Shelter dogs,university employees,and lunchtime walks: A pilot study

Abstract

BACKGROUND:

Workplace walking interventions can lead to positive physical and psychological outcomes for employees. For optimal success, however, innovative approaches that appeal to employees are needed.

OBJECTIVE:

The purpose of this study was to assess the physical activity levels and experiences of university staff members who walked shelter dogs during their lunch breaks.

METHOD:

Participants walked with a dog and a partner for 30 minutes during their lunch break one day a week for four weeks. Accelerometer data was collected during participant walks and interviews conducted post-intervention.

RESULTS:

Quantitative results indicated that participants averaged 24.9±7.4 minutes of moderate-to-vigorous physical activity (range 12– 37 min) during the walk. Qualitative findings suggested that the incorporation of shelter dogs into a walking intervention encouraged participants to take part in the study and continue each week.

CONCLUSIONS:

Both the quantitative and qualitative data from this pilot study support the notion that including shelter dogs into a university-based walking program encouraged physical activity engagement and adherence.

Keywords

Physical activity workplace canines

1 Introduction

Regular physical activity improves one’s overall physical and mental health1. Despite these benefits, Americans continue to become more and more sedentary. For instance, the Centers for Disease Control and Prevention reported that in 2013, 26 percent of Americans reported engaging in no physical activity at all. In 2014 this number rose to 28 percent [1]. Data also suggests that of those Americans who do report being physically active, approximately only half meet the recommended aerobic physical activity guidelines for improved cardiovascular health [1]. Even lower, a mere 20 percent meet the aerobic and strength training guidelines1. According to these guidelines, adults should accumulate 150 minutes of moderate to vigorous activity or 75 minutes of vigorous physical activity each week [2]. Meeting these guidelines decreases the risk for chronic illnesses and increases overall health. Walking has been identified as a simple, affordable, accessible, and enjoyable activity to help people meet these guidelines [2].

While there are numerous causal factors for why Americans do not meet the aforementioned physical activity guidelines, one increasingly prevalent factor is the inhibitive nature of work [3]. Indeed, not only have workweeks become longer, but there has also been an 83% increase in sedentary jobs since 1950 [3]. Likewise, the number of physically active jobs remains quite low. Recognizing this, numerous researchers have implemented different types of interventions meant to increase physical activity levels amongst employees within a variety of different workplaces. Common interventions involve behavioral counseling, sit-stand workstations, stair use, and walking using activity trackers [4, 5]. While some of this research has presented equivocal findings [6], some interventions have been successful [7, 8]. Success in these studies has been measured in terms of physical, social, and mental well-being, as well as intervention adherence. As Das et al. [4] noted, however, for optimal success, a paradigm shift is needed. Specifically, workplace physical activity initiatives should include innovative approaches that include a variety of activities for all employees.

2 Review of literature

2.1 Walking interventions

Recognizing the physical and psychological benefits of walking, significant research has focused on implementing walking interventions with the intent of increasing employee well-being and decreasing organizational healthcare costs. Research has demonstrated these interventions to be fairly successful across a variety of settings [9, 10]. Within the university setting, research has demonstrated that a 16-week pedometer-based walking program aimed at increasing the physical activity levels of faculty and staff can improve the health, wellness, and well-being of university employees [11]. Gilson and colleagues [9] found that the use of pedometers and adherence to a 12-week automated walking intervention increased walking by 25% across their sample of university employees. Specifically, walking increased by approximately 20 minutes per day. Indeed, college and university employees have been found to greatly benefit physically, emotionally, and professionally from walking and other physical activity interventions [12]. Furthermore, as there are over 4,600 colleges and universities in the United States [13], located in rural, suburban, and urban environments, the potential for translatability and dissemination is high.

While the interventions traditionally involve humans only, some researchers have recognized the role of companion animals in increasing physical activity levels and ultimately meeting physical activity guidelines. Working from the premise that dog owners may be more physically active than non-dog owners [14], research has demonstrated that the inclusion of dogs within a walking intervention can not only facilitate walking adherence, but also increase health benefits. For example, Johnson and Meadows [15] found that adherence to a walking program was motivated more so by the needs of the dogs than by the needs of the human participants. Specifically, participants expressed the belief that the dogs were counting on them for walks. Participants also reported enhanced psychological well-being from walking the dogs, as well as exhibited physical benefits such as weight loss and reduced BMI values. Similarly, Westgarth and colleagues [16] demonstrated that dog walking amongst dog owners was increased when the owner felt a sense of obligation to keep his or her canine companion healthy. Also referred to as purposeful activity, factoring in the needs of the dog has been found to be influential in positively influencing the physical activity levels of individuals with canine companions [17]. As a result, individuals who own a dog are more likely to meet physical activity recommendations and have a reduced risk for certain cancers and diseases [18].

2.2 Shelter dogs

Canine companions’ physical health also improves from physical interaction by resulting in a lower likelihood of becoming overweight or obese [19]. Psychological health can also be mutually enhanced for both canine companions and their owners resulting in decreased feelings of isolation and loneliness [20], a strong sense of trust [21], and improved emotional health [22]. Further, and specific to the animal shelter context, exercise and human contact can reduce stress experienced by shelter dogs and ultimately improve their well-being [23]. Indeed, physical activity is an integral component in maintaining the physical, emotional, and psychological health of companion animals and animals housed in animal shelters.

According to the Humane Society of the United States, 6– 8 million cats and dogs enter animal shelters each year. Of this 6– 8 million, three million are euthanized. The American Society for the Prevention of Cruelty to Animals estimates that fewer than half of the dogs who enter animal shelters will be adopted. Waiting to be adopted within the shelter environment can be physically and psychologically taxing on dogs, as animal shelters are exceptionally stressful places for dogs. Research has demonstrated that the stressors experienced by shelter dogs can have negative consequences for the animals, both in terms of psychological well-being and in finding forever homes [24]. Stressors include novel surroundings [25], an uncontrollable and unpredictable environment [24], social isolation [26], unfamiliar sights, sounds, and odors[27, 28], potentially damaging levels of noise[27], and separation from attachment figures [29]. Various forms of interaction with humans have been found to help alleviate the effects of these stressors, including engaging in physical activities such as walking [23].

Taken together, research has identified the benefits of walking for both human and canine populations [19]. Further, there is some indication that physical activity levels of humans can be increased by targeting the physical activity needs of canine companions [17]. Beyond the needs of dogs with homes and owners, however, exercise has been particularly helpful in providing dogs in animal shelters enrichment that enhances their well-being [23]. With the current number of animals located in animal shelters as high as it is, however, it is unreasonable to expect shelter staff to be able to exercise each and every animal. In fact, following the recommendations of the Humane Society of the United States and the National Animal Control Association, animal shelter attendants spend a minimum of nine minutes per animal per day cleaning and six minutes per animal per day feeding. This provides each animal with a minimum of 15 minutes of care each day. What this recommendation does not include, however, is any time for animal care workers to engage in enrichment programs that address the physical and mental fitness needs of each animal. Thus, the purpose of this study was to address the needs of two populations by assessing the physical activity levels and experiences of university staff members while walking local shelter dogs during their lunch breaks.

3 Methods

3.1 Participants

Upon receiving university institutional review board approval, staff members at a university were recruited through a campus listserv. An email asking for volunteers was sent out to all staff members and the first eight who responded were chosen to take part the study. The sample was limited to eight people for two reasons. First, this was a pilot study and second, the research team wanted to make sure that the details of the procedures were sufficiently overseen. With the number of individuals helping, it was logical to only bring four dogs to campus. One person did not follow through leaving seven full-time staff members (100% female, 100% white, 27– 66 years of age (M = 45 years, SD = 15.9 years)) who completed the study.

3.2 Procedures

Participants signed an informed consent document and underwent initial screening and assessment prior to the first day of walking. During this time, they were informed of the benefits associated with getting shelter dogs out of their kennels. Each day, participants secured their ActiGraph GT3X+ accelerometer (ActiGraph, Pensacola, FL) upon arrival. They were next paired and instructed to walk their assigned dog for 30 minutes using sample walking routes provided. The time of 30 minutes was chosen for two reasons. First, out of convenience. Participants had only one hour for lunch and needed time to drive to and from the location of the study. Due to parking on campus, we allowed 15 minutes each way. Second, if staff members saw it feasible to accumulate 30 minutes each day of the work week, they would be able to accumulate the minimum 150 minutes of moderate to vigorous physical activity each week. Post-intervention interviews were conducted to discuss participant experiences and assess perceived benefits from the intervention.

Members of the research team transported dogs from the local county animal shelter to campus each Friday for four weeks. The shelter is approximately two and a half miles from campus. The dogs chosen to be part of the study were available for adoption at the shelter. Each week different dogs took part, so as to increase visibility of those looking for homes. The dogs were of various breeds and ages.

