Comprehensive Analysis and Quality Assessment of an E-health Study

This report provides a comprehensive analysis and quality assessment of an e-health intervention study focused on reducing prolonged occupational sitting among desk-based employees. The study, a randomized controlled trial, involved 34 participants divided into intervention and control groups. The intervention group received prompts encouraging physical activity, while the control group did not. The report evaluates the study's selection bias, study design (randomized controlled trial), confounders, and blinding. It assesses the representativeness of the participant sample, the method of randomization, and the control of potential confounding variables. The analysis also examines whether outcome assessors and participants were aware of intervention status and research questions. The report highlights the study's strengths and weaknesses, providing an overall quality rating for each component and offering explanations based on epidemiological principles. The study's findings, indicating increased calorie expenditure in the intervention group, are considered within the context of the overall study design and methodology.

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individual work and
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Study assessed as described in:
Pedersen, S. J., Cooley, P. D., & Mainsbridge, C. (2014). An e-health intervention
designed to increase workday energy expenditure by reducing prolonged
occupational sitting habits. Work, 49(2), 289-295.
Remember, you are assessing the study which is described, and not this single
publication. You will need to check and identify if additional information about
this study is available. If so then you can incorporate the information into the
responses. Please be aware that sometimes the information may conflict. Place
your answers inside the boxes.
QUALITY ASSESSMENT TOOL FOR QUANTITATIVE STUDIES
Please complete these the questions presented as structured
paragraphs as you would in an essay. Clearly mark your
selection or cross-out the choice not applicable. Do not use
highlighting or colour change as this is not recognised in

Turnitin. Demonstrate your knowledge of epidemiological
principles within each section and support your statements.

Part 1: (Initially undertaken on your own)
Show the structured PICO question of the study
Population: Population denotes the total number of participation in the research
study. In order to accomplish the aim and objective of primary research study, it is
important and essential for researchers to select adequate number of participants.
It was identified after systematically analysis of the article that total of 460 desk
based employees of Tasmania Police have been analysed and out from which 34
participants has been selected. Total number of participants were 34 out which 17
were in intervention group and 17 were in control group.
Intervention/Issue: The 17 participants of the intervention group were regularly
exposed to prompt delivered through their desktop computer that required them to
stand up and engage in a short burst of physical activity. The issue was that desk
based employees face multiple workplace face multiple health hazards such as
insufficient physical activity and prolonged sitting.
Comparison: Comparison of 17 participants of intervention group and 17
participants of control group were made. No intervention has been provided to
control group in order to compare there health status with intervention group ones.
Though in order to prevent the Hawthorne effect, researchers conveyed that e-
helath intervention will be provided to the participants of close group after 13th
week.
Outcomes: There was a significant 2 (Group) × 2 (Test) interaction, F (1, 32) =
9.26, p < 0.05. The intervention group increased the calories expended during the
workday from pre-test (M = 866.29 ± 151.40) to post-test (M = 1054.10 ± 393.24),
whereas the control group decreased calories expended during the workday from
pre-test (M = 982.55 ± 315.66) to post-test (M = 892.21 ± 255.36).
COMPONENT RATINGS
A) SELECTION BIAS
(Q1) Are the individuals selected to participate in the study likely to be
representative of the target population?
1 1. Very likely
2 2. Somewhat likely
3 3.Not likely
4 4. Can’t tell
5
Provide your explanation: Very Likely the individuals selected to participate in
the study likely to be representative of the target population. The participants were
selected randomly from approximately 460 desk based Tasmania Police Employees
from across several metropolitan sectors (Pedersen, Cooley and Mainsbridge,
2014).

