Health Promotion International Advance Access originally published online on April 4, 2006
Health Promotion International 2006 21(3):191-200; doi:10.1093/heapro/dal012
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Worksite intervention effects on physical health: a randomized controlled trial
1 School of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney NSW, Australia 2 National Health and Medical Research Counsel: Clinical Trials Centre, University of Sydney NSW, Australia 3 Faculty of Medicine and Faculty of Health Sciences, School of Exercise and Sport Science, University of Sydney NSW, Australia 4 Jean Mayer USDA Human Nutrition Center on Aging at Tufts University Boston, MA, USA 5 Hebrew SeniorLife Boston, MA, USA
Address for correspondence: Evan Atlantis, Research Fellow, School of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe NSW 1825, Australia, E-mail: E.Atlantis{at}fhs.usyd.edu.au
Overweight and physical inactivity are risk factors for increased disease burden and health care expenditure. Well-designed studies are still needed to determine the treatment efficacy of worksite interventions targeting such risk factors. This randomized controlled trial was conducted at one of Australia's casinos in 2002–2003, to investigate the effects of a comprehensive exercise and lifestyle intervention on physical fitness. Only 6.4% of the workforce expressed interest in being study participants. Seventy-three employees (aged 32 ± 8 years, 51% overweight/obese, 73% shift workers and 52% women) were recruited and randomized to treatment or wait-list control groups for 24 weeks, 44 of whom completed the intervention. Components of the intervention include supervised moderate-to-high intensity exercise including combined aerobic (at least 20 min duration 3 days/week) and weight-training (for an estimated 30 min completed 2–3 days/week), and dietary/health education (delivered via group seminars, one-on-one counselling and literature through the provision of a worksite manual). ANCOVA, by intention-to-treat and of study completers, found significant between-group differences in the mean waist circumference and predicted maximal oxygen uptake (VO2max), favouring the intervention, but effects were concentrated in one subject. For study completers, between-group differences in the mean waist circumference (82.3 ± 9.2 versus 90.5 ± 17.8 cm, p = 0.01) and predicted VO2max (47 versus 41 ml/kg/min, p < 0.001) remained significant without the outlier, favouring the intervention. Higher intervention compliance predicted greater improvements in physical fitness. No significant effects on body mass or body mass index were found. This worksite intervention significantly improved waist circumference and aerobic fitness in healthy but sedentary employees, most of whom were shift workers. Worksite interventions have the potential to counter the increasing burden of overweight and obesity, particularly visceral adiposity, as well as physical inactivity; however, substantial barriers to adoption/adherence need to be overcome for greater feasibility and impact on employee physical health.
Key words: exercise; health promotion; waist circumference; aerobic fitness