Title: Feasibility of a low-cost, co-produced complex intervention to reduce workplace sitting time in different workplace settings
Funder: Department of Health and Social Care

Abstract: Background Prolonged sitting is associated with health conditions such as cardiovascular disease, diabetes, obesity, musculoskeletal problems, as well as early death, independent of physical activity levels.The workplace contributes to prolonged sitting due to the increase in desk-based jobs, which has resulted in desk-based workers sitting for an average of six hours per working day. Therefore, there is a need to develop interventions to reduce workplace sitting, but to encourage a range of organisations/employers to support their use these must be low-cost and not negatively impact staff productivity. Aim To develop, implement and evaluate the feasibility of a low-cost, co-produced complex intervention to reduce sitting time in different workplace settings.Research question What is the feasibility of a low-cost, co-produced complex intervention to reduce workplace sitting time in different workplace settings? Plan of investigation Desk-based workers will be recruited from four organisations to increase generalisability of findings to a range of organisations.Phase 1: A qualitative study Two small focus groups (one with management and one with other employees) will be conducted at each organisation to establish thoughts on the barriers and facilitators to reducing workplace sitting time.Phase 2: Intervention development Findings from Phase 1, intervention development learning from previous work undertaken by the fellow, and literature review findings, will be synthesised using the Behaviour Change Wheel (BCW)/COM-B theoretical framework and then used as the basis for the development of these interventions. Co-production with members of staff at each organisation will ensure the intervention developed for each organisation is specific to the setting and the characteristics of employees' job roles/activities. Although the final content of the interventions is currently unknown, based on previous work by the fellow, it is likely to include: Posters/prompts to remind staff to sit lessEmails with tips of ways to sit lessA social element involving workplace champions or social mediaSupport from management via emails and leading by exampleChanges in the way the environment is used rather than costly new equipment such as sit-stand desks.Phase 3: Intervention implementation and evaluationParticipants will be randomly recruited to this phase. Co-produced interventions will run in each workplace for 12 weeks. Baseline demographic and lifestyle data will be collected from all participants. The following data will be obtained at baseline, immediately post-intervention, and three and six months post-intervention:Total daily sitting time and physical activity levels (measured using activPal and self-reported logs)General health and wellbeing (measured using the Short Form (36) Health Survey)Sickness absence, productivity and presenteeism (measured using relevant items from the Work Productivity and Activity Impairment Questionnaire and WHO Health and Work Performance Questionnaire)Attrition rates.Data to be collected immediately post-intervention will include:Intervention awarenessQualitative data from focus groups to determine participants' views on the acceptability and feasibility of the intervention and its various componentsIntervention costsSafety/adverse events.Information on intervention fidelity will also be collected and assessed as part of the process evaluation. Potential benefits to the public and NHS It is anticipated that the findings from this feasibility study will inform the development of a toolkit for managers to support the development of tailor-made interventions to be utilised in any workplace. If successful, workplace health and safety policy may be updated to include practical recommendations for the adoption of the toolkit.Such policy changes could have long-term health improvements for employees, which could in turn translate into cost savings to the NHS due to the prevention of long-term conditions such as cardiovascular disease, diabetes, depression and musculoskeletal problems. Furthermore, improvements in productivity and absenteeism could result in cost-savings to employers and the wider economy.

Lay abstract: Background Sitting for long periods is linked to higher risks of health problems such as heart disease, diabetes, obesity, depression, neck/back problems, and early death. This link between sitting and poor health is present even for people who take part in regular exercise, if they spend the rest of their day sitting. Therefore, replacing some sitting time with light activities, such as standing and walking, could be an important way to improve population health.Workplace sitting is a particular issue when thinking about how to reduce the total amount of sitting time. This is because of the increase in desk-based jobs where workers sit for an average of six-hours a day. Therefore, there is a need to develop, test and review the practicality of changes in the workplace aimed at reducing time spent sitting. To encourage employers to support such changes, they must be low-cost and not negatively impact workers' productivity. AimThis study aims to develop, test and review how practical a low-cost package of changes is at reducing sitting time within different types of workplaces. The findings obtained in this study will be used to plan a larger trial, which may result in future changes to health and safety policy. Methods Desk-based workers will be asked to take part in this study. They will be from four different organisations a local council, a large private company, a charity, and a small business. This variety will help make the findings more relevant to different types of workplaces.Phase 1 Small groups of volunteers at each organisation will take part in a discussion about specific issues in their workplace that causes them to spend much of their day sitting and what might help them sit less at work. Phase 2 Findings from these discussions will inform the development of a package of changes aiming to reduce sitting in the workplace. The package will be developed with management support and members of staff to ensure the package suits the needs of each organisation.Although at this stage it is not known what this package of changes will look like, it is likely to include: Posters/prompts to remind staff to sit lessEmails with helpful tips of ways to sit less e.g. walking/standing meetings, regular breaks away from the deskSupport from management in the form of emails and leading by exampleChanges to the way the workspace is used e.g. encouraging the use of toilets/printers on different floors.Phase 3 Once developed, the packages will be tested in each organisation for 12-weeks. Participants will take part in the testing of the package. Some initial background information will be obtained from volunteers (e.g. age, sex, education, general lifestyle information).The information below will be collected from the volunteers at the start of this phase, immediately after the 12-week package, then at 3- and 6-months after the package:Total daily sitting time and physical activity levels (both in and outside of the workplace measured using a small, lightweight, waterproof device placed on the thigh and a seven-day sitting/activity log)Information on health and wellbeing, sickness absence and how productive participants feel at work (assessed using a questionnaire)Small-group discussions about: the package as a whole; how practical the different parts of the package had been; what could be improved; what did not work; and which parts of the package continued to be used after the 12-weeks.Information on the total cost of the package, awareness of the package, safety concerns, and the final content of each package and whether it was rolled-out as planned will be collected at the end of the 12-weeks. Public Involvement There will be a separate public involvement panel, which will advise on the research project and be actively involved in:Further shaping the design of the study to ensure the work continues to be relevantHighlighting any practical issues with the research plan including the data collection tools to be used and the recruitment of Phase 3 participantsCommenting upon the language used in participant information leaflets/consent formsPromoting the findings of this researchThe planning and design of the future larger trial.Promoting the Findings The findings from each phase of this study will be promoted using a variety of methods:Published in academic journalsPresented at national and international conferencesPresented to the local and national organisations involved in this project via meetings and updates in newsletters, websites or blogsHolding information sessions with members of public with the support of the public involvement panel.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE