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

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.

Validity and Reliability of the 8-Item Work Limitations Questionnaire

“…Furthermore, results support the continued use of an index score based on all eight items. Past studies have used the 8-item WLQ to assess associations between health-related variables and work limitations [11,12,29–32], determine cost estimates associated with poor health [10], and evaluate intervention effects [33]. Our findings provide additional support for results from these studies by providing evidence the 8-item WLQ is a valid and reliable measure.…”

Developing interventions to improve health: a systematic mapping review of international practice between 2015 and 2016

“…The rationale for this was to reduce research wastage associated with unnecessary intervention development. Many developers reviewed the existing literature in the introduction section of articles to establish the need for a new intervention [40] or to identify effective interventions, or components of existing interventions, that might be adapted or used for a different health issue [52], target population [29], or setting [53]. In a small number of articles, developers began by exploring the health issue in more detail to identify contributory or causal processes or pathways before searching the literature for existing interventions, or components of interventions, to address these.…”

“…the Behaviour Change Wheel [45] because they provided a systematic way of analysing behaviour and a comprehensive list of behaviour change techniques to consider [29,44]. The rationale for this was to bring transparency to the process of development and allow for accurate replication and evaluation of the intervention mechanisms [53,55].…”

Reducing sitting at work: process evaluation of the SMArT Work (Stand More AT Work) intervention

“…Moreover, with trends towards greater sitting in the workplace [5], office workers have been shown to engage in high levels of sitting [6]. The Stand More AT (SMArT) Work programme was an intervention tested in desk-based employees of an English East Midlands National Health Service (NHS) Trust [7][8][9]. A full study protocol is published [7], but, in brief, groups of desk-based staff within the same offices were randomised to either an intervention or control condition.…”

“…The Stand More AT (SMArT) Work programme was an intervention tested in desk-based employees of an English East Midlands National Health Service (NHS) Trust [7][8][9]. A full study protocol is published [7], but, in brief, groups of desk-based staff within the same offices were randomised to either an intervention or control condition. The intervention participants received a multi-component intervention designed to reduce workplace sitting.…”