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Original Investigation

A Systematic Evaluation of Six Different Physical Activity Routines: A Strategic Science Approach

Taylor, Wendell C.1; Bui, Chuong2; Paxton, Raheem J.3; Maity, Suman4; Walker, Timothy J.4; Robertson, Michael C.5; Sadruddin, Shehla M.4; Hare-Everline, Nicole6; Craig, Derek W.4

Author Information
Translational Journal of the ACSM: Winter 2021 - Volume 6 - Issue 1 - e000150
doi: 10.1249/TJX.0000000000000150

Abstract

INTRODUCTION

Health-promoting work breaks are defined as “organized, routine work breaks intended to improve physical and psychological health, enhance job satisfaction, and sustain or increase work productivity” (1) (p. 462). Health-promoting work breaks include meditation, rhythmic breathing, and physical activity (1,2). Given the well-documented benefits of brief bouts of physical activity (3), work breaks that promote physical activity have an important role in workplace health promotion. The benefits of these work breaks include improved cardiometabolic values (e.g., weight, body mass index [BMI], and high-density lipoprotein) (4,5), reduced stress (6–8), increased work productivity (9), increased physical activity (5,10), and reduced sedentary behavior (5).

Although there are comprehensive reviews of physical activity work breaks (11), there is an absence of data comparing different types of physical activity routines in the office environment for the standard 15-min work break (11). Three studies had participants rate either a hypothetical physical activity routine or an experiential routine (12–14); however, no study had participants rate their experiences for different physical activity routines in a way that would facilitate comparison.

Self-determination theory is a macrotheory of human motivation encapsulating individuals’ inner resources (15,16). The inner resources are three basic innate psychological needs: competence, autonomy, and relatedness. When these needs are met, self-motivation is enhanced, and when thwarted, self-motivation is diminished as well as well-being. Furthermore, self-determination theory distinguishes between two important dimensions, which are autonomous motivation (i.e., intrinsic motivation and fully internalized extrinsic motivation) and controlled motivation (i.e., externally and internally controlled extrinsic motivation) (15,16). Importantly, the relevance and the application of self-determination theory to work organizations and physical activity have been well documented (16–19).

Comparison of work break routines is important because, according to self-determination theory, the quality of one’s motivation (e.g., autonomous motivation) for engaging in a health-related behavior is a robust predictor of sustained adherence to that behavior (15–19). Workplace physical activity routines that rated high on benefit, enjoyment, and likability enhance the probability that such routines will be successfully adopted, implemented, and sustained (17–19). Moreover, the group context of these routines can facilitate social support, which is another important construct associated with physical activity maintenance (2,4,5,7,8).

In addition, a comparison of routines embraces the important perspective of strategic science. Strategic science addresses gaps in knowledge by recommending research relevant for policy and decision makers (20). This perspective differs from traditional research approaches in that it emphasizes the importance of collaboration between researchers and practitioners to address the gap between scholarship and policy. From a policy maker’s perspective, none of the reviews on workplace interventions to increase physical activity and decrease sedentary behavior (21–24), if at all, adequately address strategic science.

From the perspectives of self-determination theory and strategic science, gaps in the knowledge base pertaining to employees’ perceptions of the attributes of different types of physical activity routines undermine our ability to most effectively promote physical activity during the workday (15–20). Moreover, this gap in the literature diminishes the ability of decision makers (i.e., managers and health promotion practitioners) to determine which physical activity routines will optimize motivation, adoption, and adherence to healthy behaviors in the workplace setting. Self-determination theory constructs and a strategic science perspective have important implications for the adoption, maintenance, and sustainability of health-promoting work breaks.

Therefore, the objectives of this research were to develop six different physical activity routines and to evaluate each routine based on self-determination theory constructs and to adopt a strategic science perspective by linking scholarship (i.e., research) to policy (i.e., practice) (15–20). Ratings based on 12 distinct dimensions for six different 15-min physical activity routines were analyzed. Each routine is an intervention designed for a group context in a workplace environment to promote physical activity. The goal was to provide practical information to select physical activity routines to help determine which routine may be appropriate for an organization’s goals when implementing physical activity breaks.

The objectives of this study were as follows:

  • 1) to develop six different physical activity work break routines,
  • 2) to develop a comprehensive rating system to evaluate each routine,
  • 3) to have participants experience and rate each of the six routines, and
  • 4) to present a comparison of routines to assist decision makers in identifying the most appropriate routine for their employees.

MATERIALS AND METHODS

Participants and Recruitment

Eligibility criteria included that participants were (a) 18 to 69 yr of age, (b) employed full time, and (c) willing to participate in mild- to moderate-intensity physical activity routines. Before engaging in any of the physical activity routines, participants completed the Physical Activity Readiness Questionnaire (25,26). This questionnaire screened participants for medical issues that contraindicated physical activity. The Physical Activity Readiness Questionnaire assesses physical fitness levels and ability to engage in physical activity in adult populations and identifies contraindications to activity (25,26).

For the first wave, employees were recruited from a large church and three medical and health science center institutions in a major urban city in the United States. These institutions employ hundreds of full-time academic and administrative staff. For the second wave, recruitment e-mails were sent to individuals, and flyers were posted in buildings throughout health science centers between March 2016 and April 2016. Recruitment materials encouraged interested individuals to contact the research staff via a dedicated university e-mail account created for this purpose.

