Help for self-help enabled people in poor physical shape to get fit

Even people in poor physical shape have what it takes. Measures implemented for people in poor physical shape at Norway Post and Bring showed how everyone can be motivated to become more active - and continue that way for a long time afterwards. However, the measures did not help to improve absence from work due to sickness.

Randi Løvland and Kyrre Holstad from Posten Norge
Randi Løvland og Kyrre Holstad from Norway Post Photo: Birger Morken, Norway Post

This has been revealed in a doctoral thesis written by Cathrine Pedersen from the Norwegian School of Sport Sciences: "Worksite health promotion, co-worker support and motivation for lifestyle change".

She started by monitoring the fitness of her fellow workers at the company. She was surprised about how bad things were.

Don’t push themselves enough

—You wouldn’t believe it, would you. We are talking about people who happily walk 20,000 steps a day and who often have physically demanding jobs, but in fact most of them fell below the physical fitness levels recommended by the health authorities, says Cathrine Pedersen.

She emphasises that the people at Norway Post and Bring are hardly different from people in other professions which involve moving a lot, but without the intensity required to achieve a good level of fitness.

—Obviously they are tired after work and maybe they think that they exercise enough on the job.  But poor physical fitness results in a reduction in one’s surplus energy levels. The fact is that they do not push themselves enough and they do not cause their pulse rate to increase enough. So they don’t get fit either, says Ms Pedersen. —At the same time we all know that a good state of physical fitness makes things easier at work and otherwise.

Hectic everyday live

In 2013 Norway Post initiated a programme designed to help improve the health of its employees and to encourage them to adopt a healthier lifestyle. The programme was implemented in conjunction with the Company Health Service and so far 4,500 people have joined the scheme.

202 of these employees participated in the study conducted by Cathrine Pedersen. The aim was to increase their physical activity and fitness.

—Basically it was difficult for the participants because they were working on different shifts, at different times of the day, says Cathrine Pedersen. — So having a joint exercise session either before or after work was tricky. The fact that many of them were also out on the road for much of the day meant that it was impossible to exercise during the course of their working days.

—The solution was to create a system whereby the employees received support to engage in physical activity during their leisure hours, on their own terms.

Keen to exercise

Everyone who took part in the study attended an initial health screening where their fitness, blood pressure, cholesterol levels and waistlines were measured. They answered questions about health and lifestyle, and the results were collated in a personal report which the Company Health Service then reviewed with them.

The results were not very encouraging. A high percentage had poor levels of physical fitness, high blood pressure and generally unhealthy lifestyles.

Nevertheless Ms Pedersen praises the participants:

—They wanted to change their lifestyles. They wanted to exercise and keep fit.

The participants were then placed in smaller groups in order to learn about the health benefits and why fitness is so important. They learnt about the benefits of different levels of physical activity and - perhaps most importantly: how little exercise is actually needed in order to achieve a substantial improvement in one’s health.

—We did not criticise them, we simply provided them with impartial, practical information.

Made their own decisions

Portrait of Cathrine Pedersen
Cathrine Pedersen Photo: Private

A lot of time was spent on increasing awareness about their own habits and motivation, as well as the sort of physical activities they would prefer to do. They learnt about their options and set themselves targets. They also learnt about interval training: that simply walking quickly up a hill is as good as any other type of interval training. And that one needs to adjust training to suit one’s own level of fitness.

On this basis they made their own decisions about how much exercise they wanted to do and how they would do it.

—We were taking a chance, but according to the theory of self-determination, this is important. The participants receive support, acquire proficiency, realise they are being seen and understood and are allowed to make their own choices. The most important thing was providing them with the motivation to change. Permanent changes adjusted to suit their everyday lives.

Uncomfortable fitness boost

The participants met six times over the course of 16 weeks: two meetings with the Company Health Service and four meetings in smaller groups. They were able to talk about their successes and their failures. Before the second meeting with the Company Health Service, they were allowed to provide input about what they wanted more of at that particular time.

—They wanted everything ranging from suggestions for bodybuilding exercises to tips about post-exercise food and drink and how to exceed their threshold miles, says Ms Pedersen. She thinks that it is important to put this into words, and also to talk about the problems one is experiencing - partly because there are so many things in our everyday lives which could have an impact.

—Fitness and interval training were discussed a lot, she says. High intensity is important for improving fitness, but it is also unpleasant enough to make us dread it. We talked about how they could make their own decisions about managing duration and intensity and simultaneously achieve great benefits.

Support from colleagues

After four months of exercising, the 202 participants were examined and questioned again. The results included the following:

  • It is possible to help people become more active on their own. They become more motivated when they realise that their own experiences and needs are being taken seriously.
  • Colleagues are important for providing each other with support. They are in the same boat and in a one-to-one relationship which is not possible with a trainer, doctor or instructor.
  • A lot can be achieved with minimum intervention. The programme consisted of just 7.5 hours, with follow-up.
  • The fitness of the group increased considerably, and this increase was important for their health.
  • At the start of the programme, 70 % of the participants were well below the levels recommended by the Norwegian health authorities (5 x 30 minutes of physical activity with moderate to high intensity every week). One year later this figure had dropped to 47 %.

Not everyone was included

The scheme in which the 202 participants were involved did not result in reduced absence from work due to sickness, although the rates of absence for the participants were not particularly high previously.

—We were unable to include those employees who had a high rate of absence. However, the measures did have an effect on “everyday aches and pains” - psychosomatic ailments - which often go hand in hand with absence from work due to sickness. Both the increased activity and the fact that the participants experienced support from their colleagues as they progressed appeared to have a positive effect on their complaints.

Ms Pedersen believes that a project like the one initiated by Norway Post and Bring, “help to engage in independent exercise”, is an important public health measure which should be implemented by more companies.

Cathrine Pedersen will be defending her doctoral thesis at the Norwegian School of Sport Sciences 30 January 2019.

READ the project discription.