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Desk-based workers' perspectives on using sit-stand workstations: A qualitative analysis of the Stand@Work study


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Background Prolonged sitting time has been identified as a health risk factor. Sit-stand workstations allow desk workers to alternate between sitting and standing throughout the working day, but not much is known about their acceptability and feasibility. Hence, the aim of this study was to qualitatively evaluate the acceptability, feasibility and perceptions of using sit-stand workstations in a group of desk-based office workers. Methods This article describes the qualitative evaluation of the randomized controlled cross-over Stand@Work pilot trial. Participants were adult employees recruited from a non-government health agency in Sydney, Australia. The intervention involved using an Ergotron Workfit S sit-stand workstation for four weeks. After the four week intervention, participants shared their perceptions and experiences of using the sit-stand workstation in focus group interviews with 4–5 participants. Topics covered in the focus groups included patterns of workstation use, barriers and facilitators to standing while working, effects on work performance, physical impacts, and feasibility in the office. Focus group field notes and transcripts were analysed in an iterative process during and after the data collection period to identify the main concepts and themes. Results During nine 45-min focus groups, a total of 42 participants were interviewed. Participants were largely intrinsically motivated to try the sit-stand workstation, mostly because of curiosity to try something new, interest in potential health benefits, and the relevance to the participant’s own and organisation’s work. Most participants used the sit-stand workstation and three common usage patterns were identified: task-based routine, time-based routine, and no particular routine. Common barriers to sit-stand workstation use were working in an open plan office, and issues with sit-stand workstation design. Common facilitators of sit-stand workstation use were a supportive work environment conducive to standing, perceived physical health benefits, and perceived work benefits. When prompted, most participants indicated they were interested in using a sit-stand workstation in the future. Conclusions The use of a sit-stand workstation in this group of desk-based office workers was generally perceived as acceptable and feasible. Future studies are needed to explore this in different desk-based work populations and settings.
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RES E AR C H A R T I C L E Open Access
Desk-based workers perspectives on using
sit-stand workstations: a qualitative analysis of
the Stand@Work study
Josephine Y Chau
, Michelle Daley
, Anu Srinivasan
, Adrian E Bauman
and Hidde P van der Ploeg
Background: Prolonged sitting time has been identified as a health risk factor. Sit-stand workstations allow desk
workers to alternate between sitting and standing throughout the working day, but not much is known about their
acceptability and feasibility. Hence, the aim of this study was to qualitatively evaluate the acceptability, feasibility
and perceptions of using sit-stand workstations in a group of desk-based office workers.
Methods: This article describes the qualitative evaluation of the randomized controlled cross-over Stand@Work pilot
trial. Participants were adult employees recruited from a non-government health agency in Sydney, Australia. The
intervention involved using an Ergotron Workfit S sit-stand workstation for four weeks. After the four week intervention,
participants shared their perceptions and experiences of using the sit-stand workstation in focus group interviews with
45 participants. Topics covered in the focus groups included patterns of workstation use, barriers and facilitators to
standing while working, effects on work performance, physical impacts, and feasibility in the office. Focus group field
notes and transcripts were analysed in an iterative process during and after the data collection period to identify the
main concepts and themes.
Results: During nine 45-min focus groups, a total of 42 participants were interviewed. Participants were largely intrinsically
motivated to try the sit-stand workstation, mostly because of curiosity to try something new, interest in potential health
benefits, and the relevance to the participantsownandorganisations work. Most participants used the sit-stand
workstation and three common usage patterns were identified: task-based routine, time-based routine, and no
particular routine. Common barriers to sit-stand workstation use were working in an open plan office, and issues with
sit-stand workstation design. Common facilitators of sit-stand workstation use were a supportive work environment
conducive to standing, perceived physical health benefits, and perceived work benefits. When prompted, most
participants indicated they were interested in using a sit-stand workstation in the future.
Conclusions: The use of a sit-stand workstation in this group of desk-based office workers was generally perceived as
acceptable and feasible. Future studies are needed to explore this in different desk-based work populations and settings.
Recently, sedentary behaviour has been emerging as a po-
tential health risk behaviour for premature mortality and
chronic health conditions such as cardiovascular disease
and diabetes mellitus, even when physical activity is taken
into account [1-5]. Sedentary behaviour is defined as activ-
ities that are done sitting or reclining and cost 1.5 times
the basal metabolic rate [6].
Energy expenditure at work has decreased, with workers
becoming more sedentary and less active over the past
50 years [7], and this trend has been projected to continue
to 2030 [8]. Among Australian workers, 42% and 47% of
men and women, respectively, characterise their jobs as
involving mostly sitting, and those working full-time in
such jobs sit for 6.3 h/day at work, on average [9]. In light
of the increasingly sedentary nature of modern work and
the high levels of occupational sitting time, it is important
* Correspondence:
Prevention Research Collaboration, Sydney School of Public Health,
University of Sydney, Medical Foundation Building (K25), Camperdown, NSW
2006, Australia
Department of Public and Occupational Health, EMGO Institute for Health
and Care Research, VU University Medical Center, van der Boechorststraat 7,
1081 BT Amsterdam, The Netherlands
Full list of author information is available at the end of the article
© 2014 Chau et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain
Dedication waiver ( applies to the data made available in this article,
unless otherwise stated.
Chau et al. BMC Public Health 2014, 14:752
to address sedentary behaviour as part of workplace health
The workplace has been highlighted as an important
setting for health promotion globally and nationally [10].
Workers in desk-based occupations are considered a key
target group for workplace sitting reduction strategies
[11,12]. The current literature indicates that physical
activity workplace interventions are not effective for
specifical ly addressing workers sedentary behaviour and
also highlights a paucity of workplace interventions that
focus specifically on reducing workers sitting time [13].
Modifying the workplace environment by installing sit-
stand workstations is one potential approach for reducing
prolonged sitting among desk-based workers during work-
ing hours. Especially, as standing time has recently been
positively associated with lower all-cause and cardiovas-
cular disease mortality [14]. Much research on sit-stand
workstations has been from the perspective of occupa-
tional ergonomics, related to musculoskeletal health and
physical discomfort [15], and not to the prevention of car-
diovascular and metabolic diseases. While research has
begun to quantitatively examine the effectiveness of sit-
stand workstations for reducing sitting and increasing
standing during working hours as a strategy for chronic
disease prevention [16-19], to our knowledge, only one
study thus far has collected detailed qualitative data to
examine user experiences and perspectives related to sit-
stand w orkstations [17]. Hence, the aim of this study
was to qualitatively e valuate the acceptability, fea sibility
and perceptions of using sit-stand work stations in a
group of desk-based office workers in Sydney, Australia.
The study was approved by the University of Sydney Hu-
man Research Ethics Committee (No. 08-2011/14067) and
all participants gave written informed consent. The study
is registered with the Australian New Zealand Clinical
Trials Registry (No. ACTRN 12612000072819). This quali-
tative evaluation is one component of the Stand@Work
study. Details about the Stand@Work study and its quanti-
tative evaluation are provided elsewhere [20]. We report
this qualitative study following the RA TS qualitative re-
search review guidelines (http://www.biomedcen
Participants and design
Participants were employees recruited from a non-
government health agency in Sydney, Australia. Inclusion
criteria included: aged at least 18 years old, working at
least three days per week, and with sufficient English
language proficiency to complete study tasks. The project
was advertised to staff as part of their workplace wellness
program and interested employees contacted the research
team, who provided additional study information and an
expression of interest form. Eligible staff members who
returned an expression of interest form were randomly
drawn from a ballot by a researcher in the presence of po-
tential participants and other researchers, and were in-
cluded in the study after providing written informed
consent. The first four participants drawn from the ballot
were allocated to the intervention group to use a sit-stand
workstation for four weeks, the next four participants
drawn from the ballot served as the control group. The
remaining participants were assigned to the waitlist con-
trol condition and were placed on the waiting list in seven
groups (45 people per group). After the initial four
weeks, the previous control group (study group 2) re-
ceived the intervention with the next group from the bal-
lot draw serving as their controls (study group 3). This
was repeated until all nine groups had received the in-
tervention. This study design was used to maximise the
evaluation sample size taking into account the five avail-
able sit-stand workstations. The intervention involved
using an Ergotron model Workfit S sit-stand workstation
(Figure 1) for four weeks. Users were provided with a
demonstration and instructions on the use of the device,
but there was no accompanying behavioural intervention.
