Implementing movement at the workplace: Approaches to increase physical activity and reduce sedentary behavior in the context of work
Introduction
A large body of scientific evidence supports the benefits of physical activity (PA), exercise, cardiorespiratory fitness (CRF), and reductions in sedentary behaviors (SB) across a host of outcomes including lower risk for cardiovascular disease.1, 2., 3, 4 The new 2018 Physical Activity Guidelines for Americans, 2nd edition, and the scientific report supporting the guidelines, also indicate new evidence for health benefits of PA, including immediate and longer-term benefits for how people think, feel, function, and sleep.1,2 There is no longer the need to accumulate PA in bouts of 10 min or more to receive the benefits of PA. The most recent 2018 guidelines also include two additional topics not previously addressed, i.e., SB and interventions to promote regular PA.
The benefits of more movement, increased CRF, and less SB cover a large range of health and non-health issues.1, 2., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12., 13., 14, 15, 16, 17, 18, 19, 20, 21., 22, 23, 24, 25, 26 Among this list of health benefits, just to name a few, are improved cognition, quality of life, sleep, physical function, emotional function, and reduced depression. Benefits across various non-health domains include increased productivity, more meaningful co-worker interactions, reduced injury rates, lower presenteeism, and lower excess medical care costs.6,11,14,25,26 Furthermore, the benefits extend beyond the individual level into the organizational level. For example, improved culture of health, increased company performance in the marketplace, enhanced corporate image, and improved retention of talent.15, 16, 17, 18, 19, 20, 21., 22, 23 A more inclusive list of these benefits is presented in Table 1. As a result, it may be concluded that movement and CRF benefits both the worker and the company, an observation supported by health, social, and economic benefits.1, 2., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12., 13., 14, 15, 16, 17, 18, 19, 20, 21., 22, 23, 24, 25, 26
Unfortunately, the contemporary workplace is characterized by office work which is largely sedentary. PA requirements for work have steadily declined over the past half century. During this time, a significant shift in the proportion of jobs moving from a “moderate” activity category to “light and sedentary” categories has been noted.27 The estimated impact of this shift is a decrease in excess of 100 cal in daily occupational energy expenditure. The sedentary nature of office work has increased sitting time to the degree that prolonged sitting time has emerged as a significant health concern for office workers.28,29
The workplace represents an important setting for the promotion of PA and reduction of SB.10,29,30 It is the purpose of this article to highlight approaches to increase movement, PA, CRF, and reduce SB in the context of the workplace setting.
Section snippets
Overarching principles of program design
The goal to implement a PA promotion program needs to be considered in context of the broader health and well-being strategy at the workplace. The design of an overarching corporate health and well-being initiative should follow best practice principles that apply to all program types. Principles of program design should be based on what is known to be effective from the scientific literature and, optimally, such principles should have been applied in workplaces such that evidence-based
Strategies to increase movement, PA and reduce SB
Based on the available evidence of effectiveness,2,10,29,30 a number of interventions and programmatic options have been identified that increase PA and reduce SB. Due to their variety, these options are categorized according to a social ecological framework with four broad levels - Individual, community, the communication environment (including information technology), and the physical environment and policy. The workplace is an example of a community setting that crosscuts these four broad
Barriers
Interrupting prolonged sedentary time (i.e., more than 60 min periods) reaps benefits to health and function.48 However, at the individual and organizational levels many barriers exist to effectively and efficiently do so. It is important to call out barriers in an effort to circumvent such problems and be prepared to address them successfully in the implementation plans.
A recent study addressed this concern by focusing on the practicality of interventions designed to reduce SB in the workplace.
Conclusions
Since the late 1600's, observations of the ill-health effects of SB at work and the lack of regular PA were reported by Bernardo Ramazzini, an Italian physician who is widely recognized as the father of industrial medicine.49 In 1700, he published his Diseases of Workmen (De Morbis Arificum Diatribe), a text that later became the foundation of the occupational medicine discipline,50 and in which he advised sedentary workers to “take to physical exercise at any rate on holidays” to counteract
Author disclosure
I have nothing to disclose.
Declaration of Competing Interest
None.
Acknowledgements
This work was supported in part by a grant from the National Institute for Occupational Safety and Health (U19 OH008861) for the Harvard T.H. Chan School of Public Health Center for Work, Health and Well-being.
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From: The HealthPartners Institute, Bloomington, Minnesota, USA.