Socio-ecological Intervention to Promote Active Commuting to Work (KÄPY)

Background Cycling and walking to work is a natural way of increasing physical activity in a working population. However, the evidence on the effectiveness and cost savings of promoting active work commuting (ACW) is thin. This cluster-randomized, controlled study aims to promote ACW with environmental, social and behavioral strategies in two large workplace areas in Tampere, Finland. The paper de-scribes the protocol, evaluation and baseline findings of the study.

Methods The enrollment of the workplaces took place in 2014-15. In Phase 1, the impacts of environmental strategies (improvements to the walking and cycling trails) were evaluated in Area1 including 11 workplaces. In Phase 2, five more workplaces were recruited from Area2 to evaluate the impacts of social and behavioral strategies accustomed for each workplace. The workplaces in both areas were then randomized into experimental (EXP, n=6+2) and comparison group (COM, n=5+3). EXP promoted ACW with social and behavioral strategies; COM participated in data collection only but will have the same support post-intervention. The primary outcome is the change in employees' self-reported and accelerometer-based ACW. The secondary outcomes include e.g. the changes in employees' self-rated health and subjective wellbeing at work, the change in the number of walkers and cyclists based on the traffic calculations and the change in the quality of walking and cycling trails based on camera auditing (Area1 only). External validity of the intervention is as-sessed with the compliance rates of the workplaces and employees as well as with the fidelity of the environmental, social and behavioral strategies. Health Economic Assessment Tool for Cycling and Walking (HEAT) is used to assess the cost savings of the multilevel intervention. In addition, environmental variables and types that promote ACW and mediate and moderate the effects of environmental strategies are examined.

Results and discussion This study is one of the first in Finland to combine interdisciplinary collaboration between practi-tioners and researchers working in the fields of transportation, urban design, physical activity and sustainable development to promote ACW. The findings benefit all stakeholders interested in pro-moting ACW in urban context. The study will also produce supportive material for promoting ACW at the workplaces.

Study Overview

• Status: Completed
• Conditions: Active Travel
• Intervention / Treatment: Behavioral: KÄPY

• Study Type: Interventional
• Enrollment (Actual): 1500
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Finland
  • Pirkanmaa
    • Tampere, Pirkanmaa, Finland, 33501
      • The UKK Institute for health Promotion Research
    • Tampere, Pirkanmaa, Finland, 33500
      • UKK Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

All voluntary employees in the workplaces located in the specific area

Exclusion Criteria:

No exclusion criteria

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: KÄPY group; Workplaces, which are supported to promote employees' ACW.	Behavioral: KÄPY
No Intervention: Comparison group; Workplaces, which are not supported to promote employees' ACW but will be offered support to do so after the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in self-reported means of transportation to work	Proportion of employees walking or cycling to work (%)	1 year
Change in self-reported weekly AWC	Mean number of days employees walk or cycle to work	1 year
Change in accelerometer-based daily duration of walking and cycling to work	Daily minutes of AWC (mean)	1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in self-rated health	Employees self-reported health	1 year
Change in subjective well-being at work	Includes six indicators self-reported by the employees	1 year
Change in restrictions to ACW	Self-reported by the employees and grouped into four levels	1 year
Change in motivation for ACW	Includes six indicators self-reported by the employees	1 year
Change in injuries due to ACW	Self-reported by the employees	1 year
Change in the use of the main walking and cycling trail (Area1)	Measured with fixed-point traffic calculations	1 year
Change in the quality of the main walking and cycling trail	Audited by cycling the trails with GPS	1 year

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cost-savings	HEAT	1 year
Cost-effectiveness	cost-effectiveness ratio	1 year
Environmental evaluation	Urban environmental variables and types	1 year
Environmental evaluation	Variables, which mediate and moderate the effects of environmental strategies	1 year

Collaborators and Investigators

• Sponsor: UKK Institute
• Collaborators: University of Oxford; University of Graz; Tampere University of Technology; Department of Transport and Streets, City of Tampere; Ecofellows Ltd, City of Tampere
• Investigators: Principal Investigator: Minna Aittasalo, D.Sc., UKK Institute

Publications and helpful links

General Publications

• Aittasalo M, Tiilikainen J, Tokola K, Suni J, Sievanen H, Vaha-Ypya H, Vasankari T, Seimela T, Metsapuro P, Foster C, Titze S. Socio-Ecological Natural Experiment with Randomized Controlled Trial to Promote Active Commuting to Work: Process Evaluation, Behavioral Impacts, and Changes in the Use and Quality of Walking and Cycling Paths. Int J Environ Res Public Health. 2019 May 13;16(9):1661. doi: 10.3390/ijerph16091661.

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start: August 1, 2014
• Primary Completion (Actual): June 1, 2017
• Study Completion (Actual): June 1, 2017

Study Registration Dates

• First Submitted: September 23, 2014
• First Submitted That Met QC Criteria: September 25, 2014
• First Posted (Estimate): September 26, 2014

Study Record Updates

• Last Update Posted (Actual): October 9, 2018
• Last Update Submitted That Met QC Criteria: October 4, 2018
• Last Verified: October 1, 2018

More Information

Terms related to this study

• Keywords: physical activity; intervention; walking; environment; cycling; promotion
• Other Study ID Numbers: 179