Understanding desk-based employees\u27 and managers\u27 workplace sitting and sitting-breaks

This thesis examined the social ecological correlates of desk-based workers sedentary time and sitting-breaks

Reliability and validity of self-reported sitting and breaks from sitting in the workplace

Objectives Prolonged sitting is a health risk factor which is ubiquitous to the workplace, and breaking up prolonged sitting is widely recommended. This study evaluated the test–retest reliability and concurrent validity of a self-report measure of duration of sitting and breaks from sitting in the workplace. Design Cross-sectional study. Methods Fifty-nine workers who reported spending most of their work time sitting wore an activPAL inclinometer and the ActiGraph accelerometer for eight consecutive days, and completed single-item measures of duration of sitting (min/work hour) and breaks from sitting (frequency/per work hour), twice, seven days apart. Results Participants reported sitting at work for a median of 420 min/day (Interquartile Range = 360–450 min/day) and taking one break (Interquartile Range = 1.0–2.0) from sitting per work hour. For reported duration of workplace sitting, test–retest reliability was adequate (Intra-Class Correlations = 0.78, 95% Confidence Intervals [CI] = 0.65, 0.86), and concurrent validity fair against the activPAL (Spearman’s Rho = 0.24, CI-1.0,0.47) and the ActiGraph (Rho = 0.39, CI = 0.15, 0.68). For reported breaks from sitting (frequency/per work hour), test–retest reliability was adequate (Intra-Class Correlations = 0.65, CI = 0.48, 0.78) and concurrent validity fair against the activPAL (Spearman’s Rho = 0.39, CI = 0.25, 0.74) and the ActiGraph (Spearman’s Rho = 0.30, CI = 0.15, 0.69). Self-reported duration of sitting was biased toward over-reporting compared to the activPAL (median = 45.4 min) and under-reporting compared to the ActiGraph (median = 21.7 min). Conclusions This study found adequate reliability and fair validity for self-reported duration of sitting (min/work day) and breaks from sitting (frequency/per work hour). Further validity research is needed using the inclinometer

The impact of height-adjustable desks and classroom prompts on classroom sitting time, social, and motivational factors among adolescents

Purpose This quasi-experimental study examined the impact of height-adjustable desks in combination with prompts to break up prolonged sitting time during class time and identified social and motivational factors associated with breaking up sitting time among adolescents. Teachers’ perceptions of strategies were also examined. Methods Over 17 weeks, 1 classroom in a government secondary school in Melbourne, Australia, was equipped with 27 height-adjustable desks and prompts (posters and desk stickers) to break up classroom sitting time. Teachers received professional development in the use of the desks and prompts. One group of adolescents (n = 55) had 2–5 lessons/week using the height-adjustable desks in an intervention classroom, and a comparison group matched by year level and subject (n = 50) was taught in traditional “seated” classrooms. Adolescents wore an activPAL monitor at baseline (T0), 4 weeks (T1), and 17 weeks (T2) and completed a survey at T0 and T2. Six teachers participated in interviews at T2. Effect sizes were calculated (d). Results Linear mixed models found that, compared to the traditional “seated” classrooms, the adolescents in the intervention classroom had significantly lower sitting time (T1: –9.7 min/lesson, d = –0.96; T2: –6.7 min/lesson, d = –0.70) and time spent in sitting bouts >15 min (T2: –11.2 min/lesson, d = –0.62), and had significantly higher standing time (T1: 7.3 min/lesson, d = 0.84; T2: 5.8 min/lesson, d = 0.91), number of breaks from sitting (T1: 1.3 breaks/lesson, d = 0.49; T2: 1.8 breaks/lesson, d = 0.67), and stepping time (T1: 2.5 min/lesson, d = 0.66). Intervention classroom adolescents reported greater habit strength (d = 0.58), self-efficacy for breaking up sitting time (d = 0.75), and indicated that having a teacher/classmate remind them to stand as helpful (d = 0.50). Conclusion This intervention shows promise for targeting sitting behaviors in the classroom and indicates that incorporating social and motivational strategies may further enhance outcomes

