Dr Genevieve Healy on BeUpstanding video transcript
In 2019 Genevieve Healy, Associate Professor at the University of Queensland and lead investigator at BeUpstanding!, presented her research findings about sedentary workplaces and how physical movement improves health.
Thank you very much for the opportunity to come and speak with you today. I'm going to be talking to you about our program BeUpstanding! which is about supporting workplaces to stand up, sit less, and move more through a train the champion approach. So really is an exemplar case study of some of the things that we've been talking about today. It's really nice to do this with Comcare because they've been, as I was saying, one of the really founding people involved in the research. They were our pilot study people and now they're continuing to support us through the translation of the research through to BeUpstanding! So it's great to be here today.
Before I just move on, who does regular exercise? Yeah. And who knows that regular exercise is good for your physical and mental health and wellbeing? Yeah, it's something that everybody knows about, but exercise is just one small part of our day. And what we actually do for the majority of our waking hours is spent at sitting. And that has implications in both the short and the long-term. So short-term, I'm sure you've all felt it. You're probably feeling it right about now, and I'll help you in that in a little bit. But when you've sat in a car for a long time, or caught the plane and you feel that stiff and sore and achy and a bit sluggish, despite the fact that you've been sitting down and your body's been resting, you're actually not thinking that well either. So there's also long-term impacts of too much sitting.
Our review showed that people who were high sitters had twice the risk of developing cardiovascular disease or diabetes or one and a half times the risk of dying prematurely compared to those classified as low sitters. For those of you who do exercise, well, if you're sitting for eight or more hours a day, you need to be doing at least 60 minutes of exercise a day to counteract the impacts of that sitting. Of course, some sitting as okay, otherwise Comcare wouldn't allow you to be sitting here today. It's really those long unbroken bouts of sitting that are particularly detrimental. So what can we actually do about it? Well, the solutions are really simple. Can I just get you to stand up?
So by standing up, your postural muscles in your legs and your back are now working more than twice as hard as when you're sitting down. Okay. If you just walk up and down on the spot a little bit. Okay. You're now burning three times more energy than when you're sitting down. Okay. And if you just do a little calf raise, if you can. Yeah, and just a little squat. So imagine if you're in a queue in for the bank and you can just kind of sneak some of these in. So these simple resistance activities have been shown to provide benefits for glucose control, at least in the short-term. So that's just how simple those solutions are. So how do we then implement them at a population level. You can sit down, because not everyone can see, which is one of the barriers of doing some of these strategies.
But back in 2009, The National Preventative Health Strategy recognised that workplaces provide a really key setting for addressing prolong sedentary behaviour at a population level and they really are best place to provide that supportive culture that is needed to sustain lifestyle changes. Recent data from the ABS show that 44% of Australians described their workday as mostly sitting. And our data when we use objective monitors showed that 75% of the work day, so three quarters of the workday, is spent sitting for office workers. And the majority of that is in those prolonged unbroken bouts. Our data also shows that the majority of workers want to be able to sit less at work. So there's a real business case here for addressing prolonged sitting time. And it also can be thought of as a hazard.
In 2014 we published an article saying that contemporary offices may be failing to provide a safe system of work. And in 2016, Safe Work Australia acknowledged too much sitting as an emergent work health and safety risk. So what can we actually do about addressing this issue in the workplace? Well, the first thing to really acknowledge is that there's multiple influences on sitting time. It's those social determinants on health. So there's a reason that most of you are sitting here today and there's a reason why some of you are standing up as well and it's really understanding that there are these multiple influences.
Back in 2009 we established the Stand Up Australia program of research as a program investigating the benefits of reducing sitting in the workplace. And we looked at organisational, environmental, and individual level strategies to support workers to stand up, sit less and move more. So looked at those multiple levels of influence. And across nine studies, what we found was that supporting workers to sit less and move more was highly acceptable to both employers and employees. People really liked to have the opportunity to change their postures regularly. We were also able to achieve substantial and sustained change in the workplace sitting time. And we saw some benefits to the indicators of heart health and despite the fact that we're getting people up and moving more, we saw no detrimental impact on their productivity.
