Correlates of sedentary time in different age groups: results from a large cross sectional Dutch survey.

BACKGROUND: Evidence shows that prolonged sitting is associated with an increased risk of mortality, independent of physical activity (PA). The aim of the study was to identify correlates of sedentary time (ST) in different age groups and day types (i.e. school-/work day versus non-school-/non-work day). METHODS: The study sample consisted of 1895 Dutch children (4-11 years), 1131 adolescents (12-17 years), 8003 adults (18-64 years) and 1569 elderly (65 years and older) who enrolled in the Dutch continuous national survey 'Injuries and Physical Activity in the Netherlands' between 2006 and 2011. Respondents estimated the number of sitting hours during a regular school-/workday and a regular non-school/non-work day. Multiple linear regression analyses on cross-sectional data were used to identify correlates of ST. RESULTS: Significant positive associations with ST were observed for: higher age (4-to-17-year-olds and elderly), male gender (adults), overweight (children), higher education (adults ≥ 30 years), urban environment (adults), chronic disease (adults ≥ 30 years), sedentary work (adults), not meeting the moderate to vigorous PA (MVPA) guideline (children and adults ≥ 30 years) and not meeting the vigorous PA (VPA) guideline (4-to-17-year-olds). Correlates of ST that significantly differed between day types were working hours and meeting the VPA guideline. More working hours were associated with more ST on school-/work days. In children and adolescents, meeting the VPA guideline was associated with less ST on non-school/non-working days only. CONCLUSIONS: This study provides new insights in the correlates of ST in different age groups and thus possibilities for interventions in these groups. Correlates of ST appear to differ between age groups and to a lesser degree between day types. This implies that interventions to reduce ST should be age specific. Longitudinal studies are needed to draw conclusions on causality of the relationship between identified correlates and ST.

Longitudinal Relationship Between Sitting Time on a Working Day and Vitality, Work Performance, Presenteeism, and Sickness Absence.

OBJECTIVE: The aim of this study was to explore the longitudinal relationship between sitting time on a working day and vitality, work performance, presenteeism, and sickness absence. METHODS: At the start and end of a five-month intervention program at the workplace, as well as 10 months after the intervention, sitting time and work-related outcomes were measured using a standardized self-administered questionnaire and company records. Generalized linear mixed models were used to estimate the longitudinal relationship between sitting time and work-related outcomes, and possible interaction effects over time. RESULTS: A significant and sustainable decrease in sitting time on a working day was observed. Sitting less was significantly related to higher vitality scores, but this effect was marginal (b = -0.0006, P = 0.000). CONCLUSIONS: Our finding of significant though marginal associations between sitting time and important work-related outcomes justifies further research.

Cross-cultural adaptation of the Individual Work Performance Questionnaire.

BACKGROUND: The Individual Work Performance Questionnaire (IWPQ), measuring task performance, contextual performance, and counterproductive work behavior, was developed in The Netherlands. OBJECTIVES: To cross-culturally adapt the IWPQ from the Dutch to the American-English language, and assess the questionnaire's internal consistency and content validity in the American-English context. METHODS: A five stage translation and adaptation process was used: forward translation, synthesis, back-translation, expert committee review, and pilot-testing. During the pilot-testing, cognitive interviews with 40 American workers were performed, to examine the comprehensibility, applicability, and completeness of the American-English IWPQ. RESULTS: Questionnaire instructions were slightly modified to aid interpretation in the American-English language. Inconsistencies with verb tense were identified, and it was decided to consistently use simple past tense. The wording of five items was modified to better suit the American-English language. In general, participants were positive on the comprehensibility, applicability and completeness of the questionnaire during the pilot-testing phase. Furthermore, the study showed positive results concerning the internal consistency (Cronbach's alphas for the scales between 0.79-0.89) and content validity of the American-English IWPQ. CONCLUSION: The results indicate that the cross-cultural adaptation of the American-English IWPQ was successful and that the measurement properties of the translated version are promising.

Improving the Individual Work Performance Questionnaire using Rasch analysis.

Recently, the Individual Work Performance Questionnaire (IWPQ) version 0.2 was developed using Rasch analysis. The goal of the current study was to improve targeting of the IWPQ scales by including additional items. The IWPQ 0.2 (original) and 0.3 (including additional items) were examined using Rasch analysis. Additional items that showed misfit or did not improve targeting were removed from the IWPQ 0.3, resulting in a final IWPQ 1.0. Subsequently, the scales showed good model fit and reliability, and were examined for key measurement requirements (e.g., category ordening, unidimensionality, and differential item functioning). Finally, calculation and interpretability of scores were addressed. Compared to its previous version, the final IWPQ 1.0 showed improved targeting for two out of three scales. As a result, it can more reliably measure workers at all levels of ability, discriminate between workers at a wider range on each scale, and detect changes in individual work performance.

