ReviewAre workplace interventions to reduce sitting effective? A systematic review
Introduction
Sedentary behaviour is a term used to describe activity with very low (≤ 1.5 MET) energy expenditure, often operationalised as time spent sitting (Owen et al., 2009). It is distinct from inactivity, which is defined as not achieving recommended levels of moderate- to vigorous-intensity physical activity (Pate et al., 2008).
There is a growing body of evidence to suggest that sitting is an emerging public health concern. Sitting has been found to be associated with increased risk of adverse health conditions such as cardiovascular disease (Manson et al., 2002), cancer (Gierach et al., 2009, Howard et al., 2008), overweight and obesity (Hu et al., 2003, Proper et al., 2007), weight gain (Brown et al., 2005), type 2 diabetes (Hu et al., 2003), and mortality from all-causes or cardiovascular disease (Katzmarzyk et al., 2009, Weller and Corey, 1998). Furthermore, sitting may play a role independent of physical activity in the development of chronic illness (Healy et al., 2008b, Helmerhorst et al., 2009, Hu et al., 2003), and all-cause mortality (Katzmarzyk et al., 2009).
Most adults in developed countries spend time sitting in three domains: workplace, leisure, and transport. Recent research on occupational sitting suggests that there may be deleterious health effects associated with sitting for long periods at work specifically (Hu et al., 2003, Hu et al., 2007, Mummery et al., 2005).
Studies have found that working adults spend about one half to one third of their workday sitting down (Jans et al., 2007, Miller and Brown, 2004), and there is evidence that working adults with higher occupational sitting time do not necessarily compensate for their sitting at work by spending less time in sedentary behaviours during leisure time (Jans et al., 2007).
The World Health Organisation and World Economic Forum jointly highlight the workplace as an important setting for health promotion action (WHO/WEF, 2008). Although there have been several reviews of workplace physical activity promotion interventions (Dishman et al., 1998, Dugdill et al., 2008, Engbers et al., 2005, Marshall, 2004, Proper et al., 2003, Robroek et al., 2009), there has not yet been, to our knowledge, any systematic review of workplace studies which have aimed to reduce sitting generally or in the workplace specifically.
In light of the fact that many working adults spend significant amounts of time sitting, and that there may be adverse health effects as a consequence, it is important to know whether workplace interventions to reduce sitting are effective. The aim of this paper is, therefore, to systematically review the effectiveness of workplace interventions for reducing sitting.
Section snippets
Literature search
We searched the PubMed, PsychINFO, CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL, EMBASE and PEDro databases for studies related to workplace settings and sitting up to March–April 2009 using groups of thesaurus terms and free terms (full search for all databases, except for the EMBASE, which was searched from 1980). Terms for ‘adults’ were used in AND-combinations with terms for ‘workplace setting’, ‘sitting’, and search terms representing study design and languages
Study selection
The processes followed in the selection of papers for this review are shown in Fig. 1. A final sample of only six studies met the inclusion criteria for this review (Aittasalo et al., 2004, Gilson et al., 2009, Marshall et al., 2003, Opdenacker and Boen, 2008, Østerås and Hammer, 2006, Plotnikoff et al., 2005). The characteristics of these six studies are presented in Supplement Table 1.
Study designs
Three studies were randomised controlled trials (RCTs) (Aittasalo et al., 2004, Gilson et al., 2009,
Overview of main findings
The aim of this review was to examine the effectiveness of workplace interventions for reducing sitting. Our findings suggest that, to date, no workplace studies have attempted to reduce sitting as a primary outcome. We identified six studies that aimed primarily to promote physical activity in the workplace and secondarily to reduce sitting, either in general or at work. Overall, none of the studies showed significant differences in sitting between the intervention and control or comparison
Conclusion
This is the first systematic review to examine the effectiveness of workplace interventions for reducing sitting. The findings suggest that, to date, the evidence base is very small and includes only studies that address sitting reduction as an outcome secondary to increasing physical activity. Further methodologically rigorous research, incorporating domain-specific and objective measures of sitting, is required to address the emerging public health issue of sitting.
