Evaluation of the Dynamic Work Intervention for Office Workers to Reduce Sedentary Behaviour

Large volumes of sitting time have been associated with multiple health risks such as diabetes, heart disease and premature death. Especially, in office workers sitting time per day can accumulate to over 10 hours a day. To reduce sitting time for office workers in a Dutch insurance company, an intervention will be implemented. The intervention contains the introduction of alternative workstations, intervention sessions with an occupational physiotherapist and an activity tracker with a self-help program booklet. The goal of this study is to evaluate the (cost) effectiveness of this intervention on the short term (3 months) and long-term (12 months). The primary outcome is objectively assessed sitting time.

In a cluster randomized controlled trial 250 employees of an insurance company will participate in the study. After baseline measurements, matched departments will be randomly assigned to the control or intervention group. The evaluation includes an economic and process evaluation.

• Dynamic Work (Other), also known as Dynamisch Werken: The intervention consists of the introduction of sit-stand workstations and desk bikes in the participants work environment in a ratio of 1:2 with traditional desks and chairs. Employees will receive a half hour intervention session at the start of the intervention from an occupational physiotherapist, who will provide further intervention support in the ensuing 12 weeks. Intervention participants will also receive an activity tracker which provides feedback on sitting time and physical activity levels.

Primary outcomes

• Sitting time [Change in sitting time between baseline and 12 month follow up assessment]: Total sitting time will be measured objectively with the activPAL activity tracker

Secondary outcomes

• Occupational sitting time [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker, occupational time will be recorded and linked with a diary
• Non-occupational sitting time [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker, non-occupational time will be recorded and linked with a diary
• Total standing time [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker
• Occupational standing time [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker, occupational time will be recorded and linked with a diary
• Non-occupational standing time [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker, non-occupational time will be recorded and linked with a diary
• Total stepping time [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker
• Occupational stepping time [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker, occupational time will be recorded and linked with a diary
• Non-occupational stepping time [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker, non-occupational time will be recorded and linked with a diary
• Sitting time in bouts of 30 min [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker
• Occupational sitting time in bouts of 30 min [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker, occupational time will be recorded and linked with a diary
• Non-occupational sitting time in bouts of 30 min [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker, non-occupational time will be recorded and linked with a diary
• Sitting time in bouts of 60 min [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker
• Occupational sitting time in bouts of 60 min [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker, occupational time will be recorded and linked with a diary
• Non-occupational sitting time in bouts of 60 min [Assessed at baseline 3 months and 12 months]: Objectively assessed by the activPAL activity tracker, non-occupational time will be recorded and linked with a diary
• Waist circumference and body height [Assessed at baseline 3 months and 12 months]: Waist circumference and body height will be objectively measured in cm
• Body weight [Assessed at baseline 3 months and 12 months]: Body weight will be objectively measured in kg and used to calculate body mass index (BMI)
• Individual Work Performance [Assessed at baseline 3 months and 12 months]: Will be assessed with the Individual Work Performance Questionnaire (IWPQ)
• Need for recovery [Assessed at baseline 3 months and 12 months]: This will be assessed with the Need For Recovery (NFR) questionnaire
• Effort-reward imbalance [Assessed at baseline 3 months and 12 months]: This will be assessed with the short Effort-Reward Imbalance (ERI-short) questionnaire
• Musculoskeletal complaints [Assessed at baseline 3 months and 12 months]: This will be assessed with the Nordic Musculoskeletal questionnaire
• Vitality [Assessed at baseline 3 months and 12 months]: This will be assessed with the Vita-16© TNO questionnaire
• Quality of life measured with EQ-5D-5L [Assessed at baseline 3 months and 12 months]: This will be assessed with the EQ-5D-5L questionnaire
• Absenteeism [Assessed at baseline 3 months and 12 months]: This will be self-reported as well as assessed with company records
• Healthcare consumption [Assessed at 3 months and 12 months]: This includes general practitioner, allied health professionals, complementary medicine consumption
• Sitting, physical activity and work related outcomes [Assessed at baseline 3 months and 12 months]: These will be assessed with custom sitting, physical activity and work questions
• Process evaluation [Assessed at 3 months and 12 months]: A process evaluation will be performed using qualitative (focus group interviews) and quantitative methods (questionnaires) in order to determine the level of implementation of the intervention as well as barriers and facilitators of this implementation.

Sex: All, ages: 18 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Employed by the insurance company for at least the duration of the study (12 months)
* Employed at least 28 hours per week
* Employed at one of the participating departments

Exclusion Criteria:

* Already access to the Dynamic Working Intervention
* Unable to stand or walk for longer time periods (i.e. wheelchair bound)
* Pregnancy

• Results publication: Jelsma JGM, van der Ploeg HP, Renaud LR, Stijnman DPM, Loyen A, Huysmans MA, van der Beek AJ, van Nassau F. Mixed-methods process evaluation of the Dynamic Work study: A multicomponent intervention for office workers to reduce sitting time. Appl Ergon. 2022 Oct;104:103823. doi: 10.1016/j.apergo.2022.103823. Epub 2022 Jun 17. PMID 35724470
• Results publication: Mastenbroek VJEZ, Jelsma JGM, van der Ploeg HP, Stijnman DPM, Huysmans MA, van der Beek AJ, van Nassau F. Barriers and facilitators influencing the implementation of the occupational health intervention 'Dynamic Work': a qualitative study. BMC Public Health. 2022 May 11;22(1):947. doi: 10.1186/s12889-022-13230-9. PMID 35546228
• Results publication: Renaud LR, Jelsma JGM, Huysmans MA, van Nassau F, Lakerveld J, Spekle EM, Bosmans JE, Stijnman DPM, Loyen A, van der Beek AJ, van der Ploeg HP. Effectiveness of the multi-component dynamic work intervention to reduce sitting time in office workers - Results from a pragmatic cluster randomised controlled trial. Appl Ergon. 2020 Apr;84:103027. doi: 10.1016/j.apergo.2019.103027. Epub 2020 Jan 10. PMID 31987512
• Results publication: Jelsma JGM, Renaud LR, Huysmans MA, Coffeng JK, Loyen A, van Nassau F, Bosmans JE, Spekle EM, van der Beek AJ, van der Ploeg HP. The Dynamic Work study: study protocol of a cluster randomized controlled trial of an occupational health intervention aimed at reducing sitting time in office workers. BMC Public Health. 2019 Feb 13;19(1):188. doi: 10.1186/s12889-019-6467-0. PMID 30760231