The Cost-Effectiveness of the SMART Work & Life Intervention for Reducing Sitting Time

Development of Digital Strategies for Reducing Sedentary Behavior in a Hybrid Office Environment: Modified Delphi Study

BACKGROUND

Hybrid work is the new modus operandi for many office workers, leading to more sedentary behavior than office-only working. Given the potential of digital interventions to reduce sedentary behavior and the current lack of studies evaluating these interventions for home office settings, it is crucial to develop digital interventions for such contexts involving all stakeholders.

OBJECTIVE

This study aimed to reach expert consensus on the most feasible work strategies and the most usable digital elements as a delivery method to reduce sedentary behavior in the home office context.

METHODS

A modified Delphi study including 3 survey rounds and focus groups was conducted to achieve consensus. The first Delphi round consisted of two 9-point Likert scales for assessing the feasibility of work strategies and the potential usefulness of digital elements to deliver the strategies. The work strategies were identified and selected from a scoping review, a systematic review, and 2 qualitative studies involving managers and employees. The median and mean absolute deviation from the median for each item are reported. The second round involved 2 ranking lists with the highly feasible strategies and highly useful digital elements based on round 1 responses to order the list according to experts' preferences. The weighted average ranking for each item was calculated to determine the most highly ranked work strategies and digital elements. The third round encompassed work strategies with a weight above the median from round 2 to be matched with the most useful digital elements to implement each strategy. In total, 4 focus groups were additionally conducted to gain a greater understanding of the findings from the Delphi phase. Focus groups were analyzed using the principles of reflexive thematic analysis.

RESULTS

A total of 27 international experts in the field of occupational health participated in the first round, with response rates of 86% (25/29) and 66% (19/29) in rounds 2 and 3, respectively, and 52% (15/29) in the focus groups. Consensus was achieved on 18 work strategies and 16 digital elements. Feedback on activity progress and goal achievement; creating an action plan; and standing while reading, answering phone calls, or conducting videoconferences were the most feasible work strategies, whereas wrist-based activity trackers, a combination of media, and app interfaces in smartphones were the most useful digital elements. Moreover, experts highlighted the requirement of combining multiple levels of strategies, such as social support, physical environment, and individual strategies, to enhance their implementation and effectiveness in reducing sedentary behavior when working from home.

CONCLUSIONS

This expert consensus provided a foundation for developing digital interventions for sedentary behavior in home office workers. Ongoing interventions should enable the evaluation of feasible strategies delivered via useful digital elements in home office or hybrid contexts.

What it takes to reduce sitting at work: a pilot study on the effectiveness and correlates of a multicomponent intervention

OBJECTIVE

This study aimed to assess the feasibility and effects of a simple-to-implement multicomponent intervention to reduce sedentary time of office workers.

METHODS

Six groups of eight to ten office workers took part in the two-week Leicht Bewegt intervention. Participants completed questionnaires at baseline (T0, n = 52), after 2 weeks (T1, n = 46), and after 5 weeks (T2, n = 38), including subjective sedentary measures and social-cognitive variables based on the health action process approach (HAPA). Objective sedentary measures were obtained using activPAL trackers.

RESULTS

The intention to reduce sedentary behavior during work increased significantly from T0 to T1. Participants' objective and subjective sitting time decreased significantly from T0 to T1, corresponding to an average decrease per 8-h-workday of 55 min (d = - .66) or 74 min (d = - 1.14), respectively. This reduction persisted (for subjective sitting time) at T2 (d = - 1.08). Participants indicated a high satisfaction with the intervention.

CONCLUSIONS

The Leicht Bewegt intervention offers a feasible and effective opportunity to reduce sedentary behavior at work. Randomized controlled trials including longer follow-up time periods are needed to validate its benefits in different workplaces.

Implementation and engagement of the SMART Work & Life sitting reduction intervention: an exploratory analysis on intervention effectiveness

BACKGROUND

To enhance the impact of interventions, it is important to understand how intervention engagement relates to study outcomes. We report on the level of implementation and engagement with the SMART Work & Life (SWAL) programme (delivered with (SWAL plus desk) and without a height-adjustable desk (SWAL)) and explore the effects of different levels of this on change in daily sitting time in comparison to the control group.

