Nurses’ lifestyle behaviours, health priorities and barriers to living a healthy lifestyle: a qualitative descriptive study

Article

Phiri, Lindokuhle P., Draper, Catherine E., Lambert, Estelle V. and Kolbe-Alexander, Tracy L.. 2014. "Nurses’ lifestyle behaviours, health priorities and barriers to living a healthy lifestyle: a qualitative descriptive study." BMC Nursing. 13 (38), pp. 1-11. https://doi.org/10.1186/s12912-014-0038-6
Article Title

Nurses’ lifestyle behaviours, health priorities and
barriers to living a healthy lifestyle: a qualitative
descriptive study

ERA Journal ID40052
Article CategoryArticle
AuthorsPhiri, Lindokuhle P. (Author), Draper, Catherine E. (Author), Lambert, Estelle V. (Author) and Kolbe-Alexander, Tracy L. (Author)
Journal TitleBMC Nursing
Journal Citation13 (38), pp. 1-11
Number of Pages11
Year2014
PublisherBioMed Central Ltd.
Place of PublicationUnited Kingdom
ISSN1472-6955
Digital Object Identifier (DOI)https://doi.org/10.1186/s12912-014-0038-6
Web Address (URL)http://bmcnurs.biomedcentral.com/articles/10.1186/s12912-014-0038-6
Abstract

Background
Nurses have an increased risk for non-communicable diseases (NCDs), along with a high prevalence of obesity, poor eating habits and insufficient physical activity. The aim of this study was to determine the health concerns, health priorities and barriers to living a healthy lifestyle among nurses and hospital management staff from public hospitals in the Western Cape Metropole, South Africa.

Methods
Participants were purposively sampled (n = 103), and included management personnel (n = 9), night shift (n = 57) and day-shift nurses (n = 36). Twelve focus groups (FGDs) were conducted with nursing staff to obtain insight into nurses’ health concerns, lifestyle behaviours and worksite health promotion programmes (WHPPs). Seven key informant interviews (KII) were conducted with management personnel, to gain their perspective on health promotion in the worksite. Thematic analysis was used to analyse the data with the assistance of Atlas.ti Qualitative Data Analysis Software.

Results
Night shift nurses frequently identified weight gain and living with NCDs such as hypertension as their main health concerns. Being overweight was perceived to have a negative impact on work performance. All nurses identified backache and exposure to tuberculosis (TB) as occupation-related health concerns, and both management and nurses frequently reported a stressful working environment. Nurses frequently mentioned lack of time to prepare healthy meals due to long working hours and being overtired from work. The hospital environment was perceived to have a negative influence on the nurses’ lifestyle behaviours, including food service that offered predominantly unhealthy foods. The most commonly delivered WHPPs included independent counselling services, an online employee wellness programme offered by the Department of Health and wellness days in which clinical measures, such as blood glucose were measured. Nurses identified a preference for WHPPs that provided access to fitness facilities or support groups.

Conclusions
Public hospitals are a stressful work environment and shift work places an additional strain on nurses. The risk of NCDs and exposure to infectious disease remains a concern in this working population. Our findings highlight the need for WHPPs that support nurses in managing stress and transforming the work environment to facilitate healthy lifestyles.

