Workplace Related Quality of Life: Effect of Available Recreation Facilities on Physical Activity and Nutrition

Purpose:

Physical inactivity, the fourth leading cause of death worldwide, is a pandemic and necessitates global action in the public health arena in many intersecting sectors (Kohl et al., 2012). Physical inactivity increases risk of non-communicable diseases (e.g. cardiovascular disease and type 2 diabetes) and was linked to 9% (5.3 million) of deaths from premature mortality worldwide in 2008 (Lee, Shiroma, Lobelo, Puska, Blair, Katzmarzyk, & Lancet Physical Activity Series Working Group, 2012). In a review of US adults’ health behavior, 2008-2010, less than 53.9% of adults met the 2008 federal guidelines for physical activity (PA) for leisure-time activity (Schoenborn, Adams, & Peregoy, 2013). Workplace settings are a key area for PA promotion and program development to encourage employees to be more active (Kohl et al, 2012). Environmental settings such as workplaces can positively affect health status (Sallis, Floyd, Rodriguez, & Saelens, 2012). Kohl et al. (2012) call for a systematic approach to capacity and infrastructure building and a shift from individual to population health. Creating workplace environments that are more conducive to adopting healthy behaviors will aid in the promotion of improved quality of life, decrease stress, improved overall employee satisfaction, and favorably influence clinical outcomes (i.e. obesity, blood pressure) is imperative (Després, Almeras, & Lise, 2014). Workplace wellness programs should have the following seven components: 1) Stakeholder engagement, 2) Employee participation and involvement, 3) Organizational culture, 4) Effect on direct medical economic outcomes, 5) Effect on indirect costs, 6) Effect on humanistic outcomes, and 7) Effect on clinical outcomes (Morrison, & MacKinnon, 2008). Workplace wellness is a growing area of research and has emerged as a rich target for PA promotion for reducing presenteeism, e.g. on the job despite poor health and subpar performance, and increasing employee well-being (Brown, Gilson, Burton, & Brown, 2011). The purpose of this study is to determine workplace quality of life status of faculty and staff at a small private university located in the Pacific Northwest of the US and the effect of workplace recreation facilities on PA levels and nutrition status.

The university is at a crucial juncture with the promotion of health and wellness with the opening of a new recreation facility in August 2015. There are an approximate combined total of 1200 faculty and staff on campus, and 4,000 students. The new recreation facility has the capacity for more than 5000 individuals and emphasizes wellness and the community by having multiple-use spaces, open layout, multiple spaces for meeting and gathering, all to promote an environment of health and wellness. The recreation facility contributes to changing social norms at the university in the creation of a culture of health and wellness where the healthier choice is the easier choice. The primary problems addressed were 1) identification of indicators of work-related quality of life, 2) identification of wellness and recreation needs of the faculty and staff, and 3) identification of current usage trends of available recreation facilities.

Methods:

The faculty and staff were surveyed by electronic means (e.g. Qualtrics) between February and March 2015 and again 4 months after the facility opened. Data collection was completed 4 months after the facility opened. No identifying data were collected therefore projecting the privacy of campus faculty and staff. Participants agreed electronically to participation. Data looked at trends in work-related quality of life before and after the opening of the recreation facility. Questions included the combination of the following instruments: the Centers for Disease Control (CDC) Health-Related Quality of Life (HRQOL) which includes 14 short answer questions regarding healthy days and activity limitation (Jiang & Hesser, 2009); the short version of the International Physical Activity Questionnaire (IPAQ) which has seven short answer questions (Booth, 2000),  the Automated Self-Administered 24-hour Dietary Recall (ASA24) developed by the Applied Research Cancer Control and Population Sciences; five questions regarding use of current recreation facilities; and three open-ended questions were included to determine workplace related recreational needs. The data were analyzed at baseline and at the four month follow up. Group comparisons were made before and after the opening of facility. The open-ended questions were analyzed using content analysis to identify themes.

Results:

The participants in this study were very healthy with 75.1% stating their health was very good/excellent and 66.7% had no days in the past month where poor physical or mental health restricted their usual activities. In fact, 93.8% reported they felt very healthy and full of energy (M=18.31 days, SD=7.41). In both the pre and posttest, responses were equally represented by faculty and staff. More women than men participated (65.5% and 34.5% in the pretest vs 87.5% and 12.5% in the posttest respectively). Most participants were between ages of 30-49 years old (51% and 68.8%). Over 68% of participants reported doing vigorous PA in the past 7 days (M=2.37 days, SD=2.16; M=59.09 minutes, SD=44.26), a mean of 140.04 minutes of vigorous PA which is well above the recommended 75 minutes of vigorous PA. Over 68% of participants reported doing moderate PA in the past 7 days (M=2.88 days, SD=2.55; M=52.22 minutes, SD=38.58), a mean of 150.39 minutes of moderate PA which is above the recommended 150 minutes of moderate PA. Before the recreation facility opened, 75% of participants planned to use it at least once a week but afterwards, only 46.7% reported actually using it at least once a week. However, participants reported having a recreation facility on campus was very important (M=4 out of 5, SD=1.41). Participants listed having more classes (i.e. faculty/staff only), more early hours, a pool, faculty/staff only lockers, and decreased cost as essential to their use of the recreation facility.

Nutrition-related campus recreation findings included post-survey questions assessed additional factors that might impact faculty and staff health and nutrition at work. The majority of participants (~80%) indicated that in the last year, they were able to eat enough of the kinds of food they wanted; they did not have to cut the size of their meals/skip meals/eat less food than they felt they should; and they did not worry whether their food would run out. About 35 % of participants reported that they often or sometimes couldn’t eat balanced meals at work and they could only sometimes feel like they could afford foods on/near campus. Almost 71% of participants reported that sometimes the kinds of food they wanted were not available on/near campus and 53% of participants reported that they only sometimes felt like they had time to eat acceptable foods. Finally, on post-test, 86% of participants reported that new recreation facility did not influence their answers to the health and nutrition questions. These results suggest that faculty and staff might not have secure availability and accessibility to the kinds of food they want on or near campus; they might have trouble eating balanced meals at work; and they might not have time to eat acceptable foods. Additionally, the recreation facility, as is, does not appear to address all aspects of health and nutrition. Pre-post group analysis revealed no significant changes in diet quality.

Conclusion:

These outcomes will guide the refinement of the recreation facilities, enhance wellness opportunities, and ultimately impact the work-related quality of life and enhance preventative health efforts among faculty and staff. Further research regarding the determinants of faculty and staff wellbeing and nutritional status is recommended. The interpretation of the presented results should take into the consideration the lack of statistical differences in the groups for PA or workplace quality of life, most likely due to limited survey response (29 pretest participants, 16 posttest participants). Findings suggest areas for intervention on campuses to include offerings of nutrition classes; implementing a campus wellness challenge with participation incentives; increasing flexibility in meal options; and reducing long wait times for procuring food. Campuses can serve as role models and incubators for creating environments that promotes health and wellness and the ability for faculty and staff to role model healthy behaviors to students can be increased through improved campus environments.

These findings should be used to increase the number of components recommended by Morrison and MacKinnon (2008) as essential to successful workplace wellness programs. Currently, none of the seven components seems complete. The workplace quality of life affects overall well-being including presenteeism. Strategies to enable faculty and staff to improve their workplace quality of life should be further explored. Knowledge gained from this research aligns with Sigma Theta Tau International priorities with the promotion of healthy communities through health promotion, disease prevention and recognition of social determinants of health that affect university faculty and staff.