Implementation of Physical Activity at the Workplace to Improve Well-being - In a Danish Context

Department of Sports Sciences

Two-Year Master’s Thesis, IV610G, 4. Semester / 2020

Implementation of Physical Activity

at the Workplace to Improve

Well-being

- In a Danish Context

Sofie Kristiansen

Abstract

The purpose of the thesis was to investigate how a ten-week physical activity

intervention could affect the general well-being for employees from a sedentary office environment.

Method: 16 employees participated in a ten-week intervention which implemented

physical activity in their workplace. To measure the participant’s well-being, three surveys was distributed to all. One before, during, and after the intervention. Furthermore, were six interviews with individuals conducted after the intervention ended.

Results: The employees created awareness of the importance of being physically active,

and experienced changes in their physical and mental well-being.

Conclusion: Well-being is an individual feeling, which are affected by external

elements changing a person’s needs.

Keywords: Physical Activity, Physical Activity at the Workplace, Health Promotion,

Table of Content

1 Introduction...5

2 Previous Research ...8

2.1 What is Physical Activity? ...8

2.2 Physical Activity and Health ...9

2.3 Physical Activity Related to Psychological Well-being...10

2.4 General Well-being ...11

2.4.1 Well-being at the Workplace ...14

2.5 Physical Activity and Social Relationships ...17

2.5.1 Physical Activity and Social Relations at the Workplace ...17

2.6 Sedentary Behavior and Health...19

2.7 Promotion of Health and Physical Activity at the Workplace...20

2.8 Physical Activity Interventions and Implementation at the Workplace...22

3 Aim and Research Questions ...25

3.1 Aim...25 3.2 Research Questions ...25 3.3 Delimitations ...26 4 Methodology ...27 4.1 Background...27 4.2 Research Design...27 4.2.1 Intervention...28 4.2.2 Choice of Exercises ...29 4.2.3 Implementation...31 4.3 Data Collection ...31 4.3.1 Surveys ...31 4.3.2 SARS-CoV-2 ...33 4.3.3 Interviews ...34

4.4.1 Scientific Considerations...36

4.4.2 Social Considerations ...36

4.4.3 Ethical Considerations...38

4.5 Data Analysis...39

4.5.1 Statistical Analysis ...39

4.5.2 Interpretative Phenomenological Analysis ...39

5 Theoretical Framework...41

5.1 Organizational Behavior Management ...41

6 Results and Analysis ...43

6.1 Results...43

6.1.1 Survey...43

6.1.2 Interviews ...50

6.1.3 Physical Activity at the workplace ...51

6.2 Analysis...71

6.2.1 Physical Activity at the Workplace ...71

6.2.2 Well-being and Physical Activity when Working from Home ...78

7 Discussion...85

8 Conclusion...91

9 Appendix ...92

9.1 Walking Routes...92

9.2 Neck, Shoulder & Back Exercises ...93

9.3 Survey:...95

9.3.1 Survey questions – Translated to English...98

9.4 Interview Guide ...100

9.4.1 Danish...100

9.4.2 English ...102

9.5 Analysis...104

1 Introduction

Physical activity is associated with improved physiological and psychological well-being. It is an essential factor in reducing the risks of noncommunicable diseases like obesity, cancer, diabetes, depression, cardiovascular disease, etc. Nevertheless, are the levels of physical activity in the population declining (Kazi, 2013). The problem has developed throughout the years, and today, physical inactivity is acknowledged as a global health problem (World Health Organization, 2018c). Physical inactivity is, in today’s society, the single largest risk factor when it comes to the previously mentioned noncommunicable diseases, which are also the leading cause of death in the world (World Health Organization, 2018c). Globally, is 25% of the population not active enough (World Health Organization, 2018b). Looking specifically at the Western World, it is estimated that more than half of the population does not meet the

recommendations for physical activity of 30 minutes (H. E. F. Brown, Burton, Gilson, & Brown, 2014). In a Danish context, the Danish Health Authority recommends 30 minutes of physical activity every day. Unfortunately, only 43% of the adult population is currently living up to the recommendation (Pilgaard & Rask, 2016).

A key concept that relates to physical inactivity is “sedentary behavior.” Sedentary behavior is characterized by any waking behavior with low energy expenditure while sitting or lying down (World Health Organization, 2018a). One of the biggest

challenges regarding physical inactivity is occupational behavior. Due to the developments in the Western World, many people today possess a desk-based job instead of a manual job that requires a higher level of physical activity. Research show that especially office workers are in a high risk category of getting a noncommunicable disease since they often maintain a low fitness level due their many hours of sitting time each day (Kazi, 2013; World Health Organization, 2018a). An adult working a full-time job spends, on average, half of their waking hours at their job. Therefore, the working environment has been recognized as a good setting to promote physical activity and public health (Coulson, Field, & McKenna, 2008). Physical activity is not only

influencing people’s physical health but is, as previously mentioned, also associated as having a positive role when it comes to mental health and general well-being. At the workplace, physical activity is also seen as influencing job motivation positively, increasing employees coping skills, and how they react to minor irritations during the day (Coulson et al., 2008; Kristiansen, 2019).

Improvement of the physical and psychological health is, however, not the only

advantage when talking about promotion physical activity at the workplace. It can also be in the organization's best interest to offer the employees time and opportunity for physical activity. From an organizational perspective, does healthy employees mean fewer employee expenses, since having good mental and physical health, in theory, decreases the number of sick days, sickness presenteeism, which are days where employees show up to work feeling sick and are possibly contagious, and absenteeism. Moreover, is physical activity, as previously mentioned, also capable of increasing the job motivation for employees, which for organizations means the productivity can increase and therefore also be a financial advantage (H. E. Brown, Gilson, Burton, & Brown, 2011).

There is, however, still a lack of understanding when it comes to the role that

workplaces can have in health promotion, and therefore, also missing guidance to how physical activity successfully can be implemented and maintained to keep the effect of the implementation (Justesen, 2015b). Many organizations do today provide free fruit for all employees, courses to help quit smoking or provide the employees with the opportunity to participate in running races or other types of sports events.

Unfortunately, do these initiatives not create an actual effect on the employees' health, since these opportunities are mostly used by the people who are already active in their everyday life (Siggaard, 2014). Implementation of physical activity in an organization should be seen as a change project or a change in the organizational culture. When it comes to creating changes, there is not only one method on how to be successful.

Instead, the picture should be reversed, and a change that is adjusted to the organization should be created (Burnes & Jackson, 2011; Justesen, 2015b).

On the basis of that is the topic of this thesis physical activity at the workplace and its connection to general well-being. The study takes place in sedentary work environment in a Danish organization where the main occupation is office work.