Keywordsnurses’ health, lifestyle behaviours, perceptions, shift workers
ANZSRC Field of Research 2020420799. Sports science and exercise not elsewhere classified
420599. Nursing not elsewhere classified
Byline AffiliationsUniversity of Cape Town, South Africa
Institution of OriginUniversity of Southern Queensland
Funding source
Grant ID
University of Cape Town Carnegie Mellon Research fund awarded to Kolbe-Alexander
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Bull, Fiona C., Al-Ansari, Salih S., Biddle, Stuart, Borodulin, Katja, Buman, Matthew P., Cardon, Greet, Carty, Catherine, Chaput, Jean-Philippe, Chastin, Sebastien, Chou, Roger, Dempsey, Paddy C., DiPietro, Loretta, Ekelund, Ulf, Firth, Joseph, Friedenreich, Christine M., Garcia, Leandro, Gichu, Muthoni, Jago, Russell, Katzmarzyk, Peter T., ..., Willumsen, Juana F.. 2020. "World Health Organization 2020 guidelines on physical activity and sedentary behaviour." British Journal of Sports Medicine. 54 (24), pp. 1451-1462. https://doi.org/10.1136/bjsports-2020-102955
Advancing the global physical activity agenda: recommendations for future research by the 2020 WHO physical activity and sedentary behavior guidelines development group
DiPietro, Loretta, Al-Ansari, Salih Saad, Biddle, Stuart J. H., Borodulin, Katja, Bull, Fiona C., Buman, Matthew P., Cardon, Greet, Carty, Catherine, Chaput, Jean-Philippe, Chastin, Sebastien, Chou, Roger, Dempsey, Paddy C., Ekelund, Ulf, Firth, Joseph, Friedenreich, Christine M., Garcia, Leandro, Gichu, Muthoni, Jago, Russell, Katzmarzyk, Peter T., ..., Willumsen, Juana F.. 2020. "Advancing the global physical activity agenda: recommendations for future research by the 2020 WHO physical activity and sedentary behavior guidelines development group." International Journal of Behavioral Nutrition and Physical Activity. 17 (1), pp. 1-11. https://doi.org/10.1186/s12966-020-01042-2
Making the case for 'physical activity security': the 2020 WHO Guidelines on physical activity and sedentary behaviour from a Global South perspective
Lambert, Estelle Victoria, Kolbe-Alexander, Tracy, Adlakha, Deepti, Oyeyemi, Adewale, Anokye, Nana Kwame, Goenka, Shifalika, Mogrovejo, Patricia and Salvo, Deborah. 2020. "Making the case for 'physical activity security': the 2020 WHO Guidelines on physical activity and sedentary behaviour from a Global South perspective." British Journal of Sports Medicine. 54 (24), pp. 1447-1448. https://doi.org/10.1136/bjsports-2020-103524
Trends in Muscle-Strengthening Exercise Among Nationally Representative Samples of United States Adults Between 2011 and 2017
Bennie, Jason A., Kolbe-Alexander, Tracy, Seghers, Jan, Biddle, Stuart J.H. and De Cocker, K.. 2020. "Trends in Muscle-Strengthening Exercise Among Nationally Representative Samples of United States Adults Between 2011 and 2017." Journal of Physical Activity and Health. 17 (5), pp. 512-518. https://doi.org/10.1123/jpah.2019-0472
Changes in risk factors for non-communicable diseases associated with the ‘Healthy choices at work’ programme, South Africa
Schouw, Darcelle, Mash, Robert and Kolbe-Alexander, Tracy. 2020. "Changes in risk factors for non-communicable diseases associated with the ‘Healthy choices at work’ programme, South Africa." Global Health Action. 13 (1), pp. 1-11. https://doi.org/10.1080/16549716.2020.1827363
Assessing the validity and reliability and determining cut-points of the Actiwatch 2 in measuring physical activity
Kemp, Chadley, Pienaar, Paula R., Henst, Rob H. P., Roden, Laura C., Kolbe-Alexander, Tracy L. and Rae, Dale E.. 2020. "Assessing the validity and reliability and determining cut-points of the Actiwatch 2 in measuring physical activity." Physiological Measurement. 41 (8), pp. 1-12. https://doi.org/10.1088/1361-6579/aba80f
Ten Research Priorities Related to Youth Sport, Physical Activity, and Health
