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INTRODUCTION
Physical activity is categorized as being a light,
moderate, or vigorous in intensity, and most health benefits have been associated
with moderate to vigorous intensity physical activity1.
The
modern way of living promotes comfort and well-being in a less energy demanding
environment2`. Some modern work places create sedentary lifestyles for workers, especially among bankers
in Nigerian population. Nigerian bank workers at risk are those pre-disposed to
overweight and work as administrators or credit facilitators, and as such, engage
in screen time activities. This exposes them to being at risk of obesity; they
adhere to the workplace sitting reduction protocols and do not compensate for
this at their leisure time3. Most of them do not balance out all the
sitting at work by being more active in their free time. The human body system is not genetically
adapted for a sedentary lifestyle; thus, sedentary lifestyle or lack of
physical activity tops the chart as one of the leading causes of preventable
death worldwide4,5.
New research findings showed that time spent
sitting is associated with being overweight or obese, poor blood-glucose
and blood-lipid profiles and with premature death from heart disease6.
There is therefore need to address and overcome the lack of physical activity in job
cultures, as some jobs encourage more sedentary activity7.
Behavior change communication
interventions may be an effective way to promote awareness of risk factors
associated with sedentary lifestyle and
change knowledge of and perceptions about physical activity. Behavior
change can be enhanced by engaging in informational approaches; motivating
change through media; radio, television, newspaper, mails, billboards, and
advertisements. Motivational Messages can be used as Point-of-decision prompts,
placed by elevators and escalators to motivate people to use nearby stair cases
than using the elevators or escalators. Environmental and policy aspects can
also be addressed to provide environmental opportunities, support, and cues to
help people develop healthier behaviors; such as creation of or enhanced
access to places for physical activity, increasing the number
of breaks from sitting time, implementing strategies around postural change,
focusing on ergonomic changes to the individual workspace, and recommendations
to alter the built design of the broader workplace.
The purpose of this paper is to review scientific literatures on evidence based associated
risk factor to workplace sitting, intervention approaches, and make comparisons
on the effectiveness of controlled behavioral interventions with a focus on
physical activity (PA) and/or sedentary behaviors (SBs) for reducing sedentary
time and decrease risk factors among bank workers.
Body of
Evidence
The selection criteria includes articles
published in scientific journals that evaluated an intervention for physical
activity and/or sedentary lifestyle behaviours, or focused on weight loss; used
non randomized controlled studies or
randomized or quasi-experimental designs; measured outcomes at baseline
and a follow-up period; and included an intervention. All studies were published between 2008
and2014. The review was categorized into two groups, non-randomized controlled studies6,
8, 9 and Randomized control trials10-20. The non-randomized and randomized studies and
trials all examined changes in sedentary behavior following sedentary behavior focused intervention.
The non-randomized
multiple workplace intervention demonstrated that substantial reductions in
sitting time are achievable in an office setting. One of the non-randomized
intervention demonstrated that substantial reductions in sitting time are
achievable in an office setting10.
Among the
randomized trials, some addressed interventions at workplace; sitting time in offices,
and reported that sit-stand workstations can reduce desk-based workers sitting
time and total sitting time significantly declined in intervention participants10-13.
One of the randomized trials reported
non-significant changes for most health and work related outcomes, but stated
that activity permissive workstations can be effective to reduce occupation
sedentary time, without compromising work performance6.
Similarly, three studies addressed the relationship
between sitting or sedentary behaviour and mortality14-16.All of
these studies showed that sedentary behaviour was a risk factor for all-cause
and cardiovascular disease mortality. In the cohort study by Katzmarzyk et al
(2009)14, results showed a dose–response relationship between
sitting time and mortality from all causes and mortality from cardiovascular disease
was reported. These associations were independent of leisure time physical
activity. The result among those over age 60 showed progressively higher risk
of all-cause mortality across higher levels of sitting time.
Some of the randomized reviewed intervention
also addressed behavioral change17-19. Barwais
et al (2013)19 reported on a 4 week randomized control trial on
physical activity, which identified that total wellness is improved when
sedentary, but sufficiently physically active adults, reduce sedentary time and
increase physical activity levels (i.e. light, walking, moderate and vigorous activity)19.
