Worksite Policies and Incentives Supporting Physical Activity in Rural Communities

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Worksite Policies and Incentives Supporting
Physical Activity in Rural Communities

• Elizabeth Dodson, MPH
• Prevention Research Center
• Saint Louis University School of Public Health
• November 6, 2006

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Acknowledgements

• Sarah L. Lovegreen, MPH
• Michael B. Elliott, PhD
• Debra Haire-Joshu, PhD
• Ross C. Brownson, PhD
• NIDDK
• PRC program at SLU SPH

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What We Know

• Prevalence cost of chronic disease
• Regular physical activity as partial solution
• Half of American adults are not active at
  nationally recommended levels
• 16 remain completely inactive
• Prevalence especially high in rural U.S.

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Study Importance

• Individually targeted interventions are common
• Multi-level and policy interventions have
  potential for broad impact
• Gap Impacts of these policy interventions are
  under-researched
• Gap Rural research and policy

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Why Worksites?

• Working adults spend at least half of waking
  hours at work
• Offer access to 65 of the population over age 16
  
• Offer convenient exposure to
• contained, consistent audience
• a relatively controlled environment

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Research Questions

• What kinds of worksite incentives are available
  in rural communities?
• Does the presence of worksite incentives increase
  the likelihood that employees will meet physical
  activity recommendations?
• Are there specific incentives that are
  particularly effective, which can be easily and
  inexpensively introduced into a variety of
  worksite settings?

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Data Source

• Data collected via RDD telephone survey
• Participants part of two related, ongoing,
  quasi-experimental studies in MO, TN, AR
• Community size range 766 - 17,642 (median
  1,949)

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Methods

• Examined association of individual incentives on
  meeting physical activity recommendations
• Examined association of number (count) of
  incentives on meeting physical activity
  recommendations
• Exclusions
• Not employed for wages (n 2157)
• Mostly walking or doing heavy labor at work
  (n569)

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MeasuresDependent Variables

• Physical activity recommendations
• (CDC and ACSM guidelines)
• Moderate 30 min. moderate activity (brisk
  walking or jogging) 5 days/week
• Vigorous 20 min. vigorous activity (running,
  biking) 3 days/week
• Meeting either moderate or vigorous
• Meeting recommendations only through walking

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Worksite Incentives and EnvironmentIndependent
Variables

• Resource materials (brochures, videos)
• Subsidized health club membership
• Sponsored sports teams
• Reduced health insurance
• Other monetary incentives
• Time or breaks for exercise

• Safe and accessible stairways
• Facilities (gym, locker, shower)
• Equipment (cycle, treadmill, weights)
• Personal services (fitness testing, counseling)
• Group services (classes, health fairs)

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Structured Non-StructuredIncentives and
Environment

• Structured
• Facilities
• Equipment
• Subsidized health club membership
• Sports teams
• Group services

• Non-Structured
• Stairways
• Breaks
• Personal services
• Resource materials
• Reduced health insurance
• Monetary incentives

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Characteristics of Sample Population n977
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Association of Select Worksite Incentives to
Meeting Physical Activity Recommendations
Adjusted for age, race, gender, education
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Results Structured Incentives
All adjusted for age, race, gender, education
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Results Non-Structured Incentives
All adjusted for age, race, gender, education
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Linear trends significant at p lt 0.05
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Conclusions

• Employees with worksite incentives are more
  likely to meet physical activity recommendations
• Linear relationship between number of worksite
  incentives available and likelihood of meeting
  certain types of physical activity
  recommendations
• Some policies and incentives may be effective,
  uncomplicated and inexpensive to implement

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Limitations

• Cross-sectional data
• Self-reported levels of physical activity and
  worksite incentives
• No specific or standardized measurements for
  policies and incentives
• Generalizable only to similar populations

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Next Steps

• Replicate with rigorous measurement
• Evaluate current wellness policies
• Replicate in urban setting
• Translate and disseminate, once effective
  policies are demonstrated

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Thank you!

• Elizabeth Dodson
• Dodsonea_at_slu.edu