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Background Office workers spend 70–85% of their time at work sitting. High levels of sitting have been linked to poor physiological and psychological health. Evidence shows the need for fully powered randomised controlled trials, with long-term follow-up, to test the effectiveness of interventions to reduce sitting time. Objective Our objective was to test the clinical effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable workstation, compared with usual practice at 12-month follow-up. Design A three-arm cluster randomised controlled trial. Setting Councils in England. Participants Office workers. Intervention SMART Work & Life is a multicomponent intervention that includes behaviour change strategies, delivered by workplace champions. Clusters were randomised to (1) the SMART Work & Life intervention, (2) the SMART Work & Life intervention with a height-adjustable workstation (i.e. SMART Work & Life plus desk) or (3) a control group (i.e. usual practice). Outcome measures were assessed at baseline and at 3 and 12 months. Main outcome measures The primary outcome was device-assessed daily sitting time compared with usual practice at 12 months. Secondary outcomes included sitting, standing, stepping time, physical activity, adiposity, blood pressure, biochemical measures, musculoskeletal issues, psychosocial variables, work-related health, diet and sleep. Cost-effectiveness and process evaluation data were collected. Results A total of 78 clusters (756 participants) were randomised [control, 26 clusters (n = 267); SMART Work & Life only, 27 clusters (n = 249); SMART Work & Life plus desk, 25 clusters (n = 240)]. At 12 months, significant differences between groups were found in daily sitting time, with participants in the SMART Work & Life-only and SMART Work & Life plus desk arms sitting 22.2 minutes per day (97.5% confidence interval –38.8 to –5.7 minutes/day; p = 0.003) and 63.7 minutes per day (97.5% confidence interval –80.0 to –47.4 minutes/day; p < 0.001), respectively, less than the control group. Participants in the SMART Work & Life plus desk arm sat 41.7 minutes per day (95% confidence interval –56.3 to –27.0 minutes/day; p < 0.001) less than participants in the SMART Work & Life-only arm. Sitting time was largely replaced by standing time, and changes in daily behaviour were driven by changes during work hours on workdays. Behaviour changes observed at 12 months were similar to 3 months. At 12 months, small improvements were seen for stress, well-being and vigour in both intervention groups, and for pain in the lower extremity and social norms in the SMART Work & Life plus desk group. Results from the process evaluation supported these findings, with participants reporting feeling more energised, alert, focused and productive. The process evaluation also showed that participants viewed the intervention positively; however, the extent of engagement varied across clusters. The average cost of SMART Work & Life only and SMART Work & Life plus desk was £80.59 and £228.31 per participant, respectively. Within trial, SMART Work & Life only had an incremental cost-effectiveness ratio of £12,091 per quality-adjusted life-year, with SMART Work & Life plus desk being dominated. Over a lifetime, SMART Work & Life only and SMART Work & Life plus desk had incremental cost-effectiveness ratios of £4985 and £13,378 per quality-adjusted life-year, respectively. Limitations The study was carried out in one sector, limiting generalisability. Conclusions The SMART Work & Life intervention, provided with and without a height-adjustable workstation, was successful in changing sitting time. Future work There is a need for longer-term follow-up, as well as follow-up within different organisations. Trial registration Current Controlled Trials ISRCTN11618007. Plain language summary Office workers spend a large proportion of their day sitting. High levels of sitting have been linked to diseases, such as type 2 diabetes, heart disease and some cancers. The SMART Work & Life intervention is designed to reduce office workers’ sitting time inside and outside work. The SMART Work & Life intervention involves organisational, environmental, group and individual strategies to encourage a reduction in sitting time and was designed to be delivered with and without a height-adjustable workstation (which allows the user to switch between sitting and standing while working). To test whether or not the SMART Work & Life intervention worked, we recruited 756 office workers from councils in Leicester/Leicestershire, Greater Manchester and Liverpool, UK. Participants were from 78 office groups. One-third of the participants received the intervention, one-third received the intervention with a height-adjustable workstation and one-third were a control group (and carried on as usual). Workplace champions in each office group were given training and resources to deliver the intervention. Data were collected at the start of the study, with follow-up measurements at 3 and 12 months. We measured sitting time using a small device worn on the thigh and collected data on weight, body fat, blood pressure, blood sugar and cholesterol levels. We asked participants about their health and work and spoke to participants to find out what they thought of the intervention. Our results showed that participants who received the intervention without workstation sat for 22 minutes less per day, and participants who received the intervention with workstation sat for 64 minutes less per day, than participants in the control group. Levels of stress, well-being, vigour (i.e. personal and emotional energy and cognitive liveliness) and pain in the lower extremity appeared to improve in the intervention groups. Participants viewed the intervention positively and reported several benefits, such as feeling more energised, alert, focused and productive; however, the extent to which participants engaged with the intervention varied across groups. Scientific summary Background High levels of sedentary behaviour (e.g. sitting, reclining or lying, and expending ≤ 1.5 metabolic equivalents) have been linked to poor health outcomes, including type 2 diabetes, cardiovascular disease, some cancers and premature mortality. In addition to physiological health