The study design and recruitment is described in more de-
tail elsewhere [20]. The current manuscript adhered to the
RATS guidelines for reporting qualitative studies.
After trialling the sit-stand workstation for four weeks,
intervention participants attended a focus group facili-
tated by two membe rs of the research team who were
located at their workplace. One researcher facilitated
each focus group discussion (MD), while the other took
notes (AS). All focus groups were digitally recorded and
transcribed verbatim for the purpose of analysis. We
conducted focus groups rather than individua l interviews
due to time and resource constraints.
Each focus group discussion involved four to five par-
ticipants and ran for approximately 45 minutes. Using a
pre-prepared question guide (Table 1), participants were
invited to share their views on a range of issues relate d
to their experience with using the sit-stand workstation
(e.g., patterns of workstation use, barriers and facilitators
to standing while working, effects on work performance,
physical impacts, feasibility in the office and so on).
We analysed the focus group field notes and transcripts in
an iterative process during and after the data collection
period to identify the main concepts and themes. The focus
group scribe reviewed the field notes following each session
and generated a summary of main ideas based on the pre-
prepared question guide (a priori themes of interest) and
any emergent themes. These focus group summaries were
Chau et al. BMC Public Health 2014, 14:752 Page 2 of 10
then used as the basis of a framework for coding focus
group transcripts (checked and agreed by JYC and MD).
Transcripts were scanned for words or phrases that were
relevant to these topics and assigned codes using NVIVO
Version 10 (QSR International, 2013). All focus group re-
sponses are presented by focus group and participant num-
ber only, in order to ensure participant anonymity. Due to
the small number of participants, who all come from the
same workplace, age and gender constituted identifying
A total of nine focus groups (N = 42 participants) were
held from September 2011 to July 2012. Each group had
four to five participants, and one person was interviewed
individually as they were not able to attend a focus group.
Table 2 presents the personal characteristics of the study
Motivation for participating in the study and trying out a
sit-stand workstation
Participants were largely intrinsically motivated to join the
trial and these motivations could be grouped into three
main themes: 1) curiosity to try something new; 2) interest
in potential health benefits; and 3) relevance to the partici-
pants own and organisationswork.
Many expressed a curiosity about sit-stand workstations
and were interested in trying something new or different
at work. The idea of trying before buying appealed to
some participants, as they did not feel as though they
would have to commit to ongoing use if it was not their
to give it a test without actually having to com mit
to it really, long term the trial aspect was very
interesting. (group 4, participant 1)
Other participants were motivated by potential health
benefits that they had heard were associated with sitting
less and/or being able to stand while going about their
usual daily work in the office. Potential benefits men-
tioned included musculoskeletal complaint s, postural is-
sues, energy levels and cardio vascular health.
I wanted to know that I wasnt putting strain on my
cardiovascular system and arteries by sitting 8 hours
at a time and I just wanted to see if it had a difference
to my energy levels and my problems with my back
(group 7, participant 2)
Figure 1 Ergotron Workfit S sit-stand workstation.
Chau et al. BMC Public Health 2014, 14:752 Page 3 of 10
Some participants noted that this research was relevant
to their own and their organisations work focus. For these
participants, being able to contribute to research and
workplace policy, as well as experiencing first-hand what
it was like to use a sit-stand workstation were motivators
for engaging in the trial.
A small number of participants cited extrinsic factors
for trialling the sit-stand workstation, such as encourage-
ment from colleagues or managers.
General impressions of using sit-stand workstations
Participants impressions of the sit-stand workstation
revolved around three sub-themes 1) surprise an d de-
light; 2) impact on a bility to work; and 3) having choice.
Many participants expressed surprise and delight about
the sit-stand work stations , and discusse d how they used
they experienced unexpected benefits, such a s improved
posture and increased alertness. Negative impressions
that impacted on user comfort a nd work ability focused
on specific design issues of the sit-stand workstation. A
few participant s described how they enjoyed having the
Table 1 Focus group questions
1) What motivated you to participate in the trial of the sit-stand
2) What were your general impressions of using the sit-stand
a) How much did you use the sit-stand workstation?
b) Was there anything about using the sit-stand workstation that you
particularly liked?
c) Was there anything that you particularly disliked?
d) Any comments about the work surface attached to the
3) What types of tasks did you generally do standing up?
a) Where there times of the day when you stood more?
b) What made you change from standing to sitting?
c) Were there any reasons for those decisions?
4) What types of tasks did you generally do sitting down?
a) Where there times of the day when you sat down more?
b) What made you change from sitting to standing?
c) Were there any reasons for those decisions?
5) Did anything encourage you to stand up more to complete your
a) Were other people around you using a workstation?
b) Did certain types of footwear make it easier?
c) Were you able to stand for longer periods over time?
d) How long did you tend to stand up for each time?
6) Was there anything that stopped you from standing more than
you did?
a) Did being in an open plan office make any difference?
b) Were there any tasks that were not practical while standing?
c) Was it comfortable to stand and work?
d) Did you have any injuries or other personal factors?
7) What types of physical changes did you notice from using the
a) Any changes in posture?
b) Any musculo-skeletal changes?
c) Any changes in tiredness or energy levels?
d) Were these related to using the workstation?
8) What types of changes in your work performance did you notice
from using the sit-stand workstation?
a) Any effect on productivity?
b) Any effect on ability to concentrate?
Table 1 Focus group questions (Continued)
9) Would you continue to use the sit-stand workstation if you could?
Prompt: why/why not?
10) In closing, is there anything else youd like to say about your
experience of using the workstation or about your experience of
wearing the activity monitors?
Table 2 Participant characteristics of the Stand@Work
Characteristic Mean (SD) or n (%)
Sex (female) 36 (86%)
Age (years)
38 (11)
Body mass index (kg/m
Underweight (<18.5) 5 (13%)
Normal range (18.5 24.9) 20 (50%)
Overweight (25.0 29.9) 10 (25%)
Obese (30.0) 5 (13%)
Highest level of education
Completed all years of high school 3 (7%)
Trade, technical certificate or diploma 6 (14%)
University 33 (79%)
Working full time 34 (81%)
Office type
Own office 6 (14%)
Open-plan 36 (86%)
a. Data missing for n = 1.
b. Data missing for n = 2.
Chau et al. BMC Public Health 2014, 14:752 Page 4 of 10
choice and flexibility to work either sitting or standing
I just enjoyed the choice, you know, since its been gone,
you know, I sit there and go I should stand up and do
this task. Yeah purely for choice and, yep, being able
to make that active choice. (group 5, participant 1)
Use of sit-stand workstation sitting vs. standing
Participants patterns of use of the sit-stand workstation
while sitting or standing could be grouped into three
sub-categories: 1) task-based routine; 2) time-based rou-
tine; and 3) no particular routine.
Some participants took a task-based approach to switch-
ing between sitting and standing postures over the course
of their workday. For example, they would sit to tackle
large word processing tasks, especially those that required
using multiple resources and spreading out work mate-
rials, talk on the phone (for those in the open plan office)
and stand to check emails, read documents on the com-
puter screen, or carry out small word processing tasks. It
is worth noting there was some variation in the tasks dif-
ferent users preferred to undertake in each position.
If I need to get stuck into writing something or I need
to go through to one of my files, Ill sit back down
again, and then if Im replying to emails, or you know
just working on one document on the screen, then Ill
get back up again. (group 4, participant 1)
Others described using a time-based routine. One time-
based routine involved setting specific durations for sitting
and standing (e.g. every 30 or 60 minutes).
