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Zerguine H, Healy GN, Goode AD, Abbott A, Johnston V. Co-design and development of the sit-stand e-guide: An e-training program for the optimal use of sit-stand workstations. APPLIED ERGONOMICS 2024; 116:104207. [PMID: 38128399 DOI: 10.1016/j.apergo.2023.104207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/03/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
This paper describes the co-design and development process of an evidence-informed e-training program (Sit-Stand e-Guide) to support the safe and optimal use of sit-stand workstations from ergonomics and behavioural change perspectives. Using an instructional system design process, supported by a participatory design approach, data was collected through three workshops with workplace consumers (staff [n = 5] and managers [n = 5]), and subject matter experts (n = 5). Content and learning activities were developed based on behaviour change principles and optimal pedagogy. Key topics identified for the e-training were sedentary behaviour and health; workstation set-up; and strategies for behaviour change. Learning activities (scenarios and reflection) to enhance knowledge retention and skills implementation and an interactive one-page guide on completion were included in the e-training. The relevance and usefulness of the training prototype were reviewed through one-to-one think-aloud sessions with the workshop consumers (n = 5) and external health and safety professionals (n = 5) receiving positive feedback. The Sit-Stand e-Guide is readily available for workplace implementation and evaluation. This paper serves as a practical guide for future training development.
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Affiliation(s)
- Haroun Zerguine
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Brisbane, QLD, Australia.
| | - Genevieve N Healy
- The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia, Brisbane, QLD, Australia; Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Curtin University, School of Physiotherapy and Exercise Science, Perth, WA, Australia
| | - Ana D Goode
- The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia, Brisbane, QLD, Australia
| | - Alison Abbott
- Workplace Health and Safety Queensland, Office of Industrial Relations, Queensland Government, Brisbane, QLD, Australia
| | - Venerina Johnston
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Brisbane, QLD, Australia; University of Southern Queensland, School of Health and Medical Sciences, Ipswich, QLD, Australia
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Nour Eldein MM, Babakr AT. Evaluation of a Lipid Profile in Normoglycemic and Pre-diabetic Saudi Office Employees in Makka Region: A Case-Control Study. Cureus 2024; 16:e57608. [PMID: 38707051 PMCID: PMC11069631 DOI: 10.7759/cureus.57608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Diabetes mellitus (DM) poses a significant health challenge worldwide. The impact of a sedentary lifestyle in predicting and managing complications of diabetes represents an urgent need for health strategies. The objective of this study was to evaluate the lipid profile among normoglycemic and prediabetic Saudi office workers. METHODS The research was a case-control study carried out in Makkah al-Mukarramah (Kingdom of Saudi Arabia, KSA). Seventy-five office worker volunteers between the ages of 19 and 45 years were recruited for the study. The participants were divided into two groups: a control group of non-diabetic normal subjects (NGT) and prediabetic subjects with impaired fasting plasma glucose and/or impaired glucose tolerance (IGT), based on the American Diabetes Association recommendations. Measurements of glucose, hemoglobin A1C (HbA1C), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were performed using standard procedures and commercial kits. Statistical analysis was performed to compare the lipid profile in the two groups, and a P-value of <0.05 was considered statistically significant. RESULTS A proportion (58.7%) of the office workers are prediabetics; prediabetic office workers had higher total cholesterol compared to the control group (p < 0.05). Triglyceride levels were higher in office workers with prediabetes compared to the normoglycemic group (p < 0.05). LDL levels were elevated in the prediabetic office workers compared to the control group (p < 0.05). CONCLUSION Office employees with prediabetes exhibit elevated levels of cholesterol, triglycerides, and LDL. The disturbance in lipid profile may be linked to impaired glucose tolerance in individuals with a sedentary lifestyle, such as office workers.
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Wallmann-Sperlich B, Bucksch J, Lendt C, Biallas B, Bipp T, Froboese I. Home office shift and sedentary behaviour in Germany during the COVID-19 pandemic: descriptives and related socioecological correlates. ERGONOMICS 2024; 67:1-12. [PMID: 37125437 DOI: 10.1080/00140139.2023.2202841] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
COVID-19 working restrictions resulted in a location shift of white-collar workers into their home office (HO). Little is known about how the proportion of HO affects sitting and physical activity (PA) behaviour during working hours, and potential correlates are not well understood. A cross-sectional sample of currently working adults in HO (n = 575) completed questionnaires regarding HO proportion before and during the pandemic, work-related sitting and PA, and socioecological factors regarding HO sitting time. The reported HO proportion increased by 46.7 ± 40.6% during COVID-19 working restrictions. Workday sitting proportion correlates positively with HO proportion. The regression model identified gender, education level, working hours, working environment to stand during work, and transport and leisure PA as correlates of the workday sitting proportion in HO. This study provides findings that high HO proportions are related to higher work-related sitting times and adds insights into possible correlates of sitting time in HO.Practitioner summary: Working in the home office (HO) is a common characteristic of flexible work in white-collar workers. This study found that the workday sitting proportion correlates positively with HO proportion and identified correlates of the workday sitting in HO. Practitioners should consider the potential impacts of HO on work-related sedentary behaviour in future workplace health promotion.
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Affiliation(s)
| | - Jens Bucksch
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, University of Education Heidelberg, Heidelberg, Germany
| | - Claas Lendt
- Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Bianca Biallas
- Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Tanja Bipp
- Industrial and Organizational Psychology, Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Ingo Froboese
- Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
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Dzakpasu FQS, Owen N, Carver A, Brakenridge CJ, Eakin EG, Healy GN, Lamontagne AD, Moodie M, Coenen P, Straker L, Dunstan DW. Changes in Desk-Based Workers' Sitting, Standing, and Stepping Time: Short- and Longer-Term Effects on Musculoskeletal Pain. Med Sci Sports Exerc 2023; 55:2241-2252. [PMID: 37729188 DOI: 10.1249/mss.0000000000003248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
PURPOSE Sitting at work can be associated with musculoskeletal pain, but the effect of reductions in sitting is not well understood. We examined relationships with musculoskeletal pain of changes in sitting, standing, stepping, and short and long bouts of these behaviors. METHODS Analyses pooled data from 224 desk workers (68.4% women; mean ± SD age = 45.5 ± 9.4 yr; body mass index = 28.1 ± 6.1 kg⋅m -2 ) in intervention trial. Device-assessed (activPAL3) sitting, standing, and stepping time and multisite musculoskeletal pain (Nordic Questionnaire; 12 body areas) were assessed at baseline, 3 months, and 12 months. Compositional data analyses in linear mixed-effects regressions examined relationships within 16 waking hours of the behaviors and their short and long bouts, with changes from baseline in acute and chronic multisite musculoskeletal pain at 3 and 12 months. Analyses were adjusted for initial group randomization and relevant covariates. RESULTS At 3 months, increased standing relative to changes in other compositions was significantly associated with increased multisite musculoskeletal pain (acute: β = 1.54, 95% confidence interval [CI] = 0.10 to 2.98; chronic: β = 1.49, 95% CI = 0.12 to 2.83). By contrast, increased stepping relative to changes in other compositions was significantly associated with reduced multisite musculoskeletal pain (acute: β = -1.49, 95% CI = -2.97 to -0.02; chronic: β = -1.87, 95% CI = -3.75 to -0.01). Neither sitting reduction relative to changes in other compositions nor changes in short bouts relative to long bouts of the behaviors were significantly associated with multisite musculoskeletal pain changes. At 12 months, there were no significant associations for any of the compositional changes. CONCLUSIONS In the short term, while increasing standing with reduced sitting time can be unfavorable, concurrently increasing stepping could potentially reduce musculoskeletal pain. In the longer term, musculoskeletal pain may not be increased by moderate reductions in sitting time through spending more time standing or stepping.
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Affiliation(s)
- Francis Q S Dzakpasu
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, AUSTRALIA
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, AUSTRALIA
| | - Neville Owen
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, AUSTRALIA
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, AUSTRALIA
| | - Alison Carver
- National Centre for Healthy Ageing, Peninsula Clinical School, Monash University, Frankston, VIC, AUSTRALIA
| | - Christian J Brakenridge
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, AUSTRALIA
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, FINLAND
| | - Elizabeth G Eakin
- School of Public Health, The University of Queensland, Brisbane, QLD, AUSTRALIA
| | - Genevieve N Healy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, AUSTRALIA
| | - Anthony D Lamontagne
- Institute for Health Transformation and School of Health and Social Development, Deakin University, Geelong, VIC, AUSTRALIA
| | - Marj Moodie
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC, AUSTRALIA
| | - Pieter Coenen
- Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, THE NETHERLANDS
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, THE NETHERLANDS
| | - Leon Straker
- Curtin School of Allied Health, Curtin University, Perth, WA, AUSTRALIA
| | - David W Dunstan
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, AUSTRALIA
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, AUSTRALIA
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Edwardson CL, Maylor BD, Biddle SJ, Clemes SA, Cox E, Davies MJ, Dunstan DW, Eborall H, Granat MH, Gray LJ, Hadjiconstantinou M, Healy GN, Jaicim NB, Lawton S, Mandalia P, Munir F, Richardson G, Walker S, Yates T, Clarke-Cornwell AM. A multicomponent intervention to reduce daily sitting time in office workers: the SMART Work & Life three-arm cluster RCT. PUBLIC HEALTH RESEARCH 2023; 11:1-229. [PMID: 37786938 DOI: 10.3310/dnyc2141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Abstract
Background Office workers spend 70-85% of their time at work sitting. High levels of sitting have been linked to poor physiological and psychological health. Evidence shows the need for fully powered randomised controlled trials, with long-term follow-up, to test the effectiveness of interventions to reduce sitting time. Objective Our objective was to test the clinical effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable workstation, compared with usual practice at 12-month follow-up. Design A three-arm cluster randomised controlled trial. Setting Councils in England. Participants Office workers. Intervention SMART Work & Life is a multicomponent intervention that includes behaviour change strategies, delivered by workplace champions. Clusters were randomised to (1) the SMART Work & Life intervention, (2) the SMART Work & Life intervention with a height-adjustable workstation (i.e. SMART Work & Life plus desk) or (3) a control group (i.e. usual practice). Outcome measures were assessed at baseline and at 3 and 12 months. Main outcome measures The primary outcome was device-assessed daily sitting time compared with usual practice at 12 months. Secondary outcomes included sitting, standing, stepping time, physical activity, adiposity, blood pressure, biochemical measures, musculoskeletal issues, psychosocial variables, work-related health, diet and sleep. Cost-effectiveness and process evaluation data were collected. Results A total of 78 clusters (756 participants) were randomised [control, 26 clusters (n = 267); SMART Work & Life only, 27 clusters (n = 249); SMART Work & Life plus desk, 25 clusters (n = 240)]. At 12 months, significant differences between groups were found in daily sitting time, with participants in the SMART Work & Life-only and SMART Work & Life plus desk arms sitting 22.2 minutes per day (97.5% confidence interval -38.8 to -5.7 minutes/day; p = 0.003) and 63.7 minutes per day (97.5% confidence interval -80.0 to -47.4 minutes/day; p < 0.001), respectively, less than the control group. Participants in the SMART Work & Life plus desk arm sat 41.7 minutes per day (95% confidence interval -56.3 to -27.0 minutes/day; p < 0.001) less than participants in the SMART Work & Life-only arm. Sitting time was largely replaced by standing time, and changes in daily behaviour were driven by changes during work hours on workdays. Behaviour changes observed at 12 months were similar to 3 months. At 12 months, small improvements were seen for stress, well-being and vigour in both intervention groups, and for pain in the lower extremity and social norms in the SMART Work & Life plus desk group. Results from the process evaluation supported these findings, with participants reporting feeling more energised, alert, focused and productive. The process evaluation also showed that participants viewed the intervention positively; however, the extent of engagement varied across clusters. The average cost of SMART Work & Life only and SMART Work & Life plus desk was £80.59 and £228.31 per participant, respectively. Within trial, SMART Work & Life only had an incremental cost-effectiveness ratio of £12,091 per quality-adjusted life-year, with SMART Work & Life plus desk being dominated. Over a lifetime, SMART Work & Life only and SMART Work & Life plus desk had incremental cost-effectiveness ratios of £4985 and £13,378 per quality-adjusted life-year, respectively. Limitations The study was carried out in one sector, limiting generalisability. Conclusions The SMART Work & Life intervention, provided with and without a height-adjustable workstation, was successful in changing sitting time. Future work There is a need for longer-term follow-up, as well as follow-up within different organisations. Trial registration Current Controlled Trials ISRCTN11618007.
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Affiliation(s)
| | | | - Stuart Jh Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, QLD, Australia
| | - Stacy A Clemes
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Edward Cox
- Centre for Health Economics, University of York, York, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Helen Eborall
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | | | | | - Sarah Lawton
- School of Health & Society, University of Salford, Salford, UK
| | - Panna Mandalia
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Simon Walker
- Centre for Health Economics, University of York, York, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
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Gradidge PJ, Phaswana M, Chau JY. "If money was no object": A qualitative study of South African university office workers' perceptions of using height-adjustable sit-stand desks. SOUTH AFRICAN JOURNAL OF SPORTS MEDICINE 2023; 34:v34i1a13881. [PMID: 36815905 PMCID: PMC9924588 DOI: 10.17159/2078-516x/2022/v34i1a13881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Data from empirical investigations on the feasibility and acceptability of using sit-stand desks in an office-based setting in low- and middle-income settings are limited. Objectives To explore the perceptions of South African office workers towards using height-adjustable sit-stand desks to reduce sitting time during vocational hours. Methods Self-reported sedentary behaviour and in-depth, semi-structured interviews were conducted in December 2020. Thematic content analysis approach was used to develop themes. Results Eleven office workers with a work-time sitting time of 8 (6-8) hours were interviewed (age 40.5 ± 12.6 years), most (91%) were female. The main themes emerged and included: overall impressions of the height-adjustable sit-stand desks; enablers versus barriers to using the desk and readiness to continue using sit-stand desks. Conclusion The findings of this research add to the evidence on environmental workstation modifications for reducing sedentary behaviour. Further investigations on the efficacy of sit-stand desks are recommended in South African university office workers.
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Affiliation(s)
- PJ Gradidge
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - M Phaswana
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - JY Chau
- Department of Health Sciences, Faculty of Medicine, Health & Human Sciences, Macquarie University, Sydney,
Australia
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Kovacs P, Vîrgă D. Office job sitting demand scale: Evidence of construct and predictive validity. Scand J Psychol 2023; 64:80-88. [PMID: 35997242 DOI: 10.1111/sjop.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 07/04/2022] [Accepted: 08/04/2022] [Indexed: 01/11/2023]
Abstract
Drawing on sedentary behavior and Job Demands-Resources theory, we developed a new scale for assessing office job sitting demand, conceptualized as job demand, and validated it using two independent samples. In Study 1 (N = 252), we developed the items and tested the Office Job Sitting Demand scales' factor structure through exploratory factor analysis. In Study 2 (N = 248), we tested the scales' factorial validity through confirmatory factor analysis. Indicators of measurement invariance showed no differences between participants who engage in leisure-time sport and participants who do not. Moreover, we tested convergent, discriminant, and criterion validity. We found significant positive associations with exhaustion, work pressure, and musculoskeletal complaints. The construct was unrelated to proactive vitality management and relaxation. Our results illustrate the relation between this new job demand in the workplace with employee well-being. Based on our findings, this newly developed instrument is valid and reliable and can be used to assess office job sitting demand to prevent burnout and health complaints.
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Affiliation(s)
- Peter Kovacs
- Department of Psychology, West University of Timisoara, Timisoara, Romania
| | - Delia Vîrgă
- Department of Psychology, West University of Timisoara, Timisoara, Romania
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Eisele-Metzger A, Schoser DS, Klein MD, Grummich K, Schwarzer G, Schwingshackl L, Hermann R, Biallas B, Wilke C, Meerpohl JJ, Braun C. Interventions for preventing back pain among office workers - a systematic review and network meta-analysis. Scand J Work Environ Health 2023; 49:5-22. [PMID: 36382695 PMCID: PMC10549919 DOI: 10.5271/sjweh.4070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Back pain is common in the working population. This systematic review with network meta-analysis (NMA) aimed to compare the effects of interventions for preventing back pain among office workers. METHODS We searched eight databases and additional sources up to March 2021. We included randomized controlled trials (RCT) and cluster RCT focusing on office workers, comparing work-related interventions aimed at preventing back pain (defined as pain in any part of the spine) to a control condition and assessing back pain and/or work absence. Further outcomes considered were adverse events and participants' satisfaction. We performed both frequentist and component NMA. Risk of bias (RoB) was evaluated using RoB 2 and certainty of the evidence (CoE) was assessed using GRADE. RESULTS We screened 9809 records and included 24 studies with a total of 7080 participants. RoB was assessed as "some concerns" or "high" for all studies and outcomes. Included studies investigated multicomponent interventions, ergonomics, physical activity, education, behavioral interventions and no/minimal interventions. Effects were mostly not statistically significant and based on low/very low CoE. Physical activity probably reduces days of work absence slightly [mean difference (MD) -1.10, 95% confidence interval (CI) -2.07- -0.13], and combining physical activity and ergonomics may reduce back pain intensity (standardized MD -0.41, 95% CI -0.80- -0.02) when compared to no/minimal intervention. A large proportion of participants were satisfied with the interventions, adverse events were rarely assessed. CONCLUSIONS We observed mostly minor effects of interventions on back pain and work absence among office workers. The practical relevance of these effects is questionable.
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Affiliation(s)
- Angelika Eisele-Metzger
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 86, 79110 Freiburg, Germany.
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9
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Jepson R, Baker G, Sivaramakrishnan D, Manner J, Parker R, Lloyd S, Stoddart A. Feasibility of a theory-based intervention to reduce sedentary behaviour among contact centre staff: the SUH stepped-wedge cluster RCT. PUBLIC HEALTH RESEARCH 2022. [DOI: 10.3310/iexp0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background
Sedentary behaviour is linked to increased risk of type 2 diabetes, cardiovascular disease, musculoskeletal issues and poor mental well-being. Contact (call) centres are associated with higher levels of sedentary behaviour than other office-based workplaces. Stand Up for Health is an adaptive intervention designed to reduce sedentary behaviour in contact centres.
Objectives
The objectives were to test the acceptability and feasibility of implementing the intervention; to assess the feasibility of the study design and methods; to scope the feasibility of a future health economic evaluation; and to consider the impact of COVID-19 on the intervention. All sites received no intervention for between 3 and 12 months after the start of the study, as a waiting list control.
Design
This was a cluster-randomised stepped-wedge feasibility design.
Setting
The trial was set in 11 contact centres across the UK.
Participants
Eleven contact centres and staff.
Intervention
Stand Up for Health involved two workshops with staff in which staff developed activities for their context and culture. Activities ranged from using standing desks to individual goal-setting, group walks and changes to workplace policies and procedures.
Main outcome measures
The primary outcome was accelerometer-measured sedentary time. The secondary outcomes were subjectively measured sedentary time, overall sedentary behaviour, physical activity, productivity, mental well-being and musculoskeletal health.
Results
Stand Up for Health was implemented in 7 out of 11 centres and was acceptable, feasible and sustainable (objective 1). The COVID-19 pandemic affected the delivery of the intervention, involvement of contact centres, data collection and analysis. Organisational factors were deemed most important to the success of Stand Up for Health but also the most challenging to change. There were also difficulties with the stepped-wedge design, specifically maintaining contact centre interest (objective 2). Feasible methods for estimating cost-efficiency from an NHS and a Personal Social Services perspective were identified, assuming that alternative feasible effectiveness methodology can be applied. Detailed activity-based costing of direct intervention costs was achieved and, therefore, deemed feasible (objective 3). There was significantly more sedentary time spent in the workplace by the centres that received the intervention than those that did not (mean difference 84.06 minutes, 95% confidence interval 4.07 to 164.1 minutes). The other objective outcomes also tended to favour the control group.
Limitations
There were significant issues with the stepped-wedge design, including difficulties in maintaining centre interest and scheduling data collection. Collection of accelerometer data was not feasible during the pandemic.
Conclusions
Stand Up for Health is an adaptive, feasible and sustainable intervention. However, the stepped-wedge study design was not feasible. The effectiveness of Stand Up for Health was not demonstrated and clinically important reductions in sedentary behaviour may not be seen in a larger study. However, it may still be worthwhile conducting an effectiveness study of Stand Up for Health incorporating activities more relevant to hybrid workplaces.
Future work
Future work could include developing hybrid (office and/or home working) activities for Stand Up for Health; undertaking a larger effectiveness study and follow-up economic analysis (subject to its success); and exploring organisational features of contact centres that affect the implementation of interventions such as Stand Up for Health.
Trial registration
This trial is registered as ISRCTN11580369.
Funding
This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 13. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
| | - Graham Baker
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Divya Sivaramakrishnan
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
| | - Jillian Manner
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
| | - Richard Parker
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Scott Lloyd
- Public Health South Tees, Middlesbrough Council and Redcar & Cleveland Borough Council, Middlesbrough, UK
| | - Andrew Stoddart
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
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10
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Edwardson CL, Biddle SJH, Clemes SA, Davies MJ, Dunstan DW, Eborall H, Granat MH, Gray LJ, Healy GN, Jaicim NB, Lawton S, Maylor BD, Munir F, Richardson G, Yates T, Clarke-Cornwell AM. Effectiveness of an intervention for reducing sitting time and improving health in office workers: three arm cluster randomised controlled trial. BMJ 2022; 378:e069288. [PMID: 35977732 PMCID: PMC9382450 DOI: 10.1136/bmj-2021-069288] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To 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. DESIGN Cluster three arm randomised controlled trial with follow-up at three and 12 months. SETTING Local government councils in Leicester, Liverpool, and Greater Manchester, UK. PARTICIPANTS 78 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. INTERVENTIONS Clusters 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 MEASURES The 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. RESULTS Mean 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. CONCLUSIONS Both 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 REGISTRATION ISRCTN Registry ISRCTN11618007.
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Affiliation(s)
- Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, QLD, Australia
| | - Stacy A Clemes
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Mary MacKillop Institute for Health Research, The Australian Catholic University, Melbourne, VIC, Australia
| | - Helen Eborall
- Department of Health Sciences, University of Leicester, Leicester, UK
- Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, UK
| | - Malcolm H Granat
- School of Health and Society, University of Salford, Salford, Greater Manchester, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Genevieve N Healy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | | | - Sarah Lawton
- School of Health and Society, University of Salford, Salford, Greater Manchester, UK
| | - Benjamin D Maylor
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicester, UK
| | | | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
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11
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Lin C, Li T, Zou G, Li X, Ling L, Chen W. Implementation Evaluation of a Cluster Randomized Controlled Trial to Promote the Use of Respiratory Protective Equipment Among Migrant Workers Exposed to Organic Solvents in Small and Medium-Sized Enterprises. Front Public Health 2022; 10:772632. [PMID: 35903378 PMCID: PMC9319860 DOI: 10.3389/fpubh.2022.772632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundWhile the effectiveness of several occupational healthcare interventions has been demonstrated, successful implementation of such programs among internal migrant workers (IMWs) in small and medium-sized enterprises (SMEs) has been limited. This study aimed to evaluate the implementation of a three-arm cluster randomized controlled trial promoting respiratory protective equipment (RPE) use among IMWs exposed to organic solvents in SMEs and to assess the association between participants' compliance and effectiveness of intervention.MethodsA total of 60 SMEs were randomly allocated to a low- or high-intensive intervention group, or a control group that did not receive any intervention. The low-intensive intervention group was subjected to both traditional and mHealth occupational health education. The high-intensive intervention group was subjected to the low-intensive group activities and peer education. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide implementation evaluation of this 6-months intervention. Generalized linear mixed models (GLMMs) were used to evaluate the effects of participants' compliance with the intervention on the primary outcomes, regarding the appropriate use of RPE.ResultsOf 4,527 potentially eligible participants, 1,211 individuals were enrolled, with a reach rate of 26.8%. Sixty of the 66 SMEs approached (90.9%) SMEs adopted the intervention. Fidelity to traditional education (100.0%) and mHealth intervention (97.5%) was higher than fidelity to peer education (20.0%). Peer leaders cited inconvenient time and unfamiliarity with peers as two major barriers to delivering peer education. Compared with the control group, IMWs who complied with the interventions in both groups were more likely to wear RPE appropriately [low-intensive group: adjusted odds ratio (aOR) = 2.58, 95% confidence interval (CI): 1.56–4.28; high-intensive group: aOR = 7.52, 95% CI: 3.72–15.23]. Most participants (95.8%) were satisfied with the program and 93.1% stated that they would maintain the use of RPE in the future.ConclusionsA multi-component occupational health intervention to promote the use of RPE among IMWs in SMEs was feasible and acceptable. Peer education had great potential to enhance the occupational health behavior of IMWs, and thus strategies to improve participants' adherence to this component warrant further investigation.Clinical Trial Registrationhttp://www.chictr.org.cn, identifier: ChiCTR-IOR-15006929.
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Affiliation(s)
- Chuangpeng Lin
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Tongyang Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Guanyang Zou
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xudong Li
- Guangdong Prevention and Treatment Center for Occupational Diseases, Guangzhou, China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Wen Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Wen Chen
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12
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Leonard KS, Mullane SL, Golden CA, Rydell SA, Mitchell NR, Koskan A, Estabrooks PA, Pereira MA, Buman MP. Qualitative comparative analysis of the implementation fidelity of a workplace sedentary reduction intervention. BMC Public Health 2022; 22:1086. [PMID: 35641923 PMCID: PMC9158295 DOI: 10.1186/s12889-022-13476-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stand and Move at Work was a 12-month, multicomponent, peer-led (intervention delivery personnel) worksite intervention to reduce sedentary time. Although successful, the magnitude of reduced sedentary time varied by intervention worksite. The purpose of this study was to use a qualitative comparative analysis approach to examine potential explanatory factors that could distinguish higher from lower performing worksites based on reduced sedentary time. METHODS We assessed 12-month changes in employee sedentary time objectively using accelerometers at 12 worksites. We ranked worksites based on the magnitude of change in sedentary time and categorized sites as higher vs. lower performing. Guided by the integrated-Promoting Action on Research Implementation in Health Services framework, we created an indicator of intervention fidelity related to adherence to the protocol and competence of intervention delivery personnel (i.e., implementer). We then gathered information from employee interviews and surveys as well as delivery personnel surveys. These data were aggregated, entered into a truth table (i.e., a table containing implementation construct presence or absence), and used to examine differences between higher and lower performing worksites. RESULTS There were substantive differences in the magnitude of change in sedentary time between higher (-75.2 min/8 h workday, CI95: -93.7, -56.7) and lower (-30.3 min/8 h workday, CI95: -38.3, -22.7) performing worksites. Conditions that were present in all higher performing sites included implementation of indoor/outdoor walking route accessibility, completion of delivery personnel surveys, and worksite culture supporting breaks (i.e., adherence to protocol). A similar pattern was found for implementer willingness to continue role and employees using face-to-face interaction/stair strategies (i.e., delivery personnel competence). However, each of these factors were also present in some of the lower performing sites suggesting we were unable to identify sufficient conditions to predict program success. CONCLUSIONS Higher intervention adherence and implementer competence is necessary for greater program success. These findings illustrate the need for future research to identify what factors may influence intervention fidelity, and in turn, effectiveness. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02566317 . Registered 2 October 2015, first participant enrolled 11 January 2016.
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Affiliation(s)
- Krista S Leonard
- College of Health Solutions, Arizona State University, 425 N 5 th Street, Phoenix, AZ, 85004, USA.
| | - Sarah L Mullane
- Johnson & Johnson Health and Wellness Solutions, Inc, New Brunswick, USA
| | - Caitlin A Golden
- College of Public Health, University of Nebraska Medical School, Omaha, USA
| | - Sarah A Rydell
- School of Public Health, University of Minnesota, Minneapolis, USA
| | | | - Alexis Koskan
- College of Health Solutions, Arizona State University, 425 N 5 th Street, Phoenix, AZ, 85004, USA
| | | | - Mark A Pereira
- School of Public Health, University of Minnesota, Minneapolis, USA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, 425 N 5 th Street, Phoenix, AZ, 85004, USA
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13
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Brakenridge CJ, Gardiner PA, Grigg RV, Winkler EAH, Fjeldsoe BS, Schaumberg MA, Owen N, Eakin EG, Biddle SJH, Moodie M, Daly RM, Green DJ, Cohen N, Gray L, Comans T, Buman MP, Goode AD, Nguyen P, Gao L, Healy GN, Dunstan DW. Sitting less and moving more for improved metabolic and brain health in type 2 diabetes: 'OPTIMISE your health' trial protocol. BMC Public Health 2022; 22:929. [PMID: 35538430 PMCID: PMC9086419 DOI: 10.1186/s12889-022-13123-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Clinical practice guidelines recommend that adults with type 2 diabetes (T2D) sit less and move more throughout the day. The 18-month OPTIMISE Your Health Clinical Trial was developed to support desk-based workers with T2D achieve these recommendations. The two-arm protocol consists of an intervention and control arms. The intervention arm receives 6 months health coaching, a sit-stand desktop workstation and an activity tracker, followed by 6 months of text message support, then 6 months maintenance. The control arm receives a delayed modified intervention after 12 months of usual care. This paper describes the methods of a randomised controlled trial (RCT) evaluating the effectiveness and cost-effectiveness of the intervention, compared to a delayed intervention control. METHODS This is a two-arm RCT being conducted in Melbourne, Australia. Desk-based workers (≥0.8 full-time equivalent) aged 35-65 years, ambulatory, and with T2D and managed glycaemic control (6.5-10.0% HbA1c), are randomised to the multicomponent intervention (target n = 125) or delayed-intervention control (target n = 125) conditions. All intervention participants receive 6 months of tailored health coaching assisting them to "sit less" and "move more" at work and throughout the day, supported by a sit-stand desktop workstation and an activity tracker (Fitbit). Participants receive text message-based extended care for a further 6-months (6-12 months) followed by 6-months of non-contact (12-18 months: maintenance). Delayed intervention occurs at 12-18 months for the control arm. Assessments are undertaken at baseline, 3, 6, 12, 15 and 18-months. Primary outcomes are activPAL-measured sitting time (h/16 h day), glycosylated haemoglobin (HbA1c; %, mmol/mol) and, cognitive function measures (visual learning and new memory; Paired Associates Learning Total Errors [adjusted]). Secondary, exploratory, and process outcomes will also be collected throughout the trial. DISCUSSION The OPTIMISE Your Health trial will provide unique insights into the benefits of an intervention aimed at sitting less and moving more in desk-bound office workers with T2D, with outcomes relevant to glycaemic control, and to cardiometabolic and brain health. Findings will contribute new insights to add to the evidence base on initiating and maintaining behaviour change with clinical populations and inform practice in diabetes management. TRIAL REGISTRATION ANZCTRN12618001159246 .
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Affiliation(s)
- Christian J Brakenridge
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.
- Australian Catholic University, Mary Mackillop Institute of Health Research, Melbourne, Australia.
| | - Paul A Gardiner
- University of Southern Queensland, School of Health and Medical Sciences, Ipswich, Australia
- University of Southern Queensland, Centre for Health Research, Springfield, Australia
- The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Ruth V Grigg
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Elisabeth A H Winkler
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
| | - Brianna S Fjeldsoe
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Mia A Schaumberg
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
- University of Sunshine Coast, School of Health and Behavioural Sciences, Sunshine Coast, Australia
- Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, Australia
| | - Neville Owen
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
- Swinburne University, School of Health Sciences, Melbourne, Australia
| | - Elizabeth G Eakin
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Stuart J H Biddle
- University of Southern Queensland, Centre for Health Research, Springfield, Australia
| | - Marjory Moodie
- Deakin University, School of Health and Social Development, Melbourne, Australia
| | - Robin M Daly
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Melbourne, Australia
| | - Daniel J Green
- University of Western Australia, School of Sport Science, Exercise & Health, Perth, Australia
| | - Neale Cohen
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Len Gray
- The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Tracy Comans
- The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Matthew P Buman
- Arizona State University, College of Health Solutions, Tempe, USA
| | - Ana D Goode
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
| | - Phuong Nguyen
- Deakin University, School of Health and Social Development, Melbourne, Australia
| | - Lan Gao
- Deakin University, School of Health and Social Development, Melbourne, Australia
| | - Genevieve N Healy
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
| | - David W Dunstan
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Melbourne, Australia
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
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14
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Ojo SO, Bailey DP, Chater AM, Hewson DJ. Workplace Intervention for Reducing Sitting Time in Sedentary Workers: Protocol for a Pilot Study Using the Behavior Change Wheel. Front Public Health 2022; 10:832374. [PMID: 35493386 PMCID: PMC9039234 DOI: 10.3389/fpubh.2022.832374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
The workplace is a major contributor to excessive sitting in office workers. There are a wide array of adverse effects of high volumes of sitting time, including an increased risk of type 2 diabetes and depression. Active workstations can be used in effective interventions to decrease workplace sitting. However, there are a lack of interventions that have been developed using a systematic process that is informed by participant needs and a framework for identifying the most appropriate content for the intervention. Applying these methods could increase adherence and potential effectiveness of the intervention. Therefore, the purpose of this pilot study is to examine the feasibility, acceptability, and efficacy of a tailored workplace intervention to reduce and break up sitting in office workers that has been developed using the Behavior Change Wheel and the APEASE (Acceptability, Practicability, Effectiveness/cost-effectiveness, Affordability, Safety/side-effects, Equity) criteria. This article reports the protocol for this study that is currently ongoing. Participants will be cluster-randomized (by offices) to control and intervention groups. The evaluation of the intervention includes determining feasibility by assessing participant recruitment, retention and data completion rates. Adherence to the intervention will be assessed based on daily sitting and standing time relative to guidelines provided to participants as part of the intervention. Outcome measures also include productivity measured using Ecological Momentary Assessment, absenteeism, presenteeism, cardiometabolic risk markers, and wellbeing. The findings of this study will inform the effective design and implementation of interventions for reducing and breaking up sitting in office workers.
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Affiliation(s)
- Samson O Ojo
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom.,Quality Improvement, Northampton General Hospital NHS Trust, Northampton, United Kingdom
| | - Daniel P Bailey
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, United Kingdom.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom.,Centre for Physical Activity in Health and Disease, Brunel University London, Uxbridge, United Kingdom
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, United Kingdom.,Centre for Behaviour Change, University College London, London, United Kingdom
| | - David J Hewson
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom
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15
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Terranova CO, Winkler EAH, Healy GN, Demark-Wahnefried W, Eakin EG, Reeves MM. Dietary and physical activity changes and adherence to WCRF/AICR cancer prevention recommendations following a remotely delivered weight loss intervention for female breast cancer survivors: The Living Well after Breast Cancer randomized controlled trial. J Acad Nutr Diet 2022; 122:1644-1664.e7. [PMID: 35182789 DOI: 10.1016/j.jand.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Diet, exercise, and weight management are key in improving outcomes for breast cancer survivors, with international recommendations for cancer survivors relating to these behaviors. However, few behavioral interventions have reported outcomes aligned specifically with these recommendations. OBJECTIVE To evaluate a remotely delivered weight loss intervention versus usual care for female breast cancer survivors, on changes in multiple diet and physical activity behaviors. DESIGN A randomized controlled trial with assessments at study baseline, 6-, 12- and 18 months (i.e., mid-intervention, post-intervention, and non-contact follow-up). PARTICIPANTS/SETTING Participants were recruited between October 2012 and December 2014 through hospitals in Brisbane (Australia) and the state-based cancer registry. Eligible participants (female, 18-75 years, BMI 25-45 kg/m2, diagnosed with stage I-III breast cancer in previous two years) were randomly allocated to intervention (n=79) or usual care (n=80). INTERVENTION Participants randomized to the intervention group received 22 counseling telephone calls targeting diet and physical activity aimed at achieving 5-10% weight loss, and optional text messages, over 12 months. Usual care participants received their standard medical care and brief feedback following each assessment, which was similar to that provided to intervention participants with the exception that usual care participants' results were not compared to national and study recommendations. MAIN OUTCOME MEASURES Dietary intake (24-hour recalls); physical activity (hip-worn Actigraph); sitting time (thigh-worn activPAL3); and, adherence to World Cancer Research Fund/American Cancer Research Institute (WCRF/AICR) recommendations for cancer survivors (0-7 score) were measured at each assessment, with data collected between November 2012 and October 2016. STATISTICAL ANALYSES PERFORMED Intervention effects were assessed by linear mixed models, accounting for repeated measures and baseline values. Significance was set at P<0.05. RESULTS At baseline, participants were (mean±SD) aged 55±9 years, with a BMI of 31.4±5.0 kg/m2, 10.7±5.0 months post-diagnosis, and primarily non-minority. At baseline, only 8% (n=12) of participants met ≥5/7 WCRF/AICR recommendations (mean±SD WCRF/AICR adherence score: 3.8±1.0). At 12 months, significant intervention effects were observed in walking/running ( +21 mins/week; 95%CI: 4, 38) and WCRF/AICR adherence scores (+0.3 points; 95%CI: 0.0, 0.6) only. At 18 months, significant intervention effects were observed for energy intake (-229 kcal/day energy; 95%CI: -373, -84), total fat (-10 g/day; 95%CI: -18, -2), and saturated fat (-5 g/day; 95%CI: -9, -1), and were sustained for WCRF/AICR adherence scores (+0.5 points; 95%CI: 0.2, 0.8). CONCLUSIONS This remotely delivered weight loss intervention led to sustained improvements in WCRF/AICR adherence scores, and some improvements in diet and physical activity. These findings provide support for the health benefit of programs targeting lifestyle behaviors in line with cancer survivor recommendations, and the potential for dissemination of such programs following treatment for early-stage female breast cancer.
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Affiliation(s)
- C O Terranova
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - E A H Winkler
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - G N Healy
- School of Public Health, The University of Queensland, Brisbane, Australia; Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia; School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - W Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - E G Eakin
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - M M Reeves
- School of Public Health, The University of Queensland, Brisbane, Australia
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16
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Investigating the Immediate Influence of Moderate Pedal Exercises during an Assembly Work on Performance and Workload in Healthy Men. Healthcare (Basel) 2021; 9:healthcare9121644. [PMID: 34946369 PMCID: PMC8701139 DOI: 10.3390/healthcare9121644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/17/2022] Open
Abstract
Physical inactivity has increased in prevalence among adults in industrialized and developing countries owing to the fact that the majority of job situations require individuals to remain seated for extended periods of time. This research aims to evaluate the influence of cycling on a stationary bike while executing a keyboard assembly task on the task completion time, error percentage, and physiological and subjective measurements. The physiological measures were electroencephalography (EEG) and electrocardiographic (ECG) signal responses, whereas the subjective measures were subjective workload ratings and subjective body discomforts. Two variables were evaluated, namely assembly methods (with versus without pedal exercises at a moderate intensity) and session testing (pre- versus post-test). Thus, the repeated measures design (i.e., assembly method by session testing of participants) was used. According to the completion time, error %, participant self-reports, and ECG and EEG statistical analysis data, the participants' performances in the keyboard assembly task did not decrease while they performed pedaling exercises (p > 0.05). Additionally, when participants completed the assembly task while executing the pedaling exercises, the mean inter-beat (RR) intervals significantly reduced (p < 0.05) while the mean heart rate increased (p < 0.05), which mean that pedaling exercises caused physical workloads on the participants. Participant performance was unaffected by performing a workout while performing the assembly activity. Thus, administrations should encourage their employees to engage in short sessions of moderate-intensity exercise similar to the suggested exercise in the study to improve a person's physical health during work without interfering with the effectiveness of work.
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17
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Healy GN, Winkler EAH, Goode AD. A RE-AIM evaluation in early adopters to iteratively improve the online BeUpstanding™ program supporting workers to sit less and move more. BMC Public Health 2021; 21:1916. [PMID: 34674676 PMCID: PMC8532381 DOI: 10.1186/s12889-021-11993-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/11/2021] [Indexed: 11/16/2022] Open
Abstract
Background The web-based BeUpstanding program supports desk workers to sit less and move more. Successfully translated from a research-delivered intervention, BeUpstanding has gone through iterative development and evaluation phases in preparation for wide-scale implementation. In the third planned “early-adopters” phase (01/09/2017–11/06/2019), the program was made freely-available online. An integrated delivery and evaluation platform was also developed to enable workplace champions to run and evaluate the intervention within their work team independent of researcher support. Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, this study reports on the extent to which the program and processes were “fit-for-purpose” for a national implementation trial across the indicators of uptake (reach and adoption), implementation and engagement, and effectiveness for behaviour change. Methods Data were collected via the online surveys embedded in the program and through program access analytics. Descriptive data (with linearized variance for the clustered staff-level data) and results from mixed models (repeated data and clustering for pre-post changes) are reported. Results Despite purposeful limited promotion, uptake was good, with 182 Australian users initially registering (208 total) and 135 (from 113 organisations) then completing the sign-up process. Recruitment reached users across Australia and in 16 of 19 Australian industries. Implementation was inconsistent and limited, with signed-up users completing 0 to 14 of the program’s 14 steps and only 7 (5.2%) completing all seven core steps. Many champions (n = 69, 51.1%) had low engagement (1 day toolkit usage) and few (n = 30, 22%) were highly engaged (> 1 day toolkit usage and surveyed staff). Although only 18 users (7 organisations) performed the pre- and post-program staff evaluations (337 and 167 staff, respectively), pre-post changes showed the program effectively reduced workplace sitting by − 9.0% (95% CI -12.0, − 5.9%). Discussion The program had uptake across industries and across Australia, but implementation and engagement varied widely. Few workplaces completed the evaluation components. In those that did, the program was effective for the primary outcome (workplace sitting). Conducting a planned early adopters phase and a comprehensive evaluation according to RE-AIM helped highlight necessary program improvements to make it more suitable for wide-scale implementation and evaluation. Trial registration Australian and New Zealand Clinic Trials Registry ACTRN12617000682347. Date registered: 12/05/2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11993-1.
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Affiliation(s)
- Genevieve N Healy
- The University of Queensland, School of Public Health, 288 Herston Rd, HERSTON QLD, Brisbane, 4006, Australia. .,Baker Heart & Diabetes Institute, Melbourne, Australia.
| | - Elisabeth A H Winkler
- The University of Queensland, School of Public Health, 288 Herston Rd, HERSTON QLD, Brisbane, 4006, Australia
| | - Ana D Goode
- The University of Queensland, School of Public Health, 288 Herston Rd, HERSTON QLD, Brisbane, 4006, Australia
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18
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Hargreaves EA, Haszard JJ, Shaw S, Peddie MC. Protocol for a pilot trial to assess the feasibility of the Move More @ Work intervention to encourage employees to take the opportunity to move (be physically active) after every 30 min of sitting. Pilot Feasibility Stud 2021; 7:172. [PMID: 34493322 PMCID: PMC8422613 DOI: 10.1186/s40814-021-00903-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/20/2021] [Indexed: 11/14/2022] Open
Abstract
Background Prolonged sitting increases the risk of cardio-metabolic disease. Office-based employees are particularly susceptible to high rates of this sedentary behaviour during work hours. Laboratory studies indicate that regularly interrupting periods of prolonged sitting with short bouts (2 min) of physical activity can improve markers of cardio-metabolic health. This method of interrupting sitting time is yet to be tested in an occupational setting and may provide an alternative to providing sit-to-stand desks. Drawing on the Behaviour Change Wheel and evidence on the barriers and motivators to performing regular activity breaks, the Move More @ Work intervention was developed. The objectives of this pilot study are to examine the feasibility, and preliminary outcomes, of this intervention designed to encourage participants to perform 1–2 min of activity after every 30 min of continuous sitting throughout the work day. The study will inform if progress to a full effectiveness trial is warranted. Methods An interrupted time series design consisting of a 4-week baseline (control period), a 12-week intervention, and a 12-week follow-up will be utilised. At least 57 university employees who self-report spending > 5 h per day sitting at work on at least 3 days per week will be recruited to participate. The intervention consists of (1) a structured consultation with a Move More @ Work coach, containing a number of behaviour change techniques to create an individualised plan of how to incorporate the activity breaks into the working day, and (2) strategies to create a supportive workplace culture for performing the activity breaks. Feasibility will be assessed by recruitment and retention rates, and acceptability of the intervention. Pilot outcomes are the number of regular activity breaks taken during the workday, cardio-metabolic risk score and self-reported health, and work-related productivity outcomes. Discussion If the Move More @ Work intervention is shown to be feasible, acceptable, and shows evidence of effectiveness, this will provide justification for the progression to a full scale evaluation of the intervention. In the longer-term, this intervention may provide an alternative means of improving health outcomes through interrupting sedentary time than that offered by current sedentary behaviour interventions. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12620000354987. Registered on 12 March 2020 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00903-2.
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Affiliation(s)
- Elaine A Hargreaves
- School of Physical Education, Sport and Exercise Sciences, University of Otago, PO Box 56, Dunedin, New Zealand.
| | - Jillian J Haszard
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Sally Shaw
- School of Physical Education, Sport and Exercise Sciences, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Meredith C Peddie
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, New Zealand
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Mackenzie K, Such E, Norman P, Goyder E. Using Co-Production to Develop "Sit Less at Work" Interventions in a Range of Organisations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157751. [PMID: 34360045 PMCID: PMC8345370 DOI: 10.3390/ijerph18157751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/02/2021] [Accepted: 07/20/2021] [Indexed: 12/22/2022]
Abstract
Prolonged periods of sitting are associated with negative health outcomes, so the increase in sedentary jobs is a public health concern. Evaluation of interventions to reduce workplace sitting have suggested that participatory approaches may be more effective. This paper describes the use of co-production in four diverse organisations. Workshops with staff in each organisation were conducted to develop an organisation-specific strategy. The first workshop involved creative activities to encourage participants to develop innovative suggestions. The second workshop then developed a feasible and acceptable action plan. An ecological approach was used to consider behaviour change determinants at a range of different levels including intrapersonal, interpersonal, organisational, and environmental-level factors. 41 staff volunteered for workshops (seven in a small business, 16 in a charity, 15 in a local authority, and three in a large corporation). Of those, 27 were able to attend the first workshops and 16 were able to attend the second. Whilst there were some similarities across organisations, the smaller organisations developed a more tailored and innovative strategy than large organisations where there were more barriers to change and a more diverse workforce. Co-production resulted in bespoke interventions, tailored for different organisational contexts, maximising their potential feasibility and acceptability.
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Affiliation(s)
- Kelly Mackenzie
- School of Health and Related Research, University of Sheffield, Regent Street, Sheffield S1 4DA, UK; (E.S.); (E.G.)
- Correspondence:
| | - Elizabeth Such
- School of Health and Related Research, University of Sheffield, Regent Street, Sheffield S1 4DA, UK; (E.S.); (E.G.)
| | - Paul Norman
- Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield S1 2LT, UK;
| | - Elizabeth Goyder
- School of Health and Related Research, University of Sheffield, Regent Street, Sheffield S1 4DA, UK; (E.S.); (E.G.)
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20
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Hamidi N, Tan YR, Jawahir S, Tan EH. Determinants of community pharmacy utilisation among the adult population in Malaysia: findings from the National Health and Morbidity Survey 2019. BMC Health Serv Res 2021; 21:649. [PMID: 34217293 PMCID: PMC8254968 DOI: 10.1186/s12913-021-06656-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/17/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Community pharmacies provide alternatives for medication procurement and other basic and minor health-related services in addition to mainstream hospitals and primary healthcare services. This study aimed to determine the characteristics of community pharmacy users and associated factors for community pharmacy utilisation in Malaysia. METHODS Secondary data analysis was performed using data from the National Health and Morbidity Survey 2019, a nationwide cross-sectional household survey that used a two-stage stratified random sampling design. Adults aged 18 years and over were included in the analysis. Respondents who reported visiting the community pharmacy for health purposes two weeks prior to the study were considered as users. Complex sample descriptive statistics were used to describe the respondents' characteristics. Logistic regression analyses were employed to determine factors associated with community pharmacy utilisation. RESULTS Of the 11,155 respondents interviewed, 10.3 % reported community pharmacy utilisation for health purposes. Females (OR = 1.41, 95 % CI = 1.14, 1.73), those with tertiary education (OR = 2.03, 95 % CI = 1.26, 3.29), urban dwellers (OR = 1.42, 95 % CI = 1.13, 1.79), and those with self-reported health problems (OR = 7.62, 95 % CI = 6.05, 9.59) were more likely to utilise the community pharmacy. CONCLUSIONS Demographic and socioeconomic factors were important determinants of community pharmacy utilisation in Malaysia with sex, age, education level, locality, and self-reported health problems as the associated factors. These findings serve as evidence for policy interventions, crucial for improvements in accessibility to healthcare services.
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Affiliation(s)
- Normaizira Hamidi
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, NIH Complex, No. 1, Jalan Setia Murni U13/52, Section U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
| | - Yeung R'ong Tan
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, NIH Complex, No. 1, Jalan Setia Murni U13/52, Section U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Suhana Jawahir
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, NIH Complex, No. 1, Jalan Setia Murni U13/52, Section U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Ee Hong Tan
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, NIH Complex, No. 1, Jalan Setia Murni U13/52, Section U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
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21
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Tosta Maciel RRB, Chiavegato LD, Camelier FW, Portella DD, De Souza MC, Padula RS. Does tutors' support contribute to a telehealth program that aims to promote the quality of life of office workers? A cluster randomized controlled trial. Contemp Clin Trials Commun 2021; 21:100722. [PMID: 33604486 PMCID: PMC7875823 DOI: 10.1016/j.conctc.2021.100722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 10/23/2020] [Accepted: 01/11/2021] [Indexed: 11/25/2022] Open
Abstract
The quality of life in the workplace can be achieved by creating a place more humanized and strategies that provide wellness to workers. The aim of this study was to investigate the effectiveness of telehealth education program to promote quality of life of office workers.This is a cluster randomized controlled trial (RCT). The participants were office workers computer users (n = 326). All received 9 audiovisual content (grouped into topics: musculoskeletal health, healthy diet, and mental health) that addresses the real needs identified by them in the focus groups. The intervention group (n = 178) was instructed to seek the tutor support about topics addressed by the audiovisual content. The primary outcome measure was quality of life by WHOQOL-BREF. The secondary outcome measure was level of physical activity of the participants. Data analysis was performed by General Linear Mixed Model. After six months of telehealth education program a general improvement in health and environmental domain, was observed in the intervention group. During that period, a within-group analysis showed that there was a significant improvement in the intervention group, with respect to quality of life in general health (p < 0.05) and in the environmental domain (p < 0.01).In the baseline to the eighth month, there were statistically significant changes within-group for the general health (p < 0.05) and for the physical domain (p < 0.01) in both groups (p < 0.01). Telehealth education program promoted an improvement in the participants' quality of life. There was no benefit in favor of the telehealth education program, with tutor support in relation to the conventional program. TRIAL REGISTRATION The trial was prospectively registered at ClinicalTrial.gov (NCT02980237). The date of registration was August 23, 2016.
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Affiliation(s)
- Roberto Rodrigues Bandeira Tosta Maciel
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
- Department of Life Sciences, Universidade do Estado da Bahia, Salvador, Bahia, Brazil
| | - Luciana Dias Chiavegato
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
- Pulmonology Division, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Marcio Costa De Souza
- Department of Life Sciences, Universidade do Estado da Bahia, Salvador, Bahia, Brazil
| | - Rosimeire Simprini Padula
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
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22
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Chang SH, Chien NH, Pui-Man Wai J, Chiang CC, Yu CY. Examining the links between regular leisure-time physical activity, sitting time and prefrailty in community-dwelling older adults. J Adv Nurs 2021; 77:2761-2773. [PMID: 33619783 DOI: 10.1111/jan.14807] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/28/2020] [Accepted: 02/02/2021] [Indexed: 12/25/2022]
Abstract
AIMS To examine the relationship between leisure-time physical activity, sitting time and prefrailty in community-dwelling older adults. DESIGN Cross-sectional study. METHODS Between February and July 2019, 539 individuals over age 60 were recruited in northern Taiwan. Demographic, medical history, physical activity and frailty data were analysed using descriptive statistics, chi-square tests and logistic regression. RESULTS The prevalence of prefrailty was 24.4%; 33.2% had regular leisure-time physical activity, and 14.7% reported >6 hrs daily sitting time. Compared with individuals having regular leisure-time physical activity and shorter sitting times (daily average ≤6 hrs), those having no regular leisure-time physical activity and also shorter sitting times (adjusted OR, 1.80; 95% CI, 1.12, 2.92), or those also having regular leisure-time physical activity but longer sitting times (adjusted OR, 4.42; 95% CI, 2.22, 8.79) had an increased prefrailty risk. CONCLUSIONS Having no regular leisure-time physical activity or longer sitting times is associated with a higher risk of prefrailty. For sedentary older adults to prevent prefrailty, they can become more active, sit less or better yet, commit to both.
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Affiliation(s)
- Shu-Hung Chang
- Graduate Institute of Gerontology and Health Care Management, Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Department of Gastroenterology and Hepatology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Nai-Hui Chien
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Jackson Pui-Man Wai
- Graduate Institute of Sport Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Ching-Cheng Chiang
- Graduate Institute of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Ching-Yi Yu
- Department of Social Service, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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23
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Associations of Device-Measured Sitting, Standing, and Stepping Time With Informal Face-to-Face Interactions at Work. J Occup Environ Med 2020; 61:431-436. [PMID: 30870395 DOI: 10.1097/jom.0000000000001586] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE This cross-sectional study examined the interrelationships between workplace movement (sitting, standing, and stepping), availability of discussion space, and face-to-face (FTF) interactions between workers. METHODS Desk-based workers (n = 221) wore an activity monitor for 7 days and self-reported their weekly frequency of FTF interactions and discussion space availability. Negative binomial regression models examined behavioral and spatial factors associated with the frequency of FTF interactions. RESULTS Adjusted for potential confounders, each one standard deviation increment in time spent sitting, standing, stepping, and discussion space availability was associated with 20% lower (P = 0.004), 19% higher (P = 0.003), 6% higher (P = 0.16), and 11% higher (P = 0.26) frequency of FTF interactions, respectively CONCLUSIONS:: Lower workplace sitting was often linked to reduced risk of chronic diseases. Our findings suggest that less sitting at work may have additional benefits of increasing informal interactions between office workers.
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24
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Parker RA, Manner J, Sivaramakrishnan D, Baker G, Stoddart A, Lloyd S, Jepson R. Design, rationale and analysis plan for the Stand Up for Health trial in contact centres: a stepped wedge feasibility study. Pilot Feasibility Stud 2020; 6:139. [PMID: 32983556 PMCID: PMC7513324 DOI: 10.1186/s40814-020-00683-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 09/09/2020] [Indexed: 11/10/2022] Open
Abstract
Background Contact centres are one of the most sedentary workplaces, with employees spending a very high proportion of their working day sitting down. About a quarter of contact centre staff regularly experience musculoskeletal health problems due to high levels of sedentary behaviour, including lower back pain. There have been no previous randomised studies specifically aiming to reduce sedentary behaviour in contact centre staff. To address this gap, the Stand Up for Health (SUH) study aims to test the feasibility and acceptability of a complex theory-based intervention to reduce sedentary behaviour in contact centres. Methods The Stand Up for Health study has a stepped wedge cluster randomised trial design, which is a pragmatic design whereby clusters (contact centres) are randomised to time points at which they will begin to receive the intervention. All contact centre staff have the opportunity to experience the intervention. To minimise the resource burden in this feasibility study, data collection is not continuous, but undertaken on a selective number of occasions, so the stepped wedge design is “incomplete”. Eleven contact centres in England and Scotland have been recruited, and the sample size is approximately 27 per centre (270 in total). The statistical analysis will predominantly focus on assessing feasibility, including the calculation of recruitment rates and rates of attrition. Exploratory analysis will be performed to compare objectively measured sedentary time in the workplace (measured using an activPAL™ device) between intervention and control conditions using a linear mixed effects regression model. Discussion To our knowledge, this is the first stepped wedge feasibility study conducted in call centres. The rationale and justification of our novel staircase stepped wedge design has been presented, and we hope that by presenting our study design and statistical analysis plan, it will contribute to the literature on stepped wedge trials, and in particular feasibility stepped wedge trials. The findings of the study will also help inform whether this is a suitable design for other settings where data collection is challenging. Trial registration The trial has been registered on the ISRCTN database: http://www.isrctn.com/ISRCTN11580369
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Affiliation(s)
- Richard A Parker
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Jillian Manner
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Divya Sivaramakrishnan
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Graham Baker
- Physical Activity for Health Research Centre, Institute for Sport, P.E. and Health Sciences, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Andrew Stoddart
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Scott Lloyd
- Public Health South Tees, The Live Well Centre, Dundas House, Dundas Arcade, Middlesbrough, UK.,Fuse - UKCRC Centre for Translational Research in Public Health, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle upon Tyne, UK.,School of Health and Social Care, Teesside University, Centuria Building, Middlesbrough, UK
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Science, University of Edinburgh, Edinburgh, UK
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25
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Goode AD, Hadgraft NT, Neuhaus M, Healy GN. Perceptions of an online 'train-the-champion' approach to increase workplace movement. Health Promot Int 2020; 34:1179-1190. [PMID: 30452649 DOI: 10.1093/heapro/day092] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Prolonged sitting is now recognized as an emergent work health and safety issue. To address the need for a scalable sitting-reduction intervention for workplaces, the BeUpstanding™ Champion Toolkit was developed. This free, online toolkit uses a 'train-the-champion' approach, providing a step-by-step guide and resources to workplace champions to assist them in raising awareness and building a supportive culture to reduce sitting time in their team. This qualitative study explored champion and staff perceptions of the beta (test) version of the toolkit. Seven work teams, from a range of workplace sectors (blue-/white-collar), sizes (small/medium/large) and locations (urban/regional) participated; all team members were exposed to the program (n = 603). Approximately 4 months after program initiation, semi-structured interviews were conducted with all champions (n = 7); focus groups were conducted with a random sample of staff (n = 40). Champions were followed-up again at 12 months (n = 5). Transcripts were coded by two researchers, with codes organized into overarching themes. All champions found the 'train-the-champion' approach, and the toolkit acceptable. Common enablers for intervention delivery included: champion passion for staff health and wellbeing; perceived fit of the program within existing practice; and, management support. Champions and staff reported improvements in knowledge/awareness about sitting, cultural norms, perceived stress, productivity and resilience. Facilitators for sustained change over time included a stable organizational climate and ongoing management support; barriers included workload intensification. The beta version of the BeUpstanding™ Champion Toolkit was highly acceptable to workplace champions and staff, and was perceived to have benefits for team culture and staff knowledge and wellbeing.
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Affiliation(s)
- Ana D Goode
- School of Public Health, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Nyssa T Hadgraft
- Swinburne University of Technology, Melbourne, VIC 3122, Australia.,Baker Heart & Diabetes Institute, Melbourne, VIC 3004, Australia
| | - Maike Neuhaus
- Centre for Online Health - Centre for Health Services Research, The University of Queensland, Brisbane, QLD 4102, Australia
| | - Genevieve N Healy
- School of Public Health, The University of Queensland, Brisbane, QLD 4006, Australia.,Baker Heart & Diabetes Institute, Melbourne, VIC 3004, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth 6102, Australia
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26
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Owen N, Healy GN, Dempsey PC, Salmon J, Timperio A, Clark BK, Goode AD, Koorts H, Ridgers ND, Hadgraft NT, Lambert G, Eakin EG, Kingwell BA, Dunstan DW. Sedentary Behavior and Public Health: Integrating the Evidence and Identifying Potential Solutions. Annu Rev Public Health 2020; 41:265-287. [DOI: 10.1146/annurev-publhealth-040119-094201] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In developed and developing countries, social, economic, and environmental transitions have led to physical inactivity and large amounts of time spent sitting. Research is now unraveling the adverse public health consequences of too much sitting. We describe improvements in device-based measurement that are providing new insights into sedentary behavior and health. We consider the implications of research linking evidence from epidemiology and behavioral science with mechanistic insights into the underlying biology of sitting time. Such evidence has led to new sedentary behavior guidelines and initiatives. We highlight ways that this emerging knowledge base can inform public health strategy: First, we consider epidemiologic and experimental evidence on the health consequences of sedentary behavior; second, we describe solutions-focused research from initiatives in workplaces and schools. To inform a broad public health strategy, researchers need to pursue evidence-informed collaborations with occupational health, education, and other sectors.
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Affiliation(s)
- Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia;,
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - Genevieve N. Healy
- School of Public Health, University of Queensland, Herston, Queensland 4006, Australia;, , ,
| | - Paddy C. Dempsey
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia;,
| | - Jo Salmon
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria 3125, Australia;, , ,
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria 3125, Australia;, , ,
| | - Bronwyn K. Clark
- School of Public Health, University of Queensland, Herston, Queensland 4006, Australia;, , ,
| | - Ana D. Goode
- School of Public Health, University of Queensland, Herston, Queensland 4006, Australia;, , ,
| | - Harriet Koorts
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria 3125, Australia;, , ,
| | - Nicola D. Ridgers
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria 3125, Australia;, , ,
| | - Nyssa T. Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia;,
| | - Gavin Lambert
- Iverson Health Innovation Institute, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - Elizabeth G. Eakin
- School of Public Health, University of Queensland, Herston, Queensland 4006, Australia;, , ,
| | - Bronwyn A. Kingwell
- CSL Limited, Bio21 Institute, Melbourne, Victoria 3010, Australia
- Metabolic and Vascular Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - David W. Dunstan
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia;,
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria 3000, Australia
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27
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A Cost and Cost-Benefit Analysis of the Stand More AT Work (SMArT Work) Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041214. [PMID: 32070034 PMCID: PMC7068419 DOI: 10.3390/ijerph17041214] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/31/2020] [Accepted: 02/06/2020] [Indexed: 01/04/2023]
Abstract
This study conducted a cost and cost-benefit analysis of the Stand More AT (SMArT) Work workplace intervention, designed to reduce sitting time. The study was a cluster two-armed randomised controlled trial involving 37 office clusters (146 desk-based workers) in a National Health Service Trust. The intervention group received a height-adjustable workstation with supporting behaviour change strategies. The control group continued with usual practice. Self-report absenteeism, presenteeism and work productivity were assessed at baseline, 3, 6 and 12 months; and organisational sickness absence records 12 months prior to, and 12 months of the intervention. Mean per employee costs associated with SMArT Work were calculated. Absenteeism, presenteeism and work productivity were estimated, and employer-recorded absence data and employee wage-banding were used to provide a human-capital-based estimate of costs to the organisation. The return-on-investment (ROI) and incremental cost-efficacy ratios (ICER) were calculated. Intervention cost was £692.40 per employee. Cost-benefit estimates show a net saving of £1770.32 (95%CI £-354.40, £3895.04) per employee as a result of productivity increase. There were no significant differences in absence data compared to the control group. SMArT Work provides supporting evidence for policy-makers and employers on the cost benefits of reducing sitting time at work.
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Ali M, Ahsan GU, Hossain A. Prevalence and associated occupational factors of low back pain among the bank employees in Dhaka City. J Occup Health 2020; 62:e12131. [PMID: 32715531 PMCID: PMC7383126 DOI: 10.1002/1348-9585.12131] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 04/01/2020] [Accepted: 04/23/2020] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Low back pain (LBP) is one of the common health problems among full-time office employees that causes absenteeism from work. The aim of the study is to identify the association between occupational factors and LBP among full-time bank employees in Dhaka City. MATERIALS AND METHODS We conducted a cross-sectional study involving 593 full-time bank employees who were engaged in sedentary works. The 1-month complaint of LBP was measured using a subscale of subjective health complaints inventory. Multivariable logistic models were performed to identify variables related to LBP, and a random forest technique was performed to determine the top five important variables. RESULTS The 1-month prevalence for LBP was found to be 36.6% among the bank employees, and the prevalence was the highest (64.3%) for the 51- to 59-year-old age group. The regression analysis indicates that respondents from both agegroups, 41-50 years (OR = 2.00, 95% confidence interval [CI] = 1.10-3.69) and 51-59 years age groups (OR = 5.14, 95% CI = 2.05-13.64), are significantly associated with LBP. Furthermore, obesity (OR = 2.06, 95% CI = 1.01-4.21), and prolong working hours (>9 hours) (OR = 1.42, 95% CI = 1.01-2.0) are positively associated with LBP. The top five important variables for LBP identified by random forest technique are: age, length of employment, prolong office hours, presence of chronic illness, and physical activity. CONCLUSION LBP is highly prevalent in full-time bank employees. The occupational factors, including the length of employment (>10 years) and long working hours, play a significant role in developing LBP among bank employees. Moreover, several factors, including age, chronic illness, obesity, and physical activity, should be taken into account in the prevention of LBP in bank employees.
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Affiliation(s)
- Mohammad Ali
- Department of PhysiotherapyUttara Adhunik Medical College HospitalDhakaBangladesh
- Centre for Higher Studies and ResearchBangladesh University of ProfessionalsDhakaBangladesh
| | - Gias U. Ahsan
- Department of Public HealthNorth South UniversityDhakaBangladesh
| | - Ahmed Hossain
- Department of Public HealthNorth South UniversityDhakaBangladesh
- Health Management BD FoundationDhakaBangladesh
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29
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What Do Workers Do to Reduce Their Sitting Time? The Relationships of Strategy Use and Workplace Support With Desk-Based Workers' Behavior Changes in a Workplace-Delivered Sitting-Reduction and Activity-Promoting Intervention. J Occup Environ Med 2019; 60:1026-1033. [PMID: 30095591 DOI: 10.1097/jom.0000000000001419] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To explore workers' sitting-reduction and activity-promoting strategy use following an intervention targeting these changes, and whether strategy use and perceived workplace support impacted on 3-month sitting and activity outcomes. METHODS This secondary analysis in desk-based workers (n = 83) utilized data collected on questionnaire-derived strategy use and workplace support, and activPAL3-derived sitting (total; prolonged, ≥30 minutes) and activity (standing; stepping) at work. RESULTS Fourteen strategies were commonly used during the intervention. Increased usage of some strategies were significantly (P < 0.05) associated with beneficial changes in prolonged sitting or stepping only. Workplace support was significantly beneficially associated with changes in sitting, prolonged sitting, and stepping; these associations were largely independent of strategy use changes. CONCLUSIONS Strategies were highly used, with increased use associated with some behavioral improvements. Workplace support appears essential for improving sitting and activity in the workplace.
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30
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Stephens SK, Winkler EAH, Eakin EG, Clark BK, Owen N, Moodie M, La Montagne AD, Dunstan DW, Healy GN. Temporal features of sitting, standing and stepping changes in a cluster-randomised controlled trial of a workplace sitting-reduction intervention. Int J Behav Nutr Phys Act 2019; 16:111. [PMID: 31752916 PMCID: PMC6873403 DOI: 10.1186/s12966-019-0879-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/06/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND There is now a body of evidence on the effectiveness of interventions to reduce workplace sitting time. However, there has been limited reporting of how such interventions may impact behaviour both during and outside of work. Sitting, standing and stepping changes following a workplace intervention were examined across five timeframes (work time on work days; non-work time on work days; work days; non-work days; overall (i.e. work and non-work time on all days)), and the relationships between changes during and outside of work was assessed. METHODS The cluster-randomised controlled trial, 'Stand Up Victoria', delivered a multi-component workplace-delivered intervention that successfully reduced workplace and overall sitting time (relative to controls). Separately, over the five timeframes, changes in device (activPAL3)-assessed outcomes - sitting; prolonged sitting (≥30 min bouts); standing; and, stepping - were compared between intervention (n = 114) and controls (n = 84), along with the time-course of sitting changes during work hours, using mixed models. The potential relationships of changes during work with changes outside of work were examined using compositional data analysis. RESULTS On workdays, intervention participants significantly (p < 0.05) improved their activity profile relative to controls, with reduced sitting (- 117 min/8-h workday, 95% CI: - 141, - 93) and prolonged sitting (- 77 min/8 h workday, 95% CI: - 101, - 52); increased standing (114 min/8 h workday, 95% CI: 92, 136) and maintenance of stepping (3 min/8 h workday, 95% CI: - 7, 11, p = 0.576). Effects were nearly identical for time at work; similar but slightly weaker for overall; and, small and non-significant outside of work on workdays and non-work days. Improvements occurred at all times, but not equally, during work hours (p < 0.001). Correlations between changes during and outside of work on workdays were very weak in both the intervention group (r = - 0.07) and controls (r = - 0.09). CONCLUSIONS Sitting time was reduced almost exclusively during work hours (via replacement with standing), with reductions evident during all working hours, to varying degrees. There was no evidence of compensation, with minimal change in activity outside of work, in response to changes in activity at work. Future interventions may benefit from exploring how best to elicit change throughout the whole day, and across work and non-work domains. TRIAL REGISTRATION This trial was prospectively registered with the Australian New Zealand Clinical Trials register (ACTRN12611000742976) on 15 July 2011.
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Affiliation(s)
- Samantha K. Stephens
- School of Public Health, The University of Queensland, Herston Road, Herston, Brisbane, QLD 4006 Australia
| | - Elisabeth A. H. Winkler
- School of Public Health, The University of Queensland, Herston Road, Herston, Brisbane, QLD 4006 Australia
| | - Elizabeth G. Eakin
- School of Public Health, The University of Queensland, Herston Road, Herston, Brisbane, QLD 4006 Australia
| | - Bronwyn K. Clark
- School of Public Health, The University of Queensland, Herston Road, Herston, Brisbane, QLD 4006 Australia
| | - Neville Owen
- Baker Heart & Diabetes Institute, Melbourne, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia
| | - Marj Moodie
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Anthony D. La Montagne
- Work, Health & Wellbeing Unit, Centre for Population Health Research, Deakin University, Geelong, Australia
| | - David W. Dunstan
- School of Public Health, The University of Queensland, Herston Road, Herston, Brisbane, QLD 4006 Australia
- Baker Heart & Diabetes Institute, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Brisbane, Australia
- School of Sport Science, Exercise & Health, University of Western Australia, Perth, Australia
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Genevieve N. Healy
- School of Public Health, The University of Queensland, Herston Road, Herston, Brisbane, QLD 4006 Australia
- Baker Heart & Diabetes Institute, Melbourne, Australia
- School of Physiotherapy, Faculty of Health Sciences, Curtin University, Perth, Australia
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Parry SP, Coenen P, Shrestha N, O'Sullivan PB, Maher CG, Straker LM. Workplace interventions for increasing standing or walking for decreasing musculoskeletal symptoms in sedentary workers. Cochrane Database Syst Rev 2019; 2019:CD012487. [PMID: 31742666 PMCID: PMC6953379 DOI: 10.1002/14651858.cd012487.pub2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The prevalence of musculoskeletal symptoms among sedentary workers is high. Interventions that promote occupational standing or walking have been found to reduce occupational sedentary time, but it is unclear whether these interventions ameliorate musculoskeletal symptoms in sedentary workers. OBJECTIVES To investigate the effectiveness of workplace interventions to increase standing or walking for decreasing musculoskeletal symptoms in sedentary workers. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, OSH UPDATE, PEDro, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to January 2019. We also screened reference lists of primary studies and contacted experts to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), cluster-randomised controlled trials (cluster-RCTs), quasi RCTs, and controlled before-and-after (CBA) studies of interventions to reduce or break up workplace sitting by encouraging standing or walking in the workplace among workers with musculoskeletal symptoms. The primary outcome was self-reported intensity or presence of musculoskeletal symptoms by body region and the impact of musculoskeletal symptoms such as pain-related disability. We considered work performance and productivity, sickness absenteeism, and adverse events such as venous disorders or perinatal complications as secondary outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles, abstracts, and full-text articles for study eligibility. These review authors independently extracted data and assessed risk of bias. We contacted study authors to request additional data when required. We used GRADE considerations to assess the quality of evidence provided by studies that contributed to the meta-analyses. MAIN RESULTS We found ten studies including three RCTs, five cluster RCTs, and two CBA studies with a total of 955 participants, all from high-income countries. Interventions targeted changes to the physical work environment such as provision of sit-stand or treadmill workstations (four studies), an activity tracker (two studies) for use in individual approaches, and multi-component interventions (five studies). We did not find any studies that specifically targeted only the organisational level components. Two studies assessed pain-related disability. Physical work environment There was no significant difference in the intensity of low back symptoms (standardised mean difference (SMD) -0.35, 95% confidence interval (CI) -0.80 to 0.10; 2 RCTs; low-quality evidence) nor in the intensity of upper back symptoms (SMD -0.48, 95% CI -.096 to 0.00; 2 RCTs; low-quality evidence) in the short term (less than six months) for interventions using sit-stand workstations compared to no intervention. No studies examined discomfort outcomes at medium (six to less than 12 months) or long term (12 months and more). No significant reduction in pain-related disability was noted when a sit-stand workstation was used compared to when no intervention was provided in the medium term (mean difference (MD) -0.4, 95% CI -2.70 to 1.90; 1 RCT; low-quality evidence). Individual approach There was no significant difference in the intensity or presence of low back symptoms (SMD -0.05, 95% CI -0.87 to 0.77; 2 RCTs; low-quality evidence), upper back symptoms (SMD -0.04, 95% CI -0.92 to 0.84; 2 RCTs; low-quality evidence), neck symptoms (SMD -0.05, 95% CI -0.68 to 0.78; 2 RCTs; low-quality evidence), shoulder symptoms (SMD -0.14, 95% CI -0.63 to 0.90; 2 RCTs; low-quality evidence), or elbow/wrist and hand symptoms (SMD -0.30, 95% CI -0.63 to 0.90; 2 RCTs; low-quality evidence) for interventions involving an activity tracker compared to an alternative intervention or no intervention in the short term. No studies provided outcomes at medium term, and only one study examined outcomes at long term. Organisational level No studies evaluated the effects of interventions solely targeted at the organisational level. Multi-component approach There was no significant difference in the proportion of participants reporting low back symptoms (risk ratio (RR) 0.93, 95% CI 0.69 to 1.27; 3 RCTs; low-quality evidence), neck symptoms (RR 1.00, 95% CI 0.76 to 1.32; 3 RCTs; low-quality evidence), shoulder symptoms (RR 0.83, 95% CI 0.12 to 5.80; 2 RCTs; very low-quality evidence), and upper back symptoms (RR 0.88, 95% CI 0.76 to 1.32; 3 RCTs; low-quality evidence) for interventions using a multi-component approach compared to no intervention in the short term. Only one RCT examined outcomes at medium term and found no significant difference in low back symptoms (MD -0.40, 95% CI -1.95 to 1.15; 1 RCT; low-quality evidence), upper back symptoms (MD -0.70, 95% CI -2.12 to 0.72; low-quality evidence), and leg symptoms (MD -0.80, 95% CI -2.49 to 0.89; low-quality evidence). There was no significant difference in the proportion of participants reporting low back symptoms (RR 0.89, 95% CI 0.57 to 1.40; 2 RCTs; low-quality evidence), neck symptoms (RR 0.67, 95% CI 0.41 to 1.08; two RCTs; low-quality evidence), and upper back symptoms (RR 0.52, 95% CI 0.08 to 3.29; 2 RCTs; low-quality evidence) for interventions using a multi-component approach compared to no intervention in the long term. There was a statistically significant reduction in pain-related disability following a multi-component intervention compared to no intervention in the medium term (MD -8.80, 95% CI -17.46 to -0.14; 1 RCT; low-quality evidence). AUTHORS' CONCLUSIONS Currently available limited evidence does not show that interventions to increase standing or walking in the workplace reduced musculoskeletal symptoms among sedentary workers at short-, medium-, or long-term follow up. The quality of evidence is low or very low, largely due to study design and small sample sizes. Although the results of this review are not statistically significant, some interventions targeting the physical work environment are suggestive of an intervention effect. Therefore, in the future, larger cluster-RCTs recruiting participants with baseline musculoskeletal symptoms and long-term outcomes are needed to determine whether interventions to increase standing or walking can reduce musculoskeletal symptoms among sedentary workers and can be sustained over time.
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Affiliation(s)
- Sharon P Parry
- Curtin UniversitySchool of Physiotherapy and Exercise ScienceKent StreetBentleyPerthWest AustraliaAustralia6102
| | - Pieter Coenen
- Curtin UniversitySchool of Physiotherapy and Exercise ScienceKent StreetBentleyPerthWest AustraliaAustralia6102
- VU University Medical CenterDepartment of Public and Occupational Health, EMGO Institute for Health and Care Researchvan der Boechorststraat 7AmsterdamNetherlands1081BT
| | - Nipun Shrestha
- Victoria UniversityInstitute for Health and Sport (IHES)MelbourneVictoriaAustralia
| | - Peter B O'Sullivan
- Curtin UniversitySchool of Physiotherapy and Exercise ScienceKent StreetBentleyPerthWest AustraliaAustralia6102
| | - Christopher G Maher
- University of SydneySydney School of Public HealthLevel 10 North, King George V Building, Missenden Road, CamperdownSydneyNSWAustralia2050
| | - Leon M Straker
- Curtin UniversitySchool of Physiotherapy and Exercise ScienceKent StreetBentleyPerthWest AustraliaAustralia6102
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Wang NX, Chen J, Wagner NL, Rebello SA, Petrunoff NA, Owen N, Müller-Riemenschneider F. Understanding and Influencing Occupational Sedentary Behavior: A Mixed-Methods Approach in a Multiethnic Asian Population. HEALTH EDUCATION & BEHAVIOR 2019; 47:419-429. [PMID: 31661980 DOI: 10.1177/1090198119885431] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We aim to assess sedentary behavior (SB) and its determinants, as well as potential strategies to reduce SB among employees in a tertiary hospital in Singapore, using a mixed-methods approach grounded in the socioecological framework. All employees with email and security guards of a tertiary hospital in Singapore were invited to complete a questionnaire that captured sociodemographics and self-reported domain-specific SB. Environmental influences of occupational SB were assessed using an adapted version of the Checklist for Health Promotion Environments at the Worksite (CHEW). Focus group discussion (FGD) addressed perceptions, barriers, and strategies toward reducing workplace SB. Analyses were performed separately and integrated using an inductive comparative approach. The median occupational sitting time (n = 938) was 300 minutes/day, and highest among administrative staff (administrative, 421 minutes/day; allied health, 300 minutes/day; ancillary, 300 minutes/day; nursing, 120 minutes/day; medical/dental/others, 240 minutes/day; p value: <.001). The CHEW assessment identified poor physical and information environment contributing to occupational SB. FGDs confirmed an unsupportive environment and elicited barriers such as low SB awareness, nature of work, and workplace norms. Besides environmental approaches, participants suggested having face-to-face communication and social modelling to promote more breaks from sitting. This mixed-methods study among diverse professional groups of a tertiary hospital indicated a large amount of occupational SB, particularly among administrative staff. Raising awareness of the health risks of SB and building a supportive organizational culture, information, and physical environment emerged as significant factors. To reduce occupational SB, multicomponent interventions addressing these diverse factors are warranted.
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Affiliation(s)
| | | | | | | | | | - Neville Owen
- Swinburne University of Technology, Melbourne, Victoria, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,The University of Queensland, Herston, Brisbane, Queensland, Australia.,Monash University, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
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A "Sit Less, Walk More" Workplace Intervention for Office Workers: Long-Term Efficacy of a Quasi-Experimental Study. J Occup Environ Med 2019; 60:e290-e299. [PMID: 29438155 DOI: 10.1097/jom.0000000000001299] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study tested the maintenance outcomes of a 3-month Sit Less, Walk More (SLWM) workplace intervention for office workers compared with usual care at 12 months from the baseline. METHOD A quasi-experimental study was conducted in two workplaces. The intervention group (n = 51) received multi-component intervention and the comparison group (n = 50) received newsletters only. The outcomes of the study (self-reported psychosocial, physical activity, sitting, and lost productivity; objectively measured cardiometabolic biomarkers) were compared at baseline, 3, and 12 months. RESULTS Generalized estimating equations analyses found that the intervention group had significant improvements in self-regulation for sitting less and moving more (P = 0.017), walking (P = 0.003), weight (P = 0.013), waist circumference (P = 0.002), and insulin (P = 0.000) at 12 months compared with the comparison group. CONCLUSION The SLWM intervention was effective in improving self-regulation, walking, and some cardiometabolic biomarkers in office workers.
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The Effectiveness of Sedentary Behaviour Reduction Workplace Interventions on Cardiometabolic Risk Markers: A Systematic Review. Sports Med 2019; 49:1739-1767. [DOI: 10.1007/s40279-019-01168-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Ojo SO, Bailey DP, Brierley ML, Hewson DJ, Chater AM. Breaking barriers: using the behavior change wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time. BMC Public Health 2019; 19:1126. [PMID: 31420033 PMCID: PMC6697980 DOI: 10.1186/s12889-019-7468-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/11/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The workplace is a prominent domain for excessive sitting. The consequences of increased sitting time include adverse health outcomes such as cardiovascular disease and poor mental wellbeing. There is evidence that breaking up sitting could improve health, however, any such intervention in the workplace would need to be informed by a theoretical evidence-based framework. The aim of this study was to use the Behaviour Change Wheel (BCW) to develop a tailored intervention to break up and reduce workplace sitting in desk-based workers. METHODS The BCW guide was followed for this qualitative, pre-intervention development study. Semi-structured interviews were conducted with 25 office workers (26-59 years, mean age 40.9 [SD = 10.8] years; 68% female) who were purposively recruited from local council offices and a university in the East of England region. The interview questions were developed using the Theoretical Domains Framework (TDF). Transcripts were deductively analysed using the COM-B (Capability, Opportunity, Motivation - Behaviour) model of behaviour. The Behaviour Change Technique Taxonomy Version 1 (BCTv1) was thereafter used to identify possible strategies that could be used to facilitate change in sitting behaviour of office workers in a future intervention. RESULTS Qualitative analysis using COM-B identified that participants felt that they had the physical Capability to break up their sitting time, however, some lacked the psychological Capability in relation to the knowledge of both guidelines for sitting time and the consequences of excess sitting. Social and physical Opportunity was identified as important, such as a supportive organisational culture (social) and the need for environmental resources (physical). Motivation was highlighted as a core target for intervention, both reflective Motivation, such as beliefs about capability and intention and automatic in terms of overcoming habit through reinforcement. Seven intervention functions and three policy categories from the BCW were identified as relevant. Finally, 39 behaviour change techniques (BCTs) were identified as potential active components for an intervention to break up sitting time in the workplace. CONCLUSIONS The TDF, COM-B model and BCW can be successfully applied through a systematic process to understand the drivers of behaviour of office workers to develop a co-created intervention that can be used to break up and decrease sitting in the workplace. Intervention designers should consider the identified BCW factors and BCTs when developing interventions to reduce and break up workplace sitting.
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Affiliation(s)
- Samson O. Ojo
- Institute for Health Research, University Square, University of Bedfordshire, Luton, Bedfordshire LU1 3JU UK
| | - Daniel P. Bailey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, Bedfordshire MK41 9EA UK
| | - Marsha L. Brierley
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, Bedfordshire MK41 9EA UK
| | - David J. Hewson
- Institute for Health Research, University Square, University of Bedfordshire, Luton, Bedfordshire LU1 3JU UK
| | - Angel M. Chater
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford, Bedfordshire MK41 9EA UK
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Chambers AJ, Robertson MM, Baker NA. The effect of sit-stand desks on office worker behavioral and health outcomes: A scoping review. APPLIED ERGONOMICS 2019; 78:37-53. [PMID: 31046958 DOI: 10.1016/j.apergo.2019.01.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 06/09/2023]
Abstract
This scoping review examines the effects of sit-stand desks (SSDs) on six domains: behavior (e.g. time sitting and standing), physiological, work performance, psychological, discomfort, and posture. Fifty-three articles met criteria. We determined the percentage of significant results for each domain. Forty-seven studies were experimental trials. Sample sizes ranged from six to 231 participants. Follow-up time-frames ranged from one day to one year. Sixty-one percent of behavioral (24 studies), 37% of physiological (28 studies), 7% of work performance (23 studies), 31% of psychological (11 studies), 43% of discomfort (22 studies), and 18% of posture domain results (4 studies) were significant. We conclude that SSDs effectively change behaviors, but these changes only mildly effect health outcomes. SSDs seem most effective for discomfort and least for productivity. Further study is needed to examine long-term effects, and to determine clinically appropriate dosage and workstation setup.
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Affiliation(s)
- April J Chambers
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15261, USA.
| | - Michelle M Robertson
- Department of Psychological Sciences, Center for the Promotion of Health in the New England Workplace, University of Connecticut, Storrs, CT, 06103, USA; Office Ergonomics Research Committee, Framingham, MA, 01702, USA
| | - Nancy A Baker
- Department of Occupational Therapy, Tufts University, Medford, MA, 02155, USA
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Wallmann-Sperlich B, Hoffmann S, Salditt A, Bipp T, Froboese I. Moving to an "Active" Biophilic Designed Office Workplace: A Pilot Study about the Effects on Sitting Time and Sitting Habits of Office-Based Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091559. [PMID: 31060203 PMCID: PMC6539275 DOI: 10.3390/ijerph16091559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 12/15/2022]
Abstract
Promising initial insights show that offices designed to permit physical activity (PA) may reduce workplace sitting time. Biophilic approaches are intended to introduce natural surroundings into the workplace, and preliminary data show positive effects on stress reduction and elevated productivity within the workplace. The primary aim of this pilot study was to analyze changes in workplace sitting time and self-reported habit strength concerning uninterrupted sitting and PA during work, when relocating from a traditional office setting to “active” biophilic-designed surroundings. The secondary aim was to assess possible changes in work-associated factors such as satisfaction with the office environment, work engagement, and work performance, among office staff. In a pre-post designed field study, we collected data through an online survey on health behavior at work. Twelve participants completed the survey before (one-month pre-relocation, T1) and twice after the office relocation (three months (T2) and seven months post-relocation (T3)). Standing time per day during office hours increased from T1 to T3 by about 40 min per day (p < 0.01). Other outcomes remained unaltered. The results suggest that changing office surroundings to an active-permissive biophilic design increased standing time during working hours. Future larger-scale controlled studies are warranted to investigate the influence of office design on sitting time and work-associated factors during working hours in depth.
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Affiliation(s)
| | - Sophie Hoffmann
- Institute for Sports Science, Julius-Maximilian University Würzburg, 97082 Würzburg, Germany.
| | - Anne Salditt
- Interface Deutschland GmbH, Krefeld, 47803 Krefeld, Germany.
| | - Tanja Bipp
- Work, Industrial, and Organizational Psychology, Julius Maximilian University of Würzburg, 97070 Würzburg, Germany.
| | - Ingo Froboese
- Institute of Health Promotion and Clinical Movement Science, German Sport University Cologne, 50933 Cologne, Germany.
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Maciel RRBT, Chiavegato LD, Marin LS, Portella DDA, de Souza MC, Camelier FWR, Padula RS. Development of an e-health education program at the workplace using formative research - Technologies for improving quality of life. EVALUATION AND PROGRAM PLANNING 2019; 73:129-137. [PMID: 30622061 DOI: 10.1016/j.evalprogplan.2018.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 10/04/2018] [Accepted: 12/24/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND e-Learning, a means by which to expand people's access to information can be effective in promoting health in the workplace. This study to present steps in the development of an e-health education program at the workplace. OBJECTIVE This study aimed to present all steps of develop a telehealth education program for computer users using formative research to identify themes to health education for workers. METHODS A team of expert conducted focus groups with administrative workers (n = 36 participants) to identify thematic health to the development of program. Three meetings were audio video recorded, and notes. All data were based on constant analysis, classical content analysis and keywords in-context. RESULTS The content of the nine audio videos included four musculoskeletal health topics (Walking Program, Back School, Muscle Relaxation Techniques, and Work-related Musculoskeletal Diseases); three to healthy diet (Eating and Commensality, Ultra-processed Food and Food labeling, and Oil and Fat); two to mental health (Burnout Syndrome and the Meaning of work). CONCLUSION The proposed steps in the development of a workplace e-health education program were successfully achieved. The engagement of the workers' staged focus groups was fundamental to the choice of themes relevant to the population in question.
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Affiliation(s)
- Roberto Rodrigues Bandeira Tosta Maciel
- Master´s and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil; Department of Life Sciences, Universidade do Estado da Bahia, Salvador, BA, Brazil.
| | - Luciana Dias Chiavegato
- Master´s and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil; Pulmonology Division, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luz Stella Marin
- Department of Safety Sciences, Indiana University of Pennsylvania, Indiana, PA, USA
| | | | | | | | - Rosimeire Simprini Padula
- Master´s and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
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Measuring Time in the Office Using Bluetooth Sensors: Feasibility and Validity Considerations. ACTA ACUST UNITED AC 2019. [DOI: 10.1123/jmpb.2018-0046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Pierce J, Legg S, Godfrey JR, Kawabata E. The effects of introducing electric adjustable height desks in an office setting on workplace physical activity levels: A randomised control field trial. Work 2019; 62:139-150. [PMID: 30689597 DOI: 10.3233/wor-182849] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Electric adjustable height desks (EAHD) have been promoted as an opportunity for desk based workers to stand at work but there is limited evidence that they have an effect on light physical activity. OBJECTIVE The main objective was to determine if there would be a change in light physical activity with the introduction of EAHD. The secondary objective was to assess if there was an associated change in leisure time activity. METHODS Activity levels were measured by step counts, self-reported activity levels and pre- and post-trial recall levels. Statistical analysis of the data was performed with the software R. Generalised linear models were fitted to the data. A Poisson regression was used for count data. Statistical hypotheses were deemed significant if their p values were less than 0.05. RESULTS There was a significant (p < 0.001) effect on step counts associated with allocation of EAHD and a significant (p < 0.001) increase in self-reported activity for the Intervention (EAHD) group. Having an EAHD was associated with increased activity during leisure (p = 0.039). CONCLUSIONS Activity levels, especially light physical activity, were significantly increased with the allocation of an electric adjustable height desk. This pilot study showed that the environmental change of introduction of electric adjustable height desks into an office workplace can increase physical activity and reduce sitting durations. There is limited evidence that the increase in work activity has a positive impact on leisure time activity.
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Affiliation(s)
- Jane Pierce
- Centre for Ergonomics Occupational Safety and Health, School of Public Health, College of Health, Massey University, Palmerston North, New Zealand
| | - Stephen Legg
- Centre for Ergonomics Occupational Safety and Health, School of Public Health, College of Health, Massey University, Palmerston North, New Zealand
| | - Jonathan R Godfrey
- Statistics and Bioinformatics Group, Institute of Fundamental Sciences, Massey University, Palmerston North, New Zealand
| | - Emily Kawabata
- Statistics and Bioinformatics Group, Institute of Fundamental Sciences, Massey University, Palmerston North, New Zealand
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Winkler EAH, Chastin S, Eakin EG, Owen N, Lamontagne AD, Moodie M, Dempsey PC, Kingwell BA, Dunstan DW, Healy GN. Cardiometabolic Impact of Changing Sitting, Standing, and Stepping in the Workplace. Med Sci Sports Exerc 2018; 50:516-524. [PMID: 29166319 DOI: 10.1249/mss.0000000000001453] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND According to cross-sectional and acute experimental evidence, reducing sitting time should improve cardiometabolic health risk biomarkers. Furthermore, the improvements obtained may depend on whether sitting is replaced with standing or ambulatory activities. Based on data from the Stand Up Victoria multicomponent workplace intervention, we examined this issue using compositional data analysis-a method that can examine and compare all activity changes simultaneously. METHODS Participants receiving the intervention (n = 136 ≥ 0.6 full-time equivalent desk-based workers, 65% women, mean ± SD age = 44.6 ± 9.1 yr from seven worksites) were asked to improve whole-of-day activity by standing up, sitting less, and moving more. Their changes in the composition of daily waking hours (activPAL-assessed sitting, standing, and stepping) were quantified then tested for associations with concurrent changes in cardiometabolic risk (CMR) scores and 14 biomarkers concerning body composition, glucose, insulin, and lipid metabolism. Analyses were by mixed models, accounting for clustering (3 months, n = 105-120; 12 months, n = 80-97). RESULTS Sitting reduction was significantly (P < 0.05) associated only with lower systolic blood pressure at 3 months, and with CMR scores, weight, body fat, waist circumference, diastolic blood pressure, and fasting triglycerides, total/HDL cholesterol, and insulin at 12 months. Significant differences between standing and stepping were only observed for systolic blood pressure and insulin; both favored stepping. However, replacing sitting with standing was significantly associated only with improvements in CMR scores, whereas replacing sitting with stepping was significantly associated with CMR scores and six biomarkers. CONCLUSIONS Improvements in several cardiometabolic health risk biomarkers were significantly associated with sitting reductions that occurred in a workplace intervention. The greatest degree and/or widest range of cardiometabolic benefits appeared to occur with long-term changes, and when increasing ambulatory activities. TRIAL REGISTRATION ACTRN1211000742976.
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Affiliation(s)
| | - Sebastien Chastin
- School of Public Health, The University of Queensland, Brisbane, AUSTRALIA
| | - Elizabeth G Eakin
- School of Public Health, The University of Queensland, Brisbane, AUSTRALIA
| | - Neville Owen
- School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA
| | - Anthony D Lamontagne
- School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA
| | - Marj Moodie
- School of Public Health, The University of Queensland, Brisbane, AUSTRALIA
| | - Paddy C Dempsey
- School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA
| | - Bronwyn A Kingwell
- School of Public Health, The University of Queensland, Brisbane, AUSTRALIA
| | - David W Dunstan
- School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA
| | - Genevieve N Healy
- School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA.,School of Public Health, The University of Queensland, Brisbane, AUSTRALIA
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Shrestha N, Kukkonen‐Harjula KT, Verbeek JH, Ijaz S, Hermans V, Pedisic Z. Workplace interventions for reducing sitting at work. Cochrane Database Syst Rev 2018; 12:CD010912. [PMID: 30556590 PMCID: PMC6517221 DOI: 10.1002/14651858.cd010912.pub5] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality. OBJECTIVES To evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, OSH UPDATE, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 9 August 2017. We also screened reference lists of articles and contacted authors to find more studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), cross-over RCTs, cluster-randomised controlled trials (cluster-RCTs), and quasi-RCTs of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies. The primary outcome was time spent sitting at work per day, either self-reported or measured using devices such as an accelerometer-inclinometer and duration and number of sitting bouts lasting 30 minutes or more. We considered energy expenditure, total time spent sitting (including sitting at and outside work), time spent standing at work, work productivity and adverse events as secondary outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. MAIN RESULTS We found 34 studies - including two cross-over RCTs, 17 RCTs, seven cluster-RCTs, and eight controlled before-and-after studies - with a total of 3,397 participants, all from high-income countries. The studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi-component interventions (four studies). One study included both physical workplace changes and information and counselling components. We did not find any studies that specifically investigated the effects of standing meetings or walking meetings on sitting time.Physical workplace changesInterventions using sit-stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short-term follow-up (up to three months) compared to sit-desks (95% confidence interval (CI) -116 to -84, 10 studies, low-quality evidence). The pooled effect of two studies showed sit-stand desks reduced sitting time at medium-term follow-up (3 to 12 months) by an average of 57 minutes per day (95% CI -99 to -15) compared to sit-desks. Total sitting time (including sitting at and outside work) also decreased with sit-stand desks compared to sit-desks (mean difference (MD) -82 minutes/day, 95% CI -124 to -39, two studies) as did the duration of sitting bouts lasting 30 minutes or more (MD -53 minutes/day, 95% CI -79 to -26, two studies, very low-quality evidence).We found no significant difference between the effects of standing desks and sit-stand desks on reducing sitting at work. Active workstations, such as treadmill desks or cycling desks, had unclear or inconsistent effects on sitting time.Workplace policy changesWe found no significant effects for implementing walking strategies on workplace sitting time at short-term (MD -15 minutes per day, 95% CI -50 to 19, low-quality evidence, one study) and medium-term (MD -17 minutes/day, 95% CI -61 to 28, one study) follow-up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI -66 to -15, one study, low-quality evidence) compared to long breaks (two 15-minute breaks per workday) at short-term follow-up.Information and counsellingProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short-term follow-up (MD -19 minutes per day, 95% CI -57 to 19, two studies, low-quality evidence). However, the reduction was significant at medium-term follow-up (MD -28 minutes per day, 95% CI -51 to -5, two studies, low-quality evidence).Computer prompts combined with information resulted in no significant change in sitting time at work at short-term follow-up (MD -14 minutes per day, 95% CI -39 to 10, three studies, low-quality evidence), but at medium-term follow-up they produced a significant reduction (MD -55 minutes per day, 95% CI -96 to -14, one study). Furthermore, computer prompting resulted in a significant decrease in the average number (MD -1.1, 95% CI -1.9 to -0.3, one study) and duration (MD -74 minutes per day, 95% CI -124 to -24, one study) of sitting bouts lasting 30 minutes or more.Computer prompts with instruction to stand reduced sitting at work on average by 14 minutes per day (95% CI 10 to 19, one study) more than computer prompts with instruction to walk at least 100 steps at short-term follow-up.We found no significant reduction in workplace sitting time at medium-term follow-up following mindfulness training (MD -23 minutes per day, 95% CI -63 to 17, one study, low-quality evidence). Similarly a single study reported no change in sitting time at work following provision of highly personalised or contextualised information and less personalised or contextualised information. One study found no significant effects of activity trackers on sitting time at work.Multi-component interventions Combining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low-quality evidence) and on time spent in prolonged sitting bouts (two studies, very low-quality evidence) at short-term follow-up. AUTHORS' CONCLUSIONS At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.
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Affiliation(s)
- Nipun Shrestha
- Victoria UniversityInstitute for Health and Sport (IHES)MelbourneVictoriaAustralia
| | - Katriina T Kukkonen‐Harjula
- South Karelia Social and Health Care District EksoteRehabilitationValto Käkelän katu 3 BLappeenrantaFinland53130
| | - Jos H Verbeek
- Finnish Institute of Occupational HealthCochrane Work Review GroupTYÖTERVEYSLAITOSFinlandFI‐70032
| | - Sharea Ijaz
- Population Health Sciences, Bristol Medical School, University of BristolNIHR CLAHRC West at University Hospitals Bristol NHS Foundation TrustLewins Mead, Whitefriars BuildingBristolUKBS1 2NT
| | - Veerle Hermans
- Vrije Universiteit BrusselFaculty of Psychology & Educational Sciences, Faculty of Medicine & PharmacyPleinlaan 2BrusselsBelgium1050
| | - Zeljko Pedisic
- Victoria UniversityInstitute for Health and Sport (IHES)MelbourneVictoriaAustralia
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Wilkerson AH, Usdan SL, Knowlden AP, Leeper JL, Birch DA, Hibberd EE. Workplace-Related Factors Associated With Employees’ Standing Time at Work: A Research Brief. Am J Health Promot 2018; 33:606-610. [DOI: 10.1177/0890117118807407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: The purpose of this study was to identify the relationship between work-related, individual, and environmental factors and self-reported standing time during the workday. Design: Cross-sectional study design. Setting: Participants were recruited from a large, public university in the southeastern United States. Measures: Data were collected through an 87-item online survey using previously validated scales that assessed workplace standing time, demographic variables, work-related psychosocial factors, and workplace environment factors. Analysis: One-way analysis of variance, Pearson correlation coefficients, and nonparametric tests were used to determine univariate relationships between standing time and independent work-related variables and demographic factors. Results: Mean standing time among the sample (n = 502) was 72.49 minutes (standard deviation = 73.48) daily. There was a significant relationship between standing time and barrier self-efficacy for standing at work, self-regulation strategies, social norms, local connectivity in the workplace, overall connectivity in the workplace, and proximity of coworkers. Standing time was significantly higher for men, employees with an advanced degree, employees with a standing desk, and faculty. Conclusion: Health promotion researchers and practitioners should consider factors at multiple levels of influence when designing studies to explore workplace sedentary behavior. The findings regarding variations in workplace behavior by employee subgroups should be taken into consideration when designing future studies in the workplace.
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Affiliation(s)
- Amanda H. Wilkerson
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Stuart L. Usdan
- Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
| | - Adam P. Knowlden
- Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
| | - James L. Leeper
- Department of Community Medicine and Population Health, University of Alabama, Tuscaloosa, AL, USA
| | - David A. Birch
- Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
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Stephens SK, Eakin EG, Clark BK, Winkler EAH, Owen N, LaMontagne AD, Moodie M, Lawler SP, Dunstan DW, Healy GN. What strategies do desk-based workers choose to reduce sitting time and how well do they work? Findings from a cluster randomised controlled trial. Int J Behav Nutr Phys Act 2018; 15:98. [PMID: 30314505 PMCID: PMC6186123 DOI: 10.1186/s12966-018-0731-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 10/01/2018] [Indexed: 11/26/2022] Open
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, Electronic supplementary material The online version of this article (10.1186/s12966-018-0731-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Elizabeth G Eakin
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Bronwyn K Clark
- School of Public Health, The University of Queensland, Brisbane, Australia
| | | | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Swinburne University of Technology, Melbourne, Australia
| | - Anthony D LaMontagne
- Work, Health & Wellbeing Unit, Centre for Population Health Research, Deakin University, Geelong, Australia
| | - Marj Moodie
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Australia
| | - Sheleigh P Lawler
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - David W Dunstan
- School of Public Health, The University of Queensland, Brisbane, Australia.,Baker Heart and Diabetes Institute, Melbourne, Australia.,School of Sport Science, Exercise & Health, University of Western Australia, Perth, Australia.,School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Genevieve N Healy
- School of Public Health, The University of Queensland, Brisbane, Australia.,Baker Heart and Diabetes Institute, Melbourne, Australia.,School of Physiotherapy, Faculty of Health Sciences, Curtin University, Perth, Australia
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Edwardson CL, Yates T, Biddle SJH, Davies MJ, Dunstan DW, Esliger DW, Gray LJ, Jackson B, O'Connell SE, Waheed G, Munir F. Effectiveness of the Stand More AT (SMArT) Work intervention: cluster randomised controlled trial. BMJ 2018; 363:k3870. [PMID: 30305278 PMCID: PMC6174726 DOI: 10.1136/bmj.k3870] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the impact of a multicomponent intervention (Stand More AT (SMArT) Work) designed to reduce sitting time on short (three months), medium (six months), and longer term (12 months) changes in occupational, daily, and prolonged sitting, standing, and physical activity, and physical, psychological, and work related health. DESIGN Cluster two arm randomised controlled trial. SETTING National Health Service trust, England. PARTICIPANTS 37 office clusters (146 participants) of desk based workers: 19 clusters (77 participants) were randomised to the intervention and 18 (69 participants) to control. INTERVENTIONS The intervention group received a height adjustable workstation, a brief seminar with supporting leaflet, workstation instructions with sitting and standing targets, feedback on sitting and physical activity at three time points, posters, action planning and goal setting booklet, self monitoring and prompt tool, and coaching sessions (month 1 and every three months thereafter). The control group continued with usual practice. MAIN OUTCOME MEASURES The primary outcome was occupational sitting time (thigh worn accelerometer). Secondary outcomes were objectively measured daily sitting, prolonged sitting (≥30 minutes), and standing time, physical activity, musculoskeletal problems, self reported work related health (job performance, job satisfaction, work engagement, occupational fatigue, sickness presenteeism, and sickness absenteeism), cognitive function, and self reported psychological measures (mood and affective states, quality of life) assessed at 3, 6, and 12 months. Data were analysed using generalised estimating equation models, accounting for clustering. RESULTS A significant difference between groups (in favour of the intervention group) was found in occupational sitting time at 12 months (-83.28 min/workday, 95% confidence interval -116.57 to -49.98, P=0.001). Differences between groups (in favour of the intervention group compared with control) were observed for occupational sitting time at three months (-50.62 min/workday, -78.71 to -22.54, P<0.001) and six months (-64.40 min/workday, -97.31 to -31.50, P<0.001) and daily sitting time at six months (-59.32 min/day, -88.40 to -30.25, P<0.001) and 12 months (-82.39 min/day, -114.54 to -50.26, P=0.001). Group differences (in favour of the intervention group compared with control) were found for prolonged sitting time, standing time, job performance, work engagement, occupational fatigue, sickness presenteeism, daily anxiety, and quality of life. No differences were seen for sickness absenteeism. CONCLUSIONS SMArT Work successfully reduced sitting time over the short, medium, and longer term, and positive changes were observed in work related and psychological health. TRIAL REGISTRATION Current Controlled Trials ISRCTN10967042.