Ethics Statement

The university’s institutional review board approved all study procedures, including recruitment and research protocols. Before any study procedures, participants read and signed a written informed consent.

Study Design and Setting

This study was a within-subject repeated-measures design wherein participants completed six different physical activity routines and rated each session immediately after completing the routine. Ratings were based on 12 different dimensions (e.g., challenge, likability, movement complexity, etc.). Data were collected in three waves at two venues (venue 1 for wave 1 and venue 2 for waves 2 and 3). Both venues had large open spaces, were temperature controlled, and featured a large stage where certified personal trainers delivered the physical activity program instructions and demonstrations. The same two certified personal trainers jointly led each physical activity routine. In addition, a third personal trainer helped to lead routines in waves 1 and 2 but not wave 3. Participants were asked to arrive in usual work attire and attend two evening sessions to complete all six routines.

Each wave consisted of two weekday evening sessions. Each session lasted about 2 h and featured three different 15-min physical activity routines. Data for wave 1 were collected in December 2015; data for waves 2 and 3 were collected in April 2016. At the first session, participants completed a questionnaire capturing demographic and physical activity-related information. Immediately after each routine, there was a 15-min break, whereby participants sat down and completed a questionnaire to rate the routine they just completed. Ratings of routines were completed on an individual basis without consultation with anyone else. In the second session, after all routines had been completed and rated, participants received a $15 gift card and participated in a drawing to receive one of five $50 gift cards. Moreover, if requested, participants were given a printout of the routines.

Assessments and Measures

All surveys were in English. The first part of the survey collected demographic data to describe the sample and enable subgroup analyses. Self-report surveys were administered to assess participants’ demographic characteristics, physical activity, and sedentary behavior. Demographic questions included gender, age, race/ethnicity, occupation, and place of work. In addition, participants self-reported their height and weight, which were used to calculate BMI. Self-reported physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). The IPAQ was developed to measure physical activity in adult populations (ages 18–65 yr old) and has demonstrated strong psychometric properties (27). Physical activity was measured based on the last 7 d, including a separate section on job-related physical activity. Participants’ sitting patterns were assessed using the Multicontext Sitting Questionnaire (MSTQ), which has demonstrated acceptable psychometric properties (28). The MSTQ assesses typical workday and nonworkday sitting behavior across several sitting contexts, including sitting while at work, watching TV or movies, using a computer or videogame (nonwork), transportation, and while talking or socializing (28).

Description of Physical Activity Routines

The physical activity routines were designed by certified personal trainers and research staff to be workplace appropriate, meaning they could be performed in rooms with limited space (e.g., a large office or meeting room), required no exercise equipment, and performed in usual work attire. The routines consisted of a 1- to 2-min warm-up session, a 10- to 12- min physical activity session, and a 1- to 2-min cooldown session. The warm-up session was the same for all routines and included low-intensity dynamic stretches that targeted major muscle groups in the upper and lower body. Similarly, the cooldown session was the same for each routine and included static stretches with major muscle groups and ended with a 30-s period of deep breathing and relaxation as a transition back to the workday. The physical activity component of the routines targeted major muscle groups in the upper and lower body, ranged from light to moderate intensity, and included different types of exercises (aerobic, muscle strengthening, stretching, or a combination) (see Table 1). During the actual study sessions, all persons were instructed to participate at their own level of ability and comfort, meaning if a participant needed a break, he or she should sit down, stand, or walk in place.

TABLE 1 - Description of the Six Different Physical Activity Routines.
Routine Type(s) of Exercises Included Target Intensity Number of Different Exercises (or Movements) Description
1 Muscle strengthening Light to moderate 9 Exercises were performed with body weight. Each exercise included 2 sets of 15 reps, with a 30-s break between sets. Examples included wall push-ups, bent row, and squats.
2 Stretching and balance (yoga inspired) Light 11 Exercises were inspired by beginner yoga poses. Each stretch or pose was held for 15 s and repeated at least once with a 10-s breaks in between. Examples included open chest stretch and balance tree pose.
3 Aerobic and muscle strengthening (circuit training inspired) Moderate 12 Exercises were performed in 30-s bouts with 30 s of rest between exercises. Examples included modified jumping jack, simulated jump rope, and alternating triceps kickbacks.
4 Stretching, aerobic, and muscle strengthening (ballet inspired) Light to moderate 10 Exercises were inspired by ballet movements and featured a choreographed sequence of movements with some breaks. Examples included simulated rope climb and plies with calf raises (e.g., plie squat with calf raise).
5 Muscle strengthening and stretching (Booster Break inspired) Light to moderate 10 Exercises were inspired by an existing workplace routine (Booster Break). Some exercises included 1 set of 10 reps, and other exercises included up to 2–5 sets performed for 5–20 s. Examples included modified lunges, modified neck roll, wrist flexions, and extensions.
6 Aerobic dance (aerobic dance inspired) Light to moderate 10 Exercises were inspired by aerobic dance wherein a series of movements were sequenced with breaks of marching in place to maintain a steady heart rate.

The first objective of the study was to develop six different physical activity work break routines. Although each routine had the same warm-up and cooldown phases, the main session for each routine was unique and distinct. Examples of the distinct movements are described in Table 1. To characterize the differences, each routine was named based on the source of inspiration: aerobic dance, ballet, Booster Break, circuit training, muscle strengthening, and yoga. Certified personnel trainers and research staff reviewed and practiced each routine to confirm that the main movements of each routine were different and that participants could complete the routine in usual work attire.