When I saw the clock tick over the hour, I was like,
get up. (group 5, participant 1)
Id tried to do half hour on and half hour off. (group
6, participant 1)
Probably for around about 30 40 minute bouts, I
suppose, during the day. Probably once every two
hours or so. (group 9, participant 1)
Another time-based routine involved sitting or stand-
ing to work based on the time of day. For example some
participants indicated they would stand to start the day,
after lunch or later in the afternoon, when they felt
lower on energy, alertness, and capacity to concentrate.
I got in and normally tried to stand straight away
because I felt good standing up and it was probably
best to stand first thing in the morning. (group 1,
participant 3)
It was better concentrating in the afternoon because you
tend to get a bit dozy after lunch, so I think standing
after lunch was much better. (group 3, participant 3)
Its a good change for me to be able to stand, and
definitely the afternoon is a point where I have a lag. Its
a dead hour after lunch. Its always hard getting over
that hump into the afternoon. (group 8, participant 4)
Other participants followed no specific routine and
simply alternated between sitting and standing postures
whenever they felt like it or if they felt tired from being
in one posture.
I didnt stand for long periods. I stood and sat - I was
like a Jack-in-the-box. I was up and down, up and
down, rather than standing for a long time and sitting
for a while. (group 2, participant 2)
I didnt really assign a pattern to it, I was just like,
oh, Ive been sitting for a bit, I ll stand up or Im
getting a bit tired . (group 1, participant 3)
A few participants described standing to work as simi-
lar to developing a new habit and some viewed being
able to stand progressively for longer periods as a per-
sonal challenge.
I used to look at the clock and go Ill just do
20 minutes more and, like , it was always like a little
self-competition going. (group 4, participant 6)
I think they say it takes 3 or 6 weeks to develop a new
habit and this is really kind of like having a new
habit. (group 6, participant 4)
Barriers to using sit-stand workstation in a standing position
When participants discussed the barriers they faced re-
garding using the sit-stand workstation in a standing
position, they were generally related to either 1) working
in the open plan office, or 2) sit-stand workstation de-
sign. Some described feeling self-conscious and con-
cerned about disturbing others in the open plan office as
inhibitors to standing. This included feeling they were
invading their neighbouring colleagues privacy, revealing
confidential communications, and/or disturbing others
when talking on the phone.
I did feel if I was doing something confidential that it
was more on show, so I was a little bit wary of that.
(group 3, participant 2)
When Im on the phone standing up I feel a little bit
conscious because I feel like Im shouting out across
Chau et al. BMC Public Health 2014, 14:752 Page 5 of 10
everyone and Im sort of distracting people next to me.
(group 7, participant 3)
Some participants reported being more distracted when
standing up, particularly in the open plan office; yet other
participants reported being more focused when standing
up to work. There was a view that distractions did or
would lessen over time, as more workstation users were in
the office and employees adapted to standing as a norm.
I think if everybody was standing/sitting all the time,
nobody would actually care, people would get used to it
because if I had people moving all the time and I was
standing up, I would probably learn to concentrate more
with those distractions. (group 1, participant 4)
Many participants repor ted issues with the design of
the sit-stand workstation that made it difficult or less
comfortable for them to work standing up. These in-
cluded an unstable work platform when typing, an un-
comfortable monitor distance, height restrictions in the
standing position for taller users, and the loss of desk
space for those users who liked to spread out materials
to work.
I think it kind of depends on your working style, I
think if you are somebody who just does nothing with
a pen and paper or rarely or very rarely does, its
perfect because you know youve got everything there
that you need, but I, Im a person who often needs to
stop typing and starting jotting things down or
mapping things out or, you know, with a good old
fashion pen and paper, and then youre like okay, oh
thats wobbling. (group 5, participant 2)
I found it cut down on my desk space which was a
little bit annoying sometimes. (group 5, participant 1)
Other users also mentioned physical discomfort as a
barrier to standing as the ergonomic setup for the sit-
stand workstation differed from their usu ally desk setup.
E.g., sore eyes because of the closer monitor distance
when upright, wrist discomfort for mouse work
Sometimes I would be typing as I was standing and
going oh wow Im getting major pain in my
forearms and so that was oh it would be nice if it
was already set at your height, perfectly so you didnt
have to (adjust it every time). (group 7, participant 2)
Facilitators to using the sit-stand workstation in a standing
Participants discussed a range of factors that encouraged
or enabled them to work in a standing position. These
can be grouped into three areas 1) a supportive work en-
vironment conducive to standing; 2) perceived physical
health benefits; and 3) perceived work benefits.
Many participants felt that a supportive work environ-
ment helped to normalise standing at work in the open
planned space. They said that seeing others standing in
the office prompted them to also stand up, and it also
created a more sociable work atmosphere and encour-
aged more personal interaction and communication.
It does make it a lot more sociable environment Ithink
it encourages the interaction with going to speak to people
as opposed to just always reverting to an email and
sitting in your own little silo. (group 4, participant 2)
You dont feel alone, you know, youre going to stick
out like a sore thumb when you are doing work but its
good when other people do . (group 8, participant 1)
Some participants described perceived physical improve-
ments, such as reduced back pain and fatigue and in-
creased energy levels, as facilitators to standing more.
Others reported improved productivity, alertness, and con-
centration. There were design aspects that made standing
up to work an easy thing to do as well.
I found my back hurt less as well, cause Ive got back
issues and I found it a lot better, and I was worried
about it, you know, maybe it will be weird, but my
back has hurt a lot less standing up than sitting.
(group 2, participant 2)
I felt better at the end of the day. I felt a bit more not
as tired at the end of the day. (group 5, participant 2)
I was less fidgety I found it really good, cause I could
jump up and down and I found I got a lot more done.
(group 2, participant 1)
Willingness to continue using sit-stand workstations
Participants gave mixed responses when asked whether
they would like to continue using the sit-stand work-
station after the trial. A majority of part icipants was in
favour of using a sit-stand workstation in the future, but
some participants indicated they would prefer a different
model workstation.
Some participants did not want to continue to use
the sit-stand workstation. It is worth noting however
that almost all negative responses related to design is-
sues spec ific to th e sit-stand workstation model that
was trialled.
I dont want to stand up, but not so much that I
would knock it back I would get used to it and I
Chau et al. BMC Public Health 2014, 14:752 Page 6 of 10
would build it in to my day but I wouldnt go looking
for it. (group 6, participant 5)
Honestly, no and thats not becau se I didnt like
standing up as much it was the desk I found it
quite a challenge with just the way I work. (group 1,
participant 1)
The majority of participants expressed a willingness
and desire to keep using a sit-stand workstation. How-
ever, few participants indicated that they would like to
use sit-stand workstations in the future without further
qualifying their response. Nearly all named improve-
ments they would want in the sit-stand workstation and
provided an unprompted list of attributes of a sit-stand
workstation that they would happily use in the longer
term. Suggestions for improvement included having
more desk space, less movement in the workstation
when in the standing position, and to better adjust the
unit for taller participants.
I would love to have it back, I just think its great to
have that option of sitting standing and not have to be
tied to sitting down all day. ( group 3, participant 2)
I would actually like one that can be adjusted to be,
you know, your height and also can be adjusted a s to
how far it is from your eyes. (group 1, participant 2)
Some participants also suggested alternatives to using
sit-stand workstations to reduce sitting time in the of-
fice, including computer prompts to stand up or having
access to a standing hot desk.
Changes in sitting and standing behaviours since the trial
At the end of the discussion, participa nts had the chance
to make general comments about their involvement in
the study. Many comment s related to increased aware-
ness about the time they spent sitting each day, and their
changes in sitting or standing patterns since the sit-
stand workstation trial ended and they no longer having
had access to the workstation. Examples included choos-
ing to stand more during meetings, or adapting the
home environment to sit less. Interestingly, for some, in-
volvement in the study had shifted their view about
standing and they were less likely to want or need to sit
on public transport during their daily commute.