outcomes, high levels of sitting are detrimentally associated with cognitive function, mental health and a lower quality of life. Working-age adults spend around 60–70% of their workday sitting, with workdays being more sedentary than non-workdays; however, this can vary by occupation. Office workers spend 70–85% of their time at work sitting and accumulate a large proportion (40–50%) of this time in prolonged sitting bouts. Office workers also typically spend a large proportion of their leisure time sitting, compared with other occupations. In the workplace, lower levels of sitting have been linked to higher work vigour, higher job performance and lower presenteeism. Workplaces are, therefore, an ideal setting for implementing interventions to reduce daily sitting. Current evidence shows a need for fully powered randomised controlled trials (RCTs) with long-term follow-up to test the effectiveness of interventions to reduce sitting. Previous work from our group, evaluating multicomponent interventions to address high levels of sitting in office workers, found that significant reductions in sitting time across the day were mainly driven by changes to workplace sitting and to not daily sitting, indicating that a whole-day approach to encourage reductions in daily sitting was needed to maximise the potential health benefits. Objectives The main aim of the study was to evaluate the clinical effectiveness and cost-effectiveness of the SMART Work & Life (SWAL) intervention (provided with and without a height-adjustable workstation) in a sample of desk-based office workers. If both interventions were shown to be effective in comparison with the control group, then a secondary aim would be to determine if one intervention was more clinically effective and cost-effective than the other. Primary objective To investigate the impact of the SWAL intervention, delivered with and without a height-adjustable workstation, on device-assessed daily sitting time compared with usual practice at 12 months’ follow-up. Secondary objectives To investigate the impact of the SWAL intervention, delivered with and without a height-adjustable workstation, over the short term (assessed at 3 months) and longer term (assessed at 12 months) on: daily sitting time on any valid day (3 months) and on workdays and non-workdays sitting time during work hours daily time spent standing and in light and moderate or vigorous physical activity (MVPA) across any valid day, during work hours and on workdays and non-workdays daily time spent stepping and number of steps across any valid day, during work hours and on workdays and non-workdays markers of adiposity [i.e. body mass index (BMI), per cent body fat, waist circumference] blood pressure blood biomarkers [i.e. fasting glucose, cholesterol, triglycerides, glycated haemoglobin (HbA1c)] musculoskeletal health psychosocial health (i.e. fatigue, stress, anxiety and depression, well-being and quality of life) work-related health and performance (i.e. work engagement, job performance and satisfaction, occupational fatigue, presenteeism, sickness absence) sleep duration and quality. To undertake a full economic analysis of the SWAL intervention. To conduct a mixed-methods process evaluation throughout the intervention implementation period (using qualitative and quantitative measures) with participants and workplace champions. Methods Design A three-arm cluster RCT with a cost-effectiveness and process evaluation analysis. Follow-up measures were taken at 3 and 12 months. Setting Local councils in Leicester, Leicestershire, Greater Manchester and Liverpool, UK. Participants Participants were recruited from across participating councils (i.e. Leicester City Council, Leicestershire County Council, Salford City Council, Bolton Council, Trafford Council and Liverpool City Council). Participants were office-based employees (aged ≥ 18 years) who spent the majority (≥ 50%) of their day sitting, were at least 60% full-time equivalent and were able to walk without assistance. Employees who were pregnant, who already used a height-adjustable workstation or were unable to communicate in English were not eligible. Participants were grouped into clusters either by a shared office space (although could be made up of different teams/departments) or if they were members of the same team but split into different office spaces. To be eligible, each cluster was required to have at least one participant willing to undertake the role of workplace champion and at least four participants in the cluster. Informed consent was obtained from participants before the baseline measurement session and verbal consent was confirmed at each follow-up. Sample size To detect a 60-minute difference in average daily sitting time between the intervention groups and the control group [assuming a sitting time standard deviation (SD) of 90 minutes, 90% power, a two-tailed significance level of 5%, an average cluster size of 10 (range 4–38), an intraclass correlation coefficient of 0.05, the number of clusters being inflated by a factor of 1.23, allowing for one cluster drop out per arm and a 40% loss to follow-up/non-compliance with the activPAL (PAL Technologies Ltd, Glasgow, UK)], the required sample size was 690 participants from 72 clusters. Testing two intervention arms independently with the control arm was also taken account of as part of the sample size calculation. Interventions The SWAL intervention is a multicomponent intervention grounded in several behaviour change theories, which aims to reduce daily sitting in office workers. The SWAL intervention includes organisational-level behaviour change strategies (e.g. management buy-in), environmental-level behaviour change strategies (e.g. relocating waster bins, printers) and group-/individual-level behaviour change strategies (e.g. education, action-planning, goal-setting, addressing barriers, group coaching, challenges, self-monitoring) that are delivered by workplace champions. After all baseline measures were carried out, clusters were randomised to one of the following three conditions: (1) SWAL only, (2) the SWAL intervention with the addition of a height-adjustable workstation (i.e. SWAL plus desk) or (3) the control group. Randomisation was stratified by area (i.e. Leicester, Salford or Liverpool) and cluster size [i.e. small (