(Q2) What percentage of selected individuals agreed to participate?
1 1. 80 - 100% agreement
2 2. 60 – 79% agreement
3 3. less than 60% agreement
4 4. Not applicable
5 5. Can’t tell
Provide your explanation: Researcher randomly selected the participants from
34 participants out of 460. This implied that less than 60% of total participants
were agreed to participant in the research study conducted by the researcher. Out
of 34 participant 26 female and 8 were male employees who volunteered for the
research study.
RATE THIS SECTION STRONG MODERATE WEAK
See dictionary 1 2 3
Provide your explanation: The overall rating of this section is 2 i.e. moderate.
The questions provided here is only regarding PICO and participants. This can be
improve to further regarding the nature of study, researcher motives, etc.
B) STUDY DESIGN
Indicate the study design
1. Randomized controlled trial
2. Controlled clinical trial
3. Cohort analytic (two group pre + post)
4. Case-control
5. Cohort (one group pre + post (before and after))
6. Interrupted time series
7.Other, please specify:
8. Can’t tell
Was the study described as randomized? If NO, go to Component C.
No Yes
If Yes, was the method of randomization described? (See dictionary)
No Yes
If Yes, was the method appropriate? (See dictionary)
No Yes
Provide your explanation: According to Flick, (2015) RCT is the type of study in
which people are sorted at random to receive one of the several clinical
intervention. One of these intervention is the standard of comparison or control.
Taylor, Bogdan and DeVault, (2015) elaborated that the people who takes part in

the randomised control trial are participants. Pedersen, Cooley and Mainsbridge,
(2014) argued that In the similar manner the researchers has conducted
randomised control trial by dividing the total participants into two groups which
were intervention and control group. In the research study, researcher analysed
the impact of prolonged sitting on desk on health and body while doing work. The
reason they conducted the study as in recent years many cases were identified
where people affects with back pain, strain and neck pain. Thus, in this context, by
using randomised control trial method of research study conducted research
analysis. For this, they have selected Tasmanian Police Force department
employees as participants. Out of 460 desk based Tasmania Police employees from
several metropolitans, they have selected 34 employees as their sample (female =
26, male = 8). The method of randomisation has been elaborated clearly. In order
to provide e-health intervention, the researchers divide the volunteers into half. 17
participants of the group were selected for intervention and 17 participants of
group were selected for closed group i.e. no intervention has been provided to
them. According to Bardus, Smith and Abraham. (2015) Randomised control trial is
a study where participants are sorted at random to receive one of several clinical
intervention. One of these interventions is the standard of comparison or control.
They provide intervention to the intervention group and did not provide any
intervention to the control. Thus, it implies that researchers by using randomised
control trial method of research able to accomplish the aim and objectives of the
study. Eventually they were able to compare and generate precise result out from
it. Castro-Alves and Kendall (2018) said that RCT is the design of study in which
participants are randomly selected into an experimental and control group. Flick,
(2015) argued that it is expensive in terms of time and money. It further does not
reveal causation. Hurt and et.al. (2018) said that populations of participating
individuals are clearly identified.
RATE THIS SECTION STRONG MODERATE WEAK
See dictionary 1 2 3
Provide your explanation: The overall rating of the section is 1 which is weak as
the section only focuses on randomised control type of research design. This can
be further improve by involving all the research design.
C) CONFOUNDERS
(Q1) Were there important differences between groups prior to the
intervention?
1 1.Yes
2 2. No
3 3. Can’t tell
The following are examples of confounders:
1 1. Race
2 2. Sex
3 3. Marital status/family
4 4. Age