I just learnt to tolerate to stand a little longer now. So
in a lot of, like, meetings I go to I get up out of my seat
and stand. ( group 3, participant 1)
When Im at home on my laptop, I take it down to the
kitchen bench because its high enough for me to stand
there and do what I need to do, so I really prefer
standing now. (group 3, participant 1)
Standing on trains 70% of my choice and 30% is
simply because there are no seats Ive sat all day at
work so I just would stand but yeah, now I think I like
standing more. (group 6, participant 3)
Some participants noted changes in their own perspec-
tive and consciousness about sitting and standing as well
as seeing changes in their workplace culture and norms.
Theres definitely more (standi ng). I think its the
awareness of all this happening and I think people
think I can stand for a meeting. Its okay to stand”… I
was actually in an externa l meeting yesterday with my
colleague and she got up and stood up and the
facilitator kind of looked at her as if to say why are
you standing up?”…I just thought, you know, its quite
common in our workplace to do that now, but clearly
this woman wasnt used to that sort of thing
happening. (group 3, participant 2)
This qualitative evaluation of the Stand@Work study pre-
sents important formative research that describes office
workers user experiences and perceptions about the ac-
ceptability, and feasibility of a sit-stand workstation modi-
fication to their usual office desk. As a relatively new area
of intervention evaluation, this study was also an oppor-
tunity to assess whether the workplace culture of sitting to
undertake desk-based work could be challenged through
an environmental modification alone.
The sit-stand workstations were implemented within
the study workplace through a collaborative approach.
Managers responsible for initiating the trial promoted the
study as an opportunity to evaluate how effective and ac-
ceptable sit-stand workstations were as a sitting reduction
strategy, before committing to a larger roll out, given the
lack of evidence to guide decision making. Employees felt
they were contributing to both research and organisational
health policy, as they were consulted about their views on
the workstations while they were given an opportunity to
participate in a new area of health promotion that aligned
with the organisations purpose. This is reflected in their
reasons for participating, which encompassed both indi-
vidual motives (e.g., trying something new, interest in po-
tential health benefits, flexibility to work standing up) and
organisational factors (e.g., relevance to their own and
their organisations work around workplace wellness and
cardiovascular health).
The collaborative engagement of employees in the
Stand@Work study is consistent with previous qualita-
tive findings from office workers, that implementing any
Chau et al. BMC Public Health 2014, 14:752 Page 7 of 10
workplace sitting reduction strategy is both the respon-
sibility of individual employees and organisational man-
agement [21], and evidence that greater investment in
educating and motivating workers to use sit-stand worksta-
tions results in greater uptake [22]. The collaborative ap-
proach taken in this study is likely to have contributed to
participants willingness to try using the sit-stand desk in a
standing position. This is consistent with one study where
the intervention group comprised sedentary behaviour re-
searchers who were most likely highly supportive of work-
ing in a standing posture, educated on the potential health
effects of prolonged sitting, and applying sit -less strategies
in the workplace already with management support [16].
In contrast, another study took a top-down approach
where management decided to install a combination of
electric powered and manually operated sit-stand desks for
all staff in an office refurbishment with little information
provided to employers on how to use the new desks,
standing up [17].
While the study workplace was a health-related non-
government organisation, not all participants described
positive user experiences, although most did. Positive feed-
back about using sit-stand workstations revolved around
surprise and delight with the ease of use of the device, hav-
ing a supportive work environment, and having choice and
flexibility in selecting whether and when to sit or stand.
Occupational health and safety practitioners have empha-
sised the importance for workers to have choice over
whether they sit or stand to work, and expressed concerns
regarding the potential for perceived coercion when imple-
menting any sitting reduction strategy as employees could
feel pressured to stand for extended periods, highlighting
a tension between optional standing versus compulsory
standing [11]. Stand@Work overcame this with clear in-
structions from the start that participants did not have to
stand to work, and that their participation was an eva-
luation to inform their workplace wellness program and
future procurement decisions. Another important issue is
that we do not yet have evidence based public health rec-
ommendations to guide sit-stand workstation users on
how often they should break up sitting time or how long
they should stand for in each bout. Current guidelines
broadly recommend that adults should reduce the time
they spend sedentary or sitting and break up prolonged
periods of sitting [23-25]. In our view some caution is
needed so that we dont send a message to stand all day at
work either, as this can increase the risk on musculoskel-
etal problems and varicose veins [26,27]. Participants in
this study were advised to alternate between sitting and
standing and build standing time gradually, but then deter-
mined their own preferred approach.
Further, participants did not hesitate to give negative
feedback about aspect s of the s tudy and sit-stand
workstations. To illustrate, when asked about their will-
ingness to continue using the sit-stand workstations, the
majority of participants responded to the effect of yes,
but…” and provided an unprompted wish list of attributes
that they would like to see as part of any new sit-stand
workstations that might be purchased in the future. Inter-
estingly, almost all negative feedback related to participant
perceptions of design limitations of the model of sit-stand
workstation trialled, such as the distance of the computer
screen to their eyes, loss of desk space, or platform in-
stability when typing. Thus, it would appear that it was
not the act of standing up to work that posed a barrier per
se, but rather workstation design, and it is possible that
sentiments about future use or considerations about main-
tenance and sustainability of standing to work may be dif-
ferent should another model of sit-stand workstation, or
height adjustable desk be used. In fact, most participants
talked about how much they liked having the option to
stand to complete desk-based work, even if they did not
like the particular device trialled.
We identified several clear patterns of using the work-
stations in the sitting and standing position in the
Stand@Work study. Participants cited task-based, time-
based or non-specific routines, with some mentioning
they felt they were developing a new habit . Future re-
search could examine whethe r one approach might be
more suitable for certain types of workers or job roles.
For instance, some participants reported viewing stand-
ing up to work as a personal challenge to develop a new
habit; and while this was expressed by only a few partici-
pants, it is potentially novel and could be explored in fu-
ture studies to see if it might be another approach to
reducing sitting time.
Conducting phone calls was cited a s a barrier to using
the workstation standing by a majority of participants in
the open plan section of the office, despite being pro-
vided with a headset device that made this ergonomically
possible. Participants indicated that standing up while
on the phone could disturb colleagues in the open plan
office and was also an issue whe n phone calls were con-
fidential. This could present a particular challenge for
implementing similar desk modifications in open plan
workplaces that have a primary function built around
phone calls, such as call centres. Future research on ac-
ceptability and feasibility in this setting is recommended.
There were some positive, yet unintended consequences
of the trial where participants discussed an increased con-
sciousness about the need to sit less generally and trans-
ferred this new awareness into non-work contexts, such as
standing up on public transport or when working at home.
However, we did not find a quantitative reduction in sit-
ting time in non-occupational domains [20], and this pos-
sible transference of reduced sitting into non-work time
has not been reported in previous studies. Additionally,
Chau et al. BMC Public Health 2014, 14:752 Page 8 of 10
we found no indication that standing up to work caused
harm to participants and this may be attributable to the
emphasis on gradually building up durations of standing
time for those who chose to work in a standing position,
the ability to easily switch between positions and the rela-
tively short intervention period.
From an employer perspective, one of the potential ad-
vantages of this type of environmental modification to
reduce sitting is that work time is not interrupted. Usual
tasks can still be undertaken in the same location, and
from our participants feedback, there may also be prod-
uctivity improvements due to increased alertness, con-
centration and reduced fatigue, especially later in the
day. This needs to be validated by more objective mea-
sures, but very few users reported productivity impair-
ments from workstation use. Interestingly, those who
were distracted by sta nding generally felt this lessened
over time, as more people were involved in the trial and
seeing someone standing up to work was less of a nov-
elty. Since the completion of the trial, the organisation
has invested in additional workstations of a newer model
that overcomes many of the design limitations reported
by users (i.e. taller height limits, wider and more stable
keyboard platforms , and sits more stable on an existing
desk in the sitting position). Nonetheless, it is too early
to make a strong business case for large scale investment
in sit-stand workstations, as the health and productivity
benefits are yet to be quantified and there is a need for
more evidence about longer term use and maintenance
of reductions in sitting time reported elsewh ere [16-20].
