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

Abstract

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). Reflective and automatic Motivation was highlighted as a core target for intervention. 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 prolonged sitting in the workplace.

The user and non-user perspective: Experiences of office workers with long-term access to sit-stand workstations

“…Users indicated that they preferred to use the standing workstation when completing work tasks which did not require high levels of concentration, such as sending emails. Specific work tasks associated with standing have also been indicated in other studies [ 22 , 25 , 40 ]. Moreover, a recent study found that people did not identify “sitting” as an activity in and of itself, but rather thought of sitting in relation to the task they performed (e.g.…”

“…This might indirectly mirror a decrease in perceived productivity if these tasks were done standing. In other studies there have been indications that high focus work tasks are prioritised over the use of the standing option [ 40 ], or that sitting postures are not consciously experienced during high-focus work tasks [ 25 ].…”

“…using specific sit-stand software) seemed effective in the long-term to increase the use of the sit-stand workstation at the population level [ 51 , 52 ]. Also, seeing colleagues using the standing option was indicated as a reminder and prompt for use [ 25 , 53 ]. This might become more evident as a transition is made from a sitting culture towards a more physically active work culture, in which organisational culture promotes healthy behaviours [ 25 , 48 ].…”

“…Also, seeing colleagues using the standing option was indicated as a reminder and prompt for use [ 25 , 53 ]. This might become more evident as a transition is made from a sitting culture towards a more physically active work culture, in which organisational culture promotes healthy behaviours [ 25 , 48 ]. Standing (group) meetings, including the proper furniture, might be implemented as a strategy to alter sitting norms and promote a more active culture.…”

“…In the Stand-Up Victoria study, 82 separate strategies were identified by participants [ 22 ]. In another study, the behaviour change wheel [ 23 ] was used to develop a tailored intervention to reduce sitting, which identified 39 behaviour change techniques [ 24 ] aimed at providing information, rewards, and prompts for reducing sitting time [ 25 ]. To increase the quality and thus the reach of interventions, it is important to understand why some office workers chose to adopt the use of the standing option of their sit-stand workstations and why others do not, as well as whether other strategies are being used to reduce sitting.…”