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Interventions for increased physical activity among office workers
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.ORCID iD: 0000-0002-4656-7606
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The positive association between physical activity (PA) and health is well established. Technical developments in modern life have created major changes in our societies and working life, and a growing body of research has identified sedentary behavior (SB) as an independent risk factor for type 2 diabetes, cardiovascular disease, and cancer as well as for premature mortality. To promote health, it is important to find ways to decrease SB and incorporate PA in office settings, for example, by using new office designs and behavioral interventions.

 

The aim of this thesis was to evaluate two workplace interventions among office workers to determine if these led to increased PA and reduced SB, and to describe underlying factors behind these results.

 

The thesis is based on two workplace interventions. The first intervention was the Inphact treadmill study, a 13-month randomized controlled trial where treadmill workstations were installed and participants were instructed to use the treadmill for at least one hour per workday. The second intervention was the Active Office Design (AOD) study. This study included a multicomponent PA promoting program, implemented in parallel with an office relocation to either traditional cell offices or to a flex office with activity-based work (ABW). The two groups in the AOD study were followed from 6 months before relocation to 18 months after. 

 

Objectively measured data for SB, PA, and body measurements were collected in both studies. In the Inphact treadmill study, body composition, metabolic outcomes, self-reported energy and stress, and depression and anxiety scores were also measured. In the AOD study, measurements of health and lifestyle, musculoskeletal disorders, workload, work tasks, utilization of possibilities to be active at work, and perceptions of the performed PA promoting program were assessed via questionnaires. In addition, interview data were collected via focus groups and individual interviews. Linear mixed models were used for the main statistical analyses of the quantitative data. To explore the factors that influence SB and PA at work we combined factor analysis of mixed data with multiple linear regression.Interview data were analyzed using qualitative content analysis and a deductive approach to a process evaluation model. 

 

In both study populations, sitting time was low and stand­ing time was high already at baseline, compared to other studies on office workers. In the Inphact treadmill study, the intervention group showed increased walking time during workdays compared to the control group for all follow-up measurements. At the same time, a decrease in moderate-to-vigorous PA (MVPA) was observed in both the intervention and control groups during leisure time. No intervention effects were seen on body measurements, body composition, metabolic outcomes, stress, or anxiety during the treadmill intervention. 

 

In the AOD study, employees relocated to flex offices increased their walking time and MVPA during work hours to a greater extent than those relocated to cell offices, but neither group changed the amount of time spent sitting at work. Contrary to the Inphact treadmill study, no compensatory effects were seen during leisure time. The exploratory analysis resulted in six employee character-types, where the “harmonic and healthy” and “engaged with high workload” tended to sit more and to stand less, while the character type with “high BMI, creative and collaborative work” tended to sit less and stand more. The process evaluation of the intervention revealed a strong culture to encourage PA within the organization and that the intervention was supported by management. The timing of the program was questioned, and activities to support the relocation to the flex office with ABW were requested. Social acceptance for standing and walking at work increased, although the need for the intervention was debated due to the strong culture of facilitating PA at work already in place prior to the study.

 

In conclusion, we showed long-term increases in PA were achieved in office workers, but the changes did not lead to improvements in body measurements and metabolic balance during the follow-up period. The two studies showed conflicting results regarding compensatory effects during leisure. Participants in the Inphact treadmill study decreased their MVPA during leisure, while no compensatory effects were seen in the AOD-study. Our results suggest a possible ceiling effect for the amount sitting time can be reducedin office workers, and that SB and PA in offices is influenced by many factors, such as organizational culture, physical environment, work tasks, work load and physical comfort. Together, the studies in this thesis confirm the importance of carefully tailored worksite interventions for decreasing SB and increasing PA at work.

 

Place, publisher, year, edition, pages
Umeå: Umeå universitet , 2019. , p. 69
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2053
Keywords [en]
physical activity, sedentary behavior, office workers, office design, intervention, treadmill workstation, objective measurements
National Category
Occupational Health and Environmental Health
Research subject
Occupational and Environmental Medicine
Identifiers
URN: urn:nbn:se:umu:diva-164709ISBN: 978-91-7855-131-6 (print)OAI: oai:DiVA.org:umu-164709DiVA, id: diva2:1366209
Public defence
2019-11-22, Hörsal B, 9 trappor, Norrlands Universitetssjukhus, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2019-11-01 Created: 2019-10-28 Last updated: 2019-10-31Bibliographically approved
List of papers
1. Treadmill workstations in office workers who are overweight or obese: a randomised controlled trial
Open this publication in new window or tab >>Treadmill workstations in office workers who are overweight or obese: a randomised controlled trial
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2018 (English)In: The Lancet Public Health, ISSN 2468-2667, Vol. 3, no 11, article id e523-e535Article in journal (Refereed) Published
Abstract [en]

Background: Treadmill workstations that enable office workers to walk on a treadmill while working at their computers might increase physical activity in offices, but long-term effects are unknown. We therefore investigated whether treadmill workstations in offices increased daily walking time.

