Designing a lifestyle intervention for people with a physically demanding job

Abstract

Cardiovascular diseases are a prevalent cause of death worldwide. People with physically demanding jobs tend to have poorer cardiovascular health than people with sedentary jobs. In contrast to leisure-time physical activity (PA), occupational PA (lifting, pushing, and pulling heavy loads over a long period without sufficient recovery) seems to have detrimental health effects. This phenomenon is called the ‘PA Paradox’ and requires interventions that counteract these harmful health effects.
In the current occupational health research, interventions for this population are typically narrow, focusing on limited factors in a specific environment. These kinds of interventions are not effective for people with physically demanding jobs. Instead, an intervention for this population must respond to workers‘ complex context, fit their daily activities and preferences, and be integrated into their work and home environment. Therefore, this project aimed to explore these aspects to design a promising concept for a lifestyle intervention that shifts workers’ PA behavior in a healthier direction.

At the beginning of the project, expert interviews with occupational health researchers and practitioners were executed. Moreover, literature was reviewed to comprehend the PA Paradox and current approaches to counteract it. It was found that an intervention should stimulate moderate-vigorous PA, variation, and sufficient recovery and that workers must have the capability, motivation, and opportunity to perform a healthy PA behavior. Therefore, an extensive field study was carried out to investigate workers’ PA behavior and the factors affecting it. That yielded an overview of factors influencing workers’ capability, opportunity, and motivation for a healthy PA behavior. It showed that it would be most impactful to tackle workers’ inadequate risk perception and over-exhaustion. Research through design was applied to explore how an intervention could address these factors in workers’ home and working environments and what interactions fit workers’ needs, preferences, and possibilities.

The generated insights were merged to ‘Shift it!’, a concept that makes workers feel confident about shifting their PA behavior in a healthier direction. ‘Shift it!’ consists of two parts: A health week and a digital buddy. The health week starts with a toolbox meeting to make the workers aware of the PA paradox and its consequences. Afterwards, workers can visit the company doctor to examine their current health state and future risks and monitor their heart rate for one week to get insights into the intensity of their PA and the effect of their breaks.
The digital buddy ensures that workers understand the issue and helps them to integrate recovery and PA into their daily lives. It offers them inspiration, helps them find a plan that fits their busy lives, and supports them to realize it by reminding, encouraging, and praising them.

Finally, the concept was evaluated with the workers and other stakeholders to explore its potential. Everyone was enthusiastic about the concept and showed interest in implementing its elements. The health screening and the digital buddy with all its functions were identified as the concept‘s core, but it is not yet clear which elements can be realized.