Active Movement Pilot Research Study

Qualitative Research Debrief

Group Discussions held at UCHL March 10th 2014

13th March 2014/mike wade

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It’s easy to think it’s about what you do in the office, but it actually changes your perspective on everyday life, forever

Female clerk 45 years old

In a nutshell

The Sample

• Two group discussions amongst those who recently completed the AM six week pilot scheme

• Group One were less comprehensive adopters of the programme

• Group Two were more comprehensive adopters, including some of those who wore monitoring equipment

• Each group ran for between 45 and 50 minutes• nb: while some respondents may have been slightly pressganged into

volunteering, it should be remembered that as willing participants they are likely to be more positive than a random sample of adults would be

Key elements from Topic Guide

• Impressions of AM before and after the pilot study

• Best and worst elements of the regime

• Fun or chore? Easy to stick to regime? Reaction to monitoring

• How well tailored for office layout and location?

• What benefits felt: physical and emotional

• Work vs home application

• Continuation plans after pilot

Management Summary

• Despite the relative brevity of the pilot, AM has been well received by this sample of participants

• They adopted it out-of-office as much or more than in-office

• They adhered to the regime well in the main, enjoyed the process and will mostly continue with it despite the pilot ending

• While a few reported physical benefits, the majority “felt better” for their involvement with the programme

• The programme structure is fundamentally correct as it stands

• While printed reminders matter, face-to-face contact is crucial in maintaining the inspiration and enthusiasm that feed compliance

Participants initial assessment of AM

• Expectations of gyms and vigorous exercise emerged (off-putting)

• But intrigue and mild curiosity turned to genuine interest at the initial briefing meeting: it seemed beneficial yet do-able (unusual in a pain/gain world) and believable

• The key benefit to most participants was the way in which the cumulative effect of small changes in their normal behaviour was likely to extend life expectancy. This creates hope for the future.

• The key negative was a worry that the programme might get in the way of work (particularly given this was a minority of individuals within one department of an organisation which had not ‘adopted’ AM universally, ie wasn’t backing it as a true client company would)

Participants assessment after pilot

• Well worthwhile taking part in AM because although objective benefits weren’t yet evident to most, the programme made them feel better and was easy to participate in - making it hard to justify not doing so given the likely long term benefits to health and well-being

• Most had felt sufficient mental satisfaction to validate the relatively small effort they felt they needed to put in

• AM is something that all respondents would recommend to a friend – indeed several had already coached children, friends or family in the basic principles of AM- “stand up when you’re eating, or on-line”

• An upside without any real downside = a “no brainer”

The AM elements thought to work best

• Face-to-face contact is crucial: the initial briefing provided medical credentials plus enthusiasm through the infectious evangelism of the AM crew (and later on-site team leader/visits)

• The constant reminders via posters and emails are vital - it was felt that without them one would simply forget – and the level that was employed was felt to be about right by most

• Once you have grasped the concept it’s easy to extend it into home life

• Had the programme lasted a full year, there was a feeling that the new behaviours would have been well enough absorbed for individuals to maintain their regime without these levels of reminder

The AM elements thought to work least well

• Very little was criticised – it was felt that the programme was well devised, reminders sent at about the right frequency, the specifics well shaped for the location and office environment

• In an ideal world, the more engaged participants would have welcomed the provision of some appropriate hardware, such as “hot” standing desks and a standing table at which to eat lunch(they recognised that facilities such as these – important not just for their utility but as a reminder to use them – would not have been practical to supply for a pilot such as this one)

• Some more rebellious types (typically younger males) felt slightly uncomfortable in signing up for any sort of authoritarian regime!

Fun vs. chore

• Most respondents found the programme fun, some really got into it

• A few felt it a chore at the start, until one had got to grips with it, after which you got used to it and “the time just flew past”

• None really found it a chore as a whole, although some felt that signing pieces of paper, for example, was a bit over the top (or perhaps uncool) and so chose not to do this

• Here is a key reason for the scheme’s wide acceptance: individuals adapted the core regime to get around the bits they didn’t fancy, replacing these with fresh elements they created for themselves, like walking up tube escalators or not getting dropped off at the bus stop

The importance of an organised programme

• The organised programme is vital – it sets out a framework that some will fully adhere to, while others will use it to learn the basics from which they can find a version that works for them

• Having understood the concept, participants blended elements of the ‘official’ programme into a personal regime that best suited their particular office and home life

• It was notable that in many cases the majority of changed behaviour was out of the office

• Commuting was probably the most convenient area in which to incorporate more standing/walking, although park walks grew, too

Sticking to the AM programme

• The less involved participants didn’t read most of the literature or even open most of the emails – but these still had an effect