It would also be important to explore lower cost options
for reducing sitting because not all workplaces may be
able to install or afford sit-stand workstations. Participants
reported sitting less in other domains of their day or find-
ing alternatives to break up their sitting time, suggesting
that other strategies may be viable as well, whether as
complementary or alternative components to using sit-
stand workstation and height adjustable desks. Partici-
pants also noted the emergence of a sitting less culture
within the workplace and there are a number of ways this
could be encouraged. A menu of sitting reduction options
could be designed and provided to workplaces to allow
more choice for employers and employees.
Strengths and limitations
A strength of the study was the collaborative approach to
workplace health promotion practice, which facilitates and
informs organisational planning in terms of procurement
and workplace health promotion. Furthermore, for a quali-
tative evaluation, the study had a relatively large sample
size. A limitation of the study was the use of a convenience
sample of participants working in a health-related field
who were mostly female, had tertiary education levels, and
were of healthy BMI. The generalisability of the results to
other office/desk-based workers especially in non-health
related workplaces remains unclear. Another limitation of
the study was the short term follow-up. Longer term fol-
low up was not possible as participants could only trial the
sit-stand workstations for four weeks and we did not have
the opportunity to re-assess their behaviours for example
at 12 months.
The use of a sit-stand workstation in this group of desk-
based office workers was generally perceived as acceptable
and feasible. Most participants were interested in using a
sit-stand workstation in the future. Future studies will need
to determine the feasibility sit-stand workstations in other
populations and settings as well as the feasibility of longer
term workstation usage.
Competing interests
The authors declare that they have no competing interests.
Authors contributions
JYC conceived the study, participated in its design and coordination,
analysed the data, and drafted the manuscript. MD conceived the study,
participated in its design and coordination, carried out the group interviews,
and assisted in analysing the data. AS carried out the group interviews, and
assisted in analysing the data. SD conceived the study, and participated in its
design and coordination. AEB conceived the study, and participated in its
design and coordination. HPvdP conceived the study, participated in its
design and coordination, and assisted in drafting the manuscript. All authors
read, revised, and approved the final manuscript.
This research was supported by funding from an Australian National Health
and Medical Research Council Program Grant (#569940). The authors thank
Mrs Janelle McNicholas and Mrs Melissa Gwizd for their contribution to data
collection and study management; Ms Catherine Kiernan for transcribing
focus groups; and the study participants and managers for their support of
this research.
Author details
Prevention Research Collaboration, Sydney School of Public Health,
University of Sydney, Medical Foundation Building (K25), Camperdown, NSW
2006, Australia.
Heart Foundation New South Wales, 3/80 William Street,
2011 Sydney, NSW, Australia.
Department of Public and Occupational
Health, EMGO Institute for Health and Care Research, VU University Medical
Center, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
Received: 5 January 2014 Accepted: 21 July 2014
Published: 25 July 2014
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Cite this article as: Chau et al.: Desk-based workers perspectives on
using sit-stand workstations: a qualitative analysis of the Stand@Work
study. BMC Public Health 2014 14:752.
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Chau et al. BMC Public Health 2014, 14:752 Page 10 of 10
... In Australia, reports from Occupational Health and Safety (OHS) regulators (Straker et al., 2016;Workplace Health and Safety Queensland, 2017), and anecdotal observation, suggests that there has been a rapid uptake in SSWs across desk-based organisations. However, to date, evidence around the use of SSWs has been related to the users' experience (Chau et al., 2014;Grunseit et al., 2013). To our knowledge, there is no information concerning the use and implementation process of SSWs in workplaces; the internal mechanisms to evaluate the benefits to employees and organisations after implementation; and, monitoring (if any) of their usage by the staff. ...
... The perceived benefits of SSWs aligned with previous studies from the individual user's perspective across countries with a similar economic profile; Australia (Chau et al., 2014;Grunseit et al., 2013;Henderson et al., 2018), USA (Dutta et al., 2015), and UK (Hall et al., 2019), namely that they increased staff satisfaction and productivity, and the increased movement and postural changes achieved with SSW resulted in reduced body discomfort. Although encouraging, a recent scoping review of 53 studies by Chambers et al. (2019) found that most experimental studies were relatively small in size (<30 participants) and brief in duration (<3 months). ...
... This barrier was reported mostly by organisations which implemented manual SSWs and/or desktop convertor options (Varidesks). These types of SSWs have previously been reported as less comfortable and less useable due to an unstable working platform, height restrictions and loss of desk space (Chau et al., 2014;Henderson et al., 2018). Despite this, the current study reported desk-top SSWs were commonly used. ...
The aim of this cross-sectional mixed-method study was to understand the current use, and practices to support the implementation, of sit-stand workstations (SSWs) from the perspective of furniture purchasing decision makers in Australian organisations. An online survey, and in-depth interviews with a purposive sub-sample were conducted. A total of 216 eligible participants from 150 organisations across 18 sectors completed the survey with 17 interviews conducted. 40% of organisations provided SSWs on request while 41% reported not using them appropriately. Over half provided no training on the appropriate use of SSWs (n = 109, 51%) nor used any strategies to enhance their use (n = 163, 84%). From the interviews, SSWs were perceived effective in reducing discomforts and increasing employees’ satisfaction and productivity. Lack of resources and guidelines to support SSW usage, and lack of wellbeing knowledge, were identified as barriers. Education and ongoing monitoring are important to enhance the appropriate use and uptake of SSWs.
... Qualitative studies on single-component sit-stand desk interventions show positive overall acceptability and feasibility [15][16][17][18]. This is also the case for dual-component interventions that pair sit-stand desks with an initial educational/training session [19][20][21] or ongoing motivational support [22]. ...
... The interview schedule was modelled on Hadgraft et al. 's [23] study on employee perceptions of a multi-component intervention with sitstand desks. Additional questions were adapted from prior qualitative studies on sit-stand desk use [16,17] and walking programme engagement [42]. The questions were pilot tested on an individual not involved in the intervention who partly worked at a standing only desk. ...
... Furthermore, participants in the study described falling back on old habits of sitting when work demands increased, and that this fluctuated over time. Workload is commonly cited in the literature as a barrier to sitting reduction during interventions [17,20,23,57]. Sitting is generally perceived as a necessary means for completing one's work, which may inadvertently reinforce it [56]. ...
Full-text available
Objective Sedentary workplace interventions have had success in reducing excessive sitting time in office workers, but barriers to implementation and uptake remain. This study formally assessed a theory-derived, sit-stand desk intervention using the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side-effects, Equity) criteria. Methods Thirteen adults (eight female, mean age 38 ± 10 years) from the treatment arm of a sedentary behaviour intervention participated in semi-structured interviews. Thematic codes were inductively assigned to data items followed by deductive charting using the APEASE criteria. Results The intervention was highly acceptable, practicable, safe to deploy, and helped workers reduce workplace sitting time, though individual preferences and workload mediated engagement. Affordability of sit-stand desks and Equity of access were potential barriers to uptake. Conclusions Through the lens of the APEASE criteria, this theory-derived, multi-component sit-stand desk intervention showed acceptability, practicability and effectiveness in reducing and breaking up sedentary time at work with minimal side effects. Using this approach with further tailoring and personalisation may help workers achieve greater reductions in workplace sitting, though affordability and equity should be considered further.
