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Validity of the Occupational Sitting and Physical Activity Questionnaire (OSPAQ)
Abstract
Sitting at work is an emerging occupational health risk. Few instruments designed for use in population-based research measure occupational sitting and standing as distinct behaviors. This study aimed to develop and validate brief measure of occupational sitting and physical activity.
A convenience sample (n = 99, 61% female) was recruited from two medium-sized workplaces and by word-of-mouth in Sydney, Australia. Participants completed the newly developed Occupational Sitting and Physical Activity Questionnaire (OSPAQ) and a modified version of the MONICA Optional Study on Physical Activity Questionnaire (modified MOSPA-Q) twice, 1 wk apart. Participants also wore an ActiGraph accelerometer for the 7 d in between the test and retest. Analyses determined test-retest reliability with intraclass correlation coefficients and assessed criterion validity against accelerometers using the Spearman ρ.
The test-retest intraclass correlation coefficients for occupational sitting, standing, and walking for OSPAQ ranged from 0.73 to 0.90, while that for the modified MOSPA-Q ranged from 0.54 to 0.89. Comparison of sitting measures with accelerometers showed higher Spearman correlations for the OSPAQ (r = 0.65) than for the modified MOSPA-Q (r = 0.52). Criterion validity correlations for occupational standing and walking measures were comparable for both instruments with accelerometers (standing: r = 0.49; walking: r = 0.27-0.29).
The OSPAQ has excellent test-retest reliability and moderate validity for estimating time spent sitting and standing at work and is comparable to existing occupational physical activity measures for assessing time spent walking at work. The OSPAQ brief instrument measures sitting and standing at work as distinct behaviors and would be especially suitable in national health surveys, prospective cohort studies, and other studies that are limited by space constraints for questionnaire items.
... Twenty-five questionnaires measured PA (17 in adults [30][31][32][33][34][35][36][37][38][39][40][41][42], four in older adults [43][44][45][46] and four in adults and older adults [47][48][49][50]), 12 measured SB (eight in adults [51][52][53][54][55][56][57][58], three in older adults [59,60] and one in adults and older adults [61]), one measured sleep (in adults and older adults [62]), 12 measured the combination of PA and SB (five in adults [63][64][65][66][67], three in older adults [68][69][70] and four in adults and older adults [71][72][73][74]), one measured the combination of SB and sleep (in adults [75]), and nine measured the combination of PA, SB and sleep (six in adults [67,[76][77][78][79][80], three in adults and older adults [81][82][83]). There were no proxy-reported questionnaires. ...
... The questionnaires combining PA and SB [63][64][65][66][67][68][69][70][71][72][73][74], mostly assessed the behaviours through multi-domain (83.3%) with the occupational domain being the most prevalent (11 out of 12 questionnaires). The occupational domain was also used in single domain questionnaires [71,72]. ...
... The questionnaires combining PA and SB [63][64][65][66][67][68][69][70][71][72][73][74], mostly assessed the behaviours through multi-domain (83.3%) with the occupational domain being the most prevalent (11 out of 12 questionnaires). The occupational domain was also used in single domain questionnaires [71,72]. The most prevalent response method was the continuous method (75%) focusing on different metrics (e.g., hours/week). ...
Background
Sleep, sedentary behaviour and physical activity are constituent parts of a 24h period and there are several questionnaires to measure these movement behaviours, the objective was to systematically review the literature on content and measurement properties of self- and proxy-reported questionnaires measuring movement behaviours in adults and older adults.
Methods
The databases PubMed, CINAHL, PsycINFO and SPORTDiscus were systematically searched until April 2021. Articles were included if: the questionnaires were design for adults and older adults; the sample size for validity studies had at least 50 participants; at least, both validity and test-retest reliability results of questionnaire that were developed specifically to measure the amount of sleep, sedentary behaviour or physical activity, or their combination were reported; and articles had to be written in English, Spanish, French, Portuguese, German, Italian or Chinese.
Findings and conclusions
Data extraction, results, studies’ quality, and risk of bias were evaluated using the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Fifty-five articles were included in this review, describing 60 questionnaires. None of the questionnaires showed adequate criterion validity and adequate reliability, simultaneously; 68.3% showed adequate content validity. The risk of bias for criterion validity and reliability were very low in 72.2% and 23.6% of the studies, respectively. Existing questionnaires have insufficient measurement properties and frequent methodologic limitations, and none was developed considering the 24h movement behaviour paradigm. The lack of valid and reliable questionnaires assessing 24h movement behaviours in an integrated way, precludes accurate monitoring and surveillance systems of 24h movement behaviours.
... The primary effectiveness outcome was self-reported percentage of the workday spent sitting, collected in the pre-and post-program staff surveys using the Occupational Sitting and Physical Activity Questionnaire (OSPAQ [25];). This instrument also captures the percentage of the workday spent standing, walking and in heavy labour and has shown acceptable measurement properties for desk-based workers [25,26]. ...
... The primary effectiveness outcome was self-reported percentage of the workday spent sitting, collected in the pre-and post-program staff surveys using the Occupational Sitting and Physical Activity Questionnaire (OSPAQ [25];). This instrument also captures the percentage of the workday spent standing, walking and in heavy labour and has shown acceptable measurement properties for desk-based workers [25,26]. Heavy labour is rare in office settings and was thus combined with walking to form 'moving'. ...
... The number of days of toolkit usage varied from 1 to 52 days with a median of 1 day, with this data largely indicative of how far into the program champions had progressed. Median (minimum, maximum) days of usage were: 1 (1,7) among champions who stopped before the 'Plan' phase; 1 (1,17) among those stopping during planning; 15 (3,25) among those who stopped in the 'Do' phase; and, 12 (1, 52) in those who had reached the 'Review' phase. ...
Background
The web-based BeUpstanding program supports desk workers to sit less and move more. Successfully translated from a research-delivered intervention, BeUpstanding has gone through iterative development and evaluation phases in preparation for wide-scale implementation. In the third planned “early-adopters” phase (01/09/2017–11/06/2019), the program was made freely-available online. An integrated delivery and evaluation platform was also developed to enable workplace champions to run and evaluate the intervention within their work team independent of researcher support. Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, this study reports on the extent to which the program and processes were “fit-for-purpose” for a national implementation trial across the indicators of uptake (reach and adoption), implementation and engagement, and effectiveness for behaviour change.
Methods
Data were collected via the online surveys embedded in the program and through program access analytics. Descriptive data (with linearized variance for the clustered staff-level data) and results from mixed models (repeated data and clustering for pre-post changes) are reported.
Results
Despite purposeful limited promotion, uptake was good, with 182 Australian users initially registering (208 total) and 135 (from 113 organisations) then completing the sign-up process. Recruitment reached users across Australia and in 16 of 19 Australian industries. Implementation was inconsistent and limited, with signed-up users completing 0 to 14 of the program’s 14 steps and only 7 (5.2%) completing all seven core steps. Many champions (n = 69, 51.1%) had low engagement (1 day toolkit usage) and few (n = 30, 22%) were highly engaged (> 1 day toolkit usage and surveyed staff). Although only 18 users (7 organisations) performed the pre- and post-program staff evaluations (337 and 167 staff, respectively), pre-post changes showed the program effectively reduced workplace sitting by − 9.0% (95% CI -12.0, − 5.9%).
Discussion
The program had uptake across industries and across Australia, but implementation and engagement varied widely. Few workplaces completed the evaluation components. In those that did, the program was effective for the primary outcome (workplace sitting). Conducting a planned early adopters phase and a comprehensive evaluation according to RE-AIM helped highlight necessary program improvements to make it more suitable for wide-scale implementation and evaluation.
Trial registration
Australian and New Zealand Clinic Trials Registry ACTRN12617000682347. Date registered: 12/05/2017.
... Program effectiveness was assessed by the difference between pre-and post-program staff survey responses regarding 13 indicators of the program's impact on workplace behaviour and workplace culture targeted directly by the program and 13 measures of productivity and health and wellbeing that were expected might improve as a result of the program. The primary outcome for effectiveness was workplace sitting, measured by the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) [34], which has demonstrated fair validity and acceptable agreement at the group level for sitting and standing but with less validity for measuring moving against high quality device-based measures [35]. The post-staff survey also captured staff perceptions of the program and its impact, and adverse events. ...
... Expressions used for transformed outcomes b Adjusts for variables that may be imbalanced across pre-and post-program respondents: p < 0.2 predictors of team participation in post-program surveys (Additional File 6); p < 0.2 predictors of staff participation in post-program only versus pre-program only surveys (Additional File 7) using only one variable for concepts measured in multiple ways (organisational readiness, location, and postcode SES). Models adjusted for: small-medium enterprise (yes/no); regional staff (yes/no); inclusion of call-centre staff (yes/no); Champion Occupational Health & Safety role (yes/no); COVID-19 impact level (none/general/high); public sector (yes/ no); organisational readiness (context score); Champion age (years); full-time employment (yes/no); Job category skill[1][2][3][4][5]; team health interest level (0-4); Postcode SES c Missing data multiply imputed by chained equations (STATA) with m = 20 imputations d Model also includes random slopes for workplace, as likelihood ratio test supported random slopes over random intercept models at p < 0.05 (Additional File 8) e Inverse log transformed as ln(1 + maximum value -variable) f Log transformed as ln(variable) for positive or ln (variable + 0.001) for non-negative variables g Occupational Sitting and Physical Activity Questionnaire[34]. ...
Background
The online BeUpstanding™ program is an eight-week workplace-delivered intervention for desk-based workers to raise awareness of the benefits of sitting less and moving more and build a supportive culture for change. A workplace representative (the “champion”) delivers the program, which includes a workshop where teams collectively choose their sit less/move more strategies. A toolkit provides the champion with a step-by-step guide and associated resources to support program uptake, delivery, and evaluation. Here we report on the main findings from the Australian national implementation trial of BeUpstanding.
Methods
Recruitment (12/06/2019 to 30/09/2021) was supported by five policy and practice partners, with desk-based work teams from across Australia targeted. Effectiveness was measured via a single arm, repeated-measures trial. Data were collected via online surveys, toolkit analytics, and telephone calls with champions. The RE-AIM framework guided evaluation, with adoption/reach (number and characteristics); effectiveness (primary: self-reported workplace sitting time); implementation (completion of core components; costs); and, maintenance intentions reported here. Linear mixed models, correcting for cluster, were used for effectiveness, with reach, adoption, implementation, and maintenance outcomes described.
Results
Of the 1640 website users who signed-up to BeUpstanding during the recruitment period, 233 were eligible, 198 (85%) provided preliminary consent, and 118 (50.6%) champions consented and started the trial, with 94% (n = 111 champions) completing. Trial participation was from across Australia and across industries, and reached 2,761 staff, with 2,248 participating in the staff survey(s): 65% female; 64% university educated; 17% from a non-English speaking background. The program effectively changed workplace sitting (-38.5 [95%CI -46.0 to -28.7] minutes/8-hour workday) and all outcomes targeted by BeUpstanding (behaviours and culture), with small-to-moderate statistically-significant effects observed. All participating teams (n = 94) completed at least 5/7 core steps; 72.4% completed all seven. Most champions spent 0-$5 (10%) per team member; most (67/70 96%) intended to continue or repeat the program.
Conclusions
BeUpstanding can be adopted and successfully implemented by a range of workplaces, reach a diversity of staff, and be effective at creating a supportive culture for teams of desk-based workers to sit less and move more. Learnings will inform optimisation of the program for longer-term sustainability.
Trial registration
ACTRN12617000682347.
... The Occupational Sitting and Physical Activity Questionnaire (OSPAQ) was used to assess current sitting time and PA in the working environment (Chau et al. 2012). The OSPAQ is a validated instrument asking the participant to indicate the proportion of work time that is being spent sitting, standing, walking, and performing heavy labour on a typical workday in the last seven days. ...
... All participants were also asked to report the number of hours they had worked in the last seven days (weekly working hours) and the number of days they were at work. The OSPAQ shows satisfying test-retest reliability (ICC from 0.73 to 0.90) and moderate validity for estimating time spent sitting and standing at work in the office environment compared to accelerometers (r ¼ 0.65 and r ¼ 0.49) (Chau et al. 2012;Jancey et al. 2014). Furthermore, the OSPAQ was recently validated for the HO environment with acceptable validity for measuring sitting and standing at a group level (Dillon et al. 2021). ...
COVID-19 working restrictions resulted in a location shift of white-collar workers into their home office (HO). Little is known about how the proportion of HO affects sitting and physical activity (PA) behaviour during working hours, and potential correlates are not well understood. A cross-sectional sample of currently working adults in HO (n = 575) completed questionnaires regarding HO proportion before and during the pandemic, work-related sitting and PA, and socioecological factors regarding HO sitting time. The reported HO proportion increased by 46.7 ± 40.6% during COVID-19 working restrictions. Workday sitting proportion correlates positively with HO proportion. The regression model identified gender, education level, working hours, working environment to stand during work, and transport and leisure PA as correlates of the workday sitting proportion in HO. This study provides findings that high HO proportions are related to higher work-related sitting times and adds insights into possible correlates of sitting time in HO.
Practitioner summary: Working in the home office (HO) is a common characteristic of flexible work in white-collar workers. This study found that the workday sitting proportion correlates positively with HO proportion and identified correlates of the workday sitting in HO. Practitioners should consider the potential impacts of HO on work-related sedentary behaviour in future workplace health promotion.
... This was a cross-sectional study using a self-administered online survey sent by e-mail to 1810 employees of the multinational Spanish company Grupo Red Eléctrica. Upon accessing the website, employees completed a survey consisting of 39 questions following a structured format based on previously validated studies [21][22][23][24][25]. Seventeen of the questions in the survey were used in this study to assess information related to age, sex, job position, number of diseases, weekly PA guidelines (aerobic and strength), sedentary time and HRQoL. ...
... Measurements related to sedentary time were collected both in the work environment and during leisure and free time through the total number of hours per week spent in sedentary activities. Information on sedentary time in the workplace was obtained using the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) [24], which has acceptable reliability and validity measurement properties [27,28]. Workers were asked the following questions: "How many hours did you work during the past 7 days?" ...
Workers spend a large amount of time working, limiting the possibility of meeting physical activity (PA) guidelines. A better health-related quality of life (HRQoL) provides benefits for the employee and company. The aim of this study was to analyse the associations of four behavioural categories between compliance with PA guidelines (aerobic and strength training) and sedentary time with workers’ HRQoL. We classified the sample into four categories: (1) “Physically active & low sedentary”, (2) “Physically active & high sedentary”, (3) “Physically inactive & low sedentary”, and (4) “Physically inactive & high sedentary”. Student’s t-tests for two independent samples and a multiple linear regression adjusted for covariates were performed. A total of 1004 employees of the multinational company Grupo Red Eléctrica participated. Compliance with PA guidelines and a low level of sedentarism were associated with higher HRQoL (p < 0.001). Compared to “physically inactive & high sedentary”, “physically active & low sedentary” and “physically active & high sedentary” workers obtained a better HRQoL (B = 5.47; p = 0.006 and B = 4.10; p = 0.003; respectively). In this sample of Spanish workers, being physically active was associated with a better HRQoL, even in those with high sedentary time. Experimental studies are needed to confirm our results.
... STAQ has acceptable reliability and validity [69]. Sitting and activity are further quantified using the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) [70]. ...
... Here, participants are asked to divide their work day into percentages spent sitting, standing, stepping, and performing heavy labour tasks. OSPAQ has demonstrated acceptable validity and reliability [70,71]. Additional questions asked include the percentage of the work day that is occupied by prolonged sitting (sitting bouts equal to or greater than 30 min) is also obtained [72], as well as the proportion of the workday spent sitting in common occupational tasks [73]. ...