5 5. SES (income or class)
6 6. Education
7 7. Health status
8 8. Pre-intervention score on outcome measure
Provide your explanation: As there were no explanation regarding the race,
martial status, income or class, education, health status, no description can be
given on them. There were an aggregate of 34 participants were selected
randomly out which 26 were females and 8 were males. There were age
differences that affects both the dependent and independent variables of the
study. Pre intervention score on outcome measure for both the divided groups
were Intervention total energy M = 866.29, SD = 151.4Control group total energy
M = 982.55, SD = 315.66 (Pedersen, Cooley and Mainsbridge, 2014).
(Q2) If yes, indicate the percentage of relevant confounders that were
controlled (either in the design (e.g. stratification, matching) or analysis)?
1 1. 80 – 100% (most)
2 2. 60 – 79% (some)
3 3. Less than 60% (few or none)
4 4. Can’t Tell
RATE THIS SECTION STRONG MODERATE WEAK
See dictionary 1 2 3
Provide your explanation: The overall rating of this section is 2 i.e. moderate.
The section provide questions about confounders but have limited focus to minor
differences. This can be further enhanced in order to reach the strongest level.
D) BLINDING
(Q1) Was (were) the outcome assessor(s) aware of the intervention or
exposure status of participants?
1 1. Yes
2 2. No
3 3. Can’t tell
4
Provide your explanation: While conducting the research study, it is important
for the researcher to elaborate the purpose and motive of the research study. It is
essential because without acquiring consent of participants, researches would not
be able to proceed further. Investigators have to disclose each and every
information of the study and research interventions. The possible effects and
benefits must be discussed with the participants of the study. In order to gain the
consent of participants of Tasmania Police Force, researcher have articulated the
purpose, reason and determinants of the study adequately. In this context, the
assessors were aware of the intervention exposure statues of participants. The
researcher conduct study on two groups which were intervention and controlled
groups. Controlled groups participants were not provided any intervention in order
to conduct the analysis. But researcher conveyed that they will provide them the

intervention after 13 weeks in order to prevent Hawthorne effect. During the
session, the participants were educated about the negative health impact of
prolonged sitting and provided general instructions on performing appropriate
workplace physical activities.
(Q2) Were the study participants aware of the research question?
1. 1. Yes
2. No
3. 3. Can’t tell
Provide your explanation: It is important as well as essential for the researcher
to aware the participants about the research questions or hypothesis of the study.
This is to gain their trust and belief in the study. As it was mentioned in the
research study as before collecting any data, consent of participants has been
taken by the researchers. The researchers provided them the ethics form clearly
mentioning the motive of study, objectives research and research questions. This
provide strong evidence that research participants were aware of the research
questions. Ethical consideration is very important for conducting any sort of
research study involving public. It is important for the researchers to take their
consent before asking them questions or interrogation. This can enhance the
effectiveness of the study gradually.
RATE THIS SECTION STRONG MODERATE WEAK
See dictionary 1 2 3
Provide your explanation: This section is rated to 1 which is strong. Clear
information regarding the participants of the research study has been asked in this
section. Precise questions has been asked regarding the blinding section and exact
choices has been provided in order to attempt those questions efficiently.
E) DATA COLLECTION METHODS
(Q1) Were data collection tools shown to be valid?
1 1. Yes
2 2. No
3 3. Can’t tell
4
Provide your explanation: The data has been collected through questionnaire
survey method which was build upon Occupational Sitting and Physical Activity
Questionnaire (OSPAQ). The method is considered as valid method for collecting
the data effectively and efficiently. It separates standing and sitting behaviours
into two categories; however, beyond recording these values the OSPAQ does not
incorporate a formula that yields workplace daily energy expenditure values
(Taylor, Bogdan and DeVault, 2015). Through this method of data collection, the

