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Cover of A workplace-based intervention to increase levels of daily physical activity: the Travel to Work cluster RCT

A workplace-based intervention to increase levels of daily physical activity: the Travel to Work cluster RCT

Public Health Research, No. 7.11

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Author Information
Southampton (UK): NIHR Journals Library; .

Headline

After 12 months, the workplace-based intervention did not have any effect on levels of daily moderate to vigorous physical activity

Abstract

Background:

There may be opportunities for working adults to accumulate recommended physical activity levels (≥ 150 minutes of moderate-intensity physical activity in bouts of ≥ 10 minutes throughout the week) during the commute to work. Systematic reviews of interventions to increase active transport indicate that studies are predominantly of poor quality, rely on self-report and lack robust statistical analyses.

Objectives:

To assess the effectiveness, cost and consequences of a behavioural intervention to increase walking during the commute to work.

Design:

A multicentre, parallel-arm, cluster randomised controlled trial incorporating economic and process evaluations. Physical activity outcomes were measured using accelerometers and GPS (Global Positioning System) receivers at baseline and the 12-month follow-up.

Setting:

Workplaces in seven urban areas in south-west England and south Wales.

Participants:

Employees (n = 654) in 87 workplaces.

Interventions:

Workplace-based Walk to Work promoters were trained to implement a 10-week intervention incorporating key behaviour change techniques.

Main outcome measures:

The primary outcome was the daily number of minutes of moderate to vigorous physical activity (MVPA). Secondary outcomes included MVPA during the commute, overall levels of physical activity and modal shift (from private car to walking). Cost–consequences analysis included employer, employee and health service costs and consequences. Process outcomes included barriers to, and facilitators of, walking during the daily commute.

Results:

There was no evidence of an intervention effect on MVPA at the 12-month follow-up [adjusted difference in means 0.3 minutes, 95% confidence interval (CI) –5.3 to 5.9 minutes]. The intervention cost was on average, £181.97 per workplace and £24.19 per participating employee. In comparison with car users [mean 7.3 minutes, standard deviation (SD) 7.6 minutes], walkers (mean 34.3 minutes, SD 18.6 minutes) and public transport users (mean 25.7 minutes, SD 14.0 minutes) accrued substantially higher levels of daily MVPA during the commute. Participants who walked for ≥ 10 minutes during their commute were more likely to have a shorter commute distance (p < 0.001). No access to a car (p < 0.001) and absence of free workplace car parking (p < 0.01) were independently related to walking to work and using public transport. Higher quality-of-life scores were observed for the intervention group in a repeated-measures analysis (mean 0.018, 95% CI 0.000 to 0.036; scores anchored at 0 indicated ‘no capability’ and scores anchored at 1 indicated ‘full capability’).

Conclusions:

Although this research showed that walking to work and using public transport are important contributors to physical activity levels in a working population, the behavioural intervention was insufficient to change travel behaviour. Broader contextual factors, such as length of journey, commuting options and availability of car parking, may influence the effectiveness of behavioural interventions to change travel behaviour. Further analyses of statistical and qualitative data could focus on physical activity and travel mode and the wider determinants of workplace travel behaviour.

Trial registration:

Current Controlled Trials ISRCTN15009100.

Funding:

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 11. See the NIHR Journals Library website for further project information. Living Streets, a UK charity promoting everyday walking, provided funding for the intervention booklets and free pedometers for distribution to participants in the intervention group.

Contents

About the Series

Public Health Research
ISSN (Print): 2050-4381
ISSN (Electronic): 2050-439X

Article history

The research reported in this issue of the journal was funded by the PHR programme as project number 13/117/01. The contractual start date was in November 2014. The final report began editorial review in January 2018 and was accepted for publication in August 2018. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PHR editors and production house have tried to ensure the accuracy of the authors’ report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.

Declared competing interests of authors

Suzanne Audrey is a member of the National Institute for Health Research (NIHR) Public Health Research (PHR) Research Funding Committee (2017 to present). Chris Metcalfe is co-director of the Bristol Randomised Trials Collaboration. William Hollingworth is a member of the NIHR Health Technology Assessment Clinical Trials Board (2016 to present). Philip Insall is a member of the NIHR PHR Programme Prioritisation Committee (2014 to present).

Last reviewed: January 2018; Accepted: August 2018.

Copyright © Queen’s Printer and Controller of HMSO 2019. This work was produced by Audrey et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.
Bookshelf ID: NBK541952PMID: 31162919DOI: 10.3310/phr07110

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