Of 18 office workers who completed the 24-week intervention trial and invited, 16 office workers (nine SMART group and seven TRADE group participants) participated in the interviews.
Characteristics of the participants
Of 16 participants, majority were women (n = 10, 62.5%) and were senior executives. The participants belong to 9 different institutions of a multifaceted university situated in different geographical areas. Most of the interviewees were from administrative backgrounds and had a shared office space as their place of work. The median age of the participants was 37.5 years and had experience of 9 + years in the current job. The baseline characteristics of participants are illustrated in the Table 1.
Barriers and enablers to workplace interventions
The barriers to workplace intervention (the SMART-STEP trial) among Indian office workers are presented in thematic order: (1) individual, (2) inter-personal, and (3) organisational level. While perceived health threats, family support, and intervention acceptability were viewed as facilitators (a), workload, lack of culture and time, shared workspace, organisational responsibility, and derogatory comments were viewed as major barriers to workplace interventions. Supplementary file S3 & S4 elaborates the barriers and enablers to the SMART-STEP interventions using the constructs and the excerpts from the participants. The quotes are provided for each construct and micro-construct with participant ID, gender, age, low compliant (LC) or high compliant (HC) in parentheses.
Individual
Individual factors were found to be the predominant factors influencing adherence to the practice of workplace SB reduction strategies, compared to the interpersonal and the organisational factors. The micro-constructs of the individual factors identified were capability, intrinsic motivation, and opportunity (Supplementary file S3).
Opportunity
Majority (n = 10; 62.5%) of the participants perceived less opportunity to practise SB/PA practises at the workplace. These lesser opportunities may be due to perceived higher workload, lack of organisational space or culture to stand or walk during meetings, poor availably of resources were quoted as the prime reasons for the perceived incapability towards the workplace interventions (Supplementary file S3).
Before joining the present institution, I have worked in the corporate sector…. We do get a chance to go and use the gyms or a swimming pool in the working hours….” (P2, F, 36 years, SMART-HC).
(Q34) “…. during meetings, it’s not a culture to even stand and I use to ignore the prompts…. I cannot stand and take notes isn’t it?. Regular desks allow me only for sitting. It (organisational policies) is rigid here….” (P16, F, 44 years, SMART-LC).
Specifically, the participants of SMART group perceived that the prompts are rigid without sensing the movement and not engaging such as inclusion of the social networking.
(Q16) “there is no buddy or group in the app…. If people come together and share their success with colleagues…. Group dynamism…. Something like that… just a prompt…individual entity… It may not work…” (P16, F, 44, SMART-LC)
Motivation (intrinsic)
The strong enabler that distinguished between the compliant and non-compliant office workers was identified as intrinsic motivation. The majority of the participants were motivated (n = 10, 62.5%), despite the perceived barriers.
“I strongly believe physical exercise is a must…. Usually what happens is when we get involved with the work, we don’t realise how long we have been sitting, ……with just a pop up saying you have to move, you have to stretch, it actually helps. At least a personal reminder for me to move is there it helps.” (P2, F, 36 years, SMART-HC).
Few felt that with the tedious workload, urgent tasks, and deadlines, these reminders were helping them to move and prevent musculoskeletal problems caused by their job (Supplementary file S3: Q43-46).
“You hardly get enough time during work or after work and forget to move physically……. ‘As an office staff, I sit almost entire day. We forget to take a break or stretch at least. This intervention is simple reminds me to get off the chair” (P9, F, 33 years, TRADE-HC).
“My health was not up to my expectation even with morning walk. I expected some change during the sitting time in office hours may improve my health benefits” (P1, M, 47 years, SMART-HC)”.
Though the majority found intrinsic motivation, a few found barriers too. The participants felt that these behaviours would become habits and be sustained only when health risks were perceived (Supplementary file S3: Q4 – Q11).
“Only when people perceive their health is at risk, then only these (interventions) will work. Otherwise its waste of resource, money and other resources.” (P14, M, 36 years, TRADE-LC).
“First few weeks I was trying…… it didn’t become a habit …… I am comfortable with sitting in my office and working…” (P14, M, 36 years, TRADE-LC)
Intervention acceptability
The majority of the participants felt that the intervention needed more salient features in a contextual setting rather than just simple reminders, which are boring (Supplementary file S3: Q12 – Q16). Participants felt that instead of just rigid notifications, sensing the movement or sitting behaviour first and then appropriately sending exercise prompts (personal approach to end-user goals) would be more beneficial (Supplementary file S3: Q15). Further, the above sensing would be appropriate in the case of attending meetings and unscheduled breaks, which are common in Indian office workspaces.