researcher were able to collect the data effectively and efficiently. The researcher
with the help of this questionnaire was able to gather precise data and information
effectively that helps them to conduct the analysis and produces precise results.
Data collection is the process of gathering vital data and information in order to
conduct research analysis. It is considered as an essential process which helps the
researcher to carry out the research study effectively and efficiently.
(Q2) Were data collection tools shown to be reliable?
1 1. Yes
2 2. No
3 3. Can’t tell
Provide your explanation: Yes the data collection tools were reliable for carry
out the research study. In order to collect the data, Occupational Sitting and
Physical Activity Questionnaire (OSPAQ) has been used by the researchers. The
questionnaire survey helps in collecting and analysing the desirable data
adequately. The survey helps in analysing the behavioural and habitual pattern of
employees efficiently. As data collection is important process, it is most important
for researchers to select appropriate tool for analysing the data effectively and
efficiently. This questionnaire survey assists researchers to gather the valuable
data and proves to be reliable for the study.
RATE THIS SECTION STRONG MODERATE WEAK
See dictionary 1 2 3
Provide your explanation: This section has been rated 2 which is moderate due
to lack of questions regarding data collection methods. The section consists of 2
questions only, which were related with data collection methods and its reliability.
In order to enhance the effectiveness in this section the more information
regarding other alternative form of data collection and reasons for not choosing
them can be asked in this section. In this way more information relating with data
collection and its process can be acquired efficiently.
F) WITHDRAWALS AND DROP-OUTS
(Q1) Were withdrawals and drop-outs reported in terms of numbers and/or
reasons per group?
1 1. Yes
2 2. No
3 3. Can’t tell
4 4. Not Applicable (i.e. one time surveys or interviews)
(Q2) Indicate the percentage of participants completing the study. (If the
percentage differs by groups, record the lowest).
1 1. 80 -100%
2 2. 60 - 79%
3 3. less than 60%

4 4. Can’t tell
5 5. Not Applicable (i.e. Retrospective case-control)
RATE THIS SECTION STRONG MODERATE WEAK
See dictionary 1 2 3 Not Applicable
Provide your explanation: The overall rating of this section is 1 which is strong.
Information regarding withdrawals has been asked in this section. Question 1 was
Were withdrawals and drop-outs reported in terms of numbers and/or reasons per
group?. The response is definitely yes. The researchers asked the participants that
their participation is strictly voluntary and they can leave any time if they feel
uncomfortable. The second question was to indicate the percentage of participants
completing the study. (If the percentage differs by groups, record the lowest). In
the research study there was 0 percent withdrawal rate and 100 percent
adherence rate. No participant left the research study. Thus, this section has cover
the aspect of withdrawal and drop out rate effectively and efficiently.
G) INTERVENTION INTEGRITY
(Q1) What percentage of participants received the allocated intervention
or exposure of interest?
1 1. 80 -100%
2 2. 60 - 79%
3 3. less than 60%
4 4. Can’t tell
5
Provide your explanation: In the research study, to assess the effectiveness of
workplace health and wellbeing intervention (WHWI), a field based randomised
control trail was launched with research partnership between Tasmania State
Police Department and the University of Tasmania. In order to conduct the
research study, the researchers selected a total of 34 participants out from 460
Tasmania Police desk based employees. They divided that group into equal
number that is 17 participants were kept in intervention group while 17
participants were kept in control group. Total number of participants were 34 out
which 17 were in intervention group and 17 were in control group. The 17
participants of the intervention group were regularly exposed to prompt deliver
through their desktop computer that required them to stand up and engage in a
short burst of physical activity (Pedersen, Cooley and Mainsbridge, 2014). This
implied that 50 per cent of the participants received that allocated intervention or
exposure of interest. In order to conduct the research analysis in order to
accomplish the aim and objectives of the study, it is important for the researchers
to carefully allocate the participants who gets intervention or exposure of interest
and who will not. Effective allocation of intervention or exposure of interest can
enhance the effectiveness of the research study and researcher will be able to
accomplish the aim and objectives of the study.

