JKACHN Journal of Korean Academy of Community Health Nursing J Korean Acad Community Health Nurs 1225-9594 2288-4203 Korean Academy of Community Health Nursing 10.12799/jkachn.2019.30.3.257 jkachn-30-257 Original Article Effectiveness of a Workplace Walking Program Using a Fitness Tracker Including Individual Counseling and Tailored Text Messaging JungMira1 HaYeongmi2 Assistant Professor, Department of Nursing, Hanyeong College, Yeosu, Korea Associate Professor, College of Nursing · Institute of Health Sciences, Gyeongsang National University, Jinju, Korea Corresponding author: Ha, Yeongmi College of Nursing, Gyeongsang National University, 816 Beon-gil, 15 Jinju-daero, Jinju 52727 Korea. Tel: +82-55-772-8253, Fax: +82-55-772-8222, E-mail: yha@gnu.ac.kr 092019 12092019 30 3 257 270 07072018 10052019 15052019 Copyright © 2019 Korean Academy of Community Health Nursing 2019 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose

This study is designed as a non-equivalent, control group pre/post-test for identifying effectiveness of a workplace walking program using a fitness tracker including individual counseling and tailored text messaging.

 Methods

Seventy-nine employees from two large companies were allocated into an intervention group (n=39) and a control group (n=40). Participants were asked to wear a fitness tracker (Fitbit Charger HR) during 24-hour, 5-days per week, for 10 weeks. The intervention group was provided with daily walking steps measured by Fitbit, weekly counseling with a specifically designed workbook, and seven weekly text messaging, and the control group with the fitness tracker only.

 Results

At the week 10 measurement, there were significant differences between the intervention and control groups in physical activity self-efficacy (p<.001), physical activity behavior (p<.001), daily walking steps (p<.001), systolic blood pressure (p=.033), and wellness (p<.001).

 Conclusion

These results suggest that the workplace walking program using a fitness tracker including individual counseling and tailored text messaging is more effective for persons with 10,000 steps/day. Therefore, it is recommended to actively apply this workplace walking program to inactive employees for encouraging regular physical activities and improving their wellness.

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Conceptual framework for workplace walking program.

Workplace Walking Program using Fitness Tracker including Individual Counseling and Tailored Text Messaging

Time Methods Contents
Introduction ․ Campaign of workplace walking program using fitbit including individual counseling and tailored text messaging
․ Orientation about workplace walking program
․ Make a written pledge
․ Goal planning during workplace walking program
  - Setting on short-term and long-term goals
․ Set on counseling date and time
․ Fitbit provision and usage instruction
1st week ․ Mobile health ․ How to do stretching & aerobic exercise
workbook education ․ The importance and effect of physical activity including walking
․ Goal setting ․ Achievable goal setting on 1 week
․ Individual counseling ․ Check out own steps in the past week, identify barriers of activities, confirm or reset activity
goals, rebuild activity plan
․ Advice on employee's activity, nutrition habit, and sleep pattern
․ Customized daily text ․ Motivating text (usually monday), health information text, emotional support &
messaging with 5 areas encouragement text, supporting health behavior text, problem solving text
2nd~4th ․ Mobile health ․ Understand walking exercise guidelines (frequency, intensity, time)
week workbook education ․ Know my goal heart rate during exercise
․ Increase activity: 15~20% increase your activity every two week
․ Effects and benefits of continuous walking exercise
․ Barriers of exercise & coping strategies of exercise
․ Goal setting ․ Achievable goal setting on 2nd~4th week
․ Individual counseling ․ Check out own steps in the past week, identify barriers of activities, confirm or reset activity
goals, rebuild activity plan
․ Consult about their own goal heart rate during exercise
․ How to increase activity and maintain activity
․ Advice on employee's activity, nutrition habit, and sleep pattern
․ Customized text ․ Motivating text (usually monday), health information text, emotional support &
messaging encouragement text, supporting health behavior text, problem solving text
5th week ․ Mobile health ․ Maintain increased activity & increase exercise intensity
workbook education
․ Goal setting ․ Achievable goal setting on 5th week
․ Prompt feedback on employee's performance
․ Individual counseling ․ Check out own steps in the past week, identify barriers of activities, confirm or reset activity
goals, rebuild activity plan
․ How to increase exercise intensity & exercise course: Stairs, hill walking, fast walking
․ Advice on employee's activity, nutrition habit, and sleep pattern
․ Customized text ․ Motivating text (usually monday), health information text, emotional support &
messaging encouragement text, supporting health behavior text, problem solving text
․ Reward ․ Provide a voucher to employees with 10000 daily steps
․ Executives and an occupational health nurse encourage walking and physical activities
6th~10th ․ Mobile health ․ Nutrition: right meal eating habit
week workbook education ․ Nutrition: balanced and healthy diet
․ Nutrition: low calory diet & low cholesterol diet
․ Know my blood pressure & blood sugar
․ Preventive strategies of hypertension and diabetes
․ Know my cholesterol
․ Preventive strategies of high level of cholesterol
․ Goal setting ․ Achievable goal setting on 6th~10th week
․ Individual counseling ․ Check out own steps in the past week, identify barriers of activities, confirm or reset activity
goals, rebuild activity plan ․ Maintain exercise intensity with your goal heart rate
․ Sharing my action plan to overcome obstacles with increased activity duration
․ Advice on employee's activity, nutrition habit, and sleep pattern
․ Customized text ․ Motivating text (usually monday), health information text, emotional support &
messaging encouragement text, supporting health behavior text, problem solving text
․ Reward ․ Provide a success voucher

