Research article Topical Sections

Peer champions responses to nudge-based strategies designed to reduce prolonged sitting behaviour: Lessons learnt and implications from lived experiences of non-compliant participants

  • Received: 24 March 2022 Revised: 28 June 2022 Accepted: 05 July 2022 Published: 12 July 2022
  • Occupational sedentariness is problematic for office-based workers because of their prolonged sitting periods and the advent of technology which reduces work-based movement. A common workplace strategy to deal with this preventable health risk is to have workers engage in brief movement breaks throughout the workday. To date, the use of interventions underpinned by individual self-regulation has had less than optimal impact on changing workers sedentary work behaviours. An alternative design for workplace interventions is the use of nudge theory. Nudge theory incorporates strategies that are delivered at the point of choice designed to influence individual decision making regarding alternative behaviour options. In this study, desk-based workers were exposed to two nudge strategies which suggested alternative behaviours of regular standing and taking movement breaks during work periods to the default behaviours of prolonged sitting and sedentary work behaviour. A small group of women managers who served as peer champions (n = 6), withdrew early from the study, and then took part in an exit interview to gain an understanding of their experiences of being exposed to the two nudge strategies. Verbatim transcripts were analysed using inductive, reflexive thematic analysis. Two major themes with seven second order themes central to their experiences were extracted: facilitative behaviour and feelings (advocacy, acceptance & facilitative burden) and dysfunctional behaviours and feelings (dysfunctional behaviour & feelings, control, reactance & presenteeism). Participants initially perceived a positive exchange associated with exposure to nudge strategies. Yet, participants' emotional connection to their work roles and behaviour were perceived as a negative exchange. Participants cited numerous maladaptive feelings because of a perception of incongruency with the established work normative behaviour. These findings reveal that nudge strategies of reduced choice and social norms are viable, but perceptions of monitoring can moderate adherence.

    Citation: P. Dean Cooley, Casey P. Mainsbridge, Vaughan Cruickshank, Hongwei Guan, Anjia Ye, Scott J. Pedersen. Peer champions responses to nudge-based strategies designed to reduce prolonged sitting behaviour: Lessons learnt and implications from lived experiences of non-compliant participants[J]. AIMS Public Health, 2022, 9(3): 574-588. doi: 10.3934/publichealth.2022040

    Related Papers:

  • Occupational sedentariness is problematic for office-based workers because of their prolonged sitting periods and the advent of technology which reduces work-based movement. A common workplace strategy to deal with this preventable health risk is to have workers engage in brief movement breaks throughout the workday. To date, the use of interventions underpinned by individual self-regulation has had less than optimal impact on changing workers sedentary work behaviours. An alternative design for workplace interventions is the use of nudge theory. Nudge theory incorporates strategies that are delivered at the point of choice designed to influence individual decision making regarding alternative behaviour options. In this study, desk-based workers were exposed to two nudge strategies which suggested alternative behaviours of regular standing and taking movement breaks during work periods to the default behaviours of prolonged sitting and sedentary work behaviour. A small group of women managers who served as peer champions (n = 6), withdrew early from the study, and then took part in an exit interview to gain an understanding of their experiences of being exposed to the two nudge strategies. Verbatim transcripts were analysed using inductive, reflexive thematic analysis. Two major themes with seven second order themes central to their experiences were extracted: facilitative behaviour and feelings (advocacy, acceptance & facilitative burden) and dysfunctional behaviours and feelings (dysfunctional behaviour & feelings, control, reactance & presenteeism). Participants initially perceived a positive exchange associated with exposure to nudge strategies. Yet, participants' emotional connection to their work roles and behaviour were perceived as a negative exchange. Participants cited numerous maladaptive feelings because of a perception of incongruency with the established work normative behaviour. These findings reveal that nudge strategies of reduced choice and social norms are viable, but perceptions of monitoring can moderate adherence.



    加载中


    Conflict of interest



    The authors declare that they have no competing interests. De-identified transcripts are available from the second author upon request.