The interventions where we put in sit/stand workstations we did see the biggest changes happening there, but they were not sufficient in and of themselves. You couldn't just put the desks in. They needed to be underpinned by relevant policies, raising awareness and building a supportive culture. Another key factor for success was having senior management on board, having visible support for the change. So one of our research studies had the global CEO taking part in the research program and assessments. And having an engaged workplace champion doing all those things that Tristan was saying before. Having someone being the role model for the change. Sitting is a very habitual behaviour. You need that prompting and you need someone showcasing, getting people on board, breaking the mould and making it more normative to stand up, sit less and move more.
So we used all these findings over a decade of research plus funding from Queensland Partners in particular at the start to translate this research into the BeUpstanding Program, which is a practical tool to support workplaces to stand up, sit less and move more. So the BeUpstanding program uses a train the champion approach. So a champion is provided with an online toolkit and guides them step by step through this evidence informed program. They get all the materials, resources and tools that they need to take up the program, run the program and then evaluate the program and it's modelled in using the plan, do, review framework. So it looks very familiar to anyone running the program.
It's important that it can't be everything to everyone, like it's not intended to change the world. It really is about raising awareness. So doing things like making it more obvious about the benefits of sitting lesson and moving more. Then hoping to build a supportive culture where it is okay that some people are standing up, it is okay to be moving around more regularly. That just becomes normative part of the process. And through that it's about creating sustainable change. It's not about sit stand desks, it's really about low cost, no cost strategies. And despite the name, it's not about standing all the time either. It's about regularly shifting between sitting, standing and moving postures.
So it is a train the champion model. So the workplace champion is key and you need a workplace champion to run the program. And it is a team based approach. So the idea is that everybody in the team is involved in the program. And again, senior leadership is critical as well. Just really emphasising it is a culture change program. So it's about as I'll really emphasise again about making it normative for people to get up and move more often. So here's some of the examples from our plan phase, the research. So there's three steps. The step one is getting support from management, step two, conducting a needs assessment and step three, preparing for the program.
So the critical stage in this is in step three, which is the staff workshop. And this is where all the staff get together, have a workshop, they're showing a video to raise awareness of the benefits of sitting less and moving more. And then they collectively decide together on the strategies that they want to choose to BeUpstanding. And Comcare is one of actually the participants in our trial and they ran their workshop yesterday on this and they've chosen strategies about how they want to BeUpstanding in their workplace. So this is important because the workplace themselves knows what's going to work best for them. So this participative approach also creates ownership over the change.
The champion then uses these strategies and promotes them through emails and posters and information over an eight week program. And then they're given all the resources to evaluate the impact of the program. So what's really exciting for us, for a research perspective is that embedded in this as a lot of evaluation. So evaluation that supports the champion and the team, but also helps us to inform policy and practice as well. So, for example, there's a workplace audit that champions can do and this gives them a really good idea and what are the things in their environment and their culture and the current policies that they have around sitting less and moving more in the workplace.
The champion completes the workplace, only takes 10 minutes and then they get a report that helps them with their action planning. This champion has access to a staff survey information portal, so they understand what are the current activity levels of their staff, what do their staff want to do in terms of their sitting, standing and moving. So it helps to build the business case. What are the current barriers in their workplace, the sitting less and moving more and what strategies are they currently doing? So this information helps the champion then integrate that into that workshop so that they can provide tailored change for their team.
And the final step is that they generate a custom team performance report. So it uses all the data that's been collected through the toolkit to create a customer report for the champion that provides the business case. Why did they sign up to BeUpstanding in the first place? The impact of the program on their team as well as the costs of running the program. So all of this is available and this evaluation is available for free. And the champion themselves gets recognition for the unique journey that they took through the program. So it's based on what they actually did as part of the program. So they get to show their senior management. This is all the things that I did as a champion.