Responsiveness of the individual work performance questionnaire.

BACKGROUND: Individual work performance is an important outcome measure in studies in the workplace. Nevertheless, its conceptualization and measurement has proven challenging. To overcome limitations of existing scales, the Individual Work Performance Questionnaire (IWPQ) was recently developed. The aim of the current study was to gain insight into the responsiveness of the IWPQ. METHODS: Data were used from the Be Active & Relax randomized controlled trial. The aim of the trial was to investigate the effectiveness of an intervention to stimulate physical activity and relaxation of office workers, on need for recovery. Individual work performance was a secondary outcome measure of the trial. In total, 39 hypotheses were formulated concerning correlations between changes on the IWPQ scales and changes on similar constructs (e.g., presenteeism) and distinct constructs (e.g., need for recovery) used in the trial. RESULTS: 260 Participants completed the IWPQ at both baseline and 12 months of follow-up. For the IWPQ scales, 23%, 15%, and 38%, respectively, of the hypotheses could be confirmed. In general, the correlations between change scores were weaker than expected. Nevertheless, at least 85% of the correlations were in the expected direction. CONCLUSIONS: Based on results of the current study, no firm conclusions can be drawn about the responsiveness of the IWPQ. Several reasons may account for the weaker than expected correlations. Future research on the IWPQ's responsiveness should be conducted, preferably in other populations and intervention studies, where greater changes over time can be expected.

Construct validity of the individual work performance questionnaire.

OBJECTIVE: To examine the construct validity of the Individual Work Performance Questionnaire (IWPQ). METHODS: A total of 1424 Dutch workers from three occupational sectors (blue, pink, and white collar) participated in the study. First, IWPQ scores were correlated with related constructs (convergent validity). Second, differences between known groups were tested (discriminative validity). RESULTS: First, IWPQ scores correlated weakly to moderately with absolute and relative presenteeism, and work engagement. Second, significant differences in IWPQ scores were observed for workers differing in job satisfaction, and workers differing in health. CONCLUSION: Overall, the results indicate acceptable construct validity of the IWPQ. Researchers are provided with a reliable and valid instrument to measure individual work performance comprehensively and generically, among workers from different occupational sectors, with and without health problems.

Measuring individual work performance: identifying and selecting indicators.

BACKGROUND: Theoretically, individual work performance (IWP) can be divided into four dimensions: task performance, contextual performance, adaptive performance, and counterproductive work behavior. However, there is no consensus on the indicators used to measure these dimensions. OBJECTIVE: This study was designed to (1) identify indicators for each dimension, (2) select the most relevant indicators, and (3) determine the relative weight of each dimension in ratings of work performance. METHODS: IWP indicators were identified from multiple research disciplines, via literature, existing questionnaires, and expert interviews. Subsequently, experts selected the most relevant indicators per dimension and scored the relative weight of each dimension in ratings of IWP. RESULTS: In total, 128 unique indicators were identified. Twenty-three of these indicators were selected by experts as most relevant for measuring IWP. Task performance determined 36% of the work performance rating, while the other three dimensions respectively determined 22%, 20% and 21% of the rating. CONCLUSIONS: Notable consensus was found on relevant indicators of IWP, reducing the number from 128 to 23 relevant indicators. This provides an important step towards the development of a standardized, generic and short measurement instrument for assessing IWP.

What is actually measured in process evaluations for worksite health promotion programs: a systematic review.