... Other barriers to reducing sitting in the office included being too self-conscious to stand in the office, as peers may have thought they were not working (Chau et al., 2014;Mackenzie, Goyder, & Eves, 2015), a lack of social support from team leaders or bosses (Hadgraft et al., 2017) and being unable to change the office norm of sitting, which participants felt prevented them from getting up because of the desk-based nature of the job and the workload, which had to be their priority whilst at work (Mackenzie, Goyder, & Eves, 2015;Waters et al., 2016). These studies therefore demonstrate that reducing sitting in the office is difficult for people, and additionally it has numerous barriers attached to it. ...
... The findings of these studies have highlighted that people find it difficult to reduce sitting in the workplace because of work pressure and an inability to change office norms and environments (Chau et al., 2014;Hadgraft et al., 2017;Mackenzie, Goyder, & Eves, 2015;Waters et al., 2016). Clemes et al. (2014) also posit that those who sit at work tend not to compensate for this during their free time, therefore arguing that a separation in terms of sitting and activity levels between work and free time exists, which became apparent in the previous chapter of the current thesis. ...
Full-text available
This thesis explores how older adults with chronic obstructive pulmonary disease (COPD), and office workers, experienced sitting while wearing a self-tracking device that prompted them to break up and reduce their sitting time. My thesis draws on public health and social science research on self-tracking, as well as the temporality and rhythms literature, and I argue that sitting can be understood in relation to the wider social, personal, biographical and institutional contexts to which my participants related their experiences of the past, present and future, and their changing habitual routines. Findings were based on two studies, the motivations behind which were to encourage participants to reduce their sitting and to deduce whether wearing a self-tracking device would inspire them to do so. The first study was a qualitative nested study which was part of a multidisciplinary randomised control trial. This study investigated the feasibility of selftracking and an educational booklet created to reduce sitting in older adults with COPD. The qualitative nested study interviewed 25 patients with COPD, both before and after the study, and the first interviews explored the contexts of their lives and sitting, while the second explored how they managed with the device, educational advice and the study as a whole. The second study interviewed 24 office workers about their experiences with a self-tracking device designed to reduce their sitting. Each participant was interviewed both before and after the two-week study period – in interview 1, I explored their lives, their work and their experiences and associations with sitting, and in interview 2 I investigated their experiences with the device and the study as a whole. My four analytic chapters answer the following four questions: how do patients with chronic obstructive pulmonary disease (COPD), and office workers, use a device to self-track their sitting time? What kinds of meanings do patients with COPD and office workers attach to sitting? How do personal and social or institutional temporalities of the past and present, and the rhythms of everyday life, shape participants’ sitting and self-tracking? And what does the conceptual framework, focusing on meanings, temporalities and rhythms, add to our understanding of health, sitting and self-tracking? The findings of this thesis revealed that the meaning of sitting was different for my two participant groups, in that they were influenced heavily by their experiences with their past, present and future, as well as their daily routines and changes in pace. Therefore, in order to make sense of how these participants understood the meanings of sitting, I adopted a temporality and rhythms framework, which allowed me to make sense of how COPD participants either looked back on their previous lives and reminisced on happy memories, whereby they were mournful and sad about their current lives and changing behaviour, and sitting less was not important to them, or looked toward their futures in anticipation of a healthier life and the ability to do more. The concept of rhythms allowed me to make sense of how some of these participants felt that the self-tracking device and sitting interrupted or did not fit in with their lives and how they often felt that sitting had positive benefits, or where their existing rhythms had been interrupted by their illness and this prevented behavioural change and a reduction in sitting. The concept of rhythms also helped to make sense of those participants who adopted their existing habitual rhythms to encompass sitting less and selftracking, or those who engaged when their habitual routines coincided with sitting less and self-tracking. In contrast, office workers’ sitting and self-tracking were related to the workplace, in that they looked back on previous work times when they would make time for their health and take breaks, thus the concept of temporality helped to make sense of this biographical and institutionally dictated time. The concept of rhythms helped to decipher how these participants did not have an issue with health but associated any negative well-being consequences to their increasingly fast-paced and stressful work lives. In addition, their free time was not considered problematic, and so they did not feel the need to change their behaviour or reduce their sitting or self-tracking during this time, as they saw it as an opportunity to gain some form of freedom and do what they wanted to do. Therefore the concept of rhythms provided a way of understanding the different routines of work and home and how the pace of these rhythms differed in speed and intensity. The thesis provides a new perspective on exploring sitting and highlights the importance of exploring both it and self-tracking in relation to the experiences of biographical time (past, present and future) and changing routines. I offer insights into how, by adopting a rhythms and temporality framework, we can make sense of people’s experiences of reducing sitting and engaging with self-tracking in order to do so. The thesis brings together literature on public health, self-tracking and place and time, and it argues that by studying the meaning of sitting and adopting a temporality and rhythms framework, the complexity and experience of time and its relationship with chronic illness and work are illuminated, thereby highlighting how time, place and pace are fundamental in understanding sitting and self-tracking.
... Plans for the implementation of the "Sit Less at Work" interventions (which included addressing the broader, organisational cultural barriers) were supported by engaging management and gaining their commitment for the intervention. Engaging management has been highlighted as important by other studies [21,39,40,52,53] and was also identified as a key step in the operational framework [26] as an enabler to sitting less at work [35]. Senior management approval for the project was sought and obtained from all participating organisations. ...
Full-text available
Prolonged periods of sitting are associated with negative health outcomes, so the increase in sedentary jobs is a public health concern. Evaluation of interventions to reduce workplace sitting have suggested that participatory approaches may be more effective. This paper describes the use of co-production in four diverse organisations. Workshops with staff in each organisation were conducted to develop an organisation-specific strategy. The first workshop involved creative activities to encourage participants to develop innovative suggestions. The second workshop then developed a feasible and acceptable action plan. An ecological approach was used to consider behaviour change determinants at a range of different levels including intrapersonal, interpersonal, organisational, and environmental-level factors. 41 staff volunteered for workshops (seven in a small business, 16 in a charity, 15 in a local authority, and three in a large corporation). Of those, 27 were able to attend the first workshops and 16 were able to attend the second. Whilst there were some similarities across organisations, the smaller organisations developed a more tailored and innovative strategy than large organisations where there were more barriers to change and a more diverse workforce. Co-production resulted in bespoke interventions, tailored for different organisational contexts, maximising their potential feasibility and acceptability.
... This was compounded by the fact that only one implementer was identified in both the charity and local authority to successfully implement the interventions. A more collaborative approach driven by both managers and staff could have resulted in greater engagement and could have enhanced the organisations' readiness for change [42][43][44]. Finally, the range of job roles and teams within the larger organisations proved to be a barrier to implementation. ...
Full-text available
Long periods of workplace sitting are associated with poor health outcomes. Interventions to reduce workplace sitting time have had variable impacts, the reasons for which require further investigation. In this paper, we report on a process evaluation aiming to determine the intervention fidelity of three “sit less at work” interventions and to explore barriers and enablers to implementation, using a mixed methods “before and after” intervention study design. Convenience samples of staff were recruited from three diverse organisations to participate in pre- and post-intervention online questionnaires, objective measures of sitting time (using activPAL3™ devices) and post-intervention focus groups. Intervention implementers and key personnel were also recruited to participate in post-intervention focus groups and interviews. The process evaluation found that none of the interventions were implemented as intended, with no consistent reductions in sitting time. Contextual and organisational cultural barriers included workload pressures and the social norms of sitting, competing priorities, lack of management buy-in, and perceptions of where the responsibility for behaviour change should come from. To ensure effective implementation of future initiatives, deeper organisational-level change, requiring buy-in from all levels of management and staff, may be needed to shift organisational culture and associated social norms.
... However, about one-third of sit-stand desk owners use the sit-stand functionality less than once a month [15]. An online survey of 1098 owners found that the reason users did not use this functionality was that they simply "do not bother" to do so, despite awareness of the health implications with sitting too long [21] and a desire for a healthier lifestyle [3]. To increase adherence to consistent use of sit-stand desks, we propose the Haunted Desk that automatically controls the transitions between sitting and standing, alleviating users from the burden of decision making while promoting healthy movements across the workday. ...
