The effect of a sit-stand workstation intervention on daily sitting, standing and physical activity: protocol for a 12 month workplace randomised control trial.
ABSTRACT: A lack of physical activity and excessive sitting can contribute to poor physical health and wellbeing. The high percentage of the UK adult population in employment, and the prolonged sitting associated with desk-based office-work, make these workplaces an appropriate setting for interventions to reduce sedentary behaviour and increase physical activity. This pilot study aims to determine the effect of an office-based sit-stand workstation intervention, compared with usual desk use, on daily sitting, standing and physical activity, and to examine the factors that underlie sitting, standing and physical activity, within and outside, the workplace.A randomised control trial (RCT) comparing the effects of a sit-stand workstation only and a multi-component sit-stand workstation intervention, with usual desk-based working practice (no sit-stand workstation) will be conducted with office workers across two organisations, over a 12 month period (N?=?30). The multicomponent intervention will comprise organisational, environmental and individual elements. Objective data will be collected at baseline, and after 2-weeks, 3-months, 6-months and 12-months of the intervention. Objective measures of sitting, standing, and physical activity will be made concurrently (ActivPAL3™ and ActiGraph (GT3X+)). Activity diaries, ethnographic participant observation, and interviews with participants and key organisational personnel will be used to elicit understanding of the influence of organisational culture on sitting, standing and physical activity behaviour in the workplace.This study will be the first long-term sit-stand workstation intervention study utilising an RCT design, and incorporating a comprehensive process evaluation. The study will generate an understanding of the factors that encourage and restrict successful implementation of sit-stand workstation interventions, and will help inform future occupational wellbeing policy and practice. Other strengths include the objective measurement of physical activity during both work and non-work hours.Clinicaltrials.gov identifier NCT02172599, 22nd June 2014.
Project description:Excessive sitting time is a risk factor for cardiovascular disease mortality and morbidity independent of physical activity. This aim of this study was to evaluate the impact of a sit-stand workstation on sitting time, and vascular, metabolic and musculoskeletal outcomes in office workers, and to investigate workstation acceptability and feasibility.A two-arm, parallel-group, individually randomised controlled trial was conducted in one organisation. Participants were asymptomatic full-time office workers aged ?18 years. Each participant in the intervention arm had a sit-stand workstation installed on their workplace desk for 8 weeks. Participants in the control arm received no intervention. The primary outcome was workplace sitting time, assessed at 0, 4 and 8 weeks by an ecological momentary assessment diary. Secondary behavioural, cardiometabolic and musculoskeletal outcomes were assessed. Acceptability and feasibility were assessed via questionnaire and interview. ANCOVA and magnitude-based inferences examined intervention effects relative to controls at 4 and 8 weeks. Participants and researchers were not blind to group allocation.Forty-seven participants were randomised (intervention n?=?26; control n?=?21). Relative to the control group at 8 weeks, the intervention group had a beneficial decrease in sitting time (-80.2 min/8-h workday (95 % CI?=?-129.0, -31.4); p?=?0.002), increase in standing time (72.9 min/8-h workday (21.2, 124.6); p?=?0.007) and decrease in total cholesterol (-0.40 mmol/L (-0.79, -0.003); p?=?0.049). No harmful changes in musculoskeletal discomfort/pain were observed relative to controls, and beneficial changes in flow-mediated dilation and diastolic blood pressure were observed. Most participants self-reported that the workstation was easy to use and their work-related productivity did not decrease when using the device. Factors that negatively influenced workstation use were workstation design, the social environment, work tasks and habits.Short-term use of a feasible sit-stand workstation reduced daily sitting time and led to beneficial improvements in cardiometabolic risk parameters in asymptomatic office workers. These findings imply that if the observed use of the sit-stand workstations continued over a longer duration, sit-stand workstations may have important ramifications for the prevention and reduction of cardiometabolic risk in a large proportion of the working population.ClinicalTrials.gov NCT02496507 .
