Walks4work: Rationale and study design to investigate walking at lunchtime in the workplace setting

BMC Public Health

Valerie F Gladwell¹  Jules Pretty¹  Jo L Barton¹  Daniel K Brown¹ 

[1] School of Biological Sciences, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK

关键词: Nature;    Heart rate variability;    Cardiovascular disease;    Physical activity;    Workplace;    Walking;   

Others  :  1163425
DOI  :  10.1186/1471-2458-12-550

 received in 2012-03-26, accepted in 2012-07-10,  发布年份 2012

【 摘 要 】

Background

Following recruitment of a private sector company, an 8 week lunchtime walking intervention was implemented to examine the effect of the intervention on modifiable cardiovascular disease risk factors, and further to see if walking environment had any further effect on the cardiovascular disease risk factors.

Methods

For phase 1 of the study participants were divided into three groups, two lunchtime walking intervention groups to walk around either an urban or natural environment twice a week during their lunch break over an 8 week period. The third group was a waiting-list control who would be invited to join the walking groups after phase 1. In phase 2 all participants were encouraged to walk during their lunch break on self-selecting routes. Health checks were completed at baseline, end of phase 1 and end of phase 2 in order to measure the impact of the intervention on cardiovascular disease risk. The primary outcome variables of heart rate and heart rate variability were measured to assess autonomic function associated with cardiovascular disease. Secondary outcome variables (Body mass index, blood pressure, fitness, autonomic response to a stressor) related to cardiovascular disease were also measured. The efficacy of the intervention in increasing physical activity was objectively monitored throughout the 8-weeks using an accelerometer device.

Discussion

The results of this study will help in developing interventions with low researcher input with high participant output that may be implemented in the workplace. If effective, this study will highlight the contribution that natural environments can make in the reduction of modifiable cardiovascular disease risk factors within the workplace.