Howie, Erin K., Guagliano, Justin M., Milton, Karen, Vella, Stewart A., Gomersall, Sjaan R., Kolbe-Alexander, Tracy L., Richards, Justin and Pate, Russell R.. 2020. "Ten Research Priorities Related to Youth Sport, Physical Activity, and Health." Journal of Physical Activity and Health. 17 (9), pp. 920-929. https://doi.org/10.1123/jpah.2020-0151
A retrospective evaluation of a community-based physical activity health promotion program
Draper, Catherine E., Kolbe-Alexander, Tracy L. and Lambert, Estelle V.. 2009. "A retrospective evaluation of a community-based physical activity health promotion program." Journal of Physical Activity and Health. 6 (5), pp. 578-588. https://doi.org/10.1123/jpah.6.5.578
Controversies in the Science of Sedentary Behaviour and Health: Insights, Perspectives and Future Directions from the 2018 Queensland Sedentary Behaviour Think Tank
Biddle, Stuart J. H., Bennie, Jason A., De Cocker, Katrien, Dunstan, David, Gardiner, Paul A., Healy, Genevieve, Lynch, Brigid, Owen, Neville, Brakenridge, Charlotte, Brown, Wendy, Buman, Matthew, Clark, Bronwyn, Dohrn, Ing-Mari, Duncan, Mitch, Gilson, Nicholas, Kolbe-Alexander, Tracy, Pavey, Toby, Reid, Natasha, Vandelanotte, Corneel, ..., Vincent, Grace E.. 2019. "Controversies in the Science of Sedentary Behaviour and Health: Insights, Perspectives and Future Directions from the 2018 Queensland Sedentary Behaviour Think Tank." International Journal of Environmental Research and Public Health. 16 (23), pp. 1-20. https://doi.org/10.3390/ijerph16234762
Shift Work and Poor Mental Health: A Meta-Analysis of Longitudinal Studies
Torquati, Luciana, Mielke, Gregore I, Brown, Wendy J, Burton, Nicola W and Kolbe-Alexander, Tracy L. 2019. "Shift Work and Poor Mental Health: A Meta-Analysis of Longitudinal Studies." American Journal of Public Health. 109 (11), pp. e13-e20. https://doi.org/10.2105/AJPH.2019.305278
A hard day's night: Time use in shift workers
Kolbe-Alexander, Tracy L, Gomersall, Sjaan, Clark, Bronwyn, Torquati, Luciana, Pavey, Toby and Brown, Wendy J. 2019. "A hard day's night: Time use in shift workers." BMC Public Health. 19, pp. 1-11. https://doi.org/10.1186/s12889-019-6766-5
Promoting physical activity and reducing sedentary behaviour can minimise the risk of suicidal behaviours among adolescents
Khan, Asaduzzaman, Uddin, Riaz and Kolbe-Alexander, Tracy. 2019. "Promoting physical activity and reducing sedentary behaviour can minimise the risk of suicidal behaviours among adolescents." Acta Paediatrica. 108 (6), pp. 1163-1164. https://doi.org/10.1111/apa.14749
'In Initiative Overload': Australian Perspectives on Promoting Physical Activity in the Workplace from Diverse Industries
Chau, Josephine Y., Engelen, Lina, Kolbe-Alexander, Tracy, Young, Sarah, Olsen, Heidi, Gilson, Nicholas, Burton, Nicola W., Bauman, Adrian E. and Brown, Wendy J.. 2019. "'In Initiative Overload': Australian Perspectives on Promoting Physical Activity in the Workplace from Diverse Industries." International Journal of Environmental Research and Public Health. 16 (3), pp. 1-11. https://doi.org/10.3390/ijerph16030516
Sugar-sweetened beverage intake and relative weight gain among South African adults living in resource-poor communities: longitudinal data from the STOP-SA study
Okop, K. J., Lambert, E. V., Alaba, O., Levitt, N. S., Luke, A., Dugas, L., Dover, R. V. H., Kroff, J., Micklesfield, L. K., Kolbe-Alexander, T. L., Warren, Smit, Dugmore, H., Bobrow, K., Odunitan-Wayas, F. A. and Puone, T.. 2019. "Sugar-sweetened beverage intake and relative weight gain among South African adults living in resource-poor communities: longitudinal data from the STOP-SA study." International Journal of Obesity. 43 (3), pp. 603-614. https://doi.org/10.1038/s41366-018-0216-9
