Impact of Sit-to-Stand and Treadmill Desks on Patterns of Daily Waking Physical Behaviors Among Overweight and Obese Seated Office Workers: Cluster Randomized Controlled Trial

Background Sit-to-stand and treadmill desks may help sedentary office workers meet the physical activity guideline to “move more and sit less,” but little is known about their long-term impact on altering the accumulation patterns of physical behaviors. Objective This study explores the impact of sit-to-stand and treadmill desks on physical behavior accumulation patterns during a 12-month multicomponent intervention with an intent-to-treat design in overweight and obese seated office workers. Methods In total, 66 office workers were cluster randomized into a seated desk control (n=21, 32%; 8 clusters), sit-to-stand desk (n=23, 35%; 9 clusters), or treadmill desk (n=22, 33%; 7 clusters) group. Participants wore an activPAL (PAL Technologies Ltd) accelerometer for 7 days at baseline, 3-month follow-up (M3), 6-month follow-up (M6), and 12-month follow-up (M12) and received periodic feedback on their physical behaviors. Analyses of physical behavior patterns included total day and workday number of sedentary, standing, and stepping bouts categorized into durations ranging from 1 to 60 and >60 minutes and usual sedentary, standing, and stepping bout durations. Intervention trends were analyzed using random-intercept mixed linear models accounting for repeated measures and clustering effects. Results The treadmill desk group favored prolonged sedentary bouts (>60 min), whereas the sit-to-stand desk group accrued more short-duration sedentary bouts (<20 min). Therefore, compared with controls, sit-to-stand desk users had shorter usual sedentary bout durations short-term (total day ΔM3: −10.1 min/bout, 95% CI −17.9 to −2.2; P=.01; workday ΔM3: −20.3 min/bout, 95% CI −37.7 to −2.9; P=.02), whereas treadmill desk users had longer usual sedentary bout durations long-term (total day ΔM12: 9.0 min/bout, 95% CI 1.6-16.4; P=.02). The treadmill desk group favored prolonged standing bouts (30-60 min and >60 min), whereas the sit-to-stand desk group accrued more short-duration standing bouts (<20 min). As such, relative to controls, treadmill desk users had longer usual standing bout durations short-term (total day ΔM3: 6.9 min/bout, 95% CI 2.5-11.4; P=.002; workday ΔM3: 8.9 min/bout, 95% CI 2.1-15.7; P=.01) and sustained this long-term (total day ΔM12: 4.5 min/bout, 95% CI 0.7-8.4; P=.02; workday ΔM12: 5.8 min/bout, 95% CI 0.9-10.6; P=.02), whereas sit-to-stand desk users showed this trend only in the long-term (total day ΔM12: 4.2 min/bout, 95% CI 0.1-8.3; P=.046). The treadmill desk group accumulated more stepping bouts across various bins of duration (5-50 min), primarily at M3. Thus, treadmill desk users had longer usual stepping bout durations in the short-term compared with controls (workday ΔM3: 4.8 min/bout, 95% CI 1.3-8.3; P=.007) and in the short- and long-term compared with sit-to-stand desk users (workday ΔM3: 4.7 min/bout, 95% CI 1.6-7.8; P=.003; workday ΔM12: 3.0 min/bout, 95% CI 0.1-5.9; P=.04). Conclusions Sit-to-stand desks exerted potentially more favorable physical behavior accumulation patterns than treadmill desks. Future active workstation trials should consider strategies to promote more frequent long-term movement bouts and dissuade prolonged static postural fixity. Trial Registration ClinicalTrials.gov NCT02376504; https://clinicaltrials.gov/ct2/show/NCT02376504

Identify the mode of delivery. Preferably use "web-based" and/or "mobile" and/or "electronic game" in the title. Avoid ambiguous terms like "online", "virtual", "interactive". Use "Internet-based" only if Intervention includes non-web-based Internet components (e.g. email), use "computer-based" or "electronic" only if o ine products are used. Use "virtual" only in the context of "virtual reality" (3-D worlds). Use "online" only in the context of "online support groups". Complement or substitute product names with broader terms for the class of products (such as "mobile" or "smart phone" instead of "iphone"), especially if the application runs on different platforms.
Does your paper address subitem 1a-i? * Copy and paste relevant sections from manuscript title (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 1a-i is not applicable to our study, as our intervention was not web-, mobile-nor computer-based, but rather focused on the installation of new technologies (sit-to-stand and treadmill desks) as an environmental intervention to reduce sedentary behavior at the workplace.

