Changes in risk factors for non-communicable diseases associated with the ‘Healthy choices at work’ programme, South Africa

Article

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
Article Title

Changes in risk factors for non-communicable diseases associated with the ‘Healthy choices at work’ programme, South Africa

ERA Journal ID200558
Article CategoryArticle
AuthorsSchouw, Darcelle (Author), Mash, Robert (Author) and Kolbe-Alexander, Tracy (Author)
Journal TitleGlobal Health Action
Journal Citation13 (1), pp. 1-11
Article Number1827363
Number of Pages11
Year2020
Place of PublicationUnited Kingdom
ISSN1654-9880
Digital Object Identifier (DOI)https://doi.org/10.1080/16549716.2020.1827363
Web Address (URL)https://www.tandfonline.com/doi/full/10.1080/16549716.2020.1827363
Abstract

Background
Globally 71% of deaths are attributed to non-communicable diseases (NCD). The workplace is an opportune setting for health promotion programs and interventions that aim to prevent NCDs. However, much of the current evidence is from high-income countries. Objective: The aim of this study was to evaluate changes in NCD risk factors, associated with the Healthy Choices at Work programme (HCWP), at a commercial power plant in South Africa.

Methods
This was a before-and-after study in a randomly selected sample of 156 employees at baseline and 137 employees at 2-years. The HCWP focused on food services, physical activity, health and wellness services and managerial support. Participants completed questionnaires on tobacco smoking, harmful alcohol use, fruit and vegetable intake, physical activity, psychosocial stress and history of NCDs. Clinical measures included blood pressure, total cholesterol, random blood glucose, body mass index, waist circumference and waist-to hip ratio. The 10-year cardiovascular risk was calculated using a validated algorithm. Sample size calculations evaluated the power of the sample to detect meaningful changes in risk factors.

Results
Paired data was obtained for 137 employees, the mean age was 42.7 years (SD 9.7) and 64% were male. The prevalence of sufficient fruit and vegetable intake increased from 27% to 64% (p < 0.001), those meeting physical activity guidelines increased from 44% to 65% (p < 0.001). Harmful alcohol use decreased from 21% to 5% (p = 0.001). There were clinical and statistically significant improvements in systolic and diastolic blood pressure (mean difference −10.2 mmHg (95%CI: −7.3 to −13.2); and −3.9 mmHg (95%CI: −1.8 to −5.8); p < 0.001) and total cholesterol (mean difference −0.45 mmol/l (−0.3 to −0.6)). There were no significant improvements in BMI. Psychosocial stress from relationships with colleagues, personal finances, and personal health improved significantly. The cardiovascular risk score decreased by 4.5% (> 0.05).

Conclusion
The HCWP was associated with clinically significant reductions in behavioural, metabolic and psychosocial risk factors for NCDs.

KeywordsNon-communicable diseases; workplace health promotion; risky behaviour; risk factors; cardiovascular disease
ANZSRC Field of Research 2020429999. Other health sciences not elsewhere classified
Byline AffiliationsStellenbosch University, South Africa
School of Health and Wellbeing
Institution of OriginUniversity of Southern Queensland
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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
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