|
|
|
|
|
|
Statistically significant change in physical health |
Statistically significant change in mental health and wellbeing |
Statistically significant change in health behaviour |
| Blake, 2013 [27], UK |
Before-after study (no control) |
Employee questionnaire survey (self-report): Physical activity (modified International Physical Activity Questionnaire) Job satisfaction Perceived general health and mood (GHQ-12) Sickness absence Weight: BMI Perceived work performance
|
260 |
Non-matched samples were comparable at baseline and follow-up. Cramer’s V, ANOVA, partial eta squared. |
Physical activity: Significantly more respondents considered themselves either very or fairly ‘active at work’ at follow-up than at baseline (69.7% versus 53.9%; Cramer’s V = 0.18, p < .001). Significantly more respondents at follow- up reported actively travelling (walking or cycling) to the workplace in the previous seven days (37.6%) than at baseline (30.7%) (φ = -0.07, p < .001). Significantly more participants at follow-up than at baseline reported having walked or cycled for at least 10 minutes in the previous seven days (70.1% versus 65.1%; φ = -0.05, p = .007). Participants who met the recommended level of physical activity were labelled ‘active’, and those who did not as ‘less active’. Significant improvement observed in the proportion of active versus less active from baseline to follow-up (56.4% versus 60.5%; φ = 0.14, p < .001). Respondents at follow-up engaged in significantly more incidental physical activities than respondents at baseline (F(1,2287) = 56.5, p < .001, partial η2 = 0.02). Significantly less time sitting at follow-up (F(1,2149) = 4.9, p < .001, partial η2 = .14) and more time moving about (F(1, 2149 = 9.8, p < .001, partial η2 = 0.17) versus baseline. Job satisfaction: Significantly more respondents at follow-up reported being satisfied with their job (F(1,2529 = 11.0, p < .001, partial η2 = 0.004) and feeling committed to working for the trust (F(1,2301) = 5.7, p = .02, partial η2 = 0.002) than respondents at baseline. General health and mood: Non-significant trend of lower mood reported at follow-up (8.9%) compared with baseline (12.1%; (φ = 0.01). Overall no significant difference in self-reported general health between baseline and follow-up (Cramer’s V = 0.06, p = .12). Non-significant trends in higher proportion of staff reporting seven hours of sleep more than half of the time at follow-up (61.7%) versus baseline (59.6%; Cramer’s V = 0.04, p = .24), and proportion of smokers reducing from baseline (10.5%) to follow-up (8.6%; φ = 0.03, p = .12). Sickness absence: Reported sickness absence levels for the previous month significantly reduced from baseline (4.9%) to follow-up (2.6%; Cramer’s V = 0.13, p < .001). Weight: No significant differences in BMI between baseline (M = 25.2, SD = 4.9, range = 11.2–60) and follow-up (M = 25.4, SD = 5.9, range = 11.5–68.4). Perceived work performance: No significant difference pre- to post- intervention on satisfaction with work performance.
|
O |
O |
O |
| Dobie, 2016 [30], Australia |
Before-after study (no control) |
The Depression Anxiety Stress Scale (DASS; validated)—clinical rating of self-reported levels of depression, anxiety and stress. Higher scores reflect greater levels of subjective distress. The Kentucky Inventory of Mindfulness Skills (KIMS; validated)—rating of each participant’s self-reported competency in four mindfulness skills: observing; describing; acting with awareness; and accepting without judgement. Higher scores reflect greater levels of subjective attainment. Brief, open-ended feedback questionnaire (Not validated): surveying their attitudes and experiences toward the programme. Included question: “Score out of ten (ten being most benefit) the extent to which you feel you have benefited from practising mindfulness”
|
8 |
Small sample size: Wilcoxon signed-rank tests to evaluate differences between DASS and KIMS mean scores observed before and after. Conventional and summative content analysis to qualitatively analyse feedback questionnaires.