1a-ii) Non-web-based components or important co-interventions in title
Mention non-web-based components or important co-interventions in title, if any (e.g., "with telephone support"). Does your paper address subitem 1a-ii?
Copy and paste relevant sections from manuscript title (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study "Impact of a Sit-to-Stand and Treadmill Desk" 1a-iii) Primary condition or target group in the title Mention primary condition or target group in the title, if any (e.g., "for children with Type I Diabetes") Example: A Web-based and Mobile Intervention with Telephone Support for Children with Type I Diabetes: Randomized Controlled Trial Does your paper address subitem 1a-iii? * Copy and paste relevant sections from manuscript title (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study "Among Overweight and Obese Seated Office Workers" Does your paper address subitem 1b-i? * Copy and paste relevant sections from the manuscript abstract (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In the abstract we stated that this is a "multi-component intervention", which was described in detail within the method's "Intervention" subsection of the manuscript. We also denoted the comparator by stating: "Sixty-six office workers were cluster-randomized into a seateddesk control (n = 21; 8 clusters), sit-to-stand desk (n = 23; 9 clusters), or treadmill desk (n = 22; 7 clusters) group."

1b-ii) Level of human involvement in the METHODS section of the ABSTRACT
Clarify the level of human involvement in the abstract, e.g., use phrases like "fully automated" vs. "therapist/nurse/care provider/physician-assisted" (mention number and expertise of providers involved, if any). (Note: Only report in the abstract what the main paper is reporting. If this information is missing from the main body of text, consider adding it) subitem not at all important 1 2 3 4 5 essential Does your paper address subitem 1b-ii?
Copy and paste relevant sections from the manuscript abstract (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study This is not applicable to the main component of the intervention, which consisted of an environmental modification in the workplace, but we stated that this component of the intervention was supplemented with participants receiving "periodic feedback on their physical behaviors". Does your paper address subitem 1b-iii?
Copy and paste relevant sections from the manuscript abstract (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study For conciseness in the abstract we stated that this is a "multicomponent intervention" to point readers to the detailed methods where we stated: "Enrolled participants received initial face-to-face counseling sessions on the benefits of sitting less, standing and moving more. Supervisors of those participants in the treadmill and sit-to-stand desk groups received initial on-site training on the benefits of decreasing sedentary behavior in the workplace and on strategies to encourage participant engagement in the intervention, which they did so at regular department meetings. Participant counseling and supervisor trainings were repeated every three months for the treadmill and sit-to-stand desk groups, and these participants were also given feedback on their measured physical behaviors (described below) during these sessions. " 1b-iv) RESULTS section in abstract must contain use data Report number of participants enrolled/assessed in each group, the use/uptake of the intervention (e.g., attrition/adherence metrics, use over time, number of logins etc.), in addition to primary/secondary outcomes. (Note: Only report in the abstract what the main paper is reporting. If this information is missing from the main body of text, consider adding it) Does your paper address subitem 1b-iv?
Copy and paste relevant sections from the manuscript abstract (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study For conciseness, we chose to report the initial enrollment for each study arm in the abstract, but left attrition and adherence metrics to the manuscript and supplementary materials as there was too much data to report on these metrics given that our study design consisted of three follow-ups over a year.

1b-v) CONCLUSIONS/DISCUSSION in abstract for negative trials
Conclusions/Discussions in abstract for negative trials: Discuss the primary outcome -if the trial is negative (primary outcome not changed), and the intervention was not used, discuss whether negative results are attributable to lack of uptake and discuss reasons. Does your paper address subitem 1b-v?
Copy and paste relevant sections from the manuscript abstract (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study While the negative primary outcome of the trial (null findings on total-daily sedentary behavior change) was not the outcome of interest for this study, we stated adverse effects specific to this study in our abstract. In reporting these adverse effects, we stated: "the treadmill group favored prolonged standing bouts (30-60 min and >60 min)" and concluded that "Sit-to-stand desks exerted potentially more favorable physical behavior accumulation patterns than treadmill desks. Future active-workstation trials should consider strategies to promote more frequent long-term movement bouts and dissuade prolonged static postural fixity."

