Reducing occupational sedentary time: a systematic review and meta-analysis of evidence on activity-permissive workstations

The effect of 2 walking programs on aerobic fitness, body composition, and physical activity in sedentary office employees

Purpose

The present study examined changes in body composition, maximum oxygen uptake, and physical activity in sedentary office employees prescribed with two different walking programs during a 10-week intervention.

Methods

68 sedentary employees were randomly assigned to one of three groups: multiple bouts of walking (n = 24 (5 male, 19 female) Age = 46±9, BMI = 30.5±5.78 kg/m²), continuous walking (n = 22 (6 male, 16 female) Age = 48±9, BMI = 30.6±6.2 kg/m²) and the control group (n = 22 (5 male, 17 female) Age = 42±10, BMI = 27.5±5.23 kg/m²). Dual-energy X-ray absorptiometry (iDXA) assessed body composition and a Bruce protocol treadmill test assessed aerobic fitness at baseline and week 11. At baseline, week 6 and week 11 a waist worn accelerometer measured physical activity and sedentary behavior. Physical activity was measured throughout the program with a wrist worn accelerometer.

Results

The results from the mixed-design ANOVA show that fat mass (p < .000) and fat percentage (p < .000) decreased for all three groups as a main effect of time. Sedentary behavior did not change (p>0.05) for all three groups. Moderate intensity physical activity increased significantly from pre-test to week 6 (p<0.05), then decreased from week 6 to post-test (p<0.05), with no significant changes observed from pre-test to post-test (p>0.05) for all groups. No changes in VO₂ were observed (p>0.05) for all groups.

Conclusions

Continuous or intermittent walking activity produce similar benefits on body weight, fat mass and body fat percentage in sedentary employees. Meanwhile, intermittent walking allowed these sedentary employees to increase lean mass and fat free mass. Intermittent walking could provide at least similar benefits on body composition compared to a continuous walking program.

Health and productivity at work: which active workstation for which benefits: a systematic review

In order to reduce sedentary behaviour at work, research has examined the effectiveness of active workstations. However, despite their relevance in replacing conventional desks, the comparison between types of active workstations and their respective benefits remains unclear. The purpose of this review article is thus to compare the benefits between standing, treadmill and cycling workstations. Search criteria explored Embase, PubMed and Web of Science databases. The review included studies concerning adults using at least two types of active workstations, evaluating biomechanical, physiological work performance and/or psychobiological outcomes. Twelve original articles were included. Treadmill workstations induced greater movement/activity and greater muscular activity in the upper limbs compared with standing workstations. Treadmill and cycling workstations resulted in elevated heart rate, decreased ambulatory blood pressure and increased energy expenditure during the workday compared with standing workstations. Treadmill workstations reduced fine motor skill function (ie, typing, mouse pointing and combined keyboard/mouse tasks) compared with cycling and standing workstations. Cycling workstations resulted in improved simple processing task speeds compared with standing and treadmill workstations. Treadmill and cycling workstations increased arousal and decreased boredom compared with standing workstations. The benefits associated with each type of active workstation (eg, standing, treadmill, cycling) may not be equivalent. Overall, cycling and treadmill workstations appear to provide greater short-term physiological changes than standing workstations that could potentially lead to better health. Cycling, treadmill and standing workstations appear to show short-term productivity benefits; however, treadmill workstations can reduce the performance of computer tasks.

Effects of cycle and treadmill desks on energy expenditure and cardiometabolic parameters in sedentary workers: review and meta-analysis

Purpose. The aim of this article was to evaluate the effects of cycle and treadmill desks on energy expenditure and cardiovascular and biochemical indicators in sedentary workers. Materials and methods. In February 2018, six databases were searched. Both parallel and crossover design studies evaluating workplace cycle and treadmill desks compared to a conventional seated condition were included. Results. Twenty-two studies met the inclusion criteria. Cycle and treadmill desks significantly increased energy expenditure (standard mean difference [SMD] = 3.84, p < 0.001, I² = 95%) and the heart rate (SMD = 1.68, p < 0.001, I² = 91%), and lowered blood glucose and insulin levels (SMD = -0.54, p < 0.001, I² = 0% and SMD = -3.13, p < 0.001, I² = 76%, respectively). The interventions had no effect on blood pressure and other biochemical indicators. Conclusion. Cycle and treadmill desks may positively influence energy expenditure in sedentary workers and could be effective for reducing negative effects of workplace-related sedentary behaviour. However, considerable heterogeneity is present in the measuring protocols for energy expenditure.

Cardiometabolic Impact of Changing Sitting, Standing, and Stepping in the Workplace

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.

An Integrative, Systematic Review Exploring the Research, Effectiveness, Adoption, Implementation, and Maintenance of Interventions to Reduce Sedentary Behaviour in Office Workers

Sedentary behaviour is associated with poor health outcomes, and office-based workers are at significant health risk, as they accumulate large proportions of their overall sitting time at work. The aim of this integrated systematic review was to collate and synthesize published research on sedentary behaviour interventions in the workplace that have reported on at least one an aspect of the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. Studies were included if they involved adult office workers, were conducted in an office setting, and changes in sedentary behaviour had been measured as a primary outcome. Five electronic databases were searched yielding 7234 articles, with 75 articles (61 individual interventions) meeting the inclusion criteria. Reach indicators were the most frequently reported RE-AIM dimensions, which were reported on average 59% of the time. Efficacy/effectiveness was the second most reported dimension at 49% reporting across all of the indicators. Implementation indicators were reported an average of 44% of the time, with indicators of adoption and maintenance reported as the lowest of all indicators at 13% and 8%, respectively. Recommendations are provided to improve reporting across all RE-AIM dimensions, which is an important first step to enable the effective translation of interventions into real world settings.

Patterns of accelerometer-derived sedentary time across the lifespan

We aimed to describe ST and its patterns on a national level. A hip-worn accelerometer (ActiGraph GT1M) was used to collect data during waking hours from 4575 Portuguese' participants from 2007-2009 (2683 females) aged 10-102 years old. Data was presented by sex, in 5-years age intervals, and by adolescents (n=2833), adults (n=1122), and older adults (n=620). Lambda-mu-sigma (LMS) smoothed percentile curves were estimated. Girls, women, and older women spent 61, 57, and 64% of wear time in ST, respectively. In males, ST represented 57, 60, and 62% of wear time respectively for boys, men, and older men. Comparing to other age groups, older adults spent a larger amount of ST in bouts ≥30-min (women: 33%, men: 39% of total ST). The number of breaks/ST hour were: 10.6 in girls, 11.7 in women, and 9.6 in older women. In males, the number of breaks/ST hour were: 11.2, 10.5, and 8.5 for boys, men, and older men. In conclusion, ST was not consistently higher at older ages. Instead, we found that the potential critical moments in which ST may be higher are during adolescence and in the transition from adulthood into older adulthood, which represents critical periods for interventions.

