Workplace health promotion for healthy aging: a randomized controlled trial within the Semmelweis-EUniWell Workplace Health Promotion Model Program comparing email-based and face-to-face motivational interviewing to increase step count

Abstract

With the aging population in Europe, particularly Hungary, unhealthy aging is emerging as a growing public health challenge. Physical inactivity is a modifiable risk factor for age-related diseases and remains highly prevalent. Increasing daily physical activity is a key strategy for extending health span. Step-count-based interventions, including motivational interviewing and email-based feedback, have been shown to promote physical activity, but direct comparisons of these approaches in workplace settings are limited. Conducted within the framework of the Semmelweis-EUniWell Workplace Health Promotion Model Program, this study aimed to evaluate the effect of two scalable workplace interventions compared with a control group on increasing daily step count and total weekly physical activity, and to examine the sustainability of intervention effects over six months. In this three-armed randomized controlled trial, Semmelweis university employees were assigned to one of three groups: combined program of face-to-face motivational interviewing and email-based motivation, email-based motivation program alone or a control group with no intervention. Daily step counts were self-reported using participants' personal smart devices and recorded at baseline, every two weeks during an eight-week intervention, and at 1-, 3-, and 6-month follow-up. Total weekly physical activity was assessed using the International Physical Activity Questionnaire. Changes were modeled and compared with mixed model regression. A total of 155 employees participated (49 in the face-to-face motivational interviewing group, 53 in the email-based motivation group, and 53 controls). Both interventions were associated with increased step counts during the intervention period compared with control, with an average increase of 1,624 steps per day. Initial improvements were comparable between the two intervention groups, but the decline in step count during follow-up was slower in the face-to-face group. Additionally, at one-month post-intervention, the face-to-face group also showed a significantly higher total MET-minutes per week (997 MET/week) compared with controls. Both face-to-face and email-based interventions were effective in increasing physical activity during the intervention period. The slower decline in the face-to-face group suggests differences in sustainability between approaches. The results suggest a potential short-term benefit of workplace health promotion programs on physical activity, and that motivational interviewing may support longer-term maintenance of gains. Embedding such hybrid interventions into broader healthy aging strategies, such as those promoted by the Semmelweis-EUniWell Workplace Health Promotion Model Program, offers a promising pathway to address the aging challenge in Hungary and across Europe. Looking ahead, artificial intelligence-driven tools could enhance these programs by delivering personalized feedback, adaptive goal setting, and real-time engagement at scale, complementing human-delivered motivational support and further extending their reach and impact.

Keywords: Aging population; International physical activity questionnaire; Semmelweis–EUniWell workplace health promotion model program; Step count; Workplace health promotion.