Reduce Sedentariness and Enhance Psychological Well-being of Office Workers With TCM-based Intervention

Study Overview
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Brief Summary
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The goal of this clinical trial is to test the effects of a TCM-based anti-sedentariness program on workplace sitting time, perceived stress, and cortisol in office workers.The main questions it aims to answer are: Can a Traditional Chinese Medicine (TCM)-based anti-sedentariness program effectively reduce workplace sitting time, perceived stress and cortisol levels among office workers? Whether such anti-sedentary effect works through stress management and enhances when holistic thinking is endorsed. Participants will engage in a 4 week TCM-based program intervention including 2 weeks of health education and promotion activities (understanding sedentary behaviors, Baduanjin, acupressure, dantian breathing, and mindfulness) and 2 weeks of supported self-practice (daily reminders and tips, regular feedback on sitting time, and individual consultation). Researchers will compare a group receiving a Traditional Chinese Medicine (TCM)-based intervention with a wait-list control group to determine the effectiveness of the intervention in reducing sitting time and enhancing physical and psychological health.

Detailed Description
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Introduction: Sedentary behaviors and their associated physical and mental health risks among adults have received growing concerns among the clinical and research communities. Office workers commonly engage in sedentary behaviors due to their long stationary hours. Evidence has revealed that higher levels of sedentary behaviors were associated with higher perceived stress levels at workplace. However, scarce studies focused on the role of stress management in reducing sedentary behaviors. Traditional Chinese medicine (TCM)-based body works (such as dantian breathing, qigong, and acupressure) are low-cost techniques and found to be primising in addressing stress and sedentary behaviors at workplace. The health benefits of TCM-based bodywork in sedentary office workers may be enhanced when the workers endorse holistic thinking. The present research aims to test the effects of a TCM-based anti-sedentariness program on workplace sitting time, perceived stress, and cortisol in office workers. We will also explore the psychophysiological mechanism whether such anti-sedentary effect works through stress management and enhances when holistic thinking is endorsed. Methods: A systematic review and meta-analysis has been conducted to synthesize the pooled effect of existing anti-sedentariness interventions on office workers' sitting time and compare the effectiveness of different intervention types in reducing sedentary behaviors relative to the control group. The systematic review and meta-analysis set the theoretical foundation of intervention elements for the reduction of sedentary behaviors at workplace and their psychological effects to be applied in the present study. A randomized controlled trial will be conducted among 92 office workers with self-reported sitting time of 5.5 hours or longer per workday. They will be randomly assigned to intervention (TCM-based program) and wait-list control groups. The TCM-based program will last for 4 weeks, with 2 weeks of health education and promotion activities (understanding sedentary behaviors, Baduanjin, acupressure, dantian breathing, and mindfulness) and 2 weeks of supported self-practice (daily reminders and tips, regular feedback on sitting time, website support and individual consultation). Participants' sitting time per workday and perceived stress will be assessed at baseline, post-intervention (4 weeks after baseline), and follow-up (6 weeks after baseline). During the 2-week self-practice, participants in the intervention group will complete a diary of self-practice duration of TCM-based bodywork, perceived stress, and collect saliva samples every two days. Repeated-measures ANOVA will be used to test the group differences in changes in sitting time and perceived stress. Mediating effects of perceived stress and cortisol and moderating effects of holistic thinking will be explored through SPSS marcos. Significance: The findings of this study will provide valuable insights into the effectiveness of a TCM-based intervention in reducing sedentary behavior and improving psychological well-being. It is innovative to understand the psychophysiological mechanism of reducing sedentary behavior to explore tailored interventions to enhance the health quality of office workers. Given the easy practice and low cost of the TCM-based body works, the project can put forward a cost-effective intervention that can benefit a large population sustainably.

