Shift work and the risk of cardiovascular disease. A systematic review and meta-analysis including dose–response relationship

Article

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
Article Title

Shift work and the risk of cardiovascular disease. A systematic review and meta-analysis including dose–response
relationship

ERA Journal ID13788
Article CategoryArticle
AuthorsTorquati, Luciana (Author), Mielke, Gregore I. (Author), Brown, Wendy J. (Author) and Kolbe-Alexander, Tracy (Author)
Journal TitleScandonavian Journal of Work Environment and Health
Scandinavian Journal of Work Environment and Health
Journal Citation44 (3), pp. 229-238
Number of Pages10
Year2018
Place of PublicationFinland
ISSN0355-3140
1795-990X
Digital Object Identifier (DOI)https://doi.org/10.5271/sjweh.3700
Web Address (URL)http://www.sjweh.fi/show_abstract.php?abstract_id=3700
Abstract

Objectives
The aim of this review was to assess the risk of cardiovascular disease (CVD) events associated with shift work and determine if there is a dose–response relationship in this association.

Method
Electronic databases (PubMed, Scopus, and Web of Science) were searched for cohort or case–control control study designs in any population, reporting exposure to shift work as the main contributing factor to estimate CVD risk. For each study, adjusted relative risk (RR) ratios and 95% confidence intervals (CI) were extracted, and used to calculate the pooled RR using random-effect models. Meta-regression analysis was conducted to explore potential heterogeneity sources. Potential non-linear dose–response relationships were examined using fractional polynomial models.

Results
We included 21 studies with a total of 173 010 unique participants. The majority of the studies were ranked low-to-moderate risk of bias. The risk of any CVD event was 17% higher among shift workers than day workers. The risk of coronary heart disease (CHD) morbidity was 26% higher (1.26, 95% CI 1.10 -1.43, I2= 48.0%). Sub-group analysis showed an almost 20% higher risk of CVD and CHD mortality among shift workers than those who did not work shifts (1.22, 95% CI 1.09–1.37, I2= 0% and 1.18, 95% CI 1.06–1.32 I2=0%; respectively). After the first five years of shift work, there was a 7.1% increase in risk of CVD events for every additional five years of exposure (95% CI 1.05–1.10). Heterogeneity of the pooled effect size (ES) estimates was high (I2=67%), and meta-regression analysis showed that sample size explained 7.7% of this.

Conclusions
The association between shift work and CVD risk is non-linear and seems to appear only after the first five years of exposure. As shift work remains crucial for meeting production and service demands across many industries, policies and initiatives are needed to reduce shift workers’ CVD risk.

Keywordscoronary heart disease; CVD; effect size; shift worker
ANZSRC Field of Research 2020350505. Occupational and workplace health and safety
420799. Sports science and exercise not elsewhere classified
Public Notes

Additional material
Please note that there is additional material available belonging to this article on the Scandinavian Journal of Work, Environment & Health -website. (This has been uploaded and attached to this record. EB 31/01/2018)

