Sixteen Dutch office workers (50% female) from different professions participated. Participant characteristics are shown in Table 1. Participants' mean age was 40.7 years (SD ± 9.9); 63% were married or cohabitated; 56% had children; 88% had completed university education or professional education and all participants were born in the Netherlands. Nine participants (56%) exercised at least once a week. Participants' did not exactly know the national physical activity recommendation[1]; fourteen participants slightly or severely overestimated the recommended amount or intensity of physical activity, and two participants underestimated it. Nine participants believed that they met the (self-perceived) physical activity recommendation; three participants indicated that they did not pay attention to the recommendation, and four participants believed that they did not meet the recommendation. Five participants were dissatisfied or partly dissatisfied with their physical activity levels; three of them expressed a desire to be more active or less sedentary, and two said that they accepted their situation.
Table 1. Participants' characteristics
Participant ID
|
Gender
|
Age†
|
Marital status
|
Number of children
|
Educational attainment‡
|
Field of profession
|
Working hours§
|
P1
|
W
|
42
|
Married
|
2
|
Professional
|
Education
|
28
|
P2
|
W
|
25
|
Single
|
0
|
University
|
Pharmacy
|
40
|
P3
|
W
|
34
|
Cohabiting
|
1
|
Professional
|
Secretary
|
24
|
P4
|
W
|
34
|
Cohabiting
|
2
|
University
|
Research & consultancy
|
32
|
P5
|
W
|
32
|
Single
|
0
|
University
|
Research
|
36
|
P6
|
W
|
38
|
Single
|
0
|
Professional
|
Secretary
|
32
|
P7
|
W
|
32
|
Divorced
|
2
|
Professional
|
Management
|
32
|
P8
|
M
|
37
|
Married
|
2
|
University
|
Policy advisor
|
20
|
P9
|
M
|
45
|
Married
|
2
|
University
|
Finance
|
40
|
P10
|
M
|
55
|
Cohabiting
|
1
|
University
|
Finance
|
45
|
P11
|
M
|
60
|
Married
|
2
|
Professional
|
ICT
|
40
|
P12
|
M
|
38
|
Cohabiting
|
0
|
Professional
|
Finance
|
40
|
P13
|
M
|
41
|
Cohabiting
|
0
|
Professional
|
Finance
|
44
|
P14
|
M
|
62
|
Married
|
0
|
University
|
Finance
|
40
|
P15
|
W
|
54
|
Divorced
|
3
|
Secondary
|
Secretary
|
25
|
P16
|
M
|
42
|
Relationship
|
0
|
Secondary
|
ICT
|
36
|
Abbreviations: W woman, M man, ICT Information and communications technology
† Age in years
‡ Secondary: Secondary education including higher school or leaving certificate/trade/apprenticeship; Professional: professional education including certificate/diploma; University: university education including university degree or higher
§ Average number of working hours per week
Thematic analysis
We identified six main themes in our qualitative data, which related to participants' perspectives on physical activity and sedentary behaviour. The themes are described in the next section, illustrated by quotes.
Theme 1: Beliefs about health effects are specific regarding physical activity, but superficial regarding sedentary behaviour
When asked about the consequences of insufficient physical activity, all participants mentioned health risks (i.e. hypertension, high cholesterol levels, arteriosclerosis, diabetes, cardiovascular diseases, cancer).
[About the health risks of physical inactivity] "I think it increases the risk of cardiovascular diseases; and cholesterol levels; I think that your endurance will decrease when you're continuously sitting and if your endurance decreases, you might experience some form of mental imbalance earlier. I also think that the risk of other diseases increases, because it weakens your immune system. [P14]
Furthermore, they all explained that physical activity benefits physical health (i.e. increased endurance, prevention of weight gain, reduction of stiffness, increased blood circulation, and positive effects on muscles and joints) and most participants also mentioned mental health benefits (i.e. higher energy levels, better resistance to stress, increased relaxation and a general feeling of satisfaction).
I: "What do you like about going home by bike in the afternoon?"
P: "Well, the fresh air, I love being outside and it also gives me the chance to process my daily impressions, which makes me more relaxed when I arrive home." [P6]
Regarding sedentary behaviour, participants' beliefs were more superficial; almost all participants mentioned that too much sitting is 'bad' for one’s health, often referring to the popularized media statement 'Sitting is the new smoking'.