3.3 Analysis

Accelerometers were worn at the hip (positioned at the anterior axillary line) and were initialized to collect data in 1-minute epochs with ActiLife software (version 6.13.3). Sampling rate was 30 Hz. Vector magnitude cut-points specifically developed for the ActiGraph GT3X [30] were used to calculate time spent in spent in light physical activity, moderate-to-vigorous physical activity, and sedentary behavior during the scheduled walk.

The interviews were audio-recorded and transcribed verbatim. The data were examined using inductive content analysis [31]. As such, transcripts were first read by three members of the research team and independently coded line-by-line using open coding. Researchers then conducted a second round of coding to form preliminary codes that emerged from the interviews. After coding was completed, data were grouped together into higher order themes, after which the researchers discussed, compared, and contrasted their findings and insights until primary and secondary themes were identified [31].

4 Results

Eighty-six percent of participants (n = 7) completed all walking sessions (n = 4). Participants averaged 24.9±7.4 minutes of moderate-to-vigorous physical activity (range 12– 37 min) during the walk. Descriptively, interview data revealed that participants sat anywhere from 3– 7.5 hours out of their 8-hour workday. Participants’ self-reported being somewhat physically active outside of work, but all identified consistency as their biggest shortcoming. The most common physical activities in which they took part were walking, gardening, and an occasional fitness class.

When asked why they volunteered to take part in the study participant’s identified their love of dogs as a primary motivation. One participant stated that she volunteered, “Because I love dogs”. Another participant was interested in the type of research involving interactions with dogs and participated “just to have contact with dogs, period”. Thus, there is some suggestion that the incorporation of dogs into a university-based walking program can encourage participant recruitment and program adherence and promote moderate intensity walking among women staff members.

When asked about the experience of walking shelter dogs, participants described mixed emotions. Specifically, they looked forward to their walks with the dogs, but were sad when the walk was over because the dogs had to go back to the shelter and that they had to go back to work. As one woman noted, “I was happy to see the dogs and play with them and I was sad to come back to work and not stay and walk them some more.” Another woman stated that walking with the dogs on her lunch break was fun and a mood enhancer. In her words, “It made me sad that I had to come back to work, but it was definitely a fun experience. I enjoyed it; it made my day happier.” It is also noteworthy that these participants had no apprehension about walking shelter dogs and, in fact, overwhelmingly communicated that they believed that shelter dogs are incredibly loving and would make great pets. Other comments from participants included the desire to continue walking the shelter dogs using their designated service time allotted to them by the university and the need to repeat the study for a longer duration.

5 Discussion

The findings of this study suggest that, when dogs are included as a component of a worksite walking intervention, university staff may be increasingly likely to both engage in and adhere to the program. Fountaine and colleagues [32] identified college and university employees as prime targets for workplace physical activity interventions. Indeed, many studies have examined this population based on their high levels of prolonged sedentary behavior during their workdays [9 , 12]. A great deal of research has also recognized the utility of including canine companions in assessing adherence to physical activity among humans [15, 33]. Specifically, by focusing on the physical activity needs of their canine companions, humans have been found to feel motivated to ensure their dogs are exercised on a regular basis. This work sought to extend these works by incorporating the needs of local animal shelter dogs into a walking intervention for staff members on a university campus.

With regard to the first purpose of this study, on average participants obtained approximately 16% of the recommended weekly moderate-to-vigorous intensity aerobic physical activity requirements during their walks. Given the intervention occurred only one day per week and the self-reported amount of time spent sitting and being physically active outside of work, this percentage is noteworthy. Perhaps even more noteworthy, however, are the reasons for why the participants took part in the intervention. Participants stated emphatically that they were motivated by the opportunity to interact with dogs, suggesting that increasing physical activity levels even while at work can be aided by the presence of dogs. Thus, beyond the positive benefits associate with having pets in the workplace [33, 34], there may be an additional benefit when the opportunity to be physically active with the pet is possible.

The motivations for increasing physical activity in the workplace vary by stakeholder. For the organization or company, the motivation for implementing workplace physical activity programs may include the reduction in healthcare costs incurred by their employees and the positive organizational outcomes associated with a healthy workforce (e.g., more productivity and less absenteeism) [35]. For employees, factors such as social support, self-motivation, and fun impact the likelihood of engaging in a workplace physical activity program [36]. Findings here suggest that another factor, interacting with dogs, is also a significant motivator for engaging in a workplace physical activity program for those employees who like dogs. Further, there is some suggestion that employees may be motivated by need to help shelter dogs who might not otherwise get any physical activity. This latter point suggests that organizations may do well to partner with area animal rescues and shelters.

