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Public health
Original research
Supporting active ageing before retirement: a systematic review and meta-analysis of workplace physical activity interventions targeting older employees
  1. Dafna Merom1,
  2. Fiona Stanaway2,
  3. Klaus Gebel3,
  4. Joanna Sweeting4,
  5. Anne Tiedemann2,
  6. Shirin Mumu1,
  7. Ding Ding2
  1. 1School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
  2. 2School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  3. 3School of Public Health Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
  4. 4Cardio Genomics Program, Centenary Institute, Newtown, New South Wales, Australia
  1. Correspondence to Dr Dafna Merom; D.Merom{at}westernsydney.edu.au

Abstract

Objective With the growing representation of older adults in the workforce, the health and fitness of older employees are critical to support active ageing policies. This systematic review aimed to characterise and evaluate the effects on physical activity (PA) and fitness outcomes of workplace PA interventions targeting older employees.

Design We searched Medline, PreMedline, PsycInfo, CINAHL and the Cochrane Controlled Register of Trials (CENTRAL) for articles published from inception to 17 February 2020. Eligible studies were of any experimental design, included employees aged ≥50 years, had PA as an intervention component and reported PA-related outcomes.

Results Titles and abstracts of 8168 records were screened, and 18 unique interventions were included (3309 participants). Twelve studies were randomised controlled trials (RCTs). Seven interventions targeted multiple risk factors (n=1640), involving screening for cardiovascular disease risk factors, but had a non-specific description of the PA intervention. Four interventions targeted nutrition and PA (n=1127), and seven (n=235) focused only on PA. Interventions overwhelmingly targeted aerobic PA, compared with only four interventions targeting strength and/or balance (n=106). No studies involved screening for falls/injury risk, and only two interventions targeted employees of low socioeconomic status. Computation of effect sizes (ESs) was only possible in a maximum of three RCTs per outcome. ESs were medium for PA behaviour (ES=0.25 95% CI −0.07 to 0.56), muscle strength (ES=0.27, 95% CI −0.26 to 0.80), cardiorespiratory fitness (ES=0.28, 95% CI −22 to 0.78), flexibility (ES=0.50, 95% CI −0.04 to 1.05) and balance (ES=0.74, 95% CI −0.21 to 1.69). Grading of Recommendations Assessment, Development and Evaluation criteria-rated quality of evidence was ‘low’ due to high risk of bias, imprecision and inconsistency.

Conclusions The lack of high-quality effective workplace PA interventions contrasts the importance and urgency to improve the health and fitness in this population. Future interventions should incorporate strength and balance training and screening of falls/injury risk in multi risk factors approaches.

PROSPERO registration number CRD42018084863. (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=84863).

  • public health
  • sports medicine
  • epidemiology
  • occupational & industrial medicine

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2020-045818

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Contributors DM conceptualised the research and drafted the first manuscript. DM and JS conducted the systematic search and selection. FS and DD conducted the quality assessment. AT and DM conduced the meta-analysis. DM and SM conducted the data extraction to tables. All authors participated in the interpretation of results, commented on first draft and gave final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.