2 Previous Research

2.1 What is Physical Activity?

Physical activity is by the World Health Organization defined as “…any bodily

movement produced by skeletal muscles that require energy expenditure” (World

Health Organization, 2018b). This definition includes both structured exercises or programs but also the more incidental activities as commuting to work by walking or biking or household work (Archer & Blair, 2011; Thøgersen-Ntoumani, Fox, & Ntoumanis, 2005). The guidelines for physical activity have changed throughout time. The changes have come as a reaction to the world's development and the increasing number of people dying due to a physically inactive lifestyle (World Health

Organization, 2018c). Whereas the recommended daily physical activity was previously set to 30 minutes, the minutes have today increased, and more specific

recommendations concerning the intensity level are published, and more high-intensity training is recommended (Sundhedsstyrelsen, 2019; World Health Organization, 2010a). Not only is the intensity specified but also what type of training and the frequency of it is described. The recommendations are also divided into three age groups; kids, adults, and older adults (World Health Organization, 2010a). However, what the guidelines or recommendations do not provide is an example of what types of activities that potentially could be used for each recommended muscle group or level of intensity (Kazi, 2013). Not having exemplified what is recommended, it supports the idea that physical activity can be any bodily movement, and that only people's imaginations can stop physical activity. It does not exclude or favor with regard to abilities, gender, or groups in the population. On the other hand, does the lack of practical examples also make the term of physical activity very abstract. An abstract definition can seem unclear for many and make it hard for the population to relate to and execute (MacAuley, 1994).

2.2 Physical Activity and Health

Physical activity has been recognized as health beneficial for more than 5000 years. Greek physicians did in the fifth century recognize the importance of exercise by stating that it is food that, together with exercise, will keep a man healthy (Kazi, 2013;

MacAuley, 1994). One of the earliest findings regarding the link between physical inactivity and health is from 1864. Here, Smith (1864) found that tailors were healthier than physically inactive tradesmen. A finding that was followed up in 1910 by Osler (1910) who discovered that coronary heart disease was more present in the upper class with the men that possessed the more sedentary job positions than in the lower class who had jobs that required physical activity. The relationship between physical activity and coronary heart disease was later illustrated in British Social Class. It indicated that the mortality of coronary heart disease was double as high in the business class than in an unskilled worker. In 1939 US Weekly Public Health also reported that a higher percentage of businessmen died from coronary heart disease than men who did manual physical work (MacAuley, 1994; Paffenbarger, Blair, & Lee, 2001). Modern-day health research did, however, not pick up until after World War II. Here a well-known research study confirmed the link between physical activity and health. Here it was the British study that researched the physical health differences between bus drivers and

conductors that created a breakthrough (Morris & Crawford, 1958). The study found that the active conductors, compared to the sedentary drivers of London’s many busses were protected from the coronary heart diseases. The study ended up being an eye-opener to the population. Later the possibility that living an active lifestyle could help decrease the public health problems was tested and confirmed (Paffenbarger et al., 2001).

With knowledge from history and research, we have started to recognize the importance of physical activity when maintaining a healthy lifestyle (MacAuley, 1994). Evidence shows that physical inactivity, globally, is the cause of death for 63% of the fifty-seven-millions deaths each year (Kazi, 2013). The majority of the deaths can be connected with a noncommunicable disease in which physical inactivity plays a crucial role; it is

diseases like cardiovascular disease, obesity, diabetes, or respiratory diseases that take most lives (World Health Organization, 2010a, 2018b, 2018c). Today, research shows that there is a direct relationship between health and physical activity. By improving or maintaining a good fitness level, it is possible to reduce the risk of developing a

noncommunicable disease. Even performing physical activity as little as once a week has proved to be effective (Kazi, 2013).

2.3 Physical Activity Related to Psychological Well-being

Research shows that physical activity can have a beneficial effect on individuals' well-being, mood, and emotion (Kazi, 2013). General research is inconclusive on which type of physical activities that have the most significant effect. Some studies point out that doing high-intensity physical activity is the most beneficial and that an increase in heart rate decreases stress. Other studies find that walking, which is a low to

moderate-intensity physical activity, can be just as beneficial. Walking has been associated with antidepressant effects, and researchers point out that an increase in heart rate is not necessary to decrease stress (Freak-Poli, Wolfe, Wong, & Peeters, 2014). Studies also point out that walking has a social aspect that high-intensity training does not have to the same extent. Researchers have found that it is often easier for people to have a conversation about heavier subjects while walking than when sitting still (Marquet & Hipp, 2019). Another advantage of walking is that everyone can participate. It is not a competitive training method, and people do not compare themselves to others. It can involve a broader spectrum of people than training with higher intensity can because everyone is capable of participating (Freak-Poli et al., 2014). Even though different studies have found positive effects with different kinds of physical activities, no final recommendations of frequency or duration has been made. Instead, studies have concluded that more research is needed in the area. A suggestion is that the differences in the general population play an essential role and might not be similar for everyone. Moreover, it is also important to acknowledge our individual differences and that we each have different elements of our well-being that we wish to improve (Kazi, 2013; Thomas, Puig Ribera, Senye-Mir, Greenfield, & Eves, 2015) What is also important to

remember is that the term well-being is a concept that research has different views on, and that no official definition of the term has been made (Dodge, Daly, Huyton, & Sanders, 2012).

2.4 General Well-being

The definition of well-being has a long history behind it. It is a complex term that has experienced many debates and arguments about its content and definition. One thing is sure; research has shown that the simple saying: “how are you?” is a rather complicated question to answer. Today, a common belief between researchers is that the concept is multidimensional (Ryan & Deci, 2001).

Two approaches to well-being initially play a role in history. The first term is called the hedonic approach. Simply put, does the approach believe that the goal for human beings is happiness. To be happy, a high level of positivity must stand in contrast to a low level of negativity. Positive feelings increase the satisfaction of life, which means happiness and well-being. Another approach to the term is the eudaimonic. The eudaimonic approach suggests that well-being occurs when people’s life activities are congruent with their deeply held values. The feeling of well-being is intense and very authentic and will arise when a person exists as they truly are (Dodge et al., 2012; Ryan & Deci, 2001).

The multidimensional concept that well-being is, is believed to include aspects of both of these approaches. The reason for this is that approaches, in some cases, are

overlapping in each other’s beliefs. Moreover, does research show that when trying to measure the term of well-being, aspects from both approaches play significant roles to people (Ryan & Deci, 2001). However, has these definitions or approaches been criticized for being inaccurate about the actual content of well-being. Instead, Ryff (1989) was more concrete in his explanation and described three components which together is well-being: Life satisfaction, pleasant effect, and unpleasant effect. With effect means mood and emotions (C. Ryff, 1989). With this definition came critique,

and it became popular amongst researchers to argue that research, in general, focused too much on the descriptions of the term instead of defining it (Christopher, 1999). In the search for a definition, a new aspect called "quality of life" was introduced. However, was the inaccuracy of this statement also pointed out, and the exact content questioned. By stating that well-being equals "quality of life," did a new argument in the debate of well-being arise. Quality of life means different things to people, and it was suggested that well-being is an individualized feeling which differs from person to person (Dodge et al., 2012). The World Health Organization agreed with the suggestion of individualized well-being and expressed the importance of culture and social class since it plays a vital role when reaching the state of well-being (World Health

Organization. Division of Mental & Prevention of Substance, 1997).