BACKGROUND: Numerous worksite health promotion program (WHPPs) have been implemented the past years to improve employees' health and lifestyle (i.e., physical activity, nutrition, smoking, alcohol use and relaxation). Research primarily focused on the effectiveness of these WHPPs. Whereas process evaluations provide essential information necessary to improve large scale implementation across other settings. Therefore, this review aims to: (1) further our understanding of the quality of process evaluations alongside effect evaluations for WHPPs, (2) identify barriers/facilitators affecting implementation, and (3) explore the relationship between effectiveness and the implementation process. METHODS: Pubmed, EMBASE, PsycINFO, and Cochrane (controlled trials) were searched from 2000 to July 2012 for peer-reviewed (randomized) controlled trials published in English reporting on both the effectiveness and the implementation process of a WHPP focusing on physical activity, smoking cessation, alcohol use, healthy diet and/or relaxation at work, targeting employees aged 18-65 years. RESULTS: Of the 307 effect evaluations identified, twenty-two (7.2%) published an additional process evaluation and were included in this review. The results showed that eight of those studies based their process evaluation on a theoretical framework. The methodological quality of nine process evaluations was good. The most frequently reported process components were dose delivered and dose received. Over 50 different implementation barriers/facilitators were identified. The most frequently reported facilitator was strong management support. Lack of resources was the most frequently reported barrier. Seven studies examined the link between implementation and effectiveness. In general a positive association was found between fidelity, dose and the primary outcome of the program. CONCLUSIONS: Process evaluations are not systematically performed alongside effectiveness studies for WHPPs. The quality of the process evaluations is mostly poor to average, resulting in a lack of systematically measured barriers/facilitators. The narrow focus on implementation makes it difficult to explore the relationship between effectiveness and implementation. Furthermore, the operationalisation of process components varied between studies, indicating a need for consensus about defining and operationalising process components.

The design of a real-time formative evaluation of the implementation process of lifestyle interventions at two worksites using a 7-step strategy (BRAVO@Work).

BACKGROUND: Worksite health promotion programs (WHPPs) offer an attractive opportunity to improve the lifestyle of employees. Nevertheless, broad scale and successful implementation of WHPPs in daily practice often fails. In the present study, called BRAVO@Work, a 7-step implementation strategy was used to develop, implement and embed a WHPP in two different worksites with a focus on multiple lifestyle interventions.This article describes the design and framework for the formative evaluation of this 7-step strategy under real-time conditions by an embedded scientist with the purpose to gain insight into whether this this 7-step strategy is a useful and effective implementation strategy. Furthermore, we aim to gain insight into factors that either facilitate or hamper the implementation process, the quality of the implemented lifestyle interventions and the degree of adoption, implementation and continuation of these interventions. METHODS AND DESIGN: This study is a formative evaluation within two different worksites with an embedded scientist on site to continuously monitor the implementation process. Each worksite (i.e. a University of Applied Sciences and an Academic Hospital) will assign a participating faculty or a department, to implement a WHPP focusing on lifestyle interventions using the 7-step strategy. The primary focus will be to describe the natural course of development, implementation and maintenance of a WHPP by studying [a] the use and adherence to the 7-step strategy, [b] barriers and facilitators that influence the natural course of adoption, implementation and maintenance, and [c] the implementation process of the lifestyle interventions. All data will be collected using qualitative (i.e. real-time monitoring and semi-structured interviews) and quantitative methods (i.e. process evaluation questionnaires) applying data triangulation. Except for the real-time monitoring, the data collection will take place at baseline and after 6, 12 and 18 months. DISCUSSION: This is one of the few studies to extensively and continuously monitor the natural course of the implementation process of a WHPP by a formative evaluation using a mix of quantitative and qualitative methods on different organizational levels (i.e. management, project group, employees) with an embedded scientist on site. TRIAL REGISTRATION: NTR2861.

Short and long term effects of a lifestyle intervention for construction workers at risk for cardiovascular disease: a randomized controlled trial.

BACKGROUND: The prevalence of overweight and elevated cardiovascular disease (CVD) risk among workers in the construction industry is relatively high. Improving lifestyle lowers CVD risk and may have work-related benefits. The purpose of the study was to evaluate the effects on physical activity (PA), diet, and smoking of a lifestyle intervention consisting of individual counseling among male workers in the construction industry with an elevated risk of cardiovascular disease (CVD). METHODS: In a randomized controlled trial including 816 male blue- and white-collar workers in the construction industry with an elevated risk of CVD, usual care was compared to a 6-month lifestyle intervention. The intervention consisted of individual counseling using motivational interviewing techniques, and was delivered by an occupational physician or occupational nurse. In three face to face and four telephone contacts, the participant's risk profile, personal determinants, and barriers for behavior change were discussed, and personal goals were set. Participants chose to aim at either diet and PA, or smoking. Data were collected at baseline and after six and 12 months, by means of a questionnaire. To analyse the data, linear and logistic regression analyses were performed. RESULTS: The intervention had a statistically significant beneficial effect on snack intake (ß-1.9, 95%CI -3.7; -0.02) and fruit intake (ß 1.7, 95%CI 0.6; 2.9) at 6 months. The effect on snack intake was sustained until 12 months; 6 months after the intervention had ended (ß -1.9, 95%CI -3.6; -0.2). The intervention effects on leisure time PA and metabolic equivalent-minutes were not statistically significant. The beneficial effect on smoking was statistically significant at 6 (OR smoking 0.3, 95%CI 0.1;0.7), but not at 12 months (OR 0.8, 95%CI 0.4; 1.6). CONCLUSIONS: Beneficial effects on smoking, fruit, and snack intake can be achieved by an individual-based lifestyle intervention among male construction workers with an elevated risk of CVD. Future research should be done on strategies to improve leisure time PA and on determinants of maintenance of changed behavior. Considering the rising prevalence of unhealthy lifestyle and CVD, especially in the aging population, implementation of this intervention in the occupational health care setting is recommended. TRIAL REGISTRATION: Current Controlled Trials ISRCTN60545588

