What are the working mechanisms of a web-based workplace sitting intervention targeting psychosocial factors and action planning?

Background: Office workers demonstrate high levels of sitting on workdays. As sitting is positively associated with adverse health risks in adults, a theory-driven web-based computer-tailored intervention to influence workplace sitting, named 'Start to Stand,' was developed. The intervention was found to be effective in reducing self-reported workplace sitting among Flemish employees. The aim of this study was to investigate through which mechanisms the web-based computer-tailored intervention influenced self-reported workplace sitting. Methods: Employees (n = 155) participated in a clustered randomised controlled trial and reported socio-demographics (age, gender, education), work-related (hours at work, employment duration), health-related (weight and height, workplace sitting and physical activity) and psychosocial (knowledge, attitudes, self-efficacy, social support, intention regarding (changing) sitting behaviours) variables at baseline and 1-month follow-up. The product-of-coefficients test of MacKinnon based on multiple linear regression analyses was conducted to examine the mediating role of five psychosocial factors (knowledge, attitudes, self-efficacy, social support, intention). The influence of one self-regulation skill (action planning) in the association between the intervention and self-reported workplace sitting time was investigated via moderation analyses. Results: The intervention had a positive influence on knowledge (p = 0.040), but none of the psychosocial variables did mediate the intervention effect on self-reported workplace sitting. Action planning was found to be a significant moderator (p < 0.001) as the decrease in self-reported workplace sitting only occurred in the group completing an action plan. Conclusions: Future interventions aimed at reducing employees' workplace sitting are suggested to focus on self-regulatory skills and promote action planning when using web-based computer-tailored advice. Trial registration: Clinicaltrials.gov NCT02672215; (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT02672215). © 2017 The Author(s)

From evidence-based research to practice-based evidence: Effort, cost and uptake of disseminating a web-based computer-tailored workplace sitting intervention through a health promotion organisation

Prolonged sitting may result in adverse health outcomes; therefore, we developed and examined a web-based computer-tailored workplace sitting intervention. As this intervention has shown to be effective, the next stage was to conduct a dissemination study. As such, this study reports on the dissemination efforts of a health promotion organisation, associated costs, reach achieved, and attributes of the website users

The effectiveness of a web-based computer-tailored intervention on workplace sitting: A randomized controlled trial

Effective interventions to influence workplace sitting are needed, as office-based workers demonstrate high levels of continued sitting, and sitting too much is associated with adverse health effects. Therefore, we developed a theory-driven, Web-based, interactive, computer-tailored intervention aimed at reducing and interrupting sitting at work. Objective: The objective of our study was to investigate the effects of this intervention on objectively measured sitting time, standing time, and breaks from sitting, as well as self-reported context-specific sitting among Flemish employees in a field-based approach. Methods: Employees (n=213) participated in a 3-group randomized controlled trial that assessed outcomes at baseline, 1-month follow-up, and 3-month follow-up through self-reports. A subsample (n=122) were willing to wear an activity monitor (activPAL) from Monday to Friday. The tailored group received an automated Web-based, computer-tailored intervention including personalized feedback and tips on how to reduce or interrupt workplace sitting. The generic group received an automated Web-based generic advice with tips. The control group was a wait-list control condition, initially receiving no intervention. Intervention effects were tested with repeated-measures multivariate analysis of variance. Results: The tailored intervention was successful in decreasing self-reported total workday sitting (time × group: P<.001), sitting at work (time × group: P<.001), and leisure time sitting (time × group: P=.03), and in increasing objectively measured breaks at work (time × group: P=.07); this was not the case in the other conditions. The changes in self-reported total nonworkday sitting, sitting during transport, television viewing, and personal computer use, objectively measured total sitting time, and sitting and standing time at work did not differ between conditions. Conclusions: Our results point out the significance of computer tailoring for sedentary behavior and its potential use in public health promotion, as the effects of the tailored condition were superior to the generic and control conditions

The effectiveness of a web-based computer-tailored intervention on workplace sitting: A randomized controlled trial