Companies may not have enough space inside their buildings for walking routes; walking can be an individual activity and preferably experienced outdoors. Walking outdoors can be subject to the vicissitudes of weather and temperatures, particularly when returning to work after walking. Therefore, walking was not included in the evaluation of group physical activity routines, which engaged all major muscle groups with trained facilitators to engender group camaraderie and team building during the workday. Each routine was designed to be conducted indoors.

A second objective of the study was to develop a comprehensive rating system to evaluate each physical activity routine. After a literature search, we found no validated questionnaires to assess physical activity routines. Therefore, based on a systematic approach, we developed a comprehensive questionnaire to meet our research needs. The research team developed a series of questions to assess different dimensions of physical activity routines. For these questions, the research team reviewed previous literature (12–14), used knowledge and expertise of team members, and reviewed self-determination theory constructs (15–19).

The initial Physical Activity Routine Ratings Survey was developed to assess the characteristics of the routines across different dimensions. To develop the survey, the research team generated an initial set of dimensions to pilot test in a convenience sample of 25 full-time university employees. In the pilot test, participants performed three different physical activity routines, completed the ratings survey, and then completed a series of questions about their experience with the Physical Activity Routine Ratings Survey. Based on this feedback, the research team then made changes to the initial Physical Activity Routine Ratings Survey. We reordered content, clarified definitions, and added a new dimension—appropriateness of work attire. These changes resulted in 12 different dimensions to rate each routine. The dimensions and each corresponding definition are presented in Table 2. The 12 dimensions were as follows: appropriateness of work attire, benefit, challenge, complexity, confidence, effort (i.e., physical), embarrassment, enjoyment, fatigue, flexibility, likability, and sweat (i.e., perspiration). Participants evaluated each dimension using a 5-point Likert-type scale, where “1” represented the lowest level, “3” was moderate, and “5” represented the highest level.

TABLE 2 - Dimensions and Definitions of Physical Activity Ratings Survey.
Appropriateness of work attire The extent to which you are able to complete the routine in usual work attire
Benefit level The extent to which the routine enhances your well-being
Challenge level The extent to which the routine is hard and/or difficult to do
Complexity level The extent to which the routine is complicated, with many types of different moves
Confidence level The extent to which you are certain that you can perform the routine (belief in one’s own ability)
Effort (physical) level The extent to which energy is used to complete the routine
Embarrassment level The extent to which the routine makes you feel self-conscious and/or awkward
Enjoyment level The extent to which a feeling of pleasure, satisfaction, or fun is experienced by doing the routine
Fatigue level The extent to which the routine makes you feel tired and/or exhausted
Flexibility (physical) level The extent to which the routine requires a range of motion for muscles and joints
Likability level The extent to which the routine is engaging or appealing
Sweat (perspiration) level The extent to which the routine results in perspiration
The rating scale was from 1 (low) to 5 (high).

ANALYSIS WITH GENERALIZED LINEAR MIXED MODELS

Model Specification

Data were analyzed using a generalized linear mixed model (GLMM). As ratings were made on a 5-point Likert scale, models were estimated under the assumption of a multinomial distribution with the cumulative logit link function. The equations to be estimated are given by1

logPYjik1PYjik=αk+β1Xji+β2Zji+ui,

where P(Yjik) is the probability of Yjik (k = 5, 4, 3, 2 are the response levels, i.e., the scores on the Likert scale in this case), Yji is the score that participant i rates routine j on a particular dimension (i = 1,..n and j = 1, … 6), Xji is a set of dummy-coded variables indicating the six routines, Zji is a set of covariates2 that may or may not vary between routines, and ui is the random intercept with the assumption ui~N0σu2. In the proportional odds model, the intercepts (αk) vary depending on the response level (there are 5–1 = 4 equations, hence 4 intercepts), and the slopes (β) are identical across the logit equations.

For a given individual, β1 compares the log odds of the outcome under a particular routine (e.g., ballet) against the log odds under the reference routine (e.g., circuit training). The subject-specific interpretation of β1 is natural for a within-subject varying predictor like routines in our study. A positive (negative) β1 indicates a tendency for the response to increase (or decrease) on the 1–5 (Likert) scale, as the value of X increases by one unit. As X is a dummy-coding variable, indicating routines, X and X + 1 represent the reference routine (circuit training) and another routine (e.g., ballet).

Models were estimated separately for each of the 12 different dimensions wherein circuit training was used as the reference category. All routines were pairwise compared on each of the 12 dimensions.3 In generating the spiderweb chart (see Fig. 1), we estimated the probability P(Yji = 5) for each routine on each dimension using only the fixed-effect parameters PYji=5=11+expα5+β1Xji+β2Zji. Essentially, these probabilities are for an average participant who happens to have ui = 0. Analyses were conducted with SAS® PROC GLIMMIX. The estimated parameters of the models and one-on-one contrasts, respectively, are presented in Table 3 and Table 4. Data were analyzed with both GLMM as well as linear mixed model. Because the results were similar from both analyses, only the GLMM is presented in this article.