Background
Clinical practice guidelines recommend that adults with type 2 diabetes (T2D) sit less and move more throughout the day. The 18-month OPTIMISE Your Health Clinical Trial was developed to support desk-based workers with T2D achieve these recommendations. The two-arm protocol consists of an intervention and control arms. The intervention arm receives 6 months health coaching, a sit-stand desktop workstation and an activity tracker, followed by 6 months of text message support, then 6 months maintenance. The control arm receives a delayed modified intervention after 12 months of usual care. This paper describes the methods of a randomised controlled trial (RCT) evaluating the effectiveness and cost-effectiveness of the intervention, compared to a delayed intervention control.
Methods
This is a two-arm RCT being conducted in Melbourne, Australia. Desk-based workers (≥0.8 full-time equivalent) aged 35–65 years, ambulatory, and with T2D and managed glycaemic control (6.5–10.0% HbA1c), are randomised to the multicomponent intervention (target n = 125) or delayed-intervention control (target n = 125) conditions. All intervention participants receive 6 months of tailored health coaching assisting them to “sit less” and “move more” at work and throughout the day, supported by a sit-stand desktop workstation and an activity tracker (Fitbit). Participants receive text message-based extended care for a further 6-months (6–12 months) followed by 6-months of non-contact (12–18 months: maintenance). Delayed intervention occurs at 12–18 months for the control arm. Assessments are undertaken at baseline, 3, 6, 12, 15 and 18-months. Primary outcomes are activPAL-measured sitting time (h/16 h day), glycosylated haemoglobin (HbA1c; %, mmol/mol) and, cognitive function measures (visual learning and new memory; Paired Associates Learning Total Errors [adjusted]). Secondary, exploratory, and process outcomes will also be collected throughout the trial.
Discussion
The OPTIMISE Your Health trial will provide unique insights into the benefits of an intervention aimed at sitting less and moving more in desk-bound office workers with T2D, with outcomes relevant to glycaemic control, and to cardiometabolic and brain health. Findings will contribute new insights to add to the evidence base on initiating and maintaining behaviour change with clinical populations and inform practice in diabetes management.
Trial registration
ANZCTRN12618001159246 .
... The survey included questions about current employment status, whether there were changes in employment status since completion of the previous study, whether they still owned their adjustable sit-stand desk unit that was provided in the original study, and if not, reasons why. Included in the survey was the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) (Chau et al. 2012) which is a validated selfreporting tool for the amount of time spent working in the previous week with percentages estimated for time spent sitting, standing, walking, and performing physical labour. Also included in the survey was a 100-mm visual analog scale (VAS) (Revill et al. 1976) with endpoint anchors of no pain (0 mm) and worst imaginable pain (100 mm) for average and worst low back pain experienced during the previous 7-day period. ...
... Although they were instructed not to, participants may also have increased their activity levels during the study period due to increased awareness and knowledge of being under observation. As with all self-report measures, there is a potential for recall bias in the survey portion of the study, however participants were highly familiarised with both OSPAQ and VAS tools and OSPAQ has been validated against objectively measured accelerometry data (Chau et al. 2012). ...
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.
... Occupational Sitting and Physical Activity (OSPA) [37] was used to obtain self-report OSPA. For comparison with system-captured objective OSPA shown in Table 1, we calculated self-report stationary time by adding up sitting and standing time and calculated ambulatory time by adding up time spent on walking and heavy labor. ...
Background:
Encouraging office workers to break up prolonged sedentary behavior (SB) at work with regular microbreaks can be beneficial yet challenging. The Internet of Things (IoT) offers great promise for delivering more subtle and hence acceptable behavior change interventions in the workplace. We previously developed an IoT-enabled SB intervention, called WorkMyWay, by applying a combination of theory-informed and human-centered design approaches. According to the Medical Research Council's framework for developing and evaluating complex interventions such as WorkMyWay, process evaluation in the feasibility phase can help establish the viability of novel modes of delivery and identify facilitators and barriers to successful delivery.
Objective:
This study aims to evaluate the feasibility and acceptability of the WorkMyWay intervention and its technological delivery system.
Methods:
A mixed methods approach was adopted. A sample of 15 office workers were recruited to use WorkMyWay during work hours for 6 weeks. Questionnaires were administered before and after the intervention period to assess self-report occupational sitting and physical activity (OSPA) and psychosocial variables theoretically aligned with prolonged occupational SB (eg, intention, perceived behavioral control, prospective memory and retrospective memory of breaks, and automaticity of regular break behaviors). Behavioral and interactional data were obtained through the system database to determine adherence, quality of delivery, compliance, and objective OSPA. Semistructured interviews were conducted at the end of the study, and a thematic analysis was performed on interview transcripts.
Results:
All 15 participants completed the study (attrition=0%) and on average used the system for 25 tracking days (out of a possible 30 days; adherence=83%). Although no significant change was observed in either objective or self-report OSPA, postintervention improvements were significant in the automaticity of regular break behaviors (t14=2.606; P=.02), retrospective memory of breaks (t14=7.926; P<.001), and prospective memory of breaks (t14=-2.661; P=.02). The qualitative analysis identified 6 themes, which lent support to the high acceptability of WorkMyWay, though delivery was compromised by issues concerning Bluetooth connectivity and factors related to user behaviors. Fixing technical issues, tailoring to individual differences, soliciting organizational supports, and harnessing interpersonal influences could facilitate delivery and enhance acceptance.
Conclusions:
It is acceptable and feasible to deliver an SB intervention with an IoT system that involves a wearable activity tracking device, an app, and a digitally augmented everyday object (eg, cup). More industrial design and technological development work on WorkMyWay is warranted to improve delivery. Future research should seek to establish the broad acceptability of similar IoT-enabled interventions while expanding the range of digitally augmented objects as the modes of delivery to meet diverse needs.
... The BSA Questionnaire has been validated in German language and measures individual's leisure-time and sport activity behavior of the past 4 weeks [49]. In addition, we apply the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) with its four activity sub-categories sitting, standing, walking, and performing heavy labor at the workplace [50]. Taking into account the discussions of a PA paradox suggesting that PA in the occupational context may not provide the same health benefits as demonstrated for leisure-time PA [16,17,51,52], we deliberately prioritize leisure-time PA in its relation to occupational PA in our analyses. ...
Background
Although the nursing sector gains growing importance in an aging society, students representing the future workforce often show insufficient health. Acknowledging the health-enhancing effects of adequate physical activity, the educational system in Bavaria, Germany, has recently integrated the promotion of physical activity-related health competence (PAHCO) into the nursing curriculum. However, it cannot be assumed that PAHCO has sufficiently permeated the educational practices and routines of the nursing schools. Therefore, the goal of the present study is to examine and compare the effectiveness as well as implementation of different intervention approaches to address PAHCO in the Bavarian nursing school system.
Methods
We randomly assign 16 nursing schools (cluster-based) to four study arms (bottom-up, top-down led by teachers, top down led by external physical activity experts, control group). Schools in intervention group 1 (IG-1) develop multicomponent inventions to target PAHCO via cooperative planning (preparation, planning, and implementation phase). Intervention groups 2 and 3 (IG-2, IG-3) receive both an expert-based intervention (developed through intervention mapping) via trained mediators to address PAHCO. External physical activity experts deliver the structured PAHCO intervention in IG-2, while teachers from the nursing schools themselves conduct the PAHCO intervention in IG-3. In line with a hybrid effectiveness implementation trial, we apply questionnaire-based pre-post measurements across all conditions (sample size calculation: nfinal = 636) to examine the effectiveness of the intervention approaches and, simultaneously, draw on questionnaires, interview, and protocol data to examine their implementation. We analyze quantitative effectiveness data via linear models (times-group interaction), and implementation data using descriptive distributions and content analyses.
Conclusion
The study enables evidence-based decisions about the suitability of three intervention approaches to promote competencies for healthy, physically active lifestyles among nursing students. The findings inform dissemination activities to effectively reach all 185 schools of the Bavarian nursing system.
Trial registration
Clinical trials NCT05817396. Registered on April 18, 2023.
... To complement the accelerometer data, we will administer four questionnaires: a) the Physical Activity Questionnaire (GPAQ), a standardized tool recognized by the World Health Organization (WHO) that provides valuable information on physical activity levels globally (37), b) a single physical activity question to identify the level of physical activity through a single item (38), c) the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) will be used to determine the proportion of time participants spend on sedentary behavior during work hours (39), and finally, d) the Daily Activities Behavior Questionnaire (DABQ) to gather additional information on participants' physical activity, sedentary behavior, and sleep habits over 24-hours (40). Questionnaires b, c, and d will be validated in Spanish in a parallel study by our investigation group. ...
Background: Excessive sedentary time has been negatively associated with several health outcomes, and physical activity alone does not seem to fully counteract these consequences. This panorama emphasizes the essential of sedentary time interruption programs. "The Up Project" seeks to assess the effectiveness of two interventions, one incorporating active breaks led by a professional and the other utilizing a computer application (self-led), of both equivalent duration and intensity. These interventions will be compared with a control group to evaluate their impact on physical activity levels, sedentary time, stress perception, occupational pain, and cardiometabolic risk factors among office workers.
Methods: This quasi-experimental study includes 60 desk-based workers from universities and educational institutes in Valparaiso, Chile, assigned to three groups: a) booster breaks led by professionals, b) computer prompts that are unled, and c) a control group. The intervention protocol for both experimental groups will last 12 weeks (only weekdays). The following measurements will be performed at baseline and post-intervention: cardiometabolic risk based on body composition (fat mass, fat-free mass, and bone mass evaluated by DXA), waist circumference, blood pressure, and resting heart rate. Physical activity and sedentary time will be self-reported and objectively assessed using accelerometry. Questionnaires will be used to determine the perception of stress and occupational pain.
Discussion: Governments worldwide are addressing health issues associated with sedentary behavior, particularly concerning individuals highly exposed to it, such as desk-based workers. Despite implementing certain strategies, there remains a noticeable gap in comprehensive research comparing diverse protocols. For instance, studies that contrast the outcomes of interventions led by professionals with those prompted by computers are scarce. This ongoing project is expected to contribute to evidence-based interventions targeting reduced perceived stress levels and enhancing desk-based employees' mental and physical well-being. The implications of these findings could have the capacity to lay the groundwork for future public health initiatives and government-funded.
... The inclusion criterion for the group of T2D patients was to be diagnosed with T2D in accordance with international criteria [12]. The rest of the inclusion criteria were common for both groups, participants with diabetis and without diabetes: patients between 18 and 65 years old (working age); office employees with a minimum of 55% of their daily working hours performing sedentary tasks according to the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) [13]; and having a work contract of at least 18.5 h/week. The exclusion criteria for both groups consisted of (i) having a diagnosis of musculoskeletal, cardiovascular, pulmonary or orthopedic problems or any other physical condition that prevented them from being physically active; (ii) participating simultaneously in another study or programme of sedentary behaviour, physical activity, nutrition or weight control; (iii) being pregnant; or (iv) having a history of psychiatric problems or substance abuse that could interfere with adherence to the study protocol. ...
OBJETIVOS Este estudio evaluó la eficacia de un programa de salud móvil para «sentarse menos y moverse más», prescrito desde la práctica clínica, sobre las variables clínicas y los factores de riesgo cardiovascular (FRCV) en personas con diabetes mellitus 2 (DM2). MATERIAL Y MÉTODOS Ensayo clínico aleatorizado que compara la intervención habitual (n = 50) con el uso del programa de salud móvil centrado en reducir el sedentarismo. El grupo de intervención (n = 49), además de la atención estándar, recibió un programa de salud móvil (W@W-App) durante 13 semanas. Fueron reclutados en cinco centros de salud. Las variables principales incluyen el control glucémico, HbA1c, colesterol total, colesterol de lipoproteínas de baja densidad (cLDL), colesterol de lipoproteínas de alta densidad (cHDL), triglicéridos, presión arterial sistólica/diastólica (PAS/PAD), índice de masa corporal (IMC) y el comportamiento sedentario (medido objetivo ActivPal y subjetivo Workforce Sitting Questionnaire). Todos estos factores se midieron antes, después, a los 6 meses y a los 12 meses de seguimiento. Se compararon los resultados entre ambos grupos mediante un test t para variables continuas y un test chi cuadrado para las variables cualitativas. RESULTADOS En comparación con el grupo control, los participantes del grupo intervención tuvieron tasas de reducción significativas y clínicamente relevantes de hemoglobina glucosilada (HbA1c; ≤ -0,5%), glucemia (p < 0,01), en los niveles de triglicéridos (p < 0 ,01), PAS y PAD (p < 0,01) a los 12 meses de seguimiento. También hubo reducciones en el tiempo sentado en el trabajo a los 6 meses. CONCLUSIONES Un programa mHealth fue efectivo en el control de las variables clínicas y los FRCV en adultos con DM2. Este tipo de programas se pueden utilizar como un método complementario asequible para abordar factores de riesgo poco abordados en la práctica clínica y prevenir enfermedades cardiovasculares en adultos con DM2. CEI Comité Ético de Investigación Clínica del Instituto Universitario de Investigación en Atención Primaria (IDIAP Jordi Gol) con código P18/102.
... Total time spent on each behavior is computed by multiplying the reported percentage of time spent on the behavior by the self-reported daily working hours (weekly working hours/number of days at work per week). The OSPAQ has demonstrated sufficient validity to assess self-reported workplace behavior among samples of working adults in Australia, where moderate correlations have been found between self-reported sitting time in the OSPAQ and accelerometer-derived sitting time [29,30]. ...
Sedentary behavior (SB) is an important public health concern. Adults working in desk-based occupations spend a considerable proportion of the workday sitting. More information is needed regarding the factors that contribute to occupational SB. The aim of this study was to assess the utility of social cognitive theory (SCT) to explain work-related SB using a quantitative, cross-sectional design by administering an online questionnaire. Participants included 381 full-time employees at a large, public university in the south-central United States. Hierarchical multiple linear regression was used to determine the relationship between SCT constructs and SB. Mean work-related SB was 5.95 (SD = 1.30) h/8 h workday. In model 1, 9.6% of the total variance in SB was accounted for by standing desk ownership and physical activity level (p = 0.001; R2 = 0.096). In model 2, SCT constructs led to a statistically significant R2 increase of 4.9% (p < 0.001), where standing desk ownership, physical activity, and self-efficacy explained 13.3% of the variance in work-related SB. Findings from this study suggest that self-efficacy may be an important factor in explaining variation in occupational SB. Public health researchers and practitioners should consider strategies to address self-efficacy when developing workplace interventions to target occupational SB.
... The inclusion criteria for the group of o ce employees with DM2 was to be diagnosed with DM2 in accordance with international criteria (18). The rest of the inclusion criteria were common for both groups: adults between 18 and 65 years old (working age); o ce employees with a minimum of 55% of their daily working hours performing sedentary tasks according to the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) (19) and; having a work contract of at least 18.5 hours/week. The exclusion criteria for both groups consisted of having a diagnosis of musculoskeletal, cardiovascular, pulmonary or orthopaedic problems or any other physical condition that prevented them from being physically active. ...
Introduction
: Type 2 diabetes mellitus (DM2) is one of the main public health threats of the 21st century. Identifying and predicting DM2 is the first step to stop its progression, and new strategies with low-cost, non-invasive early detection systems must be urgently implemented. Sedentary behaviour (SB) is one of the risk factors leading to the current increase in the prevalence of DM2, so incorporating the SB pattern into the detection methods of DM2 is essential.
Objective
To develop a simple mathematical model for clinical practice that allows early identification of office employees with a diagnosis of DM2 or at risk of presenting it, based on objective measurements of the SB pattern, hours of sleep and anthropometric variables.
Methods
Cross-sectional study. Anthropometric variables (sex, age and body mass index, BMI), sleep time (hours) and the SB pattern (sedentary breaks and time spent in sedentary bouts with four different lengths) of two groups of office employees (adults with and without diabetes) were measured and compared using the ActivPAL3M device. Eighty-one participants had DM2 and 132 had normal glucose metabolism (NGM). The risk of having DM2 was modelled using a generalised linear model (GLM), selecting the variables that presented a significant correlation with DM2.
