J. Leppe1,2, O.L. Sarmiento3, G. Rada4, S. Ramos1, B. Muñoz1, M. Leppe1, R. Fontecilla1
1Universidad del Desarrollo, School of Physiotherapist, Santiago, Chile, 2Universidad Católica de Chile, Epidemiology PhD Program, Department of Public Health, Santiago, Chile, 3Universidad de Los Andes, Department of Epidemiology, Bogotá, Colombia, 4Universidad Católica de Chile, Santiago, Chile
Background: Sitting time at the workplace can reach a significant amount of time in a person's waking hours. Prolonged Sedentary behaviour is associated with an increased risk of cardiovascular diseases, obesity, and all-cause mortality.
Purpose: This review aims to provide a synthesis of evidence on interventions pointing to reduce sitting time at the workplace using computer prompts, and the effects on health or work-related outcomes.
Methods:Search: Primary studies were searched in PubMed (MEDLINE), CINAHL and CENTRAL of Cochrane Library. The publication search was carried out on September 2021 with no filter criteria.
Types of study: Only randomized controlled trials (individual or cluster) that performed an intervention in the workplace during workday were included.
Population: Studies involving desk-based workers aged 18 or more were included. Drivers (taxi, truck, bus, and heavy-equipment operators) and people with specific pathologies or disabilities were excluded.
Interventions/comparator(s): Studies evaluating computer prompt software installed at work on personal computers or laptops to reduce or break sedentary behaviour with or without associated co-interventions were included. Comparisons such as education, counselling, structured interventions, no treatment, or any unplanned, unstructured, or unintended intervention were considered.
Primary outcomes: Sedentary behaviour (e.g. sitting time or sit-to-stand transition, or standing time)
Risk of bias assessment was revised using the Cochrane Risk-of-Bias tool for randomized trials (RoB2).
Analysis: To analyze the effect of the intervention, standardized mean difference (SMD) with 95% confidence intervals (CI) was obtained as a measure of effect. The analyses were performed using the Cochrane Collaboration's Review Manager (RevMan) software, and GRADE methodology was applied for the assessment of certainty of evidence coming from primary outcomes.
PROSPERO number: CRD42021287870
Types of study: Only randomized controlled trials (individual or cluster) that performed an intervention in the workplace during workday were included.
Population: Studies involving desk-based workers aged 18 or more were included. Drivers (taxi, truck, bus, and heavy-equipment operators) and people with specific pathologies or disabilities were excluded.
Interventions/comparator(s): Studies evaluating computer prompt software installed at work on personal computers or laptops to reduce or break sedentary behaviour with or without associated co-interventions were included. Comparisons such as education, counselling, structured interventions, no treatment, or any unplanned, unstructured, or unintended intervention were considered.
Primary outcomes: Sedentary behaviour (e.g. sitting time or sit-to-stand transition, or standing time)
Risk of bias assessment was revised using the Cochrane Risk-of-Bias tool for randomized trials (RoB2).
Analysis: To analyze the effect of the intervention, standardized mean difference (SMD) with 95% confidence intervals (CI) was obtained as a measure of effect. The analyses were performed using the Cochrane Collaboration's Review Manager (RevMan) software, and GRADE methodology was applied for the assessment of certainty of evidence coming from primary outcomes.
PROSPERO number: CRD42021287870
Results: Were identified through databases n=8498 records, after duplicates removed were excluded n=6062. Reports assessed for eligibility were n=298. Fifteen studies were used for analysis. These studies considered 1147 workers.
The median term for intervention was 9.4 weeks, ranging from 3 days to 24 weeks.
Eleven studies demonstrated positive data in favour of interventions using computer prompt software programs with effect sizes from small to large. The difference in Sitting Time between the intervention and control groups is wide-ranging, from -13.9 CI(-36.5 ; 8.7) minutes to -373 CI(-452.7 ; -293.3) minutes in favour of the computer prompt software. For metanalysis, the heterogeneity is high when including all studies. According to the subgroup analysis, heterogeneity remains low to moderate and favours intervention, but the confidence intervals are not significant. For sit-to-stand transitions and standing time, the results were similar.
According to GRADE, the certainty of the evidence for primary outcomes is Low or Moderate.
The median term for intervention was 9.4 weeks, ranging from 3 days to 24 weeks.
Eleven studies demonstrated positive data in favour of interventions using computer prompt software programs with effect sizes from small to large. The difference in Sitting Time between the intervention and control groups is wide-ranging, from -13.9 CI(-36.5 ; 8.7) minutes to -373 CI(-452.7 ; -293.3) minutes in favour of the computer prompt software. For metanalysis, the heterogeneity is high when including all studies. According to the subgroup analysis, heterogeneity remains low to moderate and favours intervention, but the confidence intervals are not significant. For sit-to-stand transitions and standing time, the results were similar.
According to GRADE, the certainty of the evidence for primary outcomes is Low or Moderate.
Conclusions: Interventions using computer prompt software help reduce office workers' sitting time. However, the effect size is small, and the differences are not statistically significant. The studies had a small sample size and short-term follow-up.
Implications: Interventions using computer prompts can be a massive and low-cost strategy to decrease sitting time on office workers. It is necessary to carry out more randomized clinical studies with longer follow-up periods to assess the adherence and precision of the effect of this type of intervention.
Funding acknowledgements: This study has no funding.
Keywords:
Sitting time
Office-workers
Computer prompt software
Sitting time
Office-workers
Computer prompt software
Topics:
Occupational health & ergonomics
Health promotion & wellbeing/healthy ageing/physical activity
Occupational health & ergonomics
Health promotion & wellbeing/healthy ageing/physical activity
Did this work require ethics approval? No
Reason: This work is a systematic review with metanalysis
All authors, affiliations and abstracts have been published as submitted.
