Conclusions
prolonged sedentary behavior
Our findings suggest that sit-to-stand desks may exert a potentially more favorable behavior change response on the accumulation patterns of physical behaviors suitable for achieving the “sit less, move more” initiative than treadmill desks. Treadmill desk users favored the accumulation of sedentary and standing bouts in prolonged durations, relative to controls and sit-to-stand desk users, which was sustained for a year. In contrast, sit-to-stand desk users showed a tendency to decrease prolonged sedentary behavior and increase short-duration standing to prescribed duration standing, which was sustained for a year. Future research on treadmill desk use needs to (1) examine whether prolonged standing bouts may be a compensatory behavior to decreased stepping and (2) study the relationship between prolonged sedentary and standing bouts to determine whether increasing prolonged sedentary behavior is a compensatory behavior to electing to stand for prolonged periods. Sit-to-stand and treadmill desks may exert a minimal impact on long-term stepping patterns, as most gains observed in our study were small and not sustained. However, sit-to-stand desk users accumulated frequent short-duration stepping over M6, which may be a beneficial behavior pattern. Future active workstation studies may require behavior change strategies that are effective in promoting more frequent bouts of movement as necessary for both (1) translating short-term stepping gains, which may be attributable to the initial novelty factor of the interventions, to long-term habitual gains and (2) limiting prolonged sedentary and standing bouts to minimize health risks.The authors thank all the participants in the study and the nursing staff at Massachusetts General Hospital who assisted with data collection. The authors thank Ergotron Inc for providing the sit-to-stand desks at no cost. This work was funded by the National Institute for Occupational Safety and Health (1R21OH010564-01). This project was also supported by The Harvard School of Public Health grant 1UL1TR001102.Conflicts of Interest: None declared.Detailed study protocol.Flow diagram of enrollment, participation, attrition, and analyses for total daily time.Flow diagram of enrollment, participation, attrition, and analyses for workday time.Sample sizes after losses to follow-up and activity monitor wear times by group × time point.Intraclass correlation coefficients and significance of cluster effects by physical behavior outcome variables.Between- and within-group comparisons of the number of daily sedentary bouts classified by bout durations over the total day and workday, adjusted for age.Between- and within-group comparisons of the number of daily standing bouts classified by bout durations over the total day and workday, adjusted for age.Between- and within-group comparisons of the number of daily stepping bouts classified by bout durations over the total day and workday, adjusted for age.Baseline characteristics of aim 1 and 2 outcomes by group over the total day and workday for completers' analyses.Between- and within-group comparisons of aim 1 and 2 outcome variables for completers' analysis.CONSORT-eHEALTH checklist (V 1.6.1).