“When I am at the meetings and the exercise reminder alarms, people think I am setting alarm for moving out…. It looks awkward sometimes.” (P7, M, 36, SMART-LC)
“prompt is rigid… if I missed due to meetings and after resumed work, it does not sense……. When I want the prompt/clue was not there…. It should sense my sitting time…. Rather only rigid timing prompts…..” (P16, F, 44, SMART-LC)
Few felt that social networking might help in sharing progress, and compliance might be enhanced with peer support (Supplementary file S1: Q16). Further they expressed that social networking may reduce the derogatory comments during exercise compliance in workplaces.
“There is no buddy or group in the app…. If people come together and share their success with colleagues…. Group dynamism…. Something like that… Now it’s just a prompt…individual entity… It may not work in long term…, (P16, F, 44, SMART-LC)
Some participants highlighted the benefits of smartphone-based reminders (Supplementary file S3: Q48 – Q53).
“Now people carry everywhere……It’s (smartphone-based reminders) fun……one stretch based on popup…. Feels good and comfortable……Not monotonous…………smartphone reminders…. different exercise not repeating on the same day…. I liked the idea and did (a) couple of times” (P1, M, 46 years, SMART-HC).
Interpersonal level
Family support
All the non-compliant participants expressed concerns about less support from the family. Sometimes the participants have to face the derogatory comments from the spouse and the kids (Supplementary file S3: Q18).
“………………… they made fun as I started walking in morning and shared the study information to them… They told today ‘you are doing great… but we don’t know how long this is going to last’….” (P7, M, 36 years, SMART-LC).
However, a few participants felt that they could comply with the workplace interventions due to their family support (Supplementary file S1: Q54-56). The family members were a part of modelling the behaviour and mental support.
“…………My family was very supportive…….my family members all are kind of sports person… fitter than me” (P13, M, 42 years, SMART-HC).
Peer support
All the participants expressed the concern of poor peer support in Indian office spaces (Supplementary file S3: Q19 – Q21). The participants have to face the derogatory comments, unpleasant stare from the colleagues who were not the part of the study during initial part of the study. However, the colleagues were least bothered in due course of time.
“My colleague stared at me once while doing exercise……… She smiled and asked why you are doing all these (exercise) at 11:30 AM… She thought I turned crazy (laughs)…… After that she never bothered” (P12, F, 38 years, SMART-HC).
“every individual has their own perception and not everybody will be OK to use, you know to get into all these activities……… because of poor awareness of all these things (exercise in office). When I stood to stretch with reminders, they use to pass comments, however did not bother after that……” (P2, F, 36 years, SMART-HC).
Non-compliant participants were sharing common workspaces where they felt shy doing the exercise in front of other colleagues who were not part of the study (Supplementary file S3: Q21).
“I am shy to do in front of others. It’s an open area you know…. When my cubicle is free…. Just me… I have done the exercises………” (P11, F, 34, TRADE-LC).
Organisational level
Organisational constructs were found to be predominant factors hindering the workplace SB and PA practices among participant of our study (Supplementary file S3: Q22 – Q39). Workload, task priority, organisational norm, policy on active work/ scheduled breaks, managerial support and environmental restructure were identified to be the micro-constructs of the organisational barriers and enablers.
Workload
Significant portion of the participants (n = 13, 81.3%) were citing the workload as the predominant barrier in practicing scheduled breaks and PA at workplaces (Supplementary file S3: Q22 – Q25).
“With my typing, listening to meeting tasks, I was already mentally exhausted. I reserve my physical energy for evening to prepare meals at night and looking after my younger daughter…. I need energy that I did not want to physically exhaust myself with exercises.” (P8, F, 42 years, SMART-LC).
Few perceived that these practices would be effective in information technology sectors, where face-to-face interactions with customers and unprecedented tasks were not commonly encountered (Supplementary file S3: Q24). As the study participants were the part of administrative blocks of multifaceted institutions of university, the perceived workload and tasks would be varied. The variation in the work in different office clusters of university makes it difficult to perceive similar workload across the participants.
“This intervention may work for different institutions which vary in break or work policy. It’s a rigid system in health care accounts sections where task and consumers are priority… It may work for software professionals” (P16, F, 44 years, TRADE-LC).
Task priority
Most of the participants expressed the priority of the work and the anticipated material reward (monthly salary) for the completion of work rather than reducing SB or improving PA. The majority of participants believed that completing their current work and fulfilling their assigned duties for the organization constituted their identity and contributed to sustainability (Supplementary file S3: Q26, 27). The perceived threat of lethargy or neglecting work was also raised as a concern by a few participants.