Project description:<h4>Background</h4>Office workers typically sit for most of the workday, which has been linked to physical and mental ill-health and premature death. This mixed-methods study sought to identify barriers and facilitators to reducing sitting and increasing standing among office workers who received an intervention prototype (the 'ReSiT [Reducing Sitting Time] Study'). The intervention comprised a sit-stand workstation and tailored advice to enhance motivation, capability and opportunity to displace sitting with standing.<h4>Methods</h4>Twenty-nine UK university office workers (aged ?18y, working ?3?days per week, most time spent at a seated desk) participated in a 13-week uncontrolled study. They were initially monitored for one-week. In a subsequent face-to-face consultation, participants received sitting time feedback from a prior one-week monitoring period, and selected from a set of tailored sitting-reduction techniques. Quantitative data comprising sitting, standing and stepping time, which were objectively monitored for 7 consecutive days across three post-intervention timepoints, were descriptively analysed. Qualitative data, from semi-structured interviews conducted at 1, 6 and 12-weeks post-intervention, were thematically analysed.<h4>Results</h4>Compared to baseline, mean sitting time decreased at weeks 1, 6 and 12 by 49.7mins, 118.2mins, and 109.7mins respectively. Despite prior concerns about colleagues' reactions to standing, many reported encouragement from others, and standing could be equally conducive to social interaction or creating private, personal space. Some perceived less cognitively-demanding tasks to be more conducive to standing, though some found standing offered a valued break from challenging tasks. Participants prioritised workload over sitting reduction and were more likely to stand after rather than during work task completion. Temporary context changes, such as holidays, threatened to derail newfound routines.<h4>Conclusions</h4>Our findings emphasise the importance of understanding workers' mental representations of their work, and the social functions of sitting and standing in the workplace. Workplace intervention developers should incorporate a pre-intervention sitting time monitoring period, encourage workers to identify personally meaningful tasks and cues for standing, and build organisational support for sitting-reduction. We will use these insights to refine our intervention for self-administered delivery.<h4>Trial registration</h4>ISRCTN29395780 (registered 21 November 2016).
Project description:<h4>Purpose</h4>This study aimed to evaluate the effects of sit-to-stand and treadmill desks on sedentary behavior during a 12-month, cluster-randomized multicomponent intervention with an intent-to-treat design in overweight office workers.<h4>Methods</h4>Sixty-six office workers were cluster-randomized into a control (n = 21; 8 clusters), sit-to-stand desk (n = 23; 9 clusters), or treadmill desk (n = 22; 7 clusters) group. Participants wore an activPAL™ accelerometer for 7 d at baseline, month 3, month 6, and month 12 and received periodic feedback on their physical behaviors. The primary outcome was total daily sedentary time. Exploratory outcomes included total daily and workplace sedentary, standing and stepping time, and the number of total daily and workplace sedentary, standing, and stepping bouts. Intervention effects were analyzed using random-intercept mixed linear models accounting for repeated measures and clustering effects.<h4>Results</h4>Total daily sedentary time did not significantly differ between or within groups after 12 months. Month 3 gains were observed in total daily and workplace standing time in both intervention groups (sit-to-stand desk: mean Δ ± SD, 1.03 ± 1.9 h·d-1 and 1.10 ± 1.87 h at work; treadmill desk: mean Δ ± SD, 1.23 ± 2.25 h·d-1 and 1.44 ± 2.54 h at work). At month 3, the treadmill desk users stepped more at the workplace than the control group (mean Δ ± SD, 0.69 ± 0.87 h). Month 6 gains in total daily stepping were observed within the sit-to-stand desk group (mean Δ ± SD, 0.82 ± 1.62 h·d-1), and month 3 gains in stepping at the workplace were observed for the treadmill desk group (mean Δ ± SD, 0.77 ± 0.83 h). These trends were sustained through month 12 in only the sit-to-stand desk group.<h4>Conclusions</h4>Active-workstation interventions may cause short-term improvements in daily standing and stepping. Treadmill desk users engaged in fewer sedentary bouts, but sit-to-stand desks resulted in more frequent transitions to upright physical behaviors.
Project description:BACKGROUND:Large amounts of sitting at work have been identified as an emerging occupational health risk, and findings from intervention trials have been reported. However, few such reports have examined participant-selected strategies and their relationships with behaviour change. METHODS:The Stand Up Victoria cluster-randomised controlled trial was a workplace-delivered intervention comprising organisational, environmental and individual level behaviour change strategies aimed at reducing sitting time in desk-based workers. Sit-stand workstations were provided, and participants (n?=?134; intervention group only) were guided by health coaches to identify strategies for the 'Stand Up', 'Sit Less', and 'Move More' intervention targets, including how long they would stand using the workstation. Three-month workplace sitting and activity changes (activPAL3-assessed total sitting, prolonged sitting (i.e., sitting ?30 min continuously) and purposeful walking) were evaluated in relation to the number (regression analysis) and types of strategies (decision-tree analysis). RESULTS:Over 80 different strategies were nominated by participants. Each additional strategy nominated for the 'Stand Up' intervention target (i.e. number of strategies) was associated with a reduction in prolonged sitting of 27.6 min/8-h workday (95% CI: -53.1, -?2.1, p?=?0.034). Types of strategies were categorised into 13 distinct categories. Strategies that were task-based and phone-based were common across all three targets. The decision tree models did not select any specific strategy category as predicting changes in prolonged sitting ('Stand Up'), however four strategy categories were identified as important for total sitting time ('Sit Less') and three strategy categories for purposeful walking ('Moving More'). The uppermost nodes (foremost predictors) were nominating >?3 h/day of workstation standing (reducing total workplace sitting) and choosing a 'Move More' task-based strategy (purposeful walking). CONCLUSIONS:Workers chose a wide range of strategies, with both strategy choice and strategy quantity appearing relevant to behavioural improvement. Findings support a tailored and pragmatic approach to encourage a change in sitting and activity in the workplace. Evaluating participant-selected strategies in the context of a successful intervention serves to highlight options that may prove feasible and effective in other desk-based workplace environments. TRIAL REGISTRATION:This trial was prospectively registered with the Australian New Zealand Clinical Trials register ( ACTRN12611000742976 ) on 15 July 2011.
