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There has been considerable interest in worksite health programmes to improve employee health and productivity with programme effectiveness possibly influenced by employment category and gender. The purpose of this paper is to examine the current quality of life (QOL), physical activity (PA) levels, sitting times, and barriers/motivators to undertaking PA between academic and professional, and male and female staff within a university workplace.

Participants (105 males, 192 females, n=297) employed as full-time staff of a regional university completed an online survey with differences between staff categories (academic vs professional) and genders identified via ANCOVA using sitting time and working hours as covariates. Relationships between variables were assessed using Spearman's Rank correlations.

Academic and male staff reported greater working hours (∼7-25 per cent, p<0.05) but similar QOL, seven-day total PA (∼3,600 MET-minutes per week) and sitting times (∼6-7 hours per day) compared to professional and female staff. The most common barriers for PA were lack of time or energy, with motivators including to feel good or improve health. Male staff reported these less frequently compared to females (∼13-25 per cent, p<0.05). Significant correlations between working hours and QOL (=−0.157 to −0.220, p<0.05), sitting time and QOL (=−0.195 to 0.171, p<0.05), and PA levels and QOL (=0.141-0.192, p<0.05) were identified for all staff.

The current study has demonstrated significant employment and gender differences in working hours with staff exhibiting similar QOL, PA and sitting levels. Gender differences in working hours, and PA barriers/motivators may provide important foci for the development of worksite health programmes to improve staff health and well-being.

The workplace offers an ideal setting for facilitating physical activity and reducing sedentary behaviours. Understanding employees’ current health behaviours is required to inform appropriate, tailored, health promotion interventions. The purpose of this paper is to compare the physical activity and sedentary behaviours over 12 months of employees within and across five UK organisations. The paper also explores the association of these health behaviours with objective and self-reported health outcomes; and investigates the association between physical activity and sedentary behaviours.

Self-reported physical activity and sedentary behaviours were recorded at four time points (baseline, three, six, 12 months). BMI, per cent body fat, waist circumference, blood pressure and resting heart rate were collected in health checks (baseline, 12 months). Well-being and health were collected via questionnaire.

Low physical activity and high sedentariness were evident. Sitting levels varied by occupational role and organisation. More activity was associated with improved health outcomes; no association was evident for sedentary behaviour. No direct effects of occupational role or organisation on health outcomes emerged after accounting for physical activity/sedentary behaviours. Physical activity and sedentary levels were weakly associated.

The low activity levels are of particular concern as linked to health outcomes for this sample. The weak association between behaviours suggests worksite interventions should target both behaviours.

This study provides insight into both the physical activity and sedentary behaviours of employees of large UK employers across different occupational sectors over 12 months; importantly it is informed by the most recent guidance for these health behaviours.

The purpose of this paper is to investigate the effectiveness of a workplace intervention designed to interrupt prolonged occupational sitting time (POST) and its impact on the self-reported health of a cohort of desk-based employees.

In total, 43 participants received an interactive computer-based software intervention for 26 weeks. For the first 13 weeks the intervention passively prompted the participants to interrupt POST and perform brief bouts of non-purposeful movement. The second 13 weeks involved the passivity of the intervention being removed, with the intervention only accessible voluntarily by the participant. This approach was adopted to determine the sustainability of the intervention to change workplace health behaviour.

ANOVA results revealed a significant interaction between group and test occasion, F(2, 42)=2.79, p < 0.05, such that the experimental group increased their total health from pre-test to post-test (13 weeks), and to second post-test (26 weeks) with a medium effect size of Cohen’s d=0.37.

An action research approach was implemented for this study, and hence the participants were organised into one group. Based on a communitarian model, the intervention aimed to monitor how desk-based employees adapted to specific health behaviours, and therefore a control group was not included.

Passively prompting desk-based employees to interrupt POST and perform non-purposeful movement at work improved self-reported health. Participant perceptions of health were maintained following the removal of the passive feature of the intervention.

Interventions predicated on a social ecological model that modify how employees interact with the workplace environment might provide a framework for health behaviour change in populations where sitting is customary.

The passive approach used in this study removed the individual decision-making process to engage in health behaviour change, and established a sustainable effect on participant health.

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.

Objective – To understand the role and influence of villagers’ trust for the health insurer on enrollment in a community-based health insurance (CBHI) scheme in Cambodia.

