ And it is leading by example. When you are home, you tend to feel like you are always working.”

What Are Strategies to Achieve/maintain Equity in Physical Activity and Sedentary Reduction Through the Worksite?

Ms. Chang: “We do not have proven interventions yet about changes during the past two years, but I think strategies to improve equity across occupations, to benefit those who are required to work in person may include more pay, more time off, or more control over their schedules. Technology capabilities like scheduling apps make that easier now, allow people more control over when they work.

“It is important that employees feel some control. Giving people paid time to be physically active is important. If you feel like you have more control over your own work environment, that same locus of control could then extend into your personal life. If you feel like everyone at work is telling you what to do, and everything’s out of your control, out of your hands, then outside of work, you could carry that same feeling of dis-empowerment.”

Ms. Ziemer: “Equity is the whole case for on-demand and accessible programs. We did a research study in 2017/2018, and most people reported they would use an on-demand, accessible program if their employer funded it, because they could not afford a lifetime fitness gym or have the time if they are working multiple jobs to get to a gym.”

Ms. Wyatt: “It’s also going the next step, as the employer, to tie it all together. Making it very easy and in one system, where they can access everything, so it’s not tied to an actual on-site fitness center or offering something virtually. So the employer makes it easy for the employee to access all of these things, so they have the options.”

Ms. Petersen: “One way to do some of this is to pay, which also is a big motivation. Many companies provide some type of a wellness stipend based on employees’ physical activity. When worksites offer multiple ways to earn that bonus or stipend, it allows for more inclusivity. The employer does not need to require participation in a specific competition but can offer multiple ways for people to demonstrate that they are being active.”

Ms. Chang: “One caution - although incentives can be popular, employers must be careful with what and how they incentivize to assure the incentives are not coercive or limit access to health insurance, which can increase disparities across the workforce.”

Dr. Buman: “Offering flexibility to employees regarding the ability to work remotely is terrific. Offering flexible work hours on those days gives people the freedom to be able to spend an hour to exercise, to fit it into their day. This increases their locus of control, so they feel like they have some control over their day. Employees want to improve their health, but not at the cost of their job. There is still this perception that ‘if I’m not at my desk, I’m not working hard,’ and that has carried over into the home environment. If an employer says, ‘We want to support your health and encourage you to be active when you work,’ this requires a cultural norm change, which starts from the top, giving employees permission to be active while they work.

“At the heart of some of this is the physical activity paradox, which is the observation that occupational physical activity does not confer the same health benefits as leisure time physical activity. The difference may be attributable to limited availability for leisure time activity, along with many social determinants that are likely driving that difference. From a research perspective, it is critical to better understand what is driving that physical activity paradox. Then these drivers need to be addressed structurally, in a whole host of workplaces and sectors, especially not just knowledge workers. That will go a long way to addressing those inequities.”

Conclusion

Each of these perspectives added valuable insight into how employers are advancing health while responding to changing work environments. Employers are concerned with employees’ well-being, work culture, employee burnout, and retention. Although physical activity is not currently a priority for employers, it is an evidence-based solution to many challenges that employers are experiencing (eg stress, mental illness, worker isolation, poor productivity, burnout). Employers would do well to promote physical activity through role modeling and the implementation of innovative programs, policies, and environmental changes, regardless of the work environment.

Footnotes

Author’s Note: The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC).

References

editorial Am J Health Promot. 2023 Jun 3;37(5):722–723. doi: 10.1177/08901171231172013d

CEO Pledge for Physical Activity

Tom Richards 1,✉

For many Americans, a typical workday consists of long hours with few opportunities for physical activity. The average American workday now exceeds 8 hours, and more than 60% of civilian workers are employed in occupations classified by the Bureau of Labor Statistics as either “sedentary” (29.1%) or “light strength” (32.8%).1,2 This combination of long hours and little movement amounts to a workplace culture with profound negative consequences for employee health and performance.

The CEO Pledge for Physical Activity, spearheaded by The Physical Activity Alliance and aligned with the CDC’s “Active People, Healthy Nation”℠ initiative, is a social movement that imagines a healthier, more active workplace culture, where senior leaders strive to role model and create a supportive work environment for physical activity (Figure 1).

Figure 1.

Figure 1.

Open in a new tab

The CEO Pledge for Physical Activity is a Signature Issue of the Physical Activity Alliance.

The text of the pledge reads:

In support of our organization, our employees, our families, and our communities, I pledge to adopt strategies that will provide equitable opportunities for physical activity and healthy movement before, during or after the workday and to enhance my own health and wellness by engaging in regular physical activity.

While it’s not necessary for a signer to hold the exact title of “CEO” - for example, a president or executive director is welcome to sign - the pledge is deliberately targeted to individuals who are at the top of an organizational chart due to the enormous influence that such individuals wield for effecting the work culture. 3 By signing the pledge, organizational leaders send an unequivocal message to their teams about the high value they place on physical activity and the culture they are seeking to create. Ultimately, the Pledge is a form of written encouragement, inspiration, and permission for employees to be active.

The Physical Activity Alliance has made the Pledge readily accessible at PAAMoveWithUs.org/CEOPledge. Leaders of organizations of any size who are committed to acting as a role model and change agent to promote physical activity can sign the Pledge online. After the leader affirms the Pledge, their name and organization’s name will be added to the online registry of CEO Pledge signers and shared on social media. Signers will then receive a promotional toolkit of sample social media posts that they can use to amplify the message.

To demonstrate compliance with the Pledge, the Physical Activity Alliance asks signers to take three tangible actions:

  • 1. Adopt at least three strategies that will provide equitable opportunities for physical activity and healthy movement before, during, and/or after the workday.

  • 2. Be a role model by personally engaging in regular physical activity (whatever activity works for the signer).

  • 3. Sign up to be part of the CDC’s “Active People, Healthy NationSM” initiative to help 27 million Americans become more active by 2027. This initiative will provide signers with consistent, evidence-based information for creating an organizational culture that support physical activity.

As high-performing employers seek solutions to reduce employee turnover and increase employee morale, the case for signing the Pledge as a health benefit for employees is strong and compelling. Just one session of moderate to vigorous physical activity can provide employees with immediate benefits, such as improved sleep, reduced anxiety, and lower blood pressure. 4 More frequent sessions on a regular basis can lead to an extensive list of invaluable benefits, including a reduced risk of dementia and depression; a lower risk of heart disease, stroke and type 2 diabetes; a lower risk for several types of cancers; better bone health; a reduced risk of falls; and heathy weight management. 5

Lesser known, but equally compelling, is the business case for signing the Pledge as a driver of employee performance. For example, research demonstrates that short bouts of activity throughout the day can increase a worker’s energy and creativity.6,7 Furthermore, physical activity, as part of a workforce wellness program, can lower employer healthcare costs, increase employee productivity, reduce absenteeism, and aid in employee retention efforts. 8

There is no one ideal solution for creating a work environment that supports and encourages physical activity. A best practice is to consider several strategies, in consultation with employee stakeholders, and choose those that seem to align with the organization’s unique structure, workforce, and ability to implement. Critically, organizations should give special consideration to the needs of employees with limited capacity for pursuing physical activity due to disability, location, financial considerations, or other factors relevant to ensuring equitable opportunities.

As a reference tool, the Physical Activity Alliance maintains a menu of over 30 strategies for creating a conducive culture, which consists of three strategy categories:

  • 1. Environment - Strategies that create options for physical activity, such as onsite or virtual fitness classes for a broad range of ability levels

  • 2. Staff Policy - Strategies that provide staff with explicit permission to take part in an activity or an incentive to be physically active, such as an official policy that allows “walking meetings”

  • 3. Systems - Strategies that reach all staff members, such as a company-wide email “nudge” to prompt movement during the workday

Many effective strategies for creating a supportive work environment for physical activity require very little investment, if any. The return for signing the CEO Pledge, however, has enormous potential - for the pledge signer, the employees, and the performance of the business. At the time of this writing, the “CEO Pledge” is a burgeoning social movement with a foundation of 125 true believers and early adopters. Given the advantages of a culture that supports physical activity and healthy movement, it’s easy to imagine a time, in the very near future, when the key question for business leaders will shift from, “Will you sign the pledge?” to “Why haven’t you signed the pledge?”

The Physical Activity Alliance encourages anyone who supports the initiative to visit the website, share the promotional video on social media, and educate organizational leaders about the abundant benefits of physical activity.

References

Articles from American Journal of Health Promotion are provided here courtesy of SAGE Publications

RESOURCES