Figure 1
Figure 1:
Standings of routines on different dimensions.
TABLE 3 - Parameter Estimates, SE, and P Values from GLMM.
Dimensions Appropriateness Benefit Challenge Complexity
β SE P β SE P β SE P β SE P
Routines
Ballet 1.465 0.349 <0.0001 −1.513 0.419 0.0004 −2.386 0.355 <0.0001 −1.835 0.347 <0.0001
Booster 1.017 0.343 0.003 −1.091 0.433 0.012 −1.753 0.352 <0.0001 −1.289 0.350 0.0003
Dance 0.449 0.324 0.167 −1.306 0.410 0.002 −1.202 0.344 0.001 0.042 0.345 0.904
Muscle 1.152 0.354 0.001 −2.047 0.428 <0.0001 −2.435 0.362 <0.0001 −2.149 0.362 <0.0001
Yoga 1.175 0.341 0.001 −1.568 0.422 0.0002 −2.274 0.352 <0.0001 −1.751 0.342 <0.0001
Circuit Reference category
Dimensions Confidence Effort Embarrassment Enjoyment
β SE P β SE P β SE P β SE P
Routines
Ballet 0.484 0.363 0.183 −3.357 0.397 <0.0001 −0.293 0.354 0.409 −1.021 0.404 0.012
Booster 0.641 0.366 0.081 −2.646 0.392 <0.0001 −0.597 0.371 0.109 −0.658 0.425 0.123
Dance 0.088 0.346 0.800 −2.039 0.371 <0.0001 0.676 0.340 0.048 −0.573 0.400 0.153
Muscle 0.956 0.382 0.013 −3.096 0.396 <0.0001 −0.289 0.366 0.431 −0.566 0.423 0.181
Yoga 0.364 0.358 0.300 −3.347 0.396 <0.0001 −0.402 0.354 0.258 −1.361 0.400 0.001
Circuit Reference category
Dimensions Fatigue Flexibility Likability Sweat
β SE P β SE P β SE P β SE P
Routines
Ballet −3.552 0.394 <0.0001 −1.251 0.336 0.0002 −0.584 0.370 0.115 −4.005 0.400 <0.0001
Booster −2.718 0.373 <0.0001 −0.766 0.341 0.025 −0.290 0.389 0.457 −3.837 0.404 <0.0001
Dance −1.688 0.347 <0.0001 −1.423 0.338 <0.0001 −0.192 0.379 0.613 −1.671 0.350 <0.0001
Muscle −3.256 0.386 <0.0001 −1.873 0.351 <0.0001 −0.766 0.385 0.050 −3.513 0.394 <0.0001
Yoga −3.889 0.401 <0.0001 −0.741 0.335 0.027 −1.052 0.367 0.004 −4.495 0.421 <0.0001
Circuit Reference category
An estimated β describes the effect of a particular routine (e.g., ballet vs circuit—the reference routine) on ratings (the outcome variable) such that a positive (negative) β indicates a tendency for ratings to increase (decrease) on the 1–5 (Likert) scale. For instance, the estimated β for ballet versus circuit in terms of appropriateness is 1.467. This indicates that participants had a tendency to rate ballet higher than circuit in term of appropriateness. The eβ describes the odds ratio of receiving higher ratings between, say, ballet and circuit. If we thought of the response scale (1–5) as being “better” and “worse” groups (for example, better = 4, 5 and worse = 1, 2, 3), then ballet had higher odds of being seen as a better routine than circuit in terms of appropriateness. A positive β corresponds to eβ > 1, whereas a negative β corresponds to eβ < 1.

