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Table 1 Structure and content of the online questionnaire and computer-tailored advice of the different sections

From: Theory-driven, web-based, computer-tailored advice to reduce and interrupt sitting at work: development, feasibility and acceptability testing among employees

Assessment questionnaire (answering options)

Feedback (number of different tailored feedback messages)

Example of feedback message

Section 1: General advice on sedentary behaviour (SB)

• Demographics:

- first name, last name (open ended)

- sex (male/female)

- age (<18 years, 18, … 65, >65 years)

• Height (<145, 145,… 210, 210 cm) and

weight (<40, 40, … 120, > 120 kg)

• Number of workdays in a usual week (1–7)

• Job tasks (yes/no):

- phone calls,

- computer work,

- desk work,

- meetings,

- visiting clients

• Knowledge about SB (disagree/unsure/agree)

- link total SB with health

- independence of physical (in)activity

- link interruptions in SB with health

• Workforce Sitting Questionnaire (hours and minutes):

SB during transport, work, TV, PC use at home, leisure time

on work days and non-work days

• Interruptions every 30 minutes during prolonged SB (rarely/sometimes/mostly)

• International Physical Activity Questionnaire short version (days, hours and minutes):

- walking

- moderate intensity physical activity

- vigorous intensity physical activity

• Information: why focus on SB? (generic)

Advice on sitting and standing may seem a bit weird at first. Sitting is a habitual behaviour, we are not aware of doing it, but still it is import as too much sitting is bad for your health.

• Feedback (including graph) about

- total SB: 4 categories (<8, <12, <16 and ≥16 hrs/day) (18 different messages)

- SB on work day and non-work day (36 different items)

On average you sit 15.1 hours per day, which is more than the recommended maximum of 8 hours per day. As you already suspected, your level of SB can cause health problems.

• Information about why interruptions are important (generic) + feedback about user’s interruptions (9 different messages)

Research shows that an interruption in prolonged sitting, for example every 30 minutes, can be sufficient to counter the unhealthy processes of sitting for long periods. You indicated that you interrupt your sitting sometimes. This is positive, however try to increase this in the future…

• Information about the relationship between physical activity and SB (generic) + feedback about user’s physical activity (12 different messages)

Prolonged sitting is associated with increased health risks, even if you are regularly being physically active. So, regardless of how much you move, too much sitting is bad. You indicated that you are on average moderately active for 10 minutes a day. This is not enough to meet the health-related physical activity guidelines, indicating that you need 30 minutes of moderate-to-vigorous physical activity every day to improve your health.

• Links to the other sections of the website (generic):

What now? Okay, you are at the end of the general section of this ‘start to stand’-advice. In the other sections you will get specific tips and suggestions regarding your SB at work. You have the choice to request the other sections now or later. In each section you will have to complete some questions and based on your answers, a personal advice will be provided. Find it all out on the homepage…

Section 2: Standing interruptions in SB during work hours (non-committal)

• Frequency (number per x hour) and duration (<1’/≥1’) of standing interruptions

• Attitudes about standing up every 30 minutes (disagree/unsure/agree):

- stupid, healthy, annoying, relaxing, tiring

• Self-efficacy for standing interruptions (disagree/unsure/agree):

- overall

- when having no social support

• Barriers for standing interruptions (select):

stress, meetings, tired legs, busy day, uncomfortable shoes,…

• Intention to stand up every 30 minutes (no/within 6 months/within 1 month)

• Autonomy to decide to stand up every 30 minutes (disagree/unsure/agree)

• Feedback about interrupting behaviour (15 different messages)

You indicated that you interrupt your sitting at work once every two hours for at least one minute. Research shows that one interruption every 30 minutes for one minute is sufficient to counter the unhealthy effects of prolonged sitting. So it is positive that you stand for at least one minute, but you need to do this more frequently as you are sitting too long. The tips below can help you…

• Feedback about attitudes, intentions and social support for interruptions (30 different items)

You mentioned you are intending to stand up regularly at work within one month from now. That’s excellent! You also think positive about these interruptions. That’s why this advice is definitely for you and it will help you with this challenge.