Previous studies report decreased workplace sitting time when standing desk interventions are provided to office workers. It is unclear whether decreased sedentary behaviors are maintained long-term. This was a follow-up to a previous intervention study to investigate whether observed sitting time decreases of 30-50% were sustained 12-24 months later. A secondary aim was to compare overall physical activity between office workers with and without standing desks. Although sitting time increased over the follow-up period, this did not reach significance and reductions in workplace sitting remained significantly lower (23.5% decrease) from baseline values. There were no differences in the physical activity measures between workers with and without access to standing desks, although this was a small sample size and further research is needed. Individuals who are motivated to try standing desks at work can benefit through decreased sitting time long-term, however this may not extend to increased overall physical activity levels. PRACTITIONER SUMMARY: Providing standing desk options to office-based employees can have long-lasting impacts with reducing sitting time at work. Office workers who choose to stand at work do not appear to compensate with overall activity level reduction outside of work.
This study used linear regression analyses to investigate the influence of parent-reported home-specific social and individual factors on: (i) 235 children's home-based objectively measured overall sitting time, breaks in sitting, and PA, and; (ii) the home physical environment via an audit. Parental importance assigned to active play for children was positively associated with PA equipment (accessibility and availability), as well as light physical activity (LPA) and sitting breaks on both weekdays and weekend days. Parental preference for being active at home and limits on screen-time were associated with less household media equipment and portable media equipment, respectively. Greater parental importance placed on playing electronic games/using computers for fun was associated with less LPA and more sitting on weekdays. Further, children who preferred being sedentary sat more and engaged in less moderate-vigorous physical activity (MVPA) on weekdays. Parental and child preferences and priorities, as well as parental rules for activity at home, were associated with children's home-based sitting and PA, especially on weekdays. Such factors were also associated with the physical environment in the expected directions. The findings suggest interventions need to target social and individual factors, alongside adapting the physical environment to create homes more promotive of physical activity.
Sit-stand workstations are growing in popularity, however limited guidelines exist regarding optimal schedules of sitting and standing. This was the first known study to observe sit-stand workstation schedules when postural change is based on maintaining musculoskeletal discomfort within 'acceptable' levels. Fourteen healthy adults new to sit-stand workstations completed computer-based work at a sit-stand desk for half a workday. Participants changed between standing and sitting postures each time discomfort reached the maximum acceptable threshold. On average, the amount of standing and sitting was greatest in the first standing (median 40 minutes, interquartile range 40 minutes) and sitting (median 30 minutes, interquartile range 115 minutes) bouts. Average durations spent standing and sitting were lower in all consecutive bouts. Stand-sit ratios indicated an equal amount of standing to sitting or somewhat less standing. The schedules had substantial inter-participant variability. Future studies should consider that optimal schedules may be variable in regards to time and individual-specific.Practitioner summary: Refined guidelines are needed regarding effective use of sit-stand workstations. This study proposed a novel method of investigating potentially optimal schedules, in which postural change was based on reaching a threshold of musculoskeletal discomfort. The findings suggest that an optimal schedule may vary with time and be individual-specific.
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Objective: To estimate the prevalence of musculoskeletal symptoms and analyze their associated factors in professionals from administrative sectors working predominantly in sitting position. Methods: This is a cross-sectional study with data obtained from 451 workers from a federal public institution in Southern Brazil. The dependent variable was the number of musculoskeletal symptoms in the prior 12 months, measured using the Nordic Musculoskeletal Questionnaire. In the analyses, 19 independent variables were investigated, divided into four categories: sociodemographic, behavioral, occupational and health characteristics. Univariate analysis and multiple Poisson regression with robust variance were performed. The independent variables were inserted into blocks with stepwise backward criterion, considering the value for Wald statistics equal to 0.20. The effect measures were expressed in a relative increase (RI) in the mean value, and the data were analyzed for a 5% significance level. Results: The estimated prevalence of musculoskeletal symptoms in the prior 12 months was 90% (confidence interval - 95%CI 87-93). In the final model of regression analysis, the variables female gender (RI = 14.75%), low (RI = 100.02%) and moderate (RI = 64.06%) work ability index, use of medications (RI = 48.06%) and waist circumference at risk (RI = 15.59%) had a significant association with the increase in the mean number of symptoms; schooling with technical education acted as a protective factor, reducing the mean by 36.46%. Conclusions: The high prevalence of musculoskeletal symptoms found and the associated factors indicate the need to propose specific actions and care for this population, such as immediate treatment of symptoms and changes in the organization and work environment, to achieve balance and harmony in the demands of prolonged sitting work and avoid its impact effect of this condition on public health.
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Background Prolonged sitting time is detrimental for health. Individuals with desk-based occupations tend to sit a great deal and sit-stand workstations have been identified as a potential strategy to reduce sitting time. Hence, the objective of the current study was to examine the effects of using sit-stand workstations on office workers¿ sitting time at work and over the whole day.Methods We conducted a randomized controlled trial pilot with crossover design and waiting list control in Sydney, Australia from September 2011 to July 2012 (n¿=¿42; 86% female; mean age 38¿±¿11 years). Participants used a sit-stand workstation for four weeks in the intervention condition. In the time-matched control condition, participants received nothing and crossed over to the intervention condition after four weeks. The primary outcomes, sitting, standing and walking time at work, were assessed before and after using the workstations with ActivPALs and self-report questionnaires. Secondary outcomes, domain-specific sitting over the whole day, were assessed by self-report. Linear mixed models estimated changes in outcomes adjusting for measurement time, study grouping and covariates.ResultsIntervention participants significantly reduced objectively assessed time spent sitting at work by 73 min/workday (95% CI: ¿106,-39) and increased standing time at work by 65 min/workday (95% CI: 47, 83); these changes were significant relative to controls (p¿=¿0.004 and p¿<¿0.001, respectively). Total sitting time significantly declined in intervention participants (¿80 min/workday; 95% CI: ¿155, ¿4).Conclusions This study shows that introducing sit-stand workstations in the office can reduce desk-based workers¿ sitting time at work in the short term. Larger scale studies on more representative samples are needed to determine the public health impact of sit-stand workstations.Trial registration ACTRN12612000072819.
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To quantify the association between daily total sitting and all-cause mortality risk and to examine dose-response relationships with and without adjustment for moderate-to-vigorous physical activity. Studies published from 1989 to January 2013 were identified via searches of multiple databases, reference lists of systematic reviews on sitting and health, and from authors' personal literature databases. We included prospective cohort studies that had total daily sitting time as a quantitative exposure variable, all-cause mortality as the outcome and reported estimates of relative risk, or odds ratios or hazard ratios with 95% confidence intervals. Two authors independently extracted the data and summary estimates of associations were computed using random effects models. Six studies were included, involving data from 595,086 adults and 29,162 deaths over 3,565,569 person-years of follow-up. Study participants were mainly female, middle-aged or older adults from high-income countries; mean study quality score was 12/15 points. Associations between daily total sitting time and all-cause mortality were not linear. With physical activity adjustment, the spline model of best fit had dose-response HRs of 1.00 (95% CI: 0.98-1.03), 1.02 (95% CI: 0.99-1.05) and 1.05 (95% CI: 1.02-1.08) for every 1-hour increase in sitting time in intervals between 0-3, >3-7 and >7 h/day total sitting, respectively. This model estimated a 34% higher mortality risk for adults sitting 10 h/day, after taking physical activity into account. The overall weighted population attributable fraction for all-cause mortality for total daily sitting time was 5.9%, after adjusting for physical activity. Higher amounts of daily total sitting time are associated with greater risk of all-cause mortality and moderate-to-vigorous physical activity appears to attenuate the hazardous association. These findings provide a starting point for identifying a threshold on which to base clinical and public health recommendations for overall sitting time, in addition to physical activity guidelines.
