Efficacy of theory-informed workplace physical activity interventions: a systematic literature review with meta-analyses

ABSTRACT

This review aimed to assess the efficacy of workplace physical activity interventions; compare the efficacy of those that were and were not informed by behaviour change theory, and outline the effectiveness of different intervention components. A search was undertaken in Medline, Embase, PsycINFO, Ovid Emcare (previously CINAHL) and SportDiscus. Randomised, non-randomised and cluster-controlled trials with objectively measured physical activity and/or measured or predicted maximal oxygen uptake (VO_2max) as outcomes were included in the review (83 papers from 79 trials). Random-effects meta-analyses of mean differences were undertaken. Workplace physical activity programmes demonstrated positive overall intervention effects for daily step counts (814.01 steps/day; CI: 446.36, 1181.67; p < 0.01; i² = 88%) and measured VO_2max (2.53 ml kg⁻¹ min⁻¹; CI: 1.69, 3.36; p < 0.01; i² = 0%) with no sub-group differences between theory- and non-theory informed interventions. Significant sub-group differences were present for predicted VO_2max (p < 0.01), with a positive intervention effect for non-theory informed studies (2.11 ml.kg⁻¹ min⁻¹; CI: 1.20, 3.02; p < 0.01; i² = 78%) but not theory-informed studies (−0.63 ml kg⁻¹ min⁻¹; CI: −1.55, 0.30; p = 0.18; i² = 0%). Longer-term follow-ups ranged from 24 weeks to 13 years, with significant positive effects for measured VO_2max (2.84 ml kg⁻¹ min⁻¹; CI: 1.41, 4.27; p < 0.01; i² = 0%). Effective intervention components included the combination of self-monitoring with a goal, and exercise sessions onsite or nearby. The findings of this review were limited by the number and quality of theory-informed studies presenting some outcomes, and confounding issues in complex interventions. Future researchers should consider rigorous testing of outcomes of theory-informed workplace physical activity interventions and incorporate longer follow-ups.

KEYWORDS:

• Systematic review
• meta-analysis
• physical activity
• maximal oxygen uptake
• workplace

Acknowledgements

The first and second authors (DP) undertook the review search, screening, and coding process. The second author also undertook a pre-determined per cent of data extraction for the purposes of testing inter-rater reliability. The third (JD) and fourth (GP) authors have overseen the review from the initial planning stages to dissemination of the results. All authors have contributed to refining the final drafts of this manuscript. The authors would like to acknowledge all of the study authors that responded to communications and provided or assisted with the location of study data. The authors would also like to acknowledge Terry Boyle, Adrian Esterman, and Elizabeth Buckley for their methodological advice and statistical support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The lead author’s time (ML) is funded by the Activity for Wellbeing doctoral scholarship (ACH Group).