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      Effectiveness of an intervention for reducing sitting time and improving health in office workers: three arm cluster randomised controlled trial

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          Abstract

          Objectives

          To evaluate the effectiveness of an intervention, with and without a height adjustable desk, on daily sitting time, and to investigate the relative effectiveness of the two interventions, and the effectiveness of both interventions on physical behaviours and physical, biochemical, psychological, and work related health and performance outcomes.

          Design

          Cluster three arm randomised controlled trial with follow-up at three and 12 months.

          Setting

          Local government councils in Leicester, Liverpool, and Greater Manchester, UK.

          Participants

          78 clusters including 756 desk based employees in defined offices, departments, or teams from two councils in Leicester, three in Greater Manchester, and one in Liverpool.

          Interventions

          Clusters were randomised to one of three conditions: the SMART Work and Life (SWAL) intervention, the SWAL intervention with a height adjustable desk (SWAL plus desk), or control (usual practice).

          Main outcomes measures

          The primary outcome measure was daily sitting time, assessed by accelerometry, at 12 month follow-up. Secondary outcomes were accelerometer assessed sitting, prolonged sitting, standing and stepping time, and physical activity calculated over any valid day, work hours, workdays, and non-workdays, self-reported lifestyle behaviours, musculoskeletal problems, cardiometabolic health markers, work related health and performance, fatigue, and psychological measures.

          Results

          Mean age of participants was 44.7 years, 72.4% (n=547) were women, and 74.9% (n=566) were white. Daily sitting time at 12 months was significantly lower in the intervention groups (SWAL −22.2 min/day, 95% confidence interval −38.8 to −5.7 min/day, P=0.003; SWAL plus desk −63.7 min/day, −80.1 to −47.4 min/day, P<0.001) compared with the control group. The SWAL plus desk intervention was found to be more effective than SWAL at changing sitting time (−41.7 min/day, −56.3 to −27.0 min/day, P<0.001). Favourable differences in sitting and prolonged sitting time at three and 12 month follow-ups for both intervention groups and for standing time for the SWAL plus desk group were observed during work hours and on workdays. Both intervention groups were associated with small improvements in stress, wellbeing, and vigour, and the SWAL plus desk group was associated with improvements in pain in the lower extremity, social norms for sitting and standing at work, and support.

          Conclusions

          Both SWAL and SWAL plus desk were associated with a reduction in sitting time, although the addition of a height adjustable desk was found to be threefold more effective.

          Trial registration

          ISRCTN Registry ISRCTN11618007.

          Related collections

          Most cited references85

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          The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

          Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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            A Global Measure of Perceived Stress

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              Development and validation of brief measures of positive and negative affect: The PANAS scales.

              In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented.
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                Author and article information

                Contributors
                Role: associate professor
                Role: professor
                Role: reader
                Role: professor
                Role: professor
                Role: lecturer
                Role: professor
                Role: professor
                Role: professor
                Role: medical statistician
                Role: research assistant
                Role: research assistant
                Role: professor
                Role: professor
                Role: professor
                Role: lecturer
                Journal
                BMJ
                BMJ
                BMJ-UK
                bmj
                The BMJ
                BMJ Publishing Group Ltd.
                0959-8138
                1756-1833
                2022
                17 August 2022
                : 378
                : e069288
                Affiliations
                [1 ]Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
                [2 ]NIHR Leicester Biomedical Research Centre, Leicester, UK
                [3 ]Centre for Health Research, University of Southern Queensland, Springfield Central, QLD, Australia
                [4 ]School of Sport, Exercise and Health Sciences, Loughborough University, Leicester, UK
                [5 ]Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
                [6 ]Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
                [7 ]Mary MacKillop Institute for Health Research, The Australian Catholic University, Melbourne, VIC, Australia
                [8 ]Department of Health Sciences, University of Leicester, Leicester, UK
                [9 ]Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, UK
                [10 ]School of Health and Society, University of Salford, Salford, Greater Manchester, UK
                [11 ]School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
                [12 ]The Leicester Clinical Trials Unit, University of Leicester, Leicester, UK
                [13 ]Centre for Health Economics, University of York, York, UK
                Author notes
                Correspondence to: C L Edwardson ce95@ 123456le.ac.uk
                Author information
                https://orcid.org/0000-0001-6485-9330
                https://orcid.org/0000-0002-7663-6895
                https://orcid.org/0000-0001-5612-5898
                https://orcid.org/0000-0002-9987-9371
                https://orcid.org/0000-0003-2629-9568
                https://orcid.org/0000-0002-6023-3661
                https://orcid.org/0000-0002-0722-2760
                https://orcid.org/0000-0002-9284-9321
                https://orcid.org/0000-0001-7093-7892
                https://orcid.org/0000-0002-8584-0388
                https://orcid.org/0000-0001-5830-7521
                https://orcid.org/0000-0002-4503-0479
                https://orcid.org/0000-0002-5585-0243
                https://orcid.org/0000-0002-2360-4566
                https://orcid.org/0000-0002-5724-5178
                https://orcid.org/0000-0001-9510-7676
                Article
                bmj-2021-edwc069288.R2 edwc069288
                10.1136/bmj-2021-069288
                9382450
                35977732
                aec4bc62-115e-4d01-8187-707a6c72fd89
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/.

                History
                : 13 June 2022
                Categories
                Research

                Medicine
                Medicine

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