Project description:Prolonged sitting is ubiquitous in modern society and linked to several diseases. Height-adjustable desks are being used to decrease worksite based sitting time (ST). Single-desk sit-to-stand workplaces exhibit small ST reduction potential and short-term loss in performance. The aim of this paper is to report the study design and methodology of an ACTIVE OFFICE trial.The study was a 1-year three-arm, randomized controlled trial in 18 healthy Austrian office workers. Allocation was done via a regional health insurance, with data collection during Jan 2014 - March 2015. Participants were allocated to either an intervention or control group. Intervention group subjects were provided with traditional or two-desk sit-to-stand workstations in either the first or the second half of the study, while control subjects did not experience any changes during the whole study duration. Sitting time and physical activity (IPAQ-long), cognitive performance (text editing task, Stroop-test, d2R test of attention), workload perception (NASA-TLX) and physiological parameters (salivary cortisol, heartrate variability and body weight) were measured pre- and post-intervention (23 weeks after baseline) for intervention and control periods. Postural changes and sitting/standing time (software logger) were recorded at the workplace for the whole intervention period.This study evaluates the effects of a novel two-desk sit-to-stand workplace on sitting time, physical parameters and work performance of healthy office based workers. If the intervention proves effective, it has a great potential to be implemented in regular workplaces to reduce diseases related to prolonged sitting.ClinicalTrials.gov Identifier: NCT02825303 , July 2016 (retrospectively registered).
Project description:BACKGROUND:Sit-stand desk interventions have the potential to reduce workplace sedentary behaviour and improve employee health. However, the extent of sit-stand desk use varies between employees and in different organisational contexts. Framed by organisational cultural theory and product design theory, this study examined employees' lived experience of taking part in a workplace sit-stand desk intervention, to understand the processes influencing feasibility and acceptability. METHODS:Participant observations and qualitative interviews were conducted with 15 employees from two office-based workplaces in the UK, as part of a process evaluation that ran alongside a pilot RCT of a workplace sit-stand desk intervention. Observational field notes and transcripts were analysed using thematic analysis. RESULTS:Three themes related to the experience of using a sit-stand desk at work were generated: employees' relationship with their sit-stand desk; aspirations and outcomes related to employee health and productivity; and cultural norms and interpersonal relationships. The perceived usability of the desk varied depending on how employees interacted with the desk within their personal and organisational context. Employees reported that the perceived influence of the desk on their productivity levels shaped use of the desk; those who perceived that standing increased energy and alertness tended to stand more often. Sit-stand desks were voiced as being more acceptable than intervention strategies that involve leaving the desk, as productivity was conflated with being at the desk. CONCLUSIONS:The findings indicate a range of organisational, social-cultural and individual-level factors that shape the feasibility and acceptability of sit-stand desk use, and suggest strategies for improving employees' experiences of using a sit-stand desk at work, which might positively influence sedentary behaviour reduction and health. TRIAL REGISTRATION:Clinicaltrials.gov identifier NCT02172599, 22nd June 2014 (prospectively registered).
Project description:School-aged children are spending increasingly long periods of time engaged in sedentary activities such as sitting. Recent school-based studies have examined the intervention effects of introducing standing desks into the classroom in the short and medium term. The aim of this repeated-measures crossover design study was to assess the sit-stand behaviour, waking sedentary time and physical activity, and musculoskeletal discomfort at the start and the end of a full school year following the provision of standing desks into a Grade 4 classroom. Accelerometry and musculoskeletal discomfort were measured in both standing and traditional desk conditions at the start and at the end of the school year. At both time points, when students used a standing desk, there was an increase in standing time (17-26 min/school day) and a reduction in sitting time (17-40 min/school day). There was no significant difference in sit-stand behaviour during school hours or sedentary time and physical activity during waking hours between the start and the end of the school year. Students were less likely to report discomfort in the neck and shoulders when using a standing desk and this finding was consistent over the full school year. The beneficial effects of using a standing desk were maintained over the full school year, after the novelty of using a standing desk had worn off.