TABLE 4 - Pairwise Contrasts between Routines on Each Dimension from GLMM.
Appropriateness Benefit Challenge Complexity
Estimate SE P Estimate SE P Estimate SE P Estimate SE P
Ballet vs Booster 0.449 0.332 0.177 −0.422 0.377 0.263 −0.634 0.311 0.042 −0.546 0.314 0.083
Ballet vs dance 1.017 0.352 0.004 −0.207 0.384 0.591 −1.184 0.332 0.0004 −1.876 0.351 <0.0001
Ballet vs muscle 0.310 0.353 0.379 0.534 0.366 0.145 0.049 0.312 0.876 0.314 0.322 0.330
Ballet vs yoga 0.290 0.340 0.394 0.055 0.362 0.879 −0.112 0.308 0.717 −0.083 0.306 0.785
Booster vs dance 0.568 0.343 0.099 0.216 0.403 0.593 −0.551 0.333 0.099 −1.330 0.352 0.0002
Booster vs muscle −0.139 0.347 0.690 0.957 0.381 0.013 0.682 0.315 0.031 0.860 0.329 0.009
Booster vs yoga −0.158 0.331 0.633 0.477 0.379 0.209 0.522 0.310 0.093 0.463 0.312 0.139
Dance vs muscle −0.706 0.356 0.048 0.741 0.386 0.056 1.233 0.340 0.0003 2.191 0.366 <0.0001
Dance vs yoga −0.727 0.346 0.036 0.262 0.387 0.499 1.073 0.333 0.0014 1.793 0.347 <0.0001
Muscle vs yoga −0.020 0.344 0.954 −0.479 0.360 0.185 −0.160 0.307 0.601 −0.398 0.313 0.205
Confidence Effort Embarrassment Enjoyment
Estimate SE P Estimate SE P Estimate SE P Estimate SE P
Ballet vs Booster −0.157 0.367 0.670 −0.711 0.319 0.026 0.304 0.363 0.402 −0.363 0.400 0.366
Ballet vs dance 0.396 0.368 0.283 −1.317 0.337 0.0001 −0.968 0.356 0.007 −0.447 0.403 0.268
Ballet vs muscle −0.472 0.391 0.229 −0.261 0.320 0.416 −0.004 0.361 0.991 −0.454 0.406 0.264
Ballet vs yoga 0.120 0.369 0.745 −0.009 0.312 0.976 0.109 0.353 0.758 0.340 0.372 0.361
Booster vs dance 0.553 0.370 0.136 −0.607 0.342 0.077 −1.272 0.372 0.001 −0.085 0.426 0.842
Booster vs muscle −0.315 0.392 0.423 0.450 0.325 0.167 −0.309 0.374 0.411 −0.092 0.421 0.828
Booster vs yoga 0.277 0.367 0.451 0.701 0.319 0.028 −0.195 0.365 0.593 0.703 0.393 0.075
Dance vs muscle −0.868 0.388 0.026 1.057 0.342 0.002 0.964 0.365 0.009 −0.007 0.423 0.987
Dance vs yoga −0.276 0.365 0.449 1.308 0.338 0.0001 1.077 0.358 0.003 0.788 0.398 0.048
Muscle vs yoga 0.592 0.384 0.124 0.251 0.315 0.425 0.113 0.354 0.750 0.795 0.388 0.042
Fatigue Flexibility Likability Sweat
Estimate SE P Estimate SE P Estimate SE P Estimate SE P
Ballet vs Booster −0.835 0.335 0.013 −0.485 0.316 0.126 −0.294 0.372 0.430 −0.168 0.319 0.600
Ballet vs dance −1.865 0.361 <0.0001 0.172 0.327 0.600 −0.393 0.386 0.310 −2.334 0.354 <0.0001
Ballet vs muscle −0.296 0.340 0.385 0.622 0.323 0.055 0.181 0.371 0.626 −0.492 0.321 0.126
Ballet vs yoga 0.337 0.340 0.323 −0.510 0.315 0.106 0.468 0.349 0.181 0.491 0.331 0.139
Booster vs dance −1.030 0.350 0.004 0.657 0.337 0.052 −0.098 0.404 0.808 −2.166 0.360 <0.0001
Booster vs muscle 0.539 0.334 0.108 1.107 0.332 0.001 0.475 0.381 0.213 −0.324 0.325 0.319
Booster vs yoga 1.171 0.339 0.001 −0.025 0.318 0.937 0.762 0.364 0.037 0.658 0.335 0.050
Dance vs muscle 1.569 0.360 <0.0001 0.450 0.338 0.184 0.574 0.394 0.146 1.842 0.354 <0.0001
Dance vs yoga 2.201 0.366 <0.0001 −0.682 0.332 0.041 0.860 0.381 0.025 2.825 0.375 <0.0001
Muscle vs yoga 0.633 0.335 0.060 −1.132 0.325 0.001 0.287 0.352 0.415 0.983 0.330 0.003
Instead of alternating routines to serve as the reference category, pairwise contrasts are used. For instance, the contrast ballet vs dance is equivalent to using dance as the reference category. Interpretation of a pairwise contrast is the same as that of β. In terms of appropriateness, the estimate for ballet vs dance is 1.017, which indicates participants had a tendency to rate ballet higher than dance on this dimension. If we thought of the response scale (1–5) as being “better” and “worse” groups (for example, better = 4, 5 and worse = 1, 2, 3), then ballet had higher odds of being seen as a better routine than dance in terms of appropriateness.
P values are statistically significant (p ≤ 0.05).

RESULTS

Description of Sample

The sample was composed of 94 participants. Three individuals had missing data on covariates. Thus, 91 participants were included in the study’s analysis. Fifty-four out of the 91 participants completed all six routines, 12 completed five routines, 1 completed four routines, 18 completed three routines, 4 completed two routines, and 2 completed only one routine. Of the 91 participants, 26.4% were male and 73.6% females. The race and the ethnicity of the sample were 43.9% African American, 37.4% non-Hispanic White, 13.2% Hispanic, 4.4% Asian, and 1.1% other race. The average age was 46.9 ± 12.7, the average BMI was 31.3 ± 7.2, the average height was 1.66 ± 0.1 m, the average weight was 86.5 ± 22.3 kg, and the average total METS was 180.0 ± 460.2. The descriptive data are presented in Supplemental Content 1 (Table 1, Descriptive Statistics for International Physical Activity Questionnaire (IPAQ) Instrument, http://links.lww.com/TJACSM/A118) and Supplemental Content 2 (Table 2, Descriptive Statistics for Multicontext Sitting Questionnaire (MSTQ) Instrument, http://links.lww.com/TJACSM/A119).

The mean and SD values of scores on each dimension across routines are presented in Table 5. Across all routines, benefit, enjoyment, and likeability had high average scores (greater than 4). As noted in the Introduction section, the routines that rated high on benefit, enjoyment, and likability are more likely to be successfully adopted, implemented, and sustained (17–19). The average scores on embarrassment were quite low across routines. Participants on average rated fatigue as low or moderate across routines. For other physical dimensions, some routines were rated as moderate (e.g., ballet and yoga), whereas other routines were relatively high (e.g., like aerobic dance, Booster Break, and circuit training).