Results
The DM2 prediction model used five non-invasive clinical variables -sex, age, BMI, sleep time (hours) and sedentary breaks < 20 minutes (number/day) – related to the SB pattern. The validated model correctly classified 88.89% of the participants. The model correctly classified all the office employees with NGM and 77% of office employees with DM2. It also allowed, based on the anthropometric profile of the participant, the design of a preventive tool to modify the SB pattern of office employees with DM2.
Conclusion
Understanding SB patterns by means of mathematical models could be a simple application solution for the early identification of office employees with DM2 in clinical practice. Incorporating an algorithm that contains a mathematical expression in wearable devices for monitoring the SB pattern could promote the early detection and comprehensive control of DM2 in clinical practice.
... Data were collected via an anonymous questionnaire from 400 (200 female and 200 male) undergraduate students that are employed. Physical activity was assessed with the Occupational sitting and physical activity questionnaire (OSPAQ) (Chau, Van der Ploeg, Dunn, Kurko, & Bauman, 2012), and quality of life was assessed by RAND 36 Item Short Form Health Survey SF-36. The short form 36 (SF-36) health survey instrument is a self-administered general health questionnaire, which generates a profile of scores across eight dimensions of health (Ware & Shelbourne, 1992). ...
The industrialization of lucrative activities led people to be employed in more sedentary working activities. Aim: The purpose of this research is to establish the relationship between the type of work performed and the degree of physical pain and discomfort. Methods: Data were collected via an anonymous questionnaire from 400 (200 female and 200 male) undergraduate students that are employed. Physical activity was assessed with the Occupational sitting and physical activity questionnaire (OSPAQ), and quality of life was assessed by RAND 36 Item Short Form Health Survey SF-36. Results: The results of the study indicate the existence of correlations between the time spent standing / sitting, during lucrative activities, and the appearance of various types of physical pain. Conclusion: The type of work performed, the time spent in stand and sitting position can influence the quality of life by the occurrence of pain and physical discomfort.
... Physical health was assessed through questions on sedentary behaviour and musculoskeletal pain/discomfort frequency and severity levels. Sedentary behaviour was measured using the Occupational Sitting and Physical Activity Questionnaire [21,22]. Respondents rated their musculoskeletal discomfort/pain frequency and severity using a 5-point and 3-point Likert scale, respectively, in ve body parts: neck and shoulders; hands and ngers; arms; middle and/or lower back; and hips, bottom, legs, or feet [23]. ...
The COVID-19 pandemic has drastically changed various aspects of our lives, including how we work. Since the start of the pandemic, numerous organizations in Canada have mandated their employees to work from home (WFH) on a full-time basis. The rapid rise in the number of remote workers and the possibility for WFH continuing in the future signifies the importance of understanding the impacts of WFH on employee well-being over the course of the pandemic in Canada.
We present the findings of two surveys (initial and 6-month follow-up) to investigate the effects of mandatory WFH arrangements on worker health during the COVID-19 pandemic in Canada. We examined the changes in employees’ mental and physical health. Initial survey was completed between October 2020 and December 2020 (n = 1617); follow-up survey was completed between May 2021 and June 2021 (n = 382).
Our analyses showed significant changes in various aspects of employee mental and physical health. Burnout, stress, general mental health, and job insecurity levels significantly decreased between the two time periods. Work-related sedentary behaviour reduced over time; however, the average proportion of time spent sitting during work hours was more than 80% in both surveys. Employees received more help and feedback from their colleagues and experienced a better sense of community with their co-workers over time.
The findings can inform workers and organizations on the mental and physical health effects of mandatory WFH arrangements. By understanding the impacts of WFH, employers can develop effective strategies and implement policies that help protect workers’ health and well-being.
... The Occupational Sitting and Physical Activity Questionnaire (OSPAQ) (Chau et al., 2012) was used to assess sitting time during working hours. The OSPAQ has acceptable measurement properties for assessing occupational sitting (Maes et al., 2020). ...
Home working has increased due to COVID-19, but little is known about how this change has impacted the health risk behaviour of elevated sedentary time. The aim of this cross-sectional exploratory study was to assess occupational sitting behaviour when working at home, and use the Capability Opportunity Motivation-Behaviour (COM-B) model to identify influences on this behaviour. University staff (n = 267; 69% female; 92% white) who were predominantly working from home completed a questionnaire to assess sitting time, sitting breaks, demographic and occupational characteristics, and a 7-item COM-B questionnaire and open-ended questions to assess influences on time spent sitting whilst working from home. Data were analysed descriptively, a repeated measures ANOVA was used to determine differences in the COM-B items, and binary logistic regression was used to examine predictors of sitting time. Staff spent on average 89.5% (SD = 17.1) of their time sitting whilst working at home, and took an average of 1.36 (1.38) sitting breaks per hour. There were significant and meaningful differences in the influence of the COM factors on ability and willingness to reduce sitting behaviour (p < .0001; ηp² = .38), and the open-ended responses added further context. The included variables accounted for 20.7% of variance in sitting behaviour, with age, sitting breaks, motivation-automatic, and opportunity-physical contributing significantly. Working from home leads to elevated levels of sitting, and the COM-B provides a useful model to identify key influences on ability and willingness to reduce sitting. Strategies incorporating regular breaks, habit formation/reversal, and restructuring the physical environment may be beneficial.
... The Occupational Sitting and Physical Activity Questionnaire (OSPAQ) is used to measure occupational sedentary behavior and occupational physical movement. The OSPAQ has been validated for use with both commercial office and home office working populations [58][59][60]. To measure the construct of habit for occupational sedentary behavior and physical movement the four-item Self-Report Behavioral Automaticity Index is used [61]. ...
Engaging in physical movement has a number of mental and physical health benefits, and yet 45% of Australia’s population do not meet the recommended guidelines for physical activity. The current study aims to develop an online habit-based intervention designed to reduce sedentary behavior within the workplace, using environmental cues to instigate simple behavioral changes. Participants in this study will include full time office workers who self-report as having a highly sedentary job and work from either a commercial office, home office, or a mixture of both. Participants will complete a habit-based intervention over a four-week period designed to reduce sedentary behavior by increasing habitual responses to simple physical movement behaviors cued by their environment. Analysis will involve mixed methods ANOVAs to test the efficacy of the intervention. A successful intervention will show a reduction in sedentary behavior as a response to habitual simple physical movement behaviors.
... The content validity index and internal consistency of this questionnaire have been reported to be 0.9. [21][22][23] In the present study, Cronbach's alpha of this questionnaire was 0.75. ...
Background: Varicose vein (VV) is a common problem that mostly occurs in legs. This medical condition can influence the quality of life and working condition of nurses. Objectives: The objectives of this study were to assess the prevalence and severity of VV and its related factors in nurses working in Shahid Beheshti Hospital, Kashan, Iran, in 2020. Methods: This cross-sectional study was carried out on 157 nurses. The participants were recruited in the study using systematic random sampling. The Occupational Sitting and Physical Activity and Aberdeen Varicose Vein Questionnaires were used for data gathering. The frequency of varicose and the mean score of the severity were calculated. The related factors were analyzed using Chi-square, Mann–Whitney, Spearman's correlation, and binominal logistic regression statistical tests. SPSS software version 16 was used for data analysis. Results: The prevalence of VV was 42% (66 nurses), the duration of varicose was 4.4 ± 3.6 years, and its severity score was 32.7 ± 9.5. In bivariate analysis, the female gender (P = 0.015), age (P = 0.002), work experience (P = 0.006), hyperlipidemia (P = 0.017), number of children (P = 0.007), regular exercise (P = 0.001), family history of varicose (P = 0.0001), hours of working overtime (P = 0.018), duration of standing (P = 0.002), walking (P = 0.039), and heavy work (P = 0.038) per day had a significant relation with the prevalence of varicose. In binary logistic regression, family history of varicose (odds ratio = 5.672), number of children (odds ratio = 2.462), and minutes of heavy working during a shift (odds ratio = 1.012) showed a significant relation with VV. No variable showed a significant relation with the severity of varicose. Conclusion: The prevalence of VV in the nurses working in Kashan was high, and many factors showed a significant relation with this problem. Nurses should be informed about preventive measures and treatments for this medical condition.
... Physical health was assessed through questions on sedentary behaviour and musculoskeletal pain/discomfort frequency and severity levels. Sedentary behaviour was measured using the Occupational Sitting and Physical Activity Questionnaire [22,23]. Respondents rated their musculoskeletal discomfort/pain frequency and severity using a 5-point and 3-point Likert scale, respectively, in five body regions: neck and shoulders; hands and fingers; arms; middle and/or lower back; and hips, bottom, legs, or feet [24]. ...
Background
The COVID-19 pandemic has drastically changed various aspects of our lives, including how we work. Since the start of the pandemic, numerous organizations in Canada have mandated their employees to work from home (WFH) on a full-time basis. The rapid rise in the number of remote workers and the possibility for WFH continuing in the future signifies the importance of understanding the health and well-being of employees working from home over the course of the pandemic in Canada. We present the findings of two surveys (initial and 6-month follow-up) to examine the health and well-being of WFH employees during the COVID-19 pandemic in Canada. We analyzed the changes in mental and physical health and well-being of employees who were working from home between two time points during the pandemic.
Methods
Initial survey was completed between October 2020 and December 2020 (n = 1617); follow-up survey was completed between May 2021 and June 2021 (n = 382). We calculated the frequencies for survey questions involving demographics, WFH preferences, workstation setup training, employment situation, provision of hardware technologies, provision and usage of software technologies, and organization’s return to work plan. We conducted Wilcoxon signed-rank tests to analyze the within-individual changes in mental and physical health and well-being of the 382 respondents who completed both the initial and follow-up surveys.
Results
Our analyses showed significant changes in various aspects of employee mental and physical health and well-being. Burnout, stress, general mental health, and job insecurity levels significantly decreased between the two time periods. Work-related sedentary behaviour reduced over time; however, the average proportion of time spent sitting during work hours was more than 80% in both surveys. Employees received more help and feedback from their colleagues and experienced a better sense of community with their co-workers over time.
Conclusion
The findings can inform workers and organizations on the changes in mental and physical health and well-being of employees working from home during the pandemic. By understanding the changes in worker health and well-being, employers can develop effective strategies and implement policies that help protect employees’ health and well-being.
... The inclusion criterion for the group of T2D patients was to be diagnosed with T2D in accordance with international criteria [12]. The rest of the inclusion criteria were common for both groups, participants with diabetis and without diabetes: patients between 18 and 65 years old (working age); office employees with a minimum of 55% of their daily working hours performing sedentary tasks according to the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) [13]; and having a work contract of at least 18.5 h/week. The exclusion criteria for both groups consisted of (i) having a diagnosis of musculoskeletal, cardiovascular, pulmonary or orthopedic problems or any other physical condition that prevented them from being physically active; (ii) participating simultaneously in another study or programme of sedentary behaviour, physical activity, nutrition or weight control; (iii) being pregnant; or (iv) having a history of psychiatric problems or substance abuse that could interfere with adherence to the study protocol. ...
Aims:
To identify principal components of free-living patterns of sedentary behaviour in office employees with type 2 diabetes (T2D) compared to normal glucose metabolism (NGM) office employees, using principal component analysis (PCA).
Methods:
213 office employees (n = 81 with T2D; n = 132 with NGM) wore an activPAL inclinometer 24 h a day for 7 consecutive days. Comparions of sedentary behaviour patterns between adults with T2D and NGM determined the dimensions that best characterise the sedentary behaviour patterns of office employees with T2D at work, outside work and at weekends.
Results:
The multivariate PCA technique identified two components that explained 60% of the variability present in the data of sedentary behaviour patterns in the population with diabetes. This was characterised by a fewer number of daily breaks and breaks in time intervals of less than 20 min both at work, outside work and at weekends. On average, adults with T2D took fewer 31 breaks/day than adults without diabetes.
Conclusion:
Effective interventions from clinical practice to tackle prolonged sedentary behaviour in office employees with T2D should focus on increasing the number of daily sedentary breaks.
... Self-reported lifestyle behaviours-self-reported percentage of time spent sitting, standing, and walking were assessed using an adapted version of the Occupational Sitting and Physical Activity Questionnaire, which asks participants to report sitting, standing, and walking percentage rather than, as in the original version, sitting, standing, walking, and heavy labour. 44 Participants were also asked to estimate the hours that they spent sitting, and the number of times each hour they broke up sitting during the workday. 45 The Past Recall of Sedentary Time was used to assess time spent sitting in different contexts outside of working hours. ...
Objectives
To evaluate the effectiveness of an intervention, with and without a height adjustable desk, on daily sitting time, and to investigate the relative effectiveness of the two interventions, and the effectiveness of both interventions on physical behaviours and physical, biochemical, psychological, and work related health and performance outcomes.
Design
Cluster three arm randomised controlled trial with follow-up at three and 12 months.
Setting
Local government councils in Leicester, Liverpool, and Greater Manchester, UK.
Participants
78 clusters including 756 desk based employees in defined offices, departments, or teams from two councils in Leicester, three in Greater Manchester, and one in Liverpool.
Interventions
Clusters were randomised to one of three conditions: the SMART Work and Life (SWAL) intervention, the SWAL intervention with a height adjustable desk (SWAL plus desk), or control (usual practice).
Main outcomes measures
The primary outcome measure was daily sitting time, assessed by accelerometry, at 12 month follow-up. Secondary outcomes were accelerometer assessed sitting, prolonged sitting, standing and stepping time, and physical activity calculated over any valid day, work hours, workdays, and non-workdays, self-reported lifestyle behaviours, musculoskeletal problems, cardiometabolic health markers, work related health and performance, fatigue, and psychological measures.
Results
Mean age of participants was 44.7 years, 72.4% (n=547) were women, and 74.9% (n=566) were white. Daily sitting time at 12 months was significantly lower in the intervention groups (SWAL −22.2 min/day, 95% confidence interval −38.8 to −5.7 min/day, P=0.003; SWAL plus desk −63.7 min/day, −80.1 to −47.4 min/day, P<0.001) compared with the control group. The SWAL plus desk intervention was found to be more effective than SWAL at changing sitting time (−41.7 min/day, −56.3 to −27.0 min/day, P<0.001). Favourable differences in sitting and prolonged sitting time at three and 12 month follow-ups for both intervention groups and for standing time for the SWAL plus desk group were observed during work hours and on workdays. Both intervention groups were associated with small improvements in stress, wellbeing, and vigour, and the SWAL plus desk group was associated with improvements in pain in the lower extremity, social norms for sitting and standing at work, and support.
Conclusions
Both SWAL and SWAL plus desk were associated with a reduction in sitting time, although the addition of a height adjustable desk was found to be threefold more effective.
Trial registration
ISRCTN Registry ISRCTN11618007 .
... Examinations of the concurrent validity of the OSPAQ also suggest that the OSPAQ is an acceptable self-report measure for assessing occupational sitting and standing time when compared to objective accelerometer data (Maes et al., 2020). The brevity of the OSPAQ has also been cited as an advantage over longer measures of workplace physical activity due to its lower participant burden and faster completion times (Chau, van der Ploeg, Dunn, et al., 2012). As the current study included multiple questionnaires and a ten-minute video demonstration, the OSPAQ represented a viable measure of employee physical activity and sedentary behaviour. ...
Globally, physical activity levels have declined sharply and it has been estimated that up to 42% of individuals within developed countries are classified as being physically inactive. Insufficient physical activity is a substantial health risk and has been associated with negative psychophysiological outcomes including cardiovascular disease, diabetes and depression. Whilst there are many contributors to physical inactivity the workplace has been identified as a particularly significant contributor. Consistently high levels of sedentary behaviour have been documented within many modern workplaces, with employees spending up to 81% of working hours seated in white collar roles. Given that approximately 58% of global workforce will spend one third of their adult life at
work, the workplace has been identified as a key domain in which researchers can deliver
interventions to promote physical activity. Despite this, evidence for the efficacy of workplace physical activity interventions has been mixed. One potential explanation for this is an underutilisation of participatory approaches during intervention design. Within organisational research, concerns have been expressed regarding a widening gap between research and practice.Whilst interventions may be academically robust they may lack sufficient relevancy to the employees that they are intended to support. To address these issues this thesis adopted a pragmatic, participatory stance and drew upon co-creation methodologies to develop a new workplace physical activity intervention that would meet the needs of employees.