Homogeneity Test of Characteristics of the Participants (N=79)

Characteristics Int. (n=39)
 Cont. (n=40)
 x2 or t (p)
n (%) or M±SD n (%) or M±SD
Age (year) 42.02±7.38 41.97±7.19 0.03 (.975)
Marital status 0.41 (.521)
  Married 31 (79.5) 34 (85.0)
  Single 8 (20.5) 6 (15.0)
Educational level 4.23 (.121)
  ≤High school 8 (20.5) 16 (40.0)
  College 11 (28.2) 6 (15.0)
  ≥University 20 (51.3) 18 (45.0)
Shift work 2.15 (.142)
  Yes 4 (10.3) 9 (22.5)
  No 35 (89.7) 31 (77.5)
Physical activity behavior 2.27±0.74 2.00±0.47 1.95 (.055)
Daily walking steps (steps/day) 9,724.00±2,953.00 9,582.00±2,796.00 0.22 (.827)
  5,000~9,999† 7,838.00±1,349.00 7,482.00±1,463.00 0.86 (.396)
  ＜10,000‡ 13,092.00±1,756.00 11,903.00±1,932.00 1.81 (.079)
Physical activity self-efficacy 3.09±0.90 2.78±0.68 1.74 (.086)
Self-rated health 4.17±0.60 4.15±0.62 0.21 (.831)
Systolic blood pressure (mmHg) 130.30±11.66 129.25±10.54 0.42 (.673)
Diastolic blood pressure (mmHg) 82.66±6.67 79.55±7.39 1.97 (.052)
Total cholesterol 195.00±44.39 195.22±37.06 -0.02 (.980)
Wellness 3.35±0.52 3.21±0.38 1.38 (.171)

Int.=Intervention group; Cont.=Control group;

Int. (n=25), Cont. (n=21);

Int. (n=14), Cont. (n=19).

Physiological and Cognitive Effects of Workplace Walking Program (N=79)

Variables Group Pretest
 Posttest
 Effect by point
 Intergroup effect
M±SD M±SD t (p) t (p)
Physical activity behavior Int. 2.27±0.74 3.16±0.42 6.88 (＜.001) 10.28 (＜.001)
Cont. 2.00±0.47 2.11±0.48 1.58 (.121)
Daily walking steps Int. 9,724.00±2,953.00 13,584.00±3,562.00 6.57 (＜.001) 3.43 (＜.001)
Cont. 9,582.00±2,796.00 10,683.00±3,937.00 1.56 (.127)
  5,000~9,999 steps† Int. 7,838.00±1,349.00 12,819.00±3,622.00 6.89 (＜.001) 2.67 (.010)
Cont. 7,482.00±1,463.00 9,899.00±3,786.00 2.79 (.011)
  ≥10,000 steps‡ Int. 13,092.00±1,756.00 14,951.00±1,756.00 2.39 (.032) 1.81 (.079)
Cont. 11,903.00±1,932.00 11,550.00±4,017.00 -0.33 (.744)
Physical activity self-efficacy Int. 3.09±0.90 4.21±0.45 6.92 (＜.001) 9.96 (＜.001)
Cont. 2.78±0.68 2.90±0.67 1.08 (.285)
Self-rated health Int. 4.17±0.60 4.33±0.52 1.64 (.109) 0.26 (.795)
Cont. 4.15±0.62 4.30±0.60 1.43 (.159)
Systolic blood pressure Int. 130.30±11.66 120.89±9.79 -8.07 (＜.001) -2.17 (.033)
Cont. 129.25±10.54 125.50±9.04 -5.01 (＜.001)
Diastolic blood pressure Int. 82.66±6.67 78.84±8.69 -3.98 (＜.001) 0.99 (.326)
Cont. 79.55±7.39 77.00±7.91 -3.48 (＜.001)
Total cholesterol Int. 195.00±44.39 200.16±39.65 -1.21 (.103) -0.59 (.553)
Cont. 195.22±37.06 200.33±35.12 -0.89 (.418)
Wellness Int. 3.35±0.52 4.20±0.42 7.88 (＜.001) 10.76 (＜.001)
Cont. 3.21±0.38 3.27±0.34 0.79 (.432)

Int.=Intervention group; Cont.=Control group;

Int. (n=25), Cont. (n=21);

Int. (n=14), Cont. (n=19).