Box 1. Key recommendations for programme adaptation
Ensure appropriate placement and labelling of, and communication about, equipment for staff.Incorporate or suggest more competition-type activities for staff within and between teams and organisations, and showcase this using the programme website.Share results and benefits of the programme, especially at the individual level, to motivate staff (example- sharing individual level sedentary behaviour data).Have a higher amount and variety of communication and advertising measures to create awareness of the programme and check in with staff. This advertising and communication should include information relating to the risks of high rates of sedentary behaviour and low levels of physical activity to emphasise the programme’s importance and increase motivation to participate.Visit the centres more often and at different time points to maximise in-person contact with staff.Encourage managers and others at various management levels to actively support the programme and participate in programme activities.Set more realistic expectations with respect to the speed at which implementation of activities, and changes to behaviour and outcomes (at the various levels) are realised.Despite being impacted by the COVID-19 pandemic, the SUH programme shows potential as an appealing and acceptable intervention with several perceived benefits. Future studies should take into account a staff turnover rate of approximately 20% over a 10–12 month period. There were no participants who stated that they had previously worked for a company which had used the SUH intervention, even among the post-lockdown participants, which suggests that contamination between intervention and control groups in a future study is unlikely to be a concern in a future cluster randomised trial. We observed a greater proportion of participants who were working in the company for more than three years at baseline than we expected, and it is recommended that future questionnaires are designed with this in mind. For future studies in this population, we recommend that the “>3 years” category is sub-divided into further categories to enable more precise data to be collected on the duration working in the company. For example, the questionnaire options could include “3–5 years”, “5–10 years”, and “>10 years” options, instead of just “>3 years”.The stepped wedge study design is unlikely to be a suitable design choice for a future cluster randomised trial conducted in call centres. We experienced difficulties in maintaining site interest (e.g. if some sites were randomised to receive the intervention 12 months later), and it was challenging to ensure that each site adhered to the scheduled data collection time points. Instead of a stepped wedge trial design, we suggest that a parallel-group cluster randomised trial could be used, where sites are recruited in pairs (or groups) over time.