Effectiveness of technology-assisted and self-directed interventions to sit less and move more among Indian desk-based office workers: A three-arm cluster randomised controlled trial (SMART-STEP trial)

This cluster-randomized controlled trial evaluated the effectiveness of technology-assisted programs in replacing sedentary time (ST) with physical activity (PA) among Indian office workers. A total of 136 sedentary workers were randomized into two intervention groups: technology-assisted (SMART) and self-directed (TRADE), along with a control group. The SMART group used a smartphone app featuring hourly exercise video prompts and a pedometer, while the TRADE group received a wellness manual with strategies for reducing ST and increasing PA. ST and PA levels were assessed using accelerometers at baseline, 3 months, and 6 months. The SMART group showed a marginal reduction in ST (∼6 min/day) at 3 months (β = −0.340, p = 0.015) and 6 months (β = 0.114, p = 0.030). But the improvements were not sustained at 6 months in TRADE group (β = 0.105, p = 0.064). A significant decline in compliance (n = 57, 63 %) in both intervention groups. Future trials should incorporate organizational-level strategies to enhance compliance.