The effect of computer prompt in breaks of sedentary behaviour among office workers: a systematic review and meta-analysis.

Background: Prolonged sitting time in the workplace constitutes a significant portion of waking hours. Sedentary behaviour is associated with higher risks of cardiovascular diseases, obesity, and all-cause mortality. Interventions to reduce workplace sitting, such as health apps, height-adjustable desks, and active breaks, have shown relative effectiveness in improving health outcomes. Among these, computer prompt interventions represent a simple and scalable strategy that can remind workers to take breaks and reduce sedentary behaviour. This study evaluates the effectiveness of computer prompt interventions to reduce sitting at work compared to no intervention or combined strategies.

Methods: Primary studies were searched in PubMed (MEDLINE), EMBASE, Scopus, and CENTRAL of the Cochrane Library. The search was conducted until December 2024. Keywords included terms like "sedentary behaviour," "computer prompts," "sitting time," and "office workers." Only randomized controlled trials (individual or cluster) involving desk-based workers aged 18 or older that evaluated computer prompt software were included. Risk of bias was assessed using the Cochrane Risk-of-Bias tool (RoB2). Mean differences with 95% confidence intervals (CI) were calculated for sitting time and secondary outcomes. Analyses were performed using RevMan and R software, and GRADE methodology was applied to assess the certainty of evidence.

Results: From 17,880 records, 18 studies involving 1164 office workers were included in the analysis. Ten studies focused exclusively on computer prompts, while 8 studies implemented combined strategies (e.g., computer prompts plus sit-to-stand desks). The median intervention length was 8 weeks, ranging from one to 24 weeks. Studies using only computer prompts included breaks lasting from 1 to 10 min every 30 min up to an hour. Combined strategies included breaks from 6 to 30 min every 30 min up to 3 h. According to objective measurements, the meta-analysis showed a significant reduction of 12.46 min/workday in sitting time (95% CI: -18.12, -6.80) and a significant increase of 1029.99 steps/workday (95% CI: 815.97, 1244). Secondary outcomes included work-related, musculoskeletal, and cardiometabolic outcomes favouring computer prompts but not statistically significant. The certainty of evidence for primary outcomes is rated low to moderate according to GRADE.

Conclusions: Computer prompt software interventions show effectiveness in reducing sitting time among office workers. However, more long-term prospective studies with larger sample sizes are needed to accurately determine the effectiveness of computer prompts on various work- and health-related outcomes.

Trial registration: The review protocol was registered in the Prospero database (CRD42021287870).