|
DASS: Significant decrease in total scores from 24.67 (77th percentile) to 12.22 (45th percentile; Z = −2.31, p = 0.02); a large effect (r = 0.54). DASS subscales, statistically significant reductions in levels of anxiety (Z = −2.26, p = 0.02, r = 0.53) and stress (Z = −2.12, p = 0.03, r = 0.50). Decreases in self-reported levels of depression were approaching significance (Z = −1.90, p = 0.06). KIMS: No significant change over time in the KIMS total score (Z = −1.28, p = 0.20). Non-significant increase in participants’ self-reported competency in observing skills (Z = −1.67, p = 0.09). Brief open-ended feedback questionnaire: Thematic analysis: participants’ written feedback was generally positive and all participants reported beneficial outcomes. Two thirds reported a positive impact on body sensations and associated thoughts, including comments of feeling more relaxed, focussed and energised. All participants found the programme allowed them to learn more about stress management, with 90% reporting development of practical new ways of coping with workplace and personal stress.
|
|
O |
|
| Hess, 2011 [25], Australia |
Before-after study (no control) |
Active Australia questionnaire (validated; self-report): frequency and duration of physical activity in past week Health-related behaviour (self-report): smoking status, self-rated health, physical activity at work, self-rated physical activity level, height and weight (BMI calculated), 4 questions from NSW Health Survey on fruit, vegetable, soft drink, and vegetable consumption.
|
12 |
Within group pre-post (related samples Wilcoxon signed rank test and McNemar’s test) Inactive versus active participants (Independent samples Mann-Whitney U test) Qualitative process evaluation
|
Significant improvement before to after intervention in all health behaviours measured, except for minutes spent doing moderate exercise, ‘healthy’ travel to work, smoking frequency, and feeling depressed (* = p-value calculated with related samples Wilcoxon signed rank test; # = p-value calculated with McNemar’s test): Active Australia questionnaire: Physical activity: Number of times spent walking 10 min or more (before: 5 (3–10); after: 7 (5–14); p<0.001*); Minutes spent walking past week (before:125 (60–240); after: 200 (120–345) p<0.001*); Minutes spent doing moderate PA last week (before: 0 (0–90); after: 40 (0–120) p = 0.01*); Minutes spent doing vigorous PA last week (before: 30 (0–120); after: 85 (0–180); p<0.001*); Physical activity ≥150 min per week (before: 71.7%; after: 88.5% p<0.001#) Health-related behaviour: Diet: 2 or more serves of fruit / day (before: 57.1%; after: 81.8%; p<0.001#); 5 or more serves of vegetables/ day (before: 10.1%; after: 32.8%; p<0.001#); Breakfast on 7 days / week (before: 56.3%; after: 72.9%; p<0.001#); 1 or more cup of soft drink, cordial or sports drink / day (before: 49.0%; after: 58.3%; p = 0.008#); 4 or more cups of water consumed the previous day (before: 61.2%; after: 80.4%; p<0.001#); Currently on a diet (before: 21.2%; after: 29.0%; p = 0.007#). Mental health: Feeling stressed all the time or most of the time (before: 29.4%; after: 19.6%; p = 0.003#); Feeling depressed all the time or most of the time (before: 6.3%; after: 2.9%; p = 0.08#)
|
|
O |
O |
| Jasperson, 2010 [24], USA |
Survey study (no control) |
|
12 |
None |
Health questionnaire: After first three months of programme 68% respondents reported better diet and/or more physical activity Walking event attendance: 36% (year 1) versus 43% (year 2) of department Post-walking event surveys: 96% more motivated to do physical activity; 97% pedometer increased awareness of daily physical activity; 61% activity level same or greater since event; 73% felt department took genuine interest in employees; 76% agreed spirit of teamwork and cooperation in work unit; 74% agreed event promoted staff satisfaction
|
|
O |
O |
| Lemon, 2010 [28], USA |
Randomised-Controlled Trial |
Change in BMI. Body mass index (BMI) was calculated from measured weight and height. Weight measurement was taken on digital scales and rounded to the nearest 2/10 of a pound. Heights were measured to the nearest l/8inch using portable stadiometers. The average BMI across baseline 1 and baseline 2 assessments was used in this analysis. Fruit and vegetable and fat consumption. Fruit and vegetable and saturated fat consumption were measured by the Block rapid food screener, a brief food frequency type measure that assessed commonly eaten foods: 10 items summarised as servings of fruits and vegetables per day. The fat screener consists of 17 items summarised as percentage of total calories from saturated fat. Physical activity. Self-administered long-form of the International Physical Activity Questionnaire (IPAQ), developed by the World Health Organization, with demonstrated reasonable psychometric properties for assessing population levels of self-reported physical activity. Vigorous, moderate, and walking activity in 4 domains, work, household, free time, and transportation, were assessed. Perceived organizational commitment to employee health. 4- item subscale of the worksite health climate survey (WHC), which demonstrated strong internal reliability (a = .88). Respondents rated each item on a 5-point scale. Perceived co-worker normative behaviours. Modified versions of the WHC subscales for health norms measured employee perceptions of eating and physical activity behaviours of co-workers. Individual items were selected and adapted to focus on at-work behaviours. Four items asked about co-workers’ physical activity behaviours at work, and 5 asked about co-workers’ eating habits at work. Seven response categories (almost none to almost all) estimated the proportion of co-workers who practice specific behaviours. Negative items were reverse coded, with higher scores corresponding to healthier behaviours. Psychometric testing of each scale indicated very good internal consistency (a = .78, healthy eating; a = .74, physical activity)
|
102 |
Multivariable linear regression models for survey data to assess associations of demographic and job characteristics with the 3 worksite perceptions scales and relationships of the 3 worksite perceptions scales with BMI, fruit and vegetable consumption, saturated fat consumption, and physical activity, controlling for demographic and job characteristics. |
Perception of stronger organizational commitment to employee health was associated with lower BMI (B = 0.73, p = 0.03). Higher perception of co-worker normative healthy eating behaviours was associated with greater fruit and vegetable consumption and less fat consumption (B = .33 p < .001). Higher perception of co-worker normative physical-activity behaviours was associated with greater total physical activity (18.2%, p = 0.003). Participation dose-response effect: The more intervention activities people participated in the greater the reduction in BMI: When intervention exposure was used as the independent variable BMI decreased for each unit increase in intervention participation at 24 months (p = 0.006).
|
O |
|
O |
| McElligot, 2010 [26], USA |
Controlled before-after study |
Health Promoting Lifestyles Promotion (HPLP) II: (self-report; validated): 52 item Likert scale: 6 subscales—nutrition, stress management, spiritual growth, health responsibility, physical activity and interpersonal relations. High score indicated good health-promotion behaviours, low score indicated poor behaviours. Cronbach’s alpha = 0.93. Six subscales ranged from 0.87 to 0.66.
|
12 (+2 month response window) |
Multivariate ANOVA: pre-post and treatment-versus-control analyses. |
Experimental group showed significantly greater increase in overall HPLP II score from pre- to post- (F = 15.4, p<0.000) and in 3 of 6 HPLP II subscales from pre- to post-: stress management (F = 17.3, p<0.000), spiritual growth (F = 9.75, p<0.002), and nutrition (F = 10.97, p<0.000).
|
|
O |
O |
| Petterson, 1998 [6], Sweden |
Before-after study (no control) |
Based on results from overall factor analysis, six indices of perceived work quality (competence and skills development, job demands, work pressure, optimal workload, organizational climate and goal clarity), three indices of supporting resources (social climate, job control and coping) and two health indices (psychosomatic symptoms and exhaustion) were measured at baseline and used as outcome measures to evaluate effects of the intervention program. In general, scales used have high internal consistency. Job demands and work pressure had lower internal consistency, questioning their ability to measure unitary dimensions.
|
52 |
ANOVA pre- versus post- and high- versus low- activity uptake departments. Based on activity ratings, departments were separated into two groups, one highly active (n = 20) and one less active (n = 17) in the change process. The groups were compared regarding measures of work quality, supporting resources, and health. |
Between baseline and follow-up a notice of staff cut-back was announced which was considered a reason for the general deterioration in most measures. All hospital staff were exposed to the same information. Participation dose-response effect: Staff in departments rated as highly active in improvement activities did not deteriorate during the follow-up period compared to a worsening in departments rated as less active in work pressure (active: pre = 14.2, post = 14.2, ns; less active: pre = 14.2, post = 14.5, p<0.01), organizational climate (active: pre = 23.4, post = 23.6, ns; less active: pre = 24.1, post = 24.5, p<0.001) and coping (active: pre = 5.7, post = 5.8, ns; less active: pre = 5.9, post = 6, p<0.05). Amount of activity had no overall effect on staff well-being, perceived social climate, and job control, which decreased for both high and low activity groups.