... Participating patients must be between 18 and 65 years old (working age) and have a mobile phone (smartphone). They must also be diagnosed with DM2 in accordance with international criteria [60], be office workers with a minimum of 55% of their daily working hours performing sedentary tasks according to the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) [61] and have a work contract of at least 18.5 hours. ...
Background
Prolonged sedentary time is associated with an increased incidence of chronic disease including type 2 diabetes mellitus (DM2). Given that occupational sedentary time contributes significantly to the total amount of daily sedentariness, incorporating programmes to reduce occupational sedentary time in patients with chronic disease would allow for physical, mental and productivity benefits. The aim of this study is to evaluate the short-, medium- and long-term effectiveness of a mHealth programme for sitting less and moving more at work on habitual and occupational sedentary behaviour and physical activity in office staff with DM2. Secondary aims. To evaluate the effectiveness on glycaemic control and lipid profile at 6- and 12-month follow-up; anthropometric profile, blood pressure, mental well-being and work-related post-intervention outcomes at 3, 6 and 12 months.
Methods
Multicentre randomized controlled trial. A sample size of 220 patients will be randomly allocated into a control (n = 110) or intervention group (n = 110), with post-intervention follow-ups at 6 and 12 months. Health professionals from Spanish Primary Health Care units will randomly invite patients (18–65 years of age) diagnosed with DM2, who have sedentary office desk-based jobs. The control group will receive usual healthcare and information on the health benefits of sitting less and moving more. The intervention group will receive, through a smartphone app and website, strategies and real-time feedback for 13 weeks to change occupational sedentary behaviour. Variables: (1) Subjective and objective habitual and occupational sedentary behaviour and physical activity (Workforce Sitting Questionnaire, Brief Physical Activity Assessment Tool, activPAL3TM); 2) Glucose, HbA1c; 3) Weight, height, waist circumference; 4) Total, HDL and LDL cholesterol, triglycerides; (5) Systolic, diastolic blood pressure; (6) Mental well-being (Warwick-Edinburgh Mental Well-being); (7) Presenteeism (Work Limitations Questionnaire); (8) Impact of work on employees´ health, sickness absence (6th European Working Conditions Survey); (9) Job-related mental strain (Job Content Questionnaire). Differences between groups pre- and post- intervention on the average value of the variables will be analysed.
Discussion
If the mHealth intervention is effective in reducing sedentary time and increasing physical activity in office employees with DM2, health professionals would have a low-cost tool for the control of patients with chronic disease.
Trial Registration
ClinicalTrials.gov NCT04092738. Registered September 17, 2019.
... Few questionnaires, however, describe SB across all common domains of daily life in the general population. The majority focus on a defined domain such as leisure time, workplace, or a specific population [29][30][31][32][33]. A recent review identified 35 adult questionnaires that have undergone psychometric testing [21]. ...
Background: Sedentary behaviors (SB) are very prevalent nowadays. Prolonged sitting associates with chronic disease risks and increased mortality even while controlling for physical activity. Objective measurement of SB is costly, requires technical expertise, and is challenging in terms of time and management. Currently, there is no validated self-reported instrument in the Arabic language that assesses SB among individuals and relates sedentary time to social, environmental, and health outcomes. The aim of this research was to develop a multi-item Arabic SB questionnaire (ASBQ). Methods: The ASBQ was developed through an extensive literature review and discussion by the research team (n = 5), then went through content validation (n = 10 experts) and pre-testing using cognitive interviewing procedures (n = 51 respondents, mean (SD) age was 38.3 (18.2) years, and with 49% females). Results: The ASBQ included 13 questions comprising a wide range of sedentary activities. The Arabic SB instrument showed excellent content validity for assessing sedentary time in adolescents and adults with a very high item-level and scale-level content validity index. A kappa statistic, a measure of interrater reliability, was 0.95. The pre-testing showed that the instrument was highly rated by a diverse sample of Saudi adolescents and adults. Conclusion: The ASBQ received excellent acceptance by a panel of experts with promising pre-test results. Further testing of psychometric properties, including test-retest reliability and criterion validity is required.
... The inclusion criteria for the study were: employees had to work from home at least 80% of the time, work 30 or more hours per week and spend at least 75% of their working time seated [26]. The Occupational Sitting and Physical Activity Questionnaire [29] was used to assess whether employees met the requirements for working time spent seated. Participants were excluded if they had a medical condition that would limit their ability to stand or if they already had a height-adjustable desk. ...
Abstract
Sedentary behavior negatively impacts mental health, which can decrease employee productivity. Employee mental well-being and work performance may improve with sedentary reduction interventions, especially strategies that include environmental workplace modifications and behavior-changing strategies. However, such interventions have not been examined among employees working remotely during the COVID-19 pandemic. As part of the Stand Up Kansas program, 95 sedentary university employees working from home were randomized into one of four intervention arms: height-adjustable desk provision (Desk Only), online sedentary behavior modification program (Program Only), Desk + Program, or Control. The outcomes were measured at a baseline (November 2020) and following the 12-week intervention (February 2021). Employees reported mood (positive and negative affect), stress, fatigue (duration, interference with activities and severity) and work performance (irritability, focus, work satisfaction, non-work satisfaction and productivity) were measured using established self-report instruments. The effect sizes, by comparing the Control arm to the Desk + Program arm, revealed large improvements in mood (positive affect, d = 1.106). Moderate improvements were also seen in fatigue (duration, d = −0.533, and interference with activities, d = −0.648) and several aspects of work performance (focus, d = 0.702, work satisfaction, d = 0.751, and productivity, d = 0.572). Moderate effect sizes were also seen for positive affect (d = 0.566) and fatigue severity (d = 0.577) among the Program Only arm, whereas no noteworthy effect sizes were observed among the Desk Only arm. Combining an online sedentary behavior modification program with height-adjustable desk provisions appeared to positively affect mental well-being and work performance among remote employees.
Keywords: mental well-being; work performance; sedentary behavior; mood; energy
... Occupational sitting is a global health risk associated with physical inactivity (PI), sedentary behaviour, and poor health (Chau et al., 2012;Marshall & Gyi, 2010). The risk of non-infectious diseases (e.g. ...
University workers are among the most physically inactive workforces in the world and consequently face a higher health risk, including vulnerability to chronic health conditions. New work patterns necessitated by the outbreak of coronavirus disease 2019 (COVID-19) and its social distancing measures are expected to increase the foregoing risks. For this reason, interventions aimed at maintaining physical activity (PA) are necessary. This chapter draws on recent data to specify interventions to physical inactivity as well as stakeholders who may lead these interventions. The data used came from a cross-sectional study involving 1,064 academics from four African countries. It was found that PA and its association with academic job tasks depend on neighbourhood walkability and whether academics lived on their university campuses. This result unfolded the need for universities, university staff, and governments to take specific actions to improve neighbourhood walkability and its utilization for PA.
... Occupational sitting is a global health risk associated with physical inactivity (PI), sedentary behaviour, and poor health (Chau et al., 2012;Marshall & Gyi, 2010). The risk of non-infectious diseases (e.g. ...
The outbreak of a global pandemic in early 2020 led to a paradigm shift in learning modules in developing countries. The learning is happening online and in an integrated format, which is significantly impacting the students’ well-being. Many studies have been carried out on higher education, integrated learning, and technology usage in developing countries. However, no research aligns these areas together and provides a framework to the stakeholders and policymakers. This chapter is the first attempt to understand and create the framework related to technological adaption on students’ overall well-being in an inclusive and integrated learning environment of higher education in developing countries. The chapter also provides the implications based on the framework that requires changes in the processes and approaches used by the stakeholders and policymakers in some direction for future research on higher education in developing countries.KeywordsHigher educationEmerging economiesDeveloping countriesTechnologyWell-being
... Occupational sitting is a global health risk associated with physical inactivity (PI), sedentary behaviour, and poor health (Chau et al., 2012;Marshall & Gyi, 2010). The risk of non-infectious diseases (e.g. ...
Prior to COVID-19, a digital divide and inequality already existed within higher education (HE) in developing countries; however, the global pandemic has exacerbated this further. Although universities in developing countries are doing their best to remain relevant and meet the demands of their students, there is no doubt that they are struggling and looking to take a different approach in dealing with the impact of the pandemic. This book provides a theoretical insight to assist HE managers and other stakeholders in overcoming these challenges and helping them to understand the impact of COVID-19 on HE delivery and how they can cope with the ‘new normal’ post the pandemic. The introductory chapter highlights what we set out to do, including our aims and objectives. This is followed by our actions regarding coverage and content. The final section highlights what is outstanding in the form of research for reimagining educational futures in developing countries.
... Occupational sitting is a global health risk associated with physical inactivity (PI), sedentary behaviour, and poor health (Chau et al., 2012;Marshall & Gyi, 2010). The risk of non-infectious diseases (e.g. ...
The cultural fabric of the institutions plays a significant role in interweaving different ideas and breakthroughs. Navigating cultural fabric in the present pandemic scenario can be challenging, especially for higher education institutions. Institutions have to take the risk of separating the history, traditions, beliefs, and norms that are beginning to contradict modern-day values and practices. However, it is equally essential to communicate their cultural fabric that honors the vision and mission and captures the future aspirations of stakeholders focusing on the changing world order through transformational leadership, agile structures, and procedures under a dynamic leader’s stewardship. Hence, transformational leadership can assist higher education institutions to attain their purpose, focusing on integrated learning, collective goals, community-oriented objectives, and collective wellbeing. The present chapter will provide a framework to understand the role of the cultural fabric of higher educational institutions through transformational leadership.KeywordsCultureTransformative leadershipHigher educationEmerging economies
... Participants were asked the number of hours they worked in the last seven days. The Occupational Sitting and Physical Activity Questionnaire (OSPAQ) 26 was used to assess the time (minutes) spent sitting, during a typical workday. This questionnaire has acceptable validity and reliability in office workers. ...
Background
In some occupational groups, prolonged standing is associated with adverse symptoms. While the introduction of sit-stand workstations in office-workers is increasingly common, the profile of symptom development is not known.
Objectives
To identify and describe the location, intensity, quality, and timing of symptoms experienced by office workers while standing at a sit-stand workstation.
Methods
Cross-sectional observational study performed in an university campus laboratory simulated as an office with a sit-stand workstation. Sixty-three office workers without low back pain or prior exposure to a sit-stand workstation participated. For primary outcome measures, participants recorded any symptoms of pain, stiffness, and/or fatigue on a body chart, every 15 min during a 2-hour standing task. Participants rated symptom intensity on an 11-point numerical rating scale (NRS).
Results
Fifty-three participants (84%) experienced symptoms during the 2-hour standing task, with 30 participants (48%) reporting at least one symptom within 30 min of standing. A greater number of participants reported symptoms ≥2 on the NRS in the lumbar spine, lower extremity, and feet/ankle than the upper quadrant (odds ratios from 3.84 to 6.86). Mean maximal symptom intensity for the lumbar spine was greater than that for the upper quadrant and feet/ankles (incidence rate ratios: 1.46 to 1.79).
Conclusion
Symptoms of pain, stiffness, and fatigue, especially those affecting the lumbar spine, lower extremity, and feet/ankles are common in office workers who stand at a workstation. Study findings suggest that physical therapists should advise workers using sit-stand workstations to monitor symptoms and consider changing position within 30 min.
Efficacy of digital health (d-Health) interventions on workers’ physical activity (PA), sedentary behavior, and physiological outcomes remains unclear. This umbrella review searched PubMed, Cochrane Library, and Google Scholar up to October 25, 2024. We identified 24 systematic reviews (SRs) and selected 130 individual studies from these SRs for analysis. The AMSTAR 2 tool rated the quality of most SRs as critically low. Narrative syntheses suggested that d-Health interventions could potentially improve all outcomes compared with no intervention. However, whether d-Health interventions outperform non-d-Health interventions remains uncertain. Meta-analyses showed a significantly small effect of d-Health interventions on step counts, sedentary/sitting time, and weight compared with no intervention, while d-Health interventions slightly improved only moderate-to-vigorous PA compared with non-d-Health interventions. Subgroup analyses identified potential sources of heterogeneity (e.g., risk of bias, control conditions), which may vary between outcomes. Further high-quality studies are needed to evaluate the efficacy of d-Health interventions.
Objective
Increasing numbers of women are in employment during the menopause; however, menopause symptoms can negatively impact capacity to work. Aspects of the work environment, such as the amount of time spent in physical activity (PA) and sitting, may influence symptoms, yet this is unexplored. This study aimed to explore relationships between workplace PA and sitting, and menopause symptom severity.
Methods
Using a cross-sectional study design, 264 perimenopausal or postmenopausal women were recruited to complete an online questionnaire assessing their self-reported workplace PA and sitting time, and their menopause symptom severity (menopause quality of life, hot flash interference, symptom severity). Multiple linear regression analyses examined the associations between menopause symptom severity and the time spent in PA (standing, walking, and physically demanding tasks) and sitting during work hours. Binomial logistical regression was used to assess if menopause symptom severity predicts whether women meet workplace activity guidelines.
Results
No significant associations were observed between the time spent in PA or sitting while at work and menopause symptom severity ( P > 0.05). Menopause symptom severity did not significantly predict whether women met workplace activity guidelines ( P > 0.05).
Conclusions
In a cohort of perimenopausal and postmenopausal women, self-reported time spent in PA and sitting while at work is not associated with menopause symptom severity. Further research is needed using device-based methods to assess PA and sitting time, to explore in more detail the influence of the time spent in these behaviors while at work on menopause symptoms.
Background: The online BeUpstanding program is an eight-week workplace-delivered intervention for desk-based workers to raise awareness of the benefits of sitting less and moving more and build a supportive culture for change. A workplace representative (the champion) delivers the program, which includes a workshop where teams collectively choose their sit less/move more strategies. A toolkit provides the champion with a step-by-step guide and associated resources to support program uptake, delivery, and evaluation. Here we report on the main findings from the Australian national implementation trial of BeUpstanding.
Methods: Recruitment (12/06/2019 to 30/09/2021) was supported by five policy and practice partners, with desk-based work teams from across Australia targeted. Effectiveness was measured via a single arm, repeated-measures trial. Data were collected via online surveys, toolkit analytics, and telephone calls with champions. The RE-AIM framework guided evaluation, with adoption/reach (number and characteristics); effectiveness (primary: self-reported workplace sitting time); implementation (completion of core components; costs); and, maintenance intentions reported here. Linear mixed models, correcting for cluster, were used for effectiveness, with reach, adoption, implementation, and maintenance outcomes described.
Results: Of the 1640 website users who signed-up to BeUpstanding during the recruitment period, 233 were eligible, 198 (85%) provided preliminary consent, and 118 (50.6%) champions consented and started the trial, with 94% (n=111 champions) completing. Trial participation was from across Australia and across industries, and reached 2,761 staff, with 2,248 participating in the staff survey(s): 65% female, 64% university educated; 16.9% from non-English speaking background. The program effectively changed workplace sitting (-38.5 [95%CI -46.0 to -28.7] minutes/8-hour workday) and all outcomes targeted by BeUpstanding (behaviours and culture), with small-to-moderate statistically-significant effects observed. All participating teams (n=94) completed at least 5/7 core steps; 72.4% completed all seven. Most champions spent 0-$5 (10%) per team member; most (67/70 96%) intended to continue or repeat the program.
Conclusions: BeUpstanding can be adopted and successfully implemented by a range of workplaces, reach a diversity of staff, and be effective at creating a supportive culture for teams of desk-based workers to sit less and move more. Learnings will inform optimisation of the program for longer-term sustainability.
The 'Sit-Stand e-Guide' e-training program, designed to promote appropriate use of sit-stand workstations (SSWs), was evaluated for usability, acceptability and impact on various outcomes among SSW users. Participants from a large municipal organisation (25% male; mean age 45 [SD = 10.6] years) completed questionnaires pre-training (T0, n = 57), immediately post-training (T1, n = 50), and four weeks (T2, n = 46: primary endpoint) and twelve months later (T3, n = 30). High usability, acceptability and usefulness scores were reported at T1. Median [IQR] knowledge (4.4/5 [0.9]) and confidence (4.6/5 [1.0]) significantly increased at T1 compared to baseline (2.8 [1.2]; 3.3 [1.4]) and maintained at T2 and T3. At T2, mean [SD] sitting time (5.3 [1.2] h/workday) and low back discomfort (2.4 [2.3]) significantly decreased compared to baseline (6.1 [1.3] h; 3.4 [2.5] discomfort), SSW usage increased (1.4 [1.4]-2.8 [1.7] transitions), with no significant changes in work performance. Some behavioural changes were sustained at T3. The Sit-Stand e-Guide was acceptable and effective; evaluation across diverse workplaces and workers is now needed.
Measuring the physical demands of work is important in understanding the relationship between exposure to these job demands and their impact on the safety, health, and well-being of working people. However, work is changing and our knowledge of job demands should also evolve in anticipation of these changes. New opportunities exist for noninvasive long-term measures of physical demands through wearable motion sensors, including inertial measurement units, heart rate monitors, and muscle activity monitors. Inertial measurement units combine accelerometers, gyroscopes, and magnetometers to provide continuous measurement of a segment’s motion and the ability to estimate orientation in 3-dimensional space. There is a need for a system-thinking perspective on how and when to apply these wearable sensors within the context of research and practice surrounding the measurement of physical job demands. In this paper, a framework is presented for measuring the physical work demands that can guide designers, researchers, and users to integrate and implement these advanced sensor technologies in a way that is relevant to the decision-making needs for physical demand assessment. We (i) present a literature review of the way physical demands are currently being measured, (ii) present a framework that extends the International Classification of Functioning to guide how technology can measure the facets of work, (iii) provide a background on wearable motion sensing, and (iv) define 3 categories of decision-making that influence the questions that we can ask and measures that are needed. By forming questions within these categories at each level of the framework, this approach encourages thinking about the systems-level problems inherent in the workplace and how they manifest at different scales. Applying this framework provides a systems approach to guide study designs and methodological approaches to study how work is changing and how it impacts worker safety, health, and well-being.
This research is aimed at developing a new instrument to assess the healthy workplace qualities based on the environmental theory of stress, and ideas of salutogenic and biophilic design. A total of 319 respondents participated in the study (19–72 years; Mage = 40.86, SDage = 12.70; 69% women). Additionally, nine judges were invited to evaluate the items of the scale for content validity. Using a mixed inductive/deductive method, which included literature analysis and in-depth interviews, an initial pool of 56 items was collected. From the initial pool of 56 items, the more relevant ones were selected. This list named the People in the Office Scale (POS) was subjected to a full psychometric examination. Results of the Exploratory and Confirmatory Factor Analyses show that POS has satisfactory structural and content validity, reliability, and measurement invariance across sex and age. In its final form, POS includes 27 items and five subscales: Ergonomics; Internal Communications; External Infrastructure; Freedom of Action; and Workplace as a Life Narrative. Convergent validity measured by correlating POS scores with the variables of restorative environment, workplace attachment, and organizational cynicism was satisfactory. Divergent validity measured by correlating with mental health, was also satisfactory. This new instrument can be recommended for use in both practice and research to provide evidence-based design guidance.
Background
Office workers spend 70–85% of their time at work sitting. High levels of sitting have been linked to poor physiological and psychological health. Evidence shows the need for fully powered randomised controlled trials, with long-term follow-up, to test the effectiveness of interventions to reduce sitting time.
Objective
Our objective was to test the clinical effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable workstation, compared with usual practice at 12-month follow-up.
Design
A three-arm cluster randomised controlled trial.
Setting
Councils in England.
Participants
Office workers.
Intervention
SMART Work & Life is a multicomponent intervention that includes behaviour change strategies, delivered by workplace champions. Clusters were randomised to (1) the SMART Work & Life intervention, (2) the SMART Work & Life intervention with a height-adjustable workstation (i.e. SMART Work & Life plus desk) or (3) a control group (i.e. usual practice). Outcome measures were assessed at baseline and at 3 and 12 months.
Main outcome measures
The primary outcome was device-assessed daily sitting time compared with usual practice at 12 months. Secondary outcomes included sitting, standing, stepping time, physical activity, adiposity, blood pressure, biochemical measures, musculoskeletal issues, psychosocial variables, work-related health, diet and sleep. Cost-effectiveness and process evaluation data were collected.
Results
A total of 78 clusters (756 participants) were randomised [control, 26 clusters ( n = 267); SMART Work & Life only, 27 clusters ( n = 249); SMART Work & Life plus desk, 25 clusters ( n = 240)]. At 12 months, significant differences between groups were found in daily sitting time, with participants in the SMART Work & Life-only and SMART Work & Life plus desk arms sitting 22.2 minutes per day (97.5% confidence interval –38.8 to –5.7 minutes/day; p = 0.003) and 63.7 minutes per day (97.5% confidence interval –80.0 to –47.4 minutes/day; p < 0.001), respectively, less than the control group. Participants in the SMART Work & Life plus desk arm sat 41.7 minutes per day (95% confidence interval –56.3 to –27.0 minutes/day; p < 0.001) less than participants in the SMART Work & Life-only arm. Sitting time was largely replaced by standing time, and changes in daily behaviour were driven by changes during work hours on workdays. Behaviour changes observed at 12 months were similar to 3 months. At 12 months, small improvements were seen for stress, well-being and vigour in both intervention groups, and for pain in the lower extremity and social norms in the SMART Work & Life plus desk group. Results from the process evaluation supported these findings, with participants reporting feeling more energised, alert, focused and productive. The process evaluation also showed that participants viewed the intervention positively; however, the extent of engagement varied across clusters. The average cost of SMART Work & Life only and SMART Work & Life plus desk was £80.59 and £228.31 per participant, respectively. Within trial, SMART Work & Life only had an incremental cost-effectiveness ratio of £12,091 per quality-adjusted life-year, with SMART Work & Life plus desk being dominated. Over a lifetime, SMART Work & Life only and SMART Work & Life plus desk had incremental cost-effectiveness ratios of £4985 and £13,378 per quality-adjusted life-year, respectively.
Limitations
The study was carried out in one sector, limiting generalisability.
Conclusions
The SMART Work & Life intervention, provided with and without a height-adjustable workstation, was successful in changing sitting time.
Future work
There is a need for longer-term follow-up, as well as follow-up within different organisations.
Trial registration
Current Controlled Trials ISRCTN11618007.
Background:
Occupational well-being supports the retention of the nurse educator workforce and their ability to manage workload. There is a research gap regarding interventions promoting occupational well-being.
Purpose:
To evaluate the effectiveness of an 8-workweek digital occupational well-being intervention using self-conducted exercises among nurse educators in secondary vocational nursing schools in Finland.
Methods:
A quasi-experimental study design was applied using an intervention group (n = 37) and a control group (n = 40). Data were collected at baseline, post, and 1-month follow-up using a questionnaire and a heart rate sensor to assess the resource-workload-balance and its associating and promoting factors.
Results:
This study found no statistical effects on the resource-workload-balance. Positive effects were found on associating factors (general well-being) and promoting factors (recovery experiences and self-regulation).
Conclusions:
Self-Help INtervention for Educators (SHINE) has the potential to promote recovery experiences during working hours; however, the intervention needs more investigation.
Background:
Healthcare systems are under unprecedented pressure. GPs are crucial to the health of the population, yet their own health and wellbeing is often overlooked.
Aim:
To investigate feelings of burnout, psychological wellbeing, and musculoskeletal complaints in GPs across the UK and to examine whether these health outcomes vary according to the time GPs spent sitting, their participation in physical activity each day, the time spent working per day/week.
Design & setting:
Observational study involving GPs located across the UK.
Method:
An online survey was emailed to working members of the Royal College of General Practitioners and shared on social media. The survey included questions on burnout, psychological wellbeing, and musculoskeletal complaints, sitting time, physical activity and time spent working. Mean differences were examined for burnout, psychological wellbeing and musculoskeletal complaints.
Results:
Data from 406 GPs showed a high level of burnout (36%) and musculoskeletal complaints (82%). Psychological wellbeing was low in 25% of GPs. Burnout was lower in GPs who met current physical activity guidelines, while psychological wellbeing was higher in those with more than two breaks in sitting per hour. Musculoskeletal complaints were higher in those spending more than 50% of sitting time in prolonged bouts (≥30 minutes).
Conclusion:
A high proportion of GPs reported experiencing burnout and musculoskeletal complaints, but these health concerns were less evident in GPs who spent less time in prolonged sitting, took more breaks in sitting and who were more physically active.
Introduction
Previous research has identified associations between work–family conflict (WFC) and health outcomes (e.g., musculoskeletal pain). This study investigated whether WFC and family–work conflict explain relationships between exposure to work‐related hazards and musculoskeletal pain and stress for workers undertaking some or all of their work at home. Possible differences by home workspace location were also explored.
Methods
Longitudinal survey data were collected from workers in Australia engaged in work from home for at least two days per week. Data was collected at four timepoints approximately 6 months apart (Baseline [October 2020] n = 897; Wave 1 [May/June 2021] n = 368; Wave 2 [October/November 2021] n = 336; Wave 3 [May 2022] n = 269). Subjective measures of work‐related psychosocial hazards, occupational sitting and physical activity, musculoskeletal pain, and stress were collected via an online questionnaire. Mediation analyses were conducted using the R package “mediation.” Analyses were also conducted with the data set stratified by home office location, using R version 4.1.3.
Results
Both WFC and family–work conflict acted as mediators between psychosocial work‐related hazards and musculoskeletal pain and stress. WFC mediated more relationships than family–work conflict. Location of home workspace was important, particularly for those working in a space at home where they may be subject to interruptions.
Conclusion
Addressing WFC is a legitimate means through which musculoskeletal pain and stress can be reduced. Organizational risk management strategies need to address all work‐related risks, including those stemming from work‐life interaction.
Background:
Healthcare and social assistance workers are at increased risk for obesity. This industry has limited access to workplace health promotion resources and reports low rates of physical activity programs for workers.
Methods:
This article describes the application of the PRECEDE-PROCEED Model (PPM) to plan, implement, and evaluate a pilot physical activity intervention, Project Move, tailored to promote occupational physical activity and reduce sedentary behaviors among female workers. Actions taken by the community-based participatory research partnership assisted in the identification of the predisposing, reinforcing, and enabling factors that influenced the physical activity behaviors of female workers. The resources and capacities of the partnership were leveraged to implement and evaluate the pilot intervention.
Findings:
After the 12-week intervention, the participants' daily average steps while at work met the recommended minimum 7,000 steps/day, and the time spent sitting decreased along with positive changes in health-related psychosocial measures.
Conclusions/application to practice:
The PPM represents a feasible approach for community-based participatory partnerships to create a tailored intervention to address the occupational physical activity and sedentary behaviors of at-risk female healthcare and social assistance workforce.
Office workers who transitioned to working from home are spending an even higher percentage of their workday sitting compared with being “in-office” and this is an emerging health concern. With many office workers continuing to work from home since the onset of the COVID-19 pandemic, it is imperative to have a validated self-report questionnaire to assess sedentary behavior, break frequency, and duration, to reduce the cost and burden of using device-based assessments. This secondary analysis study aimed to validate the modified Last 7-Day Sedentary Behavior Questionnaire (SIT-Q 7d) against an activPAL4™ device in full-time home-based “office” workers (n = 148; mean age = 44.90). Participants completed the modified SIT-Q 7d and wore an activPAL4 for a full work week. The findings showed that the modified SIT-Q 7d had low (ρ = .35–.37) and weak (ρ = .27–.28) criterion validity for accurate estimates of break frequency and break duration, respectively. The 95% limits of agreement were large for break frequency (26.85–29.01) and medium for break duration (5.81–8.47), indicating that the modified SIT-Q 7d may not be appropriate for measuring occupational sedentary behavior patterns at the individual level. Further validation is still required before confidently recommending this self-report questionnaire to be used among this population to assess breaks in sedentary time.
Background
Sedentary behaviour is linked to increased risk of type 2 diabetes, cardiovascular disease, musculoskeletal issues and poor mental well-being. Contact (call) centres are associated with higher levels of sedentary behaviour than other office-based workplaces. Stand Up for Health is an adaptive intervention designed to reduce sedentary behaviour in contact centres.
Objectives
The objectives were to test the acceptability and feasibility of implementing the intervention; to assess the feasibility of the study design and methods; to scope the feasibility of a future health economic evaluation; and to consider the impact of COVID-19 on the intervention. All sites received no intervention for between 3 and 12 months after the start of the study, as a waiting list control.
Design
This was a cluster-randomised stepped-wedge feasibility design.
Setting
The trial was set in 11 contact centres across the UK.
Participants
Eleven contact centres and staff.
Intervention
Stand Up for Health involved two workshops with staff in which staff developed activities for their context and culture. Activities ranged from using standing desks to individual goal-setting, group walks and changes to workplace policies and procedures.
Main outcome measures
The primary outcome was accelerometer-measured sedentary time. The secondary outcomes were subjectively measured sedentary time, overall sedentary behaviour, physical activity, productivity, mental well-being and musculoskeletal health.
Results
Stand Up for Health was implemented in 7 out of 11 centres and was acceptable, feasible and sustainable (objective 1). The COVID-19 pandemic affected the delivery of the intervention, involvement of contact centres, data collection and analysis. Organisational factors were deemed most important to the success of Stand Up for Health but also the most challenging to change. There were also difficulties with the stepped-wedge design, specifically maintaining contact centre interest (objective 2). Feasible methods for estimating cost-efficiency from an NHS and a Personal Social Services perspective were identified, assuming that alternative feasible effectiveness methodology can be applied. Detailed activity-based costing of direct intervention costs was achieved and, therefore, deemed feasible (objective 3). There was significantly more sedentary time spent in the workplace by the centres that received the intervention than those that did not (mean difference 84.06 minutes, 95% confidence interval 4.07 to 164.1 minutes). The other objective outcomes also tended to favour the control group.
Limitations
There were significant issues with the stepped-wedge design, including difficulties in maintaining centre interest and scheduling data collection. Collection of accelerometer data was not feasible during the pandemic.
Conclusions
Stand Up for Health is an adaptive, feasible and sustainable intervention. However, the stepped-wedge study design was not feasible. The effectiveness of Stand Up for Health was not demonstrated and clinically important reductions in sedentary behaviour may not be seen in a larger study. However, it may still be worthwhile conducting an effectiveness study of Stand Up for Health incorporating activities more relevant to hybrid workplaces.
Future work
Future work could include developing hybrid (office and/or home working) activities for Stand Up for Health; undertaking a larger effectiveness study and follow-up economic analysis (subject to its success); and exploring organisational features of contact centres that affect the implementation of interventions such as Stand Up for Health.
Trial registration
This trial is registered as ISRCTN11580369.
Funding
This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme and will be published in full in Public Health Research ; Vol. 10, No. 13. See the NIHR Journals Library website for further project information.
Background:
Adjustable height sit-stand desks are becoming the norm in many workplaces. It is not known how task type, worker preference, and occupation impact utilization of the adjustable height feature.
Objective:
This survey-based study aimed to determine how task type, preference and occupation affect office workers' sitting and standing behaviors at work.
Methods:
Office workers (n = 123) from different occupations completed surveys about actual and preferred positions (sit, stand, either/both) during 39 common tasks from 4 different categories, as well as barriers to use. Each position was analyzed by task type, behavior, and occupation.
