Development and Implementation of a Health Promotion Intervention to Reduce Sedentary Behaviour among Male Office Workers in Saudi Arabia: The SLIM (Sit Less, Impress and Motivate) Study.

Abstract

Background: Sedentary behaviour (SB) and physical inactivity are global public health concerns because they have hazardous effects on people’s health. Over the last five decades, many jobs have become more sedentary as a result of technological advancements including increased access to the Internet. As a result, the prevalence of SB and physical inactivity has been increasing across the globe. Previous studies reported that working adults spend more than 8 hours/day sitting, with almost half of this sitting occurring at work. The prevalence of prolonged sitting and physical inactivity in Saudi Arabia is particularly concerning in view of the fact that more than 87% of the population is physically inactive, spending much of each day sitting. There has been, however, a dearth of intervention studies addressing SB and physical activity (PA) in Saudi Arabia. This warrants the need for a health promotion intervention to address SB and PA in this population. Aim: This research aimed to develop a health promotion intervention to reduce SB and increase light-intensity physical activity (LPA) among office workers in a Saudi university setting. The intervention, named the ‘Sit Less, Impress and Motivate (SLIM) trial’, used Social Cognitive Theory (SCT) as its theoretical framework and was tailored to the Saudi-male office workers population. It incorporated text-message support and computer prompts to reduce SB, increase LPA, and improve social-cognitive processes. To achieve this aim, two studies were conducted. These followed preliminary research, consisting of an observational audit to assess the physical environment at the University’s main campus for available assets that could be used to promote the reduction of SB and increases in LPA in the SLIM intervention. Study 1 documented the need for the SLIM intervention by assessing PA and SB levels of male staff at the University. Study 2 included the development, implementation and evaluation of SLIM. The evaluation was conducted to determine whether SLIM reduced SB, increased LPA, and positively impacted SCT constructs. Methods: The observational audit of the workplace environment that preceded these studies included observations of both indoor and outdoor spaces. This audit began by nominating four faculties within the University main campus. The Checklist of Health Promotion Environments at Worksites (CHEW) was then used to compare the buildings occupied by these four faculties in order to identify the two that were most comparable. One of these was to be randomly selected as a control group and the other as the intervention group for Study 2. The Workplace Walkability Audit Tool (WWAT) was used to assess the walkability of a walkway near these faculties on the main campus to learn if it would be useful for encouraging LPA during breaks from work. Study 1, a cross-sectional survey, assessed PA and SB levels of male staff at the University. Specifically, the staff members of the four faculties audited in the preliminary research were sent an email invitation to complete a questionnaire. This questionnaire, which included various survey measures, sought information about SB and PA. It also included questions on staff members’ preferred methods of communication, information used to inform Study 2. Descriptive statistics were computed for all study variables. Study 2 began with the development of the SLIM intervention. The intervention’s main strategies were theory-based weekly text messages and computer prompts at the workplace. The computer prompts consisted of a computer-reminder software that reminded staff, via a window on their computer screen, to break-up their sitting. A randomised controlled trial (RCT) was conducted to evaluate the intervention. Two of the faculties included in the preliminary research and in Study 1 were randomised to an intervention or a control.