|
|
O |
|
| Sorensen, 1999 [23], USA |
Randomised-Controlled Trial |
Employee survey (self-report): participation in nutrition-related activities, campaign awareness, and fruit and vegetable consumption Process tracking system (self-report): type and number of interventions, including number of people taking part
|
104 |
Pearson product moment correlations calculated to evaluate bivariate relationships between process tracking variable and outcome variables. |
Participation dose-response effect: Increase in fruit and vegetable consumption significantly correlated with number of activities per employee (r = 0.55, p<0.05) and percentage of participation in all activities (r = 0.55, p<0.05) Fruit and vegetable intake increased by 0.5 servings (19%) in the worksite-plus-family condition, by 0.2 servings (7%) in the worksite condition. There was no change in the minimal intervention condition
|
|
|
O |
| Sun, 2014 [32], China |
Randomised-Controlled Trial |
Workplace Social Capital (WSC; validated): assessed by the translated and culturally adapted 8-item measure developed in the Finnish Public Sector study. Cronbach’s alpha coefficients of total scale, horizontal and vertical subscales were 0.90, 0.85 and 0.87, respectively. Following factor analysis of scores the authors divided the eight items into two dimensions: vertical WSC and horizontal WSC. Computed the score of each dimension by summing the scores of all the items in each dimension. The average scores of individual WSC total score, vertical WSC score and horizontal score within each centre were computed to represent the facility-level WSC: Vertical WSC dimension: related to employees’ relations with their employers and supervisors: We can trust our supervisor; Our supervisor treats us with kindness and consideration; Our supervisor shows concern for our rights as an employee. Horizontal WSC dimension: related to bonding and bridging social capital, which involves social contacts, cooperation and trust in relation to co-workers: We have a ‘we are together’ attitude; People feel understood and accepted by each other; People in the work unit cooperate in order to help develop and apply new ideas; Do members of the work unit build on each other’s ideas in order to achieve the best possible outcome?; People keep each other informed about work-related issues in the work unit.
|
26 |
Bivariate difference-in-differences (DID) analysis using paired T-test to analyze the facility-level WSC intervention effects. The DID method compares the differences in WSC in pre- and post-intervention periods in the intervention and control groups. |
WSC: No changes were statistically significant. The facility-level WSC total score, horizontal WSC score and vertical WSC score in the intervention group increased by 1.2, 0.5 and 0.8 points. The same variables hardly changed in the control group. The DID estimators showed that the intervention increased the facility-level WSC total score, horizontal WSC score and vertical WSC score by 1.0, 0.4, and 0.8 points
|
|
|
|
| Uchiyama, 2013 [29], Japan |
Randomised-Controlled Trial |
Mental health status: Japanese version of the Center for Epidemiologic Studies Depression Scale (CES-D; 20 item, 4 point Likert scale) Psychosocial work environment: 3 questionnaires: Job Content Questionnaire (JCQ Japanese version); Effort-reward imbalance questionnaire (short version; ERIQ); Quality work competence (QWC) Process evaluation: champions (sub-chief nurses in each work unit) were asked to look back at the whole intervention process of their unit. Researchers’ notes that had been obtained in champion meetings and individual interviews as well as from champions’ task sheets were used. In addition, after the post-intervention survey, champions evaluated the overall interventional process, including descriptive responses
|
26 |
Paired t-tests to assess changes in score for each variable in each group. ANCOVA for each variable at post-intervention, controlling for pre-intervention score. Qualitative content analysis for process evaluation |
Mental health status: No significant intervention effect on mental health status: The change in CES-D score as the primary outcome was not statistically significant (intervention group t = 1.56, p = 0.122; control group t = 1.11, p = 0.268) Psychosocial work environment: Some significant effect of intervention on some variables of psychosocial work environment: The intervention group showed a statistically significant increase in the scales of Participatory Management (t = −2.48, p = 0.014), Job Control (t = −2.28, p = 0.024) and Co-worker Support (t = −3.43, p = 0.001), whereas the control group showed a statistically significant decrease in Goals (t = 3.55, p = 0.001). There was also a significant increase in Effort in both groups (intervention group t = −2.08, p = 0.039; control group t = −2.72, p = 0.007). The interaction effect was statistically significant for Goals (F = 8.792, p = 0.003) and Co-worker Support (F = 7.120, p = 0.008). In addition, borderline significance was observed for Job Control (F = 3.840, p = 0.051), even after taking into account the unit variation in scores. Thus although there were significant improvements in psychosocial work environment, these did not improve scores of depressive symptoms Process evaluation showed some self-reports of ‘improved work environment’