“Sometimes you hear ‘sitting is the new smoking’, but I haven't really figured out why that is the case exactly, so to be honest I don't know whether it has to do with your sedentary position or because you’re not physically active, but I've heard this saying so often that I assume it’s true.” [P8]
Still, most participants did not know which short- and long-term health effects were associated with high levels of sitting. A few participants were able to specify possible physical health effects (i.e. increased stiffness or pain in the neck, shoulders or back, weight gain, reduction of strength and endurance, and reduced blood circulation) or mental health effects (i.e. tiredness and a reduced focus), mostly relating to short-term effects.
Theme 2: In addition to health, social- and work-related values are also given priority
When asked about general values in life, participants most frequently mentioned health, family, friendships, balance, and freedom.
"A 'good life'… is being conscious right now as well as about the future, both for physical activity and healthy diet, as well as with your living circumstances." [P16]
"The urge to grow old and stay healthy, yes, I think that’s what I am doing indirectly, well, to be happy you need to be healthy." [P9]
Some of those values, especially health, family, and friendships, were also discussed to some extent when talking about motivations (theme 3) and attitudes (theme 4). The value health was most frequently mentioned as a driver of physical activity, but other values were also mentioned in relation to physical activity, either directly (e.g. exercise for pleasure), or indirectly (e.g. being active in order to age healthily to stay with one's family). Sometimes, participants were ambivalent about values relating to physical activity. In most of these cases, engaging in physical activity for health reasons conflicted with social values (i.e. family, friendships) or with work-related values (i.e. ambition, responsibility, performance, money). For instance, several participants wanted to be physically active after work but chose to spend evenings at home, because spending time with family was also considered important.
I: "Do you see opportunities at work to be more physically active or to sit less?"
P: "We have exercise facilities [at work] but I don’t feel like going for a quick workout during lunch or before or after work; after work I want to go home, eat and see my children." [P9]
Participants rarely talked about values in relation to sedentary behaviour.
Theme 3: Motivations are related to the value 'health' and the valence and time frame of outcomes
'Good health' was the most frequently mentioned motivation and reflected the value 'health'. When asked to clarify, participants specified their health-related motivations, which typically referred to short-term positive outcomes (e.g. increasing endurance, keeping fit, having a healthy body weight, feeling good), and occasionally to longer-term outcomes (e.g. maintaining a healthy body weight and being physically active at an older age). Other positive outcomes that participants claimed to strive for included having fun, attaining specific achievements (e.g. walk 10,000 steps a day) and looking good.
"Actually, I think I should exercise at least three to four times a week, just because it’s better, it’s healthier, and it may result in a good body shape [laughs]. You just want to keep looking good while aging, and maintain good endurance and good health." [P6]
[About the motivation to exercise] "I think that my biggest motivation is to look fit and to be fit." [P2]
Most motivations to engage in physical activity stemmed from a desire to achieve the aforementioned positive outcomes, indicating positive valence. Occasionally, motivations stemmed from a desire to prevent negative outcomes, indicating negative valence. Motivations to prevent negative outcomes were typically related to long-term consequences (e.g. gaining weight, getting physical complaints, and becoming ill).
[About the motivation to exercise] "Currently, I am too heavy for my height, so yes, that was certainly an important motivation to work on it" [P7]
Motivations discussed by participants concerning sedentary behaviour generally applied to the short term (e.g. reduce stiffness, move away from the computer screen, regain a better focus). This short-term focus was also reflected in participants' beliefs about sedentary behaviour (theme 1).
Theme 4: Attitudes are diverse and depend on previous experiences, underlying values, and the situation
Participants expressed diverse attitudes toward physical activity, including exercise. Many positively evaluated physical activities due to positive previous experiences, or because certain activities corresponded with their underlying values; for instance, participants who valued social connections highly enjoyed playing team sports.
[About table tennis] "I really like this sport, I really enjoy it, […] the game is really fun and the people are very nice as well." [P3]
Sometimes, participants expressed a neutral or somewhat negative attitude toward a certain physical activity (e.g. fitness or running); some of them still engaged in the activity for health reasons, reflecting health as a value.
