Providing NHS staff with height-adjustable workstations and behaviour change strategies to reduce workplace sitting time: protocol for the Stand More AT (SMArT) Work cluster randomised controlled trial.

S E O’Connell,L Gray,F Munir,C L Edwardson,D Dunstan,D Dunstan,D Dunstan,D Dunstan,D Dunstan,D Dunstan,T Yates,T Yates,S J H Biddle,D Esliger,D Esliger,M J Davies,B R Jackson,P Miller

doi:10.1186/s12889-015-2532-5

Abstract

BackgroundHigh levels of sedentary behaviour (i.e., sitting) are a risk factor for poor health. With high levels of sitting widespread in desk-based office workers, office workplaces are an appropriate setting for interventions aimed at reducing sedentary behaviour. This paper describes the development processes and proposed intervention procedures of Stand More AT (SMArT) Work, a multi-component randomised control (RCT) trial which aims to reduce occupational sitting time in desk-based office workers within the National Health Service (NHS).Methods/DesignSMArT Work consists of 2 phases: 1) intervention development: The development of the SMArT Work intervention takes a community-based participatory research approach using the Behaviour Change Wheel. Focus groups will collect detailed information to gain a better understanding of the most appropriate strategies, to sit alongside the provision of height-adjustable workstations, at the environmental, organisational and individual level that support less occupational sitting. 2) intervention delivery and evaluation: The 12 month cluster RCT aims to reduce workplace sitting in the University Hospitals of Leicester NHS Trust. Desk-based office workers (n = 238) will be randomised to control or intervention clusters, with the intervention group receiving height-adjustable workstations and supporting techniques based on the feedback received from the development phase. Data will be collected at four time points; baseline, 3, 6 and 12 months. The primary outcome is a reduction in sitting time, measured by the activPALTM micro at 12 months. Secondary outcomes include objectively measured physical activity and a variety of work-related health and psycho-social measures. A process evaluation will also take place.DiscussionThis study will be the first long-term, evidence-based, multi-component cluster RCT aimed at reducing occupational sitting within the NHS. This study will help form a better understanding and knowledge base of facilitators and barriers to creating a healthier work environment and contribute to health and wellbeing policy.Trial registrationISRCTN10967042. Registered 2 February 2015.

Highlights

IntroductionHigh levels of sedentary behaviour (i.e., sitting) are a risk factor for poor health
High levels of sedentary behaviour are a risk factor for poor health
This study will be the first long-term, evidence-based, multi-component cluster randomised control (RCT) aimed at reducing occupational sitting within the National Health Service (NHS)

Summary

Introduction

High levels of sedentary behaviour (i.e., sitting) are a risk factor for poor health. High levels of sedentary behaviour and prolonged bouts of sitting have been associated with an increased risk of overweight and obesity, cancer, type 2 diabetes, CVD, and premature mortality [3,4,5,6,7,8,9,10]. These consistent epidemiological findings are supported by research demonstrating positive effects on metabolic regulation of breaking prolonged sitting with bouts of standing and light movement [11, 12]. There is some evidence to suggest that breaking up prolonged bouts of sitting at work can improve employee’s productivity [15, 16]

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