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Affiliation(s)
- Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, UK
| | - Tom Yates
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, UK
| | - Stuart J H Biddle
- Institute for Resilient Regions, University of Southern Queensland, Education City, Springfield Central, QLD, Australia
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Medicine, Monash University, Melbourne, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA, Australia
- Mary MacKillop Institute for Health Research, The Australian Catholic University, Melbourne, VIC, Australia
| | - Dale W Esliger
- NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Benjamin Jackson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Sophie E O'Connell
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
| | - Ghazala Waheed
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Edwardson CL, Biddle SJH, Clarke-Cornwell A, Clemes S, Davies MJ, Dunstan DW, Eborall H, Granat MH, Gray LJ, Healy GN, Richardson G, Yates T, Munir F. A three arm cluster randomised controlled trial to test the effectiveness and cost-effectiveness of the SMART Work & Life intervention for reducing daily sitting time in office workers: study protocol. BMC Public Health 2018; 18:1120. [PMID: 30217233 PMCID: PMC6137871 DOI: 10.1186/s12889-018-6017-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 09/04/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Office-based workers typically spend 70-85% of working hours, and a large proportion of leisure time, sitting. High levels of sitting have been linked to poor health. There is a need for fully powered randomised controlled trials (RCTs) with long-term follow-up to test the effectiveness of interventions to reduce sitting. This paper describes the methodology of a three-arm cluster RCT designed to determine the effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable desk, for reducing daily sitting. METHODS/DESIGN A three-arm cluster RCT of 33 clusters (660 council workers) will be conducted in three areas in England (Leicester; Manchester; Liverpool). Office groups (clusters) will be randomised to the SMART Work & Life intervention delivered with (group 1) or without (group 2) a height-adjustable desk or a control group (group 3). SMART Work & Life includes organisational (e.g., management buy-in, provision/support for standing meetings), environmental (e.g., relocating waste bins, printers), and group/individual (education, action planning, goal setting, addressing barriers, coaching, self-monitoring, social support) level behaviour change strategies, with strategies driven by workplace champions. Baseline, 3, 12 and 24 month measures will be taken. PRIMARY OUTCOME Objectively measured daily sitting time (activPAL3). SECONDARY OUTCOMES objectively measured sitting, standing, stepping, prolonged sitting and moderate-to-vigorous physical activity time and number of steps at work and daily; objectively measured sleep (wrist accelerometry). Adiposity, blood pressure, fasting glucose, glycated haemoglobin, cholesterol (total, HDL, LDL) and triglycerides will be assessed from capillary blood samples. Questionnaires will examine dietary intake, fatigue, musculoskeletal issues, job performance and satisfaction, work engagement, occupational and general fatigue, stress, presenteeism, anxiety and depression and sickness absence (organisational records). Quality of life and resources used (e.g. GP visits, outpatient attendances) will also be assessed. We will conduct a full process evaluation and cost-effectiveness analysis. DISCUSSION The results of this RCT will 1) help to understand how effective an important simple, yet relatively expensive environmental change is for reducing sitting, 2) provide evidence on changing behaviour across all waking hours, and 3) provide evidence for policy guidelines around population and workplace health and well-being. TRIAL REGISTRATION ISRCTN11618007 . Registered on 21 January 2018.
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Affiliation(s)
- Charlotte L. Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Stuart J. H. Biddle
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, QLD Australia
| | | | - Stacy Clemes
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Melanie J. Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - David W. Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC Australia
- School of Public Health, The University of Queensland, Brisbane, QLD Australia
- Department of Medicine, Monash University, Melbourne, VIC Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC Australia
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC Australia
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA Australia
- Mary MacKillop Institute for Health Research, The Australian Catholic University, Melbourne, VIC Australia
| | - Helen Eborall
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Laura J. Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Genevieve N. Healy
- Baker Heart and Diabetes Institute, Melbourne, VIC Australia
- School of Public Health, The University of Queensland, Brisbane, QLD Australia
- Faculty of Health Sciences, School of Physiotherapy, Curtin University, Perth, WA Australia
| | | | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
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Evaluating Short-Term Musculoskeletal Pain Changes in Desk-Based Workers Receiving a Workplace Sitting-Reduction Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091975. [PMID: 30201930 PMCID: PMC6164528 DOI: 10.3390/ijerph15091975] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 08/29/2018] [Accepted: 09/07/2018] [Indexed: 11/16/2022]
Abstract
This paper explores changes in musculoskeletal pain among desk-based workers over three months of a workplace-delivered, sitting-reduction intervention. Participants (n = 153, 46% female; mean ± SD aged 38.9 ± 8.0 years) were cluster-randomized (n = 18 work teams) to receive an organizational change intervention, with or without an activity tracker. A modified Nordic Musculoskeletal Questionnaire assessed pain intensity (0–9; none–worst possible) in the neck, upper and lower back, upper and lower extremities, and in total. The activPAL3 (7 days, 24 h/day protocol) measured sitting and prolonged sitting in ≥30 min bouts at work. Mixed models adjusting for cluster and intervention arm examined changes in pain (n = 104), and their associations with reductions in sitting and prolonged sitting (h/10 h at work) (n = 90). Changes in pain were nonsignificant (p ≥ 0.05) and small for total pain (−0.06 [95% CI: −0.27, 0.16]) and for each body area (−0.26 [−0.66, 0.15] for upper back to 0.09 [−0.39, 0.56] for lower back). Sitting reduction was associated with reduced lower back pain (−0.84 [−1.44, −0.25] per hour, p = 0.005); other effects were small and non-significant. No substantial average changes in pain were seen; some improvement in lower back pain might be expected with larger sitting reductions. Larger samples and diverse interventions are required for more definitive evidence.
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Coenen P, Healy GN, Winkler EAH, Dunstan DW, Owen N, Moodie M, LaMontagne AD, Eakin EA, O'Sullivan PB, Straker LM. Associations of office workers' objectively assessed occupational sitting, standing and stepping time with musculoskeletal symptoms. ERGONOMICS 2018; 61:1187-1195. [PMID: 29630479 DOI: 10.1080/00140139.2018.1462891] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 04/02/2018] [Indexed: 06/08/2023]
Abstract
We examined the association of musculoskeletal symptoms (MSS) with workplace sitting, standing and stepping time, as well as sitting and standing time accumulation (i.e. usual bout duration of these activities), measured objectively with the activPAL3 monitor. Using baseline data from the Stand Up Victoria trial (216 office workers, 14 workplaces), cross-sectional associations of occupational activities with self-reported MSS (low-back, upper and lower extremity symptoms in the last three months) were examined using probit regression, correcting for clustering and adjusting for confounders. Sitting bout duration was significantly (p < 0.05) associated, non-linearly, with MSS, such that those in the middle tertile displayed the highest prevalence of upper extremity symptoms. Other associations were non-significant but sometimes involved large differences in symptom prevalence (e.g. 38%) by activity. Though causation is unclear, these non-linear associations suggest that sitting and its alternatives (i.e. standing and stepping) interact with MSS and this should be considered when designing safe work systems. Practitioner summary: We studied associations of objectively assessed occupational activities with musculoskeletal symptoms in office workers. Workers who accumulated longer sitting bouts reported fewer upper extremity symptoms. Total activity duration was not significantly associated with musculoskeletal symptoms. We underline the importance of considering total volumes and patterns of activity time in musculoskeletal research.
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Affiliation(s)
- Pieter Coenen
- a School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia
- b Department of Public and Occupational Health , Amsterdam Public Health Research Institute, VU University Medical Center , Amsterdam , The Netherlands
| | - Genevieve N Healy
- a School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia
- c School of Public Health, The University of Queensland , Brisbane , Australia
- d Baker IDI Heart and Diabetes Institute , Melbourne , Australia
| | | | - David W Dunstan
- c School of Public Health, The University of Queensland , Brisbane , Australia
- d Baker IDI Heart and Diabetes Institute , Melbourne , Australia
- e School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
- f School of Exercise and Nutrition Sciences , Deakin University , Geelong , Australia
- g Central Clinical School, Medicine , Monash University , Melbourne , Australia
- h School of Sport Science, Exercise and Health , The University of Western Australia , Perth , Australia
- i Mary MacKillop Institute for Health Research, Australian Catholic University , Melbourne , Australia
| | - Neville Owen
- c School of Public Health, The University of Queensland , Brisbane , Australia
- d Baker IDI Heart and Diabetes Institute , Melbourne , Australia
- g Central Clinical School, Medicine , Monash University , Melbourne , Australia
- j Swinburne University of Technology , Melbourne , Australia
| | - Marj Moodie
- k Deakin Health Economics, Centre for Population Health Research , Deakin University , Geelong , Australia
- l Global Obesity Centre, Centre for Population Health Research , Deakin University , Geelong , Australia
| | - Anthony D LaMontagne
- m Centre for Population Health Research, School of Health & Social Development , Deakin University , Geelong , Australia
- n Melbourne School of Population and Global Health , University of Melbourne , Melbourne , Australia
| | - Elizabeth A Eakin
- c School of Public Health, The University of Queensland , Brisbane , Australia
| | - Peter B O'Sullivan
- n Melbourne School of Population and Global Health , University of Melbourne , Melbourne , Australia
| | - Leon M Straker
- n Melbourne School of Population and Global Health , University of Melbourne , Melbourne , Australia
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Healy GN, Eakin EG, Winkler EA, Hadgraft N, Dunstan DW, Gilson ND, Goode AD. Assessing the Feasibility and Pre-Post Impact Evaluation of the Beta (Test) Version of the BeUpstanding Champion Toolkit in Reducing Workplace Sitting: Pilot Study. JMIR Form Res 2018; 2:e17. [PMID: 30684420 PMCID: PMC6334681 DOI: 10.2196/formative.9343] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/23/2018] [Accepted: 06/24/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The Web-based, evidence-informed BeUpstanding Champion Toolkit was developed to provide employers (via a "train-the-champion approach") with resources and support to help in reducing prolonged sitting in their own desk-based workplace. As part of a five-phase research-to-dissemination process, this study reports on the evaluation of the beta (test) version of this toolkit (Phase 2). OBJECTIVE The objective of our study was to evaluate (1) the implementation of the toolkit by workplace champions and (2) the impact of the toolkit on sitting (primary outcome), standing, and moving; use of activity-promoting strategies; knowledge and attitudes; and indicators of health and work performance. METHODS An implementation study using a pre-post design was conducted in 7 desk-based workplaces in Australia (September 2015 to May 2016), with work teams (one per workplace) purposively recruited to ensure representation across a range of sectors (white- or blue-collar), organizational sizes (small or medium or large), and locations (metropolitan or regional). All staff within participating teams were invited to participate in the relevant toolkit activities. Implementation outcomes (time commitment required by champions and toolkit activities completed) were collected from each champion via telephone interviews. Changes in impact outcomes, measured via a Web-based questionnaire completed by employees at baseline and 3 months postimplementation, were assessed using mixed models, correcting for clustering. RESULTS Champions reported a 30-60 minutes per week time commitment to the toolkit activities. All teams formed a wellbeing committee and sent the staff surveys at both time points; most champions held a staff consultation workshop (6/7), identified team-level strategies within that workshop (5/7), used the communication resources provided within the toolkit (emails, posters; 6/7), and completed the action plan (5/7). In total, 52% (315 of ≈600) employees participated in at least one survey and 97 (16%) participated in both. At follow-up, there was a significant (P<.05) reduction in self-reported workplace sitting time compared to baseline (-6.3%, 95% CI -10.1 to -2.5; n=85) equating to ≈30 minutes per workday. Significant benefits were also observed for the use of activity-promoting strategies, with small, nonsignificant changes observed for knowledge and attitudes and indicators of health and work performance. CONCLUSIONS The beta version of the BeUpstanding Champion Toolkit was feasible to implement and effective in reducing self-reported workplace sitting across a broad range of desk-based workplaces. The next phase (Phase 3) will build on these findings to optimize the toolkit for wider-scale implementation and longer term evaluation.
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Affiliation(s)
- Genevieve Nissa Healy
- School of Public Health, The University of Queensland, Brisbane, Australia.,Baker Heart and Diabetes Institute, Melbourne, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Elizabeth G Eakin
- School of Public Health, The University of Queensland, Brisbane, Australia
| | | | - Nyssa Hadgraft
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Swinburne University of Technology, Melbourne, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.,School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Nicholas D Gilson
- School of Human Movement Studies and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Ana D Goode
- School of Public Health, The University of Queensland, Brisbane, Australia
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Morris A, Murphy R, Shepherd S, Graves L. Multi-Stakeholder Perspectives of Factors That Influence Contact Centre Call Agents' Workplace Physical Activity and Sedentary Behaviour. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1484. [PMID: 30011821 PMCID: PMC6069165 DOI: 10.3390/ijerph15071484] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 07/05/2018] [Accepted: 07/09/2018] [Indexed: 12/13/2022]
Abstract
Contact centre call agents are highly sedentary at work, which can negatively affect cardio-metabolic health. This qualitative cross-sectional study explored factors influencing call agents' workplace physical activity (PA) and sedentary behaviour (SB), and perspectives on strategies to help agents move more and sit less at work. Semi-structured interviews and focus groups with call agents (n = 20), team leaders (n = 11) and senior staff (n = 12) across four contact centres were guided by the socio-ecological model and analysed thematically. Agents offered insights into the impact of high occupational sitting and low PA on their physical and mental health, and factors influencing their motivation to move more and sit less at work. Team leaders, although pivotal in influencing behaviours, identified their own workload, and agents' requirement to meet targets, as factors influencing their ability to promote agents to move more and sit less at work. Further, senior team leaders offered a broad organisational perspective on influential factors, including business needs and the importance of return on investment from PA and SB interventions. Unique factors, including continuous monitoring of productivity metrics and personal time, a physical connection to their workstation, and low autonomy over their working practices, seemed to limit call agents' opportunity to move more and sit less at work. Proposed strategies included acknowledgement of PA and SB within policy and job roles, height-adjustable workstations, education and training sessions and greater interpersonal support. Additionally, measuring the impact of interventions was perceived to be key for developing a business case and enhancing organisational buy-in. Multi-level interventions embedded into current working practices appear important for the multiple stakeholders, while addressing concerns regarding productivity.
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Affiliation(s)
- Abigail Morris
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK.
| | - Rebecca Murphy
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK.
| | - Sam Shepherd
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK.
| | - Lee Graves
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK.
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