Results:
There were differences between actual and preferred behavior for each position, with participants sitting more and standing less than preferred across all task categories. There were differences between task categories with participants sitting less for generative and routine, and standing more for communication tasks. The highest rates of either/both responses were for routine tasks. Engineers reported the lowest standing rates, and also indicated standing more than preferred. Information Tech and Engineering had the highest either/both responses. Finance reported the highest sitting rates. Personal, task-based and workplace limitations were cited as barriers to preferred use.
Conclusion:
Office workers would prefer to stand more at work. Occupation-specific needs and preferences, as well as types of tasks should be considered when providing workplace standing options.
Objectives:
To investigate the impacts, on mental and physical health, of a mandatory shift to working from home during the COVID-19 pandemic.
Design:
Cross sectional, online survey.
Setting:
Online survey was conducted from September 2020 to November 2020 in the general population.
Participants:
Australian residents working from home for at least 2 days a week at some time in 2020 during the COVID-19 pandemic.
Main outcome measures:
Demographics, caring responsibilities, working from home arrangements, work-related technology, work-family interface, psychosocial and physical working conditions, and reported stress and musculoskeletal pain.
Results:
924 Australians responded to the online questionnaire. Respondents were mostly women (75.5%) based in Victoria (83.7%) and employed in the education and training and healthcare sectors. Approximately 70% of respondents worked five or more days from home, with only 60% having a dedicated workstation in an uninterrupted space. Over 70% of all respondents reported experiencing musculoskeletal pain or discomfort. Gendered differences were observed; men reported higher levels of family to work conflict (3.16±1.52 to 2.94±1.59, p=0.031), and lower levels of recognition for their work (3.75±1.03 to 3.96±1.06, p=0.004), compared with women. For women, stress (2.94±0.92 to 2.66±0.88, p<0.001) and neck/shoulder pain (4.50±2.90 to 3.51±2.84, p<0.001) were higher than men and they also reported more concerns about their job security than men (3.01±1.33 to 2.78±1.40, p=0.043).
Conclusions:
Preliminary evidence from the current study suggests that working from home may impact employees' physical and mental health, and that this impact is likely to be gendered. Although further analysis is required, these data provide insights into further research opportunities needed to assist employers in optimising working from home conditions and reduce the potential negative physical and mental health impacts on their employees.
Objectives: Home working has increased due to COVID-19, but little is known about how this change has impacted the health risk behaviour of elevated sedentary time. The aim of this study was to assess occupational sitting behaviour when working at home, and use the Capability Opportunity Motivation-Behaviour (COM-B) model to identify influences on this behaviour.
Design: Cross-sectional
Methods: University staff (n=267; 69% female; 92% white) who were predominantly working from home completed a questionnaire to assess sitting time, sitting breaks, demographic and occupational characteristics, and a 7-item COM-B questionnaire and open-ended questions to assess influences on time spent sitting whilst working from home. Data were analysed descriptively, a repeated measures ANOVA was used to determine differences in the COM-B items, and binary logistic regression was used to examine predictors of sitting time.
Results: Staff spent on average 89.5% (SD=17.1) of their time sitting whilst working at home, and took an average of 1.36 (1.38) sitting breaks per hour. There were significant and meaningful differences in the influence of the COM factors on ability and willingness to reduce sitting behaviour (p<.0001; ηp²=.38), and the open-ended responses added further context. The included variables accounted for 19.6% of variance in sitting behaviour, with age, sitting breaks, motivation-automatic, and opportunity-physical contributing significantly.
Conclusions: Working from home leads to elevated levels of sitting, and the COM-B provides a useful model to identify key influences on ability and willingness to reduce sitting. Strategies incorporating regular breaks, habit formation/reversal, and restructuring the physical environment may be beneficial.
Physical activity guidelines and epidemiological studies are mixed regarding whether standing can reduce cardiovascular disease (CVD) and mortality. This review describes definitions and measures of standing, reviews prospective studies of standing with CVD risk and mortality, and discusses related cardiovascular mechanisms. Studies observe that, while higher all-day standing is associated with reduced mortality, higher occupational standing has adverse/null associations with subclinical or incident CVD. These differences may reflect distinct cardiovascular mechanisms. All-day standing is likely intermittent and volitional, whereas occupational standing is likely prolonged and obligatory. Limitations of the existing literature include suboptimal/variable measures of standing, limited length of follow-up, and methodological differences in populations and outcomes that preclude direct comparison of research studying all-day vs. occupational standing. The relationship between standing and CVD risk may differ across contexts. Future research should clarify the cardiovascular effects of all-day vs. occupational standing, including testing interventions.
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.
Unlabelled:
The objective of this study was to systematically review the literature and compare the effectiveness of controlled interventions with a focus on physical activity (PA) and/or sedentary behaviours (SBs) for reducing sedentary time in adults. Six electronic databases were searched to identify all studies that examined the effects of interventions that targeted PA and/or SBs and that reported on changes in SBs (sedentary, sitting or television time). A qualitative synthesis was performed for all studies, and meta-analyses conducted among studies with mean differences (min/d) of sedentary time.
Prospero:
CRD42014006535. Sixty-five controlled studies met inclusion criteria; 33 were used in the meta-analyses. Interventions with a focus on PA or that included a PA and SB component produced less consistent findings and generally resulted in modest reductions in sedentary time (PA: standardized mean differences [SMD] = -0.22 [95% confidence interval {CI}: -0.35, -0.10], PA+SB: SMD= -0.37 [95% CI: -0.69, -0.05]). Moderate quality evidence from the randomized controlled trial meta-analysis coupled with the qualitative synthesis provides consistent evidence that large and clinically meaningful reductions in sedentary time can be expected from interventions with a focus on reducing SBs (SMD= -1.28 [95% CI: -1.68, -0.87] ). There is evidence to support the need for interventions to include a component focused on reducing SBs in order to generate clinically meaningful reductions in sedentary time.
http://www.biomedcentral.com/1471-2458/14/749/abstract (highly accessed)
Health is associated with amount of daily physical activity. Recently, the identification of sedentary time as an independent factor, has gained interest. A valid and easy to use activity monitor is needed to objectively investigate the relationship between physical activity, sedentary time and health. We compared validity and reproducibility of physical activity measurement and posture identification of three activity monitors, as well as user friendliness.
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.
Excessive sedentary time is detrimentally linked to obesity, type 2 diabetes, cardiovascular disease and premature mortality. Studies have been investigating the use of activity-permissive workstations to reduce sedentary time in office workers, a highly sedentary target group. This review systematically summarizes the evidence for activity-permissive workstations on sedentary time, health-risk biomarkers, work performance and feasibility indicators in office workplaces. In July 2013, a literature search identified 38 relevant peer-reviewed publications. Key findings were independently extracted by two researchers. The average intervention effect on sedentary time was calculated via meta-analysis. In total, 984 participants across 19 field-based trials and 19 laboratory investigations were included, with sample sizes ranging from n = 2 to 66 per study. Sedentary time, health-risk biomarkers and work performance indicators were reported in 13, 23 and 23 studies, respectively. The pooled effect size from the meta-analysis was −77 min of sedentary time/8-h workday (95% confidence interval = −120, −35 min). Non-significant changes were reported for most health- and work-related outcomes. Studies with acceptability measures reported predominantly positive feedback. Findings suggest that activity-permissive workstations can be effective to reduce occupational sedentary time, without compromising work performance. Larger and longer-term randomized-controlled trials are needed to understand the sustainability of the sedentary time reductions and their longer-term impacts on health- and work-related outcomes.
Objective:
This study was conducted to determine whether installation of sit-stand desks (SSDs) could lead to decreased sitting time during the workday among sedentary office workers.
Methods:
A randomized cross-over trial was conducted from January to April, 2012 at a business in Minneapolis. 28 (nine men, 26 full-time) sedentary office workers took part in a 4 week intervention period which included the use of SSDs to gradually replace 50% of sitting time with standing during the workday. Physical activity was the primary outcome. Mood, energy level, fatigue, appetite, dietary intake, and productivity were explored as secondary outcomes.
Results:
The intervention reduced sitting time at work by 21% (95% CI 18%-25%) and sedentary time by 4.8 min/work-hr (95% CI 4.1-5.4 min/work-hr). For a 40 h work-week, this translates into replacement of 8 h of sitting time with standing and sedentary time being reduced by 3.2 h. Activity level during non-work hours did not change. The intervention also increased overall sense of well-being, energy, decreased fatigue, had no impact on productivity, and reduced appetite and dietary intake. The workstations were popular with the participants.
Conclusion:
The SSD intervention was successful in increasing work-time activity level, without changing activity level during non-work hours.
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.
A previous-day recall (PDR) may be a less error-prone alternative to traditional questionnaire-based estimates of physical activity and sedentary behavior (e.g., past year), but the validity of the method is not established. We evaluated the validity of an interviewer administered PDR in adolescents (12-17 yr) and adults (18-71 yr).
In a 7-d study, participants completed three PDR, wore two activity monitors, and completed measures of social desirability and body mass index. PDR measures of active and sedentary time was contrasted against an accelerometer (ActiGraph) by comparing both to a valid reference measure (activPAL) using measurement error modeling and traditional validation approaches.
Age- and sex-specific mixed models comparing PDR to activPAL indicated the following: 1) there was a strong linear relationship between measures for sedentary (regression slope, β1 = 0.80-1.13) and active time (β1 = 0.64-1.09), 2) person-specific bias was lower than random error, and 3) correlations were high (sedentary: r = 0.60-0.81; active: r = 0.52-0.80). Reporting errors were not associated with body mass index or social desirability. Models comparing ActiGraph to activPAL indicated the following: 1) there was a weaker linear relationship between measures for sedentary (β1 = 0.63-0.73) and active time (β1 = 0.61-0.72), (2) person-specific bias was slightly larger than random error, and (3) correlations were high (sedentary: r = 0.68-0.77; active: r = 0.57-0.79).
Correlations between the PDR and the activPAL were high, systematic reporting errors were low, and the validity of the PDR was comparable with the ActiGraph. PDR may have value in studies of physical activity and health, particularly those interested in measuring the specific type, location, and purpose of activity-related behaviors.
Many contemporary work tasks are characterised by little or no physical activity. This pertains to the whole body as well as specific areas such as neck and shoulders. Too little whole body physical activity is generally known to increase the risk of chronic diseases like vascular disorders and diabetes. Low-intensity tasks of static nature are regarded as one of the risk factors of work related musculoskeletal disorders of neck and shoulders. TNO Quality of Life has developed recommendations for a healthy amount of physical activity at work, both for the whole body and the neck-/shoulder area. These recommendations are presented here, including their scientific basis.
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.
Prolonged sitting time is a health risk. We describe a practice-based study designed to reduce prolonged sitting time and improve selected health factors among workers with sedentary jobs.
We conducted our study during March?"May 2011 in Minneapolis, Minnesota, among employees with sedentary jobs.
Project implementation occurred over 7 weeks with a baseline period of 1 week (period 1), an intervention period of 4 weeks (period 2), and a postintervention period of 2 weeks (period 3). The intervention group (n = 24) received a sit-stand device during period 2 designed to fit their workstation, and the comparison group (n = 10) did not. We used experience-sampling methods to monitor sitting behavior at work during the 7 weeks of the project. We estimated change scores in sitting time, health risk factors, mood states, and several office behaviors on the basis of survey responses.
The Take-a-Stand Project reduced time spent sitting by 224% (66 minutes per day), reduced upper back and neck pain by 54%, and improved mood states. Furthermore, the removal of the device largely negated all observed improvements within 2 weeks.
Our findings suggest that using a sit-stand device at work can reduce sitting time and generate other health benefits for workers.
Moderate- to vigorous-intensity physical activity has an established preventive role in cardiovascular disease, type 2 diabetes, obesity, and some cancers. However, recent epidemiologic evidence suggests that sitting time has deleterious cardiovascular and metabolic effects that are independent of whether adults meet physical activity guidelines. Evidence from "inactivity physiology" laboratory studies has identified unique mechanisms that are distinct from the biologic bases of exercising. Opportunities for sedentary behaviors are ubiquitous and are likely to increase with further innovations in technologies. We present a compelling selection of emerging evidence on the deleterious effects of sedentary behavior, as it is underpinned by the unique physiology of inactivity. It is time to consider excessive sitting a serious health hazard, with the potential for ultimately giving consideration to the inclusion of too much sitting (or too few breaks from sitting) in physical activity and health guidelines.
Sedentary (sitting) behaviours are ubiquitous in modern society. We conducted a systematic review and meta-analysis to examine the association of sedentary time with diabetes, cardiovascular disease and cardiovascular and all-cause mortality.
Medline, Embase and the Cochrane Library databases were searched for terms related to sedentary time and health outcomes. Cross-sectional and prospective studies were included. RR/HR and 95% CIs were extracted by two independent reviewers. Data were adjusted for baseline event rate and pooled using a random-effects model. Bayesian predictive effects and intervals were calculated to indicate the variance in outcomes that would be expected if new studies were conducted in the future.
Eighteen studies (16 prospective, two cross-sectional) were included, with 794,577 participants. Fifteen of these studies were moderate to high quality. The greatest sedentary time compared with the lowest was associated with a 112% increase in the RR of diabetes (RR 2.12; 95% credible interval [CrI] 1.61, 2.78), a 147% increase in the RR of cardiovascular events (RR 2.47; 95% CI 1.44, 4.24), a 90% increase in the risk of cardiovascular mortality (HR 1.90; 95% CrI 1.36, 2.66) and a 49% increase in the risk of all-cause mortality (HR 1.49; 95% CrI 1.14, 2.03). The predictive effects and intervals were only significant for diabetes.
Sedentary time is associated with an increased risk of diabetes, cardiovascular disease and cardiovascular and all-cause mortality; the strength of the association is most consistent for diabetes.
Background
Little is known about the role of low physical activity at work (sedentary work or low physical job demand) in the increasing prevalence of obesity of US workers.Methods
This cross-sectional and secondary data analysis included 1,001 male and 1,018 female workers (age range: 32–69) from the National Survey of Midlife Development in the United States (MIDUS) II study (2004–2006). Sedentary work and physical job demand were measured by questionnaire items. Total obesity (based on body mass index) and central obesity (based on waist circumference) were defined using WHO criteria.ResultsAfter controlling for covariates (socio-demographic, psychosocial working conditions, health status, and health behaviors), sedentary work, low physical job demand, or their combination increased the risk for total and central obesity in male workers, particularly when they worked longer than 40 hr per week. Sedentary work marginally increased the risk for total and central obesity in female workers.Conclusions
Low physical activity at work is a significant risk factor for total and central obesity in middle-aged US male workers. Am. J. Ind. Med. 53:1088–1101, 2010. © 2010 Wiley-Liss, Inc.
Investigations using wearable monitors have begun to examine how sedentary time behaviors influence health.
The objective of this study is to demonstrate the use of a measure of sedentary behavior and to validate the activPAL (PAL Technologies Ltd., Glasgow, Scotland) and ActiGraph GT3X (Actigraph, Pensacola, FL) for estimating measures of sedentary behavior: absolute number of breaks and break rate.
Thirteen participants completed two 10-h conditions. During the baseline condition, participants performed normal daily activity, and during the treatment condition, participants were asked to reduce and break up their sedentary time. In each condition, participants wore two ActiGraph GT3X monitors and one activPAL. The ActiGraph was tested using the low-frequency extension filter (AG-LFE) and the normal filter (AG-Norm). For both ActiGraph monitors, two count cut points to estimate sedentary time were examined: 100 and 150 counts per minute. Direct observation served as the criterion measure of total sedentary time, absolute number of breaks from sedentary time, and break rate (number of breaks per sedentary hour (brk·sed-h)).
Break rate was the only metric sensitive to changes in behavior between baseline (5.1 [3.3-6.8] brk·sed-h) and treatment conditions (7.3 [4.7-9.8] brk·sed-h) (mean (95% confidence interval)). The activPAL produced valid estimates of all sedentary behavior measures and was sensitive to changes in break rate between conditions (baseline, 5.1 [2.8-7.1] brk·sed-h; treatment, 8.0 [5.8-10.2] brk·sed-h). In general, the AG-LFE and AG-Norm were not accurate in estimating break rate or the absolute number of breaks and were not sensitive to changes between conditions.
