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Background Sedentary time is associated with chronic disease and premature mortality. We tested a multilevel workplace intervention with and without sit-stand workstations to reduce sedentary time and lower cardiometabolic risk. Methods Stand and Move at Work was a group (cluster) randomized trial conducted between January 2016 and December 2017 among full-time employees; ≥18 years; and in academic, industry/healthcare, and government worksites in Phoenix, Arizona and Minneapolis/St. Paul, Minnesota, USA. Eligible worksites were randomized to (a) MOVE+, a multilevel intervention targeting reduction in sedentary time and increases in light physical activity (LPA); or (b) STAND+, the MOVE+ intervention along with sit-stand workstations to allow employees to sit or stand while working. The primary endpoints were objectively-measured workplace sitting and LPA at 12 months. The secondary endpoint was a clustered cardiometabolic risk score (blood pressure, glucose, insulin, triglycerides, and HDL-cholesterol) at 12 months. Results Worksites (N = 24; academic [n = 8], industry/healthcare [n = 8], and government [n = 8] sectors) and employees (N = 630; 27 ± 8 per worksite; 45 ± 11 years of age, 74% female) were enrolled. All worksites were retained and 487 participants completed the intervention and provided data for the primary endpoint. The adjusted between arm difference in sitting at 12 months was − 59.2 (CI: − 74.6,-43.8) min per 8 h workday, favoring STAND+, and in LPA at 12 months was + 2.2 (− 0.9,5.4) min per 8 h workday. Change in the clustered metabolic risk score was small and not statistically significant, but favored STAND+. In an exploratory subgroup of 95 participants with prediabetes or diabetes, the effect sizes were larger and clinically meaningful, all favoring STAND+, including blood glucose, triglycerides, systolic blood pressure, glycated hemoglobin, LDL-cholesterol, body weight, and body fat. Conclusions Multilevel workplace interventions that include the use of sit-stand workstations are effective for large reductions in sitting time over 12 months. Among those with prediabetes or diabetes, clinical improvements in cardiometabolic risk factors and body weight may be realized. Trial registration ClinicalTrials.gov Identifier: NCT02566317. Registered 2 October 2015, first participant enrolled 11 January 2016.

Multicomponent interventions that use sit-stand workstations (SSW) to reduce workplace sitting time have been largely successful. However, the long-term maintenance (i.e., >12 months) of this behavior change is relatively unknown. We aimed to evaluate the 24-month maintenance of reductions in workplace sitting time, along with the effects of introducing the SSW after 12 months of multicomponent intervention only. We used data from Stand and Move at Work, a two-arm multi-site group randomized trial of 24 worksites (12 worksites per arm; N=630, 74% female, 45±11 years of age). Worksites in the STAND+ arm received 12 months of a multilevel (i.e., worksite policy, environmental, and individual-level strategies) intervention to increase light-intensity physical activity, along with a SSW, to increase standing time. Worksites in the MOVE+ arm (i.e., comparator) received the same multilevel intervention but were not provided with the SSW until after the intervention ended at 12 months. Sitting time was assessed for 7 consecutive days using the activPAL3c micro accelerometer at baseline, 12, and 24 months. Results are presented below in table form. In STAND+ , sitting time at 24 months, relative to baseline, was significantly reduced and similar in magnitude of change to what was observed at 12 months. In MOVE+ , sitting time at 24 months (a year after the SSW was introduced), relative to baseline, was significantly reduced but markedly smaller in magnitude of change than observed during the STAND+ active intervention period (i.e., 0 to 12 months). These results support the use of SSW coupled with a multicomponent intervention for optimal and long-term maintenance of reductions in workplace sitting time. Hierarchical regression models were adjusted for worksite clustering, age, sex, and baseline BMI.

Long-term effects of workplace sedentary behavior interventions on cardiometabolic risk are poorly understood. Stand and Move at Work was a multi-site group randomized trial in 24 worksites (N=630, 74% female, 45±11 years of age) of office-based employees in Phoenix, AZ and Minneapolis/St. Paul, MN. Worksites in the STAND+ study arm received 12 months of a multilevel (i.e., worksite policy, environmental, and individual-level strategies) intervention to increase light-intensity physical activity along with a sit-stand workstation (SSW) to increase standing time. Worksites in the MOVE+ study arm received the same multilevel intervention but were not provided the SSW until after the intervention ended at 12 months. The STAND+ arm, but not the MOVE+ arm, had significant reductions in sedentary time over the 12-month intervention. However, 12-month improvements in cardiometabolic risk factors were only observed among a subgroup with dysglycemia (prediabetes or diabetes). Here we report the long-term follow-up of these changes, 12 months after the end of the trial (24 months). Results are shown in the Table. The effects at 12 months were largely sustained at 24 months. Although limited by the small sample size in this subgroup, long-term meaningful and sustained improvement in blood glucose, triglycerides, systolic blood pressure, and weight may be observed from a multilevel workplace sedentary behavior intervention that includes sit-stand workstations.

