Health Behavior Clinical Trial
Official title:
Active Workplace Study
Exposure to sedentary work is an occupational hazard with significant health and safety consequences. Sedentary behavior is an independent predictor of heart disease, diabetes, early mortality, and accounts for the majority of the increase in obesity in the US. Prolonged sitting, common in modern sedentary work environments, contributes to increases in musculoskeletal pain, injuries, and detrimental changes in physiological functioning. Call center employees, who are among the most sedentary workers in the US, area priority population for Total Worker Health interventions. This project is designed to substantially improve health, safety, and well-being in call center employees, including physiological outcomes that contribute to chronic diseases.The study tests whether a Total Worker Health oriented intervention is more effective than usual practices for increasing the utilization of health and safety resources and improving worker health and safety. Study results will have implications for over 30 million sedentary workers in the US.
The purpose of this study is to evaluate how a Total Worker Health intervention targeting
sedentary behavior among call center employees improves the health, safety, and well-being of
sedentary workers. Our primary hypothesis is that a multilevel integrated intervention that
follows the Total Worker Health approach will have a stronger impact on primary outcomes
(sedentary time and light physical activity at work, musculoskeletal pain, time lost due to
injury or illness) compared to a control condition that matches typical worksite practices.
To test our hypothesis, we will 1) tailor Total Worker Health intervention components to the
call center environment, 2) determine the effects of a 6-month intervention, and 3) measure
the durability of intervention effects at 12-month follow-up.
The study will use a randomized control trial design with two conditions: a control condition
and a Total Worker Health intervention condition that includes organizational and individual
intervention components. Study participants will include employees and supervisors from up to
eight call centers. The call centers will be randomly assigned to the two conditions prior to
the start of the study. During the study, we will conduct a baseline assessment; implement a
six-month intervention; conduct a post-intervention assessment; and conduct a follow-up
assessment at twelve months. During each assessment period, study participants in both
conditions will complete a survey, physical measures, hemoglobin A1c measurement, and seven
days of physical activity data collection with accelerometers. Study participants in both
conditions could additionally be asked to complete a measurement for endothelial function
during each assessment.
The baseline assessment will occur directly after participant enrollment and consent at each
worksite. Both conditions will be given access to portable pedal stands. The intervention
condition will have additional environmental alterations including hanging signs throughout
the work environment that promote health and safety behaviors; and replacing high calorie and
high sugar food and drink options in vending machines and break rooms with fresh fruits,
vegetables, and other healthier choices.
Participants in the intervention condition will begin intervention activities. Intervention
activities that participants could be asked to complete include: computer based training,
goal setting and behavioral self-monitoring, scripted team-based health and safety
discussions, and team competitions with pedal stands. Supervisor participants could
additionally be asked to complete additional computer based training, goal setting and
behavioral self-monitoring of supportive behaviors, and inter-supervisor observations.
Participants in the control condition will receive no additional support beyond the provision
of pedal stands.
Repeated measures will be collected at baseline, six months, and 12 months. Our primary
hypotheses are that the intervention condition will produce greater reductions in sedentary
behavior, increases in light physical activity, and reductions in musculoskeletal pain and
sick day use than the control condition. To test these hypotheses, we will employ an
intent-to-treat strategy using generalized estimating equations in order to use all available
data to evaluate group differences in the magnitude of change over time in primary outcomes.
The effect of interest for each outcome will be the interaction of condition X time. We will
statistically control for confounders by measuring a wide range of demographic and
psychological variables that could impact study outcomes. We will test for baseline
differences between conditions on these variables using one-way ANOVAs (continuous variables)
or chi-squares tests (categorical variables). Variables that differ significantly between
groups at baseline will be included as covariates in the generalized estimating equation
models of intervention effects over time.
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