    [1] Smith L, Hamer M, Ucci M, et al. (2015) Weekday and weekend patterns of objectively measured sitting, standing, and stepping in a sample of office-based workers: The active buildings study. BMC Public Health 15: 9. https://doi.org/10.1186/s12889-014-1338-1
    [2] Barone Gibbs B, Kline CE, Huber KA, et al. (2021) Covid-19 shelter-at-home and work, lifestyle and well-being in desk workers. Occup Med 71: 86-94. https://doi.org/10.1093/occmed/kqab011
    [3] Hamilton MT, Healy GN, Dunstan DW, et al. (2008) Too little exercise and too much sitting: Inactivity physiology and the need for new recommendations on sedentary behaviour. Curr Cardiovasc Risk Rep 2: 292-298. https://doi.org/10.1007/s12170-008-0054-8
    [4] Hu FB, Li TY, Colditz GA, et al. (2003) Television watching and other sedentary behaviours in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 289: 1785-1791. https://doi.org/10.1001/jama.289.14.1785
    [5] Clemes SA, O'Connell SE, Edwardson CL (2014) Office workers objectively measured sedentary behaviour and physical activity during and outside working hours. J Occup Environ Med 56: 298-303. https://doi.org/10.1097/JOM.0000000000000101
    [6] Jans MP, Proper KL, Hildebrandt VH (2007) Sedentary behaviour in Dutch workers: Differences between occupations and business sectors. Am J Prev Med 33: 450-454. https://doi.org/10.1016/j.amepre.2007.07.033
    [7] Straker L, Coenen P, Dunstan D, et al. Sedentary work: Evidence on an emergent work health and safety issue (2016). Available from: https://www.safeworkaustralia.gov.au/resources-and-publications/reports/sedentary-work-evidence-emergent-work-health-and-safety-issue
    [8] Van Den Broucke S (2014) Needs, norms and nudges: The place of behaviour change in health promotion. Health Promot Int 29: 597-600. https://doi.org/10.1093/heapro/dau099
    [9] Hollands GJ, Shemilt I, Marteau TM, et al. (2013) Altering micro-environments to change population health behaviour: Towards an evidence base for choice architecture interventions. BMC Public Health 13: 1218. https://doi.org/10.1186/1471-2458-13-1218
    [10] Hunter JR, Gordon BA, Bird SR, et al. (2018) Perceived barriers and facilitators to workplace exercise participation. Int J Workplace Heal 11: 349-363. https://doi.org/10.1108/IJWHM-04-2018-0055
    [11] Bodker A, Visotcky A, Gutterman D, et al. (2021) The impact of standing desks on cardiometabolic and vascular health. Vasc Med 26: 374-382. https://doi.org/10.1177/1358863X211001934
    [12] Bailey DP, Locke CD (2015) Breaking up prolonged sitting with light-intensity walking improves postprandial glycemia, but breaking up sitting with standing does not. J Sci Med Sport 18: 294-298. https://doi.org/10.1016/j.jsams.2014.03.008
    [13] Mansfield L, Hall J, Smith L, et al. (2018) “Could you sit down please?” A qualitative analysis of employees' experiences of standing in normally-seated workplace meetings. PLoS One 13: e0198483. https://doi.org/10.1371/journal.pone.0198483
    [14] Dewitt S, Hall J, Smith L, et al. (2019) Office workers' experiences of attempts to reduce sitting-time: An exploratory, mixed methods uncontrolled intervention pilot study. BMC Public Health 19: 819. https://doi.org/10.1186/s12889-019-7196-0
    [15] Rice T (2013) The behavioural economics of health and health care. Annu Rev Public Health 34: 431-447. https://doi.org/10.1146/annurev-publhealth-031912-114353
    [16] Blumenthal-Barby JS (2016) Biases and heuristics in decision making and their impact on autonomy. Am J Bioeth 16: 5-15. https://doi.org/10.1080/15265161.2016.1159750
    [17] Thaler R, Sunstein C (2008) Nudge – Improving decisions about health, wealth and happiness. New Haven, CT: Yale University Press.
