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This paper sets out to provide an overview of the development processes, key drivers and the impact of a workplace health strategy developed in the North West of England, between 2005 and 2007. The strategy is led by a Regional Workplace Health Co‐ordinator (funded for two years by regional‐level bodies), and is aimed at a broad range of stakeholders across every layer of influence.

The paper consists of narrative which was co‐constructed by the Guest Editor (third author of the paper) and the co‐authors of the original strategy (first and second authors of the paper). A reflective interview was conducted with the first and second authors, who were interviewed by the third author in the summer of 2008. This interview was transcribed verbatim and then used to co‐construct the paper that follows. The key questions that the narrative was designed to answer were: why and how was the strategy developed? What was the interplay between national and regional levels of the system? What was the value/impact of the strategy?

The strategy provided an important platform from which regional players could develop actions that would, in the long term, positively influence the health of workers in the region. The scope and breadth of the regional strategy further informed national developments, but its effective delivery within the North West region was seriously hampered by the lack of co‐ordination, governance and ownership. The long‐term impacts of the strategy are not being measured as no funding was available for its evaluation.

Although many workplace health strategies have been developed, few are ever critically evaluated.

The purpose of this paper is to present an evaluation of the design of a stress management intervention (rather than an evaluation of the implementation and outcomes of the programme).

This paper uses data generated from a large study carried out in two social service departments in the UK. The study is carried out in three phases: first, a problem diagnosis phase, comprising the development of a questionnaire and survey (n=1,234); second, focus groups (n=16) to develop interventions in a participatory way from the baseline established; and finally, an evaluation of the processes involved in phases one and two.

Key barriers include: major changes are currently taking place within the organisations; staff are distrustful of management and sceptical of the value of the research; lack of resources; and difficulties translating the findings into actions. Key factors necessary for success include: strong commitment from senior management; willingness by staff to participate; realistic expectations, responsibilities and time‐frames agreed at the outset of the project. Key health promotion outcomes achieved include: improved health literacy; changes to organisational policies and practices and staff empowerment and participation.

Future research designing and implementing stress management interventions can draw on the evidence from this study in order to improve intervention effectiveness.

Evaluating the design of the stress management intervention has identified: what worked well, what did not, and in what context; difficulties associated with managing change; and unanticipated successes.

This paper provides an overview of the conditions which need to be created in order to achieve potentially successful outcomes and improve intervention effectiveness.

Awareness of potential health impact and variations in key risk factors for chronic disease are important considerations in multi‐site, workplace physical activity interventions. This study seeks to examine associations and site variations between workday step counts, sitting times, waist circumference and blood pressure in three universities.

Participants were white‐collar, university employees (172 women and 44 men; aged 41.0±10.3 years) from Barcelona, Spain (n=81), Brisbane, Australia (n=71) and Leeds, UK (n=64). Workday step counts and sitting times (five days) and waist circumference and blood pressure were assessed and compared against health‐related thresholds. Step counts were classified into tertiles and differences in sitting time, waist circumference and blood pressure were compared across tertiles using ANOVA, as were site variations in key variables.

Daily step counts were inversely associated with sitting times (p<0.05), women's waist circumference (p<0.05) and systolic (p<0.01) and diastolic (p<0.05) blood pressure. Activity rates – relative to the public health criterion of 10,000 daily steps – were lower in Brisbane (16 per cent) and Leeds (15 per cent), compared with Barcelona (47 per cent). Barcelona employees also sat less (p<0.001), had lower men's and women's waist circumference (p<0.01) and lower women's diastolic blood pressure (p<0.001).

The small number of male participants precluded meaningful analyses for men.

The findings evidence the health benefits of workplace walking in the samples and highlight the need to account for variations in multi‐site, multi‐national interventions.

Increasing physical activity (PA) is an international public health priority. This study aims to assess the impact of an environmental stair‐use intervention using “point of decision” prompts with varying messages in an NHS workplace in the UK.

Observational data were collected using a covert method (infra‐red sensors) in an interrupted time‐series design over an eight‐week period. Intervention consisted of posters displaying encouraging messages in the entrance to two stairways of an acute NHS hospital. The hospital site is a public building accessible to patients, staff (n=∼7,000), students and the general public. Questionnaires (n=221) assessed employee self‐reports of and attitudes towards stair‐use.

Following 24‐hour observational counts (n=143,514) no statistically significant differences were seen in either stair climbing or descent on either stairway through the introduction and removal of promotional posters. A number of determinants and barriers to stair‐use were identified. Posters were reported as “seen” by a low proportion of respondents (7‐25 per cent) and only a small number felt encouraged to use the stairs as a result of the prompts (25‐37 per cent of those who “saw” them, 3‐18 per cent of total sample).

The study evaluates the impact of a stair‐use intervention in a public hospital building, a setting within which research investigations have to date been limited. More research is needed to further investigate determinants and barriers to stair‐use and the impact of different message types and locations of “point‐of‐decision” prompts in a hospital setting.

Environmental interventions to increase stair‐use in this setting may be best placed within a comprehensive workplace programme including health education and multi‐component interventions.

“Point of decision” prompts are inexpensive as a long‐term intervention. As part of a large‐scale workplace health campaign, encouraging even a small percentage of employees to use the stairs in organisations of this size is of significance to workplace health promoters.

The purpose of this paper is to address the interplay of workplace exercising on self‐reported workplace performance.

A mixed methods design combined a randomised cross‐over trial with concurrent focus groups. Three workplaces (two private companies, one public service organisation) were purposefully selected for their provision of on‐site exercise facilities, size (>250 employees) and large proportion of sedentary occupations. Two mood diary questionnaires were distributed to employees exercising on‐site only. Order of questionnaire completion was randomised: self‐selected exercise‐day (ExD) or no‐exercise day (NExD) first. Exercise specifics (duration, intensity, mode) and ExD mood (pre‐/post‐exercise) were recorded. On NExD, mood was measured early and late in the working day. A 15‐item work performance grid was completed at day‐ends. Three on‐site focus groups were held concurrently to explore performance‐related topics.

Among 201 volunteer respondents (67 per cent female, mean age 38.2 years), mood improved on ExD, pre‐to‐post exercise (all p<0.01). Performance indicators were higher on ExD, versus NExD (all p<0.01), independent of exercise specifics and workload. Positive changes in performance outcomes were almost exclusively linked to changes in mood. Inductive analysis of focus groups revealed 13 (of 17) themes exhibiting positive outcomes. Employee tolerance and resilience were central to the subjective findings.

The naturalistic, dual‐paradigm study demonstrated that workday exercise can improve white‐collar workers' mood and self‐reported performance on days when they exercise at work over days when they do not. There are clear implications not only for employee wellbeing, but also for competitive advantage and motivation by increasing opportunities for exercising at work.

This is one of the few studies that addresses the acute effects of exercise in the workplace in the same people. Self‐rated productivity effects attributable to exercising during the working day were strongly mediated by changes in mood. Statistical power is amplified within the cross‐over design.

Instruments that measure the effect of health on productivity help to inform intervention programmes aimed at improving employees' presenteeism. The Work Limitations Questionnaire (WLQ) has been used extensively to measure presenteeism but has not been validated for use in the Catalan‐speaking population. The aim of this study is to translate and preliminarily test the reliability and validity of a Catalan version of the WLQ (CWLQ).

The WLQ was translated into Catalan using back‐translation. The final version of the instrument was administered to 19 volunteer university employees in Barcelona. Feasibility (employee debriefing) and psychometric evaluation included internal consistency (Cronbach's α), four‐day test‐retest reliability (intraclass correlation coefficient; ICC), and concurrent validity (ICC) in comparison with the original English WLQ.

Item analyses showed a high degree of internal consistency for the total score (α=0.80) and for the four scales of the CWLQ (subscale 1, r=0.82; subscale 2, r=0.80; subscale 3, r=0.81; subscale 4, r=0.78). The test‐retest reliability was also acceptable for the total score (ICC=0.69) and subscale 1 (ICC=0.68), subscale 2 (ICC=0.68), subscale 3 (ICC=0.67) and subscale 4 (ICC=0.75). The total score of the CWLQ showed good concurrent validity (ICC=0.81).

Preliminary results suggest that the CWLQ is a valid and reliable scale for the assessment of presenteeism in Catalan‐speaking employees. Use of the questionnaire will help to inform Catalan companies and business on how to effectively target presenteeism through health promotion interventions.