Rise and Recharge: Exploring Employee Perceptions of and Contextual Factors Influencing an Individual-Level E-Health Smartphone Intervention to Reduce Office Workers' Sedentary Time at Work

Development, implementation and evaluation of a smartphone application aimed to reduce sedentary time and increase physical activity among Indian sedentary office workers - findings from SMART-STEP trial

BACKGROUND

Excessive sedentary time (ST) is linked to an increased risk of cardiometabolic diseases. Although various behavioral interventions have emerged to reduce ST, the potential of smartphone (SmPh)-based interventions remains relatively unexplored in workplace settings. This study aimed to explore the development, implementation and acceptability of a SmPh application among Indian desk-based office workers.

METHODS

One hundred thirty-six office workers were randomised to one of three interventions for six months: (1) SmPh-based ST and physical activity (PA) reminders (SMART); (2) traditional education (TRADE) and (3) usual work group (CONT). A threshold of 70% adherence (equivalent to responding to at least 580 out of 828 assigned prompts) was used to classify participants as 'compliant'. Of 44 SMART group participants who were assigned to 24 weeks of intervention, nine participants were purposefully selected based on compliance, Moreover, they were interviewed for potential barriers associated with the SmPh application using semi-deductive approach.

RESULTS

The SMART STEP application was developed over eight months, during which three versions were created and pilot tested. The cost of application development was reasonable (≈ $1,860). Of 44 participants who received SmPh application-based reminders, 37 completed the two follow-ups at 3rd and 6th month. Mean prompt engagement rates, defined as 'the percentage of prompts participants actively responded to', during the 1st, 2nd, 3rd, 4th, 5th, and 6th months were 77% (n = 107), 59% (n = 82), 54% (n = 74), 45% (n = 63), 43% (n = 59), and 31% (n = 43), respectively. Barriers such as workload, lack of movement sensing, and insufficient organizational and peer support were key factors contributing to the decline in long-term engagement among office workers.

CONCLUSION

The SMART-STEP application appears to be an affordable and promising solution for reducing ST and promoting PA among office workers in low-resource settings. However, enhancements such as embedding movement sensing technology, organizational policies and peer education are needed to improve long-term usability and acceptability.

TRIAL REGISTRATION

Clinical Trial Registry of India (CTRI/2020/03/024138) registered on 20/03/2020.

A year-long case study of multicomponent interventions to promote physical activity in office workers: A randomized control trial

The purpose of this study was to identify if workplace interventions, (i.e., mindfulness classes and monetary incentives for gym attendance), influenced workers' physical activity. Office-based participants were randomized into one of four intervention assignments: 1) CONTROL (no interventions) (n = 40), 2) MINDFULNESS (n = 33), 3) GYM INCENTIVE (n = 41), or 4) BOTH mindfulness and gym incentive (n = 31). Activity-tracker and self-reported metabolic expenditure and step counts were gathered between January 2020 and December 2020 whereas the eight-week long interventions were provided between January and March 2020, when the impact of COVID-19 pandemic started. While physical activity decreased during the follow-up months, percent changes of physical activity at 1-, 2-, and 9-month follow-ups compared to baseline show no significant differences between or across the four intervention assignments (p > 0.05). These results suggest that the intervention assignments had no effect on physical activity from baseline. The lack of effectiveness of these interventions on participant physical activity could be attributed to the influence of the COVID-19 pandemic, and any effects of the interventions could not outweigh the effects of the pandemic.

Robot-Mediated Nudges for Workplace Health: Not a One-Size-Fits-All Modeling Problem

Prolonged sedentary behavior in the vast population of office and remote workers leads to increased cardiovascular and musculoskeletal health challenges, and existing solutions for encouraging breaks are either costly health coaches or notification systems that are easily ignored. A socially assistive robot (SAR) for promoting healthy workplace practices could provide the physical presence of a health coach along with the scalability of a notification system. To investigate the impact of such a system, we implemented a SAR as an alternative break-taking support solution and examined its impact on individual users' break-taking habits over relatively long-term deployments. We conducted an initial two-month-long study (N = 7) to begin to understand the robot's influence beyond the point of novelty, and we followed up with a week-long data collection (N = 14) to augment the dataset size. The resulting data was used to inform a robot behavior model and formulate possible methods of personalizing robot behaviors. We found that uninterrupted sitting time tended to decrease with our SAR intervention. During model formulation, we found participant responsiveness to the break-taking prompts could be classified into three archetypes and that archetype-specific adjustments to the general model led to improved system success. These results indicate that break-taking prompts are not a one-size-fits-all problem, and that even a small dataset can support model personalization for improving the success of assistive robotic systems.

Advantages and disadvantages of mobile applications for workplace health promotion: A scoping review

Different interventions and methods are used for workplace health promotion (WHP) programmes, including mobile applications (apps), which have proven effective among different health outcomes if properly communicated and developed. However, knowledge is lacking on the potential advantages and disadvantages of using this technology for WHP compared with nontechnical WHP programmes to support employers in their decision making and effective development of such an intervention. To obtain an overview of factors that decision-makers should consider when deciding whether to implement an WHP app, we conducted a scoping review of studies that have evaluated WHP apps. Potential advantages and disadvantages of using mobile apps for WHP were summarised using a strengths, weaknesses, opportunities and threats (SWOT) analysis. Articles were included if they focussed on a WHP app, were published between 2007 and 2022 in German or English, and evaluated an app for the general employee population. Altogether, 38 studies were included in the review, demonstrating WHP apps' effectiveness among various use cases in terms of content, e.g., mindfulness or sleep, and target groups, e.g., office workers, nurses or pilots. Strengths were found in the context of adoption, convenience for users, the targeted employee group's reach and cost-effectiveness. However, the review also identified some disadvantages in apps, including technical difficulties and usage barriers, as well as challenges, e.g., privacy issues and maintenance costs. Generally, our review found that different factors need to be considered when deciding whether to implement a WHP app based on the individual company situation, e.g., shift work, content to be communicated, and expectations for health parameter screening, among many others. By summarising recent literature on WHP apps, this review uses scientific knowledge to give employers an overview of potential factors to consider in their decision making.

Adherence to eHealth-Delivered Exercise in Adults with no Specific Health Conditions: A Scoping Review on a Conceptual Challenge

Adherence has emerged as a focal point and critical determinant of success for physical activity interventions. The term is used for both traditional and digital interventions, and for prescribed and nonprescribed activities. Many other terms for adherence are being used interchangeably, as there is no consensus on its precise conceptualization. This scoping review aimed to advance the definition of adherence to eHealth programs, specifically for the adult population with no specific health conditions. A total of 2983 papers, published between 1 January 2016 and 13 March 2022, were retrieved from different databases (including grey literature). Of those, 13 studies met the eligibility criteria and were included for review. The selected studies used a wide array of technologies and consisted mainly of exercise interventions. Most of the reviewed publications contemplated exercise adherence as a percentage of expected dose. Most (8 out of 13) studies neither assessed nor specified an expected use of the involved technology. Results suggest a need for homogeneity in the conceptualization of adherence to physical activity and exercise, including those interventions delivered digitally.