Reducing sitting time in office workers: Short-term efficacy of a multicomponent intervention

https://doi.org/10.1016/j.ypmed.2013.04.004Get rights and content

Highlights

  • This 4-week intervention aimed to reduce office workers' sitting time.

  • Individual, organizational and environmental intervention elements were included.

  • Objectively-measured workplace sitting time was reduced by over 2 h per day.

Abstract

Objective

To investigate the short-term efficacy of a multicomponent intervention to reduce office workers' sitting time.

Methods

Allocation for this non-randomized controlled trial (n = 43 participants; 56% women; 26–62 years; Melbourne, Australia) was by office floor, with data collected during July–September 2011. The 4-week intervention emphasized three key messages: “Stand Up, Sit Less, Move More” and comprised organizational, environmental, and individual elements. Changes in minutes/day at the workplace spent sitting (primary outcome), in prolonged sitting (sitting time accumulated in bouts ≥ 30 min), standing, and moving were objectively measured (activPAL3).

Results

Relative to the controls, the intervention group significantly reduced workplace sitting time (mean change [95%CI]: − 125 [− 161, − 89] min/8-h workday), with changes primarily driven by a reduction in prolonged sitting time (− 73 [− 108, − 40] min/8-h workday). Workplace sitting was almost exclusively replaced by standing (+ 127 [+ 92, + 162] min/8-h workday) with non-significant changes to stepping time (− 2 [− 7, + 4] min/8-h workday) and number of steps (− 70 [− 350, 210]).

Conclusions

This multicomponent workplace intervention demonstrated that substantial reductions in sitting time are achievable in an office setting. Larger studies with longer timeframes are needed to assess sustainability of these changes, as well as their potential longer-term impacts on health and work-related outcomes.

Introduction

Excessive sitting time – a risk factor for cardiovascular disease, type 2 diabetes, and premature mortality (Thorp et al., 2011, Wilmot et al., 2012) – is prevalent within the office-based workplace. An estimated two-thirds of work hours is spent sitting, with much of this time accumulated in prolonged unbroken bouts of at least 20 to 30 min (Evans et al., 2012, Ryan et al., 2011, Thorp et al., 2012). However, as noted in two recent reviews (Chau et al., 2010, Healy et al., 2012), relatively few workplace intervention trials have specifically addressed this prevalent health risk behavior.

To date, the evidence relating to reducing and/or interrupting sitting time at work is predominantly from the ergonomic literature, with a focus on musculoskeletal health outcomes (Healy et al., 2012, Husemann et al., 2009, Roelofs and Straker, 2002). Key research gaps identified (Healy et al., 2012) include the need for controlled trials that specifically target, and objectively measure, workplace sitting time. Furthermore, such trials should include assessment of the cardio-metabolic biomarkers shown in epidemiological and experimental studies to be detrimentally related to prolonged, unbroken sitting (Dunstan et al., 2012, Healy et al., 2011) in order to evaluate the potential health benefits of reducing workplace sitting time (and increasing standing). Finally, and consistent with best practice workplace health promotion frameworks (Carnethon et al., 2009, Department of Health and Human Services, 2008, World Health Organization, 2010), interventions should target not only the individual, but also the organization and the work environment (Healy et al., 2012, Pronk, 2009). Although previous trials have incorporated one (e.g. Alkhajah et al., 2012, John et al., 2011, Kozey-Keadle et al., 2012), or some of these intervention elements (e.g. Ellegast et al., 2012, Pronk et al., 2012), none have integrated all components to specifically address and measure reductions in objectively-assessed workplace sitting.

The aim of this trial was to assess the short-term efficacy of an intervention integrating individual-, environmental-, and organizational-change elements to reduce workplace sitting. We examined whether participants receiving the multicomponent intervention, relative to control participants, would differ in overall objectively-measured workplace sitting time (primary outcome). We also assessed differences in sitting time accrued in prolonged bouts, in standing time, and in moving time, as well as health-related (cardio-metabolic biomarkers, anthropometric measures, musculoskeletal symptoms) and work-related (work-performance, absenteeism, and presenteeism) outcomes.

Section snippets

Study design

Data for this two-arm, non-randomized controlled trial were collected between July and September 2011 and analyzed May–August 2012. The study was approved by the Alfred Health Human Ethics Committee (Melbourne, Australia). Assessments occurred at baseline, and following the final contact of the individual element of the intervention (approximately 4 weeks; follow-up). Research staff, participants, and assessors were not blinded to group allocation.

Organization

A single workplace (Comcare: the government

Results

Of the 44 employees enrolled in the study, 18 in each group provided primary outcome data at both assessments (Fig. 1). The main difference between groups was the greater proportion of women in the intervention group (Table 1).

Discussion

This study demonstrated, for the first time, that a multicomponent workplace intervention, utilizing organizational, environmental, and individual elements, was achievable within an office context. It achieved sizeable (> 2-h per 8-h workday) reductions in workplace sitting. The intervention group's sitting reduction (− 26.5% of workplace time) is consistent with previous workplace interventions that have specifically targeted sitting (range − 0.1% to − 40%; (Alkhajah et al., 2012, Ellegast et al.,

Funding sources

This study was funded by an NHMRC project grant [#1002706] and the Victorian Health Promotion Foundation. Ergotron provided the height-adjustable workstations (www.ergotron.com). Support for researchers came from: NHMRC Training Fellowship [# 569861] (Healy); NHMRC Senior Research Fellowship [#511001] (Eakin); NHMRC Program Grant [#569940], Senior Principal Research Fellowship [NHMRC #1003960] and the Victorian Government's Operational Infrastructure Support Program (Owen); Australian

Conflict of interest statement

No financial disclosures were reported by the authors of this paper, and the authors declare that there are no conflicts of interest.

Acknowledgments

We thank Parneet Sethi for her assistance with the data cleaning and analyses, as well as the Comcare employees and management.

References (44)

  • M. Carnethon et al.

    Worksite wellness programs for cardiovascular disease prevention: a policy statement from the American Heart Association

    Circulation

    (2009)
  • Comcare
  • Department of Health and Human Services

    Essential elements of effective workplace programs and policies for improving worker health and wellbeing

    (2008)
  • D.W. Dunstan et al.

    Breaking up prolonged sitting reduces postprandial glucose and insulin responses

    Diabetes Care

    (2012)
  • R. Ellegast et al.

    Method inventory for assessment of physical activity at VDU workplaces

    Work

    (2012)
  • N.D. Gilson et al.

    Does the use of standing ‘hot’ desks change sedentary work time in an open plan office?

    Prev. Med.

    (2011)
  • P.M. Grant et al.

    The validation of a novel activity monitor in the measurement of posture and motion during everyday activities

    Br. J. Sports Med.

    (2006)
  • M.T. Hamilton et al.

    Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease

    Diabetes

    (2007)
  • G.N. Healy et al.

    Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06

    Eur. Heart J.

    (2011)
  • G.N. Healy et al.

    Reducing prolonged sitting in the workplace (an evidence review: full report)

    (2012)
  • A. Hedge

    Effects of an Electric Height-Adjustable Worksurface on Self-Assessed Musculoskeletal Discomfort and Productivity in Computer Workers

    (2004)
  • B. Husemann et al.

    Comparisons of musculoskeletal complaints and data entry between a sitting and a sit–stand workstation paradigm

    Hum. Factors

    (2009)
  • Cited by (0)

    View full text