(Q2) Was the consistency of the intervention measured?
1 1. Yes
2 2. No
3 3. Can’t tell
4
Provide your explanation: The consistency of intervention has been measured
by implementing MET coefficients. Researchers applied MET coefficients for each
category using the Compendium of Physical Activities Tracking Guide. More
specifically, researchers have used the following MET coefficients for their analysis:
1.5 METs for sitting, 2.3 METs for standing, 3.3 METs for walking, and 7.0 METs for
heavy labour. The criteria for choosing these coefficients was based on the
definitions fit with white-collar, office-based work.
(Q3) Is it likely that subjects received an unintended intervention
(contamination or co-intervention) that may influence the results?
1 1. Yes
2 2. No
3 3. Can’t tell
Provide your explanation: Researcher articulated all the information regarding
the type of intervention the 17 participants receive. This implied that subjects did
not receive an unintended intervention (contamination or co-intervention) that may
influence the results. In order to enhance the effectiveness of the quality of
research study, it is important for the researcher to provide all the information
regarding the type of intervention they will get during the research study. This is to
gain their trust and motivation. Thus, in the following research, researchers didn't
used any uninitiated interventions.
H) ANALYSES
(Q1) Indicate the unit of allocation (circle one)
community / a group of people / individual or patient
(Q2) Indicate the unit of analysis (circle one)
community / a group of people / individual or patient
6
Provide your explanation to Q1 & Q2: The researchers in order to accomplish
the aim and objective of the study, researcher have launched a field based
randomised control trial. To assess the effectiveness of WHWI, researchers have
analysed Tasmania police force employees across several metropolitans. In this
way they were able to identified 460 employees who mainly do their work on desk
and less participate in any physical activity. Out of 460 desk based employees, 34
volunteered for the intervention of e-health application. In this context, researcher
have divided the group in equal number. In the research study, the researcher
selected a sample of 34 employees from 460 working at Tasmania Police across
different metropolitan sectors. In Q1 it was asked to indicate the unit of allocation.
The response was group of people. A group of 34 employees has been selected in
order to conduct research analysis. In Q2 it was asked to indicate the unit of

analysis. Researcher selected group of people in order to implement the exposure
of interests and interventions. 17 participants of intervention group and 17
participants of control group were made. No intervention has been provided to
control group in order to compare there health status with intervention group ones.
Whereas as 17 participants of intervention group has been provided with
intervention.
(Q3) Are the statistical methods appropriate for the study design? [Please
attempt to answer this question within your current knowledge of
statistics. You may wish to state the limitations of your knowledge]
1 1. Yes
2 2. No
3 3. Can’t tell
Provide your explanation: Researchers used descriptive statistics for three
workplace behaviour categories. Cronbach's alpha coefficient was calculated to
report the reliability of the data set. As the study was quantitative, it is important
for researchers to use appropriate statistical tools and methodologies. Mixed
ANOVA has been used to determine significant differences on the dependent
variable using critical alpha level of 0.05.
(Q4) Is the analysis performed by intervention allocation status (i.e.
intention to treat) rather than the actual intervention received?
1 1. Yes
2 2. No
3 3. Can’t tell
4
Provide your explanation: Researcher has performed the analysis with an
intention to treat actually. Employees who spent most of their time in front of
computers or desk tends to suffer with different types of diseases or weakness. In
this context they provided the specific software to the 17 participant of the study
and analyse the benefits of doing physical activities during offices hours on their
energy level. The results were in favour as there has been significant difference
between those who tends to do physical activities in office and those who didn't.
GLOBAL RATING
COMPONENT RATINGS
Please transcribe the information from the grey boxes on pages 1-4 onto this page.
See dictionary on how to rate this section.
A SELECTION BIAS STRONG MODERATE WEAK
1 2 3
B STUDY DESIGN STRONG MODERATE WEAK
1 2 3
C CONFOUNDERS STRONG MODERATE WEAK
1 2 3

D BLINDING STRONG MODERATE WEAK
1 2 3
E DATA COLLECTION
METHOD
STRONG MODERATE WEAK
1 2 3
F WITHDRAWALS AND
DROPOUTS
STRONG MODERATE WEAK
1 2 3 Not Applicable
CIISR.Ni92688
GLOBAL RATING FOR THIS PAPER (circle one):
1 STRONG (no WEAK ratings)
2 MODERATE (one WEAK rating)
3 WEAK (two or more WEAK ratings)