Moving for Minutes: A Health Promotion Exemplar for Employee Wellness at a School of Nursing

Background

Scientists are increasingly recognizing the importance of regular physical activity for maintaining health in both generally healthy individuals and adults with chronic diseases or disabilities. Prolonged sitting can lead to poor health outcomes and an increased risk of becoming overweight or obese. Even small increases in physical activity can yield cumulative benefits, improving overall well-being. However, nearly 80% of American adults fall short of the minimum levels of exercise needed for long-term health (U.S. Department of Health and Human Services, 2018). Current recommendations suggest 150 to 300 minutes of moderate-intensity aerobic activity per week or 75 to 150 minutes per week of vigorous aerobic exercise (Piercy et al., 2018). The benefits of physical activity extend beyond the physical, enhancing mental, emotional, and spiritual well-being (Blake, 2022).

Increased emphasis has been placed on creating healthy work environments (National Academy of Medicine, 2024; National Institute for Occupational Safety and Health, 2024a; National Institute for Occupational Safety and Health, 2024b). For nursing, the American Association of Critical Care Nurses spearheaded improved work environments in 2005 with the Standards for Establishing and Sustaining Healthy Work Environments (American Association of Critical-Care Nurses, 2005/2016).

Nurses in clinical settings—such as hospitals, outpatient clinics, and long-term care—routinely educate patients about healthy lifestyle components, including the importance of incorporating exercise into daily life. While nurses are highly trusted to provide accurate health information, not all nurses follow the advice they offer. Nursing is a physically demanding profession, but nurses transitioning to academic roles may experience additional challenges, moving from active clinical work to more sedentary environments (Miner, 2019; Walker et al., 2021).

Although physical activity is widely acknowledged as essential for health, barriers such as busy schedules, low motivation due to fatigue/burnout, and the challenge of balancing work, home, and family responsibilities, often hinder consistent exercise patterns (Saunders et al., 2021). High teaching workloads, expectations to produce scholarly work, attending meetings, and extended office hours demanded by students often result in prolonged periods of sitting (Ruth-Sahd & Beyer, 2020). Teaching environments may be the source of much stress if there are low levels of recognition, salary, and administrative support (de Farias Brehmer et al., 2022). Nurses with long academic careers may also face cumulative deficits in physical activity, underscoring the need for increased movement (Quinn et al., 2022). For nursing faculty, the immediate transition to fully online teaching during the Covid-19 pandemic was especially challenging and extremely stressful (Farber et al., 2023).

Staff in the university environment typically engage in sedentary work, with long hours at the computer (Barkley et al., 2020; Faghy et al., 2022). Physical activity among university staff was also impacted by the pandemic, due to increased sedentary behavior with the closure of exercise facilities and working from home (Barkley et al., 2020; Wilms et al., 2022). Additionally, competing demands as staff respond to multiple faculty requests, poor recognition, and inadequate compensation may contribute to work-related stress (Bakah & Atiako, 2020).

Setting external goals can be effective for both intrinsically and extrinsically motivated individuals, supporting desired behavior changes (Morris et al., 2022). Joining others with similar goals can further facilitate adopting new activities while maintaining work-life balance (Heinrich et al., 2022; Sevild et al., 2020).

To address the challenges to physical activity, a school of nursing in Southern California developed the Moving for Minutes (M4M) program, a voluntary, no-pressure self-care exercise program initiated 15 years ago by a school of nursing employee (Michaelis, personal communication, October 10, 2024). The M4M program aimed to decrease stress, encourage increased physical activity, create camaraderie, and foster a fun, “healthy competition” among faculty and staff who spend long hours in sedentary work. The purpose of this report is to describe the effectiveness of this ongoing program.

Methods

The Moving for Minutes (M4M) initiative was a quality improvement program grounded in Pender’s Health Promotion Model M4M focused on creating a plan, setting goals, and building commitment to establish and sustain good health habits (Pender et al., 2002).

