JustStand Summit 2012 - Dr. Nico Pronk


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Reducing prolonged sitting time in the office: impact of sit-to-stand workstations on health and productivity

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JustStand Summit 2012 - Dr. Nico Pronk

  1. 1. Reducing Prolonged Sitting Time in theOffice: Impact of Sit-to-Stand Workstations on Health and Productivity Ergotron Summit Eagan, MN July 10, 2012Nico Pronk, Ph.D., MA, FACSM, FAWHPVP and Health Science OfficerHealthPartners, Minneapolis, MNAdj. Professor of Society, Human Development, and HealthHarvard School of Public Health, Boson, MA
  2. 2. Agenda• Introduction• Project “Take-A-Stand” – Purpose – Approach – Methods – Results• Dissemination of findings• Discussion
  3. 3. Introduction• Physical inactivity is a major public health burden in the U.S. today• Prolonged sitting is recognized as an independent risk factor for a variety of health issues, including back pain, metabolic syndrome, hypertension, stroke, cardiovascular disease, diabetes, and all-cause as well as cardiovascular disease mortality• In the contemporary workplace, sedentary work tasks have become increasingly prevalent with many workers involved in activities characterized by extended and prolonged sitting time• Reducing prolonged sitting time among employees may prove beneficial for selected health outcomes, productivity, mood states, and overall worker well-being
  4. 4. Project “Take-a-Stand”• Purpose – To conduct a practice-based evaluation of a sit-to-stand device on prolonged sitting time, selected health-related factors, mood states, and other indices of work performance and office behavior• Design – Practice-based project – Non-randomized, interrupted time series with a two-group pre-post comparison
  5. 5. Project “Take-a-Stand”• Approach – 7 week project with intervention (n=24) and comparison groups (n=10) – Experience sampling method (ESM) used to gather insight into sitting, standing, or walking behaviors • All subjects provided with pre-paid cell phones • All subjects received 3 text messages at random times throughout the workday during the 7 week period and were asked to respond with a return text indicating: – “0” for sitting – “1” for standing – “2” for walking – 3 messages x 5 days/wk x 7 wks = 105 observations over 35 days per subject – 105 observations x 34 subjects = 3,570 observations – Surveys conducted at baseline, end of week 5, and end of week 7 – All participants monitored daily step count with pedometers throughout the 7 weeks – Change scores calculated for baseline to week 5 and week 5 to week 7 – Independent samples t-tests used to test for significance (at p<.05 and with Bonferroni correction at p<.017)
  6. 6. Project “Take-a-Stand”• Approach – During weeks 2-5, only the intervention group was provided with a sit-to-stand device (Ergotron, Eagan, MN) • WorkFit S (n=18) or WorkFit C (n=6)
  7. 7. Results• Demographics• ESM data on sitting, standing, and walking behavior• Survey data on sitting time at work, TV-viewing, and commuting time• Profile of mood states (POMS) data• Selected health factors – Back pain, upper neck and back pain – Productivity (WPAI) – Selected office behaviors – Other perceptions and observations
  8. 8. Project Participant Demographics by GroupIntervention Group Comparison Group• N = 24 • N = 10• Age = 38.4 yrs • Age = 44.2 yrs• Gender = 96% female • Gender = 80% female• BMI = 22.8 kg/m2 • BMI = 22.8 kg/m2• VO2max = 35.6 ml/kg/min • VO2max = 34.0 ml/kg/min (good/excellent) (excellent)• Physical activity = 474.6 min/wk • Physical activity = 305.5 min/wk• General health excellent or good: • General health excellent or good: 79% 100%• Job role • Job role – Administrative support: 8.3% – Administrative support: --% – Customer service: 12.5% – Customer service: --% – Account management: 12.5% – Account management: 10% – Health coach: 54.2% – Health coach: 60% – Manager: 4.2% – Manager: 20% – Other: 8.3% – Other: 10%
  9. 9. Experience Sampling Method (ESM) Data• Individual-level daily ESM by group• Individual-level daily average ESM by group• Daily average ESM by group• Weekly average ESM by group• ESM data by project period and group – Note: 1 subject missed more than 4 weeks of ESM due to PTO and was not included in the ESM data analysis – Experience Sampling Method is based on the work by M. de Vries (1992)
  10. 10. Individual-Level Daily ESM Data by Group WalkStand Sit
  11. 11. Individual-Level Daily Average ESM Data by Group WorkFit Stations Installed WalkIntervention Group Stand Sit Walk Days Control Group Stand Sit Days
  12. 12. Daily Average ESM Data by GroupWalk WorkFit Stations InstalledStand Sit
  13. 13. Weekly Average ESM Scores by Group WorkFit Stations Installed