Effective interventions to influence workplace sitting are needed, as office-based workers demonstrate high levels of continued sitting, and sitting too much is associated with adverse health effects. Therefore, we developed a theory-driven, Web-based, interactive, computer-tailored intervention aimed at reducing and interrupting sitting at work. Objective: The objective of our study was to investigate the effects of this intervention on objectively measured sitting time, standing time, and breaks from sitting, as well as self-reported context-specific sitting among Flemish employees in a field-based approach. Methods: Employees (n=213) participated in a 3-group randomized controlled trial that assessed outcomes at baseline, 1-month follow-up, and 3-month follow-up through self-reports. A subsample (n=122) were willing to wear an activity monitor (activPAL) from Monday to Friday. The tailored group received an automated Web-based, computer-tailored intervention including personalized feedback and tips on how to reduce or interrupt workplace sitting. The generic group received an automated Web-based generic advice with tips. The control group was a wait-list control condition, initially receiving no intervention. Intervention effects were tested with repeated-measures multivariate analysis of variance. Results: The tailored intervention was successful in decreasing self-reported total workday sitting (time × group: P<.001), sitting at work (time × group: P<.001), and leisure time sitting (time × group: P=.03), and in increasing objectively measured breaks at work (time × group: P=.07); this was not the case in the other conditions. The changes in self-reported total nonworkday sitting, sitting during transport, television viewing, and personal computer use, objectively measured total sitting time, and sitting and standing time at work did not differ between conditions. Conclusions: Our results point out the significance of computer tailoring for sedentary behavior and its potential use in public health promotion, as the effects of the tailored condition were superior to the generic and control conditions

Theory-driven, web-based, computer-tailored advice to reduce and interrupt sitting at work : development, feasibility and acceptability testing among employees

Background: Because of the adverse health effects in adults, interventions to influence workplace sitting, a large contributor to overall daily sedentary time, are needed. Computer-tailored interventions have demonstrated good outcomes in other health behaviours, though few have targeted sitting time at work. Therefore, the present aims were to (1) describe the development of a theory-driven, web-based, computer-tailored advice to influence sitting at work, (2) report on the feasibility of reaching employees, and (3) report on the acceptability of the advice. Methods: Employees from a public city service (n = 179) were invited by e-mail to participate. Employees interested to request the advice (n = 112) were sent the website link, a personal login and password. The online advice was based on different aspects of the Theory of Planned Behaviour, Self-Determination Theory and Self-Regulation Theory. Logistic regressions were conducted to compare characteristics (gender, age, education, employment status, amount of sitting and psychosocial correlates of workplace sitting) of employees requesting the advice (n = 90, 80.4 %) with those who did not. Two weeks after visiting the website, 47 employees (52.2 %) completed an online acceptability questionnaire. Results: Those with a high education were more likely to request the advice than those with a low education (OR = 2.4, CI = 1.0-5.8), and those with a part-time job were more likely to request the advice compared to full-time employees (OR = 2.9, CI = 1.2-7.1). The majority found the advice interesting (n = 36/47, 76.6 %), relevant (n = 33/47, 70.2 %) and motivating (n = 29/47, 61.7 %). Fewer employees believed the advice was practicable (n = 15/47, 31.9 %). After completing the advice, 58.0 % (n = 25/43) reported to have started interrupting their sitting and 32.6 % (n = 17/43) additionally intended to do so; 14.0 % (n = 6/43) reported to have reduced their sitting and another 51.2 % (n = 22/43) intended to do so. Discussion: More efforts are needed to reach lower educated and full-time workers. Further research should examinethe effects of this intervention in a rigorous randomised controlled trial. Conclusions: It is feasible to reach employees with this tool. Most of the employees who requested the advice found it acceptable and reported they changed their behaviour or intended to change it. Interrupting sitting appeared more achievable than reducing workplace sitting

From evidence-based research to practice-based evidence: Disseminating a web-based computer-tailored workplace sitting intervention through a health promotion organisation

Prolonged sitting has been linked to adverse health outcomes; therefore, we developed and examined a web-based, computer-tailored workplace sitting intervention. As we had previously shown good effectiveness, the next stage was to conduct a dissemination study. This study reports on the dissemination efforts of a health promotion organisation, associated costs, reach achieved, and attributes of the website users. The organisation systematically registered all the time and resources invested to promote the intervention. Website usage statistics (reach) and descriptive statistics (website users’ attributes) were also assessed. Online strategies (promotion on their homepage; sending e-mails, newsletters, Twitter, Facebook and LinkedIn posts to professional partners) were the main dissemination methods. The total time investment was 25.6 h, which cost approximately 845 EUR in salaries. After sixteen months, 1599 adults had visited the website and 1500 (93.8%) completed the survey to receive personalized sitting advice. This sample was 38.3 ± 11.0 years, mainly female (76.9%), college/university educated (89.0%), highly sedentary (88.5% sat >8 h/day) and intending to change (93.0%) their sitting. Given the small time and money investment, these outcomes are positive and indicate the potential for wide-scale dissemination. However, more efforts are needed to reach men, non-college/university educated employees, and those not intending behavioural change. © 2018 by the authors. Licensee MDPI, Basel, Switzerland