    [18] Kwan YH, Cheng TY, Yoon S, et al. (2020) A systematic review of nudge theories and strategies used to influence adult health behaviour and outcome in diabetes management. Diabetes Metab 46: 450-460. https://doi.org/10.1016/j.diabet.2020.04.002
    [19] Vecchio R, Cavallo C (2019) Increasing healthy food choices through nudges: A systematic review. Food Qual Prefer 78: 103714. https://doi.org/10.1016/j.foodqual.2019.05.014
    [20] Pedersen SJ, Cooley PD, Mainsbridge C (2014) An e-health intervention designed to increase workday energy expenditure by reducing prolonged occupational sitting habits. Work 49: 289-295. https://doi.org/10.3233/WOR-131644
    [21] Cooley PD, Pedersen SJ (2013) A pilot study of increasing nonpurposeful movement breaks at work as a means of reducing prolonged sitting. J Environ Public Health 2013: 128376. https://doi.org/10.1155/2013/128376
    [22] Cooley PD, Pedersen SJ, Mainsbridge CP (2014) Assessment of the impact of a workplace intervention to reduce prolonged occupational sitting time. Qual Health Res 24: 90-101. https://doi.org/10.1177/1049732313513503
    [23] Huang X, Meng P, Chen C (2020) The effects of power and social norms on power decision making. Open J Soc Sci 8: 124-142. https://doi.org/10.4236/jss.2020.84009
    [24] Walsh M, Fitzgerald MP, Gurley-Calvez T, et al. (2011) Active versus passive choice: Evidence from a public health care redesign. J Public Policy Mark 30: 191-202. https://doi.org/10.1509/jppm.30.2.191
    [25] Smith L, Pedersen SJ, Cooley PD (2013) The effect on compliance to a workplace health and wellbeing intervention: Closing the loop. Universal Public Health 1: 97-102. https://doi.org/10.13189/ujph.2013.010308
    [26] Mainsbridge CP, Ahuja K, Williams A, et al. (2018) Blood pressure response to interrupting workplace sitting time with non-exercise physical activity: Results of a 12-month cohort study. J Occup Environ Med 60: 769-774. https://doi.org/10.1097/JOM.0000000000001377
    [27] Bredahl TG, Saervoll CA, Kirkelund LS, et al. (2015) When intervention meets organisation, a qualitative study of motivation and barriers to physical exercise at the workplace. Scientific World J 2015: 12. https://doi.org/10.1155/2015/518561
    [28] Tedeschi JT (1986) Private and public experiences and the self. Public Self and Private Self. New York, NY: Springer New York 1-20. https://doi.org/10.1007/978-1-4613-9564-5_1
    [29] Venkatesh V, Morris MG, Ackerman PL (2000) A longitudinal field investigation of gender differences in individual technology adoption decision-making processes. Organ Behav Hum Decis Process 83: 33-60. https://doi.org/10.1006/obhd.2000.2896
    [30] Braun V, Clarke V (2019) Reflecting on reflexive thematic analysis. Qual Res Sport Exerc 11: 589-597. https://doi.org/10.1080/2159676X.2019.1628806
    [31] Nowell LS, Norris JM, White DE, et al. (2017) Thematic analysis: Striving to meet the trustworthiness criteria. Int J Qual Meth 16: 1609406917733847. https://doi.org/10.1177/1609406917733847
    [32] Vasileiou K, Barnett J, Thorpe S, et al. (2018) Characterising and justifying sample size sufficiency in interview-based studies: Systematic analysis of qualitative health research over a 15-year period. BMC Med Res Methodol 18: 148. https://doi.org/10.1186/s12874-018-0594-7
    [33] Kelders SM, Kok RN, Ossebaard HC, et al. (2012) Persuasive system design does matter: A systematic review of adherence to web-based interventions. J Med Internet Res 14: e152. https://doi.org/10.2196/jmir.2104
    [34] Leasure JL, Jones M (2008) Forced and voluntary exercise differentially affect brain and behaviour. Neuroscience 156: 456-465. https://doi.org/10.1016/j.neuroscience.2008.07.041