I: "Do you enjoy going to the gym?"
P: "Well let's say it’s not my favourite hobby, it’s not the most challenging thing I can think of… maybe I would rather have a home trainer in my apartment (laughs), although it’s important for me; I know it’s beneficial for my health; I’m not the kind of person who stays at home when I have an off day; I will go just because it’s important [to exercise]." [P12]
I: "You mentioned previously that you don’t like doing sports; have you never enjoyed sports?
P: "Well, I’m not very good at game-type sports […], but I did enjoy lessons like aerobics; it helped me to build up my muscles and it made me enthusiastic. Currently, however, it’s difficult to combine with work and my children; for sports lessons I have to be somewhere at a fixed time, and then I feel obliged and stressed to be there; so I can’t really enjoy it." [P4]
Participants also expressed diverse attitudes toward sedentary behaviour. Negative previous experiences with prolonged sitting, such as physical complaints in neck and shoulders, were mentioned in relation to a negative attitude toward prolonged sitting. For some participants, this seemed to result in a positive attitude toward alternating between sitting and standing postures at work. Other participants had a more negative attitude toward alternating since they experienced tiredness when working in a standing posture. Finally, attitudes seemed to depend on the situation; attitudes toward sitting were more positive when participants had already done something useful during the day (e.g. exercising or cleaning the house), or when sitting was accompanied by a relaxing activity (e.g. watching television).
Theme 5: Perceived barriers depend on internal and external factors
All participants indicated one or multiple barriers regarding physical activity or reduction of sedentary behaviour. Perceived barriers were either related to internal factors (i.e. lack of motivation/energy/inspiration or physical complaints) or external factors in the physical or social environment (i.e. bad weather, lack of childcare or lack of social support). Lack of time was a frequently mentioned barrier to physical activity and was mainly caused by competing interests (described in theme 2).
"I used to engage in sports quite often, but now I lack time and energy. It’s also due to the informal care I’ve been providing for a long time; I couldn’t combine the two any longer." [P16]
Some participants mentioned more barriers for physical activity than others; this seemed to be related to participants' values (i.e. more barriers were perceived when competing interests played a role) and the degree of motivation for physical activity (i.e. more barriers were perceived in the case of little motivation).
Perceived barriers regarding interruption of sedentary behaviour at the workplace often concerned high work pressure, inflexible work policies, lack of facilities such as sit-stand desks and unfavourable social norms (e.g. no other colleagues working in a standing position).
"Sometimes colleagues go for a short walk and invite others to join; I mostly say no due to work pressure" [P5]
[About sit-stand desks] "In general I think that those things catch on when you see others using them; then you think 'oh let's also try that once', while if nobody's ever using it, you don’t want to be the only idiot using it." [P8]
Theme 6: Supporting factors are related to the social-, physical- and information environments
Participants mentioned factors that supported them in being physically active and less sedentary, and factors that would support them in these behaviours. Supporting factors mentioned regarding the social environment included positive social norms (e.g. relating to working in a standing position), active social activities, and social support – including encouragement – from the social environment. Some participants wished to receive more social support.
I: "How could your social environment support you to be more physically active?"
P: "It would help me if others invited me to come along […]; it would support me if my partner and I exercised together; I would really enjoy that" [P3]
Regarding the physical environment, an inviting (built) environment, good weather conditions, activity trackers, and owning a pet were generally considered to encourage physical activity and less sedentary behaviour. At work, multiple participants wanted to have a sit-stand desk or more physical activity, including active breaks.
"The availability of facilities [at work], such as sit-stand desks and meetings rooms with a standing table, would support me [to stand up more often]" [P8]
Finally, multiple participants wished to (regularly) receive advice about easily applicable active behaviours, for instance through e-mails or newsletters from their employer, and some participants wanted to receive more information about the health effects of physical activity and interruption of sedentary behaviour, for instance through messages in a 'did-you-know-that…' format at the workplace.
"That’s a role for employers [to provide information about physical activity and sedentary behaviour], because an employer wants his employees to be in good health […], so it’s beneficial if employers play a role in this. Either by increasing awareness or by facilitating equipment for their employees to be more physically active" [P13]