TABLE 5 - Average Ratings and SD for Each Routine on 12 Dimensions.
Routines Ballet Booster Circuit Dance Muscle Yoga
(n = 75) (n = 73) (n = 76) (n = 70) (n = 77) (n = 81)
Dimensions
Appropriateness 4.1 (1.2) 4.0 (1.1) 3.1 (1.4) 3.4 (1.4) 4.0 (1.4) 4.0 (1.2)
Benefit 4.3 (0.8) 4.5 (0.8) 4.6 (0.6) 4.2 (0.9) 4.2 (0.9) 4.3 (0.9)
Challenge 3.2 (1.2) 3.6 (1.1) 4.3 (0.9) 3.8 (1.1) 3.2 (1.2) 3.3 (1.3)
Complexity 3.2 (1.3) 3.5 (1.3) 4.1 (1.0) 4.1 (1.0) 3.1 (1.4) 3.2 (1.2)
Confidence 4.1 (1.0) 4.3 (0.9) 3.5 (1.3) 3.5 (1.4) 4.4 (0.8) 4.1 (1.1)
Effort 3.3 (1.1) 3.7 (1.1) 4.5 (0.6) 3.9 (1.0) 3.4 (1.1) 3.4 (1.1)
Embarrassment 1.9 (1.2) 1.8 (1.2) 2.2 (1.2) 2.5 (1.4) 1.9 (1.1) 1.9 (1.2)
Enjoyment 4.3 (0.7) 4.5 (0.7) 4.4 (0.7) 4.2 (1.1) 4.5 (0.8) 4.2 (1.0)
Fatigue 2.0 (1.1) 2.3 (1.3) 3.5 (1.2) 2.8 (1.2) 2.1 (1.2) 1.9 (1.1)
Flexibility 3.7 (1.0) 4.0 (1.0) 4.1 (0.9) 3.5 (1.2) 3.4 (1.2) 4.0 (0.9)
Likability 4.3 (0.8) 4.5 (0.8) 4.3 (0.8) 4.1 (1.3) 4.3 (0.9) 4.1 (1.0)
Sweat 2.2 (1.1) 2.3 (1.2) 4.1 (1.0) 3.4 (1.1) 2.5 (1.3) 2.0 (1.3)
Participants rated each routine on 12 dimensions on the 1–5 (Likert) scale. Each mean is the average ratings participants gave to a routine on a dimension. For instance, the average ratings for ballet on (attire) appropriateness is 4.1. SD values are displayed in parentheses. n is the sample size.

Results from GLMM

Challenge

Circuit training was rated as the most challenging routine (P < 0.001). Also, participants viewed aerobic dance as more challenging than ballet, muscle strengthening, and yoga (P < 0.001). Booster Break was rated more challenging than muscle strengthening (P = 0.031).

Physical Effort

Circuit training was rated as the most demanding in terms of physical effort (P < 0.001), followed by aerobic dance (P < 0.001, except for aerobic dance vs Booster Break, P = 0.077). Booster Break was rated as requiring more physical effort than yoga (P = 0.029).

Fatigue

Circuit training was rated as most fatiguing (P < 0.001), followed by aerobic dance (P < 0.001). Booster Break was reported as more fatiguing than yoga and ballet (P < 0.01).

Sweat

Circuit training was reported as creating more sweat (i.e., perspiration) than any other routine (P < 0.001), followed by aerobic dance (P < 0.001). Muscle strengthening and Booster Break were rated as creating more sweat than yoga (P = 0.003 and 0.05, respectively).

Complexity

Circuit training and aerobic dance were viewed as requiring more movement complexity than all other routines (P < 0.001), with no significant difference between the two routines. Booster Break was reported as requiring more movement complexity than muscle strengthening (P = 0.009).

Flexibility

Circuit training was rated as requiring more flexibility than ballet, aerobic dance, muscle strengthening (P < 0.001), Booster Break, and yoga (P < 0.03). Muscle strengthening was rated as requiring less flexibility than yoga and Booster Break (P = 0.001). Aerobic dance was viewed as requiring less flexibility than yoga (P = 0.04).

Benefit

Circuit training was reported as the most beneficial of all the routines (P < 0.01). Booster Break was viewed as more beneficial than muscle strengthening (P = 0.013).

Enjoyment

Circuit training was rated as more enjoyable than ballet and yoga (P < 0.01). Aerobic dance and muscle strengthening were rated as more enjoyable than yoga (P < 0.05).

Likeability

Circuit training was viewed as more likable than yoga (P = 0.005). In addition, Booster Break and aerobic dance were evaluated as more likable than yoga (P < 0.04).

Appropriateness of Work Attire

Circuit training was rated as being less work attire appropriate than the other routines (P < 0.001), except for aerobic dance. Aerobic dance was viewed as being less work attire appropriate than ballet, yoga, and muscle strengthening (P < 0.04).

Embarrassment

Aerobic dance was rated as the most embarrassing compared with the other routines (P < 0.001), except for circuit training (P = 0.048).

Confidence

The question was “How confident are you in your ability to do this routine at work?” The participants rated that they were more confident in their ability to do the muscle strengthening routine at work compared with circuit training and aerobic dance (P < 0.01).

A spiderweb chart (see Fig. 1) was generated to summarize the aforementioned findings. The chart plots the probability of a routine receiving a score of 5 on a particular dimension. Circuit training was the most demanding in terms of physical ability, as it was more likely to be rated high on all physical dimensions, including challenge, fatigue, effort, and sweat. In addition, circuit training was most likely to be rated high with respect to benefit and enjoyment compared with the other routines. However, circuit training was least likely to be rated high in terms of work attire appropriateness. Aerobic dance was rated second on physical dimensions. However, aerobic dance was less beneficial and more likely to be viewed as embarrassing. Booster Break rated high to moderate on all dimensions. Moreover, Booster Break was less likely to be rated high on physical dimensions and benefit but more likely to be rated high on work attire appropriateness and less likely to be rated high on embarrassment.