Methods: We did a randomised controlled trial of healthy office workers who were either overweight or obese. We recruited participants from 13 different companies, which comprised 17 offices, in Umeå, Sweden. We included people who were aged 40-67 years, had sedentary work tasks, and had a body-mass index (BMI) between 25 kg/m2 and 40 kg/m2. After the baseline measurement, we stratified participants by their BMI (25-30 kg/m2 and >30 to 40 kg/m2); subsequently, an external statistician randomly assigned these participants (1:1) to either the intervention group (who received treadmill workstations for optional use) or the control group (who continued to work at their sit-stand desks as usual). Participants in the intervention group received reminders in boosting emails sent out to them at four occasions during the study period. Researchers were masked to group assignment until after analysis of the primary outcome. After the baseline measurement, participants were not masked to group belongings. The primary outcome was total daily walking time at weekdays and weekends, measured at baseline, 2 months, 6 months, 10 months, and 13 months with the accelerometer activPAL (PAL Technologies, Glasgow, UK), which was worn on the thigh of participants for 24 h a day for 7 consecutive days. We used an intention-to-treat approach for our analyses. This trial is registered with ClinicalTrials.gov, number NCT01997970, and is closed to new participants.

Findings: Between Nov 1, 2013, and June 30, 2014, a total of 80 participants were recruited and enrolled (n=40 in both the intervention and control groups). Daily walking time during total time awake at weekdays increased between baseline and 13 months by 18 min (95% CI 9 to 26) in the intervention group and 1 min (-7 to 9) in the control group (difference 22 min [95% CI 7 to 37], pinteraction=0·00045); for weekend walking, the change from baseline to 13 months was 5 min (-8 to 18) in the intervention group and 8 min (-5 to 21) in the control group (difference -1 min [-19 to 17]; pinteraction=0·00045). Neither measure met our predetermined primary outcome of 30 min difference in total walking time between the intervention and control group, so the primary outcome of the trial was not met. One adverse event was reported in a participant who accidently stepped on their Achilles tendon.

Interpretation: In a sedentary work environment, treadmill workstations result in a statistically significant but smaller-than-expected increase in daily walking time. Future studies need to investigate how increasing physical activity at work might have potentially compensatory effects on non-work activity.

Place, publisher, year, edition, pages
The Lancet Publishing Group, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-152709 (URN)10.1016/S2468-2667(18)30163-4 (DOI)000451514600013 ()30322782 (PubMedID)
Available from: 2018-10-19 Created: 2018-10-19 Last updated: 2019-10-28Bibliographically approved
2. Effects of a multicomponent physical activity promoting program on sedentary behavior, physical activity and body measures: a longitudinal study in different office types
Open this publication in new window or tab >>Effects of a multicomponent physical activity promoting program on sedentary behavior, physical activity and body measures: a longitudinal study in different office types
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2019 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 5, p. 493-504, article id 3808Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of this study was to investigate effects of a multicomponent program promoting physical activity on sedentary behavior, physical activity, and body measures, when relocating from cell offices to either a flex or cell office.

Methods: The Active Office Design (AOD) study is a longitudinal non-randomized controlled study performed in a municipality in northern Sweden. A subsample of 86 participants were randomly recruited from the AOD study to objectively measure sedentary behavior and physical activity, using ActivPAL and ActiGraph, before and after relocation to the two different office types. The multicomponent program promoting physical activity was performed in both offices. Data were analyzed using linear mixed models.

Results: Eighteen months after relocation, the total number of steps per work day increased by 21% in the flex office and 3% in the cell office group, compared to baseline. Moderate and vigorous physical activity (MVPA) during work hours increased by 42% in the flex office group and 19% in the cell office group. No changes were seen regarding sitting time at work. Small additive effects for walking and MVPA were seen for both groups during non-work time. Weight increased in the flex office group.

Conclusions: This long-term study shows that a multicomponent workplace intervention can lead to increased walking time, steps, and MVPA in a flex compared to a cell office. Small additive increases of physical activity were seen during non-work time in both groups. More long-term controlled studies are needed to confirm these results.

Place, publisher, year, edition, pages
the Nordic Association of Occupational Safety and Health (NOROSH), 2019
National Category
Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-157427 (URN)10.5271/sjweh.3808 (DOI)000484571700009 ()30860269 (PubMedID)
Available from: 2019-03-19 Created: 2019-03-19 Last updated: 2019-10-28Bibliographically approved
3. Underlying factors explaining sedentary behavior and physical activity among office workers - an exploratory analysis
Open this publication in new window or tab >>Underlying factors explaining sedentary behavior and physical activity among office workers - an exploratory analysis
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(English)Manuscript (preprint) (Other academic)
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-164703 (URN)
Available from: 2019-10-28 Created: 2019-10-28 Last updated: 2019-10-31
4. Implementing a Physical Activity promoting program in a flex-office - a process evaluation with a mixed methods design
Open this publication in new window or tab >>Implementing a Physical Activity promoting program in a flex-office - a process evaluation with a mixed methods design
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(English)Manuscript (preprint) (Other academic)
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-164706 (URN)
Available from: 2019-10-28 Created: 2019-10-28 Last updated: 2019-10-31

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34567896 of 14
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