Another perspective in the debate of definition is from a medical point of view. While some researchers wanted to de-medicalize the term entirely because they believed it was possible to consider it as separately from being ill. Others used the word "health" widely when wanting to describe the state of well-being. They argued that health is connected with illness since human beings often do not notice their health until it gets bad. They argued that the term should, therefore, not be de-medicalized. Moreover, when being aware of your health, it was argued that well-being, in that case, is a feeling of bodily freedom and functioning, which also is connected to the field of medicine (Dodge et al., 2012; Ryan & Deci, 2001). The term 'functioning' has a psychological perspective, which was emphasized by Ryff and Singer (2008). In their study, they chose to develop core values for the term of well-being in their search for a proper definition.

According to them, self-acceptance, purpose of life, environmental mastery, positive relations, and growth are the most important skills to possess to reach the desired state of well-being (C. D. Ryff & Singer, 2008).

Due to the challenge of defining being, some researchers also proposed that well-being is depending on equilibriums (Dodge et al., 2012). Heady and Wearing (1992) agreed that it should be seen as a balance between elements by suggesting a theory that

considers the relationships between what they call “stock” which a person’s social background, personality and social network, and what the theory calls “flows” which consist of events that bring positive emotions and events that brings negative, and the third factor which is the subjective well-being. What is also interesting to mention about this framework is that they keep the original approach of hedonics where they consider the positive and negative things in life while also taking life-satisfaction into

consideration (Dodge et al., 2012; Headey & Wearing, 1992; C. Ryff, 1989). The theory was widely tested since the significance of equilibrium as a key factor in well-being was questioned. Research showed that events that take place in our lives affect how we feel, both positively and negatively. These effects disappear rather quickly, and the

dominating factor will again be "stock" factors like social background, personality, and network. Therefore, these findings justified that the flow of our lives is essential to consider when assessing well-being. Later this theory was developed further. Another perspective presented is how the challenges we meet, and our personal resources affect us (Dodge et al., 2012).

With these new additions, Dodge et al. (2012) presented a new definition of well-being. In their definition, they kept the idea that challenges and personal resources are

connected. The definition is presented as being a development of Headey and Wearing's (1992) theory, where the stocks and flows have been turned into resources and

challenges. The definition is shown in a model on the next page for easier understanding:

Well-being Resources Psychological Social Physical Challenges Psychological Social Physical

Figure 1: Model of well-being (Dodge et al., 2012)

The idea with this approach is, according to Dodge et al. (2012), that well-being should be seen as a balance point between an individual's resources and their challenges. Resources is the relevant skills people has to cope with, and challenges are the events that take place in a person's life. Each of the boxes in the weight presents the pool of tools we as individuals have. To reach the desired state of well-being, these must be brought to equilibrium (Dodge et al., 2012). The model has, however, received

criticism for its simplicity of the term. A counterpoint to this very complex term is that the world of academics is not alone in using this term of well-being. Well-being has become a term that is widely used in today's society, and the importance of creating and communicating a definition accessible to everybody has never been more important. Therefore, looking further into what well-being is at the workplace is essential (Lilienfeld, 2012).

2.4.1 Well-being at the Workplace

Well-being at the workplace is by The International Labour Organization described as a key factor. Furthermore, they point out that there is a direct link between productivity and the general well-being of employees, and employee well-being is also beneficial to the organizations (Justesen, 2015a, 2015b; Kazi, 2013). One of the benefits is that when employees reach a state of well-being, a chance of increased productivity arises

From above standing section on well-being it became clear that the term does not have one clear definition. However, it was stated that applying a simple explanation of a more descriptive character can be of value when using it in a non-academical setting (International Labour Organization, 2020; Lilienfeld, 2012). In literature, it becomes very clear that although the definition is simple, the act of it reaching it is not. This becomes even harder when you are a manager in an organization whose job is to make employees feel it too. The results of how well-being is created are, therefore, also inconclusive (Abdin, Welch, Byron-Daniel, & Meyrick, 2018; Keeman, Naswall, Malinen, & Kuntz, 2017).

The World Health Organization also recognizes the importance of employee well-being and describes it as vital (World Health Organization, 2010b). However, do they not discuss it as a term that can stand alone when discussing workers. Instead, they choose to use it as a component when discussing general employee health and say that for employees to reach the desired state of health, they must also have well-being. Well-being is in other parts of literature seen as the other way around. Instead, well-Well-being is the main term, and employee health is one of the components that must be reached when creating it (Abdin et al., 2018; International Labour Organization, 2020; Keeman et al., 2017; World Health Organization, 2010b).

Another point of view that was also discussed in above standing section is that well-being is an individual term. Therefore, it is a widely discussed factor that it will not be possible to create an organizational environment that fits everyone’s individual needs. Therefore, it is recognized that it, instead, is vital that organizations try to create an environment that gives employees room and opportunity to reach their personal state of well-being, by using the provided tools (Abdin et al., 2018; Keeman et al., 2017; Thøgersen-Ntoumani et al., 2005). Thøgersen-Ntoumani et all. (2005) therefore, argues that well-being should be seen as a context-specific concept (Ryan & Deci, 2001; Thøgersen-Ntoumani et al., 2005).

Keeman et al. 2017, describe which needs that to be fulfilled to reach the state of workplace well-being. Below standing components needs to be available in the environment: 1. Connect 2. Be active 3. Take notice 4. Keep learning 5. Give

The first component is "connect, which and is concerned with social relationships. The second "be active" relates to the importance of physical activity. The third one "Take notice", is about mental health and awareness of your feelings. "Keep learning" is about challenging yourself or trying something new. The last one, "Give," is about finding joy in being kind to a colleague or doing something good for someone in the work setting. The article describes how each of the components gives positive feedback in different ways, and how people who experience all of these are more likely to reach the state of well-being (Keeman et al., 2017). Although these are all specific elements that have to be present at the workplace, do this study, when looking back to Ryff (1989) and Dodge (2012), not differ significantly. Instead, it contains many of the same elements as what is also seen in the model of Dodge et al., (2012) (see figure 1), where the components are a combination of “resources” and “challenges” presented in figure 1. The study by Keemann et al. (2017) focuses solemnly on well-being at the workplace and does not consider other aspects of employee's life. They isolate the arenas of people's lives, and by that argues that employee performance theoretically should be maximized with these components present in the environment.

Another definition and a different point of view were made by Abdin et al. (2018). They suggested that well-being can be defined as “Individual realizing his/her own

while working” (Abdin et al., 2018, p. 71). Their definition does, opposite to Keeman et

al. (2017), not isolate different areas of a person's life. They argue instead that well-being at the workplace cannot be reached without a general satisfaction with life is also present. Instead, they suggest that the workplace and general life are interdependent and that one cannot exist without the other (Abdin et al., 2018) This supports Dodge et al. (2012) thoughts about finding your personal balance. By following these thoughts, an employee can have all five components fulfilled but not reach the state of well-being if other components in his or her life are not in balance.