DISCUSSION

Physical activity has many and varied benefits (3). The workplace is an optimal venue to promote physical activity and reduce sedentary behavior (1,2,4–14,29). A recent study found strong causal evidence linking physical activity and sedentary behavior at work with late cardiovascular and cerebrovascular disease. Importantly, even previous light-intensity physical activity at work produced substantial health benefits (30). Furthermore, research suggests that increases in obesity over the past 50 yr are significantly attributed to the reduction in daily occupation-related energy expenditure (31).

Summary of Study

The objectives of this research were to assess 15-min group physical activity routines exercising all major muscle groups conducted indoors during work breaks in work attire. The four study objectives were accomplished: 1) develop six different physical activity work break routines for the 15-min work break, 2) develop and pilot test a comprehensive rating system to evaluate each routine, 3) have participants experience and then rate each of the six routines, and 4) present a comparison of routines to assist decision makers to identify the “most appropriate” routine for their workforce with the caveat that findings from one study are not definitive. Additional research is needed to replicate the results.

Workforces with employees who have similar or different demographic characteristics may have distinct preferences for types of physical activity work break routines. Strategic science emphasizes research relevant for policy and decision makers (20). All six routines had positive ratings on some dimensions. However, there were differences in ratings among the routines that can further inform decision makers.

The good news is that most of the routines were rated low on embarrassment (mean < 3.0) and acceptable on work attire appropriateness (mean > 3.0). Based on these dimensions, the routines in this study seem appropriate and suitable for work breaks in the workplace. However, the ratings indicate that three routines were distinct among the six routines. The three distinct routines were circuit training, aerobic dance, and Booster Break. Given the overall profile of circuit training, physically active employees who enjoy challenges may prefer this routine. However, given the relatively high ratings on sweat, movement complexity, embarrassment, and relatively low on work attire appropriateness, circuit training may be inappropriate for employees new to physical activity or who engage in low levels of physical activity.

Aerobic dance was rated as causing the most embarrassment. Similar to circuit training, aerobic dance may be appropriate for physically active employees who enjoy challenges. In addition, organizational culture (e.g., camaraderie, coworker support, and trust) should be considered because the aerobic dance routine was the most embarrassing.

Another study conducted a single session (one exposure) of a 10-min group physical activity break and allowed employees and supervisors to evaluate the session (12). The activity break included low-impact aerobics, stretching, and resistance movements set to music. The aerobic dance- and sports-themed moves were designed to maximize energy expenditure (incorporating lower body and upper body). Based on a survey completed immediately after the session, the findings were favorable for enjoyment, increased productivity, comfort, and feasibility (12). Their study evaluated one type of routine; our study evaluated six different routines. Nonetheless, their results were consistent with our findings in that an aerobic dance routine was perceived as beneficial.

Given the overall composite profile of the Booster Break routine with moderately favorable ratings on positive attributes combined with low ratings on unfavorable characteristics, the decision makers and managers of workforces with a variety of activity levels or those new to physical activity routines may choose this routine. Booster Break seems to be a safe choice when there is variety of preferences and management is concerned about introducing a physical activity routine into the workday.

In our study, respondents participated in six different physical activity routines and then evaluated each routine. In an earlier study (14), employees responded to a questionnaire about their preferences for the features and characteristics of a hypothetical workplace exercise program but did not do any exercises. Ratings were based on expectations and projections. The objectives of their study were to determine employee preferences and wants for an exercise program at the workplace (14). The major findings were that many participants (a) prefer exercises targeted at specific parts of the body (60%), (b) would accept exercises that are somewhat difficult to perform (50%), (c) were not concerned about embarrassment (40%), (d) prefer that the company arrange the exercise period (40%), and (e) prefer to exercise in groups (33%). In their conclusion, the authors recommended that companies design exercise programs that target specific parts of the body most affected by sedentary work causing musculoskeletal discomfort. The targeted areas were head, neck, shoulder, back, legs, and eyes (14). In a population of office workers sitting at computers, their recommendations may partially account for the favorable ratings of the Booster Break routine, which includes head nods, neck rotations, shoulder rolls, wrist flexes, finger fans, and knee raises that target areas most affected by sitting and working on computers as well as incorporating whole body movements.

Limitations and Strengths of This Study

Limitations

The limitations of the study were that participants evaluated three different physical activity routines in one session. Perhaps, the ratings would differ after experiencing the same routine multiple times, for example, during 1 wk, 1 month, or 6 months. Another limitation is that participants rated the sessions in a venue (gym or large open space) rather than at their actual workplace. In addition, the participants did not experience the routines with their usual coworkers; all routines were in the evening and not during the usual break in the workday. A larger sample size would have provided more stable estimates. Nonetheless, our sample represented various age-groups, different racial and ethnic identities, as well as men and women.

In this study, participants volunteered to engage in light- to moderate-intensity physical activity and may not represent the general population of desk-based workers and their attitudes, preferences, and motivations related to physical activity. As is the case with all volunteer and convenience samples (i.e., selection bias), any interpretation requires appropriate caution because the study sample may not represent the target population. Furthermore, because our questionnaire was novel, caution is appropriate when comparing our findings to previous research with different methods and outcome measures. In addition, participants were office- and desk-based workers. The generalizability of our findings to manual laborers such as construction workers is inappropriate.