The current findings also support the notion that psychological need fulfillment is an important factor in exercise involvement and adherence. Employing the tenets of self-determination theory [37], Podlog and Dionigi [38] demonstrated that promoting various individual and group needs within exercise interventions can foster greater enjoyment, adherence, and social interaction amongst participants. At the individual level, fulfilling the needs of, for example, sense of accomplishment and purpose can be promoted, while things such as sense of camaraderie and social support can be promoted at the group level. For individuals, the perceived obligation to walk one’s dog has been suggested to provide a sense of purpose that, as Morgan [13] notes, is a critical factor in engaging in physical activity. Indeed, focusing on the physical and psychological needs and well-being of dogs may elicit a sense of purpose amongst dog walkers thus resulting in both engagement and adherence [39]. Participants were informed of the needs of shelter dogs, suggesting that perhaps participants did indeed feel a sense of obligation and purpose when participating.

Participants were university employees and expressed an interest in using their designated service time allotted by the institution to continue to walk the dogs at the local shelter. Healy et al. [40] identified allowing employees the flexibility to tailor their activities to their own interests as one component of successfully reducing prolonged sitting in the workplace. The primary motivation of participants who volunteered to take part in this study was their love of dogs. Thus, incorporating employee interests by including things like walking dogs may be a good way to not only reduce workplace sitting time, but it may also encourage adherence to physical activity due to the perceived obligation to ensure dogs receive the necessary amount of daily physical activity (i.e., purposeful activity) [17]. To the extent that dogs from animal shelters are walked, the perceived need may be even greater, this could be advantageous for all involved.

5.1 Practical implications

This study’s findings have practical implications. As Das and colleagues [4] noted, the implementation of workplace wellness programs can have numerous benefits for the organization, including a reduction in healthcare spending and employee absenteeism. By introducing a novel approach to a workplace walking intervention, the workplace norm of sitting for several hours per day is being challenged. Likewise, by incorporating shelter dogs into the intervention, employees are not only positively impacting their own well-being, but also contributing to the positive well-being of dogs who are in dire need of physical activity and human interaction [23 –29]. Further, Das and colleagues [4] suggest that workplace physical activity programs should be structured such that benefits to the workforce are immediate and salient. Indeed, the findings from this study suggest that when employees returned to work, they were happy after interacting with and walking the dogs. While additional research is needed to examine the productivity levels related to interventions involving canines, there is some suggestion that the positive psychological benefits associated with interacting with dogs may be transferable to the workplace [20, 22].

This study’s findings also highlight a novel, mutually beneficial partnership between the university and a local, non-profit entity. Thus, the reach of the intervention went beyond the organization to include the community [4]. As many participants communicated a desire to continue walking the dogs during their designated service time, there is some suggestion that a workplace walking program that incorporates shelter dogs could be more effective than traditional programs. Again, additional research is needed to investigate this point, but previous works do indicate that adherence to walking does increase when dog walking is involved [16].

5.2 Limitations and future directions

There are two primary strengths of this study. First, to our knowledge, this is the first intervention to use companion animals to improve physical activity levels in the university workplace. While a multitude of other approaches have been used, the use of dogs extends the literature to include one additional method to explore further. The second strength of this study is that, again, to our knowledge, this is the first study in which researchers partnered with a local animal shelter to employ a community-based initiative on a university campus. Both of these strengths allowed us to evaluate the logistics, time, cost, and so on of employing larger scale studies with similar designs.

As with any study, limitations are always present. A limitation to this work was study duration. The intervention itself took place only one time per week for four weeks. A longer study may have provided greater insight to the physical and psychological benefits of the program. In fact, participants suggested that, should another study take place, the duration be extended to at least eight weeks. Similarly, each walk was only 30 minutes in duration. Participants also suggested that longer walks be included in subsequent studies so they could interact longer with the dogs. All seven participants in this pilot study identified as female, limiting the generalizability of the findings and suggesting the inclusion of males in future studies. Likewise, they were all Caucasian limiting the generalizability to other racial groups.

