title: Providing NHS staff with height-adjustable workstations and behaviour change strategies to reduce workplace sitting time: protocol for the Stand More AT (SMArT) Work cluster randomised controlled trial.
abstract: BACKGROUND
  High levels of sedentary behaviour (i.e., sitting) are a risk factor for poor health. With high levels of sitting widespread in desk-based office workers, office workplaces are an appropriate setting for interventions aimed at reducing sedentary behaviour. This paper describes the development processes and proposed intervention procedures of Stand More AT (SMArT) Work, a multi-component randomised control (RCT) trial which aims to reduce occupational sitting time in desk-based office workers within the National Health Service (NHS).
  
  
  METHODS
  SMArT Work consists of 2 phases: 1) intervention development: The development of the SMArT Work intervention takes a community-based participatory research approach using the Behaviour Change Wheel. Focus groups will collect detailed information to gain a better understanding of the most appropriate strategies, to sit alongside the provision of height-adjustable workstations, at the environmental, organisational and individual level that support less occupational sitting. 2) intervention delivery and evaluation: The 12 month cluster RCT aims to reduce workplace sitting in the University Hospitals of Leicester NHS Trust. Desk-based office workers (n = 238) will be randomised to control or intervention clusters, with the intervention group receiving height-adjustable workstations and supporting techniques based on the feedback received from the development phase. Data will be collected at four time points; baseline, 3, 6 and 12 months. The primary outcome is a reduction in sitting time, measured by the activPAL(TM) micro at 12 months. Secondary outcomes include objectively measured physical activity and a variety of work-related health and psycho-social measures. A process evaluation will also take place.
  
  
  CONCLUSIONS
  This study will be the first long-term, evidence-based, multi-component cluster RCT aimed at reducing occupational sitting within the NHS. This study will help form a better understanding and knowledge base of facilitators and barriers to creating a healthier work environment and contribute to health and wellbeing policy.
  
  
  BACKGROUND
  ISRCTN10967042 . Registered 2 February 2015.
authors.affiliation: Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK. Sophie.OConnell@uhl-tr.nhs.uk.
authors.forename: S E
authors.initials: SE
authors.lastname: O'Connell
authors.affiliation: School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK. B.R.Jackson@lboro.ac.uk.
authors.forename: B R
authors.initials: BR
authors.lastname: Jackson
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester, UK. ce95@leicester.ac.uk.|NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK. ce95@leicester.ac.uk.
authors.forename: C L
authors.initials: CL
authors.lastname: Edwardson
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester, UK. ty20@le.ac.uk.|NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK. ty20@le.ac.uk.
authors.forename: T
authors.initials: T
authors.lastname: Yates
authors.affiliation: School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK. stuart.biddle@vu.edu.au.|NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK. stuart.biddle@vu.edu.au.|Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia. stuart.biddle@vu.edu.au.
authors.forename: S J H
authors.initials: SJ
authors.lastname: Biddle
authors.affiliation: Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK. Melanie.davies@uhl-tr.nhs.uk.|Diabetes Research Centre, University of Leicester, Leicester, UK. Melanie.davies@uhl-tr.nhs.uk.|NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK. Melanie.davies@uhl-tr.nhs.uk.
authors.forename: M J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: School of Public Health, The University of Queensland, Brisbane, Queensland, Australia. David.Dunstan@bakeridi.edu.au.|Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia. David.Dunstan@bakeridi.edu.au.|Department of Medicine, Monash University, Melbourne, VIC, Australia. David.Dunstan@bakeridi.edu.au.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia. David.Dunstan@bakeridi.edu.au.|School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia. David.Dunstan@bakeridi.edu.au.|School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA, Australia. David.Dunstan@bakeridi.edu.au.|Mary MacKillop Institute for Health Research, The Australian Catholic University, Melbourne, VIC, Australia. David.Dunstan@bakeridi.edu.au.
authors.forename: D
authors.initials: D
authors.lastname: Dunstan
authors.affiliation: School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK. D.Esliger@lboro.ac.uk.|NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK. D.Esliger@lboro.ac.uk.
authors.forename: D
authors.initials: D
authors.lastname: Esliger
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester, UK. lg48@le.ac.uk.
authors.forename: L
authors.initials: L
authors.lastname: Gray
authors.affiliation: School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK. drpsjmiller@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Miller
authors.affiliation: School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK. F.Munir@lboro.ac.uk.
authors.forename: F
authors.initials: F
authors.lastname: Munir
mesh_terms: D055812:Community-Based Participatory Research; D003201:Computers; D004651:Employment; D004779:Environment Design; D017144:Focus Groups; D015438:Health Behavior; D006801:Humans; D011187:Posture; D012107:Research Design; D057185:Sedentary Behavior; D013222:State Medicine; D014937:Work; D017132:Workplace