The physical activity at work (PAW) study: a cluster randomised trial of a multicomponent short-break intervention to reduce sitting time and increase physical activity among office workers in Thailand

Katika Akksilp; Jemima Jia En Koh; Vanessa Tan; Eunice Huiying Tong; Nuttakarn Budtarad; Guo Xueying; Anna Valeria Dieterich; Bee Choo Tai; Andre Matthias Müller; Wanrudee Isaranuwatchai; Thomas Rouyard; Ryota Nakamura; Falk Müller-Riemenschneider; Yot Teerawattananon; Cynthia Chen

doi:10.1016/j.lansea.2022.100086

The physical activity at work (PAW) study: a cluster randomised trial of a multicomponent short-break intervention to reduce sitting time and increase physical activity among office workers in Thailand

Lancet Reg Health Southeast Asia. 2022 Oct 19:8:100086. doi: 10.1016/j.lansea.2022.100086. eCollection 2023 Jan.

Authors

Katika Akksilp^{1

2}, Jemima Jia En Koh¹, Vanessa Tan¹, Eunice Huiying Tong¹, Nuttakarn Budtarad², Guo Xueying¹, Anna Valeria Dieterich¹, Bee Choo Tai^{1

3}, Andre Matthias Müller¹, Wanrudee Isaranuwatchai², Thomas Rouyard⁴, Ryota Nakamura⁴, Falk Müller-Riemenschneider^{1

3}, Yot Teerawattananon^{1

2}, Cynthia Chen^{1

3}

Affiliations

¹ Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
² Health Intervention and Technology Assessment Programme (HITAP), Ministry of Public Health, Thailand.
³ Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
⁴ Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Japan.

Abstract

Background: Sedentary behaviour increases the risks of non-communicable diseases. The objective of this trial was to evaluate the effect of the Physical Activity at Work multicomponent intervention to reduce sedentary behaviour in Thai office workers.

Methods: Offices under the Ministry of Public Health Thailand, were randomly allocated to the intervention and control group in a 1:1 ratio, stratified by office size. The intervention included individual (pedometer and lottery-based financial incentives), social (group movement breaks), environmental (posters), and organisational (leader encouragement) components. At baseline and 6-month follow-up, participants wore ActiGraph^TM on the waist for ten days. The primary outcome was the between-group difference in sedentary time at 6-month, analysed using a linear mixed-effects model. Other outcomes were physical activity, biomarkers, productivity, and musculoskeletal health. Trial registration: The PAW study was registered at the Thai Clinical Trials Registry (ID TCTR20200604007) on 02 June 2020.

Findings: 282 office workers were recruited and randomly allocated to the control group (142 participants, nine offices) and the intervention group (140 participants, nine offices). The mean age was 38.6 years (SD = 10.4), and 81% were women. There was no evidence of intervention effects on sedentary time during waking hours (-26.8; 95% CI = -69.2 to 15.7 min), physical activity levels, or biomarkers between groups at 6-month. In the adjusted analysis, increases in time spent in moderate-to-vigorous physical activity (5.45; 95% CI = -0.15 to 11.1 min) and step count (718; 95% CI = -45 to 1481 steps) during waking hours were observed, although there was no evidence of a difference between groups.

Interpretation: The intervention did not significantly reduce sedentary time in Thai office workers. Suboptimal intervention uptake due to Covid-19 pandemic restrictions and loss of statistical power associated with recruitment constraints may explain this result. Further investigations are needed to evaluate the processes of the trial.

Funding: The Thai Health Promotion Foundation and the International Decision Support Initiative (iDSI).

Keywords: Physical activity; Randomised controlled trial; Sedentary behaviour; Workplace.