Joseph J. Mazzola, PhD, Meredith College; Alexander T. Jackson, PhD, Middle Tennessee State University; James Loveless, PhD, Middle Tennessee State University

Purpose/Objectives
This study aims to identify how workplace barriers and facilitators to nutrition and exercise affect working professionals’ health related choices at work, work performance, and health outcomes and which of these factors are the most prevalent (Mazzola, Jackson, & Thiele, 2019).

Background
There have been no significant decreases in obesity in recent years, suggesting that the obesity epidemic will not only continue but potentially get worse (Ng et al., 2014). Research conducted by McNeill et al. (2006) demonstrated that physical environmental factors directly impacted physical activity. While other important factors such as genetics and specific disorders certainly influence an individual’s weight (Romieu et al., 2017), it is still significantly influenced by culture, community, stress, and security induced by their environment (Stokols, 1996). Therefore, if an organization can create an environment in which individuals are able to easily and safely make healthier choices regarding physical activity and create a work culture that emphasizes proper nutrition, they can improve the likelihood of their employees achieving and maintaining a healthy lifestyle. Underlying many of these barriers/facilitators is the Theory of Planned Behavior (Ajzen, 1991), which states that attitudes toward a behavior, subjective norms, and perceived control over behaviors lead to intentions to do something, and as long as nothing prevents someone from enacting his or her intentions, those intentions ultimately lead to actual behaviors. Specifically, the main mechanism by which barriers act in this model is to prevent someone who might have the intention to eat healthy or exercise from actually completing the behavior.

Mazzola and colleagues (2017) found that the number of workplace barriers to healthy nutrition/exercise behaviors on a given day was related to their respective health behaviors on that day. Furthermore, the number of workplace facilitators reported was even more strongly related to the healthy behaviors on the day they occurred. However, they used a qualitative (rather than checklist) approach, and did not examine any other day-level work outcomes. That same study found that barriers were presented on 80% of workdays. Thus, this is something that employees face and must overcome on a nearly daily basis if they wish to live a healthy lifestyle, making the creation of health behavior facilitators a prime area for workplace health promotion with the potential for substantial effects on appropriate weight and weight maintenance (Mazzola et al., 2017).

Methods
In this study, 228 working professionals responded to daily diary surveys for a total of 947 daily responses. They were asked each day to identify the type and number of the barriers and facilitators present using a checklist development from previous research (Mazzola et al., 2019; separate checklists for nutrition barriers, exercise barriers, nutrition facilitators, and exercise facilitators). They also answered short scales on their health-related diet and exercise choices, self-reported performance, well-being, and stress levels for up to five separate consecutive work days. Participants were compensated $5-10 for each survey they completed, and all participants were included in analyses as long as they completed one full daily survey.

Hierarchical Linear Modeling was conducted to determine if the number of barriers (or facilitators) indicated for a specific day related to their health and work behaviors that day. As part of this analysis, days (level 2) were nested within participants (level 1) (Nezlek, 2008). For the health behaviors, both barriers and facilitators were entered simultaneously into the model for the relevant outcome (i.e., nutrition barriers and facilitators for diet), and for the work-related outcomes both types of barriers (or facilitators) were entered in simultaneously because our hypotheses were related to how the specific type of factors affect outcomes.

Findings
Results showed some significant relationships between the number of these barriers/facilitators reported and the health behaviors (Table 1) and several work outcomes (Table 2).

Discussion
In general, the number of nutrition barriers and facilitators reported were both related to diet behavior on that day, and the number of exercise barriers and facilitators were related to exercise behavior. Nutrition barriers were significantly related to performance and well-being negatively and positively to stress, but exercise barriers were related only to well-being (negative) and work stress (positive). Nutrition facilitators were positively related to work performance and well-being (both positive relationships), but exercise facilitators did not relate significantly to any of the three work outcomes.

Conclusions
We believe the results of this study indicate the importance of organizations creating a healthy environment for their employees, which includes removing barriers to proper diet and exercise behavior and creating/training facilitators that might help them make healthier decisions. The effects on health behaviors are clear, and research shows that these behaviors should lead to employees who are overall healthier physically and mentally (e.g., Wilborn et al., 2005). Further, particularly as it relates to nutrition barriers and facilitators, the organization may also receive benefits through high work performance and less stress among employees.

Tags: Applicable to all occupations/industries, Applied research, Comprehensive Approaches to Healthy Work Design and Well-Being, Empirical study, Organization- and Job-Level Environments and Practices, Social and Organizational Environment, Theoretical and Conceptual Issues in Job Stress, Total Worker Health, Work Organization and Stress, Workplace Stress; Outcomes; and Recovery