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

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

Effectiveness of a web-based, computer-tailored, pedometer-based physical activity intervention for adults : a cluster-randomized controlled trial

Background: Computer-tailored physical activity (PA) interventions delivered through the Internet represent a promising and appealing method to promote PA at a population level. However, personalized advice is mostly provided based on subjectively measured PA, which is not very accurate and might result in the delivery of advice that is not credible or effective. Therefore, an innovative computer-tailored PA advice was developed, based on objectively pedometer-measured PA. Objective: To evaluate the effectiveness of a computer-tailored, pedometer-based PA intervention in working adults. Methods: Participants (≥18 years) were recruited between May 2012 and December 2012 from eight Flemish workplaces. These workplaces were allocated randomly to an intervention or control group. Intervention group participants (n=137) received (1) a booklet with information on how to increase their steps, (2) a non-blinded pedometer and (3) an Internet link to request computer-tailored step advice. Control group participants (n=137) did not receive any of the above mentioned intervention components. Self-reported (IPAQ) and pedometer-based PA were assessed at baseline (T0), and one (T1) and three (T2) months post baseline. Repeated measures analyses of covariance were used to examine intervention effects for both the total sample and the sample at risk (i.e. adults not reaching 10,000 steps a day at baseline). Results: The recruitment process resulted in 274 respondents (response rate of 15%) who agreed to participate. Between T0 and T1 (one-month post baseline), significant intervention effects were found for participants’ daily step counts in both the total sample (P = .004), and the at-risk sample (P = .001). In the sample at risk, the intervention effects showed a daily step count increase of 1056 steps in the intervention group, compared to a decrease of 258 steps in the control group. Comparison of participants’ self-reported PA revealed a significant intervention effect for time spent walking in the at-risk sample (P = .02). Intervention effects were still significant three-months post baseline for participants’ daily step counts in both the total sample (P = .03) and the at-risk sample (P = .02); however, self-reported PA differences were no longer significant. Conclusions: A computer-tailored, pedometer-based PA intervention was effective in increasing both pedometer-based, and self-reported PA levels. However, more efforts should be devoted to recruit and retain participants in order to improve the public health impact of the intervention

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

Understanding occupational sitting : prevalence, correlates and moderating effects in Australian employees

Objective. To (1) compare occupational sitting between different socio-demographic, health-related, workrelated and psychosocial categories, (2) identity socio-demographic, health-related, work-related and psychosocial correlates of occupational sitting, and (3) examine the moderating effect of work-related factors in the relation between correlates and occupational sitting.Methods. Randomly-selected Australian adults completed a web-based survey assessing socio-demographic (country of birth, gender, age, education, income), health-related (general health, weight, physical activity), work-related (employment status, occupational task, occupational classification) and sedentary-specific psychosocial (social norm, social support, self-efficacy, control, advantages, disadvantage, intention) factors, and occupational sitting-time. t-tests, ANOVAs and multiple linear regression analyses were conducted (in 2013) on a sample of employees (n= 993). Results. Respondents sat on average for 3.75 (SD = 2.45) h/day during work. Investigated correlates explained 41% of the variance in occupational sitting. More occupational sitting was associated with being male, being younger, higher education and income, part-time and full-time employment, sedentary job tasks, white-collar/professional occupations, higher BMI, and perceiving more advantages of sitting less at work. Employment status and occupational classification moderated the association between control to sit less and occupational sitting. A lack of control to sit less was associated with higher occupational sitting in part-time andfull-time workers, but not in casual workers; and in white-collar and professional workers, but not in bluecollar workers. Conclusions. Most important contributors to occupational sitting were work-related and socio-demographic correlates. More research is needed to confirm present results

Sitting time In adults 65 years and over: Behaviour, knowledge, and intentions to change