  14. 14. Average Experience Sampling Score by Period and Group WorkFit Stations Installed 224% reduction in sitting timeNote: ESM = Experience Sampling Method; ESM Score represents the average arbitrary score by period generated byparticipants responding to the questions whether they were sitting, standing, or walking with a “0”, “1”, or “2”, respectively;Period 1 represents the pre-intervention period (average across 1 wk); Period 2 represents the intervention period (averageacross 4 wks); Period 3 represents the post-intervention period (average across 2 wks).
  15. 15. Sitting Time While at Work Based on surveys conducted at baseline, 5 weeks, and 7 weeks:* • Significant reduction in sitting time of 66.8 min/d (p<0.05) for the intervention group only • No change in daily sitting time related to TV-viewing or during commuting time for either group
  16. 16. Back and Neck Pain Outcomes Low Back Pain or Discomfort Upper Back, Neck, and Shoulder Pain *Low back (NS) and upper back and neck (p=0.008) pain showedimprovements for the Intervention Group but not the Comparison Group.Back pain scales on a 0 to 10 rating (no discomfort – extremely uncomfortable)
  17. 17. Profile of Mood States (POMS) Outcomes * * * * * * (Total Mood Disturbance)No significant changes noted in POMS variables for the Comparison Group
  18. 18. Selected Office BehaviorsPercent time spent on e-Mail, telephone, scheduled meetings, informal business-related face-to- face meetings with co-workers, and “moving” breaks Intervention Group Comparison Group *Face-to-face (business-related) meetings with co-workers were significantlyreduced between week 5 and week 7 (p < 0.05) for the Intervention Group.
  19. 19. Productivity and Perceived SupportProductivity • No significant changes were observed for either group in absenteeism, presenteeism, overall health-related productivity loss, or other indicators of health on functionPerceived Support • The addition of the WorkFit stations showed a non- statistically significant increase in perceived departmental support for employee health in both groups and reduced upon removal of the devices
  20. 20. Correlations• Pearson’s correlation coefficients were calculated to test the association between changes in sitting time for all participants (N=34) during period 1 and 2 of the project while at work and changes in back pain, office behaviors, and mood states.• Reductions in sitting time were significantly associated with reductions in: – Upper back and neck pain (r = .47; p = .006) – Fatigue (r = .44; p = .01) – Confusion (r = .46; p = .007) – Total mood disturbance (r = .35; p = .046)
  21. 21. Use of WorkFit Device Intervention Group only• 67% used the device to alternate between sitting and standing for most of the day• 75% indicated the typical duration when they chose to stand was 60 min or longer• Overall, alternating between a seated and standing position while working made 67% feel a lot better and 33% feel better• When asked about specific benefits gained by alternating between a seated and standing position while working, – 87% felt more comfortable – 76% felt more energized – 75% felt healthier – 71% felt more focused – 66% felt more productive – 62% felt happier – 33% indicated feeling less stressed
  22. 22. Conclusions• Introduction of the WorkFit sit-to-stand devices among a group of highly active, fit, normal weight, apparently healthy, mostly female employees with relatively sedentary work tasks: – Increased non-sitting time by more than an hour per day – Reduced upper back, neck and shoulder pain – Improved mood states – Increased face-to-face time during work• Participants felt the WorkFit devices made them feel: – More comfortable (87%) – More energized (76%) – Healthier (75%) – More focused (71%) – More productive (66%) – Happier (62%) – Less stressed (33%)• Removal of the devices after four weeks eliminated most improvements generated due to the intervention, in many cases to below baseline levels
  23. 23. Media Coverage• PR and News releases• Newspaper interviews• Feature stories in local press• PR Newswire in Times Square, New York• AHIP Solutions SmartBriefs• ABC12.com• (Google search on “healthpartners standing at work” gets 5,230,000 hits)
  24. 24. Dissemination• HealthPartners (13,000 employees) has integrated sit-to-stand devices into the workstations of all employees with sedentary work tasks AND who are interested in trying one out• HealthPartners Health and Well-Being /JourneyWell division has integrated the sit-to-stand device into its worksite health and productivity suite of solutions (reach of approximately 450,000 employees nationwide) using a deployment strategy with Ergotron (dedicated web portal)• Ergotron has integrated the result of this project into its marketing and advertising campaigns• Manuscript on the “Take-a-Stand” project has been accepted for publication and is currently in press (Preventing Chronic Disease)
  25. 25. Discussion Thank you