NUS Health Study: Improving Sleep, Sedentariness and Physical Activity in NUS Staff

'NUS Health' is a workplace-embedded health program for National University of Singapore (NUS) staff that concurrently targets sleep, sedentary behaviour, and physical activity. The intervention adopts a multilevel socioecological approach, integrating individual, social, environmental, and organisational strategies to support sustainable behaviour change.

This program was developed in response to findings from our previous study of NUS staff which revealed high levels of sedentary behaviour (>10 hours/day) and an obesity prevalence of approximately 25%, highlighting a substantial opportunity for workplace-based health promotion. These findings emerged alongside the growing national burden of chronic conditions such as hypertension and type 2 diabetes, which are strongly influenced by modifiable lifestyle behaviours including insufficient sleep, prolonged sedentary behaviour, and inadequate physical activity. Although these behaviours frequently co-occur and interact to influence health outcomes, existing intervention approaches remain largely episodic, clinic-based, and focused on individual risk factors, limiting their scalability, sustainability, and effectiveness in real-world settings. Increasing evidence indicates that interventions addressing behavioural determinants across both individual and organisational levels are more likely to achieve meaningful and sustained improvements in health. Together, these considerations informed the development of a multicomponent, workplace-embedded intervention designed to simultaneously improve sleep, reduce sedentary behaviour, and promote physical activity among NUS staff.

By combining real-time behavioural monitoring, personalised digital feedback, social engagement, and organisational change, the program seeks to establish a scalable and sustainable model for workplace health promotion. Leveraging continuous wearable-derived data, participants will receive personalised behavioural targets and feedback based on their own activity and sleep patterns. These will be complemented by a socially oriented incentive framework and institution-wide health promotion strategies embedded within the workplace environment, enabling healthy behaviours to be supported not only at the individual level but also through organisational culture and practices.

This 16-month study will be divided into three distinct phases: baseline (months 1-4), intervention (months 5-10), and post-intervention (months 11-16). There will be 4 in-person visits in total for each participant: visit 1 (once within months 1-2), visit 2 (once within months 2-4), visit 3 (once within months 9-10) and visit 4 (once within months 15-16).

The study team will evaluate the feasibility, acceptability, and effectiveness of this program in improving sleep and movement behaviours, with anticipated downstream benefits for cardiometabolic health, psychological well-being, and workplace productivity.

Specifically, we will examine how changes in sleep, sedentariness, and physical activity, affect:

Sleep: frequency of short sleep nights, sleep onset time, sleep duration, sleep variability, sleep satisfaction Sendentariness: amount of sedentary time daily and its temporal distribution Physical activity: amount of daily light-intensity physical activity (LPA) and moderate-to-vigorous activity (MVPA) and its temporal distribution Cardiometabolic markers: glucose trends, blood pressure, body roundness index, blood markers of cardiometabolic health (e.g., blood lipids, Hba1c) Bio-aging markers: blood count, liver panel, renal panel, CRP, etc.

Findings from this study will inform the development of future institution-wide health initiatives and contribute to the evidence base for integrated workplace interventions targeting multiple lifestyle risk factors simultaneously.

• NUS Health Prog (Behavioral): For the sleep component, personalised goals will focus on reducing or maintaining a low frequency of short sleep nights and, where appropriate, advancing sleep timing among individuals with delayed sleep schedules. Goals will be tailored to each participant using their biometric data. For the sedentariness component, personalised goals will focus on reducing daily sedentary time, with an overall target of approximately 8 hours per day or less. For the physical activity component, personalised goals will focus on increasing or maintaining moderate-to-vigorous physical activity (MVPA) levels.

Primary outcomes

• Sendentariness, via OURA ring [Through study completion, daily, an average of 2 years]: Amount of sedentary time daily, as measured by the OURA ring's sedentariness metric (energy expenditure of 1.5 metabolic equivalents (METs) or less ).
• Moderate-to-vigorous activity (MVPA), via OURA ring [Through study completion, daily, an average of 2 years]: Amount of daily moderate-to-vigorous activity (MVPA), as measured by the OURA ring.
• Light-intensity physical activity (LPA), via OURA ring [Through study completion, daily, an average of 2 years]: Amount of daily light-intensity physical activity (LPA), as measured by the OURA ring.
• Sleep duration, via OURA ring [Through study completion, daily, an average of 2 years]: Sleep duration as measured by the OURA ring.
• Sleep duration variability [Through study completion, an average of 2 years]: The dispersion of daily sleep duration values around a participant's personal average.
• Sleep onset time, via OURA ring [Through study completion, daily, an average of 2 years]: Sleep onset time as measured by the OURA ring.
• Sleep onset variability [Through study completion, an average of 2 years]: The dispersion of daily sleep onset timing values around a participant's personal average.
• Glucose trends across 2 weeks [2 weeks measurement period at baseline; subsequently at 9 months, and 15 months after baseline measurement]: Measured via Continuous Glucose Monitor
• Full blood count [At baseline; subsequently 9 months, and 15 months after baseline measurement]: Measured via venous blood collection
• Liver panel [At baseline; subsequently at 9 months, and 15 months after baseline measurement]: Measured via venous blood collection
• Renal panel [At baseline; subsequently at 9 months, and 15 months after baseline measurement]: Measured via venous blood collection
• Iron studies [At baseline; subsequently at 9 months, and 15 months after baseline measurement]: Measured via venous blood collection
• Urine panel [At baseline; subsequently at 9 months, and 15 months after baseline measurement]: Measured via urine collection

Sex: All, ages: 21 Years to 70 Years, accepts healthy volunteers

Inclusion Criteria:

* Full time NUS staff
* Willing to undergo blood draw procedure

Exclusion Criteria:

* Staff who tender their resignation from NUS during the 16-month study period will be discontinued from the study.

• Pereira MA, Mullane SL, Toledo MJL, Larouche ML, Rydell SA, Vuong B, Feltes LH, Mitchell NR, de Brito JN, Hasanaj K, Carlson NG, Gaesser GA, Crespo NC, Oakes JM, Buman MP. Efficacy of the 'Stand and Move at Work' multicomponent workplace intervention to reduce sedentary time and improve cardiometabolic risk: a group randomized clinical trial. Int J Behav Nutr Phys Act. 2020 Oct 27;17(1):133. doi: 10.1186/s12966-020-01033-3. PMID 33109190