Effectiveness of interventions aiming at reducing sedentary behaviour in a non-surgical population with overweight or obesity: A systematic review and meta-analysis

AIM

This systematic review and meta-analyses of randomised controlled trials (RCTs) investigated the effectiveness of interventions to reduce sedentary behaviour amongst people with overweight or obesity. Secondarily, it aimed to investigate the effectiveness of these interventions on body mass index (BMI), time spent in moderate-to-vigorous physical activity (MVPA) and health-related quality of life (HRQoL).

METHODS

A search of six databases (CENTRAL, PubMed, Embase, PEDro, CINAHL and PsycINFO) was conducted from inception to July 2018. RCTs in which sedentary behaviour was measured by accelerometry or inclinometry, with participants of any age with overweight or obesity were included. Subgroup analyses were undertaken comparing studies that included adults versus children and studies with an active component (e.g., treadmill desk, physically active breaks) versus no active component to their intervention.

RESULTS

Nine studies (n=1859) were included. Compared to the control group, the interventions significantly reduced time spent in sedentary behaviour (standardised mean difference [95% confidence interval] -0.33 [-0.59 to -0.08] overall; -0.53 [-0.95 to -0.11] in adults). Subgroup analyses demonstrated that only interventions that included active components reduced time spent in sedentary behaviour (-0.54 [-0.88 to -0.20]) and increased time spent in MVPA (1.29 [0.02 to 2.56]). Subgroup analyses demonstrated that interventions only reduced BMI in studies of children (-0.09 [-0.18 to -0.00]) and in those with no active component (-0.09 [-0.18 to -0.01]). There were insufficient data to investigate the effectiveness of these interventions on HRQoL.

CONCLUSIONS

This novel systematic review and meta-analyses suggests interventions aiming to effectively reduce objectively-measured sedentary behaviour need to specifically include an active component.

Introducing a Dynamic Workstation in the Office: Insights in Characteristics of Use and Short-Term Changes of Well-Being in a 12 Week Observational Study

The present field study evaluates the use of dynamic workstations (cycling devices) in a real-life office environment. Specific characteristics of use were recorded and possible relationships with short-term changes in well-being were investigated. For a period of 12 weeks, 36 employees were given free access to eight devices. Frequency, duration and speed of use were self-determined but registered objectively for every event of use. Immediately before and after using a cycling device, employees rated their well-being with a modified version of the EZ-scale from Nitsch to assess changes in the short-term. In total, 817 events of use were registered. On each day of the intervention period one of the devices was used. Participants used the devices between one day to all days present at the office, for 21.09 (SD 0.58) to 31.58 (SD 2.19) minutes on average per event of use per day. Comparing the pre- and post-measurements, a significant increase in well-being after using a cycling device was found. Results of a Generalized Estimating Equations (GEE) analysis showed mixed effects for the duration of use, the speed and variation of speed on the probability of reporting positive changes in recovery, calmness and mood. Therefore, using cycling devices in the office might improve short-term well-being.

Treadmill workstations in office workers who are overweight or obese: a randomised controlled trial

BACKGROUND

Treadmill workstations that enable office workers to walk on a treadmill while working at their computers might increase physical activity in offices, but long-term effects are unknown. We therefore investigated whether treadmill workstations in offices increased daily walking time.

METHODS

We did a randomised controlled trial of healthy office workers who were either overweight or obese. We recruited participants from 13 different companies, which comprised 17 offices, in Umeå, Sweden. We included people who were aged 40-67 years, had sedentary work tasks, and had a body-mass index (BMI) between 25 kg/m² and 40 kg/m². After the baseline measurement, we stratified participants by their BMI (25-30 kg/m² and >30 to 40 kg/m²); subsequently, an external statistician randomly assigned these participants (1:1) to either the intervention group (who received treadmill workstations for optional use) or the control group (who continued to work at their sit-stand desks as usual). Participants in the intervention group received reminders in boosting emails sent out to them at four occasions during the study period. Researchers were masked to group assignment until after analysis of the primary outcome. After the baseline measurement, participants were not masked to group belongings. The primary outcome was total daily walking time at weekdays and weekends, measured at baseline, 2 months, 6 months, 10 months, and 13 months with the accelerometer activPAL (PAL Technologies, Glasgow, UK), which was worn on the thigh of participants for 24 h a day for 7 consecutive days. We used an intention-to-treat approach for our analyses. This trial is registered with ClinicalTrials.gov, number NCT01997970, and is closed to new participants.

FINDINGS

Between Nov 1, 2013, and June 30, 2014, a total of 80 participants were recruited and enrolled (n=40 in both the intervention and control groups). Daily walking time during total time awake at weekdays increased between baseline and 13 months by 18 min (95% CI 9 to 26) in the intervention group and 1 min (-7 to 9) in the control group (difference 22 min [95% CI 7 to 37], p_interaction=0·00045); for weekend walking, the change from baseline to 13 months was 5 min (-8 to 18) in the intervention group and 8 min (-5 to 21) in the control group (difference -1 min [-19 to 17]; p_interaction=0·00045). Neither measure met our predetermined primary outcome of 30 min difference in total walking time between the intervention and control group, so the primary outcome of the trial was not met. One adverse event was reported in a participant who accidently stepped on their Achilles tendon.

INTERPRETATION

In a sedentary work environment, treadmill workstations result in a statistically significant but smaller-than-expected increase in daily walking time. Future studies need to investigate how increasing physical activity at work might have potentially compensatory effects on non-work activity.

FUNDING

Umeå University, the Västerbotten County Council, and the Mayo Clinic Foundation for Research.

Associations of neighborhood environmental attributes with adults' objectively-assessed sedentary time: IPEN adult multi-country study

Neighborhood environmental attributes have been found to be associated with residents' time spent walking and in physical activity, in studies from single countries and in multiple-country investigations. There are, however, mixed findings on such environmental relationships with sedentary (sitting) time, which primarily have used evidence derived from single-country investigations with self-reported behavioral outcome measures. We examined potential relationships of neighborhood environmental attributes with objectively-assessed sedentary time using data from 5712 adults recruited from higher and lower socio-economic status neighborhoods in 12 sites in 10 countries, between 2002 and 2011. Ten perceived neighborhood attributes, derived from an internationally-validated scale, were assessed by questionnaire. Sedentary time was derived from hip-worn accelerometer data. Associations of individual environmental attributes and a composite environmental index with sedentary time were estimated using generalized additive mixed models. In fully adjusted models, higher street connectivity was significantly related to lower sedentary time. Residential density, pedestrian infrastructure and safety, and lack of barriers to walking were related to higher sedentary time. Aesthetics and safety from crime were related to less sedentary time in women only. The predicted difference in sedentary time between those with the minimum versus maximum composite environmental index values was 71 min/day. Overall, certain built environment attributes, including street connectivity, land use mix and aesthetics were found to be related to sedentary behavior in both expected and unexpected directions. Further research using context-specific measures of sedentary time is required to improve understanding of the potential role of built environment characteristics as influences on adults' sedentary behavior.

Perceptions of the acceptability and feasibility of reducing occupational sitting: review and thematic synthesis

BACKGROUND

Reducing workplace sedentary behaviour (sitting) is a topic of contemporary public health and occupational health interest. Understanding workers' perspectives on the feasibility and acceptability of strategies, and barriers and facilitators to reducing workplace sitting time, can help inform the design and implementation of targeted interventions. The aim of this qualitative synthesis was to identify and synthesise the evidence on factors perceived to influence the acceptability and feasibility of reducing sitting at work, without, and with, an associated intervention component.

METHODS

A systematic search of the peer-reviewed literature was conducted across multiple databases in October 2017 to identify studies with a qualitative component relating to reducing workplace sitting time. Relevant data were extracted and imported into NVivo, and analysed by three of the authors by coding the results sections of papers line-by-line, with codes organised into sub-themes and then into overarching themes. Studies with and without an associated intervention were analysed separately.

RESULTS

Thirty-two studies met the inclusion criteria, 22 of which had collected qualitative data during and/or following a workplace intervention. Sample sizes ranged from five through to 71 participants. Studies predominately involved desk-based workers (28/32) and were most frequently conducted in Australia, USA or the United Kingdom (26/32). Similar themes were identified across non-intervention and intervention studies, particularly relating to barriers and facilitators to reducing workplace sitting. Predominately, work and social environment attributes were identified as barriers/facilitators, with desk-based work and work pressures influencing the perceived feasibility of reducing sitting, particularly for low-cost interventions. Support from co-workers and managers was considered a key facilitator to reducing sitting, while social norms that discouraged movement were a prominent barrier. Across all studies, some consistent perceptions of benefits to reducing sitting were identified, including improved physical health, enhanced emotional well-being and associated work-related benefits.

CONCLUSION

Common barriers and facilitators to reducing workplace sitting time were identified across the literature, most prominently involving the social environment and job-related demands. These findings can inform the design and implementation of workplace sitting reduction strategies. To increase the generalisability of findings, further research is needed in a more diverse range of countries and industries.

Long-Term Access to Sit-Stand Workstations in a Large Office Population: User Profiles Reveal Differences in Sitting Time and Perceptions

Background: To decrease the detrimental health effects of prolonged sitting, the implementation of sit-stand workstations is a commonly used intervention for office workers. Most studies on this topic evaluated the effects of newly introduced sit-stand workstations. The objective of this study was to determine how often and how long the standing option is used and how the use of sit-stand workstations is perceived in office workers with long-term access to these workstations. Methods: Using an online survey, 1098 office employees responded to questions about frequency of usage of the sit-stand workstation, sitting time, physical activity, and positive and negative perceptions of the use of the sit-stand workstations. Results: Based on the frequency of use, three user groups were identified: non-users (32.1%), monthly/weekly users (37.5%) and daily users (30.4%). Non-users reported to sit more, stand less and have longer bouts of sitting, compared to monthly/weekly users, and these differences were even larger compared to daily users. A higher proportion of daily users perceived the use of the sit-stand workstation as being more healthy and appealing and making them more productive and energetic compared to the non-users. A higher proportion of the non-users perceived it as being uncomfortable, distracting, and unpractical, compared to the other user groups. Conclusions: The differences between the three identified user groups with respect to sitting, standing and perceptions of sit-stand workstations, might be helpful in tailoring future interventions to reduce occupational sitting time, to increase the reach, effectiveness and sustainability.

Evaluating Short-Term Musculoskeletal Pain Changes in Desk-Based Workers Receiving a Workplace Sitting-Reduction Intervention

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.

Use and physiological responses of portable dynamic office workstations in an occupational setting - A field study

OBJECTIVE

The aim of this study was to investigate the use of two types of dynamic workstations (Deskbike, activeLife Trainer) and their effects on physiological activation in an occupational setting.

METHODS

30 employees were given access to the devices for 28 days. Frequency and duration of borrowing and use was recorded by a Chipcard-system. Physiological activation (energy expenditure, heart rate) while working in a seated position and using the workstations was measured with the activity tracker Fitbit Charge HR.

RESULTS

Participants used dynamic workstations on 40% of their working days for an average of 54.3 ± 23.9 min per day. Energy expenditure and heart rate increased significantly while using the workstations compared to working seated. The Deskbike was used more frequently and resulted in greater heart rate elevation.

CONCLUSION

Both types of dynamic workstations were used by the employees and had positive effects on physiological activation. The implementation of either type can be recommended.

Assessing the Feasibility and Pre-Post Impact Evaluation of the Beta (Test) Version of the BeUpstanding Champion Toolkit in Reducing Workplace Sitting: Pilot Study

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.

The impact of the built environment on health behaviours and disease transmission in social systems

The environment plays an important role in disease dynamics and in determining the health of individuals. Specifically, the built environment has a large impact on the prevention and containment of both chronic and infectious disease in humans and in non-human animals. The effects of the built environment on health can be direct, for example, by influencing environmental quality, or indirect by influencing behaviours that impact disease transmission and health. Furthermore, these impacts can happen at many scales, from the individual to the society, and from the design of the plates we eat from to the design of cities. In this paper, we review the ways that the built environment affects both the prevention and the containment of chronic and infectious disease. We bring examples from both human and animal societies and attempt to identify parallels and gaps between the study of humans and animals that can be capitalized on to advance the scope and perspective of research in each respective field. By consolidating this literature, we hope to highlight the importance of built structures in determining the complex dynamics of disease and in impacting the health behaviours of both humans and animals.This article is part of the theme issue 'Interdisciplinary approaches for uncovering the impacts of architecture on collective behaviour'.

The development, implementation and evaluation of interventions to reduce workplace sitting: a qualitative systematic review and evidence-based operational framework

BACKGROUND

Prolonged sitting is associated with increased risks of cardiovascular disease, Type 2 diabetes, some cancers, musculoskeletal disorders and premature mortality. Workplaces contribute to a large proportion of daily sitting time, particularly among office-based workers. Interventions to reduce workplace sitting therefore represent important public health initiatives. Previous systematic reviews suggest such interventions can be effective but have reported wide variations. Further, there is uncertainty as to whether effectiveness in controlled trials can be replicated when implemented outside the research setting. The aims of this review are to identify factors important for the implementation of workplace sitting interventions and to translate these findings into a useful operational framework to support the future implementation of such interventions.

METHODS

A qualitative systematic review was conducted. Four health and social science databases were searched for studies set in the workplace, with office-based employees and with the primary aim of reducing workplace sitting. Extracted data were primarily from author descriptions of interventions and their implementation. Inductive thematic analysis and synthesis was undertaken.