Abstract There is increasing evidence that sedentary behaviour is in itself a health risk, regardless of the daily amount of moderate to vigorous physical activity. Therefore, sedentary behaviour should be targeted as important health behaviour. It is known that even relatively small changes of health behaviour often require serious efforts from an individual and from people in their environment to become part of their lifestyle. Therefore, interventions to promote healthy behaviours should ideally be simple, easy to perform and easily available. Since sitting is likely to be highly habitual, confrontation with an intervention should almost automatically elicit a reaction of getting up, and thus break up and reduce sitting time. One important prerequisite for successful dissemination of such an intervention could be the use of a recognisable term relating to sedentary behaviour, which should have the characteristics of an effective brand name. To become wide spread, this term may need to meet three criteria: the “Law of the few”, the “Stickiness factor”, and the “Power of context”. For that purpose we introduce STUFF: Stand Up For Fitness. STUFF can be defined as “interrupting long sitting periods by short breaks”, for instance, interrupting sitting every 30 min by standing for at least five minutes. Even though we still need evidence to test the health-enhancing effects of interrupted sitting, we hope that the introduction of STUFF will facilitate the testing of the social, psychological and health effects of interventions to reduce sitting time.

Abstract Background The rising prevalence of Type 2 Diabetes Mellitus (T2DM) is a major public health problem. There is an urgent need for effective lifestyle interventions to prevent the development of T2DM. Sedentary behaviour (sitting time) has recently been identified as a risk factor for diabetes, often independent of the time spent in moderate-to-vigorous physical activity. Project STAND (Sedentary Time ANd Diabetes) is a study which aims to reduce sedentary behaviour in younger adults at high risk of T2DM. Methods/Design A reduction in sedentary time is targeted using theory driven group structured education. The STAND programme is subject to piloting and process evaluation in line with the MRC framework for complex interventions. Participants are encouraged to self-monitor and self-regulate their behaviour. The intervention is being assessed in a randomised controlled trial with 12 month follow up. Inclusion criteria are a) aged 18-40 years with a BMI in the obese range; b) 18-40 years with a BMI in the overweight range plus an additional risk factor for T2DM. Participants are randomised to the intervention (n = 89) or control (n = 89) arm. The primary outcome is a reduction in sedentary behaviour at 12 months as measured by an accelerometer (count < 100/min). Secondary outcomes include physical activity, sitting/lying time using the ActivPAL posture monitor, fasting and 2 h oral glucose tolerance test, lipids, inflammatory biomarkers, body weight, waist circumference, blood pressure, illness perceptions, and efficacy beliefs for behaviour change. Conclusions This is the first UK trial to address sedentary behaviour change in a population of younger adults at risk of T2DM. The results will provide a platform for the development of a range of future multidisciplinary interventions in this rapidly expanding high-risk population. Trial registration Current controlled trials ISRCTN08434554, MRC project 91409.