2a-i) Problem and the type of system/solution
Describe the problem and the type of system/solution that is object of the study: intended as stand-alone intervention vs. incorporated in broader health care program? Intended for a particular patient population? Goals of the intervention, e.g., being more cost-effective to other interventions, replace or complement other solutions? (Note: Details about the intervention are provided in "Methods" under 5) subitem not at all important 1 2 3 4 5 essential Does your paper address subitem 2a-i? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study The problem and proposed solution we tested in this trial are addressed with the following statements in the introduction: i) " The workplace is considered to be a priority setting to reduce sedentary behavior [7] because a substantial proportion of the workforce is employed in full-time seated desk jobs [8-10]. Treadmill and sit-to-stand desks have gained popularity as alternatives to traditional seated workstations to promote interruptions in workplace sitting. A better understanding of how these desks alter the accumulation of physical behaviors among sedentary office workers may be useful to develop effective strategies to "move more and sit less" [6]." ii) ii) " little experimental evidence exists on the impact of treadmill and sit-to-stand desks on the daily transitional balance between time spent in static postures (i.e., sitting and standing) versus stepping. Such evidence may be useful in tackling the public health challenge of promoting sitting less and moving more often in at risk populations." 2a-ii) Scientific background, rationale: What is known about the (type of) system Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study After setting up the background for the research question, our introduction addressed the rational for the study by stating that i) " little experimental evidence exists on the impact of treadmill and sit-to-stand desks on the daily transitional balance between time spent in static postures (i.e., sitting and standing) versus stepping." and ii) "Most treadmill and sitstand desk studies, to date, report effects on overall volume of time spent in waking physical behaviors with minimal information on the pattern of accumulating behavioral bouts." Does your paper address CONSORT subitem 2b? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Our introduction stated specific objectives of our study in the sub-section titled "Objectives of this Study".
3b) Important changes to methods after trial commencement (such as eligibility criteria), with reasons subitem not at all important 1 2 3 4 5 essential Does your paper address CONSORT subitem 3a? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 3a was addressed in the methods of our study where we stated: "Data presented in this study is from a 12-month three-arm cluster-randomized controlled trial".
Does your paper address CONSORT subitem 3b? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We had no protocol deviations to report.

3b-i) Bug fixes, Downtimes, Content Changes
Bug xes, Downtimes, Content Changes: ehealth systems are often dynamic systems. A description of changes to methods therefore also includes important changes made on the intervention or comparator during the trial (e.g., major bug xes or changes in the functionality or content) (5-iii) and other "unexpected events" that may have in uenced study design such as staff changes, system failures/downtimes, etc. [2].

4a) Eligibility criteria for participants
Does your paper address subitem 3b-i?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 3b-i is not relevant to our study.
Does your paper address CONSORT subitem 4a? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Eligibility criteria were stated in the "Setting and Participants" subsection of our methods: "Employees within these clusters were initially considered eligible if they were employed in a full-time seated-desk job, were between 18 and 65 years of age, had a body mass index greater than 25 kg/m2, did not engage in any structured physical activity on more than two days/week, and were free of limitations that prevented walking and standing in bouts lasting 40 to 60 min. An additional criterion for women was that they were not pregnant nor planning to become pregnant in the next year. Subjects were also screened for hypertension, diabetes, cardiovascular disease, and musculoskeletal conditions (i.e., joint, bone or muscle conditions) using a medical history questionnaire at baseline."