From evidence-based research to practice-based evidence: Disseminating a web-based computer-tailored workplace sitting intervention through a health promotion organisation

Prolonged sitting has been linked to adverse health outcomes; therefore, we developed and examined a web-based, computer-tailored workplace sitting intervention. As we had previously shown good effectiveness, the next stage was to conduct a dissemination study. This study reports on the dissemination efforts of a health promotion organisation, associated costs, reach achieved, and attributes of the website users. The organisation systematically registered all the time and resources invested to promote the intervention. Website usage statistics (reach) and descriptive statistics (website users’ attributes) were also assessed. Online strategies (promotion on their homepage; sending e-mails, newsletters, Twitter, Facebook and LinkedIn posts to professional partners) were the main dissemination methods. The total time investment was 25.6 h, which cost approximately 845 EUR in salaries. After sixteen months, 1599 adults had visited the website and 1500 (93.8%) completed the survey to receive personalized sitting advice. This sample was 38.3 ± 11.0 years, mainly female (76.9%), college/university educated (89.0%), highly sedentary (88.5% sat >8 h/day) and intending to change (93.0%) their sitting. Given the small time and money investment, these outcomes are positive and indicate the potential for wide-scale dissemination. However, more efforts are needed to reach men, non-college/university educated employees, and those not intending behavioural change. © 2018 by the authors. Licensee MDPI, Basel, Switzerland

Web-based, computer-tailored, pedometer-based physical activity advice: Development, dissemination through general practice, acceptability, and preliminary efficacy in a randomized controlled trial

Background: Computer tailoring is a relatively innovative and promising physical activity intervention approach. However, few computer-tailored physical activity interventions in adults have provided feedback based on pedometer use. Objectives: To (1) describe the development of a Web-based, pedometer-based, computer-tailored step advice intervention, (2) report on the dissemination of this tool through general practice, (3) report on its perceived acceptability, and (4) evaluate the preliminary efficacy of this tool in comparison with a standard intervention

Who uses action planning in a web-based computer-tailored intervention to reduce workplace sitting and what do action plans look like? Analyses of the start to stand intervention among Flemish employees

Background: Action planning plays an important role in many web-based behaviour change interventions. As such, it is important to identify who engages in action planning and what action plans look like. This study examines (1) attributes of users creating an action plan and (2) the content of action plans made during a web-based intervention to reduce workplace sitting. Methods: Users answered “what” (short standing breaks and/or longer periods of standing), “when” (working hours, work breaks, commuting), “where” (workplace, transport mode), and “how” (frequency, duration, implementation intentions) questions. MANOVA and chi-squared tests were conducted to compare those creating an action plan with those who did not. Descriptive statistics were used to examine the content of the action plans. Results: Those creating an action plan (n = 236/1,701) were significantly older, more sedentary at work, and more aware of health risks related to excessive sitting compared to those not planning (n = 1,465). The majority planned standing breaks (n = 212) every 30 minutes, and periods of standing (n = 173) for 1 to 2 hours. Conclusions: Future interventions should promote action planning more, especially among younger employees and those with less health-related knowledge about sitting. Action plans were compatible with current sitting messages used in health promotion. © 2019 The International Association of Applied Psycholog

Web-based, computer-tailored, pedometer-based physical activity advice: Development, dissemination through general practice, acceptability, and preliminary efficacy in a randomized controlled trial

Background: Computer tailoring is a relatively innovative and promising physical activity intervention approach. However, few computer-tailored physical activity interventions in adults have provided feedback based on pedometer use. Objectives: To (1) describe the development of a Web-based, pedometer-based, computer-tailored step advice intervention, (2) report on the dissemination of this tool through general practice, (3) report on its perceived acceptability, and (4) evaluate the preliminary efficacy of this tool in comparison with a standard intervention