2.5 Physical Activity and Social Relationships

Studies of social capital have found that being a member of a sports club is positively related to social interactions (Lindström, Moghaddassi, & Merlo, 2003; Seippel, 2006). Especially sport participation in teams or larger groups increases the social capital (Di Bartolomeo & Papa, 2019). The study by Di Bartolomeo & Papa (2019) did also find that the social relations created in a sport setting more often than not go beyond the setting it has been created in. The reason for social bonding is that when people experience the same things, the chance of gaining social capital increases. To support this argument, it is also found that if you do not have friends in a sports club, you are more likely to skip a workout than if you have people who expect you to come (Unger & Johnson, 1995). The social bonding can, moreover, be increased when people have been in situations together where they have been stressed or pressured either physically or mentally, which sport or physical activity has the potential to do (Di Bartolomeo & Papa, 2019; Seippel, 2006). Unger & Johnson (1995) nger & Johnson (1995) does, therefore, also suggest that friendship that involves exercising together may be a more significant motivator than the exercise in itself

2.5.1 Physical Activity and Social Relations at the Workplace

The workplace is in many ways a representative of the society (Andersen et al., 2015). Therefore, does many of the same things as in above standing section also apply at the

workplace. Physical activity at the workplace is often presented as a group based activity (Andersen et al., 2015). Knox et al. (2017) arguments that the reason for this is to motivate employees to participate. Das et al. (2016) support that with finding that people often are inactive because they do not have a social support system at home. At the workplace, however, physical activity will create an opportunity to create bonds that will benefit the individuals both inside and outside the work setting.

Another benefit to socializing while being active at the workplace is mental health (Michishita et al., 2017). Michishita et al. (2017) study reported that participants who had done physical activity during their lunch break with colleagues decreased their level of stress and generally felt happier. Andersen et al. (2015) headed in the same direction a couple of years before and found that physical activity in the workplace generally increases the social relationships between employees. The employees emphasized that it strengthened their relationship with colleagues because it gave them a common interest beyond their job and they had experiences with each other that had nothing to do with their standard work setting. This advantage of physical activity was also reported to strengthen their relationship in later working situations where they did not agree on a subject (Andersen et al., 2015). Blake et al. (2008), and Rodriguez-Allyon et al. (2019) have reported similar results and point out that meeting people in a more informal setting also created new relationships both professionally and personally inside

organizations. A supplement to this did Thomas et al. (2015) make when they noted that increasing social relationships only happen when an employee generally feels good in the working environment. If this is not the case, the social perspective can be a big barrier. Instead, the employee will be embarrassed about themselves. This will potentially affect both the general motivation for going to work and naturally, their participation in the physical activity. The employee might already feel like an outsider of the social setting, and when not participating in a social thing, that feeling can be increased (Thomas et al., 2015).

2.6 Sedentary Behavior and Health

Sedentary behavior is by the World Health Organization characterized by “a very low

energy expenditure, such sitting, reclining or lying down” (World Health Organization,

2018a, p. 8). Research shows that extended periods of sedentary behavior is associated with overweight, metabolic risk factors, type 2 diabetes, cancer, and mortality from all causes of cardiovascular disease (Gierach et al., 2009). Katzmarzyk et al. (2009) did in their study find that even though a person meets the recommendations for physical activity, it does not compensate for the excessive time of sitting. Instead, it still increases the risk of developing a lifestyle disease. Therefore do they point out that future recommendations for physical activity should address the daily sitting time and not just daily bodily movemen (Katzmarzyk, Church, Craig, & Bouchard, 2009).

In his dissertation, Kazi (2013) continues down the same road as Katzmarzyk et al. (2013). He argues that it is crucial to recognize that sedentary behavior is not necessarily a lack of physical activity but should solemnly be seen as a cluster of activities at low energy expenditure. Therefore, he also emphasizes that physical

activity and sedentary behavior are not necessarily related to one another. He points out that due to a changing society, how it, during the last many years, has developed with automatization and technology, large numbers of people in the Western World today has become more sedentary during their day. Many possess sedentary jobs and use transportation that often requires them to sit down. He, therefore, believes that for many, sedentary behavior becomes an occupational hazard. Kazi (2013) points, furthermore, out that there today are very different demands when it comes to staying active throughout the day than before the technological development in the Western World. The natural movement that many jobs before required are now sedentary. He argues, therefore, that to decrease sedentary time during the workday, it should be recognized as public health priority (Katzmarzyk et al., 2009; Kazi, 2013).

2.7 Promotion of Health and Physical Activity at the

Workplace

Workplaces are in literature generally seen as a good place for health promotion and physical activity (Das et al., 2016; Grande, Cieslak, & Silva, 2016; Jirathananuwat & Pongpirul, 2017; Knox, Musson, & Adams, 2017; Nooijen, Blom, Ekblom, Ekblom, & Kallings, 2019; Price, Mackay, & Swinburn, 2000; Tanir & Özmaden, 2018; Thomas et al., 2015). The reason for this statement is in studies often that people spend around fifty percent of their waking hours at their job, provided that a workday is around eight hours. Therefore, the workplace is a very logical place to promote living a healthy lifestyle. Argumentation for using the workplace to target is that when spending that many hours there, it is possible to be constant in the promotion and do it in a systematic way to create the biggest effect (Price et al., 2000). Many studies and reports have, for the same reasons, therefore, been developed throughout the years. One of the most positive things about physical activity at the workplace is that not only does it benefit the employees participating but also the organizations(Das et al., 2016; Grande et al., 2016; Jirathananuwat & Pongpirul, 2017; Kristiansen, 2019; Mansfield & Piggin, 2016; Marquet & Hipp, 2019; Nooijen et al., 2019; Rodriguez-Ayllon et al., 2019).

In literature, have the concept of physical activity been widely discussed. What differs mostly in the literature is the point of view from which the articles are written. The two points of view which are mostly used are the organization’s providing the activities or the employees performing the activities. The importance of discussing the point of view should be emphasized since they have different end goals as their success criteria. The primary goal for both parts is their health. For the employees, health is this, of course, their physical and mental health, while it for the organizations is their increased productivity, and healthy employees is seen as a way to get there (Knox et al., 2017; Nooijen et al., 2019; Price et al., 2000; Tanir & Özmaden, 2018). Research shows that the healthier the employees are, the more productive they are. Implementing physical activity at the workplace can, therefore, be a beneficial action to take. It can decrease

the average number of sick days and increase the energy level which will make

employee perform better (Thøgersen-Ntoumani et al., 2005). The different perspectives are important to recognize when looking through literature. The reason for this is that motivation for why a study is created differs widely due to priorities. and (Abdin et al., 2018; Batt, 2009; Blaakilde, Hansen, Olesen, & Wingstrand, 2018; Fitness Solutions, 2019; Justesen, 2015a, 2019; Justesen & Holm, 2019; Muir et al., 2019; Siggaard, 2014; To, Chen, Magnussen, & To, 2013).

