Increasing Employees' Health by Workplace Physical Activity Counseling: The Mediating Role of Step-Based Physical Activity Behavior Change.

BACKGROUND: This study evaluated the effects of a 3-month workplace physical activity (PA) intervention on employees' health-related fitness and well-being. Moreover, mediational pathways were examined. METHODS: A longitudinal, quasi-experimental trial was evaluated in Belgian employees. The intervention group (IG: n = 246) received 3-months individualized, tailored PA counseling, consisting of face-to-face counseling and follow-up e-mail and telephone contacts. The reference group (n = 54) received no PA counseling. Outcome measures (assessed at baseline, 3 mo [short term], and 9 mo [long term]) included body composition, cardiorespiratory fitness, well-being, and step-based PA. RESULTS: With no changes in the reference group, the IG showed short-term improvements in body mass index (-0.24 kg/m2, P < .001), body fat (-0.88%, P < .001), waist circumference (-1.47 cm, P < .001), and muscle percentage (+0.47%, P < .001). Moreover, with respect to cardiorespiratory fitness, IG participants improved on perceived exertion, both in the short term (-0.91, P < .001) and long term (-0.83, P < .001). Furthermore, perceived physical well-being increased in the IG, both in the short term (+0.57, P < .001) and long term (+0.57, P < .001). The observed intervention effects on body composition, perceived exertion, and well-being were mediated by (increases in) step-based PA. CONCLUSIONS: Workplace PA counseling programs have the potential to enhance employees' health-related fitness and well-being. Importantly, step-based PA behavior change was found to contribute to the postintervention improvements.

Validation of a smart chair and corresponding smartphone app as an objective measure of desk-based sitting.

OBJECTIVES: This study evaluated the validity of a smart chair and corresponding smartphone app (chair&app) to measure sitting time and sitting interruptions against camera-derived observation and activPAL. METHODS: Belgian deskbound university employees (n = 28, 17 women, mean age 30 ± 7.5 years, mean BMI 22.1 ± 2.0 kg/m2 ) were provided with the chair&app in three conditions: a controlled condition (following a prescribed protocol), a free-living condition (conducting usual office work for 2 hours), and an extended free-living condition (conducting usual office work for three consecutive days). Total sitting time and the number of sitting interruptions were compared between the chair&app and criterion measures (camera observation and activPAL). Criterion validity was assessed using mean differences (95% CI) and intra-class correlation coefficients (ICC; 95% CI). RESULTS: In the controlled condition, mean sitting time and number of sitting interruptions differed between chair&app and camera observation by 2.7 (-2.4, 7.9) minutes and -8.0 (-10.4, -5.6) interruptions, respectively. For the free-living condition, there was good agreement between chair&app and camera observation for both sitting time (ICC: 0.74; 0.28, 0.93) and sitting interruptions (ICC: 0.68; 0.10, 0.91). For the extended free-living condition, there was excellent agreement between chair&app and activPAL for sitting time (ICC: 0.89; 0.49, 0.97). Meanwhile, there was poor agreement between chair&app and activPAL for sitting interruptions (ICC: 0.38; -0.04, 0.70). CONCLUSIONS: Chair&app generally provided reliable measures of desk-based sitting. Consequently, chair&app might be useful as a self-monitoring tool in the workplace context. Further research is needed to explore its usefulness in reducing adults' desk-based sitting.

Evaluation of stAPP: a smartphone-based intervention to reduce prolonged sitting among Belgian adults.

Excessive uninterrupted sitting, also known as sedentary behavior, has been detrimentally associated with several health outcomes. However, the general population is often unaware of these health risks. Mobile phone technology offers great potential to increase awareness and to initiate behavior change. This study examined the short-term effects of stAPP, a smartphone-based intervention, on prolonged sitting behavior. Fifty-eight participants were randomly assigned to an intervention group (IG, n = 31) or a control group (CG, n = 27). After 1 week of baseline assessment, the IG received stAPP (i.e. smartphone, smartphone app and corresponding motion sensor) and used it during the following week. CG participants were monitored during 2 weeks without receiving stAPP. Total daily sitting time and prolonged sitting bouts (>30 min bouts of sitting) were objectively assessed using activPAL3 inclinometers. Although no significant changes emerged in the CG in any of the sitting parameters, total sitting time (on weekdays; p = 0.032), number of prolonged sitting bouts (>30 min of sitting) [both on week- (p < 0.001) and weekend days (p = 0.008)] and average duration of prolonged sitting bouts [both on week- (p = 0.004) and weekend days (p = 0.029)] decreased significantly in the IG. The stAPP smartphone-based intervention constitutes a promising intervention tool to interrupt and reduce prolonged sitting behavior. Further long-term studies on a larger scale are needed to further explore the effectiveness of a smartphone-based intervention aimed at reducing prolonged sitting behavior.