Program information was sent out by email and announced in meetings quarterly, inviting school of nursing employees (faculty and staff) to join. There were no eligibility requirements, as employees of all abilities were included. Potential participants were informed that the aim of the program was to increase physical activity beyond their day-to-day functioning and/or current exercise regimen. The scope of physical activity was limited to “premeditated, intentional, aerobic exercise.” Even though being generally active has been shown to be beneficial, the M4M program wanted specific, easily measurable exercise sessions. Each quarter, employees interested in joining M4M emailed their names to the coordinator, who then grouped them into teams with chosen names. Participants engaged in a physical activity of their choice—such as walking, jogging, cycling, or swimming—and recorded their daily minutes, totaling them weekly. This weekly data was sent to the coordinator, who logged it in an Excel “dashboard” for tracking. Each week the coordinator replied to each participant with a personal email message conveying encouragement and positive reinforcement. After the weekly group participant data was entered into the results Excel spreadsheet, each participant got a copy of that spreadsheet so they could see how they are doing compared to their fellow participants.

The program outcome, total minutes of physical activity per week, was chosen as a means of comparing to the established benchmark recommendation of at least 150 minutes of moderate exercise per week established by the Centers for Disease Control and Prevention (CDC) and the American College of Sports Medicine (ACSM) in their 1995 joint position statement (Pate et al., 1995), which has been repeatedly endorsed and remains the current guideline (World Health Organization, 2020).

At the end of each quarter, the individuals and teams with the highest total minutes were recognized. A lunchtime celebration with healthy snacks was held, where winners were announced to the tune of “Gonna Fly Now” from Rocky. These events were designed to be fun and motivating. Small prizes were provided for winners to choose from. During these events, informal feedback (program evaluation) was solicited from participants about why they engaged in the program, what they liked best, and suggestions. Quantitative data were analyzed using Excel and SPSS version 26. Qualitative (anecdotal) data were analyzed using a thematic approach.

Findings

Over the last 15 years, 128 individuals have participated in the program. Many of these individuals repeatedly enrolled in the program, for a total of 753 enrollments over 15 years. Individual enrollment ranged from 1 to 44 quarters, interrupted only by the COVID-19 pandemic of Spring 2020. While participation fluctuated, on average, 20% of the school of nursing workforce (both faculty and staff) participated per quarter, ranging from 9 to 36 participants per quarter. Participants averaged 273 (SD = 43.25) minutes of recorded physical activity per week, ranging from 201 to 374 minutes per week. For those who participated in two or more quarters, the difference in individual participants’ lowest to highest minutes of exercise ranged from 95 to 280 minutes per week.

Informal feedback from participants revealed positive impacts of the program. Some participants reported experiencing improved physical and emotional health, leading to stress reduction and greater productivity. Participants voiced that the program “made me feel better,” and “fostered increased physical activity.” One participant tracking her health indicators while participating in the program stated, “Yes, it has been improving my healthy by lowering my A1c. Also, I have more energy and feel less tired, and sleep better when I walk late afternoon.”

The program also fostered a sense of community among participants, with the end-of-the-quarter gathering becoming an event to look forward to. All school of nursing employees were welcome, regardless of physical ability or motivation for joining. One of our most consistent participants used a walker, others joined the program after healing from a recreational injury. Some found that participation supported their personal weight-loss or health-improvement journey. Comments during the celebrations noted that it was “lighthearted and fun,” while creating a “culture of wellness.”

Many participants admitted they would have exercised less or lacked motivation if it were not for joining a M4M team. While never pressed to join, they expressed that the “friendly competition” was positive, and some participants expressed feeling some guilt if their weekly minutes were low or if they did not participate regularly in M4M.

Discussion

A public health savvy employee started the Moving for Minutes program 15 years ago for employees of a school of nursing, rather than the program coming from an external source such as the occupational health department, human resources, or university administration. Perhaps because of the grassroots nature of the program, it became part of the culture at our school of nursing, ultimately promoting not only physical activity, but wholeness and wellness. Recent literature supports the participatory approach and that stakeholder involvement creates value and buy-in, gradually creating a collective cultural shift toward well-being and a health-promoting environment (Cheney et al., 2024; Ruvalcaba et al., 2022; Wieneke et al., 2025).

Participants’ average minutes of physical activity reported per week, at 273 minutes, was well within the recommended 150 to 300 minutes (Piercy et al., 2018), therefore M4M met its primary objective to promote physical activity. Some participants noted that participating in the M4M program instilled a sense of personal accountability, encouraging them to stay consistent in their physical activity efforts. Consistent with studies among university students, the perceived faculty and staff benefits of participation, including stress reduction, appear to outweigh the minimal burdens of participation (additional physical activity and reporting minutes of exercise), rather than adding to work-life imbalance or obstacles to exercise (Herbert, 2022; Khorshtd et al., 2020).

