Effects of a Sedentary Behaviors at Work on Health in Emergency Medical Dispatchers and CODIS Operators (SECODIS)

Study Overview
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Brief Summary
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The purpose of the study is to demonstrate a reduction of sedentary behavior following a behavioral intervention (sit-and-stand desk, and cycloergometer)

Detailed Description
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Each emergency medical services dispatcher and each firefighter participates in the study for three days. A normal working day from of 12h is compared to: (i) a working day during which the participants have to get up at least 5 min/hour (sit-and-stand desk), (ii) a working day during which they can use a cycloergometer installed under the desk. Conditions will be random using Latin Square design with stratification between sequences cross-over design on occupation (EMD vs. firefighters). The heart rate variability (measured using Zephyr®), the electrodermal activity (Empatica® E4), the level of physical activity (Actigraph®) as well as the blood sugar (Freestyle®) will be measured continuously during the 12 hours of work and the night after except for Actigraph® and Freestyle® device that will be let one week. Blood and saliva samples will be collected at the beginning and end of each working day (6 samples in total). Participants will have to complete a detailed questionnaire to identify the particular events (vital emergencies, etc.) that may influence the parameters measured. Participants will be asked to answer a general questionnaire once at the start of the study that will cover different aspects: Sociodemographic, Visual analogue scale (VAS) related to psychosocial factors : stress at home, burnout / burnout, decision latitude / autonomy at work, psychological demands at work (workload), support from the hierarchy, support from co-workers, family support, job satisfaction with regard to effort, commitment to work, addiction to work, quality of life, need for psychological support, Eating habits. They will then have to answer a short questionnaire at the beginning and at the end of each measurement day. It will cover different aspects: Four VAS (stress level, fatigue, anxiety, mood), Physical activity and sedentary lifestyle (number of hours of physical activity and sitting during the last 24 hours), Daily consumption (tobacco, alcohol, cannabis, coffee, tea).

Official Title
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Effects of a Sedentary Behaviors at Work on Health in Emergency Medical Dispatchers and CODIS Operators

Conditions
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Sedentary Behavior, Occupational Stress

Intervention / Treatment
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* Behavioral: Control
* Behavioral: Sit-and-stand desk
* Behavioral: Cycloergometer


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Emergency medical dispatchers or firefighters from the departmental fire and rescue operational center (CODIS). Person able to give an informed consent to participate in research Affiliated with a Social Security scheme. Exclusion Criteria: Non-affiliated to a health insurance, Protected persons (minors, pregnant women, breastfeeding women, guardianship, curatorship, deprived of freedoms, safeguard of justice), Refusal to participate.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Emergency medical dispatchers<br> | Behavioral: Control<br>* A normal working day from of 12h<br>Behavioral: Sit-and-stand desk<br>* a working day during which the participants have to get up at least 5 min/hour<br>Behavioral: Cycloergometer<br>* a working day during which they can use a cycloergometer installed under the desk<br>|
| Experimental: Firefighter<br> | Behavioral: Control<br>* A normal working day from of 12h<br>Behavioral: Sit-and-stand desk<br>* a working day during which the participants have to get up at least 5 min/hour<br>Behavioral: Cycloergometer<br>* a working day during which they can use a cycloergometer installed under the desk<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sedentary behavior | Sedentary behavior measured by actimetry using Actigraph® in number of minutes per day standing/active. | 12 hours of work corresponding to the control condition | 
| Sedentary behavior | Sedentary behavior measured by actimetry using Actigraph® in number of minutes per day standing/active. | 12 hours of work corresponding to the sit-and-stand desk condition | 
| Sedentary behavior | Sedentary behavior measured by actimetry using Actigraph® in number of minutes per day standing/active. | 12 hours of work corresponding to the cycloergometer condition | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sedentary behavior | Sedentary behavior measured by actimetry using Actigraph® in number of minutes per day standing/active. | one-week (168 hours) control cycle | 
| Sedentary behavior | Sedentary behavior measured by actimetry using Actigraph® in number of minutes standing/active during one week. | one-week (168 hours) sit-and-stand desk cycle | 
| Sedentary behavior | Sedentary behavior measured by actimetry using Actigraph® in number of minutes standing/active during one week. | one-week (168 hours) cycloergometer cycle | 
| Heart rate variabily | The heart rate variability measured using Zephyr® | 24 hours record corresponding to 12 hours of work and the next 12 hours of rest | 