METHODS

The extent of intervention delivery by workplace champions and the extent of engagement by champions and participants (staff) with each intervention activity was assessed by training attendance logs, workplace champion withdrawal dates, intervention activities logs and questionnaires. These data were used to assess whether a cluster met defined criteria for low, medium, or high implementation and engagement or none of these. Mixed effects linear regression analyses tested whether change in sitting time varied by: (i) the number of intervention activities implemented and engaged with, and (ii) the percentage of implementation and engagement with all intervention strategies.

RESULTS

Workplace champions were recruited for all clusters, with 51/52 (98%) attending training. Overall, 12/27 (44.4%) SWAL and 9/25 (36.0%) SWAL plus desk clusters implemented all main intervention strategies. Across remaining clusters, the level of intervention implementation varied. Those in the SWAL (n = 8 (29.6%) clusters, 80 (32.1%) participants) and SWAL plus desk (n = 5 (20.0%) clusters, 41 (17.1%) participants) intervention groups who implemented and engaged with the most intervention strategies and had the highest percentage of cluster implementation and engagement with all intervention strategies sat for 30.9 (95% CI -53.9 to -7.9, p = 0.01) and 75.6 (95% CI -103.6 to -47.7, p < 0.001) fewer minutes/day respectively compared to the control group at 12 month follow up. These differences were larger than the complete case analysis. The differences in sitting time observed for the medium and low levels were similar to the complete case analysis.

CONCLUSIONS

Most intervention strategies were delivered to some extent across the clusters although there was large variation. Superior effects for sitting reduction were seen for those intervention groups who implemented and engaged with the most intervention components and had the highest level of cluster implementation and engagement.

TRIAL REGISTRATION

ISRCTN11618007. Registered on 24 January 2018. https://www.isrctn.com/ISRCTNISRCTN11618007 .

Participant and workplace champion experiences of an intervention designed to reduce sitting time in desk-based workers: SMART work & life

BACKGROUND

A cluster randomised controlled trial demonstrated the effectiveness of the SMART Work & Life (SWAL) behaviour change intervention, with and without a height-adjustable desk, for reducing sitting time in desk-based workers. Staff within organisations volunteered to be trained to facilitate delivery of the SWAL intervention and act as workplace champions. This paper presents the experiences of these champions on the training and intervention delivery, and from participants on their intervention participation.

METHODS

Quantitative and qualitative feedback from workplace champions on their training session was collected. Participants provided quantitative feedback via questionnaires at 3 and 12 month follow-up on the intervention strategies (education, group catch ups, sitting less challenges, self-monitoring and prompts, and the height-adjustable desk [SWAL plus desk group only]). Interviews and focus groups were also conducted at 12 month follow-up with workplace champions and participants respectively to gather more detailed feedback. Transcripts were uploaded to NVivo and the constant comparative approach informed the analysis of the interviews and focus groups.

RESULTS

Workplace champions rated the training highly with mean scores ranging from 5.3/6 to 5.7/6 for the eight parts. Most participants felt the education increased their awareness of the health consequences of high levels of sitting (SWAL: 90.7%; SWAL plus desk: 88.2%) and motivated them to change their sitting time (SWAL: 77.5%; SWAL plus desk: 85.77%). A high percentage of participants (70%) reported finding the group catch up session helpful and worthwhile. However, focus groups highlighted mixed responses to the group catch-up sessions, sitting less challenges and self-monitoring intervention components. Participants in the SWAL plus desk group felt that having a height-adjustable desk was key in changing their behaviour, with intrinsic as well as time based factors reported as key influences on the height-adjustable desk usage. In both intervention groups, participants reported a range of benefits from the intervention including more energy, less fatigue, an increase in focus, alertness, productivity and concentration as well as less musculoskeletal problems (SWAL plus desk group only). Work-related, interpersonal, personal attributes, physical office environment and physical barriers were identified as barriers when trying to sit less and move more.

CONCLUSIONS

Workplace champion and participant feedback on the intervention was largely positive but it is clear that different behaviour change strategies worked for different people indicating that a 'one size fits all' approach may not be appropriate for this type of intervention. The SWAL intervention could be tested in a broader range of organisations following a few minor adaptations based on the champion and participant feedback.

TRIAL REGISTRATION

ISCRCTN registry (ISRCTN11618007).