4a-i) Computer / Internet literacy
Computer / Internet literacy is often an implicit "de facto" eligibility criterion -this should be explicitly clari ed.
Does your paper address subitem 4a-i?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 4a-i is not relevant to our study.
4a-ii) Open vs. closed, web-based vs. face-to-face assessments: Open vs. closed, web-based vs. face-to-face assessments: Mention how participants were recruited (online vs. o ine), e.g., from an open access website or from a clinic, and clarify if this was a purely web-based trial, or there were face-to-face components (as part of the intervention or for assessment), i.e., to what degree got the study team to know the participant. In online-only trials, clarify if participants were quasi-anonymous and whether having multiple identities was possible or whether technical or logistical measures (e.g., cookies, email con rmation, phone calls) were used to detect/prevent these.
Does your paper address subitem 4a-ii? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Recruitment and enrollment specifications relevant to subitem 4a-ii were stated in the following sections of our supplementary "Detailed Protocol": Section III-b "Source of subjects and Recruitment methods", Section IV-a "Methods of enrollment, including procedures for patient registration and/or randomization", and section IV-b "Procedures for obtaining informed consent (including timing of consent process)".
In addition, in our manuscript we indicated the "face-to-face" components of our intervention relevant to this study by stating: "Enrolled individuals received initial face-toface counseling sessions on the benefits of sitting less, standing and moving more. Supervisors of those participants in the treadmill and sit-to-stand desk groups received initial on-site training on the benefits of decreasing sedentary behavior in the workplace and on strategies to encourage participant engagement in the intervention, which they did so at regular department meetings. Participant counseling and supervisor trainings were repeated every three months for the treadmill and sit-to-stand desk groups, and these participants were also given feedback on their measured physical behaviors (described below) during these sessions.
"Finally, in section V-b of our supplementary "Detailed Protocol" we delineated measures of the trial that were performed on on-site face-to-face with study personnel versus at home by stating "The participant will complete measures 1 to 5 in a lab and measures 6 to 8 at home within 1-week of completing the former. Several of these measures will be recorded on a hard-copy data collection sheet." subitem not at all important 1 2 3 4 5 essential 4b) Settings and locations where the data were collected 4a-iii) Information giving during recruitment Information given during recruitment. Specify how participants were briefed for recruitment and in the informed consent procedures (e.g., publish the informed consent documentation as appendix, see also item X26), as this information may have an effect on user self-selection, user expectation and may also bias results.
Does your paper address subitem 4a-iii?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 4a-iii is addressed in our the supplementary "Detailed Protocol" under "b) Procedures for obtaining informed consent (including timing of consent process)".
Does your paper address CONSORT subitem 4b? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We stated the setting of the intervention in the manuscript ("Sixty-six office-workers were recruited in clusters from The Massachusetts General Hospital and Northeastern University in Boston, MA") and described the details of the setting for recruitment in the "detailed protocol" supplement. 4b-i) Report if outcomes were (self-)assessed through online questionnaires Clearly report if outcomes were (self-)assessed through online questionnaires (as common in web-based trials) or otherwise.
Does your paper address subitem 4b-i? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study While the questionnaire-based self-assessments used in this trial were not relevant to this particular study, we stated in the "Detailed Protocol" that "items 6) Affect and stress, 7) Musculoskeletal discomfort symptoms, and 8) Dietary Intake were measured at home via questionnaire."

4b-ii) Report how institutional affiliations are displayed
Report how institutional a liations are displayed to potential participants [on ehealth media], as a liations with prestigious hospitals or universities may affect volunteer rates, use, and reactions with regards to an intervention.(Not a required item -describe only if this may bias results) 5) The interventions for each group with sufficient details to allow replication, including how and when they were actually administered subitem not at all important 1 2 3 4 5 essential Does your paper address subitem 4b-ii?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study The authors have no conflicts of interest to disclose.

5-i) Mention names, credential, affiliations of the developers, sponsors, and owners
Mention names, credential, a liations of the developers, sponsors, and owners [6] (if authors/evaluators are owners or developer of the software, this needs to be declared in a "Con ict of interest" section or mentioned elsewhere in the manuscript).

Does your paper address subitem 5-i?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In our manuscript we mentioned the developers of the technology we used in our intervention by stating: "The height-adjustable desks used in this study were the WorkFit-D from Ergotron® Inc. For the treadmill desk group, a WorkFit-D desk was retrofitted with a treadmill (TR1200 DT-3, LifeSpan Fitness Inc.) for each participant." subitem not at all important 1 2 3 4 5 essential 5-ii) Describe the history/development process Describe the history/development process of the application and previous formative evaluations (e.g., focus groups, usability testing), as these will have an impact on adoption/use rates and help with interpreting results.
Does your paper address subitem 5-ii?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In our manuscript we described the source of instruction we provided participants on the proper use of the sit-to-stand and treadmill desks we installed where we stated: "Prior to using the desks, participants were trained on appropriate ergonomic postures while standing and sitting at the height-adjustable desk and were instructed on gradually acclimating to standing and walking while working.

