In the workplace, sedentary behaviour has become an unavoidable consequence of desk-based jobs. Research shows that adults spend an average of 9-10 hours each day, or approximately 60% of their waking hours, sitting. This prolonged sedentary behaviour is even more pronounced among office-based workers, who spend 73% of their work hours and 66% of their entire waking day sitting. While this may seem innocuous at first glance, it is increasingly clear that such extended periods of inactivity pose significant health risks.

Numerous studies have linked excessive sedentary time to a wide range of health conditions, including cardiovascular mortality, type 2 diabetes, and several forms of cancer, such as endometrial, colon, and lung cancers. Beyond physical health, sitting for extended periods is associated with mental health challenges such as increased anxiety and depression, as well as an overall reduction in quality of life. With these concerns in mind, global health organisations, including the World Health Organisation (WHO), have developed guidelines urging individuals to reduce and regularly break up sedentary time.

Urgent Need for Workplace Interventions

The workplace, as a setting where people spend a significant portion of their day, has become a critical focus for reducing sedentary behaviour. Interventions aimed at decreasing sitting time at work have grown in popularity, with height-adjustable desks emerging as a widely recommended solution. These desks allow employees to alternate between sitting and standing, promoting more dynamic movement throughout the day.

Despite their promise, past interventions have been limited in scope and impact. Many studies had small sample sizes, short follow-up periods, and unreliable methods for measuring changes in sedentary behaviour. Additionally, most interventions focused exclusively on reducing sitting during work hours, leaving non-work sedentary behaviour largely unaddressed. This limited scope reduces the overall health impact, as individuals tend to remain sedentary outside of the workplace.

Recognising these gaps, researchers developed the SMART Work and Life (SWAL) intervention. Unlike previous approaches, SWAL takes a whole-day perspective, addressing sedentary behaviour during both work and non-work hours. This comprehensive approach seeks to maximise the potential health benefits of reducing sitting time, providing a clearer path for organisations to adopt sustainable solutions.

Design and Implementation

To evaluate the effectiveness of the SWAL intervention, researchers conducted a large cluster randomised controlled trial involving 756 desk-based employees from six UK local government councils. Local government was chosen as the setting because it represents one of the largest employment sectors in the country and features a workforce predominantly engaged in desk-based activities.

Participants were divided into three groups:

1. Control Group: Continued with usual workplace practices.
2. SWAL Group: Implemented the SWAL intervention without height-adjustable desks.
3. SWAL + Desk Group: Implemented the SWAL intervention with the addition of height-adjustable desks.

The intervention was designed to be delivered by workplace champions, rather than researchers, to mimic real-world implementation and enhance scalability. Workplace champions received training to lead the intervention, which included strategies to encourage employees to reduce and break up their sitting time throughout the day. For the SWAL + Desk group, participants were provided with height-adjustable desks to further facilitate behaviour change.

Reductions in Sitting Time

At the 12-month follow-up, the study’s results demonstrated the clear effectiveness of both intervention groups in reducing sitting time compared to the control group. Participants in the SWAL group reduced their daily sitting time by an average of 22 minutes per day. Those in the SWAL + Desk group achieved even greater reductions, sitting for 64 minutes less per day than the control group. This difference of 42 minutes highlights the added benefit of incorporating height-adjustable desks into workplace interventions.

Importantly, these reductions in sitting time were not limited to short-term changes. The study found that participants maintained these changes across both three-month and 12-month follow-ups, indicating that the interventions led to sustained behaviour change. Reductions in sitting time were largely replaced by increased standing time, with the majority of changes occurring during work hours. However, there was minimal impact on sedentary behaviour outside of work, highlighting the need for future interventions to address non-work sitting time.

Behavioural Impacts and Demographic Insights

The study also demonstrated demographic patterns in the effectiveness of the interventions. Older participants (aged 46 years and above) in the SWAL + Desk group experienced greater reductions in sitting time during work hours compared to younger participants. This finding suggests that older employees may be more receptive to interventions that include height-adjustable desks, possibly due to a greater awareness of the health risks associated with prolonged sitting.

