Understanding movement behaviours in shift workers: towards the development of a health promotion program for shift workers

Understanding movement behaviours in shift workers: towards the development of a health promotion program for shift workers

Shift workers are prone to physical inactivity and high sedentary behaviour, which could lead to adverse health outcomes. Nonetheless, these behaviours are not well understood in shift workers. To address this gap, first, a meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (PRISMA) guidelines to summarize physical activity and sedentary behaviours in shift and non-shift workers. Results showed that shift and non-shift workers had similar physical activity patterns, but shift workers were less sedentary than non-shift workers. Only about 40% of shift workers met the physical activity guidelines. Additionally, previous studies mostly used retrospective self-report measures to assess behaviours. These results highlight the need to consider more objective measures to minimize recall biases, and the need to develop physical activity health promotion programs for shift workers. Second, a pilot study was conducted to test the applicability of a novel mobile Ecological Momentary Assessment (EMA) app with shift and non-shift workers (n=120). Participants downloaded an EMA app and answered 5 EMA surveys per day, for 7-10 days. Results indicate that EMA, tailored in real-time for shift workers, is a feasible and valid tool to assess physical activity and sedentary behaviour in this population. Finally, the feasibility and efficacy of a health promotion program during a 24-day shift cycle to improve habitual levels of physical activity was conducted. Shift workers in a mining company (n=51) were allocated to intervention or comparison groups. Efficacy outcome measures included moderate-to-vigorous physical activity (MVPA) steps and other movement-related outcomes (activPAL assessed), quality of sleep (PQSI), and quality of life (WHO-5). Participants in the intervention group participated in an action planning session and received messages to motivate change in physical activity and EMA surveys for self-reporting physical activity. The comparison group received feedback on their baseline assessments and generic health promotion material. The intervention resulted in changes in MVPA steps on all days (p=0.00), day shift (p=0.04), and non-workdays (p=0.00) in the intervention group, but not during night or evening shifts. Other outcomes remained unchanged. In addition to testing efficacy, a process evaluation with the intervention group (n=25) using the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework was conducted. Online exit surveys, interviews, and the researcher log were used to assess the intervention feasibility. Based on the process evaluation findings, workers were positive and desired most intervention ii components. However, there is a need to address the identified barriers, including fatigue and better company management involvement. The thesis findings revealed the habitual movement-related behaviours in shift workers to provide the base to guide health promotion programs. The two empirical studies provided insights into using newer mobile technology to assess behaviours and promote physical activity for shift workers in their natural environment and in real time.

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