“I immerse so much when I start work…. I ignore even calls…. These mobile notifications……I ignore most…… I want to complete my work assigned to me…. other things come next…” (P13, F, 37, SMART-LC).
However, a small number of participants who prioritized their health over their tasks or workload exhibited high compliance with the workplace intervention trial (the SMART-STEP) (Supplementary file S3: Q57).
“As Indians, we do not prioritise things (work and health balance), we take it for granted…. Only when health is at risk, they look for such interventions” (P2, F, 36, SMART-HC).
Managerial demands/ support
Majority of the participants expressed that the managers or workplace champions were least bothered about the performance or adherence towards workplace PA or SB interventions (Supplementary file S3: Q28). The fear of perceived laziness or neglecting work during the working hours by the managers was found to be a significant contributor to the non-adherence in majority of the participants.
“…. they (managers) are least bothered. We get a chance to do all these (exercise) things only when we get a space for it. If you are not accepted the way you should be then we will be forced to what boss is going to tell us …. least importance is given to the physical fitness or the mental fitness.” (P12, F, 32 years, SMART-HC).
Few perceived the managers should be aware about the benefits of such SB/PA interventions and authoritative enough to implement in sedentary Indian workspaces (Supplementary file S3: Q58).
Active work policies
Participants voiced concerns about the lack of workplace policies promoting physical activity in Indian offices, believing such policies could enhance emotional bonds and productivity (Supplementary file S3: Q29 – Q36). They also stressed the importance of raising awareness among university management and faculty, advocating for initiatives promoting active work, scheduled breaks, flexibility, and recreational facilities to promote exercise and sport.
“As you know about Indians, they take it (health) for granted at young age. We need a push from the institution side……when you come up with certain policies, rules and regulations (regarding these kind of exercise at workplace) ……. somewhere you are touching them personally also. Yes, institution is concerned about my health…… If I am keeping well, I can definitely give back 10 more times.” (P2, F, 36 years, SMART-HC).
“If you want such policy (promoting health in organisations), strong individuals should be there in that position, who can implement it, and actually see the working process gets on. Unfortunately, no one is there to promote such in national level……” (P11, F, 34 years, TRADE-LC).
“……. top level organisation should be aware of how more PA will make the employee effective and productive at work. Breaking in-between sitting may actually keep us healthy and more productive” (P13, F, 37 years, SMART-LC).
Figure 3 depicts the constructs and micro-constructs at the individual, interpersonal and organisational level barriers and enablers to the workplace SB/PA interventions. Supplementary file S4 is the extension of the Fig. 2 demonstrating mind-mapping of constructs and micro-constructs of the barriers and enablers to workplace SB/PA interventions.
Schematic representation of the algorithm designed to predict adherence among Indian office workers to the intervention, utilizing the constructs and micro-constructs of the socioecological model
Differences in the barriers/enablers between SMART and TRADE interventions
TRADE group participants perceived more barriers (lack of privacy & policies for scheduled breaks, bored on education-based PA/SB schedules, lack of exercise facilities in the vicinity of working bay) than SMART group participants. Majority of TRADE group participants perceived organisation-based barriers are more significant than individual level barriers (Supplementary file S3).
(Q31) “In case you have a job where you have to sit for …. say 9 hours, 10 hours, the management should be flexible in allowing for breaks or exercise or gym provisions” (P11, F, 34 years, TRADE-LC).
Q37 – “providing exercise facilities at workplace may encourage more rather than simple break schedule… I am bored” (P5, M, 39 years, TRADE-LC).
Q60 “these things possible only when the organisations make it compulsory for these kinds of…. practicing exercise or walk breaks…. during office hours……” (P4, F, 43, TRADE-LC).
On the other hand, SMART group participants perceived individual barriers (not using mobile phones during work, not engaging and rigid interventions) and interpersonal (perceived neglect of work, sarcastic comments on alarms) more than the TRADE group participants.
(Q12) “See my work is completely computer based and liaison with the administrative representatives, I do not have time to check the mobile only for exercise break videos. I do not see mobile phone sometimes hours together due to workload” (P6, F, 39 years, SMART-LC).
(Q13) “I didn’t follow because it’s just an alarm…. that tells me what I must do.” (P8, F, 42 years, SMART-LC).
(Q14) “When I am at the meetings and the exercise reminder alarms, people think I am setting alarm for moving out…. It looks awkward sometimes.” (P7, M, 36, SMART-LC)
(Q15) “prompt is rigid… if I missed due to meetings and after resumed work, it does not sense……. When I want the prompt/clue was not there…. It should sense my sitting time…. Rather only rigid timing prompts….”. (P16, F, 44, SMART-LC)
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