Transforming the workplace environment to prevent non-communicable chronic diseases: participatory action research in a South African power plant
Schouw, Darcelle, Mash, Robert and Kolbe-Alexander, Tracy. 2018. "Transforming the workplace environment to prevent non-communicable chronic diseases: participatory action research in a South African power plant." Global Health Action. 11 (1), pp. 1-11. https://doi.org/10.1080/16549716.2018.1544336
A brief self-directed intervention to reduce office employees’ sedentary behaviour in a flexible workplace
Olsen, Heidi M., Brown, Wendy J., Kolbe-Alexander, Tracy and Burton, Nicola W.. 2018. "A brief self-directed intervention to reduce office employees’ sedentary behaviour in a flexible workplace." Journal of Occupational and Environmental Medicine. 60 (10), pp. 954-959. https://doi.org/10.1097/JOM.0000000000001389
Feasibility for the use of a standardized fitness testing protocol among Australian fitness industry professionals
Bennie, Jason A., Wiesner, Glen H., Vergeer, Ineke, Kolbe-Alexander, Tracy, De Cocker, Katrien, Alexander, Chris and Biddle, Stuart J. H.. 2018. "Feasibility for the use of a standardized fitness testing protocol among Australian fitness industry professionals." Research Quarterly for Exercise and Sport. 89 (3), pp. 380-385. https://doi.org/10.1080/02701367.2018.1486965
Changing diet and physical activity in nurses: a pilot study and process evaluation highlighting challenges in workplace health promotion
Torquati, Luciana, Kolbe-Alexander, Tracy, Pavey, Toby and Leveritt, Michael. 2018. "Changing diet and physical activity in nurses: a pilot study and process evaluation highlighting challenges in workplace health promotion." Journal of Nutrition Education and Behavior. 50 (10), pp. 1015-1025. https://doi.org/10.1016/j.jneb.2017.12.001
Physical activity and sedentary behaviour in a flexible office-based workplace: employee perceptions and priorities for change
Olsen, Heidi M., Brown, Wendy J., Kolbe-Alexander, Tracy and Burton, Nicola W.. 2018. "Physical activity and sedentary behaviour in a flexible office-based workplace: employee perceptions and priorities for change." Health Promotion Journal of Australia. 29 (3), pp. 344-352. https://doi.org/10.1002/hpja.164
Australian fitness professionals' level of interest in engaging with high health-risk population subgroups: findings from a national survey
Bennie, J. A., Thomas, G., Wiesner, G. H., van Uffelen, J. G. Z., Khan, A., Kolbe-Alexander, T., Vergeer, I. and Biddle, S. J. H.. 2018. "Australian fitness professionals' level of interest in engaging with high health-risk population subgroups: findings from a national survey." Public Health. 160, pp. 108-115. https://doi.org/10.1016/j.puhe.2018.03.035
Qualitative evaluation of a physical activity-based chronic disease prevention program in a low-income, rural South African setting
Draper, C. E., Nemutandani, S. M., Grimsrud, A. T., Rudolph, M., Kolbe-Alexander, T. L., de Kock, L. and Lambert, E. V.. 2010. "Qualitative evaluation of a physical activity-based chronic disease prevention program in a low-income, rural South African setting." Rural and Remote Health. 10 (3).
Evaluation of a school-based physical activity intervention in Alexandra Township
Draper, Catherine E., de Kock, Lauren, Grimsrud, Anna T., Rudolph, Michael, Nemutandani, Simon, Kolbe-Alexander, Tracy and Lambert, Estelle V.. 2010. "Evaluation of a school-based physical activity intervention in Alexandra Township." South African Journal of Sports Medicine. 22 (1), pp. 12-19.
Physical activity advocacy and promotion: the South African experience
Kolbe-Alexander, T. L., Bull, Fiona and Lambert, Estelle V.. 2012. "Physical activity advocacy and promotion: the South African experience." South African Journal of Sports Medicine. 24 (4), pp. 112-116.
A systematic review of physical activity-based interventions in shift workers
Flahr, Hannah, Brown, Wendy J. and Kolbe-Alexander, Tracy L.. 2018. "A systematic review of physical activity-based interventions in shift workers." Preventive Medicine Reports. 10, pp. 323-331. https://doi.org/10.1016/j.pmedr.2018.04.004
From evidence-based research to practice-based evidence: disseminating a web-based computer-tailored workplace sitting intervention through a Health Promotion Organisation
De Cocker, Katrien, Cardon, Greet, Bennie, Jason A., Kolbe-Alexander, Tracy, De Meester, Femke and Vandelanotte, Corneel. 2018. "From evidence-based research to practice-based evidence: disseminating a web-based computer-tailored workplace sitting intervention through a Health Promotion Organisation." International Journal of Environmental Research and Public Health. 15 (5). https://doi.org/10.3390/ijerph15051049
Shifting the physical inactivity curve worldwide by closing the gender gap
Mielke, Gregore I., da Silva, Inacio Chrochemore M., Kolbe-Alexander, Tracy L. and Brown, Wendy J.. 2018. "Shifting the physical inactivity curve worldwide by closing the gender gap." Sports Medicine. 48 (2), pp. 481-489. https://doi.org/10.1007/s40279-017-0754-7
The relationship between functional status, physical fitness and cognitive performance in physically active older adults: A pilot study
Ramnath, U., Rauch, L., Lambert, E. V. and Kolbe-Alexander, T. L.. 2018. "The relationship between functional status, physical fitness and cognitive performance in physically active older adults: A pilot study." PLoS One. 13 (4), pp. 1-16. https://doi.org/10.1371/journal.pone.0194918
Shift work and the risk of cardiovascular disease. A systematic review and meta-analysis including dose–response relationship
Torquati, Luciana, Mielke, Gregore I., Brown, Wendy J. and Kolbe-Alexander, Tracy. 2018. "Shift work and the risk of cardiovascular disease. A systematic review and meta-analysis including dose–response relationship." Scandonavian Journal of Work Environment and Health. 44 (3), pp. 229-238. https://doi.org/10.5271/sjweh.3700
Flexible work: The impact of a new policy on employees’ sedentary behaviour and physical activity
Olsen, Heidi M, Brown, Wendy J., Kolbe-Alexander, Tracy and Burton, Nicola W.. 2017. "Flexible work: The impact of a new policy on employees’ sedentary behaviour and physical activity." Journal of Occupational and Environmental Medicine. 60 (1), pp. 23-28. https://doi.org/10.1097/JOM.0000000000001190
Gender equality in sport for improved public health
Brown, Wendy J., Mielke, Gregore I. and Kolbe-Alexander, Tracy L.. 2016. "Gender equality in sport for improved public health." The Lancet. 388 (10051), pp. 1257-1258. https://doi.org/10.1016/S0140-6736(16)30881-9
Which Women are Highly Active Over a 12-Year Period? A Prospective Analysis of Data from the Australian Longitudinal Study on Women’s Health
Pavey, Toby G., Kolbe-Alexander, Tracy L., Uitdewilligen, Leonie and Brown, Wendy J.. 2017. "Which Women are Highly Active Over a 12-Year Period? A Prospective Analysis of Data from the Australian Longitudinal Study on Women’s Health." Sports Medicine. 47 (12), pp. 2653-2666. https://doi.org/10.1007/s40279-017-0732-0
The economic burden of physical inactivity: a systematic review and critical appraisal
Ding, Ding, Kolbe-Alexander, Tracy, Nguyen, Binh, Katzmarzyk, Peter T., Pratt, Michael and Lawson, Kenny D.. 2017. "The economic burden of physical inactivity: a systematic review and critical appraisal." British Journal of Sports Medicine. 51 (19), pp. 1392-1409. https://doi.org/10.1136/bjsports-2016-097385
Sitting time, physical activity and sleep by work type and pattern – The Australian Longitudinal Study on Women’s Health
Clark, Bronwyn k., Kolbe-Alexander, Tracy L., Duncan, Mitch J. and Brown, Wendy. 2017. "Sitting time, physical activity and sleep by work type and pattern – The Australian Longitudinal Study on Women’s Health." International Journal of Environmental Research and Public Health. 14 (3). https://doi.org/10.3390/ijerph14030290
International Olympic Committee consensus statement on the health and fitness of young people through physical activity and sport
Mountjoy, Margo, Andersen, Lars Bo, Armstrong, Neil, Biddle, Stuart, Boreham, Colin, Brandl Bedenbeck, Hans Peter, Ekelund, Ulf, Engebretsen, Lars, Hardman, Ken, Hills, Andrew, Kahlmeier, Sonja, Kriemler, Susi, Lambert, Estelle, Ljungqvist, Arne, Matsudo, Victor, McKay, Heather, Micheli, Lyle, Pate, Russell, Riddoch, Chris, ..., van Mechelen, Willem. 2011. "International Olympic Committee consensus statement on the health and fitness of young people through physical activity and sport." British Journal of Sports Medicine. 45 (11), pp. 839-848. https://doi.org/10.1136/bjsports-2011-090228
