Effectiveness of a Workplace Walking Program Using a Fitness Tracker Including Individual Counseling and Tailored Text Messaging

Mira Jung; Yeongmi Ha

doi:10.12799/jkachn.2019.30.3.257

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Jung and Ha: Effectiveness of a Workplace Walking Program Using a Fitness Tracker Including Individual Counseling and Tailored Text Messaging

Original Article

J Korean Acad Community Health Nurs 2019;30(3):257-270.

Published online: 12 September 2019

DOI: https://doi.org/10.12799/jkachn.2019.30.3.257

Effectiveness of a Workplace Walking Program Using a Fitness Tracker Including Individual Counseling and Tailored Text Messaging

Mira Jung¹, Yeongmi Ha²

¹Assistant Professor, Department of Nursing, Hanyeong College, Yeosu, Korea

²Associate 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

Received 7 July 2018 Revised 10 May 2019 Accepted 15 May 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.

Keywords: Fitness trackers, Text messaging, Workplace, Health promotion

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Figure 1.

Conceptual framework for workplace walking program.

Table 1.

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

Table 2.

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

Characteristics	Int. (n=39)	Cont. (n=40)	x² or t (p)
Characteristics	n (%) or M±SD	n (%) or M±SD	x² or t (p)
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).

Table 3.

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

Variables	Group	Pretest	Posttest	Effect by point	Intergroup effect
Variables	Group	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).

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