Other randomized interventions addressed the
benefits of physical activity on participants with different disease
conditions17-20. A systematic review of fourteen randomized
controlled trials addressing the benefits of physical activity for people with Parkinson’s
disease was done. It was observed that various physical activity
interventions led to improvements in physical functioning, quality of life,
strength, balance, and gait speed for people with Parkinson’s disease21.
Another intervention also provided report on a systematic review of 34 studies
which found mixed results of beneficial outcomes from physical activity
interventions on cognitive function indices22. A similar report showed that in a large systematic
review of 254 studies, higher levels of physical activity reduce the risk for
premature all-cause mortality24. The study also reported on the
risks associated with morbidity for a number of conditions; breast cancer,
colon cancer, stroke, cardiovascular disease, hypertension, osteoporosis, and
type 2 diabetes24.
Summary and conclusion
In this review, there was sufficient evidence to support
that physical activity beneficially improves total wellness of individuals. Thus,
the review found evidence on the
potential benefits of sedentary time reduction at work stations, their impact on health and work
related outcomes. There is enough evidence to show that reducing sitting time
in work places will not affect quality of work and interventions used at
workplace, showed impact on behavioral change. In particular, the study by
Nauhaus et al (2014), demonstrated the use of multi-component
intervention at work place to bring about behavioral change. The intervention comprised
of installation of height-adjustable workstations and organizational-level
(management consultation, staff education, manager e-mails to staff) and
individual-level (face-to-face coaching, telephone support) elements6.
The
evidence on the risks of physical inactivity among workers, especially of older
people suggests that having a less active or more sedentary lifestyle increases
the risk of premature mortality and other undesirable health-related outcomes,
relative to leading an active lifestyle10-13. There is therefore a
direct cause effect relationship between sedentary lifestyle and mortality and
the presence of large amount of time spent sitting appear to be independent
risk factors for negative health outcomes. The study by Katzemarzyk et al
(2013)14 presented findings in the 1981 Canada fitness survey (CFS).
The sample had 7278 men and 9735 women aged 18-90 years. Participants were
placed into physically active and inactive groups using a threshold of 7.5
MET.h.wk-1, which corresponds to the physical activity recommended
threshold. The results of this study provide sufficient evidence to
support the suggestion that recommendations to limit sedentary time may be
important for public health14. The limitation in this study is the
long follow up period of 12.9 years; it makes it difficult to actually perceive
the barrier in physical activity. Also, Studies
that characterize the biology of sitting may be best placed for discoveries if
they focus on individuals at the extremes of sitting behavior. However, the strengths
of the study include the prospective design, the large representative national
sample of men and women, and the detailed evaluation of participants at baseline.
This study differ from a 4 week randomized study by Bawals et al, (2013)19where
22 men and 11 women were randomly assigned to either an intervention designed
to reduce sedentary time and increase physical activity of daily living.
Participants in the intervention group interacted with an online personal
activity monitor. One limitation of this study is the
relatively small sample size, which consisted of office workers or university
students. This study stated the
associations between decreased sedentary behavior, increased physical activity
levels and increases in total wellness scores among sedentary adults.
Generally, limitations from the research literature s
are evident from multi component interventions, measures, methodology, and
limited statistical power in many of the studies, so additional large
high-quality studies with standardized measures and methods are needed.
In
order to overcome sedentary lifestyle at workplaces, there is the need to
educate and motivate workers especially in banks on the benefits of physical
activity and address environmental and policy aspects to
provide environmental opportunities, support, and cues to help people develop
healthier behaviors and implement strategies around postural change.
Communication intervention is important in addressing and overcoming sedentary
lifestyle, greater results will be obtained with multiple interventions. With
the average adults spending the majority of their waking hours in
sedentary pursuits and the detrimental health risks
associated with these behaviors, there is the need to design interventions and
to reduce sedentary time and improve physical activity especially amongst
Nigerian bank workers. The findings of this systematic
review therefore will have significant implications for the design
of these interventions, so that workers will overcome sedentary lifestyle and
embrace physical activity.