• They were less comfortable with signing paper to prove they had walked somewhere or taking prescribed routes for a stroll

• Nevertheless, they complied in many other ways – typically stairs over lifts, more frequent visits to the copier, standing on transport

• The group who participated more willingly complied with pretty much the whole programme, although standing in meetings could be embarrassing and standing for phone calls impractical if one made many calls a day

Opinions of programme tailoring

• The tailoring of the programme to individual office layout and location is very important in encouraging compliance

• Virtually all respondents felt that generic suggestions would have had a substantially diminished effect compared to specific suggestions about movement within and outside their actual office

• Posters increased the “fun” element, press cuttings helped credibility

• While some participants stopped short of some elements (walking routes outside the office being the most frequently mentioned), the existence even of unused stimulus in the programme encouraged by suggesting a level of professionalism and thoroughness of design

Opinions of monitoring process

• Participants were very keen on the monitoring process

• Partly because it strengthened medical credentials of the programme, partly because they were hoping for some feedback on how they were doing – something a belt might assist in

• Some belt-wearers found the device a little inconvenient to wear all day and so removed it upon arrival at home (thus potentially missing an element of their increased activity in home)

• Some non-belt wearers wished they had been selected to wear one

Physical responses to AM experience

• Most respondents felt that any physical results would take longer to emerge than six weeks

• However, a minority of respondents reported easier walking or breathing during/after exercise following this short pilot, (these tended to be the less evidently fit)

• Some felt that increased activity “kept you away from the biscuits in the desk drawer” and so indirectly led to better health or weight loss

• Respondents who were regular gym-goers or sports enthusiasts did not expect AM to add much to their levels of fitness but seemed happy that they were ‘keeping up standards’ at work, too

• Some respondents referred to improving posture/flexibility as a benefit

Emotional responses to AM experience

• This is where much of the value existed for many participants

• Some cited feeling mentally sharper through less “wallowing” in their office chairs for long periods

• To most, though, the mental benefit was more emotional: feeling better about oneself because one was making a bit more of an effort – despite the fact that the effort wasn’t that big a deal - giving a little more hope for the future and one’s health prospects

• Also there were social benefits – they got to better know other participants, whose own AM actions created reinforcement

• And they had low level bragging rights over friends and workmates

The overall effect of AM experience

• Nothing but positive

• The worst anyone could say was the fitter respondents’ view that they “didn’t really need it” – but might as well have it anyway

• At best there were some truly grateful participants who asked if they could pass on thanks for having had the chance to learn things new to them and be trained to benefit from this knowledge

• Participation undoubtedly set up a group dynamic which is of considerable benefit in maintaining compliance – a gently competitive element operates that might be fostered via sub-groups in cases where participation is universal

Views on continuing with AM

• Virtually all respondents will continue ‘on their own’ now the pilot has finished

• Many wished that the pilot would continue (as they knew this would improve their compliance)

• Several suggested that the NHS should adopt it for all admin staff

• In the absence of the full programme they would like another reference point – such as a YouTube channel – to use as a reminder and a refresher (not necessarily great from your commercial perspective, though).

• Many would willingly make happy ambassadors or spokespeople

In conclusion

• The AM programme was enjoyed and considered beneficial• Participants engaged with it sufficiently to take it home from the

office, plan to continue to adhere to it after the pilot is finished and pass on their learnings to family and friends

• The majority would like it to be continued - indeed feel that it should be adopted by organisations like theirs on a broad basis

• They see the existing plan as well conceived both in general and in the UCHL site specifics

• Both the medical credibility of Dr Mike and the enthusiasm of Peter (followed up by the on-site team leader) were key to engagement, adherence and so, ultimately, to success

Useful quotes 1

• The programme isn’t a rule book – it’s a guide you adapt for yourself• It makes you feel less lazy, more positive, with a more active mind• My motivation? Staying alive to spend longer with my children• I didn’t find it difficult – I just slotted it into my work environment• I could feel a difference to my health - previously I got more breathless• It makes you feel better, it gives you an overall feeling of well being• It’s a better way of exercising than the gym, it fits into your day• Doing it in a group is good – you support each other

Useful quotes 2

• Now I understand the benefits I’m going to keep on – implementing the things I’ve picked up in my daily activities

• It’s made a change, it’s made an impact

• I would have liked to be monitored to find out better how I was doing

• I would say to a friend – just do it

• I’m not having to do much, yet I’m extending my life!

• It’s a bit of fun, while being a bit medical, too

• I learned so much I’d never heard of before

Any questions?

Mike Wade

Quoll

mike.wade1@btinternet.com