Participation in fitness-related activities of an incentive-based health promotion program and hospital costs: a retrospective longitudinal study
Patel, Deepak, Lambert, Estelle V., da Silva, Roseanne, Greyling, Mike, Kolbe-Alexander, Tracy, Noach, Adam, Conradie, Jaco, Nossel, Craig, Borrenson, Jill and Gaziano, Thomas. 2011. "Participation in fitness-related activities of an incentive-based health promotion program and hospital costs: a retrospective longitudinal study." American Journal of Health Promotion. 25 (5), pp. 341-348. https://doi.org/10.4278/ajhp.100603-QUAN-172
Construct validity of the neighborhood environment walkability scale for Africa
Oyeyemi, Adewale L., Conway, Terry L., Adedoyin, Rufus A., Akinroye, Kingsley K., Aryeetey, Richmond, Assah, Felix, Cain, Kelli L., Gavand, Kavita A., Kosoma, Sandra S., Kolbe-Alexander, Tracy L., Lambert, Estelle V., Larouche, Richard, Moss, Sarah J., Ocansey, Reginald, Onywera, Vincent O., Prista, Antonio, Tremblay, Mark S. and Sallis, James F.. 2017. "Construct validity of the neighborhood environment walkability scale for Africa." Medicine and Science in Sports and Exercise. 49 (3), pp. 482-491. https://doi.org/10.1249/MSS.0000000000001131
'Be active!' Revisiting the South African food-based dietary guideline for activity
Botha, C. R., Wright, H. H., Moss, Sarah and Kolbe-Alexander, Tracy L.. 2013. "'Be active!' Revisiting the South African food-based dietary guideline for activity." South African Journal of Clinical Nutrition. 26 (3 (Supplement)), pp. S18-S27.
Non-communicable disease prevention and worksite health promotion programs: a brief review
Kolbe-Alexander, T. L. and Lambert, E. V.. 2013. "Non-communicable disease prevention and worksite health promotion programs: a brief review." Occupational Medicine and Health Affairs. 1 (7), pp. 1-8. https://doi.org/10.4172/2329-6879.1000141
Innovative strategies targeting obesity and non-communicable diseases in South Africa: what can we learn from the private healthcare sector?
Lambert, E. V. and Kolbe-Alexander, T. L.. 2013. "Innovative strategies targeting obesity and non-communicable diseases in South Africa: what can we learn from the private healthcare sector?" Obesity Reviews. 14 (2 (Supplement)), pp. 141-149. https://doi.org/10.1111/obr.12094
The relationship between leadership support, workplace health promotion and employee wellbeing in South Africa
Milner, Karen, Greyling, Michael, Goetzel, Ron, da Silva, Roseanne, Kolbe-Alexander, Tracy, Patel, Deepak, Nossel, Craig and Beckowski, Meghan. 2015. "The relationship between leadership support, workplace health promotion and employee wellbeing in South Africa." Health Promotion International. 30 (3), pp. 514-522. https://doi.org/10.1093/heapro/dat064
The perceived role and influencers of physical activity among pregnant women from low socioeconomic status communities in South Africa
Muzigaba, Moise, Kolbe-Alexander, Tracy L. and Wong, Fiona. 2014. "The perceived role and influencers of physical activity among pregnant women from low socioeconomic status communities in South Africa." Journal of Physical Activity and Health. 11 (7), pp. 1276-1283. https://doi.org/10.1123/jpah.2012-0386
The Healthiest Company Index: a campaign to promote worksite wellness in South Africa
Patel, Deepak, Goetzel, Ron Z., Beckowski, Meghan, Milner, Karen, Greyling, Mike, da Silva, Roseanne, Kolbe-Alexander, Tracy, Tabrizi, Maryam J. and Nossel, Craig. 2013. "The Healthiest Company Index: a campaign to promote worksite wellness in South Africa." Journal of Occupational and Environmental Medicine. 55 (2), pp. 172-178. https://doi.org/10.1097/JOM.0b013e3182728d61
The relationship between workplace environment and employee health behaviors in a South African workforce
Kolbe-Alexander, Tracy, Greyling, Michael, da Silva, Roseanne, Milner, Karen, Patel, Deepak, Wyper, Lauren, Beckowski, Meghan, Lambert, Estelle V. and Goetzel, Ron. 2014. "The relationship between workplace environment and employee health behaviors in a South African workforce." Journal of Occupational and Environmental Medicine. 56 (10), pp. 1094-1099. https://doi.org/10.1097/JOM.0000000000000236
Steps that count: physical activity recommendations, brisk walking, and steps per minute - how do they relate?