Methodology/approach – This study was conducted in northwest Cambodia where a CBHI scheme operates with the highest enrollment rates in the country. A mixed method approach was employed to gauge how individuals in the community trust the health insurer, and whether this plays a role in their decisions to enroll in CBHI schemes. Focus groups and household surveys were carried out to identify and measure trust levels, and to explore the association between insurer trust and enrollment in CBHI schemes.

Findings – Although villagers generally trusted the health insurance organization, villagers with poor experiences with other organizations in the past were less willing to trust the insurer. Insurer trust represented a combination of interpersonal and impersonal trust. After controlling for demographic factors, health care utilization, and household socio-economic status, insurer trust levels for villagers who newly enrolled (RRR=1.07, p<0.001) and renewed insurance (RRR=1.15, p<0.001) were significantly higher than those who never enrolled in CBHI schemes.

Implications for policy – This study illustrates the relationship between CBHI enrollment and villagers’ trust for the health insurer in a low-income, post-conflict country. It highlights the need for staff of health insurance organizations to place greater emphasis on building trusting interpersonal relationships with villagers. Understanding the nature of trust for the health insurer is essential to improve health insurance enrollment and protect people in poor rural communities against the impact of health-related shocks.

This issue of Research in Law and Economics covers several areas of important research by a variety of international scholars. It contains technical papers on the appropriate way to estimate damages in patent disputes, as well as methods for evaluating relevant markets and vertically integrated firms when determining the competitive effects of mergers and other actions. There are also papers on the implication of different legal processes, regulations, and liability rules on consumer welfare, which range from the impact of delays in legal decisions in labor cases in France to issues of criminal liability related to the use of artificial intelligence.

This paper presents some key theoretical issues about trust, and seeks to demonstrate their relevance to understanding of, and research on, health systems. Although drawing particularly on empirical evidence from low‐ and middle‐income countries (LMICs), the paper aims to stimulate thinking across country settings.

Drawing both on conceptual literature and relevant empirical research from LMICs, the paper presents an argument about the role of trust within key health system relationships and identifies future research needs.

Theoretical perspectives on four questions are first discussed: what is trust and can it be constructed? Why does it matter to health systems? On what is it based? What are the dangers of trust? The relevance of these theoretical perspectives is then considered in relation to: understanding the nature of health systems; issues of equity and justice in health care; and policy and managerial priorities. The identified research needs are investigation of: the role of trusting workplace relationships as a source of non‐financial incentives; the influence of trust over the operation of different forms of citizen‐health system engagement; approaches to training trustworthy public managers; and the institutional developments required to sustain trustworthy behaviour within health systems.

The policy and management actions needed to strengthen health systems within LMICs, and elsewhere, include: recruitment of health workers that have the attitudes and capacity for moral understanding and motivation; training curriculae that develop such motivation; and developing the institutions (e.g. communication and decision‐making practices, payment mechanisms) that can sustain trusting relationships across a health system. It is also important to recognise that distrust in some relationships may act to guard against the abuse of power.

Although the notion of trust has become of increasing importance in health policy debates in high‐income countries, it has received less attention in the context of LMICs. The papers adds to the very limited literature on trust in LMIC health systems and also opens new lines of thinking for those working in high income countries – particularly around the role of health systems in generating wider social value.

This paper aims to report a synopsis of a recent systematic review of the literature regarding the effectiveness of workplace physical activity interventions, commissioned by the National Institute for Health and Clinical Excellence (NICE).

A search for English‐language papers published between 1996 and 2007 was conducted using 12 relevant databases and associated grey literature. Search protocols and analysis regarding study quality as recommended by NICE were utilised. Key inclusion criteria were, workplace intervention aiming to increase physical activity, intervention aimed at working adults, intervention initiated/endorsed by the employer, physical activity outcome. Thirty‐three studies (38 papers) met the inclusion criteria and were independently reviewed (checked by two reviewers) with a narrative synthesis of findings.

Fourteen studies were graded as high quality or good quality. Evidence from previous systematic reviews was inconclusive. Data regarding the effectiveness of stair walking interventions was limited and intervention effects were short‐lived. Three public sector studies provided evidence that workplace walking interventions using pedometers can increase daily step counts. One good quality study reported a positive intervention effect on walking to work behaviour (active travel) in economically advantaged female employees. There was strong evidence that workplace counselling influenced physical activity behaviour. There is a dearth of evidence for small and medium enterprises.

Due to the necessary UK focus and time constraints, only studies from Europe, Australia, New Zealand and Canada were included.

The paper shows that there is a growing evidence base that workplace physical activity interventions can positively influence physical activity behaviour.

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.