Reducing office workers' sedentary time

Abstract

Listen

Translate article

Background: Due to technological advances, adults living in industrialised countries now spend the majority of their waking hours sedentary (i.e. sitting down and expending little energy). Given that high volumes of sedentary time are linked to increased risk of poor health and premature mortality, interventions to reduce sedentary time have been identified as a key public health priority. To increase the effectiveness of such interventions, settings-based approaches have been suggested. Desk-based office workers comprise a large occupational sector and spend an average of 75% of the workday sitting. The office-based workplace has thus been identified as a particularly opportune target setting to address this behaviour. A recent evidence review of workplace strategies to reduce office workers’ sedentary time concluded that provision of activity-permissive workstations may be needed to achieve meaningful reductions in sedentary time. Activity-permissive workstations allow office workers to stand, walk, or pedal while undertaking their usual computer and desk-based job tasks. Studies have reported sedentary time reductions of over two hours per working day following installation of such workstations. However to date, this evidence, including what is known about the feasibility and impact on health- and work-related outcomes, has not been systematically summarised. Furthermore, ecologic models and workplace health promotion frameworks suggest that the provision of such workstations should be integrated with additional strategies targeting personal health resources and the psychosocial work environment. However, published reports of such interventions are few. Hence, there is limited evidence supporting their feasibility and efficacy. Aim: The overall aim of this thesis research is to contribute to the evidence informing interventions using activity-permissive workstations to reduce workplace sedentary time in office workers. This was accomplished through three studies. Methods and Results: 1)Study 1 comprised a systematic literature review and meta-analysis examining the impact of activity-permissive workstations on office workers’ sedentary time, health- and work-related outcomes. This review also summarised the evidence on the feasibility of such workstations in office workplaces. Results showed that the use of activity-permissive workstations was well accepted among office workers and led to an average reduction in sedentary time of 77 minutes across included studies. Health- and work-related outcomes remained predominantly unchanged following intervention. However, there was considerable heterogeneity among the studies in the way that the workstations were implemented. 2)Study 2 consisted of the systematic and iterative development of a multi-component intervention to reduce office workers’ sedentary time. This intervention included activity-permissive workstations as well as strategies targeting personal health resources and the psychosocial work environment consistent with workplace health promotion frameworks. 3)The effectiveness of the above-mentioned multi-component intervention was evaluated in a 3-arm trial within Study 3 of this PhD research. Here, the effectiveness of the multi-component intervention developed in Study 2 was compared to an intervention comprising activity-permissive workstations only and a (usual workplace-practice) control group. Following intervention, participants receiving the multi-component intervention reduced their workplace sedentary time by an average of 89 minutes per 8-hour workday (95% CI= -130, -47 minutes; p<0.001) relative to the control group, while the group receiving the workstations only reduced their sedentary time by 33 minutes per 8-hour workday (95% CI= -74, 7 minutes, p=0.285). Following the end of the additional intervention components (i.e. strategies targeting personal health resources and the psychosocial work environment) at 3 months, sedentary time increased by 23 minutes per 8-hour workday in the multi-component intervention group, while reductions in the workstations-only group were largely sustained. However, there was still a substantial difference regarding sedentary time reductions between these two groups 12 months post baseline. Conclusions: Results from these PhD studies suggest that activity-permissive workstations, if the chosen model is suitable to individual needs and job tasks, can be an effective means to reduce sedentary time in office-workplaces. However, a change in workplace culture around adopting more active routines is needed to achieve more substantial reduction in sedentary time. This can be facilitated through strategies targeting the psychosocial work environment and/or personal health resources as suggested by workplace health promotion frameworks. Ongoing provision of such strategies may be needed to sustain sedentary time reductions in the long-term. More research is needed to examine the sustainability of sedentary time reductions as well as the potential impact of longer-term reductions on health-related outcomes and work performance indicators. Furthermore, future studies should examine the effectiveness of the multiple intervention components in isolation. In order to facilitate the adoption of less sedentary routines in workplaces, integrating a focus on reducing sedentary time into occupational health and safety policies is likely to be needed.