Pillay, Julian D., Kolbe-Alexander, Tracy L., Proper, Karin I., van Mechelen, Willem and Lambert, Estelle V.. 2014. "Steps that count: physical activity recommendations, brisk walking, and steps per minute - how do they relate?" Journal of Physical Activity and Health. 11 (3), pp. 502-508. https://doi.org/10.1123/jpah.2012-0210
The relationship between the built environment and habitual levels of physical activity in South African older adults: a pilot study
Kolbe-Alexander, Tracy L., Pacheco, Kyla, Tomaz, Simone A., Karpul, David and Lambert, Estelle V.. 2015. "The relationship between the built environment and habitual levels of physical activity in South African older adults: a pilot study." BMC Public Health. 15 (518), pp. 1-9. https://doi.org/10.1186/s12889-015-1853-8
The association between daily steps and health, and the mediating role of body composition: a pedometer-based, cross-sectional study in an employed South African population
Pillay, Julian D., van der Ploeg, Hidde P., Kolbe-Alexander, Tracy L., Proper, Karin I., van Stralen, Maartjie, Tomaz, Simone A., van Mechelen, Willem and Lambert, Eztelle V.. 2015. "The association between daily steps and health, and the mediating role of body composition: a pedometer-based, cross-sectional study in an employed South African population." BMC Public Health. 15 (174), pp. 1-12. https://doi.org/10.1186/s12889-015-1381-6
A comparative study of Australian and New Zealand male and female nurses’ health: a sex comparison and gender analysis
Tuckett, Anthony, Henwood, Tim, Oliffe, John L., Kolbe-Alexander, Tracy L. and Rin Kim, Jae. 2016. "A comparative study of Australian and New Zealand male and female nurses’ health: a sex comparison and gender analysis." American Journal of Men's Health. 10 (6), pp. 450-458. https://doi.org/10.1177/1557988314567222
Steps that count: pedometer-measured physical activity, self-reported physical activity and current physical guidelines ‒ how do they relate?
Pillay, J. D., Kolbe-Alexander, T. L., Proper, K. I., Tomaz, S. A, van Mechelen, W. and Lambert, E. V.. 2014. "Steps that count: pedometer-measured physical activity, self-reported physical activity and current physical guidelines ‒ how do they relate?" South African Journal of Sports Medicine. 26 (3), pp. 77-81. https://doi.org/10.7196/SAJSM.534
Steps that count: the association between the number and intensity of steps accumulated and fitness and health measures
Pillay, Julian David, Kolbe-Alexander, Tracy L., van Mechelen, Willem and Lambert, Estelle Vicki. 2014. "Steps that count: the association between the number and intensity of steps accumulated and fitness and health measures." Journal of Physical Activity and Health. 11 (1), pp. 10-17. https://doi.org/10.1123/jpah.2011-0288
Clustering of risk factors for non-communicable disease and healthcare expenditure in employees with private health insurance presenting for health risk appraisal: a cross-sectional study
Kolbe-Alexander, Tracy L., Conradie, Jaco and Lambert, Estelle V.. 2013. "Clustering of risk factors for non-communicable disease and healthcare expenditure in employees with private health insurance presenting for health risk appraisal: a cross-sectional study." BMC Public Health. 13 (1213), pp. 1-10. https://doi.org/10.1186/1471-2458-13-1213
Steps that count! A feasibility study of a pedometer-based, healthpromotion intervention in an employed, South African population
Pillay, J. D., Kolbe-Alexander, T. L., Proper, K. I., van Mechelen, W. and Lambert, E. V.. 2014. "Steps that count! A feasibility study of a pedometer-based, healthpromotion intervention in an employed, South African population." South African Journal of Sports Medicine. 26 (1), pp. 15-19. https://doi.org/10.7196/SAJSM.500