Short- and long-term effectiveness of a three-month individualized need-supportive physical activity counseling intervention at the workplace.

BACKGROUND: The objective of the present study was to evaluate the short- and long-term intervention and mediation effects of a 3-month individualized need-supportive physical activity (PA) counseling intervention on employees' PA and sedentary behavior. METHODS: Insufficiently active employees (n = 300; mean age 42 ± 9 years; 78% female) were recruited from a large pharmaceutical company in Flanders, Belgium. A quasi-experimental design was used in which the intervention group (N = 246) was recruited separately from the reference group (N = 54). Intervention group participants received a 3-month behavioral support intervention, which consisted of two one-hour face-to-face counseling sessions and three follow-up counseling contacts by e-mail or telephone at weeks three, six and nine. PA counseling, delivered by qualified PA counselors, aimed to satisfy participants' basic psychological needs for autonomy, competence, and relatedness. Reference group participants did not receive individualized PA counseling. Outcome measures included objectively assessed and self-reported PA and sedentary time and psychological need satisfaction. Assessments were held at baseline, immediately after the intervention (short-term) and 6 months post-intervention (long-term). Mixed model analyses and bootstrapping analyses were used to determine intervention and mediation effects, respectively. RESULTS: The intervention group increased weekday daily steps both in the short- and long-term, while the reference group showed reductions in daily step count (ES = .65 and ES = .48 in the short- and long-term, respectively). In the short-term, weekday moderate-to-vigorous PA increased more pronouncedly in the intervention group compared to the reference group (ES = .34). Moreover, the intervention group demonstrated reductions in self-reported sitting time during weekends both in the short- and long-term, whereas the reference group reported increased sitting time (ES = .44 and ES = .32 in the short- and long-term, respectively). Changes in perceived autonomy and competence need satisfaction mediated the long-term intervention effects on daily step count. CONCLUSIONS: A 3-month individualized need-supportive PA counseling intervention among employees resulted in significant and sustained improvements in weekday daily step count and in decreased self-reported sitting during weekends. Our findings contribute to the growing evidence of the long-term effectiveness of need-supportive PA counseling. TRIAL REGISTRATION: ClinicalTrials.gov NCT01759927 . Registered December 30, 2012.

Subcortical structures in humans can be facilitated by transcranial direct current stimulation.

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that alters cortical excitability. Interestingly, in recent animal studies facilitatory effects of tDCS have also been observed on subcortical structures. Here, we sought to provide evidence for the potential of tDCS to facilitate subcortical structures in humans as well. Subjects received anodal-tDCS and sham-tDCS on two separate testing days in a counterbalanced order. After stimulation, we assessed the effect of tDCS on two responses that arise from subcortical structures; (1) wrist and ankle responses to an imperative stimulus combined with a startling acoustic stimulus (SAS), and (2) automatic postural responses to external balance perturbations with and without a concurrent SAS. During all tasks, response onsets were significantly faster following anodal-tDCS compared to sham-tDCS, both in trials with and without a SAS. The effect of tDCS was similar for the dominant and non-dominant leg. The SAS accelerated the onsets of ankle and wrist movements and the responses to backward, but not forward perturbations. The faster onsets of SAS-induced wrist and ankle movements and automatic postural responses following stimulation provide strong evidence that, in humans, subcortical structures--in particular the reticular formation--can be facilitated by tDCS. This effect may be explained by two mechanisms that are not mutually exclusive. First, subcortical facilitation may have resulted from enhanced cortico-reticular drive. Second, the applied current may have directly stimulated the reticular formation. Strengthening reticulospinal output by tDCS may be of interest to neurorehabilitation, as there is evidence for reticulospinal compensation after corticospinal lesions.