【 授权许可】

   
2012 Brown et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1 .

【 参考文献 】

• [1]Alwan A, Maclean DR, Riley LM, d'Espaignet ET, Mathers CD, Stevens GA, Bettcher D: Monitoring and surveillance of chronic non-communicable diseases: progress and capacity in high-burden countries. Lancet 2010, 376(9755):1861-1868.
• [2]European Cardiovascular Disease Statistics 2008. 2008. http://www.ehnheart.org/cvd-statistics.html webcite
• [3]WHO: Global status report on noncommunicable diseases 2010. WHO; 2011.
• [4]WHO: Global recommendations on physical activity for health. Geneva: WHO; 2010.
• [5]Health Survey for England. http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-related-surveys/health-survey-for-england/health-survey-for-england--2010-trend-tables webcite
• [6]Department of Health: Physical Activity, Health Improvement and Protection. In Start active, stay active: A report on physical activity from the four home countries' chief medical officers. Edited by Health UD. Crown; 2011:38-44.
• [7]King NA, Hopkins M, Caudwell P, Stubbs RJ, Blundell JE: Beneficial effects of exercise: shifting the focus from body weight to other markers of health. Br J Sports Med 2009, 43(12):924-927.
• [8]Billman GE, Kukielka M: Effect of endurance exercise training on heart rate onset and heart rate recovery responses to submaximal exercise in animals susceptible to ventricular fibrillation. J Appl Physiol 2007, 102(1):231-240.
• [9]Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS: Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med 1999, 341(18):1351-1357.
• [10]Cole CR, Foody JM, Blackstone EH, Lauer MS: Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort. Ann Intern Med 2000, 132(7):552-555.
• [11]Nishime EO, Cole CR, Blackstone EH, Pashkow FJ, Lauer MS: Heart rate recovery and treadmill exercise score as predictors of mortality in patients referred for exercise ECG. JAMA : the journal of the American Medical Association 2000, 284(11):1392-1398.
• [12]Jouven X, Ducimetiere P: Recovery of heart rate after exercise. N Engl J Med 2000, 342(9):662-663.
• [13]Blair SN, Kampert JB, Kohl HW, Barlow CE, Macera CA, Paffenbarger RS: Gibbons LW: Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. Jama 1996, 276(3):205-210.
• [14]Stevens J, Evenson KR, Thomas O, Cai J, Thomas R: Associations of fitness and fatness with mortality in Russian and American men in the lipids research clinics study. Int J Obes Relat Metab Disord 2004, 28(11):1463-1470.
• [15]Duncan GE: The "fit but fat" concept revisited: population-based estimates using NHANES. Int J Behav Nutr Phys Act 47, 7:47.
• [16]Seals DR, Chase PB: Influence of physical training on heart rate variability and baroreflex circulatory control. J Appl Physiol 1989, 66(4):1886-1895.
• [17]Task Force: Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation 1996, 93(5):1043-1065.
• [18]Tsuji H, Venditti FJ: Manders ES, Evans JC, Larson MG, Feldman CL. Levy D: Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study. Circulation 1994, 90(2):878-883.
• [19]La Rovere MT, Bigger JT, Marcus FI, Mortara A, Schwartz PJ: Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Lancet 1998, 351(9101):478-484.
• [20]La Rovere MT, Pinna GD, Hohnloser SH, Marcus FI, Mortara A, Nohara R, Bigger JT: Camm AJ, Schwartz PJ: Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmias: implications for clinical trials. Circulation 2001, 103(16):2072-2077.
• [21]Zipes DP, Rubart M: Neural modulation of cardiac arrhythmias and sudden cardiac death. Hear Rhythm 2006, 3(1):108-113.
• [22]Minisi AJ: Ventricular reflex interactions during transmural myocardial ischemia. Auton Neurosci 2005, 119(1):9-15.
• [23]Sandercock GR, Bromley PD, Brodie DA: Effects of exercise on heart rate variability: inferences from meta-analysis. Med Sci Sports Exerc 2005, 37(3):433-439.
• [24]Ogoh S, Fisher JP, Dawson EA, White MJ, Secher NH, Raven PB: Autonomic nervous system influence on arterial baroreflex control of heart rate during exercise in humans. J Physiol 2005, 566(Pt 2):599-611.
• [25]Nelson AJ, Juraska JM, Musch TI, Iwamoto GA: Neuroplastic adaptations to exercise: neuronal remodeling in cardiorespiratory and locomotor areas. J Appl Physiol 2005, 99(6):2312-2322.
• [26]Penn MS, Bakken EE: Heart-brain medicine: Update 2009. Cleveland Clinic journal of medicine 2010, 77(Suppl 3):S4-S6.
• [27]Juster RP, McEwen BS, Lupien SJ: Allostatic load biomarkers of chronic stress and impact on health and cognition. Neurosci Biobehav Rev 2010, 35(1):2-16.
• [28]Rosmond R, Bjorntorp P: Occupational status, cortisol secretory pattern, and visceral obesity in middle-aged men. Obes Res 2000, 8(6):445-450.
• [29]Chandola T, Britton A, Brunner E, Hemingway H, Malik M, Kumari M, Badrick E, Kivimaki M, Marmot M: Work stress and coronary heart disease: what are the mechanisms? Eur Heart J 2008, 29(5):640-648.
• [30]Hemingway H, Shipley M, Brunner E, Britton A, Malik M, Marmot M: Does autonomic function link social position to coronary risk? The Whitehall II study. Circulation 2005, 111(23):3071-3077.
• [31]Rystedt LW, Cropley M, Devereux JJ, Michalianou G: The relationship between long-term job strain and morning and evening saliva cortisol secretion among white-collar workers. J Occup Heal Psychol 2008, 13(2):105-113.
• [32]Welk GJ, Differding JA, Thompson RW, Blair SN, Dziura J, Hart P: The utility of the Digi-walker step counter to assess daily physical activity patterns. Med Sci Sports Exerc 2000, 32(9 Suppl):S481-488.
• [33]Chan CB, Ryan DA, Tudor-Locke C: Health benefits of a pedometer-based physical activity intervention in sedentary workers. Prev Med 2004, 39(6):1215-1222.
• [34]Puig-Ribera A, McKenna J, Gilson N, Brown WJ: Change in work day step counts, wellbeing and job performance in Catalan university employees: a randomised controlled trial. Promot Educ 2008, 15(4):11-16.
• [35]Hess I, Borg J, Rissel C: Workplace nutrition and physical activity promotion at Liverpool Hospital. Health Promot J Austr 2011, 22(1):44-50.
