Wednesday, June 27, 2018

Workplace interventions (methods) for reducing time spent sitting at work

Cochrane: Time spent sitting and being physically inactive at work has increased in recent decades. Long periods of sitting may increase the risk of obesity, heart disease, and premature death. It is unclear whether interventions that aim to reduce sitting at workplaces are effective. We wanted to find out the effects of interventions aimed at reducing sitting time at work. We searched the literature in various databases up to 9 August 2017.
What trials did the review find?
We found 34 studies conducted with a total of 3,397 employees from high-income countries. Sixteen studies evaluated physical changes in the workplace design and environment, four studies evaluated changes in workplace policies, 10 studies evaluated information and counselling interventions, and four studies evaluated multi-category interventions.
Effect of sit-stand desks
The use of sit-stand desks seems to reduce workplace sitting on average by 84 to 116 minutes per day. When combined with the provision of information and counselling, the use of sit-stand desks seems to result in similar reductions in sitting at work. Sit-stand desks also seem to reduce total sitting time (including sitting at work and outside work) and the duration of workplace sitting bouts that last 30 minutes or longer. One study compared standing desks and sit-stand desks but due to the small number of employees included, it does not provide enough evidence to determine which type of desk is more effective at reducing sitting time.
Effect of active workstations
Treadmill desks combined with counselling seem to reduce sitting time at work, while the available evidence is insufficient to conclude whether cycling desks combined with the provision of information reduce sitting at work more than the provision of information alone.
Effect of walking during breaks or length of breaks
The available evidence is insufficient to draw conclusions about the effectiveness of walking during breaks in reducing sitting time. Taking short breaks (one to two minutes every half hour) seems to reduce time spent sitting at work by 15 to 66 minutes per day more than taking long breaks (two 15-minute breaks per workday).
Effect of information and counselling
Providing information, feedback, counselling, or all of these reduces sitting time at medium-term follow-up (3 to 12 months after the intervention) on average by 5 to 51 minutes per day. The available evidence is insufficient to draw conclusions about the effects at short-term follow-up (up to three months after the intervention). The use of computer prompts combined with providing information reduces sitting time in the medium-term on average by 14 to 96 minutes per day. The available evidence is insufficient to draw conclusions about the effects in the short-term.
One study found that prompts to stand reduce sitting time more than prompts to step, on average by 10 to 19 minutes per day.
The available evidence is insufficient to conclude whether providing highly personalised or contextualised information is more or less effective than providing less personalised or contextualised information in reducing siting time at work. The available evidence is also insufficient to draw conclusions about the effect of mindfulness training and the use of activity trackers on sitting at work.
Effect of combining multiple interventions
Combining multiple interventions seems to be effective in reducing sitting time and time spent in prolonged sitting bouts in the short-term and the medium-term. However, this evidence comes from only a small number of studies and the effects were very different across the studies.
Conclusions
The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. At present there is low-quality evidence that sit-stand desks may reduce sitting at work in the first year of their use. However, the effects are likely to reduce with time. There is generally insufficient evidence to draw conclusions about such effects for other types of interventions and for the effectiveness of reducing workplace sitting over periods longer than one year. More research is needed to assess the effectiveness of different types of interventions for reducing sitting at workplaces, particularly over longer periods.
Authors' conclusions: 
At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.