Children spend between 50 and 70 % of their time sitting while at school. Independent of physical activity levels, prolonged sitting is associated with poor health outcomes in adulthood. While there is mixed evidence of health associations among children and adolescents, public health guidelines in the USA, UK, Australia and Canada now recommend young people should break up long periods of sitting as frequently as possible. A potentially effective approach for reducing and breaking up sitting throughout the day is changing the classroom environment. This paper presents an overview of a relatively new area of research designed to reduce youth sitting time while at school by changing the classroom environment (n = 13 studies). Environmental changes included placement of height-adjustable or stand-biased standing desks/workstations with stools, chairs, exercise balls, bean bags or mats in the classroom. These 13 published studies suggest that irrespective of the approach, youth sitting time was reduced by between ~44 and 60 min/day and standing time was increased by between 18 and 55 min/day during classroom time at school. Other benefits include increased energy expenditure and the potential for improved management of students' behaviour in the classroom. However, few large trials have been conducted, and there remains little evidence regarding the impact on children's learning and academic achievement. Nevertheless, with an increasing demand placed on schools and teachers regarding students' learning outcomes, strategies that integrate moving throughout the school day and that potentially enhance the learning experience and future health outcomes for young people warrant further exploration.

The redesign of the physical workplace according to activity-based working (ABW) principles has potential to influence employee health and workplace outcomes. This natural experiment examined changes in accelerometer-derived workplace activity, self-reported eating behaviours, productivity, workplace satisfaction before (March to November 2014) and six to nine months after moving to an ABW workplace compared to a comparison workplace (n = 146 at baseline (56% ABW, aged 40.1 ± 8.5 years, 72% female). Interviews were also conducted with 21 ABW participants. Between- and within-group differences were examined and mixed model analysis examined intervention effects over time. Effect sizes were calculated on change scores (Cohen’s d). Although not statistically significant, ABW participants had meaningful improvements in workday sedentary time, light-, and moderate-to-vigorous intensity physical activity, job satisfaction and relationship with co-workers (d = 0.379–0.577), and small declines in productivity (d = 0.278). There were significant, meaningful, and beneficial intervention effects on perceived organisational support for being active in the workplace, frequency of eating lunch with colleagues, and satisfaction with the physical environment in ABW compared to comparison participants (d = 0.501–0.839). Qualitative data suggested that ABW employees associated ABW with greater opportunities for movement and collaboration, but had mixed views on the impact on productivity. Future research with larger samples and over longer follow-up periods is warranted.

ObjectiveTo provide preliminary evidence for the impact of problem-solving therapy for diabetes (PST-D) in adults with diabetic retinopathy (DR) and diabetes distress.Research design and methodsIn a pilot randomized controlled trial, 40 participants with DR and diabetes distress were allocated to the PST-D or control groups. Diabetes distress (DDS), depressive symptoms (PHQ-9), self-care activities (SDSCA), and HbA1c were assessed at baseline, and 3 and 6-month follow-ups.ResultsAt the 6-month follow-up, the PST-D group showed significant improvements relative to the control group, in ‘regimen-related distress’ (PST-D: −1.3±1.4; control: −0.4±1.1), depressive symptoms (PST-D: −4.3±6.1; control: −0.3±4.6), and HbA1c (PST-D: −1.2%±1.01; control: 0.2%±1.2%) (all p<0.05). In multiple regression analysis, adjusting for baseline values and sociodemographic factors, PST-D was associated with significant improvement in ‘regimen-related distress’, depressive symptoms, and HbA1c at the 6-month follow-up (p<0.05).ConclusionsPST-D is a promising intervention for improving psychological outcomes and glycemic control. A fully powered study is required to confirm these findings and examine mechanisms of change in HbA1c.Trial registration numberACTRN12616001010482; results.

During school hours, children can sit for prolonged and unbroken periods of time. This study investigated the impact of an 8-month classroom-based intervention focusing on reducing and breaking-up sitting time on children’s cardio-metabolic risk factors (i.e., body mass index, waist circumference, blood pressure) and perceptions of musculoskeletal discomfort. Two Year-6 classes (24 students per class) in one primary school were assigned to either an intervention or control classroom. The intervention classroom was equipped with height-adjustable desks and the teacher was instructed in the delivery of pedagogical strategies to reduce and break-up sitting in class. The control classroom followed standard practice using traditional furniture. At baseline, and after 8-months, time spent sitting, standing, stepping, and sitting-bouts (occasions of continuous sitting) as well as the frequency of sit-to-stand transitions were obtained from activPAL inclinometers and the time spent in light-intensity physical activity was obtained from ActiGraph accelerometers. Demographics and musculoskeletal characteristics were obtained from a self-report survey. Hierarchical linear mixed models found that during class-time, children’s overall time spent sitting in long bouts (>10 min) were lower and the number of sit-to-stand transitions were higher in the intervention group compared to the control group, while no changes were observed for musculoskeletal pain/discomfort. No significant intervention effects were found for the anthropometrics measures and blood pressure. Height-adjustable desks and pedagogical strategies to reduce/break-up sitting can positively modify classroom sitting patterns in children. Longer interventions, larger and varied sample size may be needed to show health impacts; however, these desks did not increase musculoskeletal pain/discomfort.

Children spend over 60% of their school day sitting; much of this occurs in the classroom. Emerging research has examined the impact of environmental interventions on classroom sitting. While this research is promising, it has predominantly focused on the primary school setting. This study examined the impact and feasibility of height-adjustable desks on time spent sitting/standing during classroom lessons in a secondary school. Traditional desks in a Melbourne secondary school classroom were replaced with 27 height-adjustable desks (intervention classroom). Forty-three adolescents (51% male; mean age 13.7 ± 1.4 years) from Grades 7, 9 and 10 wore an inclinometer and accelerometer for schooldays and completed a survey after using the desks during lessons for seven weeks. Ten teachers (50% male) completed a survey. Time spent sitting, standing, and the length of sitting bouts were compared between periods when adolescents were in the intervention classroom versus traditional classrooms (matched on teacher and subject). Compared to the traditional classroom, adolescents spent 25% less time sitting and 24% more time standing in the intervention classroom (effect size > 0.8), and had a greater frequency of short sitting bouts and fewer longer bouts. The majority of teachers (71%) and students (70%) reported wanting to continue to use the height-adjustable desks. When standing during lessons, adolescents reported working well (69%); however, a third reported difficulties paying attention (28%) and becoming distracted (36%). Few teachers reported negative influences on adolescents' ability to work (14%) and concentrate (14%). Half the adolescents reported leg, or back pain with standing. Introducing height-adjustable desks resulted in lower levels of sitting compared with traditional classrooms, was acceptable and had some adverse effects on concentration and discomfort. The study provides preliminary evidence that height-adjustable desks may help reduce prolonged sitting in school among adolescents. Future research should incorporate a control group and explore behavioural and academic outcomes.