| Electrodermal activity | The electrodermal activity measured using Empatica E4 | 24 hours record corresponding to 12 hours of work and the next 12 hours of rest | 
| Stress at home | Stress at home measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 8 am, beginning of the control day | 
| Stress at home | Stress at home measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 8 am, beginning of the sit-and-stand desk day | 
| Stress at home | Stress at home measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 8 am, beginning of the cycloergometer day | 
| Stress at home | Stress at home measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 6 pm, end of the control day | 
| Stress at home | Stress at home measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 6 pm, end of the sit-and-stand desk day | 
| Stress at home | Stress at home measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 6 pm, end of the cycloergometer day | 
| Fatigue | Fatigue measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 8 am, beginning of the control day | 
| Fatigue | Fatigue measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 8 am, beginning of the sit-and-stand desk day | 
| Fatigue | Fatigue measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 8 am, beginning of the cycloergometer day | 
| Fatigue | Fatigue measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 6 pm, end of the control day | 
| Fatigue | Fatigue measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 6 pm, end of the sit-and-stand desk day | 
| Fatigue | Fatigue measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 6 pm, end of the cycloergometer day | 
| Anxiety | Anxiety measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 8 am, beginning of the control day | 
| Anxiety | Anxiety measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 8 am, beginning of the sit-and-stand desk day | 
| Anxiety | Anxiety measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 8 am, beginning of the cycloergometer day | 
| Anxiety | Anxiety measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 6 pm, end of the control day | 
| Anxiety | Anxiety measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 6 pm, end of the sit-and-stand desk day | 
| Anxiety | Anxiety measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | 6 pm, end of the cycloergometer day | 
| Mood | Mood measured using visual analogue scale ranging from 0 (Bad) to 100 (Excellent). Higher scores mean a better outcome. | 6 pm, beginning of the control day | 
| Mood | Mood measured using visual analogue scale ranging from 0 (Bad) to 100 (Excellent).Higher scores mean a better outcome. | 8 am, beginning of the sit-and-stand desk day | 
| Mood | Mood measured using visual analogue scale ranging from 0 (Bad) to 100 (Excellent).Higher scores mean a better outcome. | 8 am, beginning of the cycloergometer day | 
| Mood | Mood measured using visual analogue scale ranging from 0 (Bad) to 100 (Excellent).Higher scores mean a better outcome. | 6 pm, end of the control day | 
| Mood | Mood measured using visual analogue scale ranging from 0 (Bad) to 100 (Excellent).Higher scores mean a better outcome. | 6 pm, end of the sit-and-stand desk day | 
| Mood | Mood measured using visual analogue scale ranging from 0 (Bad) to 100 (Excellent).Higher scores mean a better outcome. | 6 pm, end of the cycloergometer day | 
| Stress at work | Stress at work measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum).Higher scores mean a worse outcome. | 8 am, beginning of the control day | 
| Stress at work | Stress at work measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum).Higher scores mean a worse outcome. | 8 am, beginning of the sit-and-stand desk day | 
| Stress at work | Stress at work measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum).Higher scores mean a worse outcome. | 8 am, beginning of the cycloergometer desk day | 
| Stress at work | Stress at work measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum).Higher scores mean a worse outcome. | 6 pm, end of the control day | 
| Stress at work | Stress at work measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum).Higher scores mean a worse outcome. | 6 pm, end of the sit-and-stand desk day | 
| Stress at work | Stress at work measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum).Higher scores mean a worse outcome. | 6 pm, end of the cycloergometer day | 
| Amount of physical activity | Number of hours of physical activity during the last 24 hours | 8 am, beginning of the control day | 
| Intensity of physical activity | Physical activity intensity during the last 24 hours measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a higher intensity. | 8 am, beginning of the control day | 
| Amount of physical activity | Number of hours of physical activity during the last 24 hours | 8 am, beginning of the sit-and-stand desk day | 
| Intensity of physical activity | Physical activity intensity during the last 24 hours measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a higher intensity. | 8 am, beginning of the sit-and-stand desk day | 
| Amount of physical activity | Number of hours of physical activity during the last 24 hours | 8 am, beginning of the cycloergometer day | 
| Intensity of physical activity | Physical activity intensity during the last 24 hours measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a higher intensity. | 8 am, beginning of the cycloergometer day | 
| Amount of physical activity | Number of hours of physical activity during the working day | 6 pm, end of the control day | 
| Intensity of physical activity | Physical activity intensity during the working day measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a higher intensity. | 6 pm, end of the control day | 
| Amount of physical activity | Number of hours of physical activity during the working day | 6 pm, end of the sit-and-stand desk day | 
| Intensity of physical activity | Physical activity intensity during the working day measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a higher intensity. | 6 pm, end of the sit-and-stand desk day | 
| Amount of physical activity | Number of hours of physical activity during the working day | 6 pm, end of the cycloergometer day | 
| Intensity of physical activity | Physical activity intensity during the working day measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a higher intensity. | 6 pm, end of the cycloergometer day | 
| Sitting time | Number of hours sit during the last 24 hours | 8 am, beginning of the control day | 
| Sitting time | Number of hours sit during the last 24 hours | 8 am, beginning of the sit-and-stand desk day | 
| Sitting time | Number of hours sit during the last 24 hours | 8 am, beginning of the cycloergometer day | 
| Sitting time | Number of hours sit during the working day | 6 pm, end of the control day | 
| Sitting time | Number of hours sit during the working day | 6 pm, end of the sit-and-stand desk day | 
| Sitting time | Number of hours sit during the working day | 6 pm, end of the cycloergometer day | 
| Tabacco consumption | Number of cigarette during the last 24h | 8 am, beginning of the control day | 
| Tabacco consumption | Number of cigarette during the last 24h | 8 am, beginning of the sit-and-stand desk day | 
| Tabacco consumption | Number of cigarette during the last 24h | 8 am, beginning of the cycloergometer day | 
| Tabacco consumption | Number of cigarette during the working day | 6 pm, end of the control day | 
| Tabacco consumption | Number of cigarette during the working day | 6 pm, end of the sit-and-stand desk day | 
| Tabacco consumption | Number of cigarette during the working day | 6 pm, end of the cycloergometer day | 
| Tea consumption | Number of cups of tea during the last 24h | 8 am, beginning of the control day | 
| Tea consumption | Number of cups of tea during the last 24h | 8 am, beginning of the sit-and-stand desk day | 
| Tea consumption | Number of cups of tea during the last 24h | 8 am, beginning of the cycloergometer day | 
| Tea consumption | Number of cups of tea during the last 24h | 6 pm, end of the control day | 
| Tea consumption | Number of cups of tea during the last 24h | 6 pm, end of the sit-and-stand desk day | 
| Tea consumption | Number of cups of tea during the last 24h | 6 pm, end of the cycloergometer day | 
| Coffee consumption | Number of cups of coffee during the last 24h | 8 am, beginning of the control day | 
| Coffee consumption | Number of cups of coffee during the last 24h | 8 am, beginning of the sit-and-stand desk day | 
| Coffee consumption | Number of cups of coffee during the last 24h | 8 am, beginning of the cycloergometer day | 
| Coffee consumption | Number of cups of coffee during the working day | 6 pm, end of the control day | 
| Coffee consumption | Number of cups of coffee during the working day | 6 pm, end of the sit-and-stand desk day | 
| Coffee consumption | Number of cups of coffee during the working day | 6 pm, end of the cycloergometer day | 
| Sociodemographic | Sociodemographic will be assessed: gender, age, marital status, children, occupation, and recent stressful event | Once at baseline | 
| Sleep quality | Sleep quality measured using visual analogue scale ranging from 0 (Bad) to 100 (Excellent). Higher scores mean a better outcome. | Once at baseline | 
| Familly support | Family support measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a better outcome. | Once at baseline | 
| Burnout | Burnout measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | Once at baseline | 
| Job demand | Job demand measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a worse outcome. | Once at baseline | 
| Job control | Job control measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a better outcome. | Once at baseline | 
| Hierarchy support | Hierarchy support measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a better outcome. | Once at baseline | 
| Colleagues support | Colleagues support measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a better outcome. | Once at baseline | 
| Effort reward-imbalance | Effort reward-imbalance measured using visual analogue scale ranging from 0 (Minimum) to 100 (Maximum). Higher scores mean a better outcome. | Once at baseline | 
| Medical treatment | Medical treatment measured using multi-choice question do you take long terme medication? | Once at baseline | 
| Allergy | Allergy measured using multi-choice question do you have allergy? | Once at baseline | 
| Average physical activity | Average number of hours of physical activity per week | Once at baseline | 
| Average physical activity intensity | Average physical activity intensity per week | Once at baseline | 