Strengths

Despite these limitations, the study has several strengths. There is no known study that developed and described six different physical activity routines for 15-min work breaks and developed a comprehensive evaluation of physical activity routines. We created a series of questions to assess 12 dimensions of physical activity routines, which were developed based on a review of the literature, expert opinion, and self-determination theory constructs (12–19). We pilot tested our scale and made appropriate changes.

Our assessments profiled each routine across 12 dimensions. Results from this approach can facilitate implementation effectiveness based on the systematic evaluation of each routine. Additional strengths of the study include a racially and ethnically diverse study sample, the order of routines was varied to eliminate sequence effects, and standard warm-up and cooldown sessions were implemented for consistency. Our study is novel and unique with the objective of promoting physical activity and reducing sedentary behavior among desk-based workers by providing useful information for decision makers.

Active work breaks are underutilized opportunities to promote physical activity and reduce sedentary behavior among desk-based workers (1,2,4,5,7–10). Based on demographic characteristics of the workforce and employee preferences, the most appropriate routine can be selected to facilitate intervention effectiveness. The ratings by participants distinguished the six physical activity routines; these distinctions can inform the dissemination and implementation of brief physical activity routines at the workplace. The findings most relevant for policy makers are that circuit training and aerobic dance routines were the most demanding and challenging and, thus, appropriate for workforces with employees who are physically active and/or prefer challenges (32). For workforces with employees who have a variety of attitudes, preferences, activity levels, or abilities, the Booster Break routine may be the preferred choice. If employees are perspiration averse during the workday, yoga, Booster Break, and ballet would be appropriate choices; circuit training and aerobic dance should be avoided. Although we did not include walking in this study, in practice, walking during breaks is a viable option for physical activity promotion in some workplaces. Policy and decision makers can select a physical activity work break routine for their workforce that most appropriately reflects the optimal mix and balance of the 12 dimensions.

Future Directions

More research is needed with different types of routines, larger sample sizes, and an evaluation of kilocalorie expenditure per routine and other metrics such as attendance and lifestyle changes. Research with different routines conducted during the workday in office settings with coworkers for extended periods can better represent the reality of experiencing active work breaks. Future analyses should control for demographic factors such as age, gender, race/ethnicity, and BMI as well as behavioral variables, for example, physical activity, sedentary behavior, and previous experiences with active work breaks. Another important consideration for the success of a workplace intervention is organizational culture and climate that should be evaluated to enhance the effectiveness of any intervention (33).

There is much unrealized potential for research to contribute to the common good by having the evidence base communicated more effectively to policy makers (20). More research is needed to facilitate the reach, effectiveness, adoption, implementation, and maintenance of effective workplace physical activity programs—REAIM model (34). Given the ubiquitous nature of 15-min work breaks, these breaks can be transformed to group, active work breaks (1,2). Health-promoting work breaks represent a “back to basics movement” characterized by high touch (i.e., group sessions facilitating social interactions among coworkers and led by trained coworkers) and low tech (i.e., no equipment, technology, computer applications, or any type of apps) (1,2,4,5,7–10). Ultimately, the findings from this study can stimulate further research to achieve the public health objective of improving the health of employees by increasing physical activity and decreasing sedentary behavior at the workplace during the workday.

The authors thank Karen L. Pepkin, M.A., for her careful review of the manuscript. The research team was composed of the authors of this article, university staff, and public health graduate students (both master’s and doctoral students) who contributed to all facets of the research process from conception to the final product. The research included clear and concise hypotheses, developing and pilot testing the instruments, recruiting participants, implementing the research protocol, creating a database, and entering and analyzing data. The authors gratefully acknowledge the contributions of Andrea C. Betts, Cristina Espinosa Da Silva, Devi Das, Sania Durrani, Zubayr H. Effendi, Monica K. Guidry, Ananth Iyer, Kelly McGauhey, Chinmay P. Mungi, Dr. Ogechi Nwaokelemeh, Kerri-Anne R. Parkes, Rajani Pinnamaneni, Andrea Siceluff, Aditi Tomar, Vyvy Tran, and Amy Wieczorek. In addition, the authors recruited four outstanding, certified personal trainers (one for the pilot study and three for the main study) who conducted each session with contagious enthusiasm and demonstrated proper form of each movement for different routines. They owe a debt of gratitude to Carina De Victoria Garth (pilot study trainer) and the trainers for the main study, Carly N. Dalton, Lisa Guarneiri, and Ellen T. Ogedegbe.

Michael C. Robertson was supported by the National Cancer Institute of the National Institutes of Health under Award Number F31 CA236433. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. For the remaining authors, none (i.e., conflicts of interest or funding) was declared. The results of the present study do not constitute endorsement by the American College of Sports Medicine.

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1Estimations were carried out with SAS® PROC GLIMMIX. Option “descending” was used to ask SAS to reverse the ordering of the response levels such that 5 becomes the lowest and 1 becomes the highest. In this manner, the specified equations will be estimated.

2The covariates included age, gender, race/ethnicity, BMI, METs, and feasibility of implementing active work break routines at your organization (i.e., six questions).

3This analysis is equivalent to alternating routines to serve the reference category.

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