Conceptual frameworks of individual work performance: a systematic review.

OBJECTIVE: Individual work performance is differently conceptualized and operationalized in different disciplines. The aim of the current review was twofold: (1) identifying conceptual frameworks of individual work performance and (2) integrating these to reach a heuristic conceptual framework. METHODS: A systematic review was conducted in medical, psychological, and management databases. Studies were selected independently by two researchers and included when they presented a conceptual framework of individual work performance. RESULTS: A total of 17 generic frameworks (applying across occupations) and 18 job-specific frameworks (applying to specific occupations) were identified. Dimensions frequently used to describe individual work performance were task performance, contextual performance, counterproductive work behavior, and adaptive performance. CONCLUSION: On the basis of the literature, a heuristic conceptual framework of individual work performance was proposed. This framework can serve as a theoretical basis for future research and practice.

Evaluation of neural networks to identify types of activity using accelerometers.

PURPOSE: To develop and evaluate two artificial neural network (ANN) models based on single-sensor accelerometer data and an ANN model based on the data of two accelerometers for the identification of types of physical activity in adults. METHODS: Forty-nine subjects (21 men and 28 women; age range = 22-62 yr) performed a controlled sequence of activities: sitting, standing, using the stairs, and walking and cycling at two self-paced speeds. All subjects wore an ActiGraph accelerometer on the hip and the ankle. In the ANN models, the following accelerometer signal characteristics were used: 10th, 25th, 75th, and 90th percentiles, absolute deviation, coefficient of variability, and lag-one autocorrelation. RESULTS: The model based on the hip accelerometer data and the model based on the ankle accelerometer data correctly classified the five activities 80.4% and 77.7% of the time, respectively, whereas the model based on the data from both sensors achieved a percentage of 83.0%. The hip model produced a better classification of the activities cycling, using the stairs, and sitting, whereas the ankle model was better able to correctly classify the activities walking and standing still. All three models often misclassified using the stairs and standing still. The accuracy of the models significantly decreased when a distinction was made between regular versus brisk walking or cycling and between going up and going down the stairs. CONCLUSIONS: Relatively simple ANN models perform well in identifying the type but not the speed of the activity of adults from accelerometer data.

The cost-effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on recovery from neck and upper limb symptoms and pain reduction in computer workers.

OBJECTIVES: To evaluate the cost-effectiveness of a work style (WS) intervention and a work style plus physical activity (WSPA) intervention in computer workers with neck and upper limb symptoms compared with usual care. METHODS: An economic evaluation was conducted from an employer's perspective and alongside a randomised controlled trial in which 466 computer workers with neck and upper limb symptoms were randomised to a WS group (N = 152), a WSPA group (N = 156) or a usual care group (N=158). Total costs were compared to the effects on recovery and pain intensity. In the primary analyses, missing effect data were imputed using multiple imputation techniques. RESULTS: Total costs during the 12-month intervention and follow-up period were €1907 (WS), €2811 (WSPA) and €2310 (usual care). Differences between groups were not statistically significant. Neither intervention was more effective than usual care in improving overall recovery. The WS intervention was more effective than usual care in reducing current pain, average pain and worst pain in the past 4 weeks, but the WSPA intervention was not. The acceptability curve showed that when a company is willing to pay approximately €900 for a 1-point reduction in average pain (scale from 0 to 10), the probability of cost-effectiveness compared to usual care is 95%. Similar results were observed for current and worst pain. CONCLUSIONS: This study shows that the WS intervention was not cost-effective for improving recovery but was cost-effective for reducing pain intensity, although this reduction was not clinically significant. The WSPA intervention was not cost-effective compared with usual care. Trial registration number ISRCTN87019406.