So we've been, we went live with BeUpstanding in September, 2017 in the first iteration of it. And we've built on the learnings from the workplaces since then, but early findings are really showing that it works. So we've had 236 work teams sign up for the program already from across Australia and across multiple industries. We've seen a nearly 10% reduction in self-reported sitting time. And we've seen teams who report improvements in their health and wellbeing in terms of fewer and less severe musculoskeletal symptoms and higher levels of physical and mental health and wellbeing as well as energy levels. We've also seen impacts on those pillars that we really underpin the BeUpstanding program in terms of the culture in their team around sitting less and moving more, the knowledge of sitting less, the attitudes towards sitting, standing and moving and their awareness of sitting behaviours. So lots of positive impacts of the program so far.
But we're very fortunate to receive funding from the national health and medical research council to conduct a national implementation trial of the BeUpstanding program. And so this is conducted in partnership with key policy and practice partners, including Comcare. And we're looking here at key questions in terms of what is the uptake, what is the implementation? So what are champions actually doing? How's it working? We know it's working, but who doesn't it work for? What are the work teams who it doesn't work? This is a currently generic program. We don't expect it to work for every work team. So who does it work for but who also doesn't it work for and what are the costs of running the program? So this is a little bit of a like Tristan, I'll do a call for action in terms of can you help us and be part of this national implementation trial?
This is a world first trial. It's very exciting to be part of it. The main thing that you need to do is just to be committed to the evaluation component of it, fill in the surveys that are provided within the toolkit and in return you get free health coaching from a expert Yuki staff, so it really is as easy as signing up right now. I've got a lot of flyers and information down the back there for people who are keen and interested as well as examples of those performance reports. One of our key partners as I saying was the Queensland Office of Industrial Relations. And they've just put together this video for us to show us why they chose to be part of BeUpstanding.
(Video played during presentation)
Alison Abbott: We got involved with BeUpstanding because Safe Work Australia have acknowledged that sedentary occupations and now a health and safety risk due to claims from aches and pains and injuries, sprains, strains and also there's research to show there that too much, being sedentary for too long contributes to your risk of chronic disease.
Leanne Sweeney: We're really strong advocates for the BeUpstanding. It's all about postural variation. At our workplaces we have high adjustable desks and we also normalise stand up meetings so when you go to one of our meetings you find half the people are standing up around the room and it's quite normalised behaviour now. We also, instead of just catching cabs to meetings, if we've got a meeting in the city, we often take public transport or we actually walk to meetings. Often if you're having a meeting with just one of your colleagues, we actually have a meeting outside when we go to the park or go for a walk during the meetings.
Leanne Sweeney: I've only been with the organisation for 12 months and I've noticed a change just in the last 12 months where there's just a slightly different feeling around our organisation now where moving is the norm. I'd definitely advocate for a workplace to bring in BeUpstanding. It's so easy to use and it's just evidence based program. It's a really simple step by step program. It's very easily understood. It's got some great resources and as Alison said, there's a really nice, there's a plan, there's an implementation but a fantastic evaluation so workplaces can get a really feel on what's going on with their workers and making a difference for them.
Alison Abbott: Feedback I've heard from a couple of people is they don't have the aches and pains in their back they did or their knees. So it's all about balance really. You don't stand all day, you don't sit all day. So it's moving.
(Video ends and Dr Genevieve Healy begins speaking again)
Dr. Genevieve Healy (con’d): If you do want to help continue the change, this is another call. We are looking now towards our next phase of research. So if you are interested in partnering with us then please get in touch as well. So I do want to just leave you with some suggestions on how you can be an upstanding leader in your workplace. And these are just some suggestions, but it really comes back to that role modelling. It's such a critical element of it. Be that person who takes the stairs, does the active travel, wears casual shoes to work to get changed, provide, have walking meetings where possible. Facilitate postural changes in your workplace. Make it easy for people to get up and down. Look at the job roles and job tasks that they do to see how could we incorporate regular postural changes into that.
Do one of the strategies that Comcare is taking up in terms of having a sitting or standing stretch break into meeting agendas. Have a no lunch at desk policy. These are easy things to get people up and moving around and provide support for your change champions. Recognise that the efforts that they put in and provide that through reward and recognition as well as just visible support for them. So thank you so much for your time and efforts today, and I really just thank you to the amazing partners and people that have been involved in bringing this program to life. Thank you.