RESULTS

Forty studies met the inclusion criteria. Nine descriptive themes were identified from which emerged three higher-order analytical themes, which related to the development, implementation and evaluation of workplace sitting interventions. Key findings included: the importance of grounding interventions in theory; utilising participative approaches during intervention development and implementation; and conducting comprehensive process and outcome evaluations. There was a general under-reporting of information relating to the context within which workplace sitting interventions were implemented, such as details of local organisation processes and structures, as well as the wider political and economic landscape, which if present would aid the translation of knowledge into "real-world" settings.

CONCLUSIONS

These findings provided the basis for an operational framework, which is a representation of all nine descriptive themes and three higher-order analytical themes, to support workplace sitting intervention development, implementation and evaluation. Once tested and refined, this framework has the potential to be incorporated into a practical toolkit, which could be used by a range of organisations to develop, implement and evaluate their own interventions to reduce workplace sitting time amongst staff.

Implementation of Active Workstations in University Libraries-A Comparison of Portable Pedal Exercise Machines and Standing Desks

Sedentary behaviors are an important issue worldwide, as prolonged sitting time has been associated with health problems. Recently, active workstations have been developed as a strategy to counteract sedentary behaviors. The present study examined the rationale and perceptions of university students’ and staff following their first use of an active workstation in library settings. Ninety-nine volunteers completed a self-administered questionnaire after using a portable pedal exercise machine (PPEM) or a standing desk (SD). Computer tasks were performed on the SD (p = 0.001) and paperwork tasks on a PPEM (p = 0.037) to a larger extent. Men preferred the SD and women chose the PPEM (p = 0.037). The appreciation of the PPEM was revealed to be higher than for the SD, due to its higher scores for effective, useful, functional, convenient, and comfortable dimensions. Younger participants (<25 years of age) found the active workstation more pleasant to use than older participants, and participants who spent between 4 to 8 h per day in a seated position found active workstations were more effective and convenient than participants sitting fewer than 4 h per day. The results of this study are a preliminary step to better understanding the feasibility and acceptability of active workstations on university campuses.

Effect of alternating postures on cognitive performance for healthy people performing sedentary work

Prolonged sitting is a risk factor for several diseases and the prevalence of worksite-based interventions such as sit-to-stand workstations is increasing. Although their impact on sedentary behaviour has been regularly investigated, the effect of working in alternating body postures on cognitive performance is unclear. To address this uncertainty, 45 students participated in a two-arm, randomised controlled cross-over trial under laboratory conditions. Subjects executed validated cognitive tests (working speed, reaction time, concentration performance) either in sitting or alternating working postures on two separate days (ClinicalTrials.gov Identifier: NCT02863731). MANOVA results showed no significant difference in cognitive performance between trials executed in alternating, standing or sitting postures. Perceived workload did not differ between sitting and alternating days. Repeated measures ANOVA revealed significant learning effects regarding concentration performance and working speed for both days. These results suggest that working posture did not affect cognitive performance in the short term. Practitioner Summary: Prior reports indicated health-related benefits based on alternated (sit/stand) body postures. Nevertheless, their effect on cognitive performance is unknown. This randomised controlled trial showed that working in alternating body postures did not influence reaction time, concentration performance, working speed or workload perception in the short term.

Sitting patterns after relocation to activity-based offices: A controlled study of a natural intervention

This study determined the effect of relocating workers from traditional to activity-based offices on objectively measured sitting patterns. Office workers (n=493) from five office-sites within a large Swedish government agency were included in a controlled study of a natural intervention (2015-2017). At four sites, traditional offices were replaced by activity-based offices, while workers at one site with no relocation acted as controls. Sitting, standing and walking were measured objectively for 5-8days in a sub-sample (n=110) using accelerometry (Actigraph). Total sitting time (% of working time) and time spent in short (<5min), moderate (5-30min) and prolonged (>30min) uninterrupted periods in sitting were determined. Intervention effects were determined at 3- and 12-month follow-ups using linear mixed models adjusted for baseline age, gender and office type, and stratified by office-site (referencing controls). The relocation to activity-based offices did not result in an overall effect (across sites) on occupational sitting time (all p>0.05), while walking time had increased significantly by 1.4% of the working time at 12months compared with controls. Heterogeneous results were found across offices after 12months on total sitting time compared with controls (estimated change -18.3% time-1.4% time), prolonged sitting (change -18.3% to -3.8%), walking (change 0.5%-3.5%) and standing (change -1.4%-13.9%). In conclusion, relocation to activity-based offices had a limited overall effect on occupational sitting patterns in the studied organization, but differed considerably between office sites. Site-specific determinants of sitting behavior in activity-based offices need be identified.

The Impact of Activity Based Working (ABW) on Workplace Activity, Eating Behaviours, Productivity, and Satisfaction

The redesign of the physical workplace according to activity-based working (ABW) principles has potential to influence employee health and workplace outcomes. This natural experiment examined changes in accelerometer-derived workplace activity, self-reported eating behaviours, productivity, workplace satisfaction before (March to November 2014) and six to nine months after moving to an ABW workplace compared to a comparison workplace (n = 146 at baseline (56% ABW, aged 40.1 ± 8.5 years, 72% female). Interviews were also conducted with 21 ABW participants. Between- and within-group differences were examined and mixed model analysis examined intervention effects over time. Effect sizes were calculated on change scores (Cohen’s d). Although not statistically significant, ABW participants had meaningful improvements in workday sedentary time, light-, and moderate-to-vigorous intensity physical activity, job satisfaction and relationship with co-workers (d = 0.379–0.577), and small declines in productivity (d = 0.278). There were significant, meaningful, and beneficial intervention effects on perceived organisational support for being active in the workplace, frequency of eating lunch with colleagues, and satisfaction with the physical environment in ABW compared to comparison participants (d = 0.501–0.839). Qualitative data suggested that ABW employees associated ABW with greater opportunities for movement and collaboration, but had mixed views on the impact on productivity. Future research with larger samples and over longer follow-up periods is warranted.

Take a Stand!-a multi-component intervention aimed at reducing sitting time among office workers-a cluster randomized trial

Background

Prolonged sitting time has been associated with adverse health outcomes. Interventions at work may contribute to reduced sitting. The objective was to test if a multicomponent work-based intervention can reduce sitting time and the number of prolonged sitting periods (> 30 min), increase the number of sit-to-stand transitions and decrease waist circumference and body fat percentage among office workers. Primary outcomes were: change in sitting time, prolonged sitting periods and sit-to-stand transitions at follow-up 1 month later.

Methods

At four workplaces, 19 offices (317 workers in total) were cluster randomized for intervention or control. The intervention included the appointment of local ambassadors, management support, environmental changes, a lecture and a workshop. Sitting time was measured using an ActiGraph GT3X+ fixed on the thigh. Data were processed using Acti4 software providing data on time spent sitting, standing and doing other activities. Control participants were instructed to behave as usual. Follow-up measurements were obtained after 1 and 3 months.

Results

At 1 and 3 months, total sitting time was 71 ( P < 0.001) and 48 min ( P < 0.001) lower per 8-h workday in the intervention group compared with the control group. At 1 month, the number of prolonged sitting periods was lower (-0.79/8-h workday, P < 0.001) and sit-to-stand transitions were higher (+14%/sitting hour, P = 0.001) in the intervention compared with the control group. After 3 months, trends persisted. The body fat percentage was lower by 0.61 percentage points ( P = 0.011) in the intervention group compared with the control group after 3 months.

Conclusions

The multicomponent workplace-based intervention was effective in reducing sitting time, prolonged sitting periods and body fat percentage, and in increasing the number of sit-to-stand transitions.

Stand Up to Work: assessing the health impact of adjustable workstations

Purpose

Sedentary behavior is linked to health risks, and prolonged sitting is prevalent among office workers. Adjustable workstations (AWS) promote health by allowing transitions between sitting and standing. Stand Up to Work compares workers with AWS to traditional desks (TD). The paper aims to discuss these issues.

Design/methodology/approach

Employees were randomly selected from one office floor to receive AWS, two identical floors maintained TD. Participants received workplace wellness and ergonomic training, completed self-administered questionnaires, and responded to repeated micropolling at baseline (T0), 3 (T1), 6 (T2), and 12 (T3) months in Atlanta, 2015-2016. Groups were compared using two-sample t-tests and nonparametric Wilcoxon tests.

Findings

Compared to TD (n = 24), participants with AWS (n = 24) reported significantly less sedentary behavior at T1 and T2 after AWS installation (p<0.05), with a retention rate at T2 of 80 and 65 percent for the AWS and TD group, respectively. In all, 47 percent of participants with AWS reported decline in upper back, shoulder, and neck discomfort (p=0.04); 88 percent of AWS participants reported convenience to use, 65 percent reported increased productivity, and 65 percent reported positive impact outside the workplace. Individuals with normal or underweight body mass index (BMI) reported a significantly greater decline in percent of time sitting compared to participants with overweight or obese BMI at all three time points.

Originality/value

AWS are beneficial in reducing sedentary behavior in and outside the workplace. Behavioral changes were sustained over time and associated with less self-reported muscle pain, more self-reported energy, and awareness of standing. When considering total worker health, employers should include options for AWS to promote reducing sedentary behavior.

Economic stress and low leisure-time physical activity: Two life course hypotheses

The aim was to investigate associations between economic stress in childhood and adulthood, and low leisure-time physical activity (LTPA) in adulthood from two life course perspectives. The public health survey in Scania in the southernmost part of Sweden in 2012 is a cross-sectional study based on a stratified random sample with 28,029 respondents aged 18-80 (51.7% response rate). Associations between childhood and adult economic stress, and low LTPA were analyzed with logistic regressions. A 14.8% prevalence of men and 13.5% of women had low LTPA (sedentary lifestyle). Low LTPA was associated with higher age, being born abroad, low socioeconomic status, low trust, smoking, poor self-rated health, and economic stress in childhood and adulthood. The odds ratios of low LTPA increased with more accumulated economic stress across the life course in a dose-response relationship. There was no specific critical period (childhood or adulthood), because economic stress in childhood and adulthood were both associated with low LTPA but the associations were attenuated after the introduction of smoking and self-rated health. The accumulation hypothesis was supported because the odds ratios of low LTPA indicated a graded response to life course economic stress. The critical period hypothesis was thus not supported. Economic stress across the life course seems to be associated with low LTPA in adulthood.

Longitudinal Relationship Between Sitting Time on a Working Day and Vitality, Work Performance, Presenteeism, and Sickness Absence

OBJECTIVE

The aim of this study was to explore the longitudinal relationship between sitting time on a working day and vitality, work performance, presenteeism, and sickness absence.

METHODS

At the start and end of a five-month intervention program at the workplace, as well as 10 months after the intervention, sitting time and work-related outcomes were measured using a standardized self-administered questionnaire and company records. Generalized linear mixed models were used to estimate the longitudinal relationship between sitting time and work-related outcomes, and possible interaction effects over time.

RESULTS

A significant and sustainable decrease in sitting time on a working day was observed. Sitting less was significantly related to higher vitality scores, but this effect was marginal (b = -0.0006, P = 0.000).

CONCLUSIONS

Our finding of significant though marginal associations between sitting time and important work-related outcomes justifies further research.

Metabolic Rate during a Cognitive Vigilance Challenge at Alternative Workstations

OBJECTIVE

The aim of this study was to compare energy expenditure (EE, kcal/min) at three workstations during an attention-demanding cognitive function task (Test of Variables of Attention or TOVA). Workstations included the seated desk (SIT), standing desk (STAND), and seated workstation designed to promote spontaneous movement (SWING).

METHODS

Adult males (n = 11) and females (n = 13) were assessed for EE using VO2 and VCO2 per quarter of the 22-min TOVA.

RESULTS

Average EE were 1.39 ± 0.06 (SIT), 1.55 ± 0.08 (SWING), and 1.44 ± 0.08 (STAND). Main effects (P < 0.05) were seen for workstation (SWING, STAND > SIT), and quarter of TOVA (Q2 < Q1,Q3,Q4). TOVA errors and response times were not different for workstations but increased for Q3 and Q4.

CONCLUSION

Spontaneous movement at an alternative workstation elevated EE 10% to 11% compared with sitting and could increase daily nonexercise activity thermogenesis without diminishing mental attention to desk work.

Reducing Sedentary Time for Obese Older Adults: Protocol for a Randomized Controlled Trial

Background

Older adults have high rates of obesity and are prone to chronic health conditions. These conditions are in part due to high rates of sedentary time (ST). As such, reducing ST could be an innovative strategy for improving health outcomes among obese older adults. To test this theory, we developed a novel, technology-enhanced intervention to reduce sitting time (I-STAND) and pilot tested it to assess the feasibility, acceptability, and preliminary effects of the intervention on ST and biometric outcomes.

Objective

The current paper aims to describe the rationale, design, and methods of the I-STAND sitting reduction pilot trial.

Methods

Older adults with obesity (n=60) were recruited from a large health care system and randomized to receive I-STAND or a healthy living intervention. I-STAND combined personal coaching with a technology-enhanced intervention (Jawbone UP band) to cue breaks from sitting. Participants completed self-report and biometric assessments at baseline and 3 months. Additional qualitative results were collected from a subset of I-STAND participants (n=22) to further inform the feasibility and acceptability of the interventions. The primary outcome was total hours of daily sitting time measured by the activPAL device. Secondary outcomes included sit-to-stand transitions, bouts of sitting longer than 30 minutes, physical function, blood pressure, fasting glucose, cholesterol, and depressive symptoms.

Results

Study enrollment has ended and data processing is underway.

Conclusions

Data from randomized trials on sitting reduction are needed to inform novel approaches to health promotion among older adults with obesity. Our trial will help fill this gap. The methods used in our study can guide future research on using technology-based devices to assess or prompt sedentary behavior reduction, or those interested in behavioral interventions targeting obese older adults with novel approaches

Trial Registration

ClinicalTrials.gov: NCT02692560; https://clinicaltrials.gov/ct2/show/NCT02692560 (Archived by WebCite at http://www.webcitation.org/6wppLTWAl)

The Effect of a Leisure Time Physical Activity Intervention Delivered via a Workplace: 15-Month Follow-Up Study

In line with recommendations from both the World Health Organization and the European Union some employers encourage workplace health promotion through physical activity (PA) facilities and leisure time PA-initiatives. The current study describes a 15-month follow-up after an 8-week workplace delivered PA-initiative, investigates if improvements in cardiovascular risk status are sustainable, and elucidates differences according to educational level. One hundred and twenty one employees (43 women) were examined before and after the 8-week PA-initiative and 94 at the 15-month follow-up. PA-levels, blood pressure, resting heart rate, lipids, glycosylated hemoglobin (HbA1c), C-reactive protein (CRP), and selected markers of inflammation were registered at baseline, immediately after the 8-week PA-initiative, and 15 months after baseline. At the end of follow-up (15-month), PA-levels—increased during the 8-week intervention—had returned to baseline values. None of the five improvements in cardiovascular markers (total cholesterol, low density lipoprotein (LDL), P-selectin, CD40Ligand (CD40L) and Monocyte chemoattractant protein-1 (MCP-1)) seen at the 8-week follow-up were sustained. At the 15-month follow-up as compared to baseline HbA1c, CRP (log) and interleukin-6 (IL-6) were reduced by 0.06 mmol/L (95% CI −0.11,−0.01), 0.25 mg/L (95% CI −0.46,−0.04) and 0.39 pg/mL (95% CI −0.75, −0.04), respectively. At baseline, there were differences in cardiovascular risk factors comparing men with low versus high levels of education. No differences in changes in outcomes between these groups of men were found during follow-up. In this study highly educated men generally have lower levels of cardiovascular risk factors, but the effect of PA on such markers in this group do not differ from the effects seen in less educated men.

Office workers' beliefs about reducing sitting time at work: a belief elicitation study

Objectives

Prolonged sitting has adverse health consequences, yet office workers can spend over 10 hours sitting each day. The Theory of Planned Behaviour may offer a useful perspective for understanding and enhancing psychological determinants of sitting at work. The aim of this belief elicitation study was to identify office workers’ most salient beliefs relating to achieving the recently published Public Health England recommendation of accumulating at least two hours per day of standing and light activity at work.

Methods

Full-time office-based workers (n = 105) responded to our invitation on Twitter to complete an on-line questionnaire. Participants responded to six open-ended questions about their behavioural (i.e. advantages/disadvantages), normative (i.e. who would approve/disapprove), and control (i.e. easy/difficult) beliefs relating to the target behaviour, and the data were content analysed to identify the most salient themes.

Results

The most salient advantage of the behaviour was better health (n = 243), and most salient disadvantage was decreased work productivity (n = 64). Participants believed that people in work with a remit for health (n = 34) were likely to approve of the behaviour, but that managers (n = 68) would be likely to disapprove. It was believed that a better physical environment (n = 75) would make it easier, and work demands (n = 102) would make it difficult to execute the behaviour.

Conclusions

Although participants recognised many benefits of engaging in the behaviour, there was consistent evidence that participants believed the behaviour may have implications for working effectively, and would be influenced by the physical environment and work culture. Interventions should target these salient beliefs.

Office-Cycling: A Promising Way to Raise Pain Thresholds and Increase Metabolism with Minimal Compromising of Work Performance

Aim

Establishing the effects of low intensity cycling (LC), moderate intensity cycling (MC), and standing at a simulated office workstation on pain modulation, work performance, and metabolic expenditure.

Methods

36 healthy adults (21 females), mean age 26.8 (SD 7.6) years, partook in this randomized 3 × 3 crossover trial with 75 minutes of LC on 20% of maximum aerobic power (MAP) output, 30 minutes of MC on 50% of MAP, and standing 30 minutes with 48-hour wash-out periods. Outcome measures were pain modulation (pressure pain threshold (PPT) and thermal pain threshold)), work performance (transcription, mouse pointing, and cognitive performance), and metabolic expenditure.

Results

PPTs increased in all conditions. PPT trapezius showed the highest increase after LC, 39.3 kilopascals (kPa) (15.6; 78.6), compared to MC, 17.0 kPa (2.8; 49.9), and standing, 16.8 kPa (-5.6; 39.4), p = 0.015. Transcription was reduced during LC and MC. Mouse pointing precision was best during standing and worst and slowest during MC. Cognitive performance did not differ between conditions. Metabolic expenditure rates were 1.4 (1.3; 1.7), 3.3 (2.3; 3.7), and 7.5 (5.8; 8.7) kcal/minute during standing, LC, and MC, respectively (p < 0.001).

Conclusions

LC seems to be the preferred option; it raised PPTs, more than doubled metabolic expenditure, whilst minimally influencing work performance.

Self-reported actual and desired proportion of sitting, standing, walking and physically demanding tasks of office employees in the workplace setting: do they fit together?

OBJECTIVE

Occupational sitting time in white-collar workers represents a prominent contributor to overall daily sitting time, which is associated with various health risks. Workplace interventions intending to reduce sitting time during work typically focus on replacing sitting with standing. The aim was to investigate and compare actual and desired proportions of time spent sitting, standing, walking, and doing physically demanding tasks at work reported by desk-based workers. Cross-sectional data were collected from German desk-based workers (n = 614; 53.3% men; 40.9 ± 13.5 years). All were interviewed about their self-reported actual and desired level of sitting, standing, walking and physically demanding tasks at work.

RESULTS

Desk-based workers reported to sit 73.0%, stand 10.2%, walk 12.9% and do physically demanding tasks 3.9% of their working hours. However, the individuals desire to sit, stand, walk and do physically demand tasks significantly different [53.8% sit, 15.8% stand, 22.8% walk, physically demanding tasks (7.7%), p < 0.001]. The present data revealed greatest mismatch between the desk-based workers' actual and desired time for sitting and walking. Health promotion programs should offer not only options for more standing but also opportunities for more walking within the workplace setting to better match workers' desires.

