Brief Original Report Acceptability of standing workstations in elementary schools: A pilot study Erica A. Hinckson a, ⁎, Saeideh Aminian a , Erika Ikeda a , Tom Stewart b , Melody Oliver b , Scott Duncan b , Grant Schofield b a Centre for Physical Activity and Nutrition, Centre for Child Health, Institute of Public Health and Mental Health, Auckland University of Technology, Private Bag 92006, Auckland, New Zealand b Centre for Physical Activity and Nutrition, Institute of Public Health and Mental Health, Auckland University of Technology, Private Bag 92006, Auckland, New Zealand abstract article info Available online 23 October 2012 Keywords: Accelerometer ActivPAL Physical activity Sedentary Sitting Standing desks Objective. To examine the acceptability of introducing standing workstations in elementary-school classrooms; and to quantify changes in children's time spent sitting, standing, and walking; step counts; sit-to-stand transitions; and musculoskeletal discomfort. Methods. A controlled trial was conducted in two elementary schools in Auckland, New Zealand (March–May 2012). Participants were 30 third and fourth graders (n = 23 intervention, n = 7 control). Intervention classes received standing workstations; control class retained usual sitting desks. Children wore ActivPAL monitors over 7 days at baseline and during the fourth week of the intervention. Results. Children spoke enthusiastically of the standing workstations. School staffs were supportive of the standing workstations because they offered “flexibility in learning”. Overall, children in the intervention group sat less (intervention: 8.27 (1.45), mean (SD); control: 9.00 (0.80) h/day), stood longer (3.75 (0.88); 2.85 (0.30) h/day), and engaged in fewer transitions from sitting to standing (93 (17); 98 (26) counts) com- pared to the control group. Effect size ranged from small-large (-0.49; 95% confidence limits (0.64)%, 0.71; (0.48), -0.96; (0.54)% respectively). Results for time spent stepping and step counts were unclear. Conclusion. Standing workstations can be successfully integrated in classroom environments and appear to decrease overall sedentariness. © 2012 Elsevier Inc. All rights reserved. Introduction Children are naturally active (Boreham and Riddoch, 2001), but they are continually exposed to opportunities and environments that cause them to be sedentary (prolonged sitting) on a daily basis (Boreham and Riddoch, 2001). Sedentary behaviors in childhood are associated with risk of overweight and poor fitness, and raised cho- lesterol in adulthood (Hancox et al., 2004). Increased sedentariness in childhood predicts chronic fatigue syndrome in adulthood (Viner and Hotopf, 2004), and is associated with reduced academic achieve- ment (Kristjánsson et al., 2009) and less energy expended during the day (Lanningham-Foster et al., 2006). Several studies have also shown (Grimes and Legg, 2004; Harreby et al., 1999; Trevelyan and Legg, 2010) an association between low back pain and sitting in chil- dren. An innovative approach to potentially reduce prolonged sitting and increase overall physical activity levels in children is to remove chairs and replace traditional desks with standing workstations in classrooms. However, the acceptability of standing workstations and consequences of increasing standing time in classrooms need to be explored before full implementation. Methods Participants A sample of convenience of 30, children (14 boys, 16 girls, age 10 (1) years, mean (SD), height 1.43 (0.08) m, weight 45.57 (13.00) kg, BMI 23.11 (7.25) kg/m 2 , waist circumference, 27.97 (4.65) cm) from three ele- mentary school classrooms in Auckland, New Zealand participated in the study. Complete data were provided from 23 children in the intervention group (9 (1) years, 1.42 (0.08) m, 42.45 (11.00) kg, 22.49 (7.48) kg/m 2 , 27.00 (4.12 cm)), and 7 children in the control group (10 (0) years, 1.49 (0.06) m, 56.28 (14.44) kg, 25.26 (6.42), 31.29 (5.16) cm). All 3rd and 4th grade children were invited to participate. For children's participation, we received parental consent along with child assent. Parental, principal and teacher consents were received prior to participation in focus group and semi-structured interviews. Ethical approval was granted from the Institution's ethics committee. The schools were located in the lowest socioeconomic area. Design Prior to introduction of standing desks, semi-structured interviews were conducted with 10 principals and teachers in 2011 to identify current teaching Preventive Medicine 56 (2013) 82–85 ⁎ Corresponding author. Fax: +64 9 921 9746. E-mail addresses: erica.hinckson@aut.ac.nz (E.A. Hinckson), saeideh.aminian@aut.ac.nz (S. Aminian), erika.ikeda@aut.ac.nz (E. Ikeda), tom.stewart@aut.ac.nz (T. Stewart), melody.oliver@aut.ac.nz (M. Oliver), scott.duncan@aut.ac.nz (S. Duncan), grant.schofield@aut.ac.nz (G. Schofield). 0091-7435/$ – see front matter © 2012 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.ypmed.2012.10.014 Contents lists available at SciVerse ScienceDirect Preventive Medicine journal homepage: www.elsevier.com/locate/ypmed