This study demonstrates the use of expressing breaks from sedentary time as a rate per sedentary hour, a metric specifically relevant to free-living behavior, and provides further evidence that the activPAL is a valid tool to measure components of sedentary behavior in free-living environments.
Background: The true causes of the obesity epidemic are not well understood and there are few longitudinal population-based data published examining this issue. The objective of this analysis was to examine trends in occupational physical activity during the past 5 decades and explore how these trends relate to concurrent changes in body weight in the U.S.
Sedentary behaviors predominate modern life, yet we do not fully understand the adverse effects of these behaviors on mortality after considering the benefits of moderate-vigorous physical activity (MVPA).
We tested the hypotheses that higher amounts of overall sitting time and television viewing are positively associated with mortality and described the independent and combined effects of these sedentary behaviors and MVPA on mortality.
In the NIH-AARP Diet and Health Study, we examined 240,819 adults (aged 50-71 y) who did not report any cancer, cardiovascular disease, or respiratory disease at baseline. Mortality was ascertained over 8.5 y.
Sedentary behaviors were positively associated with mortality after adjustment for age, sex, education, smoking, diet, race, and MVPA. Participants who reported the most television viewing (≥7 h compared with <1 h/d) were at greater risk of all-cause (HR: 1.61; 95% CI: 1.47, 1.76), cardiovascular (HR: 1.85; 95% CI: 1.56, 2.20), and cancer (HR: 1.22; 95% CI: 1.06, 1.40) mortality after adjustment for MVPA. Overall sitting was associated with all-cause mortality. Even among adults reporting high levels of MVPA (>7 h/wk), high amounts of television viewing (≥7 h/d) remained associated with increased risk of all-cause (HR: 1.47; 95% CI: 1.20, 1.79) and cardiovascular (HR: 2.00; 95% CI: 1.33, 3.00) mortality compared with those reporting the least television viewing (<1 h/d).
Time spent in sedentary behaviors was positively associated with mortality, and participation in high levels of MVPA did not fully mitigate health risks associated with prolonged time watching television. Adults should be encouraged to reduce time spent in sedentary behaviors, when possible, and to participate in MVPA at recommended levels. The NIH-AARP Diet and Health Study was registered at clinicaltrials.gov as NCT00340015.
This study examined the feasibility of reducing free-living sedentary time (ST) and the convergent validity of various tools to measure ST. Twenty overweight/obese participants wore the activPAL (AP) (criterion measure) and ActiGraph (AG; 100 and 150 count/minute cut-points) for a 7-day baseline period. Next, they received a simple intervention targeting free-living ST reductions (7-day intervention period). ST was measured using two questionnaires following each period. ST significantly decreased from 67% of wear time (baseline period) to 62.7% of wear time (intervention period) according to AP (
n
= 14,
P
<
0.01
). No other measurement tool detected a reduction in ST. The AG measures were more accurate (lower bias) and more precise (smaller confidence intervals) than the questionnaires. Participants reduced ST by ~5%, which is equivalent to a 48_min reduction over a 16-hour waking day. These data describe ST measurement properties from wearable monitors and self-report tools to inform sample-size estimates for future ST interventions.
Sedentary time (too much sitting) increasingly is being recognized as a distinct health risk behavior. This paper reviews the reliability and validity of self-reported and device-based sedentary time measures and provides recommendations for their use in population-based studies. The focus is on instruments that have been used in free-living, population-based research in adults. Data from the 2003-2006 National Health and Nutrition Examination Survey are utilized to compare the descriptive epidemiology of sedentary time that arises from the use of different sedentary time measures. A key recommendation from this review is that, wherever possible, population-based monitoring of sedentary time should incorporate both self-reported measures (to capture important domain- and behavior-specific sedentary time information) and device-based measures (to measure both total sedentary time and patterns of sedentary time accumulation).
With evidence that prolonged sitting has deleterious health consequences, decreasing sedentary time is a potentially important preventive health target. High-quality measures, particularly for use with older adults, who are the most sedentary population group, are needed to evaluate the effect of sedentary behavior interventions. We examined the reliability, validity, and responsiveness to change of a self-report sedentary behavior questionnaire that assessed time spent in behaviors common among older adults: watching television, computer use, reading, socializing, transport and hobbies, and a summary measure (total sedentary time).
In the context of a sedentary behavior intervention, nonworking older adults (n = 48, age = 73 ± 8 yr (mean ± SD)) completed the questionnaire on three occasions during a 2-wk period (7 d between administrations) and wore an accelerometer (ActiGraph model GT1M) for two periods of 6 d. Test-retest reliability (for the individual items and the summary measure) and validity (self-reported total sedentary time compared with accelerometer-derived sedentary time) were assessed during the 1-wk preintervention period, using Spearman (ρ) correlations and 95% confidence intervals (CI). Responsiveness to change after the intervention was assessed using the responsiveness statistic (RS).
Test-retest reliability was excellent for television viewing time (ρ (95% CI) = 0.78 (0.63-0.89)), computer use (ρ (95% CI) = 0.90 (0.83-0.94)), and reading (ρ (95% CI) = 0.77 (0.62-0.86)); acceptable for hobbies (ρ (95% CI) = 0.61 (0.39-0.76)); and poor for socializing and transport (ρ < 0.45). Total sedentary time had acceptable test-retest reliability (ρ (95% CI) = 0.52 (0.27-0.70)) and validity (ρ (95% CI) = 0.30 (0.02-0.54)). Self-report total sedentary time was similarly responsive to change (RS = 0.47) as accelerometer-derived sedentary time (RS = 0.39).
The summary measure of total sedentary time has good repeatability and modest validity and is sufficiently responsive to change suggesting that it is suitable for use in interventions with older adults.
A primary barrier to elucidating the association between sedentary behavior (SB) and health outcomes is the lack of valid monitors to assess SB in a free-living environment. The purpose of this study was to examine the validity of commercially available monitors to assess SB.
Twenty overweight (mean ± SD: body mass index = 33.7 ± 5.7 kg·m(-2)) inactive, office workers age 46.5 ± 10.7 yr were directly observed for two 6-h periods while wearing an activPAL (AP) and an ActiGraph GT3X (AG). During the second observation, participants were instructed to reduce sitting time. We assessed the validity of the commonly used cut point of 100 counts per minute (AG100) and several additional AG cut points for defining SB. We used direct observation (DO) using focal sampling with duration coding to record either sedentary (sitting/lying) or nonsedentary behavior. The accuracy and precision of the monitors and the sensitivity of the monitors to detect reductions in sitting time were assessed using mixed-model repeated-measures analyses.
On average, the AP and the AG100 underestimated sitting time by 2.8% and 4.9%, respectively. The correlation between the AP and DO was R2 = 0.94, and the AG100 and DO sedentary minutes was R2 = 0.39. Only the AP was able to detect reductions in sitting time. The AG 150-counts-per-minute threshold demonstrated the lowest bias (1.8%) of the AG cut points.
The AP was more precise and more sensitive to reductions in sitting time than the AG, and thus, studies designed to assess SB should consider using the AP. When the AG monitor is used, 150 counts per minute may be the most appropriate cut point to define SB.
The aim of this study was to examine the relationship between occupational category and 3 health-related behaviors: participation in leisure-time physical activity, active transport (AT) and occupational sitting in a sample of employed Australian adults.
A random, cross-sectional sample of 592 adults aged 18 to 71 years completed a telephone survey in October/November 2006. Reported occupations were categorized as professional (n = 332, 56.1%), white-collar (n = 181, 30.6%), and blue-collar (n = 79, 13.3%). Relationships between occupational category and AT, sufficient physical activity and occupational sitting were examined using logistic regression.
White-collar employees (OR = 0.36, 95% CI 0.14-0.95) were less likely to engage in AT and more likely to engage in occupational sitting (OR = 3.10, 95% CI 1.63-5.92) when compared with blue-collar workers. Professionals (OR = 3.04, 95% CI 1.94-4.76) were also more likely to engage in occupational sitting compared with blue-collar workers. No relationship was observed between occupational category and engagement in sufficient physical activity.
No association between occupational category and sufficient physical activity levels was observed, although white-collar and professionals were likely to engage in high levels of occupational sitting. Innovative and sustainable strategies are required to reduce occupational sitting to improve health.
Many countries conduct regular national time use surveys, some of which date back as far as the 1960s. Time use surveys potentially provide more detailed and accurate national estimates of the prevalence of sedentary and physical activity behavior than more traditional self-report surveillance systems. In this study, the authors determined the reliability and validity of time use surveys for assessing sedentary and physical activity behavior. In 2006 and 2007, participants (n = 134) were recruited from work sites in the Australian state of New South Wales. Participants completed a 2-day time use diary twice, 7 days apart, and wore an accelerometer. The 2 diaries were compared for test-retest reliability, and comparison with the accelerometer determined concurrent validity. Participants with similar activity patterns during the 2 diary periods showed reliability intraclass correlations of 0.74 and 0.73 for nonoccupational sedentary behavior and moderate/vigorous physical activity, respectively. Comparison of the diary with the accelerometer showed Spearman correlations of 0.57-0.59 and 0.45-0.69 for nonoccupational sedentary behavior and moderate/vigorous physical activity, respectively. Time use surveys appear to be more valid for population surveillance of nonoccupational sedentary behavior and health-enhancing physical activity than more traditional surveillance systems. National time use surveys could be used to retrospectively study nonoccupational sedentary and physical activity behavior over the past 5 decades.
This study aims to review systematically the repeatability and validity of questionnaires used to assess occupational physical activity among healthy adults.
We searched PubMed and Embase using occupational, work-related, job-related, physical activity, motor activity, and questionnaires as keywords. Two reviewers independently performed article selection, data extraction, and quality assessment. The methodological quality and results of the studies were evaluated based on an existing checklist. The level of evidence and repeatability, criterion, and construct validity were rated.
We included 31 papers describing 30 questionnaires in the review. Repeatability was assessed in 22 studies, 11 used appropriate measures to assess 12 questionnaires. Intra-class correlation coefficients and weighted Cohen's kappa ranged between 0.43-0.95. Six studies used appropriate measures to assess criterion validity of 13 questionnaires. One questionnaire, the Tecumseh Self Administered Occupational Physical Activity Questionnaire (TOQ), showed good criterion validity against a physical activity (PA) record. Eighteen studies used appropriate measures to assess the construct validity of 23 questionnaires. Comparison included those against accelerometers, maximal oxygen uptake, questionnaires, and body composition measures. None showed good construct validity.
There is strong evidence for good reliability of four questionnaires. None of the reviewed questionnaires showed good criterion validity compared to objective measures. Compared to PA records, moderate-to-good validity was observed for two questionnaires. Objective measures of occupational PA are needed.
The possible benefit of lifetime physical activity (PA) in reducing prostate cancer incidence and mortality is unclear.
A prospective cohort of 45,887 men aged 45-79 years was followed up from January 1998 to December 2007 for prostate cancer incidence (n=2735) and to December 2006 for its subtypes and for fatal (n=190) prostate cancer.
We observed an inverse association between lifetime (average of age 30 and 50 years, and baseline age) total PA levels and prostate cancer risk. Multivariate-adjusted incidence in the top quartile of lifetime total PA decreased by 16% (95% confidence interval (CI)=2-27%) compared with that in the bottom quartile. We also observed an inverse association between average lifetime work or occupational activity and walking or bicycling duration and prostate cancer risk. Compared with men who mostly sit during their main work or occupation, men who sit half of the time experienced a 20% lower risk (95% CI=7-31%). The rate ratio linearly decreased by 7% (95% CI=1-12%) for total, 8% (95% CI=0-16%) for localised and 12% (95% CI=2-20%) for advanced prostate cancer for every 30 min per day increment of lifetime walking or bicycling in the range of 30 to 120 min per day.
Our results suggest that not sitting for most of the time during work or occupational activity and walking or bicycling more than 30 min per day during adult life is associated with reduced incidence of prostate cancer.
OBJECTIVE
To study the relation between neck pain and work related neck flexion, neck rotation, and sitting.
METHODS
A prospective cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies. Work related physical load was assessed by analysing objectively measured exposure data (video recordings) of neck flexion, neck rotation, and sitting posture. Neck pain was assessed by a questionnaire. Adjustments were made for various physical factors that were related or not related to work, psychosocial factors, and individual characteristics.
RESULTS
A significant positive relation was found between the percentage of the working time in a sitting position and neck pain, implying an increased risk of neck pain for workers who were sitting for more than 95% of the working time (crude relative risk (RR) 2.01, 95% confidence interval (95% CI) 1.04 to 3.88; adjusted RR 2.34, 95% CI 1.05 to 5.21). A trend for a positive relation between neck flexion and neck pain was found, suggesting an increased risk of neck pain for people working with the neck at a minimum of 20° of flexion for more than 70% of the working time (crude RR 2.01, 95% CI 0.98 to 4.11; adjusted RR 1.63, 95% CI 0.70 to 3.82). No clear relation was found between neck rotation and neck pain.
CONCLUSION
Sitting at work for more than 95% of the working time seems to be a risk factor for neck pain and there is a trend for a positive relation between neck flexion and neck pain. No clear relation was found between neck rotation and neck pain.
Background:
The magnitude, consistency, and manner of association between sedentary time and outcomes independent of physical activity remain unclear.
Purpose:
To quantify the association between sedentary time and hospitalizations, all-cause mortality, cardiovascular disease, diabetes, and cancer in adults independent of physical activity.
Data sources:
English-language studies in MEDLINE, PubMed, EMBASE, CINAHL, Cochrane Library, Web of Knowledge, and Google Scholar databases were searched through August 2014 with hand-searching of in-text citations and no publication date limitations.
Study selection:
Studies assessing sedentary behavior in adults, adjusted for physical activity and correlated to at least 1 outcome.
Data extraction:
Two independent reviewers performed data abstraction and quality assessment, and a third reviewer resolved inconsistencies.
Data synthesis:
Forty-seven articles met our eligibility criteria. Meta-analyses were performed on outcomes for cardiovascular disease and diabetes (14 studies), cancer (14 studies), and all-cause mortality (13 studies). Prospective cohort designs were used in all but 3 studies; sedentary times were quantified using self-report in all but 1 study. Significant hazard ratio (HR) associations were found with all-cause mortality (HR, 1.240 [95% CI, 1.090 to 1.410]), cardiovascular disease mortality (HR, 1.179 [CI, 1.106 to 1.257]), cardiovascular disease incidence (HR, 1.143 [CI, 1.002 to 1.729]), cancer mortality (HR, 1.173 [CI, 1.108 to 1.242]), cancer incidence (HR, 1.130 [CI, 1.053 to 1.213]), and type 2 diabetes incidence (HR, 1.910 [CI, 1.642 to 2.222]). Hazard ratios associated with sedentary time and outcomes were generally more pronounced at lower levels of physical activity than at higher levels.
Limitation:
There was marked heterogeneity in research designs and the assessment of sedentary time and physical activity.
Conclusion:
Prolonged sedentary time was independently associated with deleterious health outcomes regardless of physical activity.
Primary funding source:
None.
The purpose of this study was to determine the responsiveness of two motion sensors to detect change in sedentary behaviour (SB) and physical activity (PA) during an occupational intervention to reduce sitting time.
SB and PA were assessed using a hip-worn Actigraph GTX3 (AG) and a thigh-worn activPAL (AP) during three consecutive workdays throughout baseline and intervention periods. Mean scores at baseline and intervention were estimated by hierarchical linear models (HLM) with robust SEs, adjusting for random variance of average scores between participants. Change scores (mean baseline minus mean intervention) were calculated for each device. Response to change was assessed for each device using the standardised response mean.