While the interventions successfully reduced sedentary behaviour during work hours, the limited impact on non-work sitting time highlights a key challenge for researchers and employers. Encouraging individuals to change their behaviour outside of the structured work environment requires additional strategies and support mechanisms.

Health and Wellbeing Outcomes

Beyond reducing sitting time, the study also evaluated the impact of the interventions on participants’ physical and mental health. Although there were no significant changes in cardiometabolic health markers such as blood glucose levels or cholesterol, likely because participants had healthy baseline levels, the interventions did lead to small but meaningful improvements in mental health and wellbeing.

Participants in both intervention groups reported reduced stress levels, increased feelings of wellbeing, and greater vigour at work. These benefits were particularly pronounced in the SWAL + Desk group, which also experienced a reduction in lower extremity pain. These findings suggest that reducing sitting time can have a positive impact on both physical and mental health, even if the effects on specific health markers are less pronounced.

Comparing SWAL with Previous Research

The results of the SWAL study align with findings from other large randomised controlled trials that evaluated interventions to reduce workplace sitting time. Previous studies involving height-adjustable desks reported similar reductions in sitting time, although they often lacked the comprehensive, whole-day approach of the SWAL intervention. Unlike earlier interventions, which were typically delivered by researchers, the SWAL study’s use of workplace champions represents a significant step forward in real-world implementation.

One notable limitation of previous research was its failure to impact sedentary behaviour outside of work. The SWAL study’s findings confirm that this remains a challenge, even with a whole-day intervention approach. Future research will need to explore innovative strategies to support behaviour change during non-work hours, such as incorporating technology-based reminders or community-based initiatives.

Real-World Implementation and Scalability

A key strength of the SWAL intervention was its emphasis on real-world scalability. By training workplace champions to deliver the program, the researchers demonstrated that the intervention could be implemented without relying on external experts. This approach not only reduces costs but also encourages organisations to take ownership of their employees’ health and wellbeing.

However, the study also highlighted variability in implementation across different workplace clusters. Some champions and participants engaged with the intervention more actively than others, suggesting the need for further adaptations to ensure consistent delivery. Providing additional training and resources for workplace champions may help address these challenges and enhance the intervention’s effectiveness.

Future Research

While the SWAL study represents a significant step forward in reducing workplace sitting time, it also highlights several areas for future research. One critical priority is understanding how to encourage behaviour change outside of work hours. Since the majority of sedentary time occurs during leisure activities, targeting these periods could further enhance the health benefits of interventions.

Long-term studies are also needed to investigate the sustained impact of sedentary behaviour interventions on health outcomes, workplace culture, and employee productivity. The SWAL study’s 12-month follow-up provides valuable insights into medium-term behaviour change, but longer follow-up periods would help determine whether these changes lead to lasting improvements in health and wellbeing.

Additionally, future research should explore how interventions can be adapted for different employment sectors. While the SWAL study focused on local government employees, its findings may not be directly applicable to other industries with different work environments and cultural norms. Expanding the intervention to diverse settings will help ensure its broader relevance and applicability.

Conclusion

The SMART Work and Life (SWAL) intervention demonstrates that workplace-based strategies can effectively reduce sedentary behaviour, particularly when height-adjustable desks are included. By achieving sustained reductions in sitting time and modest improvements in mental wellbeing, the SWAL intervention provides a valuable framework for organisations looking to promote employee health.

While challenges remain, such as addressing sedentary behaviour outside of work and ensuring consistent implementation, the study’s findings highlight the potential of workplace interventions to drive meaningful behaviour change. As research continues to refine these approaches, organisations have an opportunity to play a pivotal role in creating healthier, more active work environments for their employees. With the right strategies and support, the sedentary epidemic in modern workplaces can be effectively addressed, paving the way for a healthier future.

References

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Healy, G. N., Eakin, E. G., Owen, N., Lamontagne, A. D., Moodie, M., Winkler, E. A. H., Fjeldsoe, B. S., Wiesner, G., Willenberg, L., & Dunstan, D. W. (2016). A cluster randomized controlled trial to reduce office workers’ sitting time: Effect on activity outcomes. Medicine and Science in Sports and Exercise, 48(9), 1787–1797. https://doi.org/10.1249/MSS.0000000000000972

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