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What strategies do desk-based workers choose to reduce sitting time and how well do they work? Findings from a cluster randomised controlled trial.

ABSTRACT: BACKGROUND:Large amounts of sitting at work have been identified as an emerging occupational health risk, and findings from intervention trials have been reported. However, few such reports have examined participant-selected strategies and their relationships with behaviour change. METHODS:The Stand Up Victoria cluster-randomised controlled trial was a workplace-delivered intervention comprising organisational, environmental and individual level behaviour change strategies aimed at reducing sitting time in desk-based workers. Sit-stand workstations were provided, and participants (n?=?134; intervention group only) were guided by health coaches to identify strategies for the 'Stand Up', 'Sit Less', and 'Move More' intervention targets, including how long they would stand using the workstation. Three-month workplace sitting and activity changes (activPAL3-assessed total sitting, prolonged sitting (i.e., sitting ?30 min continuously) and purposeful walking) were evaluated in relation to the number (regression analysis) and types of strategies (decision-tree analysis). RESULTS:Over 80 different strategies were nominated by participants. Each additional strategy nominated for the 'Stand Up' intervention target (i.e. number of strategies) was associated with a reduction in prolonged sitting of 27.6 min/8-h workday (95% CI: -53.1, -?2.1, p?=?0.034). Types of strategies were categorised into 13 distinct categories. Strategies that were task-based and phone-based were common across all three targets. The decision tree models did not select any specific strategy category as predicting changes in prolonged sitting ('Stand Up'), however four strategy categories were identified as important for total sitting time ('Sit Less') and three strategy categories for purposeful walking ('Moving More'). The uppermost nodes (foremost predictors) were nominating >?3 h/day of workstation standing (reducing total workplace sitting) and choosing a 'Move More' task-based strategy (purposeful walking). CONCLUSIONS:Workers chose a wide range of strategies, with both strategy choice and strategy quantity appearing relevant to behavioural improvement. Findings support a tailored and pragmatic approach to encourage a change in sitting and activity in the workplace. Evaluating participant-selected strategies in the context of a successful intervention serves to highlight options that may prove feasible and effective in other desk-based workplace environments. TRIAL REGISTRATION:This trial was prospectively registered with the Australian New Zealand Clinical Trials register ( ACTRN12611000742976 ) on 15 July 2011.

SUBMITTER: Stephens SK

PROVIDER: S-EPMC6186123 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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What strategies do desk-based workers choose to reduce sitting time and how well do they work? Findings from a cluster randomised controlled trial.

Stephens Samantha K SK Eakin Elizabeth G EG Clark Bronwyn K BK Winkler Elisabeth A H EAH Owen Neville N LaMontagne Anthony D AD Moodie Marj M Lawler Sheleigh P SP Dunstan David W DW Healy Genevieve N GN

The international journal of behavioral nutrition and physical activity 20181012 1

<h4>Background</h4>Large amounts of sitting at work have been identified as an emerging occupational health risk, and findings from intervention trials have been reported. However, few such reports have examined participant-selected strategies and their relationships with behaviour change.<h4>Methods</h4>The Stand Up Victoria cluster-randomised controlled trial was a workplace-delivered intervention comprising organisational, environmental and individual level behaviour change strategies aimed a ...[more]

PMID: 30314505

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Project description:BACKGROUND:Although the main targets for reducing workplace sedentary behavior have been clarified, only a few studies have examined the association between social-ecological factors and workplace sedentary behavior for effective intervention. The present study aimed to examine the social-ecological factors of workplace sedentary behavior among Japanese sedentary workers. METHODS:Participants were recruited via a cross-sectional mail survey targeting randomly sampled 6000 middle-aged people dwelling in Matsuyama-city and Koto-ku in Japan. Participants answered a questionnaire on social-ecological factors, recorded their work time in a diary, and wore a triaxial accelerometer during waking time for 7 consecutive days. Workplace sedentary behavior was measured using accelerometer and was referred to as the work time in the recorded diary. Full-time workers who had mainly sitting work and valid accelerometer data were included in the analysis. Workplace sedentary variables were sedentary breaks per sedentary hour, sedentary time, and ≥ 30 min bouts of sedentary time. The associations between each sedentary variable and social-ecological factors were explored by conducting three multiple linear regression analyses adjusting for sociodemographic and health-related factors. RESULTS:A total of 227 participants (133 men, mean age 49.9 ± 6.9 years) were included in the analysis. In the overall sample, "typically seeing work colleagues take sedentary breaks" was significantly associated with more sedentary breaks (B [95% confidence interval {CI}=1.40 [0.07 to 2.73]) and shorter ≥30-min bouts of sedentary time (B [95% CI] = -7.08 [-13.75 to -0.40]). "I am motivated to take sedentary breaks" had an unfavorable association with less sedentary breaks (B [95% CI] = -1.36 [-2.61 to -0.12]) and longer sedentary time (B [95% CI] = 4.15 [0.29 to 8.00]). In male workers, "Too stressed to take sedentary breaks" was significantly associated with less sedentary breaks (B [95% CI] = -5.6 [-9.17 to -2.02]). CONCLUSIONS:Seeing work colleagues take sedentary breaks may be important for reducing workplace sedentary behavior. Those who are more sedentary are motivated to take sedentary breaks. Male workers who feel the need to take sedentary breaks at work are more sedentary.

Project description:BACKGROUND:High levels of sedentary behaviour (i.e., sitting) are a risk factor for poor health. With high levels of sitting widespread in desk-based office workers, office workplaces are an appropriate setting for interventions aimed at reducing sedentary behaviour. This paper describes the development processes and proposed intervention procedures of Stand More AT (SMArT) Work, a multi-component randomised control (RCT) trial which aims to reduce occupational sitting time in desk-based office workers within the National Health Service (NHS). METHODS/DESIGN:SMArT Work consists of 2 phases: 1) intervention development: The development of the SMArT Work intervention takes a community-based participatory research approach using the Behaviour Change Wheel. Focus groups will collect detailed information to gain a better understanding of the most appropriate strategies, to sit alongside the provision of height-adjustable workstations, at the environmental, organisational and individual level that support less occupational sitting. 2) intervention delivery and evaluation: The 12 month cluster RCT aims to reduce workplace sitting in the University Hospitals of Leicester NHS Trust. Desk-based office workers (n?=?238) will be randomised to control or intervention clusters, with the intervention group receiving height-adjustable workstations and supporting techniques based on the feedback received from the development phase. Data will be collected at four time points; baseline, 3, 6 and 12 months. The primary outcome is a reduction in sitting time, measured by the activPAL(TM) micro at 12 months. Secondary outcomes include objectively measured physical activity and a variety of work-related health and psycho-social measures. A process evaluation will also take place. DISCUSSION:This study will be the first long-term, evidence-based, multi-component cluster RCT aimed at reducing occupational sitting within the NHS. This study will help form a better understanding and knowledge base of facilitators and barriers to creating a healthier work environment and contribute to health and wellbeing policy. TRIAL REGISTRATION:ISRCTN10967042 . Registered 2 February 2015.

Project description:BackgroundSedentary behaviour increases the risks of non-communicable diseases. The objective of this trial was to evaluate the effect of the Physical Activity at Work multicomponent intervention to reduce sedentary behaviour in Thai office workers.MethodsOffices under the Ministry of Public Health Thailand, were randomly allocated to the intervention and control group in a 1:1 ratio, stratified by office size. The intervention included individual (pedometer and lottery-based financial incentives), social (group movement breaks), environmental (posters), and organisational (leader encouragement) components. At baseline and 6-month follow-up, participants wore ActiGraphTM on the waist for ten days. The primary outcome was the between-group difference in sedentary time at 6-month, analysed using a linear mixed-effects model. Other outcomes were physical activity, biomarkers, productivity, and musculoskeletal health. Trial registration: The PAW study was registered at the Thai Clinical Trials Registry (ID TCTR20200604007) on 02 June 2020.Findings282 office workers were recruited and randomly allocated to the control group (142 participants, nine offices) and the intervention group (140 participants, nine offices). The mean age was 38.6 years (SD = 10.4), and 81% were women. There was no evidence of intervention effects on sedentary time during waking hours (-26.8; 95% CI = -69.2 to 15.7 min), physical activity levels, or biomarkers between groups at 6-month. In the adjusted analysis, increases in time spent in moderate-to-vigorous physical activity (5.45; 95% CI = -0.15 to 11.1 min) and step count (718; 95% CI = -45 to 1481 steps) during waking hours were observed, although there was no evidence of a difference between groups.InterpretationThe intervention did not significantly reduce sedentary time in Thai office workers. Suboptimal intervention uptake due to Covid-19 pandemic restrictions and loss of statistical power associated with recruitment constraints may explain this result. Further investigations are needed to evaluate the processes of the trial.FundingThe Thai Health Promotion Foundation and the International Decision Support Initiative (iDSI).

Project description:BACKGROUND:Excessive sedentary behaviour (sitting) is a risk factor for poor health in children and adults. Incorporating sit-stand desks in the classroom environment has been highlighted as a potential strategy to reduce children's sitting time. The primary aim of this study was to examine the feasibility of conducting a cluster randomised controlled trial (RCT) of a sit-stand desk intervention within primary school classrooms. METHODS:We conducted a two-armed pilot cluster RCT involving 8 primary schools in Bradford, United Kingdom. Schools were randomised on a 1:1 basis to the intervention or usual practice control arm. All children (aged 9-10?years) in participating classes were eligible to take part. Six sit-stand desks replaced three standard desks (sitting 6 children) in the intervention classrooms for 4.5-months. Teachers were encouraged to use a rotation system to ensure all pupils were exposed to the sit-stand desks for >?1?h/day on average. Trial feasibility outcomes (assessed using quantitative and qualitative measures) included school and participant recruitment and attrition, intervention and outcome measure completion rates, acceptability, and preliminary effectiveness of the intervention for reducing sitting time. A weighted linear regression model compared changes in weekday sitting time (assessed using the activPAL accelerometer) between trial arms. RESULTS:School and child recruitment rates were 33% (n =?8) and 75% (n =?176). At follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63 to 97%. A preliminary estimate of intervention effectiveness revealed a mean difference in change in sitting of -?30.6?min/day (95% CI: -?56.42 to -?4.84) in favour of the intervention group, after adjusting for baseline sitting and wear time. Qualitative measures revealed the intervention and evaluation procedures were acceptable to teachers and children, except for some problems with activPAL attachment. CONCLUSION:This study provides evidence of the acceptability and feasibility of a sit-stand desk intervention and evaluation methods. Preliminary evidence suggests the intervention showed potential in reducing children's weekday sitting but some adaptations to the desk rotation system are needed to maximize exposure. Lessons learnt from this trial will inform the planning of a definitive trial. TRIAL REGISTRATION:ISRCTN12915848 (registered: 09/11/16).

Project description:BackgroundHigh levels of sedentary behaviour (SB) are associated with non-communicable diseases. In 2016, the estimated total healthcare expenditure from physical activity (PA) in Thailand added up to $190 million in international dollars. The challenge to reduce SB and increase PA among office workers is more urgent now than ever as Thailand is transforming itself from a predominantly rural country to an increasingly urban one. This study will investigate the effectiveness of a multicomponent short break intervention on the reduction of SB during office hours.Methods/designThis two-armed Physical Activity at Work (PAW) cluster randomised controlled trial will recruit 360 office workers from 18 offices in the Thailand's Ministry of Public Health (MOPH). Offices will be randomised to either the intervention group or the control group. The multicomponent intervention is informed by the Social Ecological Model and Behaviour Change Techniques (BCTs) and contains four components: (i) organisational, including heads of the participating divisions leading exercises, sending encouragement text messages and acknowledging efforts; (ii) social, including team movement breaks and team-based incentives; (iii) environmental, including posters to encourage exercise; and (iv) individual components including real-time PA feedback via an individual device. The main intervention component will be a short break intervention. The primary outcome of this study is the sedentary time of office workers. Secondary outcomes include time spent on PA, cardiometabolic outcomes, work productivity, musculoskeletal pain, and quality of life. The study also includes process and economic evaluations from the individual and societal perspective.DiscussionThe study will be the first experimental study in Thailand to investigate the effect of a short-break intervention at the workplace on SBs of office workers and health outcomes. The study will also include a cost-effectiveness analysis to inform investments on short break interventions under the Universal Healthcare Coverage in Thailand, which includes health promotion and disease prevention component.Trial registrationThe PAW study has been registered at the Thai Clinical Trials Registry (TCTR) under the study ID TCTR20200604007 . Registered 02 June 2020,.

Project description:BACKGROUND:Large volumes of sitting time have been associated with multiple health risks. To reduce sitting time of office workers working for a Dutch insurance company, the Dynamic Work intervention was developed. The primary objective of this paper is to describe the study protocol of the Dynamic Work study, which aims to evaluate if this multicomponent intervention is (cost-)effective in reducing total sitting time on the short-term (?3?months) and longer-term (?12?months) compared to usual practice. METHODS/DESIGN:This two-arm cluster randomized controlled trial will recruit 250 desk-based office workers working at different locations of an insurance company in the Netherlands. After baseline measurements, departments will be matched in pairs and each pair will be randomly assigned to the control or intervention condition. The multicomponent intervention contains organizational (i.e. face to face session with the head of the department), work environmental (i.e. the introduction of sit-stand desks and cycling workstations), and individual elements (i.e. counselling and activity/sitting tracker with a self-help program booklet). The counselling involves two group intervention sessions and four on-site department consultations with an occupational physiotherapist. Sitting time (primary outcome), upright time and step counts will be assessed objectively using the activPAL activity monitor at baseline, short-term (approximately 3?months) and longer-term (12?months). Other outcomes will include: self-reported lifestyle behaviours, anthropometrics, work-related outcomes (i.e. absenteeism, presenteeism, work performance, work-related stress), health-related outcomes (i.e. vitality, musculoskeletal symptoms, need for recovery, quality of life), and costs from both company and societal perspective. The study will include economic and process evaluations. DISCUSSION:This study will assess the longer-term (cost-) effectiveness of a multicomponent workplace intervention aimed at reducing sitting time in comparison with usual practice. Furthermore, the process evaluation will provide insights in factors associated with successful implementation of this intervention. TRIAL REGISTRATION:ClinicalTrials.gov NCT03115645 ; Registered 13 April 2017. Retrospectively registered.

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What strategies do desk-based workers choose to reduce sitting time and how well do they work? Findings from a cluster randomised controlled trial.

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What strategies do desk-based workers choose to reduce sitting time and how well do they work? Findings from a cluster randomised controlled trial.

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