Byline AffiliationsUniversity of Queensland
University of Queensland
School of Health and Wellbeing
Institution of OriginUniversity of Southern Queensland
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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
Sedentary time in older adults: a critical review of measurement, associations with health, and interventions
Copeland, Jennifer L., Ashe, Maureen C., Biddle, Stuart J. H., Brown, Wendy J., Buman, Matthew P., Chastin, Sebastien, Gardiner, Paul A., Inoue, Shigeru, Jefferis, Barbara J., Oka, Koichiro, Owen, Neville, Sardinha, Lius B., Skelton, Dawn A., Sugiyama, Takemi and Dogra, Shilpa. 2017. "Sedentary time in older adults: a critical review of measurement, associations with health, and interventions." British Journal of Sports Medicine. 51 (21), pp. 1-8. https://doi.org/10.1136/bjsports-2016-097210
Four-year follow-up of the community intervention '10,000 steps Ghent'
De Cocker, Katrien A., De Bourdeaudhuij, Ilse M., Brown, Wendy J. and Cardon, Greet M.. 2011. "Four-year follow-up of the community intervention '10,000 steps Ghent'." Health Education Research. 26 (2), pp. 372-380. https://doi.org/10.1093/her/cyr015
Associations between sitting time and weight in young adult Australian women
De Cocker, Katrien. A., van Uffelen, Jannique G. Z. and Brown, Wendy J.. 2010. "Associations between sitting time and weight in young adult Australian women." Preventive Medicine. 51 (5), pp. 361-367. https://doi.org/10.1016/j.ypmed.2010.07.009
The effect of a pedometer-based physical activity intervention on sitting time
De Cocker, Katrien. A., De Bourdeaudhuij, Ilse. M., Brown, Wendy. J. and Cardon, Greet. M.. 2008. "The effect of a pedometer-based physical activity intervention on sitting time." Preventive Medicine. 47 (2), pp. 179-181. https://doi.org/10.1016/j.ypmed.2008.05.012
Effects of '10,000 steps Ghent': a whole-community intervention
De Cocker, Katrien. A., De Bourdeaudhuij, Ilse. M., Brown, Wendy. J. and Cardon, Greet. M.. 2007. "Effects of '10,000 steps Ghent': a whole-community intervention." American Journal of Preventive Medicine. 33 (6), pp. 455-463. https://doi.org/10.1016/j.amepre.2007.07.037
The epidemiology of aerobic physical activity and muscle-strengthening activity guideline adherence among 383,928 U.S. adults
Bennie, Jason A., De Cocker, Katien, Teychenne, Megan J., Brown, Wendy J. and Biddle, Stuart J. H.. 2019. "The epidemiology of aerobic physical activity and muscle-strengthening activity guideline adherence among 383,928 U.S. adults." International Journal of Behavioral Nutrition and Physical Activity. 16, pp. 1-11. https://doi.org/10.1186/s12966-019-0797-2
Moderators and mediators of pedometer use and step count increase in the '10,000 Steps Ghent' intervention
De Cocker, Katrien, De Bourdeaudhuij, Ilse, Brown, Wendy and Cardon, Greet. 2009. "Moderators and mediators of pedometer use and step count increase in the '10,000 Steps Ghent' intervention." International Journal of Behavioral Nutrition and Physical Activity. 6 (3), pp. 1-7. https://doi.org/10.1186/1479-5868-6-3
How many steps/day are enough? For adults
Tudor-Locke, Catrine, Craig, Cora L., Brown, Wendy J., Clemes, Stacey A., De Cocker, Katrien, Giles-Corti, Billie, Hatano, Yoshiro, Inoue, Shigeru, Matsudo, Sandra M., Mutrie, Nanette, Oppert, Jean-Michel, Rowe, David A., Schmidt, Michael D., Schofield, Grant M., Spence, John C., Teixeira, Pedro J., Tully, Mart A. and Blair, Steven N.. 2011. "How many steps/day are enough? For adults." International Journal of Behavioral Nutrition and Physical Activity. 8, pp. 79-95. https://doi.org/10.1186/1479-5868-8-79
'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
Sedentary time in older men and women: an international consensus statement and research priorities
Dogra, Shilpa, Ashe, Maureen C., Biddle, Stuart J. H., Brown, Wendy J., Buman, Matthew P., Chastin, Sebastien, Gardiner, Paul A., Inoue, Shigeru, Jefferis, Barbara J., Oka, Koichiro, Owen, Neville, Sardinha, Luis B., Skelton, Dawn A., Sugiyama, Takemi and Copeland, Jennifer L.. 2017. "Sedentary time in older men and women: an international consensus statement and research priorities." British Journal of Sports Medicine. 51 (21), pp. 1526-1532. https://doi.org/10.1136/bjsports-2016-097209
A pilot study to assess the effects of Tai Chi on health indicators in type 1 diabetes patients
Liu, Xin, Russell, Anthony, Kabir, Enamul and Brown, Wendy. 2019. "A pilot study to assess the effects of Tai Chi on health indicators in type 1 diabetes patients." Health. 11, pp. 341-350. https://doi.org/10.4236/health.2019.113030
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
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
BMI transitions in Australian women: amount and causes of weight change associated with progression from healthy to unhealthy BMI over 16 years
Brown, Wendy J., Kabir, Enamul, Gomersall, Sjaan and Clark, Bronwyn. 2017. "BMI transitions in Australian women: amount and causes of weight change associated with progression from healthy to unhealthy BMI over 16 years." 24th European Congress on Obesity (ECO2017). Porto, Portugal 17 - 20 May 2017
What factors should we focus on to prevent progression from healthy to unhealthy BMI in Australian women?
Brown, Wendy, Kabir, Enamul, Clark, Bronwyn and Gomersall, Sjaan. 2016. "What factors should we focus on to prevent progression from healthy to unhealthy BMI in Australian women?" 6th International Congress on Physical Activity and Public Health (ISPAH 2016). Bangkok, Thailand 16 - 19 Nov 2016 Thailand.
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
Physical activity interventions and depression in children and adolescents: a systematic review and meta-analysis
Brown, Helen Elizabeth, Brown, Wendy J., Biddle, Stuart J. H., Pearson, Natalie and Braithwaite, Rock E.. 2013. "Physical activity interventions and depression in children and adolescents: a systematic review and meta-analysis." Sports Medicine. 43 (3), pp. 195-206. https://doi.org/10.1007/s40279-012-0015-8
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
Nurses’ lifestyle behaviours, health priorities and barriers to living a healthy lifestyle: a qualitative descriptive study
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
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
Maintaining a healthy BMI: data from a 16-year study of young Australian women
Brown, Wendy J., Kabir, Enamul, Clark, Bronwyn K. and Gomersall, Sjaan R.. 2016. "Maintaining a healthy BMI: data from a 16-year study of young Australian women." American Journal of Preventive Medicine. 51 (6), pp. e165-e178. https://doi.org/10.1016/j.amepre.2016.09.007
Cluster analysis of behavioural weight management strategies and associations with weight change in young women: a longitudinal analysis
Madigan, C. D., Daley, A. J., Kabir, E., Aveyard, P. and Brown, W.. 2015. "Cluster analysis of behavioural weight management strategies and associations with weight change in young women: a longitudinal analysis." International Journal of Obesity. 39 (11), pp. 1601-1606. https://doi.org/10.1038/ijo.2015.116
Opportunities, barriers and constraints to physical activity in rural Queensland, Australia
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