• Breaking barriers: using the Behavior Change Wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time

      Ojo, Samson Oluseye; Bailey, Daniel Paul; Brierley, Marsha L.; Hewson, David; Chater, Angel M.; University of Bedfordshire (Springer Nature, 2019-08-16)
      Background The workplace is a prominent domain for excessive sitting. The consequences of increased sitting time include adverse health outcomes such as cardiovascular disease and poor mental wellbeing. There is evidence that breaking up sitting could improve health, however, any such intervention in the workplace would need to be informed by a theoretical evidence-based framework. The aim of this study was to use the Behaviour Change Wheel (BCW) to develop a tailored intervention to break up and reduce workplace sitting in desk-based workers. Methods The BCW guide was followed for this qualitative, pre-intervention development study. Semi-structured interviews were conducted with 25 office workers (26–59 years, mean age 40.9 [SD = 10.8] years; 68% female) who were purposively recruited from local council offices and a university in the East of England region. The interview questions were developed using the Theoretical Domains Framework (TDF). Transcripts were deductively analysed using the COM-B (Capability, Opportunity, Motivation – Behaviour) model of behaviour. The Behaviour Change Technique Taxonomy Version 1 (BCTv1) was thereafter used to identify possible strategies that could be used to facilitate change in sitting behaviour of office workers in a future intervention. Results Qualitative analysis using COM-B identified that participants felt that they had the physical Capability to break up their sitting time, however, some lacked the psychological Capability in relation to the knowledge of both guidelines for sitting time and the consequences of excess sitting. Social and physical Opportunity was identified as important, such as a supportive organisational culture (social) and the need for environmental resources (physical). Motivation was highlighted as a core target for intervention, both reflective Motivation, such as beliefs about capability and intention and automatic in terms of overcoming habit through reinforcement. Seven intervention functions and three policy categories from the BCW were identified as relevant. Finally, 39 behaviour change techniques (BCTs) were identified as potential active components for an intervention to break up sitting time in the workplace. Conclusions The TDF, COM-B model and BCW can be successfully applied through a systematic process to understand the drivers of behaviour of office workers to develop a co-created intervention that can be used to break up and decrease sitting in the workplace. Intervention designers should consider the identified BCW factors and BCTs when developing interventions to reduce and break up workplace sitting.
    • The effectiveness of sedentary behaviour reduction workplace interventions on cardiometabolic risk markers: A systematic review

      Brierley, Marsha L.; Chater, Angel M.; Smith, Lindsey Rachel; Bailey, Daniel Paul; University of Bedfordshire (Springer Nature, 2019-08-19)
      Background Sedentary behaviour is a risk factor for type 2 diabetes and cardiovascular disease. Objectives The aims of this work were to systematically review the effects of workplace sedentary behaviour reduction interventions on cardiometabolic risk markers (primary aim) and identify the active behaviour change techniques (BCTs) by which these interventions work (secondary aim). Methods A systematic search of 11 databases for articles published up to 12 April 2019 yielded a total of 4255 unique titles, with 29 articles being identified for inclusion. Interventions were rated as very promising, quite promising or non-promising based on their effects on cardiometabolic risk markers compared with baseline and/or a comparison arm. Interventions were coded for BCTs used. To assess the relative effectiveness of BCTs, a promise ratio was calculated as the frequency of a BCT appearing in all promising interventions divided by its frequency of appearance in all non-promising interventions. Results A narrative synthesis included 29 published studies of varying study design and comprised of 30 interventions. Risk of bias was high for blinding and allocation concealment, moderate for random sequence generation, and low for outcome assessment. Nine interventions were very promising, 11 were quite promising, 10 were non-promising, and 10 active control groups did not experience cardiometabolic changes. Significant sedentary behaviour reductions were present in all but five studies where cardiometabolic risk markers improved. The BCTs of social comparison, problem solving, demonstration of the behaviour, goal setting (behaviour), behaviour substitution, and habit reversal, demonstrated moderate to high promise ratios. Conclusions Workplace interventions show promise for improving cardiometabolic risk markers. The BCTs with the greatest promise of cardiometabolic risk marker improvements included social comparison, those related to individual habits, and behaviour goals.