Edwardson 2018.

Methods	Study design: cluster‐randomised controlled trial Study duration: 12 months Dropout: 25% at 12 months (all participants) Location: UK Recruitment: team managers and staff from 3 hospitals across Leiscester, as part of the University Hospitals of Leicester NHS Trust, were approached to participate in the study. Recruitment also took place through intranet online advertisements, e‐newsletters, and posters
Participants	Population: office workers as self‐reported and later confirmed by site visit Intervention group: 19 clusters with 77 participants (whole group), 12 to 50 with baseline pain Control group: 18 clusters with 69 participants (whole group), 14 to 44 with baseline pain Included criteria: 18 to 70 years of age, office‐based, spent ≥ 75% of the workday sitting, worked 0.6 full‐time equivalent, worked at the same desk for at least 3 days/week, capable of standing Excluded criteria: not reported Baseline characteristics: for the whole group, baseline characteristics were similar between intervention and control groups, except for ethnicity. Physical activity, sitting, and standing were similar between groups. Baseline characteristics for participants with baseline pain not available
Interventions	Intervention Description of intervention: multi‐component intervention ‐ SMArt Work, based on behavioural change theories and implemented through the Behavioural Change Wheel. Intervention incorporates organisational strategies (management involvement), environmental strategies (provision of sit‐stand workstation with brief training), and individual and group strategies (educational seminar, feedback from baseline sit/stand/stepping measurements, provision of DARMA cushion that tracks sitting and prompts user to regularly break up sitting, provision of educational posters, individual coaching sessions) Duration of intervention: 12 months Intensity of intervention: contact by research team at 1 month and then every 3 months to review progress Control Description of intervention: not provided with lifestyle advice, guidance, or feedback from baseline sit/stand/stepping measurements but provided with results of health measures such as weight and blood pressure. These participants continued with their usual work practices Duration of intervention: 12 months Intensity of intervention: not stated
Outcomes	Outcome name, measurement tool, body region Musculoskeletal health Standardised Nordic Questionnaire for 9 body regions ‐ neck, shoulder, upper back, elbow, wrist, lower back, hip, knee, and ankle ‐ over last week and last year Changes in occupational sitting Measured by activPAL accelerometer/inclinometer device Physical activity, daily sitting, prolonged sitting, standing time, stepping time (light, moderate, and vigorous) for work hours and for all waking hours Measured by activPAL accelerometer/inclinometer device and Actigraph Link accelerometer worn on the wrist Work‐related measures Work engagement ‐ 9‐item questionnaire with 7‐point Likert scale Job satisfaction and performance ‐ single‐item question on a 7‐point Likert scale Occupational fatigue ‐ Need for Recovery Scale Sickness presenteeism ‐ Work Limitations Questionnaire Absenteeism ‐ Work Productivity and Activity Impairment Questionnaire Cognitive function ‐ computer and paper tasks Mood and affective states ‐ Mood Affect Adjective Check List ‐ Revised Quality of life ‐ World Health Organization Quality of Life ‐ BREF
Identification
Notes	Sponsorship source: nil relevant
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation	Unclear risk	Quote: "using computer generated lists, a statistician randomised office groups (clusters) 1:1 to either intervention or control group stratified by cluster size (≤4 and >4 participants) with a block size of six. Randomisation was performed in batches after participant clusters had completed their baseline measures" Judgement comment: randomisation at the office group level was carried out by a statistician using computer‐generated lists. Although the overall randomisation procedure was low risk, as only a select group of participants with baseline pain were included in the review, randomisation was compromised
Allocation concealment	Unclear risk	Judgement comment: it is not stated whether allocation was concealed
Blinding of participants and personnel	High risk	Quote: "randomisation occurred at the office group level to reduce the risk of contamination" Quote: "the team leads could not be blinded as they were responsible for study coordination, including delivery of the desks and intervention components. Team leads had no involvement in data processing and analysis" Judgement comment: participants and/or researchers were not blinded. Although attempts were made to physically separate clusters within the workplace, it is unlikely that participants would not be aware of their allocation. It would not be possible to blind research personnel due to the nature of the intervention
Blinding of outcome assessment	Unclear risk	Quote: "team members who took measurements were blinded to group randomisation" Judgement comment: team leads were not not involved with data processing or analysis, and it is stated that team members who took measurements were blinded to group allocation but is not stated whether there was blinding of outcome assessors for all outcome measures. In addition, in this study, musculoskeletal outcomes were a secondary outcome, so it unclear whether the fact that participants were not blinded to the intervention would contribute to bias in self‐reporting of musculoskeletal outcomes
Incomplete outcome data	Unclear risk	Judgement comment: for the whole cohort ‐ at 3‐month follow‐up, 52/69 in the control group were lost to follow‐up and 69/77 in the intervention group; at 6‐month follow‐up, 50/69 in the control group were lost to follow‐up and 65/77 in the intervention group; and at 12‐month follow‐up, 46/69 in the control group were lost to follow‐up and 63/77 in the intervention group. Attrition was greater in the control group (33%) than in the intervention group (17%). Attrition details were not provided for participants with baseline pain
Selective reporting	Low risk	Judgement comment: all outcomes reported were reported at trial registration, and no outcomes in the trial registration were omitted
Baseline imbalance	Unclear risk	Judgement comment: some differences in baseline symptoms were noted for some body regions (e.g. neck, shoulder)