In summary, while reducing
Conflict of interest statement
None.
Acknowledgments
This review was funded by a grant from Health Promotion Queensland (Queensland Health HPQ00.01/021). Chau, van der Ploeg and van Uffelen are supported by a National Health and Medical Research Council (NHMRC) Program Grant (Owen, Bauman, Brown, No. 301200). Owen is supported by a Queensland Health Core Research Infrastructure Grant. Healy is supported by a NHMRC (No. 569861) and National Heart Foundation of Australia (PH 08B 3905) Postdoctoral Fellowship. Dunstan is supported by a Victorian
References (42)
- et al.
The effectiveness of physical activity counseling in a work-site setting: a randomized, controlled trial
Patient Educ. Couns.
(2004) - et al.
Worksite physical activity interventions
Am. J. Prev. Med.
(1998) - et al.
Worksite Health Promotion Programs with Environmental Changes. A Systematic Review
Am. J. Prev. Med.
(2005) - et al.
Occupational, commuting and leisure-time physical activity in relation to coronary heart disease among middle-aged Finnish men and women
Atherosclerosis
(2007) - et al.
Sedentary behavior in Dutch workers: differences between occupations and business sectors
Am. J. Prev. Med.
(2007) Challenges and opportunities for promoting physical activity in the workplace
J. Sci. Med. Sport
(2004)- et al.
Print versus website physical activity programs: a randomized trial
Am. J. Prev. Med.
(2003) - et al.
Occupational sitting time and overweight and obesity in Australian workers
Am. J. Prev. Med.
(2005) - et al.
The effectiveness of a pragmatic worksite physical activity program on maximal oxygen consumption and the physical activity level in healthy people
J. Bodyw. Mov. Ther.
(2006) - et al.
The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus
J. Clin. Epidemiol.
(1998)
Increasing passive energy expenditure during clerical work
Eur. J. Appl. Physiol.
Identifying the energy gap: magnitude and determinants of 5-year weight gain in midage women
Obes. Res.
Validity and reliability of measures of television viewing time and other non-occupational sedentary behaviour of adults: a review
Obes. Rev.
Recommendations for sufficient physical activity at work
International Physical Activity Questionnaire: 12-country reliability and validity
Med. Sci. Sports Exerc.
Activities contributing to total energy expenditure in the United States: results from the NHAPS Study
Int. J. Behav. Nutr. Phys. Act.
Workplace physical activity interventions: a systematic review
Int. J. Health Plann. Manage.
Physical activity, sedentary behavior, and endometrial cancer risk in the NIH-AARP Diet and Health Study
Int. J. Cancer
Do walking strategies to increase physical activity reduce sitting in workplaces: a randomized control trial
IJBNPA.
Breaks in sedentary time: beneficial associations with metabolic risk
Diab. Care
Objectively measured sedentary time, physical activity and metabolic risk. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab)
Diab. Care
Cited by (199)
Personal predictors of the longest episode of occupational sitting and their interaction with workplace support for health among workers in Accra: A cross-sectional analysis with sensitivity analyses
2023, International Journal of Industrial ErgonomicsSmart-Cover: A real time sitting posture monitoring system
2021, Sensors and Actuators, A: PhysicalCitation Excerpt :Indeed, prolonged sitting seems to be the new norm for many. Significant changes in social behaviours and arrangements, related to one’s work, commute, communication, entertainment and home are often leading people to prolonged periods of sitting [2–4]. On the other hand, the benefits of exercise are well recognized; but prolonged sitting has only been associated with a wide range of medical ailments including musculoskeletal, cardiovascular, cerebrovascular disease (strokes), type 2 diabetes mellitus, decubitus ulcers, early death and some malignancies [4,5].
Does frequency or duration of standing breaks drive changes in glycemic response? A randomized crossover trial
2023, Scandinavian Journal of Medicine and Science in SportsDifferential trends in prolonged sitting time in Europe: a multilevel analysis of European Eurobarometer data from 2013 to 2022
2023, Journal of Public Health (Germany)