This is a plain English summary of an original research article. The views expressed are those of the author(s) and reviewer(s) at the time of publication.
An intervention to encourage office workers to stand and move reduced their sitting time after 1 year, research found. The effect was 3-times greater when the intervention included a sit-to-stand, height-adjustable desk.
Researchers developed an intervention called SMART Work and Life, which included initiatives such as standing meetings. A long-term trial included 756 desk-based office workers. It compared the intervention to intervention plus sit-to-stand desk, and to usual working practice.
After 12 months, people in the intervention group sat for 22 minutes less per day than those in the usual practice group. Those in the group which received intervention plus sit-to-stand desk, sat for 64 minutes less per day than those in the usual practice group. Small improvements in stress, wellbeing and vigour were seen for both intervention groups. Reduced leg and foot pain was also reported in the intervention plus desk group. The intervention (with and without desk) promoted workers’ health and was likely to be cost-effective when wider public costs were considered over the long-term.
NICE guidelines on physical activity in the workplace advise increasing physical activity and decreasing sitting time at work. These guidelines will be updated shortly to include some of the strategies used in this study.
More information about increasing physical activity can be found on the NHS website. The benefits of reducing sitting time are described in the Promoting active workplaces section of an NIHR Evidence report on obesity.
UPDATE (23/11/2023): The full Health Technology Assessment of the SMART Work & Life intervention has been published.
The issue: how to spend less time sitting time at work
Office workers, who are usually desk-based, spend three-quarters of their working day sitting; plus two-thirds of their time outside of work. Sitting for long periods of time is associated with several diseases including type 2 diabetes, diseases affecting the heart and blood vessels and anxiety. In the workplace, it is linked with low vigour (energy and enthusiasm) and low job performance. Public health professionals encourage decreased sitting time to improve health.
The SMART Work and Life intervention aims to reduce daily sitting time and includes:
- online education
- self-monitoring of behaviour and prompts to break up sitting
- a dedicated workplace champion in each workplace to implement SMART and provide ongoing support
- small changes to the office environment such as standing meetings and moving waste bins further away from desks.
Researchers wanted to find out whether the intervention alone could reduce daily sitting time (during and outside of work), without the need for costly changes to offices, such as height-adjustable desks. They looked at the impact of the intervention alone, and intervention plus height-adjustable desk, after 1 year.
What’s new?
The study was carried out in local council offices in Leicester, Liverpool and Greater Manchester. Researchers randomly assigned desk-based employees to either: intervention (249 people), intervention plus height-adjustable desk (240 people) or usual practice (267 people). They were assessed a year after the intervention was introduced.
Participants wore a monitoring device on their thigh for 8 days. The device gathered data on sitting time during waking hours. The researchers also measured body weight, blood pressure and blood sugar levels. Participants completed questionnaires about muscle and joint problems, anxiety and depression, stress, wellbeing, fatigue, job performance and job satisfaction.
One year after the intervention was introduced:
- the intervention alone reduced sitting time by 22 minutes each day compared with usual practice
- intervention plus desk reduced sitting time by 64 minutes each day compared with usual practice
- people in the intervention plus desk group had less pain in their legs and feet
- both intervention groups had small improvements in stress, wellbeing and vigour.
The cost per office worker of the intervention was £81, and of the intervention plus desk was £228. This included training workplace champions, manager correspondence time, and setting up desks. When wider public costs were taken into account, both interventions were likely to be cost-effective in the long-term by reducing deaths associated with sitting for long periods. Cost-effectiveness was shown most clearly among those whose sitting time was most reduced, and who continued with their changed behaviour over the long-term.
Why is this important?
The study showed that the intervention reduced daily sitting time after 1 year. The addition of the height-adjustable desk to the intervention reduced sitting time 3-fold, by an extra 42 minutes each day. The intervention plus desk could prevent health problems linked with excessive sitting, the researchers say.
Participants in both intervention groups reported small improvements in stress, wellbeing and vigour compared with the usual practice. People in the desk group had greater improvements in muscle aches and pains than others.
The intervention was delivered by a workplace champion rather than by the research team. This is a strength of this study since it reflects how the intervention would be delivered in the real-world.
What’s next?
The intervention is now being rolled out to organisations across the UK and internationally. The researchers are planning to evaluate progress. NICE guidelines on physical activity in the workplace will be updated with some of the strategies used in this trial.
This study was conducted in office-based employees of local government. The interventions will need to be tested in other sectors. More research is also needed to investigate how people can best be supported to make changes outside of work. Participants were 45 years old on average, and most (72%) were women. Further research could establish whether the interventions are as effective in all groups.
You may be interested to read
This Alert is based on: Edwardson CL, and others. Effectiveness of an intervention for reducing sitting time and improving health in office workers: three arm cluster randomised controlled trial. British Medical Journal. 2022;373:e069288.
The cost-effectiveness analysis of the intervention: Cox E, and others. The cost-effectiveness of the SMARTWork & Life intervention for reducing sitting time. International Journal of Environmental Research and Public Health. 2022;19:14861.
Experiences of workplace champions: Edwardson CL, and others. Participant and workplace champion experiences of an intervention designed to reduce sitting time in desk-based workers: SMART work & life. International Journal of Behavioral Nutrition and Physical Activity. 2023;20(142).
An NIHR Evidence Collection about obesity: How can local authorities reduce obesity? Insights from NIHR research.
A 2023 Guardian article about the benefits of different movements (and standing): Starrett K, Starrett J. Stand on one leg – and 16 other life-changing daily moves that will keep your body happy.
Funding: This study was funded by the NIHR Public Health Research Programme.
Conflicts of Interest: Some of the researchers had interests to declare. A full list can be found on the original research papers (effectiveness and cost-effectiveness).
Disclaimer: NIHR Alerts are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that views expressed in NIHR Alerts are those of the author(s) and reviewer(s) at the time of publication. They do not necessarily reflect the views of the NHS, the NIHR or the Department of Health and Social Care.