Project description:Background:Desk-based workers engage in long periods of uninterrupted sitting time, which has been associated with morbidity and premature mortality. Previous workplace intervention trials have demonstrated the potential of providing sit-stand workstations, and of administering motivational behaviour change techniques, for reducing sitting time. Yet, few studies have combined these approaches or explored the acceptability of discrete sitting-reduction behaviour change strategies. This paper describes the rationale for a sitting-reduction intervention that combines sit-stand workstations with motivational techniques, and procedures for a pilot study to explore the acceptability of core intervention components among university office workers. Methods:The intervention is based on a theory and evidence-based analysis of why office workers sit, and how best to reduce sitting time. It seeks to enhance motivation and capability, as well as identify opportunities, required to reduce sitting time. Thirty office workers will participate in the pilot study. They will complete an initial awareness-raising monitoring and feedback task and subsequently receive a sit-stand workstation for a 12-week period. They will also select from a 'menu' of behaviour change techniques tailored to self-declared barriers to sitting reduction, effectively co-producing and personally tailoring their intervention. Interviews at 1, 6, and 12 weeks post-intervention will explore intervention acceptability. Discussion:To our knowledge, this will be the first study to explore direct feedback from office workers on the acceptability of discrete tailored sitting-reduction intervention components that they have received. Participants' choice of and reflections on intervention techniques will aid identification of strategies suitable for inclusion in the next iteration of the intervention, which will be delivered in a self-administered format to minimise resource burden. Trial registration:ISRCTN29395780 (registered 21 November 2016).
Project description:Uncertainties remain about the overall effect of sit-stand desks for reducing prolonged sitting among office-based workers. This study assessed the feasibility of a randomised controlled trial of the impact of workplace sit-stand desks on overall energy expenditure, sitting time and cardio-metabolic outcomes. It involved four phases: Phase I: online survey; Phase II: workspace auditing; Phase III: randomised intervention (provision of sit-stand desks at work for 3?months); Phase IV: qualitative component. Participants were off?ce-based employees of two companies in Cambridge, England. Among Phase I participants interested in the trial, 100 were randomised to Phase II. Of those with workspaces suitable for sit-stand desks, 20 were randomised to Phase III. Those allocated to the intervention completed Phase IV. Outcomes included: trial participation interest, desk-type (full desks/desk mounts) and assessment location (work/laboratory/home) preferences (Phase I); proportion of workspaces permitting sit-stand desk installation (Phase II); energy expenditure, sitting time and cardio-metabolic outcomes (Phase III); study participation experiences (Phase IV). Data were collected between May 2015 and December 2016. Recruitment and trial implementation were feasible: 92% of survey respondents expressed participation interest; 80% of workspaces could accommodate sit-stand desks; assessments were done in workplaces, preferred by 71%. Sit-stand desk provision reduced workplace sitting time by 94?min/day (95% CI 17.7-170.7). Their impact on energy expenditure and cardio-metabolic outcomes is unclear. The results confirm the feasibility of a trial assessing sit-stand desks' impact on energy expenditure, sitting time and cardio-metabolic outcomes, which should reduce uncertainty concerning the intervention's potential to reduce the health risks of prolonged sitting. <b>Trial registration</b> ISRCTN44827407.
Project description:Office workers spend most of their working day sitting, and prolonged sitting has been associated with increased risk of poor health. Standing in meetings has been proposed as a strategy by which to reduce workplace sitting but little is known about the standing experience. This study documented workers' experiences of standing in normally seated meetings. Twenty-five participants (18+ years), recruited from three UK universities, volunteered to stand in 3 separate, seated meetings that they were already scheduled to attend. They were instructed to stand when and for however long they deemed appropriate, and gave semi-structured interviews after each meeting. Verbatim transcripts were analysed using Framework Analysis. Four themes, central to the experience of standing in meetings, were extracted: physical challenges to standing; implications of standing for meeting engagement; standing as norm violation; and standing as appropriation of power. Participants typically experienced some physical discomfort from prolonged standing, apparently due to choosing to stand for as long as possible, and noted practical difficulties of fully engaging in meetings while standing. Many participants experienced marked psychological discomfort due to concern at being seen to be violating a strong perceived sitting norm. While standing when leading the meeting was felt to confer a sense of power and control, when not leading the meeting participants felt uncomfortable at being misperceived to be challenging the authority of other attendees. These findings reveal important barriers to standing in normally-seated meetings, and suggest strategies for acclimatising to standing during meetings. Physical discomfort might be offset by building standing time slowly and incorporating more sit-stand transitions. Psychological discomfort may be lessened by notifying other attendees about intentions to stand. Organisational buy-in to promotional strategies for standing may be required to dispel perceptions of sitting norms, and to progress a wider workplace health and wellbeing agenda.