|
|
O |
|
| Wieneke, 2016 [31], USA |
Cohort study |
A (web-based) survey (validated) was conducted to assess whether the objectives of the wellness champion programme were achieved. The objectives were to increase awareness and participation in healthy living programmes, promote positive health behaviours among employees, and provide a supportive work environment among employees: Wellbeing: A validated single-item question was used to assess well-being. Awareness and participation: 2 Likert scale items were designed by a health and wellness expert panel to assess awareness and participation in the wellness champions programme. Self-rated health: Participants were asked to rate their overall health and wellness on a scale of 0 to 10 (0 being the “worst health and wellness” and 10 being the “best health and wellness”). The effect of the wellness champions programme on health behaviours: A team of medical and wellness experts created 2 additional study specific items that asked participants to rate on a 5-point Likert scale, from strongly agree to strongly disagree, their answers to: (1) My co-workers and I support one another in our effort to practice a healthy lifestyle; and (2) My organization provides a supportive environment for its employees to live a healthy lifestyle. Those familiar with the wellness champion program were asked to rank their level of agreement with: Since the introduction of the wellness champion program, I have increased my participation in healthy living programs provided by the organization. The same group of participants was asked: In what ways have you benefited by having the wellness champion program available in your work area?
|
n/a |
The survey items were categorical. Responses to levels of agreement to particular statements (5-point Likert agreement scale) were summarized with percentages. Overall health and wellness (scale from 0 [worst]– 10 [best]) was summarized with percentages (respondents reporting level of 8+) as well as means and standard deviations (SD). Level of agreement and overall health and wellness were compared between program participants versus those not familiar with the program using Wilcoxon rank-sum tests. The survey items specific to the wellness champions program were summarized with percentages among those who reported being aware of the program. |
Employees that were familiar and participating in the wellness champion program (N = 666) reported the following benefits of having the wellness champion program available in their work area: 68.5% report an increased awareness of wellness opportunities; 45.2% report having a positive role model for healthy behaviours; 32.6% were guided to new or improved lifestyle habits; 23.3% report an improved work atmosphere; 18.8% were provided with a new trusted resource; 46.9% strongly agreed or agreed that they had increased participation in healthy living programs since the introduction of the wellness champions program Participation dose-response effect: When comparing responses for those who identified themselves as participating in the wellness champion program (N = 666) to those who were not familiar with the wellness champions program but worked in the same work area (N = 675), there were significant differences in responses: Of those participating 82.7% strongly agreed or agreed that the organization provides a supportive environment to live a healthy lifestyle compared to 69.4% of those not familiar with the wellness champions (p < .001); Of those participating in the wellness champions program, 76.8% strongly agreed or agreed that their co-workers support one another in practicing a healthy lifestyle compared to 53.7% of those not familiar with the wellness champions program (p < .001); Those participating rated their overall health and wellness as higher (39.2% with score of 8 or higher on scale of 0–10) as compared to those who were not familiar (33.4%); average rating of 6.9 (SD = 1.5) and 6.6 (SD = 1.7) for the 2 groups, respectively (p = .002) The wellness champions program extended the reach of the onsite wellness center staff, increased engagement, and positively impacted the work environment for many employees Participation in the wellness champions program increased reported overall health and wellness. Participation in wellness champion activities further increased awareness of wellness opportunities, guided employees to new or improved lifestyle habits, and improved the work atmosphere. Participants noted greater support among their colleagues and organization compared to those not familiar with the program
|
|
O |
|