5-iii) Revisions and updating
Revisions and updating. Clearly mention the date and/or version number of the application/intervention (and comparator, if applicable) evaluated, or describe whether the intervention underwent major changes during the evaluation process, or whether the development and/or content was "frozen" during the trial. Describe dynamic components such as news feeds or changing content which may have an impact on the replicability of the intervention (for unexpected events see item 3b).

Does your paper address subitem 5-iii?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study The trial was funded from National Institute for Occupational Safety and Health under contract award number 1R21OH010564-01. The intervention did not undergo major changes following approval from the funding agency and was carried out as originally designed in the application.

5-iv) Quality assurance methods
Provide information on quality assurance methods to ensure accuracy and quality of information provided [1], if applicable. Does your paper address subitem 5-iv?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 5-iv was addressed in section IX) "Monitoring and Quality Assurance" of our "Detailed Protocol" under subsections: "a) Independent monitoring of source data", "b) Safety monitoring", "c) Outcomes monitoring", and "d) Adverse event reporting guidelines".

5-v)
Ensure replicability by publishing the source code, and/or providing screenshots/screen-capture video, and/or providing flowcharts of the algorithms used Ensure replicability by publishing the source code, and/or providing screenshots/screencapture video, and/or providing owcharts of the algorithms used. Replicability (i.e., other researchers should in principle be able to replicate the study) is a hallmark of scienti c reporting.

Does your paper address subitem 5-v?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 5-v is not relevant to our study.

5-vi) Digital preservation
Digital preservation: Provide the URL of the application, but as the intervention is likely to change or disappear over the course of the years; also make sure the intervention is archived (Internet Archive, webcitation.org, and/or publishing the source code or screenshots/videos alongside the article). As pages behind login screens cannot be archived, consider creating demo pages which are accessible without login.

Does your paper address subitem 5-vi?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 5-vi is not relevant to our study.

5-vii) Access
Access: Describe how participants accessed the application, in what setting/context, if they had to pay (or were paid) or not, whether they had to be a member of speci c group. If known, describe how participants obtained "access to the platform and Internet" [1]. To ensure access for editors/reviewers/readers, consider to provide a "backdoor" login account or demo mode for reviewers/readers to explore the application (also important for archiving purposes, see vi). Does your paper address subitem 5-viii? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study The theoretical framework of our trial was addressed in the methods section of our manuscript where we stated: "This was a multicomponent intervention to decrease sedentary behavior in the workplace and comprised of organizational-, environmental-, and individual-level strategies to target behavior change at both the individual and cluster levels [22]. " In addition, we stated the how participant tracked their progress and received feedback when we stated: "Participant counseling and supervisor trainings were repeated every three months for the treadmill and sit-to-stand desk groups, and these participants were also given feedback on their measured physical behaviors (described below) during these sessions."

5-ix) Describe use parameters
Describe use parameters (e.g., intended "doses" and optimal timing for use). Clarify what instructions or recommendations were given to the user, e.g., regarding timing, frequency, heaviness of use, if any, or was the intervention used ad libitum. Does your paper address subitem 5-ix?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We stated the use parameters of the sit-to-stand and treadmill workstations in the methods section of our manuscript: " Both treadmill and sit-to-stand desk workers were recommended to replace at least 3 hours of daily sedentary time with upright behaviors (i.e., three hours of standing/day in bouts of 10-30 min after acclimation for sit-to-stand desk participants, and two hours of walking/day and one hour of standing/day in bouts of 10-30 min after acclimation for treadmill desk participants

5-x) Clarify the level of human involvement
Clarify the level of human involvement (care providers or health professionals, also technical assistance) in the e-intervention or as co-intervention (detail number and expertise of professionals involved, if any, as well as "type of assistance offered, the timing and frequency of the support, how it is initiated, and the medium by which the assistance is delivered". It may be necessary to distinguish between the level of human involvement required for the trial, and the level of human involvement required for a routine application outside of a RCT setting (discuss under item 21 -generalizability). Does your paper address subitem 5-x?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In our manuscript we described how participant in our treatment arm received organization support to reduce sedentary behavior when we stated: "Supervisors of those participants in the treadmill and sit-to-stand desk groups received initial on-site training on the benefits of decreasing sedentary behavior in the workplace and on strategies to encourage participant engagement in the intervention, which they did so at regular department meetings."

5-xi) Report any prompts/reminders used
Report any prompts/reminders used: Clarify if there were prompts (letters, emails, phone calls, SMS) to use the application, what triggered them, frequency etc. It may be necessary to distinguish between the level of prompts/reminders required for the trial, and the level of prompts/reminders for a routine application outside of a RCT setting (discuss under item 21 -generalizability).
Does your paper address subitem 5-xi? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 5-xi is not relevant to our study. Does your paper address subitem 5-xii? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We described training for organizational, individual and environmental components of our trial in the methods section where we stated: "Enrolled individuals received initial face-to-face counseling sessions on the benefits of sitting less, standing and moving more. Supervisors of those participants in the treadmill and sit-to-stand desk groups received initial on-site training on the benefits of decreasing sedentary behavior in the workplace and on strategies to encourage participant engagement in the intervention, which they did so at regular department meetings. Participant counseling and supervisor trainings were repeated every three months for the treadmill and sit-to-stand desk groups, and these participants were also given feedback on their measured physical behaviors (described below) during these sessions.", and "Prior to using the desks, participants were trained on appropriate ergonomic postures while standing and sitting at the height-adjustable desk and were instructed on gradually acclimating to standing and walking while working." 6a) Completely defined pre-specified primary and secondary outcome measures, including how and when they were assessed subitem not at all important 1 2 3 4 5 essential Does your paper address CONSORT subitem 6a? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Our study focused on secondary exploratory outcomes and we made this point in our manuscript when we stated: " The sample size of 66 equally distributed over three study arms was based on conservative power estimates of the change in the trial's primary outcome of total daily sedentary behavior accounting for a potential loss to follow-up. Details of our power and sample size estimation have been reported previously [22] and are also available in the supplemental "Detailed Protocol"., and "Since our outcomes are exploratory, we present post hoc determination of treatment-response trends for behavior change models indicated by unidirectional 95% confidence intervals, which do not overlap the null value. 6a-ii) Describe whether and how "use" (including intensity of use/dosage) was defined/measured/monitored Describe whether and how "use" (including intensity of use/dosage) was de ned/measured/monitored (logins, log le analysis, etc.). Use/adoption metrics are important process outcomes that should be reported in any ehealth trial.
subitem not at all important 1 2 3 4 5 essential Does your paper address subitem 6a-ii?
Copy and paste relevant sections from manuscript text Sub item 6a-ii) was addressed in the manuscript methods and "detailed protocol" describing the activity monitor protocol used to measure resultant physical behaviors from workstation use and time in the workplace.
"Assessments included activity monitoring (activPALTM 3C, PAL Technologies Ltd., Glasgow, UK; 7 days on right thigh during waking hours) that occurred at baseline and after 3, 6 and 12 months. In our results we use the following abbreviations: M3 = month-3 follow-up, M6= month-6 follow-up, and M12= month-12 follow-up." "Activity monitoring: This measurement will be conducted for a period of 1 week. Participants will be asked to wear 2 small activity monitors (53 x 35 x 7 mm, weight=15 grams), one on the right thigh and the other on the torso (chest or abdomen). The device will be attached to the skin using medical grade, hypoallergenic tape or soft elastic bands. We will measure time spent at work and outside the workplace for one week using radio frequency identification technology (RFID). A thin RFID sticker tag (120 mm x 44 mm x 0.4 mm) will be wrapped around the activity monitor on the torso. This will record every time a participant enters and leaves their place of work on an RFID reader installed in the building. During this 1-week period, participants will record the times they wore and removed the monitors and the times they arrived and left their workplace. Based on the data collected using these devices, participants will be provided with retrospective feedback every 3 months on their activity behavior. " 6a-iii) Describe whether, how, and when qualitative feedback from participants was obtained Describe whether, how, and when qualitative feedback from participants was obtained (e.g., through emails, feedback forms, interviews, focus groups).
6b) Any changes to trial outcomes after the trial commenced, with reasons 7a) How sample size was determined NPT: When applicable, details of whether and how the clustering by care provides or centers was addressed Does your paper address subitem 6a-iii?
Copy and paste relevant sections from manuscript text Qualitative feedback was not obtained from participants.
Does your paper address CONSORT subitem 6b? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study There were no major outcome changes to the trial after commencement. Our exploration of physical behavior patterns is a post-study response to a new public health initiative to promote strategies for at risk populations to "move more and sit less", which the a priori "sedentary behavior" volume metric was unable to fully capture. Henceforth, sensor data collected for the primary objective was examined with greater granularity to answer exploratory research questions relevant to new public health guidelines not available at the time of the study. subitem not at all important 1 2 3 4 5 essential 7b) When applicable, explanation of any interim analyses and stopping guidelines 7a-i) Describe whether and how expected attrition was taken into account when calculating the sample size Describe whether and how expected attrition was taken into account when calculating the sample size.