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Sedentary behavior, as distinct from a lack of moderate-to-vigorous physical activity, is an emerging health risk behavior for the development of chronic diseases. Examples of sedentary behavior include sitting, watching television, using a computer, and driving a car. In this article, we define sedentary behavior; outline key concepts related to the physiology of sedentary behavior, review the recent evidence on the effects of prolonged sedentary behavior (or sitting) on the risk of cardio-metabolic disease and all cause mortality, and discuss the implications for current clinical practice. We found that most large scale studies on sedentary behavior were published in the last 5 years. There is moderately consistent evidence for an association between total sitting time and all-cause mortality, even when adjusted for or stratified by leisure time physical activity. Overall, we identified a compelling case for sitting reduction to be included in clinical preventive advice as a key component of ‘active living,’ where adults and children are encouraged to ‘move more and sit less’ across different settings and locations throughout the day.
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Background Epidemiological research has established sitting as a new risk factor for the development of non-communicable chronic disease. Sit-stand desks have been proposed as one strategy to reduce occupational sedentary time. This formative research study evaluated the acceptability and usability of manually and electrically operated sit-stand desks in a medium-sized government organisation located in Sydney, Australia. Methods Sitting time pre- and three months post -installation of the sit-stand desks was measured using validated self-report measures. Additionally, three group interviews and one key-informant interview were conducted with staff regarding perceptions about ease of, and barriers to, use and satisfaction with the sit-stand desks. All interviews were recorded, transcribed and analysed for themes regarding usability and acceptability. Results Of 31 staff, 18 completed baseline questionnaires, and 13 completed follow-up questionnaires. The median proportion of sitting time for work was 85% (range 50%-95%) at baseline and 60% (range 10%-95%) at follow-up. Formal statistical testing of paired data (n=11) showed that the change from baseline to follow-up in time spent sitting (mean change=1.7 hours, p=.014) was statistically significant. From the qualitative data, reasons given for initiating use of the desks in the standing position were the potential health benefits, or a willingness to experiment or through external prompting. Factors influencing continued use included: concern for, and experience of, short and long term health impacts; perceived productivity whilst sitting and standing; practical accommodation of transitions between sitting and standing; electric or manual operation height adjustment. Several trajectories in patterns of initiation and continued use were identified that centered on the source and timing of commitment to using the desk in the standing position. Conclusions Sit-stand desks had high usability and acceptability and reduced sitting time at work. Use could be promoted by emphasizing the health benefits, providing guidance on appropriate set-up and normalizing standing for work-related tasks.
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Background To examine sedentary time, prolonged sedentary bouts and physical activity in Australian employees from different workplace settings, within work and non-work contexts. Methods A convenience sample of 193 employees working in offices (131), call centres (36) and customer service (26) was recruited. Actigraph GT1M accelerometers were used to derive percentages of time spent sedentary (<100 counts per minute; cpm), in prolonged sedentary bouts (≥20 minutes or ≥30 minutes), light-intensity activity (100–1951 cpm) and moderate-to-vigorous physical activity (MVPA; ≥1952 cpm). Using mixed models adjusted for confounders, these were compared for: work days versus non-work days; work hours versus non-work hours (work days only); and, across workplace settings. Results Working hours were mostly spent sedentary (77.0%, 95%CI: 76.3, 77.6), with approximately half of this time accumulated in prolonged bouts of 20 minutes or more. There were significant (p<0.05) differences in all outcomes between workdays and non-work days, and, on workdays, between work- versus non-work hours. Results consistently showed “work” was more sedentary and had less light-intensity activity, than “non-work”. The period immediately after work appeared important for MVPA. There were significant (p<0.05) differences in all sedentary and activity outcomes occurring during work hours across the workplace settings. Call-centre workers were generally the most sedentary and least physically active at work; customer service workers were typically the least sedentary and the most active at work. Conclusion The workplace is a key setting for prolonged sedentary time, especially for some occupational groups, and the potential health risk burden attached requires investigation. Future workplace regulations and health promotion initiatives for sedentary occupations to reduce prolonged sitting time should be considered.
Several studies have documented significant associations between sedentary behaviors such as sitting or television viewing and premature mortality. However, the associations between mortality and other low energy expenditure activities such as standing have not been explored. The purpose of this study was to examine the association between daily standing time and mortality among 16,586 Canadian adults 18-90 years of age. Information on self-reported time spent standing as well as several covariates including smoking, alcohol consumption, physical activity readiness, and moderate-to-vigorous physical activity was collected at baseline in the 1981 Canada Fitness Survey. Participants were followed for an average of 12.0 y for the ascertainment of mortality status. There were 1785 deaths (743 cardiovascular disease (CVD), 530 cancer, 512 other causes) in the cohort. After adjustment for age, sex and additional covariates, time spent standing was negatively related to mortality rates from all causes, CVD and other causes. Across successively higher categories of daily standing, the multivariable-adjusted hazard ratios were 1.00, 0.79, 0.79, 0.73, and 0.67 for all-cause mortality (p for trend <0.0001), 1.00, 0.82, 0.84, 0.68, and 0.75 for CVD mortality (p for trend 0.02), and 1.00, 0.76, 0.63, 0.67 and 0.65 for other mortality (p for trend <0.001). There was no association between standing and cancer mortality. There was a significant interaction between physical activity and standing (p<0.05), and the association between standing and mortality was significant only among the physically inactive (<7.5 MET·h·wk). The results suggest that standing may not be a hazardous form of behavior. Given that mortality rates declined at higher levels of standing, standing may be a healthier alternative to excessive periods of sitting.
Issue addressed: Workplace practitioners are well placed to provide practical insights on sedentary behaviour issues in the workplace. This study consulted occupational health and safety (OHS) practitioners, examining their perceptions of sedentary health risks and views on strategies and influences to reduce and break prolonged occupational sitting. Methods: Three focus groups were conducted with convenience samples of OHS practitioners (n=34; 6 men; 46.4 ± 9.6 years) attending an Australian national conference in November 2010. Open-ended questions concerning health risks, sitting reduction strategies and influences were posed by lead researchers and practitioners invited to express opinions, viewpoints and experiences. Audio-recordings and summary notes of focus group discussions were reviewed by researchers to identify key response themes. Results: OHS practitioners were well informed about the chronic disease and musculoskeletal risks associated with prolonged occupational sitting, but noted the importance of not replacing one workplace health issue (too much sitting) with another (too much standing). Ideas for strategies were diverse and explored the dichotomy between providing choices for employees to stand and move more (e.g. sit-stand desks), as opposed to obligating change through adapting job and office design (e.g. centralising printers and scanners). Productivity concerns were cited as a major influence for change. OHS practitioners also highlighted the value of using cross-disciplinary expertise to bridge the gap between research and practice. Conclusions: This study identified that OHS practitioners in Australia have a good understanding of the risks of prolonged occupational sitting and potential strategies to manage these risks.
Objective: To investigate whether or not use of sit-stand desks and awareness of the importance of postural variation and breaks are associated with the pattern of sedentary behavior in office workers. Method: The data came from a cross-sectional observation study of Swedish call centre workers. Inclinometers recorded 'seated' or 'standing/walking' episodes of 131 operators over a full work shift. Differences in sedentary behavior based on desk type and awareness of the importance of posture variation and breaks were assessed by non-parametric analyses. Results: 90 (68.7%) operators worked at a sit-stand desk. Working at a sit-stand desk, as opposed to a sit desk, was associated with less time seated (78.5 vs 83.8%, p = 0.010), and less time taken to accumulate 5 min of standing/walking (36.2 vs 46.3 min, p = 0.022), but no significant difference to sitting episode length or the number of switches between sitting and standing/walking per hour. Ergonomics awareness was not associated with any sedentary pattern variable among those using a sit-stand desk. Conclusion: Use of sit-stand desks was associated with better sedentary behavior in call centre workers, however ergonomics awareness did not enhance the effect.