| Average tabacco consumption | Average number of cigarette per day | Once at baseline | 
| Average alcohol consumption | Average number of alcohol glasses per week | Once at baseline | 
| Average cannabis consumption | Average number of cannabis joint per week | Once at baseline | 
| Average tea consumption | Average number of cup of tea per day | Once at baseline | 
| Average coffee consumption | Average number of cup of coffee per day | Once at baseline | 
| Average food consumption | Average food consumption of 16 food group | Once at baseline | 
| Diet characterization | How do you characterize your diet measured on a visual analogue scale ranging from 0 (Not at all balanced) to 100 (Very balanced) | Once at baseline | 
| Average burnout level | Average burnout level measured on a visual analogue scale ranging from 0 (Minimum) to 100 (Maximum) | Once at baseline | 
| Average job control level | Average job control level measured on a visual analogue scale ranging from 0 (Minimum) to 100 (Maximum) | Once at baseline | 
| Average hierarchy support | Average hierarchy support measured on a visual analogue scale ranging from 0 (Minimum) to 100 (Maximum) | Once at baseline | 
| Average colleagues support | Average colleagues support measured on a visual analogue scale ranging from 0 (Minimum) to 100 (Maximum) | Once at baseline | 
| Average family support | Average family support measured on a visual analogue scale ranging from 0 (Minimum) to 100 (Maximum) | Once at baseline | 
| Average effort reward imbalance | Average effort reward imbalance measured on a visual analogue scale ranging from 0 (Minimum) to 100 (Maximum) | Once at baseline | 
| Average sleep quality | Average sleep quality imbalance measured on a visual analogue scale ranging from 0 (Minimum) to 100 (Maximum) | Once at baseline | 
| RPAQ questionnaire | The Recent Physical Activity Questionnaire (RPAQ) assesses the level of physical activity and sedentary lifestyle in adults over the past four weeks. It is divided into three parts: work and study, home and leisure, and finally, stairs and travel. It makes it possible to classify individuals into several categories, one on sedentary lifestyle (low, resistant either 3-7h/day or high or >7h/day) and one on the level of physical activity (<8.3 MET.hour/week: inactive or >8.3 MET.h/wk: active). | Once at baseline | 
| MBI questionnaire | The Maslach Burn-out Inventory (MBI) is composed of 22 items designed to assess the three components of the burn-out syndrome: emotional exhaustion (9 items), depersonalization (5 items) and reduced personal accomplishment (8 items). The items are written in the form of statements about personal feelings or attitudes. Items are made of a 7-point scale frequency of feelings, varying from never to every day. The scores for each component of the burn-out syndrome are considered separately. If desired for participant feedback, each score can be coded as low, average, or high. | Once at baseline | 
| JDSC questionnaire | The Job Demand-Control-Support (JDSC) questionnaire of Karasek assessed job demands, job control and social support through 26 items. The questionnaire measures nine items of job demands, nine items of job control and eight items of social support. Items of JCQ are scored on a four-point Likert-type scale, ranging from 1 = strongly disagree to 4 = strongly agree. Among the 26 items, five negative statements require reverse scoring. From French data, the job strain threshold is set for a demands score higher than 20 and a control score lower than 71; the isostrain threshold is determined from a combining score of job strain and social support lower than 24. We would ask the participants to fulfil the questionnaire from memories that they keep of their work. | Once at baseline | 
| ERI questionnaire | The Effort-Reward Imbalance Questionnaire (ERI) is a self-administrated test assessing psychological distress and health problems that may occur when there is an imbalance between the efforts required by the work and the rewards received. We used the 46 items of the French version of the ERI model exploring efforts (six items), over commitment (eleven items), and rewards (seventeen items). Items of ERI were scored on a five-point Likert-type scale, ranging from 1 = disagree to 5 = agree and very disturbed. A ratio extrinsic efforts and rewards can assess the imbalance between these two dimensions. A ratio greater than one defines employees exposed to an imbalance between efforts and rewards. | Once at baseline | 
| Salivary cortisol | Salivary cortisol measured in µg/dl | Once at baseline | 
| Blood cortisol | Blood cortisol measured in ng/ml or nmol/l | Once at baseline | 
| Salivary DHEAS | Salivary DHEAS measured in pg/ml | Once at baseline | 
| Blood DHEAS | Blood DHEAS measured in µg/ml | Once at baseline | 
| Salivary leptin | Salivary leptin measured in ng/ml | Once at baseline | 
| Blood leptin | Blood leptin measured in ng/ml | Once at baseline | 
| Salivary ghrelin | Salivary ghrelin measured in ng/ml | Once at baseline | 
| Blood ghrelin | Blood ghrelin measured in pg/ml | Once at baseline | 
| Blood BDNF | Blood brain-derived neurotrophic factor (BDNF) measured in pg/ml | Once at baseline | 
| Blood pro-inflammatory cytokines | Blood pro-inflammatory cytokines measured in pg/ml | Once at baseline | 
| Blood NPY | Blood vascular distribution of neuropeptide Y (NPY) measured in pg/ml | Once at baseline |