Abstract Background Screen-viewing has been associated with increased body mass, increased risk of metabolic syndrome and lower psychological well-being among children and adolescents. There is a shortage of information about the nature of contemporary screen-viewing amongst children especially given the rapid advances in screen-viewing equipment technology and their widespread availability. Anecdotal evidence suggests that large numbers of children embrace the multi-functionality of current devices to engage in multiple forms of screen-viewing at the same time. In this paper we used qualitative methods to assess the nature and extent of multiple forms of screen-viewing in UK children. Methods Focus groups were conducted with 10-11 year old children (n = 63) who were recruited from five primary schools in Bristol, UK. Topics included the types of screen-viewing in which the participants engaged; whether the participants ever engaged in more than one form of screen-viewing at any time and if so the nature of this multiple viewing; reasons for engaging in multi-screen-viewing; the room within the house where multi-screen-viewing took place and the reasons for selecting that room. All focus groups were transcribed verbatim, anonymised and thematically analysed. Results Multi-screen viewing was a common behaviour. Although multi-screen viewing often involved watching TV, TV viewing was often the background behaviour with attention focussed towards a laptop, handheld device or smart-phone. There were three main reasons for engaging in multi-screen viewing: 1) tempering impatience that was associated with a programme loading; 2) multi-screen facilitated filtering out unwanted content such as advertisements; and 3) multi-screen viewing was perceived to be enjoyable. Multi-screen viewing occurred either in the child's bedroom or in the main living area of the home. There was considerable variability in the level and timing of viewing and this appeared to be a function of whether the participants attended after-school clubs. Conclusions UK children regularly engage in two or more forms of screen-viewing at the same time. There are currently no means of assessing multi-screen viewing nor any interventions that specifically focus on reducing multi-screen viewing. To reduce children's overall screen-viewing we need to understand and then develop approaches to reduce multi-screen viewing among children.

Abstract Background The assessment of physical activity is an essential part of understanding patterns and influences of behaviour, designing interventions, and undertaking population surveillance and monitoring, but it is particularly problematic when using self-report instruments with young people. This study reviewed available self-report physical activity instruments developed for use with children and adolescents to assess their suitability and feasibility for use in population surveillance systems, particularly in Europe. Methods Systematic searches and review, supplemented by expert panel assessment. Results Papers (n = 437) were assessed as potentially relevant; 89 physical activity measures were identified with 20 activity-based measures receiving detailed assessment. Three received support from the majority of the expert group: Physical Activity Questionnaire for Children/Adolescents (PAQ-C/PAQ-A), Youth Risk Behaviour Surveillance Survey (YRBS), and the Teen Health Survey. Conclusions Population surveillance of youth physical activity is strongly recommended and those involved in developing and undertaking this task should consider the three identified shortlisted instruments and evaluate their appropriateness for application within their national context. Further development and testing of measures suitable for population surveillance with young people is required.

Abstract Background The potential synergistic effects of multiple dietary and physical activity behaviours on the risk of chronic conditions and health outcomes is a key issue for public health. This study examined the prevalence and clustering patterns of multiple health behaviours among a sample of adolescents in the UK. Methods Cross-sectional survey of 176 adolescents aged 12–16 years (49% boys). Adolescents wore accelerometers for seven days and completed a questionnaire assessing fruit, vegetable, and breakfast consumption. The prevalence of adolescents meeting the physical activity (≥ 60 minutes moderate-to-vigorous physical activity/day), fruit and vegetable (≥ 5 portions of FV per day) and breakfast recommendations (eating breakfast on ≥ 5 days per week), and clustering patterns of these health behaviours are described. Results Boys were more active than girls (p < 0.001) and younger adolescents were more active than older adolescents (p < 0.01). Boys ate breakfast on more days per week than girls (p < 0.01) and older adolescents ate more fruit and vegetables than younger adolescents (p < 0.01). Almost 54% of adolescents had multiple risk behaviours and only 6% achieved all three of the recommendations. Girls had significantly more risk factors than boys (p < 0.01). For adolescents with two risk behaviours, the most prevalent cluster was formed by not meeting the physical activity and fruit and vegetable recommendations. Conclusion Many adolescents fail to meet multiple diet and physical activity recommendations, highlighting that physical activity and dietary behaviours do not occur in isolation. Future research should investigate how best to achieve multiple health behaviour change in adolescent boys and girls.

Abstract Background There is evidence of a clustering of healthy dietary patterns and physical activity among young people and also of unhealthy behaviours. The identification of influences on children's health behaviors, particularly clustered health behaviors, at the time at which they develop is imperative for the design of interventions. This study examines associations between parental modelling and support and children's physical activity (PA) and consumption of fruit and vegetables (FV), and combinations of these behaviours. Methods In 2002/3 parents of 775 Australian children aged 10–12 years reported how frequently their child ate a variety of fruits and vegetables in the last week. Children wore accelerometers for eight days during waking hours. Parental modelling and parental support (financial and transport) were self-reported. Binary logistic and multinomial logistic regression analyses examined the likelihood of achieving ≥ 2 hours of PA per day (high PA) and of consuming ≥ 5 portions of FV per day (high FV) and combinations of these behaviors (e.g. high PA/low FV), according to parental modelling and support. Results Items of parental modelling and support were differentially associated with child behaviours. For example, girls whose parents reported high PA modelling had higher odds of consuming ≥ 5 portions of FV/day (OR = 1.95, 95% CI = 1.32–2.87, p < 0.001). Boys whose parents reported high financial support for snacks/fast foods had higher odds of having 'high PA/low FV' (OR = 2.0, 95% CI = 1.1–3.7). Conclusion Parental modelling of and support for physical activity and fruit and vegetable consumption were differentially associated with these behaviours in children across behavioural domains and with combinations of these behaviours. Promoting parents' own healthy eating and physical activity behaviours as well encouraging parental modelling and support of these behaviours in their children may be important strategies to test in future research.

Abstract Background Identification of non-modifiable correlates of physical activity and sedentary behaviour in youth contributes to the development of effective targeted intervention strategies. The purpose of this research was to examine the relationships between family circumstances (e.g. socio-economic status, single vs. dual parent household, presence/absence of siblings) and leisure-time physical activity and sedentary behaviours in adolescents. Methods A total of 1171 adolescents (40% male; mean age 14.8 years) completed ecological momentary assessment diaries every 15 minutes for 3 weekdays outside of school hours and 1 weekend day. Analysed behaviours were sports/exercise, active travel, TV viewing, computer use, sedentary socialising (hanging-out, using the telephone, sitting and talking) and total sedentary behaviour. Linear regression was employed to estimate levels of association between individual family circumstance variables and each behaviour. Results Compared to girls from higher socioeconomic status (SES) groups, girls from low SES groups reported higher weekend TV viewing and higher weekday total sedentary behaviour. For boys, single parent status was associated with greater total sedentary behaviour compared to those from dual parent households. Boys and girls from low socio-economic neighbourhoods reported lower participation in sports/exercise compared to those living in higher socio-economic neighbourhoods. Conclusion Associations were not consistent across behaviours or between genders. Overall, findings indicate that boys from single parent households and girls from low socio-economic families may be at increased risk of high sedentary behaviour. Those living in low socioeconomic neighbourhoods may be at increased risk of reduced participation in sports and exercise.

BackgroundGiven the substantive health inequalities in peri-urban communities and the potential for physical activity to promote health in these communities, identifying modifiable physical activity determinants in this population is important. This study explored effects of the peri-urban environment and psychological constructs on physical activity intentions and behavioural automaticity guided by an integrated theoretical framework.MethodsPeri-urban Australians (N = 271) completed self-report measures of environmental (i.e. physical/social environment, and neighbourhood selection), motivational (i.e. autonomous motivation), and social cognition (i.e. attitudes, norms, and perceived behavioural control [PBC]) constructs, past behaviour, intentions, and automaticity.ResultsA well-fitting path analytic model revealed that: autonomous motivation predicted all social cognition constructs; subjective norms and PBC, but not attitudes; autonomous motivation predicted intentions and automaticity; and subjective norms and PBC mediated effects of autonomous motivation on intentions. Of the environmental constructs, only neighbourhood selection was related to intentions, mediated by PBC.ConclusionsAutonomous motivation is an important correlate of physical activity intentions and automaticity, and subjective norms and PBC also related to intentions. Individuals perceiving a supportive environment were more likely to report positive PBC and intentions. Targeting change in autonomous motivation, and normative and control beliefs may help enhance physical activity intentions and automaticity in peri-urban communities.