67 adults (45±11 years; 29.3±7.7 kg/m(2)) wore the acceleration-based motion sensors for 8.3 (SD=1.2) and 8.3 (SD=1.1) h during the baseline and intervention periods, respectively. HLM showed that AP sitting/lying time (-16.5 min, -5%), AP stepping (+7.5 min, 19%), AP steps/day (+838 steps/day, +22%), AP sit-to-stand transitions (+3, +10%), AG SB (-14.6 min, -4%), AG lifestyle moderate-intensity PA (LMPA, +4 min, +15%) and AG MPA (+3 min, 23%) changed significantly between the baseline and the intervention period. Standardised response means for AP sitting/lying time, stepping, steps/day, sit-to-stand transitions and AG SB, LMPA and MPA were above 0.3, indicating a small but similar responsiveness to change.
Responsiveness to change in SB and PA was similar and comparable for the AP and AG, indicating agreement across both measurement devices.
Prolonged sitting is considered detrimental to health, but evidence regarding the independent relationship of total sitting time with all-cause mortality is limited. This study aimed to determine the independent relationship of sitting time with all-cause mortality.
We linked prospective questionnaire data from 222 497 individuals 45 years or older from the 45 and Up Study to mortality data from the New South Wales Registry of Births, Deaths, and Marriages (Australia) from February 1, 2006, through December 31, 2010. Cox proportional hazards models examined all-cause mortality in relation to sitting time, adjusting for potential confounders that included sex, age, education, urban/rural residence, physical activity, body mass index, smoking status, self-rated health, and disability.
During 621 695 person-years of follow-up (mean follow-up, 2.8 years), 5405 deaths were registered. All-cause mortality hazard ratios were 1.02 (95% CI, 0.95-1.09), 1.15 (1.06-1.25), and 1.40 (1.27-1.55) for 4 to less than 8, 8 to less than 11, and 11 or more h/d of sitting, respectively, compared with less than 4 h/d, adjusting for physical activity and other confounders. The population-attributable fraction for sitting was 6.9%. The association between sitting and all-cause mortality appeared consistent across the sexes, age groups, body mass index categories, and physical activity levels and across healthy participants compared with participants with preexisting cardiovascular disease or diabetes mellitus.
Prolonged sitting is a risk factor for all-cause mortality, independent of physical activity. Public health programs should focus on reducing sitting time in addition to increasing physical activity levels.
Sitting time is an emerging health risk, and many working adults spend large amounts of time sitting each day. It is important to have reliable and accurate measurement tools to assess sitting time in different contexts.
To validate the Workforce Sitting Questionnaire (WSQ), an adapted measure of total and domain-specific sitting time based on work and non-workdays for use in working adults.
A convenience sample (N=95, 63.2% women) was recruited from two workplaces and by word-of-mouth in Sydney, Australia. Participants completed the WSQ, which asked about sitting time (1) while travelling to and from places; (2) while at work; (3) while watching TV; (4) while using a computer at home; and (5) while doing other leisure activities on work and non-workdays on two occasions, 7 days apart. Participants also wore an accelerometer for the 7 days between test and retest. They recorded the times they wore the accelerometer, the days they worked and their work times in a logbook. Analyses determined test-retest reliability with intraclass correlation coefficients (ICCs) and assessed criterion validity against accelerometers using Spearman's r and Bland-Altman plots.
Measuring total sitting time based on a workday, non-workday and on average had fair to excellent test-retest reliability (ICC=0.46-0.90) and had sufficient criterion validity against accelerometry in women (r=0.22-0.46) and men (r=0.18-0.29). Measuring domain-specific sitting at work on a workday was also reliable (ICC=0.63) and valid (r=0.45).
The WSQ has acceptable measurement properties for measuring sitting time at work on a workday and for assessing total sitting time based on work and non-workdays. This questionnaire would be suitable for use in research investigating the relationships between sitting time and health in working populations.
To systematically review and provide an informative synthesis of findings from longitudinal studies published since 1996 reporting on relationships between self-reported sedentary behavior and device-based measures of sedentary time with health-related outcomes in adults.
Studies published between 1996 and January 2011 were identified by examining existing literature reviews and by systematic searches in Web of Science, MEDLINE, PubMed, and PsycINFO. English-written articles were selected according to study design, targeted behavior, and health outcome.
Forty-eight articles met the inclusion criteria; of these, 46 incorporated self-reported measures including total sitting time; TV viewing time only; TV viewing time and other screen-time behaviors; and TV viewing time plus other sedentary behaviors. Findings indicate a consistent relationship of self-reported sedentary behavior with mortality and with weight gain from childhood to the adult years. However, findings were mixed for associations with disease incidence, weight gain during adulthood, and cardiometabolic risk. Of the three studies that used device-based measures of sedentary time, one showed that markers of obesity predicted sedentary time, whereas inconclusive findings have been observed for markers of insulin resistance.
There is a growing body of evidence that sedentary behavior may be a distinct risk factor, independent of physical activity, for multiple adverse health outcomes in adults. Prospective studies using device-based measures are required to provide a clearer understanding of the impact of sedentary time on health outcomes.
Nowadays, people spend a substantial amount of time per day on sedentary behaviors and it is likely that the time spent sedentary will continue to rise. To date, there is no review of prospective studies that systematically examined the relationship between diverse sedentary behaviors and various health outcomes among adults.
This review aimed to systematically review the literature as to the relationship between sedentary behaviors and health outcomes considering the methodologic quality of the studies.
In February 2010, a search for prospective studies was performed in diverse electronic databases. After inclusion, in 2010, the methodologic quality of each study was assessed. A best-evidence synthesis was applied to draw conclusions.
19 studies were included, of which 14 were of high methodologic quality. Based on inconsistency in findings among the studies and lack of high-quality prospective studies, insufficient evidence was concluded for body weight-related measures, CVD risk, and endometrial cancer. Further, moderate evidence for a positive relationship between the time spent sitting and the risk for type 2 diabetes was concluded. Based on three high-quality studies, there was no evidence for a relationship between sedentary behavior and mortality from cancer, but strong evidence for all-cause and CVD mortality.
Given the trend toward increased time in sedentary behaviors, additional prospective studies of high methodologic quality are recommended to clarify the causal relationships between sedentary behavior and health outcomes. Meanwhile, evidence to date suggests that interventions aimed at reducing sedentary behavior are needed.
Sedentary behavior is related to obesity, but measures of sedentary behaviors are lacking for adults. The purpose of this study was to examine the reliability and validity of the Sedentary Behavior Questionnaire (SBQ) among overweight adults.
Participants were 49 adults for the 2 week test-retest reliability study (67% female, 53% white, mean age = 20) and 401 overweight women (mean age = 41, 61% white) and 441 overweight men (mean age = 44, 81% white) for the validity study. The SBQ consisted of reports of time spent in 9 sedentary behaviors. Outcomes for validity included accelerometer measured inactivity, sitting time (International Physical Activity Questionnaire), and BMI. Intraclass correlation coefficients (ICCs) assessed reliability and partial correlations assessed validity.
ICCs were acceptable for all items and the total scale (range = .51-.93). For men, there were significant relationships of SBQ items with IPAQ sitting time and BMI. For women, there were relationships between the SBQ and accelerometer inactivity minutes, IPAQ sitting time, and BMI.
The SBQ has acceptable measurement properties for use among overweight adults. Specific measures of sedentary behavior should be included in studies and population surveillance.
Emerging evidence suggests that sedentary behavior (i.e., time spent sitting) may be negatively associated with health. The aim of this study was to systematically review the evidence on associations between occupational sitting and health risks.
Studies were identified in March-April 2009 by literature searches in PubMed, PsycINFO, CENTRAL, CINAHL, EMBASE, and PEDro, with subsequent related-article searches in PubMed and citation searches in Web of Science. Identified studies were categorized by health outcome. Two independent reviewers assessed methodologic quality using a 15-item quality rating list (score range 0-15 points, higher score indicating better quality). Data on study design, study population, measures of occupational sitting, health risks, analyses, and results were extracted.
43 papers met the inclusion criteria (21% cross-sectional, 14% case-control, 65% prospective); they examined the associations between occupational sitting and BMI (n=12); cancer (n=17); cardiovascular disease (CVD, n=8); diabetes mellitus (DM, n=4); and mortality (n=6). The median study-quality score was 12 points. Half the cross-sectional studies showed a positive association between occupational sitting and BMI, but prospective studies failed to confirm a causal relationship. There was some case-control evidence for a positive association between occupational sitting and cancer; however, this was generally not supported by prospective studies. The majority of prospective studies found that occupational sitting was associated with a higher risk of DM and mortality.
Limited evidence was found to support a positive relationship between occupational sitting and health risks. The heterogeneity of study designs, measures, and findings makes it difficult to draw definitive conclusions at this time.
To systematically review the effectiveness of workplace interventions for reducing sitting.
Studies published up to April 2009 were identified by literature searches in multiple databases. Studies were included if they were interventions to increase energy expenditure (increase physical activity or decrease sitting); were conducted in a workplace setting; and specifically measured sitting as a primary or secondary outcome. Two independent reviewers assessed methodological quality of the included studies, and data on study design, sample, measures of sitting, intervention and results were extracted.
Six studies met the inclusion criteria (five randomised trials and one pre-post study). The primary aim of all six was to increase physical activity; all had reducing sitting as a secondary aim. All used self-report measures of sitting; one specifically assessed occupational sitting time; the others used measures of general sitting. No studies showed that sitting decreased significantly in the intervention group, compared with a control or comparison group.
Currently, there is a dearth of evidence on the effectiveness of workplace interventions for reducing sitting. In light of the growing body of evidence that prolonged sitting is negatively associated with health, this highlights a gap in the scientific literature that needs to be addressed.
To examine the convergent validity of the ActiGraph and activPAL accelerometers with the Bouchard Activity Record (BAR) in adults. Sedentary behavior and walking were evaluated in all instruments; standing and moderate-to-vigorous physical activity (MVPA) was evaluated only in those that detected such variables.
Thirty-two participants wore the accelerometers and completed the BAR concurrently for 1 d. Descriptive statistics and delta values were reported for all instruments. Summary time spent in sedentary behavior and walking was compared between all instruments using repeated-measures ANOVA. Dependent t-tests were used to analyze summary time in 1) standing between activPAL and BAR and 2) MVPA between ActiGraph and BAR. Bland-Altman plots were interpreted for systematic bias. On a detailed level, concurrent time interval data were compared using mean percent agreement and κ statistics.
There was a significant difference found in summary time spent in sedentary behavior apparent between ActiGraph and activPAL as well as between ActiGraph and BAR. There was also a significant difference detected in time spent in walking, apparent between ActiGraph and activPAL, and between ActiGraph and BAR. In the time interval analysis, mean percent agreement ranged from 54.0% (for walking detected by ActiGraph and activPAL) to 86.7% (for MVPA by ActiGraph and BAR). κ values ranged from 0.25 (for walking by ActiGraph and activPAL) to 0.70 (for sedentary behavior between activPAL and BAR). Differences were also found in standing and MVPA.
The activPAL and BAR showed convergence on both summary and concurrent time interval levels in both sedentary behavior and walking. The comparative discordance between activPAL and BAR with ActiGraph was likely a function of different approaches used to distinguish sedentary behavior from walking.
Many questionnaires have been developed to measure physical activity (PA), but an overview of the measurement properties of PA questionnaires is lacking. A summary of this information is useful for choosing the best questionnaire available. Therefore, the objective of this study was to evaluate and compare measurement properties of self-administered questionnaires assessing PA in adults. We searched MEDLINE, EMBASE and SportDiscus, using 'exercise', 'physical activity', 'motor activity' and 'questionnaire' as keywords. We included studies that evaluated the measurement properties of self-report questionnaires assessing PA. Article selection, data extraction and quality assessment were performed by two independent reviewers. The quality and results of the studies were evaluated using the Quality Assessment of Physical Activity Questionnaires (QAPAQ) checklist. Construct validity, reliability and responsiveness were rated as positive, negative or indeterminate, depending on the methods and results. We included 85 (versions of) questionnaires. Overall, the quality of the studies assessing measurement properties of PA questionnaires was rather poor. Information on content validity was mostly lacking. Construct validity was assessed in 76 of the questionnaires, mostly by correlations with accelerometer data, maximal oxygen uptake or activity diaries. Fifty-one questionnaires were tested for reliability. Only a few questionnaires had sufficient construct validity and reliability, but these need to be further validated. Responsiveness was studied for only two questionnaires and was poor. There is a clear lack of standardization of PA questionnaires, resulting in many variations of questionnaires. No questionnaire or type of questionnaire for assessing PA was superior and therefore could not be strongly recommended above others. In the future, more attention should be paid to the methodology of studies assessing measurement properties of PA questionnaires and the quality of reporting.
Background
In 2001, the Behavioral Risk Factor Surveillance System (BRFSS) included a new occupational physical activity (PA) question. This article evaluates the reliability of this survey question.
Methods
Forty-six subjects were followed for 3 wk, answered 3 PA surveys by telephone, and completed daily PA logs for 1 wk. Kappa statistics determined the reliability of occupational activities (sitting/standing, walking, and heavy lifting). A descriptive analysis compared the time in specific occupational activities.
Results
Eighty percent of the respondents reported “mostly sitting or standing” at work; and test–retest reliability was moderate ( k = 0.40 to 0.45). The occupationally inactive sat/stood for 85% (mean hours = 5.6) of the workday, whereas the occupationally active sat/stood for 53% (mean hours = 3.9) of the workday.
Conclusions
The BRFSS occupational activity question has moderate reliability, distinguishes between occupationally active and inactive persons, and can be used in surveillance systems to estimate adult occupational PA.
Although independent relationships between sitting behaviors (mainly television viewing) and health outcomes have been reported, few studies have examined the measurement properties of self-report sitting questions. This study assessed gender-specific test-retest reliability and validity of a questionnaire that assessed time spent sitting on weekdays and weekend days: 1) traveling to and from places, 2) at work, 3) watching television, 4) using a computer at home, and 5) for leisure, not including television.
Test-retest reliability of domain-specific sitting time (min x d(-1)) on weekdays and weekend days was assessed using data collected on two occasions (median = 11 d apart). Validity of domain-specific self-reported sitting time on weekdays and weekend days was assessed against log data and sedentary accelerometer data.
Complete repeat questionnaire and log data were obtained from 157 women (aged 51-59 yr) and 96 men (aged 45-63 yr). Reliability coefficients were high for weekday sitting time at work, watching television, and using a computer at home (r = 0.84-0.78) but lower for weekend days across all domains (r = 0.23-0.74). Validity coefficients were highest for weekday sitting time at work and using a computer at home (r = 0.69-0.74). With the exception of computer use and watching television for women, validity of the weekend-day sitting time items was low.
This study confirms the importance of measuring domain- and day-specific sitting time. The measurement properties of questions that assess structured domain-specific and weekday sitting time were acceptable and may be used in future studies that aim to elucidate associations between domain-specific sitting and health outcomes.
The evidence concerning the possible association between physical activity and the risk of prostate cancer is inconsistent and additional data are needed. We examined the association between risk of prostate cancer and physical activity at work and in leisure time in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. In our study, including 127,923 men aged 20-97 years from 8 European countries, 2,458 cases of prostate cancer were identified during 8.5 years of followup. Using the Cox proportional hazards model, we investigated the associations between prostate cancer incidence rate and occupational activity and leisure time activity in terms of participation in sports, cycling, walking and gardening; a metabolic equivalent (MET) score based on weekly time spent on the 4 activities; and a physical activity index. MET hours per week of leisure time activity, higher score in the physical activity index, participation in any of the 4 leisure time activities, and the number of leisure time activities in which the participants were active were not associated with prostate cancer incidence. However, higher level of occupational physical activity was associated with lower risk of advanced stage prostate cancer (p(trend) = 0.024). In conclusion, our data support the hypothesis of an inverse association between advanced prostate cancer risk and occupational physical activity, but we found no support for an association between prostate cancer risk and leisure time physical activity.