Finally, this pilot study was conducted within the United States and my not be replicable in some other countries. That said, however, there are examples of similar programs taking place in Australia and New Zealand. In 2014, an organization called The Lost Dogs Home implemented The Human Walking Program in downtown Melbourne, Australia. The purpose of the program was to “rescue” humans from their workplace desks by having them come to a common area to walk adoptable dogs from a local animal shelter. A secondary purpose was to get these dogs seen, change perceptions of shelter dogs, and, in turn, get the dogs adopted. The organization reported that the program rescued some 5000 workers from their desks and that all the dogs were adopted. Indeed, both human and canine needs were met and the issues of employee health, physical inactivity, and homeless animals were addressed. The Human Walking Program also provided a guide for similarly designed initiatives and encouraged other organizations to follow suit. Despite these limitations, however, the strengths of this work do suggest that future study can be designed to examine more populations and in additional contexts.

6 Conclusion

The primary purpose of this study was to assess the amount of physical activity obtained by university staff members engaging in lunchtime walks with shelter dogs. Findings suggest that participants reached a notable percentage of their recommended weekly physical activity levels on their walks. The second purpose of this work was to explore the experiences of those who volunteered to take part in this unique study. Qualitative findings revealed that incorporating dogs into a university-based walking program can encourage program engagement and adherence as well as promoted moderate intensity walking among women staff members. Both the quantitative and qualitative data from this pilot study identified innovative and promising tactics for increasing physical activity in the workplace. While replication and implementation of this program may vary in structure, integrating shelter dogs into workplace physical activity initiatives

Conflict of interest

The authors have no conflict of interest.

References

Centers for Disease Control and Prevention. Physical Activity Basics. [Internet]. Atlanta, GA, US: Center for Disease Control and Prevention; 2015 [cited 2018 Feb 15]. Available from: https://www.cdc.gov/physicalactivity/basics/index.htm.

Centers for Disease Control and Prevention.Walking. [Internet]. Atlanta, CA, US: Center for Disease Control and Prevention; 2015 [cited 2018 Feb 15]. Available from: https://www.cdc.gov/physicalactivity/walking/index.htm.

Church

, Thomas

, Tudor-Locke

, Katzmarzyk

, Earnest

, Rodarte

, Martin

, Blair

, Bouchard

. Trends over 5 decades of U.S. occupation-related physical activity and their associations with obesity. PLoS. 2011;6(5):1.

Das

, Mailey

, Murray

, Phillips

, Torres

, King

. From sedentary to active: Shifting the movement paradigm in workplaces. Work. 2016;54(2):481.

Ryde

, Brown

. Physical activity and workplace wellbeing. In Cooper CL, Leiter MP, editors. The Routledge Companion to Wellbeing at Work. New York: Taylor & Francis; 2017, p. 298.

Malik

, Blake

, Suggs

. A systematic review of workplace health promotion interventions for increasing physical activity. Br J Health Psychol. 2014;19:149.

Abraham

, Graham-Row

. Are worksite interventions effective in increasing physical activity? A systematic review and meta-analysis. Health Psychol Rev. 2009;3:108.

Schroer

, Haupt

, Pieper

. Evidence-based lifestyle interventions in the workplace – an overview. Occup Med. 2014;64(1):8.

Gilson

, Faulkner

, Murphy

, Meyer

, Washington

, Ryde

, Arbour-Nicitopoulos

, Dillon

. Walk@Work: An automated intervention to increase walking in university employees not achieving 10,000 daily steps. Prev Med. 2013;56(5):283.

10.

Mansi

, Milosavljevic

, Tumilty

, Hendrick

, Higgs

, Baxter

. Investigating the effect of a 3-month workplace-based pedometer-driven walking programme on health-related quality of life in meat processing workers: A feasibility study within a randomized controlled trial. BMC Public Health. 2015;15:410.

11.

Haines

, Davis

, Rancour

, Wagner

. A pilot intervention to promote walking and wellness and to improve the health of college faculty and staff. J Am Coll Health. 2007;55(4):219.

12.

Plotnikoff

, Collins

, Williams

, Germov

, Callister

. Effectiveness of interventions targeting health behaviors in university and college staff: A systematic review. Am J Health Promot. 2015;29(5):169.

13.

Morgan

. Prescription of physical activity: A paradigm shift. Quest. 2001;53(3):366.

14.

Higgins

, Temple

, Murray

, Kumm

, Rhodes

. Walking sole mates: Dogs motivating, enabling, and supporting guardians’ physical activity. Anthrozoos. 2013;26(2):237.

15.

Johnson

, Meadows

. Dog walking: Motivation for adherence to a walking program. Clin Nurs Res. 2010;19(4):387.

16.