BackgroundPolicy analysis is considered essential for achieving successful reforms in health promotion and public health. The only framework for physical activity (PA) policy analysis was developed at a time when the field of PA policy research was in its early stages. PA policy research has since grown, and our understanding of what elements need to be included in a comprehensive analysis of PA policy is now more refined. This study developed a new conceptual framework for PA policy analysis - the Comprehensive Analysis of Policy on Physical Activity (CAPPA) framework.MethodsThe development of the CAPPA framework was based on: (i) an extensive review of literature; (ii) an open discussion between the authors; (iii) three rounds of a Delphi process; and (iv) two-rounds of consultations with PA policy stakeholders.ResultsThe CAPPA framework specifies 38 elements of a comprehensive analysis of PA policies in the following six categories, which comprise the building blocks of the framework: (i) purpose of analysis (including auditing and assessment of policies); (ii) policy level (including: international; national; subnational; local; and institutional policies); (iii) policy sector (including: health; sport; recreation and leisure; education; transport; environment; urban/rural planning and design; tourism; work and employment; public finance; and research sectors); (iv) type of policy (including: formal written policies; unwritten formal statements; written standards and guidelines; formal procedures; and informal policies); (v) stage of policy cycle (including: agenda setting; formulation; endorsement/legitimisation; implementation; evaluation; maintenance; termination; and succession); and (vi) scope of analysis (including availability; context; processes; actors; political will; content; and effects). Based on the CAPPA framework, we also proposed broad and inclusive definitions of PA policy and PA policy analysis.ConclusionThe CAPPA framework may be used to guide future studies related to PA policy and to provide a context for the analysis of its specific components. The framework could be used in the same way for sedentary behaviour policy research. Future research should examine the extent to which PA policy analysis has covered each of the elements specified in the CAPPA framework and analyse the elements for which evidence is lacking. Future studies should also determine whether the existing tools allow for auditing and assessment of all the CAPPA elements and develop new tools if needed to allow for a more comprehensive PA policy analysis.

Objective: To investigate the association of running participation and the dose of running with the risk of all-cause, cardiovascular and cancer mortality.Design: Systematic review and meta-analysis.Data Sources: Journal articles, conference papers and doctoral theses indexed in Academic Search Ultimate, CINAHL, Health Source: Nursing/Academic Edition, MasterFILE Complete, Networked Digital Library of Theses and Dissertations, Open Access Theses and Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, SPORTDiscus and Web of Science.Eligibility Criteria For Selecting Studies: Prospective cohort studies on the association between running or jogging participation and the risk of all-cause, cardiovascular and/or cancer mortality in a non-clinical population of adults were included.Results: Fourteen studies from six prospective cohorts with a pooled sample of 232 149 participants were included. In total, 25 951 deaths were recorded during 5.5-35 year follow-ups. Our meta-analysis showed that running participation is associated with 27%, 30% and 23% lower risk of all-cause (pooled adjusted hazard ratio (HR)=0.73; 95% confidence interval (CI) 0.68 to 0.79), cardiovascular (HR=0.70; 95% CI 0.49 to 0.98) and cancer (HR=0.77; 95% CI 0.68 to 0.87) mortality, respectively, compared with no running. A meta-regression analysis showed no significant dose-response trends for weekly frequency, weekly duration, pace and the total volume of running.Conclusion: Increased rates of participation in running, regardless of its dose, would probably lead to substantial improvements in population health and longevity. Any amount of running, even just once a week, is better than no running, but higher doses of running may not necessarily be associated with greater mortality benefits. [ABSTRACT FROM AUTHOR]

Sedentary behaviour – i.e., low energy-expending waking behaviour while seated or lying down – is a health risk factor, even when controlling for physical activity. This review sought to describe the behaviour change strategies used within interventions that have sought to reduce sedentary behaviour in adults. Studies were identified through existing literature reviews, a systematic database search, and hand-searches of eligible papers. Interventions were categorised as ‘very promising’, ‘quite promising’, or ‘non-promising’ according to observed behaviour changes. Intervention functions and behaviour change techniques were compared across promising and non-promising interventions. Twenty-six eligible studies reported thirty-eight interventions, of which twenty (53%) were worksite-based. Fifteen interventions (39%) were very promising, eight quite promising (21%), and fifteen non-promising (39%). Very or quite promising interventions tended to have targeted sedentary behaviour instead of physical activity. Interventions based on environmental restructuring, persuasion, or education were most promising. Self-monitoring, problem solving, and restructuring the social or physical environment were particularly promising behaviour change techniques. Future sedentary reduction interventions might most fruitfully incorporate environmental modification and self-regulatory skills training. The evidence base is, however, weakened by low-quality evaluation methods; more RCTs, employing no-treatment control groups, and collecting objective data are needed. [ABSTRACT FROM PUBLISHER]