Should We Scale-Up? A Mixed Methods Process Evaluation of an Intervention Targeting Sedentary Office Workers Using the RE-AIM QuEST Framework

Abstract

Background: Interventions targeting a reduction in sedentary behaviour in office workers need to be scaled-up to have impact. In this study, the RE-AIM QuEST framework was used to evaluate the potential for further implementation and scale-up of a consultation based workplace intervention which targeted both the reduction, and breaking up of sitting time. Methods: To evaluate the Springfield College sedentary behaviour intervention across multiple RE-AIM QuEST indicators; intervention participant, non-participant (employees who did not participate) and key informant (consultation delivery team; members of the research team and stakeholders in workplace health promotion) data were collected using interviews, focus groups and questionnaires. Questionnaires were summarized using descriptive statistics and interviews and focus groups were transcribed verbatim, and thematically analysed. Results: Barriers to scale-up were: participant burden of activity monitoring; lack of management support; influence of policy; flexibility (scheduling/locations); time and cost. Facilitators to scale up were: visible leadership; social and cultural changes in the workplace; high acceptability; existing health and wellbeing programmes; culture and philosophy of the participating college. Conclusions: There is potential for scale-up, however adaptations will need to be made to address the barriers to scale-up. Future interventions in office workers should evaluate for scalability during the pilot phases of research.

A Mixed Methods Evaluation of a Digital Intervention to Improve Sedentary Behaviour Across Multiple Workplace Settings

“…Interestingly, the intervention did not require or suggest leadership roles, yet they evolved naturally within three of the companies. This result is similar to other research studies in which team champions and visible leadership were reported as important to the success of the intervention [16,49].…”

“…Additionally, Companies 1 and 4 also had management engagement compared to less management engagement in Companies 2 and 3. This aligns to other interventions in which the level of buy-in from management appeared to affect the participation rate within the intervention [16,39,44]. To improve future participation rates, it may be important in the future for digital interventions to build in strategies (e.g., targeted management incentives) to ensure management buy-in and participation.…”

“…Additionally, despite discussions of the high-level security features and compatibility of Welbot, larger companies that did not adopt the intervention reported concerns related to the IT security as a reason for not adopting the intervention. Evidence from other workplace health interventions indicates that to improve adoption, more assessments of the organisational culture may be needed to understand how to create "buy-in" at multiple levels of companies with complex management structures [16,[38][39][40][41]. When recruiting larger companies, digital interventions may need to allocate further resources towards developing additional recruitment and engagement tactics aimed at building a relationship to create buy-in at all levels.…”

“…In this study, it may have acted as a significant barrier to office workers in Company 1 feeling free to engage with nudges. Recent research has suggested that it will be important that broader contexts of the office are understood, and organisational level barriers are addressed to improve the potential for sustainable change [16,59] 4.4.2. Facilitators and Barriers to Effectiveness Perceived lack of time was also a barrier for changing behaviour, suggesting that office workers do feel it is challenging to interrupt work-related tasks when busy.…”

“…This should maximise the capacity to adequately test a technology's potential to influence behaviour in the workplace [11,12]. Additionally, experts have suggested that these evaluations should be performed in early phases of research [13][14][15], and evaluate multiple indicators of real-world potential, to enable early understanding of the adaptations which may be needed to have large scale, real-world impact [8,13,[15][16][17]. This approach, however, would require appropriate evaluation methods, and in two recent reviews of digital workplace sedentary behaviour interventions, both authors advocated for the use of evaluation frameworks that support mixed methods study designs to more robustly plan, conduct and report digital interventions in office workers [8,9].…”