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Explore the effectiveness of the "ACTIVE WAYS" program on sedentary young female hospital staff's physical activity behavior. Results show substantial improvements in program participants. Qualitative analysis indicates challenges and supports for sustaining physical activity.
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University of Limerick O L L S C O I L L U I M N I G H Mid-Western Area Parallel Sessions IV: Friday, May 20, 2005, Session IV Health promotion for hospital staff - Coping with work related risks and developing health promoting lifestyles The Effect of a Physical Activity Education Programme in the Hospital Workplace Setting Sohun, R., MacDonncha C., Breen, A. & Neeson, B. 13th International Health Promotion Conference, Dublin May 18th-20th 2005
INTRODUCTION • Sedentary behaviour is a leading contributor to chronic health problems (European Heart Network, 1999) • The workplace has been identified as a setting for health promotion intervention • Physical activity participation rates of young women are low (National Health & Lifestyle Surveys, 1998 & 2002) 1998 2002 • Participation in Mild Physical Activity: 25% 17% • Participation in Moderate Physical Activity: 44% 41% • Participation in Strenuous Physical Activity 8% 8% • No participation in Physical Activity: 14% 21%
Personal Factors Interpersonal Factors Psychological Theory Success of physical activity programme Institutional Factors Environmental Factors Policy/Legislation Behavioural Intervention Methods Success of Physical Activity Programmes is Dependent on a Number of Factors Access to Education
OBJECTIVE To examine the effectiveness of a 10-week educational physical activity intervention called “ACTIVE WAYS” on the physical activity behaviour of sedentary young female staff in a hospital setting
METHODOLOGY Physical Activity Lifestyle Survey • Distribution of a Physical Activity Lifestyle Survey to females (18-40 years) in 2 hospitals (n=719 Regional Hospital, n=150 Maternity Hospital) • Overall Response Rate : 38% • Respondents categorised according to: • Willingness/Interest to attend a PA programme • Suitablility according to the PAR-Q (Health Screen) • Physical Activity Stage of Change Model
INCLUDED EXCLUDED Physical Activity Stage of Change Model (Marcus et al, 1992) • Proposes 5 stages of readiness for adopting physical activity • Pre-Contemplators • Contemplators • Preparation • Action • Maintenance
SAMPLE Intervention Group • 62 invited to participate (fit criteria) • 27 signed up • 23 began the programme (mean age 32.9±5.4 years) • Received the intervention • Control Group • 24 invited to participate • 9 participated (mean age 29.4±5.3 years) • Received no intervention
INTERVENTION • 10-week programme • 1hr weekly in the hospital • Supported by hospital mgmt • Participant Workbook • Time management • Activity Types • Barriers to Physical Activity • Measuring Progress (included PA) • Social Support • Goal Setting • Healthy Eating X 2 • Assistance with planning PA • Pedometer
INTERVENTION MEASURES • Body Mass Index • Stage of Change • Physical Activity History • Mediators of Physical Activity • Processes of Change • Self-Efficacy • Decisional Balance • Outcome Expectations for Exercise • Enjoyment of Exercise • Pre, Post, 6 month time points (Intervention Group) • Pre, Post (Control Group)
INTERVENTION GRP 78% PA by 1-2 stages Attendance at 50% sessions (> change) Improvement in Mediators of Physical Activity: 8 of 10 Processes of Change Decisional Balance Self-Efficacy Outcome Exp for PA Enjoyment for PA (p0.05) CONTROL GRP 45% PA by 1 stage No significant differences in control group on Mediators of Physical Activity RESULTS – POST INTERVENTION
QUALITATIVE ANALYSIS • Primary Theme SUSTAINING PHYSICAL ACTIVITY Challenges Supports • Methodology • Field Notes from Informal Interviews (post intervention) • Inductive analysis for Primary Themes Sustaining Physical Activity Barriers to Attending the Programme Physical Activity Levels on Entry to Programme
“I just don’t have time [to exercise]. I have to wait until my husband comes home. He works nights and sometimes shift work” (Debbie) “Weather and time are my big problems” (Ann) “I had a lovely ring route I used to walk, but now there are a few dogs on the route…so I can’t use it” (Sinead) Challenges to Sustaining PA
“I always ask my sister to come walking with me and my other sister” “By going to the walking series…… I found out about other walks” (Joanne) “I have a work colleague ….she asks me [to walk with her] and is brilliant to motivate us” (Clare) Supports for Physical Activity
“As a person with a weight issue and being very big, it was very disconcerting and de-motivating on day 1 to have people reporting that they were active 2-3 days per week. I was doing nothing….It was horrible to compare myself. When I did manage to attend, I found myself lying as the group standard was far higher [than what I was doing].” (Mary) Physical Activity Levels on Entry to Programme
RESULTS – 6 MONTHS POST (INTERVENTION GROUP ONLY n=21) • 14% moved positively by 1 or 2 stages • 19% retained their positive change • 10% remained unchanged in contemplative stage • 57% regressed by 1 or 2 stages • Improvement in self-efficacy and 2 processes of change (p0.05) • Regression on 8 processes of change, decisional balance & enjoyment for PA (p0.05) • No significant regression from pre-intervention to 6-month follow up occurred. Positive trends overall.
CONCLUSION • Intervention was successful at changing physical activity behaviour of sedentary female hospital employees. • To maintain change additional support may be required. • Recommendations & Considerations • Size of the workplace (adequate sample) • Time of programme (consideration for shift patterns) • Support from Hospital Management is essential • Inclusion of Physical Activity during Programme • Physical Activity Goal (individual or group) on finishing programme