The association between commuter cycling and sickness absence.

OBJECTIVE: To study the association between commuter cycling and all-cause sickness absence, and the possible dose-response relationship between absenteeism and the distance, frequency and speed of commuter cycling. METHOD: Cross-sectional data about cycling in 1236 Dutch employees were collected using a self-report questionnaire. Company absenteeism records were checked over a one-year period (May 2007-April 2008). Propensity scores were used to make groups comparable and to adjust for confounders. Zero-inflated Poisson models were used to assess differences in absenteeism between cyclists and non-cyclists. RESULTS: The mean total duration of absenteeism over the study year was more than 1 day shorter in cyclists than in non-cyclists. This can be explained by the higher proportion of people with no absenteeism in the cycling group. A dose-response relationship was observed between the speed and distance of cycling and absenteeism. Compared to people who cycle a short distance (

Lifestyle-focused interventions at the workplace to reduce the risk of cardiovascular disease--a systematic review.

OBJECTIVE: The goal of this review was to summarize the evidence for an effect of lifestyle-targeted interventions at the workplace on the main biological risk factors for cardiovascular disease (CVD). METHODS: We performed an extensive systematic literature search for randomized controlled trials (RCT) that met the following inclusion criteria: (i) targeted at workers; (ii) aimed at increasing physical activity and/or improving diet; and (iii) measured body weight, body fat, blood pressure, blood lipids and/or blood glucose. We used a nine-item methodological quality list to determine the quality of each study. A best-evidence system was applied, taking into account study quality and consistency of effects. RESULTS: Our review included 31 RCT, describing a diversity of interventions (eg counseling, group education, or exercise). Of these studies, 18 were of high quality. Strong evidence was found for a positive effect on body fat, one of the strongest predictors of CVD risk. Among populations "at risk", there was strong evidence for a positive effect on body weight. Due to inconsistencies in results between studies, there was no evidence for the effectiveness of interventions on the remaining outcomes. CONCLUSIONS: We found strong evidence for the effectiveness of workplace lifestyle-based interventions on body fat and, in populations at risk for CVD, body weight. Populations with an elevated risk of CVD seemed to benefit most from lifestyle interventions; supervised exercise interventions appeared the least effective intervention strategy. To gain better insight into the mechanisms that led to the intervention effects, the participants' compliance with the intervention and the lifestyle changes achieved should be reported in future studies.

Overweight and obesity among Dutch workers: differences between occupational groups and sectors.

PURPOSE: To describe the prevalence of overweight and obesity among different occupational groups and sectors in a representative sample of the Dutch working population, and to test whether these differences still exist after adjustment for socio-demographic variables. METHODS: Cross-sectional data among 7,588 working adults were used. Univariate analyses of variance was performed to test differences in body mass index (BMI) values between occupational groups (n = 7) and sectors (n = 28). Adjusted analyses were carried out to examine the role of socio-demographic factors in the differences in overweight and obesity between occupational groups and sectors. RESULTS: On average, the mean BMI was 24.3 kg/m(2) with 31% being overweight and 6% being obese. Those working in trade, industrial, or transportation occupations as well as the legislators and senior managers had the highest BMI and a relatively high prevalence of overweight (36.7 and 35.5%, respectively) and obesity (6.9 and 7.5%, respectively). In contrast, those working in scientific and artistic professions had the most favorable BMI profile with 25.7% being overweight and 4.2% being obese. After adjusting for sex, age, and education, the proportion of variance changed from about 0.01 to 0.10 with age being the main contributor of the differences in overweight and obesity. CONCLUSIONS: BMI profile and prevalence of overweight and obesity differs between occupations and sectors. Despite the differences are explained partly by socio-demographic factors, based on a given distribution of age, sex, and education within each occupational group and sector, occupational group- and sector-specific strategies to prevent and reduce overweight are recommended.

Factors associated with non-participation and drop-out in a lifestyle intervention for workers with an elevated risk of cardiovascular disease.