• Tips to increase/maintain interruptions tailored to job tasks (15 different messages)

You mentioned you don’t have to get up to take your prints. Why not put your printer further away from your desk so that you need to get up and interrupt your sitting. You could also decide to put other devices such as the coffee machine out of reach!

• Tips on how to overcome barriers (8 different messages)

You think you won’t be able to interrupt your sitting when you are being busy. The good news is that changing your SB doesn’t need to take long. Small changes like getting up when the phone rings or reading some documents while standing,… are easier to implement than you might think.

• Feedback about self-efficacy and social support (9 different messages)

A lack of support from the management doesn’t seem to bother you to stand up regularly. It is very positive that you’re confident that you can stand up even if they think this is weird. Keep up this spirit! Though, it’s a pity you doubt you can stand up when colleagues don’t support you or think this is ridiculous. Maybe they are not familiar with the concept of ‘stand more, sit less’. Try to convince them that standing up regularly is meaningful!

• Feedback about the autonomy to make decisions (3 different messages)

Finally, you have, to a certain degree, autonomy over the decision to stand up during work hours. Take advantage of this privilege. Good luck with the implementation of the tips!

• Invitation to other sections (generic)

If you want to design a concrete personal plan to change your SB at work, click [here].

Section 3: Replacing SB by standing during work hours (non-committal)

• Job roster (half-time, half days/half-time, full days/full-time)

• Job hours (only for full-time workers) (<42 hours/week/≥42 hours/week)

• Attitudes about (partly) standing during work (disagree/unsure/agree):

- stupid, healthy, annoying, relaxing, tiring

• Self-efficacy for standing during work (disagree/unsure/agree):

- overall

- when feeling tired, when feeling stressed

• Advantages of standing during work (select):

more focus, stronger legs, better energy balance,…

• Intention to stand during work (no/within 6 months/within 1 month)

• Autonomy to decide to stand during work (disagree/unsure/agree)

• Feedback about SB during working hours tailored to job roster and job hours: 3 categories based on <180, <342, <378 minutes/day (24 different messages)

It appears that you spend 420 minutes (about 7 hours) sitting during work hours. This is too much, as this is more than 75 % of the time you work. So you sit more than other employees do. You mentioned you work overtime a lot, this is probably the cause for your prolonged sitting. In this case, reducing these long periods of sitting is even more important! Try to sit less at work every day. This is easier than it seems and you can for example do this in small blocks, once in the morning and once in the afternoon.

• Feedback about attitudes and intention to stand during work (40 different messages)

You mentioned you are not intending to stand while working. It’s a pity, but maybe the following tips can change your mind. We invite you to read them, even though you are not positive about standing during work hours. Give it a chance and maybe you experience some benefits while trying. Good luck!

• Tips to increase/maintain standing tailored to job task (7 different messages)

Check whether you have the ability to put your laptop or computer on a raised table or cupboard. It is not necessary to stand the whole day, but choosing to stand for a couple of hours is an excellent idea! Build this up slowly and start with short periods of standing. You’ll get used to it quickly.

• Feedback on benefits (6 different messages)

An important benefit of standing during work hours for you is a better health in the long-term. Too much sitting is indeed associated with a higher risk for diabetes, cancer, heart disease and mental illness. Furthermore, there is convincing evidence that sedentary behavior (= sitting) is linked to increased mortality in men and women. So it is a great idea to sit less and stand more.

• Feedback about what is stimulating, tailored to self-efficacy (9 different messages)

You don’t mind to stand even when you are tired. This is wonderful, because reducing your sitting and standing while working will give you more energy compared to staying seated the whole day.

• Feedback about the power to make decision (3 different messages)

Finally, you have the autonomy to decide to stand while working. Take advantage of this privilege. You will see that it can often be easy to change your sedentary behaviour. Good luck with the implementation of the tips!

• Invitation to other sections (generic)

Take also a look at the other sections to get a complete personalized ‘start to stand’-advice!