Additionally, in keeping with the literature indicating that physical activity enhances mental, emotional, and spiritual well-being (Blake, 2022; Herbert, 2022), observations and anecdotal comments about the M4M program point to several serendipitous outcomes. These outcomes include positive organizational cultural norms, social capital, inclusivity, and prevention of health problems or increase in health and well-being.

The M4M program normalized a positive social expectation to engage in physical activity, it became a part of the organizational culture at the school of nursing. The importance of workplace culture cannot be underestimated (Saunders et al., 2021). The M4M structure of being on a team built in peer support, and the friendly camaraderie between teams increased friendly banter. The structure inherently encouraged individual participants to increase their number of reportable exercise minutes as they desired to be a contributing member of the team. At the same time, participating on a team was achievable and decreased the stress of individual performance (Heinrich et al., 2022; Sevild et al., 2020).

M4M teams consisted of both graduate and undergraduate faculty, and staff, providing an opportunity for individuals from these groups to get to know each other outside of their roles as employees of the school of nursing. Developing rapport and friendships engenders understanding and trust that bridges the difference in roles that sometimes produces tension. This finding is in keeping with prior research indicating that group or team-based physical activity enhances workplace social capital (Andersen et al., 2015).

Furthermore, the M4M program celebrated participation and positive outcomes, fostering inclusivity rather than elitism. Participation was about self-care and encouraging others. Faculty and staff also expressed enjoying the end-of-quarter celebrations as fun and motivating. These aspects of the program likely increased adherence as prior research on group exercise interventions indicate that participants find shared interests and develop a sense of community (Heinrich et al., 2022; Saunders et al., 2021).

A recent systematic review suggests that workplace interventions are effective in treating or perhaps preventing musculoskeletal problems among employees working in an office setting, which alone, makes it a good return on investment (Tersa-Miralles et al., 2022). Additionally, the multiple general health and brain health benefits of exercise are well established (Blake, 2022; Saunders et al., 2021; Stillman et al., 2020). Furthermore, prior studies indicate that emotional well-being and productivity are increased with workplace exercise programs (Jakobsen et al., 2017; Sjøgaard et al., 2016). Therefore, we submit that overall, the cost and effort required to continue the M4M program are well worth it. This sentiment is evident in the fact that, although the founder and coordinator of the M4M program for the last 15 years is now retired, the program continues by popular demand.

Because the program required some of the coordinator’s work time and a modest budget for incentives, approval was sought from and granted by the dean of the school of nursing. A recent systematic review found no correlation between cash participant incentives and participation rates (Bensa & Širok, 2023), therefore, we assert that the program is successful despite the modest budget and funds should not be a major barrier to implementing similar programs elsewhere.

Our 20% average participation rate is higher than many employee wellness programs comprised of physical activity interventions according to a recent scoping review of participation rates in various types of workplace health promotion programs (Bensa & Širok, 2023). Perhaps the popularity of the M4M program reflects the results of a cluster randomized controlled trial indicating that exercising with work colleagues increased vitality more than exercising at home (Jakobsen et al., 2017). The personal email to the participants each week may also be a major factor in keeping the participants motivated and decreasing attrition.

It is also possible that the combination of administrative support and grassroots nature of the M4M program is a winning combination. A recent longitudinal study conducted in an academic setting found that both top-down and ground-up approaches are needed to promote health and well-being (Cheney et al., 2024).

There are several limitations of the quality improvement program. Because the M4M program was initiated informally, no baseline measurement was obtained prior to participants engaging in the program. Continuous enrollment and variable length of participation limited analysis of change in the primary program outcome (total minutes of physical activity) for overall program effectiveness. However, repeated enrollment and a fairly high participation rate indicated that it was valued by employees and strengthened the findings. The Hawthorne Effect may have contributed to bias, as participants were aware of their performance being tracked (Leong & Austin, 2023). Additionally, as with most voluntary wellness programs, it could be that employees most conscientious about their health are those who choose to participate, rather than those who needed it most—thus inadvertently contributing to reporting bias (Bensa & Širok, 2023). Finally, while informally collected, anecdotal data is a legitimate source of data (Poole, 2023) and in this project reinforced findings of the value added to the workplace environment and our efforts to promote health and well-being.

Overall, the Moving for Minutes program was proven to be highly beneficial by promoting a healthy work environment, encouraging self-care, boosting morale, and fostering camaraderie among faculty and staff at the school of nursing—in addition to increasing physical activity, health, and well-being.