This study examined sitting time, knowledge and intentions to change sitting time in older adults. An online survey was completed by 494 Australians aged 65+. Average daily sitting was high (9.0 hrs). Daily sitting time was the highest during TV (3.3 hrs), computer (2.1 hrs) and leisure (1.7 hrs). A regression analysis demonstrated that women were more knowledgeable about the health risks of sitting compared to men. The percentage of older adults intending to sit less were the highest for TV (24%), leisure (24%) and computer (19%) sitting time. Regression analyses demonstrated that intentions varied by gender (for TV sitting), education (leisure and work sitting), BMI (computer, leisure and transport sitting) and physical activity (TV, computer and leisure sitting). Interventions should target older adults' TV, computer and leisure time sitting, with a focus on intentions in older males and older adults with low education, those who are active and those with a normal weight

Development and usability of a computer-tailored pedometer-based physical activity advice for breast cancer survivors

This observational study aimed to adapt a computer-tailored step advice for the general population into a feasible advice for breast cancer survivors and to test its usability. First, several adaptations were made to the original design (adding cancer-related physical activity (PA) barriers and beliefs, and self-management strategies to improve survivors’ personal control). Second, the adapted advice was evaluated in two phases: (1) a usability testing in healthy women (n = 3) and survivors (n = 6); and (2) a process evaluation during 3 weeks in breast cancer survivors (n = 8). Preliminary usability testing revealed no problems during logging-in; however, three survivors misinterpreted some questions. After refining the questionnaire and advice, survivors evaluated the advice as interesting, attractive to read, comprehensible and credible. Inactive survivors found the advice novel, but too long. The process evaluation indicated that the majority of the women (n = 5/8) reported increased steps. Monitoring step counts by using a pedometer was perceived as an important motivator to be more active. To conclude, this study provides initial support for the usability and acceptability of a computer tailored pedometer-based PA advice for breast cancer survivors. After testing efficacy and effectiveness of thisintervention, this tool can broaden the reach of PA promotion in breast cancer survivors

Physical activity recommendations from general practitioners in Australia. Results from a national survey

Objective: To identify subgroups of Australian adults likely to receive physical activity advicefrom their general practitioner and to evaluate the content of the advice provided. Methods: Participants (n=1,799), recruited from the Australian Health and Social Science panel, completed an online survey. Signal Detection Analysis was used to identify subgroups that were more/less likely to have received physical activity recommendations. Results: Overall, 18% of participants received a physical activity recommendation from their general practitioner in the past 12 months and eight unique subgroups were identified. The subgroup with the highest proportion (54%) of participants reporting that they received a physical activity recommendation was those with poor physical and mental health-related quality of life and an average daily sitting time of <11 hours. Other subgroups with high proportions of individuals receiving recommendations were characterised by higher weight and/or the presence of co-morbidities. The most commonly prescribed physical activity type was aerobic activity. Few participants received specific physical activity advice. Conclusions: General practitioners are incorporating physical activity promotion into their practice, but primarily as a disease management tool and with limited specificity. Implications: Strategies to assist Australian general practitioners to effectively promote physical activity are needed.</p

Controversies in the science of sedentary behaviour and health: Insights, perspectives and future directions from the 2018 Queensland Sedentary Behaviour Think Tank

The development in research concerning sedentary behaviour has been rapid over the past two decades. This has led to the development of evidence and views that have become more advanced, diverse and, possibly, contentious. These include the effects of standing, the breaking up of prolonged sitting and the role of moderate-to-vigorous physical activity (MVPA) in the association between sedentary behaviour and health outcomes. The present aim is to report the views of experts (n = 21) brought together (one-day face-to-face meeting in 2018) to consider these issues and provide conclusions and recommendations for future work. Each topic was reviewed and presented by one expert followed by full group discussion, which was recorded, transcribed and analysed. The experts concluded that (a). standing may bring benefits that accrue from postural shifts. Prolonged (mainly static) standing and prolonged sitting are both bad for health; (b). 'the best posture is the next posture'. Regularly breaking up of sitting with postural shifts and movement is vital; (c). health effects of prolonged sitting are evident even after controlling for MVPA, but high levels of MVPA can attenuate the deleterious effects of prolonged sitting depending on the health outcome of interest. Expert discussion addressed measurement, messaging and future directions