A three arm cluster randomised controlled trial to test the effectiveness and cost-effectiveness of the SMART work & life intervention for reducing daily sitting time in office workers : study protocol

Background:Office-based workers typically spend 70-85% of working hours, and a large proportion of leisure time, sitting. High levels of sitting have been linked to poor health. There is a need for fully powered randomised controlled trials (RCTs) with long-term follow-up to test the effectiveness of interventions to reduce sitting. This paper describes the methodology of a three-arm cluster RCT designed to determine the effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable desk, for reducing daily sitting. Methods/Design:A three-arm cluster RCT of 33 clusters (660 council workers) will be conducted in three areas in England (Leicester; Manchester; Liverpool). Office groups (clusters) will be randomised to the SMART Work & Life intervention delivered with (group 1) or without (group 2) a height-adjustable desk or a control group (group 3). SMART Work & Life includes organisational (e.g., management buy-in, provision/support for standing meetings), environmental (e.g., relocating waste bins, printers), and group/individual (education, action planning, goal setting, addressing barriers, coaching, self-monitoring, social support) level behaviour change strategies, with strategies driven by workplace champions. Baseline, 3, 12 and 24 month measures will be taken. Objectively measured daily sitting time (activPAL3). objectively measured sitting, standing, stepping, prolonged sitting and moderate-to-vigorous physical activity time and number of steps at work and daily; objectively measured sleep (wrist accelerometry). Adiposity, blood pressure, fasting glucose, glycated haemoglobin, cholesterol (total, HDL, LDL) and triglycerides will be assessed from capillary blood samples. Questionnaires will examine dietary intake, fatigue, musculoskeletal issues, job performance and satisfaction, work engagement, occupational and general fatigue, stress, presenteeism, anxiety and depression and sickness absence (organisational records). Quality of life and resources used (e.g. GP visits, outpatient attendances) will also be assessed. We will conduct a full process evaluation and cost-effectiveness analysis. Discussion:The results of this RCT will 1) help to understand how effective an important simple, yet relatively expensive environmental change is for reducing sitting, 2) provide evidence on changing behaviour across all waking hours, and 3) provide evidence for policy guidelines around population and workplace health and well-being. Trial registration: ISRCTN11618007 . Registered on 21 January 2018

The impact of musculoskeletal injuries sustained in road traffic crashes on work-related outcomes: a protocol for a systematic review

Background: Musculoskeletal injuries (strains/sprains, contusions, dislocations, and fractures) are the most common injury sustained in a road traffic crash. They can have a long-term impact upon the ability to engage in work. Persisting symptoms as well as poor physical and psychological recovery may reduce the ability to return to or remain at work necessitating the use of sick leave or alternate duties to enable a gradual return to full duties. There is also a need to investigate rates of return to work, along with other work-related outcomes in this population so that interventions designed to facilitate return to work can be targeted to this clinical population. In addition, there is a need to explore factors associated with work-related outcomes in people with musculoskeletal injuries subsequent to a road traffic crash.Methods: A systematic review will be conducted to determine the impact of sustaining a musculoskeletal injury during a road traffic crash on an individual's ability to work. Observational studies will be identified by searching six electronic databases for reports of adults having sustained musculoskeletal injuries during a road traffic crash. Studies featuring paediatric cohorts or those with neurological injuries will be excluded. To be eligible for inclusion, studies must report at least one of the following work-related outcomes: return to work status/rate, sick leave, work ability, work capacity, and health-related work productivity loss. The methodological quality of included studies will be assessed with the National Institutes of Health National Heart, Lung, and Blood Institute Study Quality Assessment Tools for observational cohort and cross-sectional studies, and case-control studies.Discussion: The results of this systematic review may increase our knowledge of work-related outcomes and understanding of the associated factors for people with musculoskeletal injuries following road traffic crashes. Future studies could use the results to plan interventions and influence policy and legislation, and raise awareness of the needs of this clinical population

The Impact of Musculoskeletal Injuries Sustained in Road Traffic Crashes on Work-Related Outcomes: A Systematic Review

Musculoskeletal injuries occur frequently after road traffic crashes (RTCs), and the effect on work participation is not fully understood. The primary aim of this review was to determine the impact of sustaining a musculoskeletal injury during an RTC on the rate of return to work (RTW), sick leave, and other work outcomes. The secondary aim was to determine factors associated with these work-related outcomes. An electronic search of relevant databases to identify observational studies related to work and employment, RTC, and musculoskeletal injuries was conducted. Where possible, outcome data were pooled by follow-up period to answer the primary aim. Fifty-three studies were included in this review, of which 28 were included in meta-analyses. The pooled rate of RTW was 70% at 1 month, 67% at 3 months, 76% at 6 months, 83% at 12 months, and 70% at 24 months. Twenty-seven percent of participants took some sick leave by one month follow-up, 13% by 3 months, 23% by 6 months, 36% by 12 months, and 22% by 24 months. Most of the factors identified as associated with work outcomes were health-related, with some evidence also for sociodemographic factors. While 70% of people with RTC-related musculoskeletal injury RTW shortly after accident, many still have not RTW two years later