Purpose: To review enrollment strategies, participation barriers, and program reach of a large, 2-year workplace intervention targeting sedentary behavior. Approach: Cross-sectional, retrospective review. Setting: Twenty-four worksites balanced across academic, industry, and government sectors in Minneapolis/Saint Paul (Minnesota) and Phoenix (Arizona) regions. Participants: Full-time (≥30+ h/wk), sedentary office workers. Methods: Reach was calculated as the proportion of eligible employees who enrolled in the intervention ([N enrolled/(proportion of eligible employees × N total employees)] × 100). Mean (1 standard deviation) and median worksite sizes were calculated at each enrollment step. Participation barriers and modifications were recorded by the research team. A survey was sent to a subset of nonparticipants (N = 57), and thematic analyses were conducted to examine reasons for nonparticipation, positive impacts, and negative experiences. Results: Employer reach was 65% (56 worksites invited to participate; 66% eligible of 56 responses; 24 enrolled). Employee reach was 58% (1317 invited to participate, 83% eligible of 906 responses; 632 enrolled). Postrandomization, on average, 59% (15%) of the worksites participated. Eighteen modifications were developed to overcome participant-, context-, and research-related participation barriers. Conclusion: A high proportion of worksites and employees approached to participate in a sedentary behavior reduction intervention engaged in the study. Interventions that provide flexible enrollment, graded participant engagement options, and adopt a participant-centered approach may facilitate workplace intervention success.

Background To identify social ecological correlates of objectively measured workplace sedentary behavior. Methods Participants from 24 worksites - across academic, industrial, and government sectors - wore an activPAL-micro accelerometer for 7-days (Jan-Nov 2016). Work time was segmented using daily logs. Sedentary behavior outcomes included time spent sitting, standing, in light intensity physical activity (LPA, stepping cadence 30 min). Outcomes were standardized to an 8 h work day. Two electronic surveys were completed to derive individual (job type and work engagement), cultural (lunch away from the desk, walking at lunch and face-to-face interaction), physical (personal printer and office type) and organizational (sector) factors. Mixed-model analyses with worksite-level clustering were performed to examine multi-level associations. Secondary analyses examined job type and sector as moderators of these associations. All models were adjusted for age, race/ethnicity and gender. Results Participants (N = 478; 72% female; age: 45.0 ± 11.3 years; 77.8% non-Hispanic white) wore the activPAL-micro for 90.2 ± 15.5% of the reported workday. Walking at lunch was positively associated with LPA (5.0 ± 0.5 min/8 h, P

Background American workers spend 70–80% of their time at work being sedentary. Traditional approaches to increase moderate-vigorous physical activity (MVPA) may be perceived to be harmful to productivity. Approaches that target reductions in sedentary behavior and/or increases in standing or light-intensity physical activity [LPA] may not interfere with productivity and may be more feasible to achieve through small changes accumulated throughout the workday Methods/design This group randomized trial (i.e., cluster randomized trial) will test the relative efficacy of two sedentary behavior focused interventions in 24 worksites across two states (N = 720 workers). The MOVE + intervention is a multilevel individual, social, environmental, and organizational intervention targeting increases in light-intensity physical activity in the workplace. The STAND + intervention is the MOVE + intervention with the addition of the installation and use of sit-stand workstations to reduce sedentary behavior and enhance light-intensity physical activity opportunities. Our primary outcome will be objectively-measured changes in sedentary behavior and light-intensity physical activity over 12 months, with additional process measures at 3 months and longer-term sustainability outcomes at 24 months. Our secondary outcomes will be a clustered cardiometabolic risk score (comprised of fasting glucose, insulin, triglycerides, HDL-cholesterol, and blood pressure), workplace productivity, and job satisfaction Discussion This study will determine the efficacy of a multi-level workplace intervention (including the use of a sit-stand workstation) to reduce sedentary behavior and increase LPA and concomitant impact on cardiometabolic health, workplace productivity, and satisfaction. Trial registration: ClinicalTrials.gov Identifier: NCT02566317 (date of registration: 10/1/2015).

Background: Sedentary time has been shown to have deleterious effects on health. Today's workforce spends most of the day sitting. The objective of this study was to evaluate the effect of workplac...