    [35] Ekblom-Bak E, Ekblom B, Vikström M, et al. (2014) The importance of non-exercise physical activity for cardiovascular health and longevity. Brit J Sport Med 48: 233-238. https://doi.org/10.1136/bjsports-2012-092038
    [36] Ellis R, Saringer C, Davis A, et al. (2021) Examining the impact of wellness champions on the effectiveness of a workplace health and well-being program. Am J Health Promot 35: 121-126. https://doi.org/10.1177/0890117120929131
    [37] O'Brien BC, Harris IB, Beckman TJ, et al. (2014) Standards for reporting qualitative research: A synthesis of recommendations. Acad Med 89: 1245-1251. https://doi.org/10.1097/ACM.0000000000000388
    [38] DeJonckheere M, Vaughn LM (2019) Semistructured interviewing in primary care research: A balance of relationship and rigour. Fam Med Community He 7: e000057. https://doi.org/10.1136/fmch-2018-000057
    [39] Chau JY, van der Ploeg HP, van Uffelen JG, et al. (2010) Are workplace interventions to reduce sitting effective?. Prev Med 51: 352-356. https://doi.org/10.1016/j.ypmed.2010.08.012
    [40] Tong A, Sainsbury P, Craig J (2007) Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Health C 19: 349-357. https://doi.org/10.1093/intqhc/mzm042
    [41] Boyatzis RE (1998) Transforming qualitative information: Thematic analysis and code development. Sage: California, USA.
    [42] Braun V, Clarke V (2012) Thematic analysis. APA Handbook of Research Methods in Psychology: Quantitative, Qualitative. Washington DC: American Psychological Association 57-71. https://doi.org/10.1037/13620-004
    [43] Goodwin H, Haycraft E, Meyer C (2014) Emotion regulation styles as longitudinal predictors of compulsive exercise: A twelve-month prospective study. J Adolescence 37: 1399-1404. https://doi.org/10.1016/j.adolescence.2014.10.001
    [44] Saito J, Odawara M, Takahashi H, et al. (2021) Barriers and facilitative factors in the implementation of workplace health promotion activities in small and medium-sized enterprises: A qualitative study. Implement Sci Commun 3: 23. https://doi.org/10.1186/s43058-022-00268-4
    [45] Mackay M, Yamazaki S, Jennings S, et al. (2019) The influence of nudges on compliance behaviour in recreational fisheries: A laboratory experiment. ICES J Mar Sci 77: 2319-2332. https://doi.org/10.1093/icesjms/fsz020
    [46] Patel MS (2018) Nudges for influenza vaccination. Nat Hum Behav 2: 720-721. https://doi.org/10.1038/s41562-018-0445-x
    [47] Arno A, Thomas S (2016) The efficacy of nudge theory strategies in influencing adult dietary behaviour: A systematic review and meta-analysis. BMC Public Health 16: 676. https://doi.org/10.1186/s12889-016-3272-x
    [48] Hansen PG, Jespersen AM (2013) Nudge and the manipulation of choice: A framework for the responsible use of the nudge approach to behaviour change in public policy. Eur J Risk Regul 4: 3-28. https://doi.org/10.1017/S1867299X00002762
    [49] Sallis JF, Owen N, Fisher EB (2015) Ecological models of health behaviour. Health Behaviour and Health Education: Theory, Research, and Practice. San Francisco: Jossey-Bass 43-64.
    [50] Strijbosch W, Mitas O, van Gisbergen M, et al. (2019) From experience to memory: On the robustness of the peak-and-end-rule for complex, heterogeneous experiences. Front Psychol 10: 1705. https://doi.org/10.3389/fpsyg.2019.01705
  • publichealth-09-03-040-s001.pdf
  • Reader Comments
  • © 2022 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(2302) PDF downloads(134) Cited by(1)

Article outline

Figures and Tables

Tables(1)

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog