Changing diet and physical activity in nurses: a pilot study and process evaluation highlighting challenges in workplace health promotion

Objective: To use the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework to evaluate and understand key implementation and context factors of a diet and physical activity (PA) workplace intervention for nurses.Methods: A 3-month pilot intervention was developed to promote diet and PA behavior through selfmonitoring, goal setting, and social support using pedometers, a smartphone app, and a dedicated Facebook group. Measures included diet quality, daily PA, adoption, and implementation (including qualitative data). Maintenance was assessed at 6-month follow-up. Results: Forty-seven nurses participated in the study. At 3 months, fruit and vegetable intake significantly increased (P = .04) whereas PA significantly decreased (P = .01). The intervention was partially adopted as planned, with low reach and efficacy. Participants reported that changing 2 behaviors at the same time was difficult, with the majority feeling it was easier to change diet than to become more physically active. Conclusions and Implications: The ability to change diet and PA behaviors at the same time was challenging in nurses. Future studies examining whether similar occupational groups with high stress, fatigue, and lack of time face the same challenges would contribute to understanding these results