BACKGROUND: Non-response and drop-out are problems that are commonly encountered in health promotion trials. Understanding the health-related characteristics of non-participants and drop-outs and the reasons for non-participation and drop-out may be beneficial for future intervention trials. METHODS: Male construction workers with an elevated risk of cardiovascular disease (CVD) were invited to participate in a lifestyle intervention study. In order to investigate the associations between participation and CVD risk factors, and drop-out and CVD risk factors, crude and multiple logistic regression analyses were performed. The reasons for non-participation and drop-out were assessed qualitatively. RESULTS: 20% of the workers who were invited decided to participate; 8.6% of the participants dropped out before the first follow-up measurement. The main reasons for non-participation were 'no interest', 'current (para-)medical treatment', and 'feeling healthy', and for drop-out they were 'lack of motivation', 'current (para-)medical treatment', and 'disappointment'. Participants were 4.2 years older, had a higher blood pressure, higher total cholesterol, and lower HDL cholesterol than non-participants, and were more likely to report 'tiredness and/or stress' and 'chest pain and/or shortness of breath'. After adjusting for age, most risk factors were not significantly associated with participation. Drop-outs were 4.6 years younger than those who completed the study. The prevalence of smoking was higher among non-participants and drop-outs. CONCLUSION: Participants had a worse CVD risk profile than non-participants, mainly because of the difference in age. Non-participants and drop-outs were younger and more likely to be smokers. The main reasons for non-participation and drop-out were health-related. Investigators in the field of health promotion should be encouraged to share comparable information. TRIAL REGISTRATION: Current Controlled Trials ISRCTN60545588.

Improving work style behavior in computer workers with neck and upper limb symptoms.

INTRODUCTION: The goal of this study was to assess the effectiveness of a group-based interactive work style intervention in improving work style behavior. METHODS: Computer workers with neck and upper limb symptoms were randomised into the work style group (WS, N = 152), the work style and physical activity group (WSPA, N = 156), or the usual care group (N = 158). Both intervention groups received the same work style intervention but the WSPA group also received a lifestyle physical activity intervention. Participants from the intervention groups attended six group meetings which focused on behavioral change with regard to body posture and workstation adjustment, breaks, and coping with high work demands in order to reduce work stress. Stage of change, breaks and exercise behavior, and stress outcomes were assessed by questionnaire at baseline (T0) and after 6 (T1) and 12 months (T2). Body posture and workstation adjustment were assessed by observation and by questionnaire at T0, T1, and T2. Multilevel analyses were used to study differences in work style behavior between study groups. RESULTS: The work style intervention was effective in improving stage of change with regard to body posture, workstation adjustment, and the use of sufficient breaks during computer work. These findings were confirmed by higher self-reported use of breaks and exercise reminder software and less working hours without breaks. However, self-reported changes in body posture and workstation adjustment were less consistent. The work style intervention was ineffective in changing stress outcomes. CONCLUSION: A group-based work style intervention seems to be effective in improving some elements of work style behavior. Future studies should investigate the effectiveness of work style interventions on all dimensions of the Feuerstein work style model.

Web-based tailored lifestyle programs: exploration of the target group's interests and implications for practice.

An important challenge in Web-based health promotion is to increase the reach of the target audience by taking the target groups' desires into consideration. Data from 505 members of a Dutch Internet panel (representative for Dutch Internet users) were used to asses the target group's interests and needs. 28% participated in Web-based tailored lifestyle programs, 57% expressed an interest in such programs, and 15% expressed no interest. Interest in Web-based programs was predominantly caused by a general interest in lifestyle and online tests. Participation in Web-based tailored lifestyle programs should not take more than 17 minutes per occasion. 84% were interested in follow-up testing after the initial participation. Responders were particularly interested in physical activity and nutrition. Hardly anyone was willing to pay for participation. The results from this study support the use of Web-based tailored lifestyle programs in behavior change efforts.

Sedentary behavior in Dutch workers: differences between occupations and business sectors.

BACKGROUND: Sedentary behavior is an independent risk factor for excess body weight and other health problems. There are no published data on sitting time at work, or how this is related to occupation and sector (branch of business). No published study has shown whether extended sitting at work is compensated for by sitting less during leisure time. METHODS: This study used data from a continuous cross-sectional survey, from 2000 to 2005 (N=7720). Workers were asked how many minutes they spent sitting during the preceding day, both at work and in their leisure time. To test differences in sitting times among occupational groups and sectors, descriptive analyses and analyses of variance were carried out in 2006. RESULTS: On average, the Dutch working population reported sitting for 7 hours each day, one third of which was at work. Occupational groups and sectors differed significantly in sedentary behavior, mainly involving sitting periods at work. Workers spending long periods sitting at work did not compensate by sitting less during their leisure time. CONCLUSIONS: Workers spend a substantial part of their waking and working time seated. Those who sat for long periods at work did not compensate for this lack of activity by adopting less-sedentary behaviors during leisure time. To prevent health problems, the best approach may be to reduce sedentary behavior at work, when traveling to and from work, and during leisure time.