• [36]Gilson N, Brown WJ, Faulkner G, McKenna J, Murphy M, Pringle A, Proper K, Puig-Ribera A, Stathi A: The International Universities Walking Project: development of a framework for workplace intervention using the Delphi technique. J Phys Act Health 2009, 6(4):520-528.
• [37]Tudor-Locke C, Ainsworth BE, Whitt MC, Thompson RW, Addy CL, Jones DA: The relationship between pedometer-determined ambulatory activity and body composition variables. Int J Obes Relat Metab Disord 2001, 25(11):1571-1578.
• [38]WHO: Global status report on noncommunicable diseases 2010. 2011, 176.
• [39]Workplace health promotion: how to encourage employees to be physically active. www.nice.org.uk/PH013 webcite
• [40]Racette SB, Deusinger SS, Inman CL, Burlis TL, Highstein GR, Buskirk TD, Steger-May K, Peterson LR: Worksite Opportunities for Wellness (WOW): effects on cardiovascular disease risk factors after 1 year. Prev Med 2009, 49(2–3):108-114.
• [41]Murtagh EM, Murphy MH, Boone-Heinonen J: Walking: the first steps in cardiovascular disease prevention. Curr Opin Cardiol 2010, 25(5):490-496.
• [42]Conn VS, Hafdahl AR, Cooper PS, Brown LM, Lusk SL: Meta-analysis of workplace physical activity interventions. Am J Prev Med 2009, 37(4):330-339.
• [43]Brown HE, Gilson ND, Burton NW, Brown WJ: Does physical activity impact on presenteeism and other indicators of workplace well-being? Sports Med 2011, 41(3):249-262.
• [44]Building the case for wellness. http://www.dwp.gov.uk/docs/hwwb-dwp-wellness-report-public.pdf webcite
• [45]Department_of_Health: Tackling health inequalities. In 10 years on - a review of developments in tackling health inequalities in England over the last 10 years. Department_of_Health, London; 2009.
• [46]Hartig T, Mang M, Evans GW: Restorative effects of natural environment experiences. Environment and Behaviour 1991, 23:3-26.
• [47]Pretty J: The greening of healthcare. New Scientist 2007., 32
• [48]Pretty J, Peacock J, Sellens M, Griffin M: The mental and physical health outcomes of green exercise. Int J Environ Heal R 2005, 15(5):319-337.
• [49]Park BJ, Tsunetsugu Y, Kasetani T, Kagawa T, Miyazaki Y: The physiological effects of Shinrin-yoku (taking in forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan. Environ Health Pre Med 2010, 15:18-26.
• [50]Gladwell VF, Brown DK, Barton JL, Tarvainen MP, Kuoppa P, Pretty J: Suddaby JM. Sandercock GR: The effects of views of nature on autonomic control. Eur J Appl Physiol; 2012.
• [51]Li Q, Otsuka T, Kobayashi M, Wakayama Y, Inagaki H, Katsumata M, Hirata Y, Li Y, Hirata K, Shimizu T, et al.: Acute effects of walking in forest environments on cardiovascular and metabolic parameters. Eur J Appl Physiol 2011, 111(11):2845-2853.
• [52]Barton J, Griffin M, Pretty J: Exercise, nature and socially interactive based initiatives improve mood and self-esteem in the clinical population. Public Health: Perspect; 2011.
• [53]Pretty J, Peacock J, Hine R, Sellens M, South N, Griffin M: Green exercise in the UK countryside: effects on health and psychological well-being. J Environ Plan Manag 2007, 50(2):211-231.
• [54]Barton J, Pretty J: What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environ Sci Technol 2010, 44(10):3947-3955.
• [55]Hautala AJ, Makikallio TH, Kiviniemi A, Laukkanen RT, Nissila S, Huikuri HV, Tulppo MP: Cardiovascular autonomic function correlates with the response to aerobic training in healthy sedentary subjects. Am J Physiol Heart Circ Physiol 2003, 285(4):H1747-1752.
• [56]Buckley JP, Sim J, Eston RG, Hession R, Fox R: Reliability and validity of measures taken during the Chester step test to predict aerobic power and to prescribe aerobic exercise. British Journal of Sports Medicine 2004, 38(2):197-205.
• [57]Sykes K, Roberts A: The Chester step test–a simple yet effective tool for the prediction of aerobic capacity. Physiotherapy 2004, 90(4):183-188.
• [58]Borg G, Dahlstrom H: A pilot study of perceived exertion and physical working capacity. Acta Soc Med Ups 1962, 67:21-27.
• [59]Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, et al.: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003, 35(8):1381-1395.
• [60]Watson D, Clark L, Tellegen A: Development and validation of brief measures of positive and negative affect: The PANAS scales. J Pers Soc Psychol 1988, 54(6):1063-1070.
• [61]Rosenberg M: Society and the Adolescent self-image. Princeton, NJ: Princeton University Press; 1965.
• [62]Cohen S, Kamarck T, Mermelstein R: A global measure of perceived stress. J Health Soc Behav 1983, 24(4):385-396.
• [63]Schaufeli WB: Martínez IM, Pinto AM, Salanova M, Bakker AB: Burnout and engagement in university students. Journal of Cross-Cultural Psychology 2002, 33(5):464-481.
• [64]Schaufeli WB, Salanova M: González-Romá V, Bakker AB: The measurement of engagement and burnout: A two sample confirmatory factor analytic approach. Journal of Happiness studies 2002, 3(1):71-92.
• [65]Nisbet EK, Zelenski JM, Murphy SA: The Nature Relatedness Scale: Linking individuals’ connection with nature to environmental concern and behavior. Environ Behav 2009, 41(5):715-740.
• [66]Cox T, Mackay C: The measurement of self-reported stress and arousal. British journal of psychology (London, England: 1953) 1985, 76:183.
• [67]Chen KY, Bassett DR: The technology of accelerometry-based activity monitors: current and future. Med Sci Sports Exerc 2005, 37(11 Suppl):S490-500.
• [68]Hoyt RW, Knapik JJ, Lanza JF, Jones BH, Staab JS: Ambulatory foot contact monitor to estimate metabolic cost of human locomotion. J Appl Physiol 1994, 76(4):1818-1822.
• [69]Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007, 39(8):1423-1434.
• [70]Murphy MH, Murtagh EM, Boreham CA, Hare LG, Nevill AM: The effect of a worksite based walking programme on cardiovascular risk in previously sedentary civil servants [NCT00284479]. BMC Publ Health 2006, 6:136. BioMed Central Full Text