Title: SMArT Work: Stand More AT Work
Funder: Department of Health (England)

Abstract: Background Research now suggests that high sedentary behaviour (‘sitting time’) has significant deleterious effects on cardiometabolic and musculoskeletal health, independent of moderate-to-vigorous physical activity (MVPA). Adults average about 60% of their waking time and 70-80% of their working time sedentary. Epidemiological and experimental (including occupational health) research all support the notion that reducing sitting behaviour and promoting standing and light movement will result in enhanced health and wellbeing. However, the effectiveness, cost-effectiveness and sustainability of simple occupational health strategies have not been adequately elucidated and data from the UK is entirely lacking, hence the effect on policy has been minimal. Previous research shows that three approaches to behaviour change hold promise: a). environmental change making standing/movement more accessible; b). self-monitoring of sitting time to increase awareness; c). behavioural prompts to sit less and stand/move more, thus breaking ‘the habit’. The proposed strategies can be implemented with very low ‘cognitive load’ to participants. Aim Primary: To investigate whether providing sit-to-stand workstations and behaviour change strategies increases standing and movement. Secondary: To investigate whether providing sit-to-stand workstations and behaviour change strategies to increase standing and movement affects work-related health and psycho-social outcomes. Research Plan Using the ‘behaviour change wheel’ (BCW) - itself developed to inform policy - we will use environmental, organisational and individual behaviour change strategies to increase standing and moving. The programme of research will be delivered in two phases: Developmental Phase : This phase incorporates both the Organisational and Individual aspects of the BCW. Discussions will take place with NHS managers and employees to ascertain the most appropriate and acceptable way of implementing proposed changes . Behaviour change strategies (e.g., self monitoring and behavioural prompts) for increasing standing and moving will be developed following focus groups with employees, along with input from occupational and health psychologists. Implementation Phase : Following on from the developmental work, we will undertake a behaviour change cluster randomised controlled trial within the local NHS workforce and evaluate efficacy and cost effectiveness. Strategies for promoting behaviour change will include the provision of sit-to-stand height adjustable work stations to desk bound employees to encourage a reduction in work sitting time. The behaviour change strategies (e.g., behavioural prompts, self monitoring) developed during the developmental stage will be implemented alongside the provision of sit-to-stand height adjustable work stations. Research Team Our research team brings together experts in sedentary behaviour, interventions, behaviour change, determinants of health behaviour, prevention of chronic disease, and occupational health. Applicants and collaborators are at the forefront of these fields. This grant will add significant value to The NIHR Leicester-Loughborough Lifestyle Biomedical Research Unit (MD Director, TY senior researcher); it affords the unique opportunity of bringing together a multi-disciplinary group of international experts to assess the impact of re-engineering the occupational environment founded on the evidence-based premise that sitting less and standing/moving more is beneficial for health. Potential impact/influence on policy field, users and wider stakeholders The recently published mandate from the Government to the NHS Commissioning Board is clear in its identification of the need to prevent premature deaths. Moreover, The Public Health Responsibility Deal was set up to encourage organisations to improve public health. Dame Carol Black, has stated “… acting to prevent people from becoming ill at work … is ultimately critical to the nation’s financial health.” This pilot work will be undertaken within the country’s largest employer (NHS), which is known to have high rates of absenteeism. If shown to be successful, the simple strategy proposed here could have a major impact on the health and wealth of the country.


Research activity codes: 5.7 PHYSICAL;6.7 PHYSICAL
Health categories: GENERIC HEALTH RELEVANCE