Elsevier

Preventive Medicine

Volume 51, Issue 5, November 2010, Pages 352-356
Preventive Medicine

Review
Are workplace interventions to reduce sitting effective? A systematic review

https://doi.org/10.1016/j.ypmed.2010.08.012Get rights and content

Abstract

Objective

To systematically review the effectiveness of workplace interventions for reducing sitting.

Methods

Studies published up to April 2009 were identified by literature searches in multiple databases. Studies were included if they were interventions to increase energy expenditure (increase physical activity or decrease sitting); were conducted in a workplace setting; and specifically measured sitting as a primary or secondary outcome. Two independent reviewers assessed methodological quality of the included studies, and data on study design, sample, measures of sitting, intervention and results were extracted.

Results

Six studies met the inclusion criteria (five randomised trials and one pre–post study). The primary aim of all six was to increase physical activity; all had reducing sitting as a secondary aim. All used self-report measures of sitting; one specifically assessed occupational sitting time; the others used measures of general sitting. No studies showed that sitting decreased significantly in the intervention group, compared with a control or comparison group.

Conclusion

Currently, there is a dearth of evidence on the effectiveness of workplace interventions for reducing sitting. In light of the growing body of evidence that prolonged sitting is negatively associated with health, this highlights a gap in the scientific literature that needs to be addressed.

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

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