| dc.description.abstract | There is strong evidence demonstrating that there is a relationship between greater time spent in sedentary behaviour (SB) and greater all-cause mortality, cardiovascular disease mortality and incidence, type 2 diabetes incidence, and incidence of colon, endometrial, and lung cancer. The use of multi-level interventions developed using participative approaches targeted at specific at-risk subgroups can be helpful in reducing SB.
Objectives and methods
The aim of this PhD research was to develop, implement and evaluate an evidence-based pilot intervention to reduce SB in an adult male population, guided by the socio-ecological model throughout. A multiphase mixed method design was applied to achieve four objectives. The first was to describe the prevalence and correlates of domain-specific prolonged SB using secondary analysis of an Irish cohort dataset. The second objective was to explore the barriers and facilitators to reducing SB in the workplace setting in which most SB occurs using a qualitative approach. The third objective was to adopt a qualitative participatory approach in the development of a workplace pilot intervention to reduce SB in two worksites, with managers and employees. The fourth objective was to test the acceptability and feasibility of a small-scale theory-based intervention to reduce SB in a workplace population using mixed methodology to collect objective and subjective data. The primary outcomes of the study were acceptability and feasibility of assessments, study procedures and processes from an employee and management perspective, recruitment and retention, and a qualitative evaluation of participants perspectives of the intervention overall.
Main findings
The results of Study 1 revealed that Irish adults (n= 7,328) self-reported a median daily sitting time of 450 minutes/day (7.5 hours), and the workplace was the context in which most sitting occurred (>3 hours/day). Males, with third level educational attainment, with professional occupations, and who lived in an urban location reported the longest sitting times (mean 497.6 mins/day; SD 192). The findings informed the choice of the target population and setting of Study 2, which explored professional men s perceptions of the barriers and facilitators to reducing workplace SB. Study 2 demonstrated that the primary barrier to reducing workplace SB in professional men (n=23) was the primacy of work, we have to get through the day s work so that s the reality at the end of the day . The main facilitating factor was the motivation to break up prolonged sedentary behaviour as a result of the increased awareness of the dangers garnered from the education session, and the level of PA needed to attenuate the risks, that you have to do 70-90 minutes a day of exercise to offset 6 hours of sitting down, I mean that s pretty stark . Ensuring minimal impact on work productivity and capacity was an important facilitator to employees and managers, as long as we can fit in that and everyone is still as productive as they are today, or more in some ways hopefully, I don t have an issue .
Flexible and supportive management staff was a key facilitator for employees to reduce their SB at an organisational level. Employees acknowledged, [managers] encourage us to do various things to achieve that and make us happier, if you re happier, you re healthier . At an environmental level, the restrictive traditional work desk was a barrier to movement, and an an alternative as opposed to sitting was sought by participants to aid the reduction of occupational SB. Active sitting as opposed to reduced sitting was favoured by the participants, [if] there s things you can do while you re at your desk, while still getting through your work, [I d be] 100% be behind it .
The results of the participative approach in Study 2 confirmed that participants were supportive of each proposed intervention component, and of the study overall. Participants confirmed the appropriateness of the pedal device, It s a very good idea. It s very subtle . The mHealth component using a physical activity tracker watch and its associated platform to target behaviour change techniques was of interest and deemed acceptable to the participants in both worksites. The study design and measures overall were concluded as acceptable, context-appropriate and suitable to the target users in both worksites, they re not invasive in your life or in your working day so I can t see any barriers, I can only see benefits to be honest .
The pilot feasibility study was developed using the socio-ecological model. The results of Study 3 showed that the intervention, as well as the trial processes were somewhat acceptable and feasible to conduct (n=21). Trial-related accelerometry outcome measures were collected from 85.5% of participants. Recruitment rate was 40% at cluster level, and at an individual level 73.3% of target sample were recruited. Retention was 95% from baseline to post-intervention (8-weeks). The main intervention benefit was an increase of the awareness of the dangers of SB, at both management and employee level, definitely think because we were doing the study it would make you think about moving . Minimal impact on productivity from pedalling was observed from a management perspective, is it disrupting their productivity? I have to say they were doing it as they were working . The main intervention barriers were time priorities and the sometimes uncomfortable ergonomic set up of the pedal machine, with some participants expressing that this was too difficult to overcome at times and would require assistance in future studies. Mean cycling time was 27 minutes/day (SD 10.23) in the intervention period. Workplace SB was reduced by 20.4 minutes/day, and total weekday SB reduced by 45.7 minutes/day in the intervention period compared to the control period.
Conclusion
This intervention was the first of its kind to specifically target this at-risk sub-group population and address the main influences of workplace SB pertinent to them. This PhD research presents a formative, iterative, participatory, and evidence-based multicomponent approach that was guided by the socio-ecological model at all stages of the research design, development, and evaluation. The study has demonstrated the acceptability of a multicomponent intervention to reduce workplace SB in professional men. However, considerable assistance with the ergonomic set-up of the pedal device, and automatic recording of pedalling bouts are required before future implementation as an initiative to reduce workplace SB. This thesis provides important exploratory findings, and key considerations for researchers to utilise in behaviour change interventions to reduce occupational SB, detailing barriers and issues that should be attended to in future evaluations. | en |