Section 4: SB during commuting to work (non-committal)

• Public transport (yes/no)

• Distance to transport stop or work (<2/2–8/>8 km)

• Attitudes about standing during public transport or active transportation (disagree/unsure/agree):

- stupid, healthy, annoying, relaxing, tiring

• Self-efficacy for standing during public transport or active transportation (disagree/unsure/agree):

- overall

- when having no social support

• Barriers for active transportation (select):

weather, traffic, lack of time,…

• Ability to change current transport mode given living situation (disagree/unsure/agree)

• Feedback about transport mode + tips to change (28 different messages)

You mention you generally use public transport to go to work. This is great because this means you are able to stand during the trip. We recommend you to stand during at least 10 minutes of your trip in order to reduce your amount of sitting. Please also stand while you are waiting at the stops.

• Feedback about attitudes and self-efficacy for standing during public transport/active transportation (47 different messages)

You travel by car, but you have the choice to park your car further away and walk the last 5 or 10 minutes. This is a great opportunity to increase your physical activity. You also feel positive about this, but you believe you are not able to achieve this challenge. Maybe this advice will change your way of thinking because the effort is smaller than you imagine.

• Tips to overcome barriers (32 different messages)

A lack of time is an important barrier for you to park your car further away and walk the last part. Realize this is only 5 to 10 minutes of your entire day… in addition, walking is good for your health, fitness and weight!

• Feedback about the ability to change transport mode (9 different messages)

Finally, you believe that in your situation it is too hard to park your car further away and walk some part. This is a pity. Maybe this advice can change your mind and make you more open-minded to active transportation. If not, the information in the other sections may be important for you.

• Invitation to other sections (generic)

You’re at the end of this section. Also have a look at the other sections…

Section 5: SB during (lunch) breaks at work (non-committal)

• Duration lunch break (<30 min/30–60 min/> 1 hour)

• Type of meal during lunch break (sandwiches/hot meal)

• Number of lunch breaks spent (1–5):

- sitting

- actively

• Attitudes about changing SB during (lunch) breaks (disagree/unsure/agree):

- stupid, healthy, annoying, relaxing, tiring

• Self-efficacy for changing SB during (lunch) breaks (disagree/unsure/agree):

- overall

- when having no social support

- when being busy

• Feedback about how breaks from work are being spent (18 different messages)

You mention you spend your lunch break and coffee breaks mostly sitting…

• Feedback about attitudes and self-efficacy for changes in SB during breaks (27 different messages)

…You believe you’re not able to change this. However, these breaks provide a unique opportunity to sit less (or be active), especially when this is difficult during the work hours. Try at least to stand for half of your breaks. By trying you may change your mind about what is possible…

• Tips to change (13 different messages)

As you eat sandwiches during lunch, you are able to eat these while standing or walking. Even though there are no raised tables available, check whether it is possible to stand in the canteen. A sandwich meal can even be taken while walking, in the fresh air.

• Invitation to other sections (generic)

Section 6: action plan: plan to change SB (non-committal)

• What do you want to change? (increase interruptions/replace sitting by standing/both)

• How often, how long?

• In which situations do you want to make changes?

(work hours/work breaks/commuting/combinations)

• Which actions seem feasible? (select + open-ended)

e.g. if the phone rings, then I will stand up; if my computer starts up, then I will install a software program to remind me to stand up every x minutes; if I’m waiting for the bus/train, then I will stand; if I restart work after lunch time, then I will work standing for a period;…

• What will I change? (3 different messages)

I will increase my interruptions in sitting by standing up frequently

• How long/how often will I do this? (12 different items)

Every 45 minutes, I will stand up for 40 seconds

• In which situations will I do this? (7 different messages)

During the working hours, work breaks and commuting to/from work

• IF-THEN plan (25 different messages)

- if I have a meeting, I will get something to drink halfway the meeting

- if I need to put something in the bin, I will stand up

- if I eat a snack at my desk, I will stand up

- if I have a glass of water, I will stand up while drinking

- if I have a hot meal during lunch, I will clean up immediately instead of staying seated at the table.

• When will I start doing this? (individual)

Monday March 10, 2014

  1. SB sedentary behaviour