Promoting diet and physical activity in nurses: a systematic review
Torquati, Luciana, Pavey, Toby, Kolbe-Alexander, Tracy and Leveritt, Michael. 2017. "Promoting diet and physical activity in nurses: a systematic review." American Journal of Health Promotion. 31 (1), pp. 19-27. https://doi.org/10.4278/ajhp.141107-LIT-562
NEWS for Africa: adaptation and reliability of a built environment questionnaire for physical activity in seven African countries
Oyeyemi, Adewale L., Kasoma, Sandra S., Onywera, Vincent O., Assah, Felix, Adedoyin, Rufus A., Conway, Terry L., Moss, Sarah J., Ocansey, Reginald, Kolbe-Alexander, Tracy L., Akinroye, Kingsley K., Prista, Antonio, Larouche, Richard, Gavand, Kavita A., Cain, Kelli L., Lambert, Estelle V., Aryeetey, Richmond, Bartels, Clare, Tremblay, Mark S. and Sallis, James F.. 2016. "NEWS for Africa: adaptation and reliability of a built environment questionnaire for physical activity in seven African countries." International Journal of Behavioral Nutrition and Physical Activity. 13 (33), pp. 1-12. https://doi.org/10.1186/s12966-016-0357-y
Diet and physical activity behaviour in nurses: a qualitative study
Torquati, Luciana, Kolbe-Alexander, Tracy L, Pavey, Toby, Perrson, Christina and Leveritt, Michael. 2016. "Diet and physical activity behaviour in nurses: a qualitative study." International Journal of Health Promotion and Education. 54 (6), pp. 268-282. https://doi.org/10.1080/14635240.2016.1169943
The economic burden of physical inactivity: a global analysis of major non-communicable diseases
Ding, Ding, Lawson, Kenny D., Kolbe-Alexander, Tracy L., Finkelstein, Eric A., Katzmarzyk, Peter T., van Mechelen, Willem and Pratt, Michael. 2016. "The economic burden of physical inactivity: a global analysis of major non-communicable diseases." The Lancet. 388 (10051), pp. 1311-1324. https://doi.org/10.1016/S0140-6736(16)30383-X
Can the use of Bus Rapid Transit lead to a healthier lifestyle in urban South Africa? The SUN Study
Bartels, Clare, Kolbe-Alexander, Tracy, Behrens, Roger, Hendricks, Sharief and Lambert, Estelle V.. 2016. "Can the use of Bus Rapid Transit lead to a healthier lifestyle in urban South Africa? The SUN Study." Journal of Transport and Health. 3 (2), pp. 200-210. https://doi.org/10.1016/j.jth.2016.04.003
Cardiovascular fitness is associated with bias between self-reported and objectively measured physical activity
Tomaz, S. A., Lambert, E. V., Karpul, D. and Kolbe-Alexander, T. L.. 2016. "Cardiovascular fitness is associated with bias between self-reported and objectively measured physical activity." European Journal of Sport Science. 16 (1), pp. 149-157. https://doi.org/10.1080/17461391.2014.987323
Working on wellness (WOW): a worksite health promotion intervention programme
Kolbe-Alexander, Tracy L., Proper, Karin I., Lambert, Estelle V., van Wier, Marieke F., Pillay, Julian D., Nossel, Craig, Adonis, Leegale and Van Mechelen, Willem. 2012. "Working on wellness (WOW): a worksite health promotion intervention programme." BMC Public Health. 12 (1), pp. 372-383. https://doi.org/10.1186/1471-2458-12-372
Steps that count!: The development of a pedometer-based health promotion intervention in an employed, health insured South African population
Pillay, Julian D., Kolbe-Alexander, Tracy, Proper, Karin I., van Mechelen, Willem and Lambert, Estelle V.. 2012. "Steps that count!: The development of a pedometer-based health promotion intervention in an employed, health insured South African population." BMC Public Health. 12 (1), pp. 880-887. https://doi.org/10.1186/1471-2458-12-880