Telephone, print, and Web-based interventions for physical activity, diet, and weight control among cancer survivors: a systematic review

Purpose Broad-reach (non-face-to-face) modalities offer an accessible and cost-effective means to provide behavior change programs in diverse and growing cancer survivor populations. The purpose of this systematic review is to evaluate the efficacy of physical activity, dietary, and/or weight control interventions for cancer survivors in which telephone, short-message service, print, and/or Web is the primary method of delivery

Telephone, print, and Web-based interventions for physical activity, diet, and weight control among cancer survivors: a systematic review

Abstract Purpose Broad-reach (non-face-to-face) modalities offer an accessible and cost-effective means to provide behavior changeprogramsindiverseandgrowingcancersurvivorpopulations. The purpose of this systematic review is to evaluate the efficacyofphysicalactivity,dietary,and/orweight control interventions for cancer survivors in which telephone, shortmessage service, print, and/or Web is the primary method of delivery. Methods A structured search of PubMed, Embase, Web of Science,CINAHL,andCENTRAL(May2013)wasconducted. Included studies focused and reported onphysical activity (PA) and dietary change and/or weight control in adult cancer survivors, delivered at least 50 % of intervention contacts by broad-reach modality and included a control group. Study design,interventionfeatures,andbehavioral/weightoutcomes were extracted, tabulated, and summarized. Results Twenty-seven studies were included; 22 telephone, three Web, and two print. Sixteen studies targeted PA, two diet, and nine targeted multiple behaviors. Most studies (18/ 27)targetedasinglesurvivorgroup,namelybreastcancer(n=12). Nineteen of 27 studies found evidence for initiation of behavior change, with only eight reporting on maintenance and one on cost-effectiveness. Conclusions This review provides support for broad-reach modalities, particularly the telephone, in the delivery of lifestyleinterventionstocancersurvivors.Futureresearchshould evaluate (1) newer technologies (i.e., SMS and mobile phone applications), (2) interventions for diverse cancer survivors and those targeting multiple behaviors, (3) long-term outcomes, and 4) cost-effectiveness. ImplicationsforCancerSurvivors Broad-reachlifestyleinterventionsareeffective,withfurtherresearchneededtoevaluate their generalizability and integration into cancer care

Using Bluetooth proximity sensing to determine where office workers spend time at work

<div><p>Background</p><p>Most wearable devices that measure movement in workplaces cannot determine the context in which people spend time. This study examined the accuracy of Bluetooth sensing (10-second intervals) via the ActiGraph GT9X Link monitor to determine location in an office setting, using two simple, bespoke algorithms.</p><p>Methods</p><p>For one work day (mean±SD 6.2±1.1 hours), 30 office workers (30% men, aged 38±11 years) simultaneously wore chest-mounted cameras (video recording) and Bluetooth-enabled monitors (initialised as receivers) on the wrist and thigh. Additional monitors (initialised as beacons) were placed in the entry, kitchen, photocopy room, corridors, and the wearer’s office. Firstly, participant presence/absence at each location was predicted from the presence/absence of signals at that location (ignoring all other signals). Secondly, using the information gathered at multiple locations simultaneously, a simple heuristic model was used to predict at which location the participant was present. The Bluetooth-determined location for each algorithm was tested against the camera in terms of F-scores.</p><p>Results</p><p>When considering locations individually, the accuracy obtained was excellent in the office (F-score = 0.98 and 0.97 for thigh and wrist positions) but poor in other locations (F-score = 0.04 to 0.36), stemming primarily from a high false positive rate. The multi-location algorithm exhibited high accuracy for the office location (F-score = 0.97 for both wear positions). It also improved the F-scores obtained in the remaining locations, but not always to levels indicating good accuracy (e.g., F-score for photocopy room ≈0.1 in both wear positions).</p><p>Conclusions</p><p>The Bluetooth signalling function shows promise for determining where workers spend most of their time (i.e., their office). Placing beacons in multiple locations and using a rule-based decision model improved classification accuracy; however, for workplace locations visited infrequently or with considerable movement, accuracy was below desirable levels. Further development of algorithms is warranted.</p></div

Agreement with direct observation of the monitor-ascertained presence/absence at each location, using beacons from one location at a time (n = 30 participants, n = 67616 observations).

<p>Agreement with direct observation of the monitor-ascertained presence/absence at each location, using beacons from one location at a time (n = 30 participants, n = 67616 observations).</p

Attributes, usage and movement within five common workplace locations (n = 30 participants).

<p>Attributes, usage and movement within five common workplace locations (n = 30 participants).</p

Typical layout of workplace floor and beacon placement.

<p>Typical layout of workplace floor and beacon placement.</p