Office activity classification using first-reflection ultrasonic echolocation

Excessive sedentary time poses considerable health risks for individuals predominately engaged in desk-bound work. To empower interventions aimed at addressing this problem, reliable technologies for continuous activity monitoring within an office environment are required. As an alternative to existing solutions, we propose the Echolocation-based Activity Detector, a contactless sensor array of four first-reflection ultrasonic distance sensors. The research described herein demonstrates the capacity of the sensor to distinguish between common activities performed at a workstation within an office environment, including sedentary sitting, typing, writing, and standing. Cubic support vector machine classifiers are developed using dispersion-related features computed from the time-series array outputs. Average classification accuracy for sedentary activities exceeds 85%, while classification accuracy for the entire activity set exceeds 80% for a controlled experiment conducted with six participants.

Is sedentary behaviour just physical inactivity by another name?

The relationship between sedentary behaviour and physical activity and their role in the development of health conditions is an ongoing topic of research. This debate paper presents arguments in favour and against the statement: "Is sedentary behaviour just physical inactivity by another name?" The paper finishes with recommendations for future research in the field of sedentary behaviour, physical activity and public health.

Associations of prolonged standing with musculoskeletal symptoms-A systematic review of laboratory studies

While prolonged standing has shown to be detrimentally associated with musculoskeletal symptoms, exposure limits and underlying mechanisms are not well understood. We systematically reviewed evidence from laboratory studies on musculoskeletal symptom development during prolonged (≥20min) uninterrupted standing, quantified acute dose-response associations and described underlying mechanisms. Peer-reviewed articles were systematically searched for. Data from included articles were tabulated, and dose-response associations were statistically pooled. A linear interpolation of pooled dose-response associations was performed to estimate the duration of prolonged standing associated with musculoskeletal symptoms with a clinically relevant intensity of ≥9 (out of 100). We included 26 articles (from 25 studies with 591 participants), of which the majority examined associations of prolonged standing with low back and lower extremity symptoms. Evidence on other (e.g., upper limb) symptoms was limited and inconsistent. Pooled dose-response associations showed that clinically relevant levels of low back symptoms were reached after 71min of prolonged standing, with this shortened to 42min in those considered pain developers. Regarding standing-related low back symptoms, consistent evidence was found for postural mechanisms (i.e., trunk flexion and lumbar curvature), but not for mechanisms of muscle fatigue and/or variation in movement. Blood pooling was the most consistently reported mechanism for standing-related lower extremity symptoms. Evidence suggests a detrimental association of prolonged standing with low back and lower extremity symptoms. To avoid musculoskeletal symptoms (without having a-priori knowledge on whether someone will develop symptoms or not), dose-response evidence from this study suggests a recommendation to refrain from standing for prolonged periods >40min. Interventions should also focus on underlying pain mechanisms.

Do Sitting, Standing, or Treadmill Desks Impact Psychobiological Indicators of Work Productivity?

Background:

This pilot study investigated the links between psychobiological indicators of work productivity, prolonged desk sitting, and conditions whereby office workers were able to interrupt sitting using a sit–stand or treadmill desk.

Methods:

Twenty participants visited our laboratory and completed their own desk work in counterbalanced sit-only, sit–stand (Varidesk Pro Plus 48™), and sit–walk conditions (Infiniti TR1200-DTS™). Steady-state visually evoked potentials calculated from electroencephalography recordings during a set task at the end of the workday assessed attentional resource. Salivary cortisol samples were taken during the morning and afternoon to measure stress response. Within-subject analyses were used to compare work productivity indicators relative to condition.

Results:

No significant differences in mean steady-state visually evoked potential amplitude were observed, although attentional resource allocation was found to be the most effective following the sit–stand [1.01 (0.46) μV] compared with the sit–walk [0.9 (0.28) μV] and sit-only [0.91 (0.32) μV] conditions. The mean magnitude of decrease in cortisol was most apparent when workers used treadmill (1.5 nmol/L; P = .007) and sit–stand (1.6 nmol/L; P = .001) desks, and least evident in the sit-only condition (1.0 nmol/L; P = .146).

Conclusions:

The findings highlight the potential benefits of standing or active deskwork to the allocation of attentional resources and the regulation of stress.

Is Active Design changing the workplace? - A natural pre-post experiment looking at health behaviour and workplace perceptions

BACKGROUND

Active Design is a relatively new concept and evaluation on its effects on healthy behaviour is lacking.

OBJECTIVE

To investigate Active Design influence on workplace physical activity, sedentary behaviour, musculoskeletal complaints, and perceptions of the workplace and productivity.

METHODS

Participants (n = 118 adults) moving from 14 workplaces into a new building completed an online questionnaire pre- and post-move. The questions related to health behaviours (physical activity, sitting time and sleep); musculoskeletal issues; perceptions of the office environment; productivity; and engagement.

RESULTS

After the move, 68% of participants were located in an open plan building (21% before the move). In the new workplace participants tended to sit less during their work time (72% - 66%; p < 0.05) and stand more (15% - 19%; p < 0.05) while walking remained unchanged. Participants reported less lower-back pain. The new work environment was perceived as more motivating and providing better light, air quality and temperature, but less storage space. Participants reported looking forward to going to work more than before. No difference was reported in productivity related measures.

CONCLUSIONS

Moving to a new Active Design building can have some physical health-promoting effects on occupants. Satisfaction with environmental characteristics tended to improve in the new building though perceptions of productivity measures were variable.

Social ecological correlates of workplace sedentary behavior

Background

To identify social ecological correlates of objectively measured workplace sedentary behavior.

Methods

Participants from 24 worksites - across academic, industrial, and government sectors - wore an activPAL-micro accelerometer for 7-days (Jan-Nov 2016). Work time was segmented using daily logs. Sedentary behavior outcomes included time spent sitting, standing, in light intensity physical activity (LPA, stepping cadence <100 steps/min), and in prolonged sitting bouts (>30 min). Outcomes were standardized to an 8 h work day. Two electronic surveys were completed to derive individual (job type and work engagement), cultural (lunch away from the desk, walking at lunch and face-to-face interaction), physical (personal printer and office type) and organizational (sector) factors. Mixed-model analyses with worksite-level clustering were performed to examine multi-level associations. Secondary analyses examined job type and sector as moderators of these associations. All models were adjusted for age, race/ethnicity and gender.

Results

Participants (N = 478; 72% female; age: 45.0 ± 11.3 years; 77.8% non-Hispanic white) wore the activPAL-micro for 90.2 ± 15.5% of the reported workday. Walking at lunch was positively associated with LPA (5.0 ± 0.5 min/8 h, P < 0.001). Regular face-to-face interaction was negatively associated with prolonged sitting (−11.3 ± 4.8 min/8 h, P < 0.05). Individuals in private offices sat more (20.1 ± 9.1 min/8 h, P < 0.05), stood less (−21.5 ± 8.8 min/8 h, P < 0.05), and engaged in more prolonged sitting (40.9 ± 11.2 min/8 h, P < 0.001) than those in public office space. These associations were further modified by job type and sector.

Conclusions

Work-specific individual, cultural, physical and organizational factors are associated with workplace sedentary behavior. Associations vary by job type and sector and should be considered in the design of workplace interventions to reduce sedentary behavior.

Trial registration

Clinical trial No. NCT02566317; Registered Sept 22nd 2015.

Using computer, mobile and wearable technology enhanced interventions to reduce sedentary behaviour: a systematic review and meta-analysis

Background

High levels of sedentary behaviour (SB) are associated with negative health consequences. Technology enhanced solutions such as mobile applications, activity monitors, prompting software, texts, emails and websites are being harnessed to reduce SB. The aim of this paper is to evaluate the effectiveness of such technology enhanced interventions aimed at reducing SB in healthy adults and to examine the behaviour change techniques (BCTs) used.

Methods

Five electronic databases were searched to identify randomised-controlled trials (RCTs), published up to June 2016. Interventions using computer, mobile or wearable technologies to facilitate a reduction in SB, using a measure of sedentary time as an outcome, were eligible for inclusion. Risk of bias was assessed using the Cochrane Collaboration’s tool and interventions were coded using the BCT Taxonomy (v1).

Results

Meta-analysis of 15/17 RCTs suggested that computer, mobile and wearable technology tools resulted in a mean reduction of −41.28 min per day (min/day) of sitting time (95% CI -60.99, −21.58, I2 = 77%, n = 1402), in favour of the intervention group at end point follow-up. The pooled effects showed mean reductions at short (≤ 3 months), medium (>3 to 6 months), and long-term follow-up (>6 months) of −42.42 min/day, −37.23 min/day and −1.65 min/day, respectively. Overall, 16/17 studies were deemed as having a high or unclear risk of bias, and 1/17 was judged to be at a low risk of bias. A total of 46 BCTs (14 unique) were coded for the computer, mobile and wearable components of the interventions. The most frequently coded were “prompts and cues”, “self-monitoring of behaviour”, “social support (unspecified)” and “goal setting (behaviour)”.

Conclusion

Interventions using computer, mobile and wearable technologies can be effective in reducing SB. Effectiveness appeared most prominent in the short-term and lessened over time. A range of BCTs have been implemented in these interventions. Future studies need to improve reporting of BCTs within interventions and address the methodological flaws identified within the review through the use of more rigorously controlled study designs with longer-term follow-ups, objective measures of SB and the incorporation of strategies to reduce attrition.

Trial registration

The review protocol was registered with PROSPERO: CRD42016038187

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-017-0561-4) contains supplementary material, which is available to authorized users.

Targeting Reductions in Sitting Time to Increase Physical Activity and Improve Health

: New evidence suggests that reductions in sedentary behavior may increase physical activity and improve health. These findings point to new behavioral targets for intervention and new ways to think about intervening to increase overall physical activity in the population. This report provides a knowledge update reflecting the rapid accumulation of new evidence related to sedentary behavior and health among adults. Recent observational studies suggest that leveraging the time-inverse relationship between sedentary and active behaviors by replacing sitting with standing, light- or moderate-intensity activity can have important health benefits, particularly among less active adults. Clinical studies are providing evidence of the probable physiologic mechanisms underlying these associations, as well as insights into the cardiometabolic impact of breaking up and reducing sedentary behavior. In contrast to the well-established behavioral theories that guide the development and dissemination of evidence-based interventions to increase moderate- to vigorous-intensity physical activity, much less is known about how to reduce sedentary time to increase daily activities. It has become clear that the environmental, social, and individual level determinants for sedentary time are distinct from those linked to the adoption and maintenance of moderate- to vigorous-intensity physical activity. As a result, novel intervention strategies that focus on sitting and lower-intensity activities by leveraging the surrounding environment (e.g., workplace, school, and home) as well as individual-level cues and habits of sedentary behavior are being tested to increase the potency of interventions designed to increase overall physical activity. Herein we summarize the solutions-oriented research across the behavioral research framework, with a focus on highlighting areas of synergy across disciplines and identifying gaps for future research.

Physical Activity and Sedentary Behaviour of Master of Physical Therapy Students: An Exploratory Study of Facilitators and Barriers

Purpose: A full 85% of Canadians fail to meet physical activity (PA) guidelines, and 69% report being sedentary. Physical therapists are uniquely positioned to promote an active lifestyle; thus, we explored the PA and sedentary behaviour (SB) of Master of Physical Therapy (MPT) students as well as the associated facilitators and barriers. Methods: We used a mixed-methods approach, accelerometry and photovoice (a focus group discussion in which participants discussed self-selected photographs). Accelerometer data were used to quantify PA (light, moderate, and vigorous) and SB. Thematic analysis of the focus group discussion was informed by the socio-ecological model. Results: A total of 26% of participants met national PA guidelines, and mean daily sedentary time for participants was 670.7 (SD 34.4) minutes. Photovoice analysis revealed four main themes related to the facilitators of and barriers to PA and SB: (1) priorities and life balance, (2) commitment and accountability, (3) environment, and (4) MPT programming. Conclusions: A full 74% of participants did not meet the recommended PA guidelines; this is concerning given their immanent roles as health care professionals. Physical therapists are well prepared to prescribe PA to clients. Not only do MPT students need competencies in prescribing PA and exercise, but they may also need to be supported in meeting PA guidelines themselves and limiting SB throughout their studies.

The Effect of Changes in Physical Activity on Sedentary Behavior: Results From a Randomized Lifestyle Intervention Trial

PURPOSE

To investigate whether changes in physical activity (PA) have an impact on sedentary behavior (SB) during a lifestyle intervention.

DESIGN

Study design was a randomized trial.

SETTING/SUBJECTS

Participants (n = 204) were individuals with low PA and high sedentary leisure screen time from the Chicago area.

INTERVENTION

Participants were randomized to either increase PA (iPA) or decrease sedentary leisure (dSED). The intervention consisted of decision support, coaching, and financial incentives. For iPA participants, the goal was at least 60 min/d of self-reported moderate-tovigorous-intensity PA (MVPA). For dSED participants the goal was less than 90 min/d of sedentary leisure screen time.

MEASURES

Daily accelerometer-based measures of SB and bout-corrected MVPA were obtained.

ANALYSIS

Linear mixed-effects models were fit to estimate the effect of the intervention on MVPA and total SB and to estimate the effect of daily changes in MVPA on daily SB.

RESULTS

The iPA participants increased their bout-corrected MVPA by 14 min/d (p < .001) and decreased their total SB by 18 min/d (p < .001). The dSED participants did not significantly change their PA or their total SB. On days when participants exercised, each 10-minute bout of MVPA was associated with a 6-minute decrease in SB on the same day (p < .001).

CONCLUSION

In an intervention study designed to increase MVPA, participants who increase their time spent exercising will obtain much of this time by reducing their SB.