A thing that is central for most studies is that they all strive to create an effect, that looking in the long-term perspective will make a difference. Unfortunately, has this been one of the things that studies have a hard time finding. This is partly because many researchers do not follow the organizations long enough to measure an effect over a more extended period of time. The other part is that the researchers that do follow organizations for a longer period of time have yet to prove the difference they have created in an organization. A hypothesis to why a long-term effect has not yet been found is that researchers have not found one right way to implement physical activity at the workplace (Batt, 2009; Mainsbridge, Cooley, Fraser, & Pedersen, 2016; Muir et al., 2019; Sahin et al., 2018; Siefken, Junge, & Laemmle, 2019; Siggaard, 2014; The Institute for Health and Productivity Studies & Johns Hopkins Bloomberg School of Public Health, 2016; Thiese, 2014; Thomas et al., 2015; To et al., 2013).

An often discussed subject when promoting physical activity and health at the workplace is the importance of recognizing that all organizations are different (Burn, Weston, Maguire, Atkinson, & Weston, 2019; Voxted, 2013). When promoting, it is vital not only to consider the business orientated side of an organization, but also the internal culture, the physical environment, and workplace location. Those components are what create the circumstances for what is possible to implement (Burn et al., 2019; Burnes & Jackson, 2011). Especially the internal culture of the organization is widely discussed in the literature. Price et al. (2000) found that employee motivation is the key to successful promotion and implementation, and that participation is very dependent on

approval from an employee’s closest leader. Bernstein and Nash (2008) do in line with Price et al. (2000) also state that because we as humans seek approval from authorities, we tend not to participate if we do not feel that our closest authority seems committed or supportive of the initiative. Knox et al. (2017) supports this argument and continues with findings that clearly show that it does not matter what the top management of an organization does if they do not communicate this to all management-levels. However, does the study suggest that organizations with a wide organizational structure tend to have more success with implementations of physical activity because they are in closer contact with their leaders than organizations with a steep structure and many layers (Knox et al., 2017; Voxted, 2013). If the management instead proves to be supportive and even participates in activities, the employees feel more comfortable are more likely to be motivated (Bennie, Timperio, Dunstan, Crawford, & Salmon, 2010; Coulson et al., 2008). Another perspective when it comes to motivation is that studies report success with the implementation of physical activity when making participators

understand that they are responsible for their own health and that they are the only ones that can make a difference (Knox et al., 2017).

2.8 Physical Activity Interventions and Implementation at

the Workplace

Implementing physical activity at the workplace has been done in many different ways. It is essential to mention that implementations mostly happen by using interventions (Mainsbridge et al., 2016; Price et al., 2000; Seaton, Bottorff, Jones-Bricker, & Lamont, 2018; Tanir & Özmaden, 2018). An intervention can be characterized by “an action

taken to improve a situation” (Oxford University Press.). Before implementing the

intervention, organizations or researchers should, according Nooijen et al. (2019), have identified the one or more challenges that they would like to address. A reason for this is that research shows that organizations who have not identified what they want to obtainbe, can have substantial consequences for the progress of the intervention. An example is that the combination of activities often has significant meaning when it

comes to creating results. Without clear wanted results, choosing the right exercises or activities will be difficult. While some strive to create better physical health, others focus more on mental health. Attempts to create a combination of the two is also widely seen. The combination of physical and mental health is often, in literature, described as the term "well-being." For the moment no literature has yet to prove whether one of the three has more success than one of the others (Andreasen, Falk, & Niels, 2010;

Arbejdstilsynet, 2006; Blaakilde et al., 2018; Great Place to Work, 2019; Justesen, 2015a, 2019; Justesen & Holm, 2019, 2020; Siggaard, 2014; Sørensen, Nielsen, & Christensen, 2017).

As stated above, using interventions is a popular way to promote health and implement physical activities. What is central in litterateur about physical activity interventions at the workplace is the purpose of doing it. The purpose of creating physical activity interventions is to implement changes to make improvements in an existing

environment by using a clear strategized structure (Jirathananuwat & Pongpirul, 2017; Price et al., 2000; Tanir & Özmaden, 2018; Thomas et al., 2015). The argument for using interventions is from Thomas et al. (2015) that it makes it possible to implement several changes at the same time. If adding them one by one, there is a risk that they replace each other instead of being combined, and no change will be made.

It is pointed out that creating interventions can differ depending on the organization (Coulson et al., 2008; Price et al., 2000). This, both with regard to what the individual organization wishes to improve, what type of activities they want to organize, but also the physical environment plays an essential role since it creates natural limitations for what is possible to implement and also what an organization can demand from their employees (Blake, Lee, Stanton, & Gorely, 2008; Grande et al., 2016; Knox et al., 2017; Kristiansen, 2019; Marquet & Hipp, 2019; Price et al., 2000; Seaton et al., 2018). The employees are also a big factor when it comes to creating an intervention. Seaton et al. (2018) emphasize that it is important to recognize that there exists a big difference between men and women when it comes to the concept of "physical activity at the

workplace." The study found that men, in general, are harder to motivate and should, therefore, be targeted with more specific activities. This means that when planning an intervention, the distribution of men and women should be taken into consideration as well. Thomas et al. (2015) reported that one of the main differences between men and women is that men are often more driven by competition, while women are more concerned with the direct health benefits exercising can bring. Creating activities that target both genders is, therefore, a beneficial action to take (Leicht, Sealey, & Devine, 2013).

When creating an intervention, a general starting point in literature is that all activities need to be accessible for all employees and activities should take place "in-house" or at least have its staring point there (Burn et al., 2019; Das et al., 2016; Edmunds, Hurst, & Harvey, 2013; Hutchinson & Wilson, 2011; Jirathananuwat & Pongpirul, 2017; Nooijen et al., 2019). Unger & Johnson (1995) found that creating interventions with activities that include a social component is the most effective. They found that emphasizing the social components also decreases the risk that people do not wish to participate or skip out on different activities. Social relationships motivate exercise behavior, and the study suggests that exercising with a social relation creates the greatest satisfaction, which is important for a person's mental health (Unger & Johnson, 1995). However, can the social component be different from person to person, and while some prosper in big groups, others benefit more from one on one contact. Organizations might increase their effectiveness by implementing both types of activities (Thomas et al., 2015).

3 Aim and Research Questions

3.1 Aim

The aim of this study is to investigate how a ten-week intervention with the

implementation of low-intensity physical activity influences the general well-being of employees from a sedentary office environment in a Danish organization.

3.2 Research Questions

1. How do employees from a sedentary office environment perceive changes in their mental- and physical well-being after the intervention?

