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

Minna Aittasalo, Johanna Tiilikainen, Kari Tokola, Jaana Suni, Harri Sievänen, Henri Vähä-Ypyä, Tommi Vasankari, Timo Seimelä, Pasi Metsäpuro, Charlie Foster, Sylvia Titze, Minna Aittasalo, Johanna Tiilikainen, Kari Tokola, Jaana Suni, Harri Sievänen, Henri Vähä-Ypyä, Tommi Vasankari, Timo Seimelä, Pasi Metsäpuro, Charlie Foster, Sylvia Titze

Abstract

Active commuting to work (ACW) has beneficial effects on health, traffic, and climate. However, more robust evidence is needed on how to promote ACW. This paper reports the findings of a multilevel natural experiment with a randomized controlled trial in 16 Finnish workplaces. In Phase 1, 11 workplaces (1823 employees) from Area 1 were exposed to environmental improvements in walking and cycling paths. In Phase 2, five more workplaces (826 employees) were recruited from Area 2 and all workplaces were randomized into experimental group (EXP) promoting ACW with social and behavioral strategies and comparison group (COM) participating only in data collection. Process and impact evaluation with questionnaires, travel diaries, accelerometers, traffic calculations, and auditing were conducted. Statistics included Wilcoxon Signed Ranks Test, Mann-Whitney U-test, and after-before differences with 95% confidence intervals (95% CI). After Phase 1, positive change was seen in the self-reported number of days, which the employees intended to cycle part of their journey to work in the following week (p = 0.001). After Phase 2, intervention effect was observed in the proportion of employees, who reported willingness to increase walking (8.7%; 95% CI 1.8 to 15.6) and cycling (5.5%; 2.2 to 8.8) and opportunity to cycle part of their journey to work (5.9%; 2.1 to 9.7). To conclude, the intervention facilitated employees' motivation for ACW, which is the first step towards behavior change.

Keywords: active travel; intervention; multilevel; natural experiment; workplace.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of Phase 1 (workplaces in Area 1): Effects of improvements to walking and cycling paths in a longitudinal pre-post design.
Figure 2
Figure 2
Flow chart of Phase 2 (workplaces in Area 1 and Area 2): Effectiveness of workplace-specific social and behavioral strategies in a cluster-randomized controlled design.

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