Effectiveness of the Stand More AT (SMArT) Work intervention: cluster randomised controlled trial

Effectiveness of the Stand More AT (SMArT) Work intervention: cluster randomised controlled trial

Objectives: Primary: To evaluate the impact of Stand More AT (SMArT) Work on occupational sitting time compared to usual practice at 12 months. Secondary: To investigate whether SMArT Work leads to short (3 months), medium (6 months) and longer term (12 months) changes in occupational, daily and prolonged sitting, standing and physical activity and physical, psychological and work-related health.

Design: Cluster two arm randomised controlled trial.

Setting: A National Health Service (NHS) Trust.

Participants: Desk-based workers.

Interventions: SMArT Work was implemented through the Behaviour Change Wheel and the associated COM-B approach. The intervention group received a height-adjustable workstation; a brief seminar with supporting leaflet; workstation instructions with sitting and standing targets ; feedback on sitting and physical activity at three time-points; posters; action planning and goal setting booklet; self-monitoring and prompt tool;; and coaching sessions (month one and every 3 months thereafter). The control group continued with usual practice.

Main outcomes measures: Primary: occupational sitting time (thigh worn accelerometer). Secondary: objectively measured daily, prolonged sitting(≥30 minutes), and standing time, physical activity; musculoskeletal issues, self-reported work-related health (job performance, job satisfaction, work engagement, occupational fatigue, sickness presenteeism and absenteeism), cognitive function, and self-reported psychological measures (mood/affective states, quality of life) assessed at 3, 6 and 12 months. Data were analysed using generalized estimating equation models, accounting for clustering.

Results: 37 office clusters (146 participants) were recruited. 19 clusters (77 participants) were randomised to the intervention and 18 (69 participants) to control. Primary outcome: A significant difference between groups (in favour of the intervention group) was found in occupational sitting time at 12 months (-83.28 minutes/workday (95% CI -116.57 to -49.98, p=0.001). Secondary outcomes: Differences between groups (in favour of the intervention group compared to control) were observed for occupational sitting time at 3 (-50.62 minutes/workday (95% CI -78.71 to -22.54, p<0.001) and 6 (-64.4 minutes/workday (95% CI -97.31 to -31.50, p<0.001) months and daily sitting time at 6 (-59.32 minutes/day (95% CI -88.40 to-30.25, p<0.001) and 12 months (-82.39 minutes/day (95% CI -114.54 to -50.26, p=0.001)). Group differences (in favour of the intervention group compared to control) were found for prolonged sitting time, standing time, job performance, work engagement, occupational fatigue, presenteeism, daily anxiety and quality of life. No differences were seen for sickness absence.

Conclusions: SMArT Work successfully reduced sitting time over the short, medium and longer term and positive changes were observed in work-related and psychological health.