2. How does the organization of the workplace affect the outcome of the intervention?

Due to the effects the outbreak of SARS-CoV-2 had on the data collection, this study will look at the following question:

3. How do employees from a sedentary office environment perceive changes in their well-being and physical activity level when transitioning from working in an office to working from home full-time?

3.3 Delimitations

The study aimed to investigate how a ten-week intervention with low-intensity physical activity can influence the general well-being of employees in a Danish Organization. Since this study does not wish to measure any bodily change, employees' performance during the intervention was not measured. Instead, all data are based on the employees' feelings and perceptions which are collected through surveys and interviews. To capture employees’ feelings and the organization of the workplace, questions about the

organization, work routines, and leadership are asked. However, does the study not wish to measure any work performance or production but is solemnly concerned with their well-being at the workplace.

Due to the situation of SARS-CoV-2, does this study also concern itself, with the situation where employees work from home. The virus outbreak changed the study, and actions had to be taken to secure its continuance. Therefore, does the study only wish to investigate the concept of employees working from home in relation to the ongoing intervention and how it affected the participants’ physical activity and general well-being. It does not strive to create results that can be generalized to the concept of working from in general.

4 Methodology

4.1 Background

Following study is carried out in a medium sized Danish organization called Velliv. Velliv is a commercial pension company and the study takes place in their Customer Service department. It involves sixteen participants. The main occupation in the organization is office based sedentary work.

4.2 Research Design

The thesis is designed as an intervention study. It is an experiment that was carried out by implementing low-intensity physical activity at the workplace during office hours. The study aims to investigate if the intervention can have an effect on the participant’s general well-being. The intervention began January 20th_{, 2020 and ended March 27}th_,

2020. A timeline for the intervention can be seen below:

4.2.1 Intervention

The intervention lasted ten weeks and consisted of five activities, all of which were possible to perform inside the working environment or the area surrounding the office (Mainsbridge et al., 2016; Voxted, 2006, 2013). The intervention was set to ten weeks since research shows that it takes 66 days for a person to create a habit and to be able of evaluating its effect thoroughly (Mainsbridge et al., 2016). The design of the

intervention and validation technique was built on the theoretic framework of

Organizational Management Behavior. The framework will be presented in more details later on. To create the content of the intervention, observations of the physical

environment were made, and previous literature was used to develop and choose exercises that fit the aim of the study. Below are the five activities that were implemented in Velliv:

1. Stair walking

2. 1 hour working while standing 3. 5-minutes’ walk inside the office 4. 30-minute outdoor walks

5. Neck, back and shoulder exercises

The participants were told to stop all use of the elevator when moving between floors and only use the stairs. The second activity was raising their desk and stand up for one hour each day while working. The time could be divided as they wished throughout the day. The third exercise was a five-minute walk every 2-3 hours inside the office. These walks should include stairs. When presenting the exercises for the participants, they were encouraged to use a route that included walking down to floors, crossing the floor, up to two floors again, and cross back to their department offices. The fourth exercise participants were told to carry out were three 30-minute walks during the week, preferably in their lunch breaks. Employees were already familiar with two walking routes, which they were encourages to use. These were provided both physically and send by email. The routes can be seen in appendix 8.1. There are two different

distances, 30 minutes or 45 minutes. Looking at the map is can be seen that Velliv has two offices close to each other. All participants in the study were located at “LV10”. No recommendation of which route to choose was made. The fifth activity was neck, shoulder, and back exercises. A compendium of thirteen different exercises was handed out to each participant. They were asked to pick 3-4 different exercises each time and to carry them out at least three times per week. The compendium of exercises can be seen in appendix 8.2. Below a visual example of how a day during the experiment could look like:

4.2.2 Choice of Exercises

Stair Walking

Stair walking was part of this study because research shows that it is health beneficial. Stair walking increases energy expenditure and has the potential to raise the heart rhythm. Besides, is it a beneficial way to break up the many hours of sedentary behavior. Lastly, stair walking also has a social aspect. There is a chance that it

increases the number of people a person communicates with when walking the stairs as opposed to using the elevator and can create stronger social relations (Blake et al., 2008; Thomas et al., 2015).

Daily Activities:

- No use of elevator only stair walking

- 5 min. walk every 2-3 hours (includes stair walking) - Work standing 1 hour throughout the day - 30 minutes walk (three times per week) - Neck, back and shoulder exercises (voluntary)

7.00 AM 8.00 AM 9.00 AM 10.00 AM 11.00 AM 12.00 PM 1.00 PM 2.00 PM 3.00 PM 4.00 PM 5.00 PM

Raised Desk

Working while standing was chosen because it is associated with not only physical health benefits but does also increase alertness and generates positive emotions.

Standing op while working can decrease neck, shoulder, and back pain. It also activates the cardiovascular system and decreases the risks of lifestyle diseases. Moreover, it is also suggested that standing up has a positive effect on the productivity since research shows that working upright increases the creativity (Finch, Tomiyama, & Ward, 2017; Husemann, Von Mach, Borsotto, Zepf, & Scharnbacher, 2009).

5-min Indoor Walking

5-min walk inside the office with the inclusion of stair walking was added to the

intervention to decrease sedentary behavior and improve mental health by implementing small breaks during the day to clear the head and gain new energy. Furthermore, did it also have potential to increase social relations since participants were encouraged to walk with a colleague. In general, taking small breaks during the day is reported to have positive effects on the general well-being and decrease fatigue and stress during the day. Furthermore, does research show that taking breaks throughout the workday can

increase productivity, especially at the end of the day (Blasche, Pasalic, Bauböck, Haluza, & Schoberberger, 2016; Dababneh, Swanson, & Shell, 2001).

Lunch walks

The 30-minute outdoor lunch walk was added to the design because of the health benefits and its social benefits. Walking, therefore, has both physical and psychological benefits. This type of physical activity is something that everybody can participate in, and it does not exclude anyone. It decreases the sedentary behavior and helps in the prevention of lifestyle diseases. Moreover, does it generate positive emotions, decrease stress, and increase productivity. It also helps with releasing the body of tension from desk work. Research also shows that a conversation flows easier when walking, and does, therefore, help improve social relations and can create new relationships.

(Thøgersen-Ntoumani, Loughren, Duda, Fox, & Kinnafick, 2010; Thøgersen-Ntoumani, Loughren, Taylor, Duda, & Fox, 2014).

Neck, Back, and Shoulder Exercises

The neck, back, and shoulder exercises were chosen since office workers often suffer from one or more of these pains due to the many hours of desk work (Green, 2008). Moreover, when looking through results from a Workplace Assessment Survey made in the fall of 2018 in Velliv, it was evident that this was a big issue amongst the employees (Velliv Pension & Livsforsikring A/S, 2018). The exercises can help release pain and prevent it from occurring in the future. Not suffering from daily pain increases the general well-being (Green, 2008; Schneck, 2019).

4.2.3 Implementation

On December 20th_{, 2019, all employees from Customer Service in Velliv received an}

email with the invitation to participate in the intervention. The email was sent out to 138 individuals. All terms and information about the intervention was described in the email. Sixteen employees replied to the email with a wish to participate; all of them were women. By signing up to participate, they also agreed to answer three surveys and participate in a focus group interview. The experiment began on January 16th_{, 2020. All}

the participants were brought together, and the intervention was explained in detail. Here they also had the opportunity to ask questions. In this meeting, everyone also completed the baseline survey.

4.3 Data Collection

4.3.1 Surveys

To measure the effect of the physical activity, three surveys were distributed to the participants throughout the ten-week intervention. All three surveys contained the same twenty-six questions (Olsen, 2006). The surveys ask the same questions to measure changes within the ten weeks. The surveys consist of multiple-choice questions to avoid

individual interpretations and answers to the questions (Olsen, 2006). Most questions followed the Likert scale. However, was it not possible to create them all after this structure due to the content of the question (I. Andersen, 2014). The questions were divided into following five different themes, and together they aimed to capture the different perspectives and dimensions of what lies in the concept of well-being (Abdin et al., 2018).

1. Physical Activity Level Outside of the Workplace 2. Phycological Environment

3. Social Relations

4. Physiological Environment 5. Organizational Changes

The purpose of using the surveys was to measure and follow the development participants went through during the ten-week intervention. The development of the questions relies on previous literature and Velliv’s latest workplace assessment survey, which was published in the fall of 2018. Moreover, were other surveys published by other organizations also used as inspiration. The questions were created in Danish and went through two rounds of validations with third parties before being distributed to participants (Guadagnolo, Cina, Koop, Brunette, & Petereit, 2011; Wordminds, 2019). The first survey was, as previously mentioned, handed out a few days before the intervention began, the second survey was distributed and collected after the first five weeks, and the last survey was handed out the first working day after the intervention ended. The first two surveys were distributed physically, and the last one online due to the outbreak of SARS-CoV-2 in Denmark (Olsen, 2006).

The purpose of the first survey was to create a baseline. The baseline is the starting point of the study, and it is the results that the survey provides that the intervention aims to improve. The survey is the first data, and it is this data the results from the two following surveys was compared to when investigating whether a change in the general

well-being was seen (Olsen, 2006). The two following surveys, asked, as previously stated, the same twenty-six questions. The surveys asked the same questions to make it possible to compare the results with each other and find a potential effect from the physical activities (I. Andersen, 2014; Olsen, 2006). The second survey was distributed in the middle of the process to be able to investigate whether a change could be seen after only five weeks. Moreover, was it interesting to be able to compare the results from the third survey, both five and ten weeks back and look at the developments. In the end, the second survey became important in a different way, because that was the last primary data collected at the workplace.

4.3.2 SARS-CoV-2

The unforeseen event of the virus, SARS-CoV-2, hit Denmark in the beginning of March 2020. During the seventh week of the ongoing intervention, on Wednesday, March 11th, 2020, the Danish Government decided to close down the country. Everybody was here advised to work from home. From Thursday, March 12th, 2020, Velliv encouraged all employees to start working from home. From Monday, March 16th, 2020, all participants in the intervention worked from home. The Government asked the population to stay home as much as possible, but there was no actual prohibition of leaving your home. These amendments lasted past the end date of the intervention (Den Danske Regering, 2020).

Therefore, was the data from the third survey was collected after participants had worked from home for two weeks. The purpose of the third survey was, after the

intervention ended, to investigate if the ten-week intervention had made a difference for the participants (I. Andersen, 2014). Due to the outbreak of SARS-CoV-2 virus, many participants were unable to uphold the execution of activities that the intervention requested initially. This significant change in the participant's life can have affected the results in the third survey. The midway survey helped as a guideline with the

assessment of the post-survey. A guideline was essential, due to the importance of recognizing the effect of the SARS-CoV-2 situation.

4.3.3 Interviews

Focus group interview

After the experiments ended, focus group interviews were planned, and all participants had received and accepted an invitation for the interview. The participants were divided into four groups. The purpose of the focus group interviews was initially to create an opportunity to start a conversation between the participants. The conversations were meant to have its point of departure in participants' individual experiences throughout the intervention and to discuss the concept of "physical activity at the workplace" (Halkier, 2002). The interviews were planned to take place during the first two weeks of April 2020. However, with the virus, everybody working from home, and not at least, the government's recommendations to not be in unnecessary physical contact, the interviews were no longer a possibility. Considerations about hosting the focus groups interviews with help from online video conference tools were made, but in the end, rejected. In the focus group interviews, the dynamics between the participants are essential, and tt would be almost impossible to create the same effect online (Halkier, 2002; Merriam & Tisdell, 2015).

Individual Interviews

Due to the virus, the design of the study needed to be changed. Instead, individual interviews with six participants were conducted. The interviews were all conducted as video interviews, since doing them in person was not possible. Before any interviews were conducted, an online pilot-interview was made with a third party for validation (Bryman, 2012). Conducting interviews with all participants would have been preferred. Unfortunately, was this not a possibility with time being a preventing factor

(Tonnequist, 2009). The interviews were conducted using the video conference program called "Teams" since each participant, with their employment in Velliv, already has an account and is familiar with the tool.

During the development of the interview, an active choice to use the SARS-CoV-2 situation was made. After getting in touch with the organization to gain approval, a new research question was created, and questions regarding the situation developed. The choice to use the situation actively instead of ignoring it was due to the impact the situation most like would have on collected data. Instead, a stronger validity, especially in the survey, could be obtained by investigating participants' feelings and perceptions while standing in the middle of a difficult situation (Bryman, 2012). This could be seen as a supplement in understanding the result from the post-survey. Before conducting the interviews, an interview guide was sent to all participants. The guide can be seen in appendix 9.4. The interviews were semi-structured, and all consisted of 25 questions, follow-up questions excluded. The questions were divided into the following five groups:

1. General about physical activity 2. Physical activity at the workplace 3. Social Relations

4. Corona (SARS-CoV-2) 5. Velliv

The purpose of the interviews was to investigate the concept of "physical activity at the workplace" by asking questions about the participant's experiences throughout the intervention. These to use for a later interpretative phenomenological analysis. The interviews allowed participants to evaluate their experiences and reflect upon them (Pietkiewicz & Smith, 2014). The questions consisted of many of the same elements as in the survey for them to complement each in the later analysis (I. Andersen, 2014). Moreover, questions regarding the transition to working from home and physical activity were created to investigate the feelings and perceptions of this experience. The interviews strived to obtain information about the participant's well-being in the special time, and how they felt it had affected them individually. The interviews asked broad questions to make room for any perception participants might have. To create this

reflection, open-ended questions were asked, which was essential for the forthcoming analysis (Pietkiewicz & Smith, 2014).