Impact of an 8-month trial using height-adjustable desks on children\u27s classroom sitting patterns and markers of cardio-metabolic and musculoskeletal health

During school hours, children can sit for prolonged and unbroken periods of time. This study investigated the impact of an 8-month classroom-based intervention focusing on reducing and breaking-up sitting time on children\u27s cardio-metabolic risk factors (i.e., body mass index, waist circumference, blood pressure) and perceptions of musculoskeletal discomfort. Two Year-6 classes (24 students per class) in one primary school were assigned to either an intervention or control classroom. The intervention classroom was equipped with height-adjustable desks and the teacher was instructed in the delivery of pedagogical strategies to reduce and break-up sitting in class. The control classroom followed standard practice using traditional furniture. At baseline, and after 8-months, time spent sitting, standing, stepping, and sitting-bouts (occasions of continuous sitting) as well as the frequency of sit-to-stand transitions were obtained from activPAL inclinometers and the time spent in light-intensity physical activity was obtained from ActiGraph accelerometers. Demographics and musculoskeletal characteristics were obtained from a self-report survey. Hierarchical linear mixed models found that during class-time, children\u27s overall time spent sitting in long bouts (>10 min) were lower and the number of sit-to-stand transitions were higher in the intervention group compared to the control group, while no changes were observed for musculoskeletal pain/discomfort. No significant intervention effects were found for the anthropometrics measures and blood pressure. Height-adjustable desks and pedagogical strategies to reduce/break-up sitting can positively modify classroom sitting patterns in children. Longer interventions, larger and varied sample size may be needed to show health impacts; however, these desks did not increase musculoskeletal pain/discomfort

Problem-solving therapy for adults with diabetic retinopathy and diabetes-specific distress: a pilot randomized controlled trial

OBJECTIVE: To provide preliminary evidence for the impact of problem-solving therapy for diabetes (PST-D) in adults with diabetic retinopathy (DR) and diabetes distress. RESEARCH DESIGN AND METHODS: In a pilot randomized controlled trial, 40 participants with DR and diabetes distress were allocated to the PST-D or control groups. Diabetes distress (DDS), depressive symptoms (PHQ-9), self-care activities (SDSCA), and HbA1c were assessed at baseline, and 3 and 6-month follow-ups. RESULTS: At the 6-month follow-up, the PST-D group showed significant improvements relative to the control group, in \u27regimen-related distress\u27 (PST-D: -1.3&plusmn;1.4; control: -0.4&plusmn;1.1), depressive symptoms (PST-D: -4.3&plusmn;6.1; control: -0.3&plusmn;4.6), and HbA1c (PST-D: -1.2%&plusmn;1.01; control: 0.2%&plusmn;1.2%) (all p&lt;0.05). In multiple regression analysis, adjusting for baseline values and sociodemographic factors, PST-D was associated with significant improvement in \u27regimen-related distress\u27, depressive symptoms, and HbA1c at the 6-month follow-up (p&lt;0.05). CONCLUSIONS: PST-D is a promising intervention for improving psychological outcomes and glycemic control. A fully powered study is required to confirm these findings and examine mechanisms of change in HbA1c.<br /

The SOS-framework (Systems of Sedentary behaviours): an international transdisciplinary consensus framework for the study of determinants, research priorities and policy on sedentary behaviour across the life course: a DEDIPAC-study.