Official Title
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Reduce Sedentariness and Enhance Physical and Psychological Health of Office Workers With TCM-based Anti-sedentary Intervention: Efficacy and Potential Psychophysiological Mechanisms

Conditions
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Sedentary Behavior

Intervention / Treatment
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* Behavioral: Traditional Chinese Medicine-based program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 18 or above with a full-time and office-based job Reported >5.5 hours of sitting per day at work Native Chinese speaker (Cantonese or Mandarin) Be able to give consent Exclusion Criteria: Have severe or chronic illness and not suitable for physical exercise Be oversensitive to tactile stimulation Have regular practice of qigong, acupressure, or mindfulness-based activities during the 4 weeks prior to recruitment

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: A randomized controlled trial will be conducted among 92 office workers with self-reported sitting time of 5.5 hours or longer per workday. They will be randomly assigned to intervention (TCM-based program) and wait-list control groups.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: TCM-based anti-sedentariness intervention group<br>The TCM-based program will last for 4 weeks, with 2 weeks of health education and promotion activities (understanding sedentary behaviors, Baduanjin, acupressure, dantian breathing, and mindfulness) and 2 weeks of supported self-practice (daily reminders and tips, regular feedback on sitting time, website support and individual consultation). | Behavioral: Traditional Chinese Medicine-based program<br>* Week1-2: one health talk session(60 mins); three workshops (each workshop will last for 60-90mins) to provide hands-on training in Baduanjin, acupressure techniques, mindful stretching, and effective strategies to combat sedentary behavior in the workplace. Week 3-4: group practice sessions will take place for one hour every other day throughout the workweek; website support.<br>* Other names: TCM-based program;|
| Other: Wait-list control group<br>The same intervention components as the experimental group will be provided after completion of all assessments. | Behavioral: Traditional Chinese Medicine-based program<br>* Week1-2: one health talk session(60 mins); three workshops (each workshop will last for 60-90mins) to provide hands-on training in Baduanjin, acupressure techniques, mindful stretching, and effective strategies to combat sedentary behavior in the workplace. Week 3-4: group practice sessions will take place for one hour every other day throughout the workweek; website support.<br>* Other names: TCM-based program;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| sedentary behavior- total sitting time/workday | measured by Actigraph wGT3X-BT | Baseline, week 5, week 9 | 
| sedentary behavior- sitting time/9-h working time | measured by Actigraph wGT3X-BT | Baseline, week 5, week 9 | 
| Self-report sedentary behaviors | measured by International Physical Activity Questionnaire(short version) | Baseline, week 5, week 9 | 
| psychological stress | measured by perceived stress scale with 10 items.Higher scores are correlated to more stress. | Baseline, week 5, week 9 | 
| physiological stress | measured by salivary cortisol concentration(measured in ng/mL) | Baseline, week 5, week 9 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Holistic thinking | measured by Analysis-Holism Scale.Higher scores indicate greater holistic cognitive style, and lower scores indicate greater analytic cognitive style. | Baseline | 
| Health-related quality of life | measured by The Chinese (Hong Kong) SF-36 Health Survey. It consists of 36 questions that cover eight different domains: physical functioning, role limitations due to physical health problems, bodily pain, general health perceptions, vitality, social functioning, role limitations due to emotional problems, and mental health. A higher score indicates better quality of life. | Baseline, week 5, week 9 | 
| Sleep quality | measured by The Pittsburgh Sleep Quality Index, PSQI.The Pittsburgh Sleep Quality Index consists of 19 individual items, with a total score of 21 and a higher score indicating poorer sleep quality. | Baseline, week 5, week 9 | 
| Psychological distress | measured by Depression Anxiety Stress Scale(DASS).The DASS-21 consists of 21 items, with seven items dedicated to each of the three subscales: depression, anxiety, and stress. A higher score indicates more depression, anxiety and stress. | Baseline, week 5, week 9 | 
| Self efficay | measured by The Chinese Self-Efficacy Scale. It consists of 10 items.The total score is calculated by finding the sum of the all items. For the GSE, the total score ranges between 10 and 40, with a higher score indicating more self-efficacy. | Baseline, week 5, week 9 | 
| Blood pressure | measured by Omron blood pressure monitor | Baseline, week 5, week 9 | 
| Hand grip strength | measured by Jamar handheld dynamometer | Baseline, week 5, week 9 | 
| IL-6 | Collect saliva samples to assay IL-6 concentration by using enzyme-linked immunoassay according to the manufacturer's instruction. | Baseline, week 5, week 9 | 
| IL-1β | Collect saliva samples to assay IL-1β concentration by using enzyme-linked immunoassay according to the manufacturer's instruction. | Baseline, week 5, week 9 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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RCT, sedentary behavior, office worker, Traditional Chinese Medicine, psychophysiological mechanism