4.4 Scientific, Social, and Ethical Considerations

4.4.1 Scientific Considerations

The study consists of both qualitative- and quantitative data. The mixed methods increase both the validity and reliability of the study. The qualitative data collection is applied to seek understanding of the circumstances around the research questions while the quantitative data measure the change (Merriam & Tisdell, 2015). The internal validity of the study strived for strength by building the intervention on previous studies to modify it to the specific context (Bryman, 2012). Moreover, should it by

implementing an intervention based on previous research also make it possible to strengthen the external validity (Bryman, 2012). The external reliability is concerned with whether it is possible to create the same results again. Since only one intervention will be done in this study, which did not get the opportunity to be properly carried, does, and moreover does not have a control group, it is not possible to say whether the results are repeatable (Bryman, 2012; Voxted, 2006). The interviews strengthen the internal reliability of the study because interview participants were asked the same questions about the phenomenon. Together it is their perceptions and reflection that stand as the foundation for the analysis, which creates a broader knowledge of the concept. The study strives for objectivity, but it can be affected by the researcher being employed in the organization (Merriam & Tisdell, 2015; Voxted, 2006, 2013).

SARS-CoV-2

The situation of SARS-CoV-2 is for everyone unknown, and not much data has yet been published. Results connected to this should, therefore, be seen as a contribution to the field. However, should this not be seen as a representative selection of the society, since interviews are conducted with six women who possess the same job type from the same organization. Moreover, is the study created in a Danish context, and the results might not be considered translatable in other contexts (Voxted, 2006).

4.4.2 Social Considerations

This study should be seen as a supplement to the field of sport science and as an inspiration for similar organizations to make changes in their environment to increase the employer's general well-being. Moreover, it can also be seen as an inspiration for how physical activity can be used in the workplace setting and what activities can be implemented in everyday life without creating major changes. Sedentary lifestyles have become an increasing challenge in our society. Especially the workplace, represents a big risk, with so many hours of sedentary positions each day. Creating more knowledge in the area, promoting and clarifying the importance of the societal challenge we are against, benefits the society (Siggaard, 2014; Voxted, 2006, 2013).

However, it is also important to be aware of the limitations of the study. Since it only consists of sixteen participants, all women, it should be considered a modified version of reality. Results can, therefore, not be translated directly to another workplace setting. Another thing that needs to be considered when discussing limitations is the researcher's employment in the organization since it can have affected the study. This can affect researcher and have affected participants commitment and performance in the study, both positively and negatively (Bryman, 2012; Merriam & Tisdell, 2015; Voxted, 2006, 2013). In light of the above standing, the study does, therefore, use a neo-positivistic point of view with epistemological consequences. It creates awareness about the fact that the study might not be able to find the complete truth. As humans, we are affected by our feelings, biases, and values, and even though the study strives for objectivity, it also recognizes the human being inadequacies. These things limit to what degree realism can be obtained, and instead, a modified truth is presented (Voxted, 2006, 2013).

4.4.3 Ethical Considerations

On December 6th, 2019, the director of Customer Service approved the idea of the intervention and signed off for it to take place. Moreover, did he right after sent out an email to all managers in the area, with the information hereof. In the email, the study was shortly described. On December 20th, 2019, all employees in Customer Service received an email with the invitation and opportunity to participate in the intervention (Voxted, 2013). An agreement with the organization meant that no collected data would be shared with anyone inside the organization.

In the email which was sent to all potential participants, the intervention was described thoroughly, and no content was left out. Here anonymity in the study was also declared. The researcher is employed in the organization, and the opportunity to meet personally and discuss participation was offered. Due to the researcher's employment in the organization, the anonymity of the study was highly emphasized. It was stated that no obtained information could be used for any other purposes. The email also declared that participation would not affect their job situation. After finding the sixteen employees who participated in the study, written consent was obtained. Furthermore, was all rules related to GDPR followed (Malmö University, 2019; Silverman, 2017).

Following the situation of SARS-CoV-2, the first design was changed, and the terms the participants had agreed to were no longer possible to execute. After getting approval from the organization, the design was changed, and participants noted hereof. Since no physical contact was possible, a new written consent was not possible to obtain. In this situation, Velliv has, as an organization, decided that when making internal agreements, terms can be agreed on by confirmation emails (Jensen, 2020). Therefore, a new email was sent out to all participants, and they were asked to reply with a confirmation email if they agreed to the new terms. After receiving the emails, the study continued.

The interview guide was attached as a file to the email when inviting people to

to read through the email and interview guide before agreeing. In the interview guide, it was noted that the interview would be recorded with the program "Teams" and that it would only be used for this study. If they could agree on these terms, they were asked to send back a confirmation email. When starting the interviews, the participants were notified of being recorded.

4.5 Data Analysis

4.5.1 Statistical Analysis

To interpret the data collected from the surveys, a statistical analysis was used. The three surveys had the same questions, and it was, therefore, possible to use the first survey to create a foundation for the study. After the answers from the second and third surveys were collected, it was possible to compare the results to the baseline, and hereafter evaluate in which areas the intervention had made a difference (Guadagnolo et al., 2011). The data were analyzed using descriptive analysis. The analysis compared the distribution of the answers from the baseline to midway and post-survey.

("Analyzing Quantitative Data," 2003).

4.5.2 Interpretative Phenomenological Analysis

To analyze the data from the interviews, an interpretative phenomenological analysis was used. The analysis was chosen because it aims to provide a detailed examination of a personal lived experience. The analysis produces an account of lived experiences in its terms rather than creating a hypothesis (J. A. Smith, & Osborn, M., 2003; J. A. Smith & Osborn, 2015).. In this thesis, the analysis strives "to make sense of the participants

trying to make sense of what is happening to them." (J. A. Smith & Osborn, 2015, p. 41). Put in a different way, does the analysis examine the participants' experiences

during the intervention (J. A. Smith, & Osborn, M., 2003; J. A. Smith & Osborn, 2015). The purpose of using interpretative phenomenological analysis was to learn something about the participant's thoughts and feelings going through the intervention. It is trying to understand the content and the complexity of their thoughts (J. A. Smith, & Osborn, M., 2003). To create the analysis, the transcripts from the six interviews were read and

reviewed several times to become familiar with the content (J. A. Smith, & Osborn, M., 2003). In this review, the identification of themes began. All themes from each

transcript were collected, and it was possible to connect them and develop them

further(Pietkiewicz & Smith, 2014; J. A. Smith, & Osborn, M., 2003). The process can be seen in appendix 9.5. This process ended in five themes regarding "physical activity at the workplace," and four themes regarding "the transitioning to work from home," which will be used for the actual analysis: The themes can be seen below:

In the first part regarding physical activity at the workplace following themes will be presented: 1. Effects of Intervention 2. Social Relationships 3. Group Motivation 4. Practical Conditions 5. Workplace Expectations

The second part, regarding the transitioning to work from home, consist of following themes:

1. Work-life Balance 2. Workplace Expectations 3. Social Relationships 4. Physical Activity