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Improving office workers' mental health and cognition: a 3-arm cluster randomized controlled trial targeting physical activity and sedentary behavior in multi-component interventions.

ABSTRACT: BACKGROUND:Physically inactive and sedentary lifestyles are negatively related to both mental health and cognition. For office-workers, who spend two-thirds of their workday sitting, it is important to improve these lifestyles. The aim of this study is to assess the effectiveness of multi-component interventions, incorporating individual, environmental and organizational changes, to increase physical activity or reduce sedentary behavior among office-workers in order to improve mental health and cognition. METHODS:a 3-arm, clustered randomized controlled trial (RCT) with waiting list control group amongst adult office-workers of two large Swedish companies. Cluster teams will be randomized into 6-month interventions or to a passive waiting list control group which will receive the allocated intervention with a 6-month delay. Two multicomponent interventions will be studied of which one focuses on improving physical activity and the other on reducing sedentary behavior. Both interventions include 5 sessions of motivational counselling. In the physical activity intervention persons also get access to a gym and team leaders will organize lunch walks and encourage to exercise. In the sedentary behavior intervention standing- and walking meetings will be implemented and team leaders will encourage to reduce sitting. The recruitment target is 110 office-workers per arm (330 in total). Measurements will be repeated every 6?months for a total intended duration of 24?months. Proximal main outcomes are physical activity measured with accelerometers and sedentary behavior with inclinometers. Distal outcomes are self-reported mental health and a cognition test battery. Additional outcomes will include cardiovascular fitness, body composition, sleep, self-reported physical activity and sedentary behavior, other health habits, physical health, and working mechanisms from blood samples and questionnaires. DISCUSSION:This cluster RCT will contribute to the currently available evidence by comparing the effectiveness of multi-component interventions targeting physical activity or sedentary behavior with the end goal of improving mental health and cognition. This study is strong in its cluster randomized design, numerous objective outcome measures and long-term follow-up. The exact content of the interventions has been defined by combining theory with results from a larger research project as well as having a continuous dialogue with the involved companies. TRIAL REGISTRATION:ISRCTN92968402 .

SUBMITTER: Nooijen CFJ

PROVIDER: S-EPMC6402109 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Improving office workers' mental health and cognition: a 3-arm cluster randomized controlled trial targeting physical activity and sedentary behavior in multi-component interventions.

Nooijen Carla F J CFJ Blom Victoria V Ekblom Örjan Ö Ekblom Maria M MM Kallings Lena V LV

BMC public health 20190305 1

<h4>Background</h4>Physically inactive and sedentary lifestyles are negatively related to both mental health and cognition. For office-workers, who spend two-thirds of their workday sitting, it is important to improve these lifestyles. The aim of this study is to assess the effectiveness of multi-component interventions, incorporating individual, environmental and organizational changes, to increase physical activity or reduce sedentary behavior among office-workers in order to improve mental he ...[more]

PMID: 30836957

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Project description:BackgroundInterventions to increase physical activity or reduce sedentary behaviour within the workplace setting have shown mixed effects. This cluster randomised controlled trial assessed whether multi-component interventions, focusing on changes at the individual, environmental, and organisational levels, either increased physical activity or reduced sedentary behaviour, compared to a passive control group.MethodsTeams of office-workers from two companies participated in one of two interventions (iPA: targeting physical activity; or iSED: targeting sedentary behaviour), or wait-list control group (C). Exclusion criterion was very high physical activity level (MVPA ≥30 min/day in ≥10 min bouts every day). Randomisation occurred at the level of workplace cluster, and groups were randomly allocated (1:1) with stratification for company and cluster size. Personnel involved in data collection and processing were blinded to group allocation. Both interventions included five sessions of cognitive behavioural therapy counselling for 6 months. iPA included counselling focused on physical activity, access to a gym, and encouragement to exercise, and go for lunch walks. iSED included counselling on sedentary behaviour and encouragement to reduce sitting and increase engagement in standing- and walking-meetings. At baseline and the 6-month mark accelerometers were worn on the hip and thigh for 7 days. The primary outcomes were group differences in time spent in moderate-to-vigorous intensity physical activity (%MVPA) and in sedentary behaviour (%), analysed using Bayesian multilevel modelling for those with complete data.ResultsTwo-hundred and sixty three office workers (73% women, mean age 42 ± 9 years, education 15 ± 2 years) were randomised into 23 cluster teams (iPA n = 84, 8 clusters; iSED n = 87, 7 clusters; C n = 92, 7 clusters). No significant group differences (posterior mean ratios: 95% credible interval) were found after the intervention for %MVPA or for %Sedentary. %MVPA: iPA vs C (0·04: - 0·80-0·82); iSED vs C (0·47: - 0·41-1·32); iPA vs iSED (0·43: - 0·42-1·27). %Sedentary: iPA vs C (1·16: - 1·66-4·02); iSED vs C (- 0·44: - 3·50-2·64); iPA vs iSED (- 1·60: - 4·72-1·47).ConclusionsThe multi-component interventions focusing on either physical activity or sedentary behaviour were unsuccessful at increasing device-measured physical activity or reducing sedentary behaviour compared to a control group.Trial registrationISRCTN, ISRCTN92968402 . Registered 27/2/2018, recruitment started 15/03/2018.

Project description:BackgroundWe have previously reported on the design and efficacy of two cluster-randomized multi-level workplace interventions, attempting to decrease sedentary behavior (SED) or increase moderate to vigorous physical activity (MVPA) among office workers to improve mental health outcomes. The aim of this study was to investigate intervention effects on mental health outcomes, i.e., mental wellbeing, depression or anxiety symptoms, and stress immediately after the 6-month intervention period.MethodsTeams of 263 office workers were cluster-randomized to one of two interventions or a waitlist control group. The PA intervention (iPA) focused on increasing MVPA and the SED intervention (iSED) on reducing SED. Both multi-level interventions targeted individual office workers and their social, physical, and organizational work environment, incorporating counseling based on cognitive behavioral therapy and motivational interviewing. Mental health outcomes were assessed using validated questionnaires before and immediately after the intervention. Intervention effects were analyzed using linear mixed effects models.ResultsParticipants were mostly female and highly educated, with a mean age of 42 years and had favorable levels of mental health at baseline. Mental wellbeing improved for the iSED group (β = 8, 95% CI 1 to 15, p = 0.030) but not for the iPA group (β = 6, 95% CI -1 to 12, p = 0.072) compared to the control group. No effects were found for depression or anxiety symptoms or stress.ConclusionsThe multi-level interventions improved mental wellbeing among this population of office workers, reaching statistical significance in the iSED group. The size of the effect can be regarded meaningful, considering favorable mental health and high PA level at baseline. Thus, workplace interventions that provide support on multiple levels appear to have potential for improving mental wellbeing, but not reducing ill-health variables, among healthy office workers. More research is needed to understand the mechanisms through which such improvements can be achieved and to identify the most effective intervention components.Trial registrationISRCTN92968402 (27 February 2018).

Project description:BackgroundThere is a clear public health need to reduce office workers' sedentary behaviors (SBs), especially in the workplace. Digital technologies are increasingly being deployed in the workplace to measure and modify office workers' SBs. However, knowledge of the range and nature of research on this topic is limited; it also remains unclear to what extent digital interventions have exploited the technological possibilities.ObjectiveThis study aimed to investigate the technological landscape of digital interventions for SB reduction in office workers and to map the research activity in this field.MethodsTerms related to SB, office worker, and digital technology were applied in various combinations to search Cochrane Library, Joanna Briggs Institute Database of Systematic Reviews, MEDLINE, PsycARTICLES, PsycINFO, Scopus, Association for Computing Machinery Digital Library, Engineering index Compendex, and Google Scholar for the years 2000 to 2017. Data regarding the study and intervention details were extracted. Interventions and studies were categorized into development, feasibility and/piloting, evaluation, or implementation phase based on the UK Medical Research Council (MRC) framework for developing and evaluating complex interventions. A novel framework was developed to classify technological features and annotate technological configurations. A mix of quantitative and qualitative approaches was used to summarize data.ResultsWe identified 68 articles describing 45 digital interventions designed to intervene with office workers' SB. A total of 6 common technological features had been applied to interventions with various combinations. Configurations such as "information delivery and mediated organizational and social support" and "digital log and automated tailored feedback" were well established in evaluation and implementation studies; in contrast, the integration of passive data collection, connected devices, and ATF or scheduled prompts was mostly present in development and piloting research.ConclusionsThis review is the first to map and describe the use of digital technologies in research on SB reduction in office workers. Interdisciplinary collaborations can help to maximize the potential of technologies. As novel modes of delivery that capitalize on embedded computing and electronics, wireless technologies have been developed and piloted in engineering, computing, and design fields, efforts can be directed to move them to the next phase of evaluation with more rigorous study designs. Quality of research may be improved by fostering conversations between different research communities and encouraging researchers to plan, conduct, and report their research under the MRC framework. This review will be particularly informative to those deciding on areas where further research or development is needed and to those looking to locate the relevant expertise, resources, and design inputs when designing their own systems or interventions.

Project description:ObjectivesTo evaluate the effectiveness of an intervention, with and without a height adjustable desk, on daily sitting time, and to investigate the relative effectiveness of the two interventions, and the effectiveness of both interventions on physical behaviours and physical, biochemical, psychological, and work related health and performance outcomes.DesignCluster three arm randomised controlled trial with follow-up at three and 12 months.SettingLocal government councils in Leicester, Liverpool, and Greater Manchester, UK.Participants78 clusters including 756 desk based employees in defined offices, departments, or teams from two councils in Leicester, three in Greater Manchester, and one in Liverpool.InterventionsClusters were randomised to one of three conditions: the SMART Work and Life (SWAL) intervention, the SWAL intervention with a height adjustable desk (SWAL plus desk), or control (usual practice).Main outcomes measuresThe primary outcome measure was daily sitting time, assessed by accelerometry, at 12 month follow-up. Secondary outcomes were accelerometer assessed sitting, prolonged sitting, standing and stepping time, and physical activity calculated over any valid day, work hours, workdays, and non-workdays, self-reported lifestyle behaviours, musculoskeletal problems, cardiometabolic health markers, work related health and performance, fatigue, and psychological measures.ResultsMean age of participants was 44.7 years, 72.4% (n=547) were women, and 74.9% (n=566) were white. Daily sitting time at 12 months was significantly lower in the intervention groups (SWAL -22.2 min/day, 95% confidence interval -38.8 to -5.7 min/day, P=0.003; SWAL plus desk -63.7 min/day, -80.1 to -47.4 min/day, P<0.001) compared with the control group. The SWAL plus desk intervention was found to be more effective than SWAL at changing sitting time (-41.7 min/day, -56.3 to -27.0 min/day, P<0.001). Favourable differences in sitting and prolonged sitting time at three and 12 month follow-ups for both intervention groups and for standing time for the SWAL plus desk group were observed during work hours and on workdays. Both intervention groups were associated with small improvements in stress, wellbeing, and vigour, and the SWAL plus desk group was associated with improvements in pain in the lower extremity, social norms for sitting and standing at work, and support.ConclusionsBoth SWAL and SWAL plus desk were associated with a reduction in sitting time, although the addition of a height adjustable desk was found to be threefold more effective.Trial registrationISRCTN Registry ISRCTN11618007.

Project description:BACKGROUND: Occupational sedentary behaviour is an important contributor to overall sedentary risk. There is limited evidence for effective workplace interventions to reduce occupational sedentary time and increase light activity during work hours. The purpose of the study was to determine if participatory workplace interventions could reduce total sedentary time, sustained sedentary time (bouts >30 minutes), increase the frequency of breaks in sedentary time and promote light intensity activity and moderate/vigorous activity (MVPA) during work hours. METHODS: A randomised controlled trial (ANZCTR NUMBER: ACTN12612000743864) was conducted using clerical, call centre and data processing workers (n?=?62, aged 25-59 years) in 3 large government organisations in Perth, Australia. Three groups developed interventions with a participatory approach: 'Active office' (n?=?19), 'Active Workstation' and promotion of incidental office activity; 'Traditional physical activity' (n?=?14), pedometer challenge to increase activity between productive work time and 'Office ergonomics' (n?=?29), computer workstation design and breaking up computer tasks. Accelerometer (ActiGraph GT3X, 7 days) determined sedentary time, sustained sedentary time, breaks in sedentary time, light intensity activity and MVPA on work days and during work hours were measured before and following a 12 week intervention period. RESULTS: For all participants there was a significant reduction in sedentary time on work days (-1.6%, p?=?0.006) and during work hours (-1.7%, p?=?0.014) and a significant increase in number of breaks/sedentary hour on work days (0.64, p?=?0.005) and during work hours (0.72, p?=?0.015); there was a concurrent significant increase in light activity during work hours (1.5%, p?=?0.012) and MVPA on work days (0.6%, p?=?0.012). CONCLUSIONS: This study explored novel ways to modify work practices to reduce occupational sedentary behaviour. Participatory workplace interventions can reduce sedentary time, increase the frequency of breaks and improve light activity and MVPA of office workers by using a variety of interventions. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTN12612000743864.

Project description:BackgroundOffice workers spend a significant part of their workday sitting. Interventions that aim to reduce sedentary behaviour and increase physical activity might be more effective if greater attention is paid to individual perspectives that influence behavioural choices, including beliefs and values. This study aimed to gain insight into office workers' perspectives on physical activity and sedentary behaviour.MethodsSixteen Dutch office workers (50% female) from different professions participated in semi-structured face-to-face interviews in March 2019. To facilitate the interviews, participants received a sensitizing booklet one week before the interview. The booklet aimed to trigger them to reflect on their physical activity and sedentary behaviour and on their values in life. All interviews were audiotaped, transcribed verbatim and coded following codebook thematic analysis.ResultsSix themes were identified: 1) beliefs about health effects are specific regarding physical activity, but superficial regarding sedentary behaviour; 2) in addition to 'health' as a value, other values are also given priority; 3) motivations to engage in physical activity mainly stem from prioritizing the value 'health', reflected by a desire to both achieve positive short/mid-term outcomes and to prevent long-term negative outcomes; 4) attitudes towards physical inactivity and sedentary behaviour are diverse and depend on individual values and previous experiences; 5) perceived barriers depend on internal and external factors; 6) supporting factors are related to support and information in the social and physical environment.ConclusionsThe great value that office workers attach to health is reflected in their motivations and attitudes regarding physical activity. Increasing office workers' knowledge of the health risks of prolonged sitting may therefore increase their motivation to sit less. Although 'health' is considered important, other values, including social and work-related values, are sometimes prioritized. We conclude that interventions that aim to reduce sedentary behaviour and increase physical activity among office workers could be improved by informing about health effects of sedentary behaviour and short/mid-term benefits of physical activity, including mental health benefits. Moreover, interventions could frame physical activity as congruent with values and support value-congruent choices. Finally, the work environment could support physical activity and interruption of sedentary behaviour.

Dataset Information

Improving office workers' mental health and cognition: a 3-arm cluster randomized controlled trial targeting physical activity and sedentary behavior in multi-component interventions.

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Improving office workers' mental health and cognition: a 3-arm cluster randomized controlled trial targeting physical activity and sedentary behavior in multi-component interventions.

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