The Impact of Exercise and Health Management on Workplace Creativity

Objectives This study aimed to investigate Japan’s service sector employees to determine whether employee creativity is associated with the provision of a fitness program (that encourages employees to perform physical exercise) or a health and productivity management (H&PM) program at the workplace. Design This was a cross-sectional study. Methods A nationwide online survey was conducted using stratified sampling. Data were obtained for respondents’ demographic characteristics, subjective health, exercise frequency, and organizational wellness support. Workplace creativity, psychological safety, and leadership were evaluated using standardized scales. A binary logistic regression was performed to examine the relationship between organizational wellness support programs and workplace creativity. Results Respondents were 1,955 full-time employees in private-sector organizations (979 men and 976 women; mean age 40.30 ± 10.85). Workplace creativity was significantly more likely respondents whose employers provided a fitness program (adjusted OR = 1.86, 95% CI = 1.39-2.48, p<.001) or an H&PM program (adjusted OR = 2.07, 95% CI = 1.53-2.80, p<.001). Furthermore, workplace creativity was significantly more likely in employees who perceived themselves as rather healthy or healthy. Employees who exercised frequently over the past year were more likely to display creativity than those never exercised. Conclusions Workplace creativity was associated with good subjective health, high exercise frequency, and organizational wellness support programs offered by employers. Human resource management for employees’ fitness and health is crucial for cultivating the productivity and innovation necessary for business success.


Introduction
In Japan, the Third Sport Basic Plan was formulated on March 25, 2022.The new plan outlines the specific policies and targets to be advanced by the government and other organizations over the next five years (2022/4 to 2027/3) 1) .The plan has been designed to ensure the legacy of the Tokyo 2020 Olympic and Paralympic Games and to facilitate the growth of the sports industry among others.However, for Japan to achieve economic growth, a major hurdle must be overcome: low productivity amid a lack of innovation 2) .This is a particularly important issue in Japan's industry (the service sector) 2) , which employs around 70% of the country's working population and encompasses the sports and health sectors 3) .Moreover, as an impediment to innovation, around half of the companies in a government survey revealed that they lacked talented workers 2) .While there is a growing focus on using digital technology in the workplace, Furukawa et al. notes that human knowledge and human skills are all the more important in a volatile business environment 4) .Amabile et al. defined creativity

The Impact of Exercise and Health Management on Workplace Creativity
Yasuyuki HOCHI 1,2) , Motoki MIZUNO 3) 1) Faculty of Health and Sports Science, Juntendo University, Chiba, Japan 2) Japan Women's College of Physical Education, Tokyo, Japan 3) Graduate School of Health and Sports Science, Juntendo University, Chiba, Japan as the production of novel and useful ideas in any domain, and innovation as the successful implementation of creative ideas within an organization 5) .In this light, individual and team creativity is a starting point for innovation.Considerable evidence suggests that employee creativity can substantially contribute to organizational innovation, effectiveness, and survival [5][6][7] . Wen employees exhibit creativity at work, they produce novel, and potentially useful, ideas about organizational products, practices, services, or procedures 5,8) .Thus, in the workplace, both individual and team creativity is essential for addressing all manner of workplace problems; as such, it will become an increasingly important priority for all organizational layers in the service sector 9) .Therefore, there is an increasing need for a greater understanding of the contextual factors that may enhance or diminish employees' creativity as well as the interaction between personal characteristics and work environment [8][9][10] .Further, it is important to identify the role of leadership in encouraging employee creativity 9,10) .Another concept gaining increasing attention in the corporate sector is psychological safety (as defined by Edmondson, 1999) 11) .Studies have shown that psychological safety correlates positively with creativity, and that effective leadership facilitates both psychological safety and employee creativity in the workplace [12][13][14][15][16] .
Japan has shown interest in organizational support for employee wellness, inspired by the ideas in The Healthy Company (Rosen, 1992) 17) .In this context, Japan sports agency (MEXT) led a wellness program named the Sports Yell Company program 18) .Alongside this, there are company-level "health and productivity management" (H&PM) programs, which align with a model of employee wellness promoted by the Ministry of Economy, Trade and Industry (METI) 19) .Previous studies have revealed that, companies with an effective H&PM program tend to have better stock performance 20,21) .Given the well-demonstrated association between employee health (as measured by absenteeism, for instance) and productivity (as measured by presenteeism, for instance), greater corporate interest in employee health will lead to more positive outcomes.However, thus far, the literature has focused on outcomes such as return on (or loss on) investment in health, productivity measures, and health problems [22][23][24][25][26][27][28][29][30][31] ; few studies have measured creativity in a work-place context or changes in employee attitudes and behaviors. Sme reports suggest that physical exercise positively affects creative thinking, creative idea generation, and cognitive processing 32,33) .However, systematic reviews concluded that further research is necessary to obtain clear evidence of the association between exercise and creativity 34,35) .The present study was motivated by the following idea: if it was demonstrated that employee creativity is greater in workplaces with wellness programs, this would offer the corporate sector a greater incentive to invest in human resource management for employee health, ultimately leading to greater innovation.
To this end, we conducted a cross-sectional study on employees in the service sector to determine whether employee creativity is associated with the provision of either one or both of the following types of organizational wellness support: a fitness program (a program encouraging employees to engage in physical exercise) and an H&PM program.

Sample and procedure
A nationwide online survey was conducted using stratified sampling, including individuals who were aged 20-59 and employed full time in privatesector organizations, classified as tertiary industry (service sector) employers by the Ministry of Internal Affairs and Communications.The study sample comprised participants selected from the panel registered with Cross Marketing, Inc., a leading marketing research agency in Japan.The survey was conducted between October and November 2022.Before starting the online survey, the participants were presented with a webpage detailing the rationale, objective of the survey, ethical considerations and stating that their anonymity would be safeguarded.The participants were then invited to click on an "agree" button to indicate their informed consent to participate in the survey.
Survey data cleaning was performed to eliminate data from respondents whose responses could bias the results.Specifically, we identified and removed straight liners (respondents who chose the same answer option repeatedly) and set a trick question (a question designed to "trap" respondents who were not paying attention).

Participant characteristics
The following participant attributes were obtained: gender, age, education (highest level of education), marital status, parental status (whether the person has any children), age of the youngest (or only) child (if any), managerial status (whether the person has a management title), work hours, occupation, subjective health, exercise frequency, and whether wellness support was provided in the workplace.Subjective health was rated on a 4-point scale, with the following answer options: unhealthy, rather unhealthy, rather healthy, and healthy.For exercise frequency, respondents described how frequently they had engaged in an exercise session lasting at least 30 minutes, over the past year; the answer options were: never, one to three days a year, four to eleven days a year, one to three days a month, one to two days a week, and at least three days a week.To determine whether organizational wellness support was provided, the following questions were presented: "Does your workplace provide a fitness program?" and "Does your workplace provide a H&PM program?"In both cases, respondents could answer "yes," "no," or "unsure."

Workplace creativity
Creativity in the workplace was measured using a six-item scale by Maruyama and Fuji (2022) 36) , based on the original scale by Carmeli and Schaubroeck (2007) that measures creative involvement at work 10) .Each item contained a statement rated on a 7-point scale to indicate level of agreement (absolutely disagree to strongly agree).The items (as translated from Japanese) were as follows: "I exhibit originality at work," "I take risks to generate new ideas needed in my work," "I'm prepared to change existing work procedures and methods and I look for new ways to use equipment," "I resolve the issues that entail difficulties," "I try out new ideas when approaching problems," and "I generate ideas that are unprecedented but useful for work."Based on their total scores for the six items, the respondents were divided into quartiles, with the top 25% categorized as the high creativity group and the remaining 75% as the non-high creativity group.

Workplace culture and leadership
The previous study suggests that employees' creativity is moderated by contextual factors such as workplace culture and leadership, as well as by intra-individual factors 8,9) .To evaluate workplace culture, we used Edmondson's (1999) Team Psychological Safety Scale 11) .To assess leadership, we used Walumbwa et al.'s (2008) Authentic Leadership Questionnaire 37) .The Team Psychological Safety Scale consists of seven items, each rated on a 7-point scale (from "completely disagree" to "absolutely agree").The items were prefaced with the following statement: "We will ask you about your team (workplace, department, store members) with which you usually work."The Authentic Leadership Questionnaire consists of 16 items, each rated on a 5-point scale (from "not at all" to "frequently, if not always") and prefaced with the following statement: "The following survey items refer to your leader's style, as you perceive it.Judge how frequently each statement fits his or her leadership style using the following scale."

Ethical considerations
This study was approved by the research ethics committee of the Japan Women's College of Physical Education (Application Number: 2022-20).

Statistical analysis
A binomial logistic regression was performed, with the explanatory variables being subjective health, exercise frequency, and organizational wellness support, and the objective variable being workplace creativity.We also set several moderator variables (confounders) on the premise that the variables in question could affect workplace creativity directly or indirectly.These moderator variables included: gender, age, education, marital status, parental status, managerial status, work hours, occupation, psychological safety, and authentic leadership.Using the adjusted odds ratios for these items, we could control the confounding factors.IBM SPSS version 28 for Windows was used for statistical analysis.

Creativity at the workplace
A total of 502 respondents were classed as creative, their total scores falling in the top quartile of scores (M = 30.48± 3.27), while 1,453 were classed as uncreative (M = 17.53 ± 6.39).The two groups were compared regarding their basic attributes using a chi-squared test.The analysis revealed significant inter-group differences for gender, age, education, marital status, parental status, whether the respondent had a managerial status, work hours, and occupation (Table 1).
The two groups also differed significantly on all items of subjective health, exercise frequency, whether a fitness activity was promoted, whether an H&PM program was promoted, Team Psychological Safety Scores, and Authentic Leadership Questionnaire scores (Table 2).For the team psychological safety scale and the Authentic Leadership Questionnaire, following the precedent set in the literature, using Welch's t-test.

Factors related to employee creativity in the workplace.
Table 3 shows the results of the binomial logistic regression analysis.Employee creativity in the workplace was significantly more likely in respondents who perceived themselves as rather healthy (adjusted OR = 2.14, 95% CI = 1.23-3.71,p<.01) or healthy (adjusted OR = 2.09, 95% CI = 1.18-3.70,p<.05) than those who perceived themselves as unhealthy.Furthermore, workplace creativity was significantly more likely in respondents who engaged in an exercise session lasting at least 30 minutes for one to three days a month (adjusted OR = 1.90, 95% CI = 1.26-2.86,p<.01), one to two days a week (adjusted OR = 1.69, 95% CI = 1.26-2.27,p<.001), or at least three days a week (adjusted OR = 1.76, 95% CI = 1.27-2.46,p<.001), than by those who had never exercised in the past year.Of the exercise frequency categories, "at least three days a week" was associated with the greatest increase in adjusted odds ratio.In addition, workplace creativity was significantly more likely in respondents whose employers promoted fitness activities (adjusted OR = 1.86, 95% CI = 1.39-2.48,p<.001) and those whose employers provided an H&PM program (adjusted OR = 2.07, 95% CI = 1.53-2.80,p<.001) than in respon-dents whose employers did not provide either.

Discussion
This study examined survey data from employees in the service sector to reveal how employee creativity is associated with exercise and organizational wellness support.Having controlled for certain respondent attributes that could affect employee creativity (gender, age, education, marital status, parental status, managerial status, work hours, occupation, psychological safety, and authentic leadership), we found that employees' creativity in the workplace is associated with their subjective health and whether the employer provides a fitness program or an H&PM program.To the best of our knowledge, this finding constitutes the first scientific evidence of such an association.

Exercise and workplace creativity
Our survey revealed that, over the past year, 45% (879) of the respondents had never engaged in an exercise session lasting at least 30 minutes, while 34.7% (681) had done so at least one day a week.In a 2022 survey on engagement in sport, the Japan Sports Agency found that 47% of Japanese men and women aged 20-59 engage in exercise at least one day a week.However, the agency's exercise data pertained to general members of the public, who may or may not have been employed and who could have been employed in any kind of job; the value of our data lies in the fact that it specifically highlights exercise frequency among people employed full-time in Japan's private sector.Our analysis revealed that workplace creativity was significantly more likely to be exhibited by employees who perceived themselves as rather than by those who perceived themselves as unhealthy.The literature on the relationship between employee health and workplace productivity has shown that effective organizational support for employee wellness, as measured by a decline in presenteeism among other things, leads to higher workplace creativity.Creativity was also significantly more likely to be exhibited by employees engaged in an exercise session lasting at least 30 minutes on one to three days a month (adjusted OR = 1.90, 95% CI = 1.26-2.86,p<.01), one to two days a week (adjusted OR = 1.69, 95% CI = 1.26-2.27,p<.001), or at least three days a week (adjusted OR = 1.76, 95% CI = 1.27-2.46,p<.001) over the past year, than by those who had never exercised in the past year; further- more, the highest adjusted odds ratio was found for those exercised "at least three days a month.The Government of Japan is committed to the goal of having 70% of the adult population engage in exercise at least one day a week and having 50% engage in exercise at least three days a week.In this regard, our findings offer important insights for employees in the service sector; exercising one to three days a month is more effective for facilitating creativity in the workplace than not exercising at all.Other studies suggest that exercise can facilitate workplace creativity even at a low frequency, provided that the physical activity is regular.Specifically, one report suggested that even a single exercise session can facilitate creative thinking 32) ; other studies showed that habitual physical activity has a moderate effect on creative ideation, and that chronic physical activity interventions enhance creativity [33][34][35] .

Organizational wellness support and creativity
Our second main finding concerns the role of organizational wellness support employees' creativity.We found that workplace creativity was significantly more likely to occur among respon-dents whose employers promoted fitness activity (adjusted OR = 1.86, 95% CI = 1.39-2.48,p<.001) than among those whose employers did not.Furthermore, creativity was significantly more likely to occur among respondents whose employers provided an H&PM program (adjusted OR = 2.07, 95% CI = 1.53-2.80,p<.001) than among those whose employers did not.Admittedly, these results offer no precise insights into how such programs contribute to individual employees' behaviors and health condition.Nonetheless, they do corroborate the claim made in "The Healthy Company" that companies with healthier workforces are more profitable; that is, individual and team creativity constitutes both the starting point for innovation and a process for resolving problems.There is extensive evidence showing that employee creativity facilitates organizational innovation and organizational effectiveness 6,7) .
Finally, we discuss the results in Table 2. Japan has shown increasing interest in having the corporate sector execute integrated strategies for encouraging employees to engage in physical and healthsupporting activities, as evidenced by governmentled programs such as the Sports Yell Company program 18) and the H&PM program 19) .However, our results suggest that the government's employee wellness agenda is yet to gain traction; in our survey, few companies provided a fitness or H&PM program for employees.As stated in the Introduction section, a report suggested that the greatest impediment to innovation is a lack of talented workers within the company 2) .In today's volatile, uncertain, complex, and ambiguous business environment, it is all the more essential to provide a workplace and talent management strategy that unleashes employees' creativity.While it is true that profit growth will always be paramount to business survival, and that employers are sometimes unable to invest enough in talent development and employee welfare, sacrificing employee wellness for the sake of immediate profit is the wrong approach.Although investing in employee wellness yields no instant or immediately apparent return on investment, organizational support for employees' fitness and health plays a crucial role in cultivating the productivity and innovation necessary for business success in a volatile, uncertain, complex, and ambiguous environment.

Conclusions
Using survey data pertaining to 1,955 full-time employees in Japan's service sector, we conducted a cross-sectional study to examine the relationship between organizational wellness support at the workplace, exercise frequency, and workplace creativity.Based on the results, three conclusions can be drawn.First, creativity in the workplace is associated with subjective health: compared with those who perceived themselves as unhealthy, respondents who perceived themselves as healthy had increased adjusted odds ratios from 2.09 to 2.14 for demonstrating workplace creativity.Second, workplace creativity is associated with habitual exercise: compared with those who had never exercised in the past year, respondents who performed exercise showed increased workplace creativity, with adjusted odds ratios of 1.90 for those who exercised for one to three days a month, 1.69 for those who exercised for one to two days a week, and 1.76 for those who exercised at least three days a week.Third, workplace creativity is associated with organizational wellness support: provision of a fitness program and an H&PM program by employers was associated with increased adjusted odds ratios of 1.86 and 2.07, respectively, for workplace creativity.Thus, human resource management for employees' fitness and health is crucial for cultivating the productivity and innovation necessary for business success.

Limitations and future research
This study adopted a cross-sectional approach and analyzed survey data pertaining to a single time-point.As such, the findings warrant no conclusions about any direct causal relationship that exercise and organizational wellness support may have with workplace creativity (the interaction mechanism).Furthermore, we believe that the impact of company size, such as number of employees and capitalization, should also be taken into consideration.When interpreting the results, the following precautions should be observed.First, as respondents rated their own creativity, we cannot rule out the possibility that their self-reports were affected by cognitive bias (such as the Dunning-Kruger effect).Thus, workplace creativity as measured in our study may not accurately reflect actual behaviors and outcomes in everyday workplace activities.Second, as respondents were asked about their exercise frequency over the past year, there is a possibility that their responses were influenced by recall bias, too.Many complex and latent factors moderate employee behavior in the workplace.By combining survey data with objective data from wearable devices or physiological measures, it is possible to deliver more reliable evidence for the effects of exercise and organizational wellness support on employees.Rigorously conducted randomized controlled intervention studies and more cross-sectional studies are needed to broaden the evidence in this nascent field of research.

Table 1
Differences in workplace creativity according to the participants' attributes

Table 2
Differences in workplace creativity according to exercise frequency and health management a **p<.01,*p<.05.bThe psychological safety and the Authentic Leadership were using Welch's t-test.