Process Evaluation of a Worksite Physical Activity Program for Employees at Risk for Cardiovascular Disease: Implications for practice

Introduction: Cardiovascular disease is a major issue for today’s workforce. While worksite wellness programs can increase physical activity among employees most research on such programs focuses on program outcomes, and little work has been done documenting implementation fidelity and other process evaluation issues.

Purpose: To evaluate implementation process for a 12-week physical activity (PA) program among university employees.

Methods: Inactive employees (40-64 years) with dyslipidemia were randomly assigned to a Walking-Only (WO) or Walking-Plus (WP) intervention. Both groups received instructions to engage in progressive walking, however, the WP group received additional instructions to interrupt long bouts of sedentary time (2-minute break every 30 minutes). Groups were asked to join a Facebook support group, submit weekly logs, and received periodic motivational emails and phone calls. Response rates to program activities, such as online surveys, phone calls, and emails were tracked throughout the program. At the end of the program, participants’ attitudes about the program were evaluated through a semi-formal interview.

Results: WP group (WP=54.5% vs. WO=50%) had a better compliance for log submissions but the WO group had better phone communication. Both groups had low response rates to motivational emails (WP=20% vs. WO=18%). The WP group had better compliance for accelerometer wear time (≥10 hours/day for 7 days) compared to the WO group.

Conclusion: Overall, participants showed poorer adherence to the program than expected due to time constrains, work commitments, difficulty wearing evaluation devices, and difficulty reaching the PA recommendations. To ensure compliance, we recommend providing tangible incentives throughout the program.