工作场所身体活动（PAW）研究：一项多组分短休息干预措施的整群随机试验，旨在减少泰国办公室职员的久坐时间并增加其身体活动量
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.
作者信息
Akksilp Katika, Koh Jemima Jia En, Tan Vanessa, Tong Eunice Huiying, Budtarad Nuttakarn, Xueying Guo, Dieterich Anna Valeria, Tai Bee Choo, Müller Andre Matthias, Isaranuwatchai Wanrudee, Rouyard Thomas, Nakamura Ryota, Müller-Riemenschneider Falk, Teerawattananon Yot, Chen Cynthia
机构信息
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
Health Intervention and Technology Assessment Programme (HITAP), Ministry of Public Health, Thailand.
出版信息
Lancet Reg Health Southeast Asia. 2022 Oct 19;8:100086. doi: 10.1016/j.lansea.2022.100086. eCollection 2023 Jan.
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 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).
背景
久坐行为会增加患非传染性疾病的风险。本试验的目的是评估工作场所身体活动多组分干预措施对减少泰国上班族久坐行为的效果。
方法
泰国公共卫生部下属的办公室按1:1的比例随机分配到干预组和对照组，并按办公室规模分层。干预措施包括个人层面（计步器和基于抽奖的经济激励）、社交层面（集体活动休息）、环境层面（海报）和组织层面（领导鼓励）的组成部分。在基线期和6个月随访时，参与者在腰部佩戴ActiGraph计步器10天。主要结局是6个月时两组之间久坐时间的组间差异，采用线性混合效应模型进行分析。其他结局包括身体活动、生物标志物、生产力和肌肉骨骼健康。试验注册情况：PAW研究于2020年6月2日在泰国临床试验注册中心注册（注册号TCTR20200604007）。
研究结果
招募了282名上班族，随机分配到对照组（142名参与者，9个办公室）和干预组（140名参与者，9个办公室）。平均年龄为38.6岁（标准差=10.4），81%为女性。没有证据表明干预措施在6个月时对清醒时间的久坐时间（-26.8；95%置信区间=-69.2至15.7分钟）、身体活动水平或两组之间的生物标志物有影响。在调整分析中，观察到清醒时间内中度至剧烈身体活动时间（5.45；95%置信区间=-0.15至11.1分钟）和步数（718；95%置信区间=-45至1481步）有所增加，尽管没有证据表明两组之间存在差异。
解读
该干预措施并未显著减少泰国上班族的久坐时间。由于新冠疫情限制导致干预措施的接受度欠佳，以及与招募限制相关的统计效能损失，可能解释了这一结果。需要进一步调查以评估该试验的过程。
资金来源
泰国健康促进基金会和国际决策支持倡议（iDSI）。
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