Westgarth

, Christley

, Christian

. How might we increase physical activity through dog walking? A comprehensive review of dog walking correlates. Int J Behav Nutr Phys Act. 2014;11(83):1.

17.

Rhodes

, Murray

, Temple

, Tuokko

, Higgins

. Pilot study of a dog walking randomized intervention: Effects of a focus on canine exercise. Prev Med. 2012;54(5):309.

18.

Christian

, Westgarth

, Bauman

, Richards

, Rhodes

, Evenson

, Mayer

, Thorpe

. Dog ownership and physical activity: A review of evidence. J Phys Act Health. 2013;10(5):750.

19.

Kushner

, Blatner

, Jewell

, Rudloff

. The PPET Study: People and pets exercising together. Obes. 2006;14(10):1762.

20.

Casciotti

, Zuckerman

. The benefits of pets for human health. [Internet]. National Center for Health Research; 2016. [cited 2018 Feb 15]. Available from: http://center4research.org/healthy-living-prevention/pets-and-health-the-impact-of-companion-animals/.

21.

Maharaj

, Haney

. A qualitative investigation of the significance of companion dogs. West J Nurs Res. 2015;37(9):1175.

22.

Campbell

, Smith

, Tumilty

, Cameron

, Treharne

. How does dog-walking influence perceptions of health and wellbeing in healthy adults? A qualitative dog-walk-along study. Anthrozoös. 2016;29(2):181.

23.

Menor-Campos

, Molleda-Carbonell

, Lopez-Rodriguez

. Effects of exercise and human contact on animal welfare in a dog shelter. Vet Rec. 2011;169(15):288.

24.

Beerda

, Schilder

MBH

, van Hooff

JARAM

, de Vries

, Mol

. Chronic stress in dogs subjected to social and special restriction. I. Behavioral Responses. Phys Behav. 1999;66(2):233.

25.

Hennessy

, Davis

, Williams

, Mellott

, Douglas

. Plasma cortisol levels of dogs at a county animal shelter. Phys Behav. 1997;62(3):485.

26.

Hubrecht

, Serpell

, Poole

. Correlates of pen size and housing conditions on the behavior of kenneled dogs. Appl Anim Behav Sci. 1992;34:365.

27.

Coppola

, Grandin

, Enns

. Noise in the animal shelter environment: Building design and the effects of daily noise exposure. J Appl Anim Welf Sci. 2006a;9(1):1.

28.

Coppola

, Grandin

, Enns

. Human interaction and cortisol: Can human contact reduce stress for shelter dogs? Phys Behav. 2006b;87(3):537.

29.

Hennessy

. Hypothalamic-pituitary-adrenal responses to brief social separation. Neurosci Biobehav Rev. 1997;21(1):11.

30.

Sasaki

, Dinesh

, Freedson

. Validation and comparison of ActiGraph activity monitors. J Sci Med Sport. 2011;14:411.

31.

Mayring

. Qualitative content analysis. Forum Qual Soc Res. 2000;1(2).

32.

Fountaine

, Piacentini

, Liguori

. Occupational sitting and physical activity among university employees. Int J Exerc Sci. 2014;7(4):295–301.

33.

Perrine

, Wells

. Labradors to Persians: Perceptions of pets in the workplace. Anthrozoos. 2006;19(1):65.

34.

Wilkin

, Fairlie

, Ezzedeen

. Who let the dogs in? A look at pet-friendly workplaces. Int J Workplace Health Manag. 2016;9(1):96.

35.

Baicker

, Cutler

, Song

. Workplace wellness programs can generate savings. Health Aff. 2010;29(2):304.

36.

Fletcher

, Behrens

, Domina

. Barriers and enabling factors for worksite physical activity programs: A qualitative examination. J Phys Act Health. 2008;5:418.

37.

Ryan

, Deci

. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68.

38.

Podlog

, Dionigi

. Psychological need fulfillment among workers in an exercise intervention: A qualitative investigation. Res Q Exerc Sport. 2013;80(4):774.

39.

Hoerster

, Mayer

, Sallis

, Pizzi

, Talley

, Pichon

, Butler

. Dog walking: Its association with physical activity guideline adherence and its correlates. Prev Med. 2011;52(1):33.

40.

Healy

, Lawler

, Thorp

, Neuhaus

, Robson

, Owen

, Dunstan

. Reducing prolonged sitting in the workplace. An evidence review: full report. [Internet]. VicHealth; 2012 [cited 2018 Feb 15]. Available from http://www.vichealth.vic.gov.au.