BACKGROUND: Ecological models are currently the most used approaches to classify and conceptualise determinants of sedentary behaviour, but these approaches are limited in their ability to capture the complexity of and interplay between determinants. The aim of the project described here was to develop a transdisciplinary dynamic framework, grounded in a system-based approach, for research on determinants of sedentary behaviour across the life span and intervention and policy planning and evaluation. METHODS: A comprehensive concept mapping approach was used to develop the Systems Of Sedentary behaviours (SOS) framework, involving four main phases: (1) preparation, (2) generation of statements, (3) structuring (sorting and ranking), and (4) analysis and interpretation. The first two phases were undertaken between December 2013 and February 2015 by the DEDIPAC KH team (DEterminants of DIet and Physical Activity Knowledge Hub). The last two phases were completed during a two-day consensus meeting in June 2015. RESULTS: During the first phase, 550 factors regarding sedentary behaviour were listed across three age groups (i.e., youths, adults and older adults), which were reduced to a final list of 190 life course factors in phase 2 used during the consensus meeting. In total, 69 international delegates, seven invited experts and one concept mapping consultant attended the consensus meeting. The final framework obtained during that meeting consisted of six clusters of determinants: Physical Health and Wellbeing (71% consensus), Social and Cultural Context (59% consensus), Built and Natural Environment (65% consensus), Psychology and Behaviour (80% consensus), Politics and Economics (78% consensus), and Institutional and Home Settings (78% consensus). Conducting studies on Institutional Settings was ranked as the first research priority. The view that this framework captures a system-based map of determinants of sedentary behaviour was expressed by 89% of the participants. CONCLUSION: Through an international transdisciplinary consensus process, the SOS framework was developed for the determinants of sedentary behaviour through the life course. Investigating the influence of Institutional and Home Settings was deemed to be the most important area of research to focus on at present and potentially the most modifiable. The SOS framework can be used as an important tool to prioritise future research and to develop policies to reduce sedentary time

The impact of height-adjustable desks and prompts to break-up classroom sitting on adolescents' energy expenditure, adiposity markers and perceived musculoskeletal discomfort.

Adolescents spend large amounts of time sitting at school. Little is known about the impact of reducing and breaking-up prolonged sitting during school lessons on adolescents' health. This study aimed to investigate the impact of an intervention to reduce classroom sitting time on adolescents' energy expenditure (EE; kcal/lesson), body mass index (BMI), waist circumference (WC), and musculoskeletal discomfort. A secondary school classroom was equipped with height-adjustable desks, posters promoting the health benefits of and strategies for breaking-up sitting time, and desk stickers reminding students to periodically stand up. Classroom teachers participated in a professional development session. Using a quasi-experimental design, differences between 49 participants who utilised the intervention classroom 2-5 times/week and a comparison group (39 adolescents, matched by year level and subject) who used traditional classrooms, were examined. EE, BMI and WC were objectively measured and musculoskeletal discomfort was self-reported at baseline, 4-weeks, and 17-weeks. Hierarchical linear and multilevel logistic regression-mixed models were used to examine intervention effects, adjusting for baseline values, sex and age. EE was significantly higher at 4-weeks and 17-weeks (29.4 and 37.7 kcal/lesson, respectively), BMI was higher at 4-weeks (0.34 kg/m2), and WC was lower at 4-weeks and 17-weeks (-3.53 and -2.64 cm, respectively) in the intervention compared to the comparison group. No intervention effect was found for musculoskeletal discomfort. Findings provide preliminary indications that these strategies may benefit health among adolescents in the short term. However, extended longer-duration trials are needed to determine longer-term health effects

Standing classrooms : research and lessons learned from around the world

Children spend between 50 and 70&nbsp;% of their time sitting while at school. Independent of physical activity levels, prolonged sitting is associated with poor health outcomes in adulthood. While there is mixed evidence of health associations among children and adolescents, public health guidelines in the USA, UK, Australia and Canada now recommend young people should break up long periods of sitting as frequently as possible. A potentially effective approach for reducing and breaking up sitting throughout the day is changing the classroom environment. This paper presents an overview of a relatively new area of research designed to reduce youth sitting time while at school by changing the classroom environment (n&nbsp;=&nbsp;13 studies). Environmental changes included placement of height-adjustable or stand-biased standing desks/workstations with stools, chairs, exercise balls, bean bags or mats in the classroom. These 13 published studies suggest that irrespective of the approach, youth sitting time was reduced by between ~44 and 60&nbsp;min/day and standing time was increased by between 18 and 55&nbsp;min/day during classroom time at school. Other benefits include increased energy expenditure and the potential for improved management of students\u27 behaviour in the classroom. However, few large trials have been conducted, and there remains little evidence regarding the impact on children\u27s learning and academic achievement. Nevertheless, with an increasing demand placed on schools and teachers regarding students\u27 learning outcomes, strategies that integrate moving throughout the school day and that potentially enhance the learning experience and future health outcomes for young people warrant further exploration