Does your paper address subitem 7a-i?
Copy and paste relevant sections from manuscript title (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In the "detailed protocol" we stated: "c) Power analyses Sample size calculations are based on body weight change among participants (N=12) in our preliminary study.11 Our current study will have 22 participants in each of the three study arms. This will provide sufficient power to detect an effect size of 0.89 between each of the groups where the effect size = Δ/s (Δ: mean difference between two groups; s: common standard deviation). A standard deviation of 3.9 kg for weight observed in our pilot study corresponds to a mean detectable difference of 3.5 kg between groups. Although we anticipate minimal clustering within the departments at the study site, the power estimates presented above are based on an effective sample size of 60 subjects reflecting an intraclass correlation coefficient of 0.01. Comparisons between the most effective intervention and the control group will have substantially greater power reflecting larger differences in mean measurements." 8a) Method used to generate the random allocation sequence NPT: When applicable, how care providers were allocated to each trial group Does your paper address CONSORT subitem 7b? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In the "detailed protocol" we specified stopping guidelines: "b) Safety monitoring A trained research staff member will meet with study participants twice a month and examine workstation function and set up. The staff member will also directly enquire if participants have any concerns regarding being part of the study. The participant can terminate participation in this study at any time if they do not wish to continue being a part of the study. There are no specific rules for stopping the study other than the occurrence of an adverse event." Does your paper address CONSORT subitem 8a? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In the "detailed protocol" we stated: "c) Treatment assignment and randomization We will do a cluster randomization of various departments mentioned above into the control and 2 intervention groups. If employees from a department express interest in the study, the department will be cluster randomized into either the treadmill workstation, sit-stand workstation, or control group. Twenty-two volunteers will be randomly selected from each department group. In the event of insufficient volunteers in a group, the project manager will approach other departments within the hospital to solicit study participation." 8b) Type of randomisation; details of any restriction (such as blocking and block size) 9) Mechanism used to implement the random allocation sequence (such as sequentially numbered containers), describing any steps taken to conceal the sequence until interventions were assigned 10) Who generated the random allocation sequence, who enrolled participants, and who assigned participants to interventions Does your paper address CONSORT subitem 8b? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Yes, we stated that our design was a "cluster-randomization".
Does your paper address CONSORT subitem 9? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Randomization followed informed consent, there was no blinding to treatment allocation prior to baseline assessments. We specified the sequence of randomization in the "detailed protocol": "If employees from a department express interest in the study, the department will be cluster randomized into either the treadmill workstation, sit-stand workstation, or control group after completing informed consent procedures." 11a) If done, who was blinded after assignment to interventions (for example, participants, care providers, those assessing outcomes) and how NPT: Whether or not administering co-interventions were blinded to group assignment subitem not at all important 1 2 3 4 5 essential Does your paper address CONSORT subitem 10? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Enrollment, randomization, and assignment to treatment arms were all carried out by the same study manager. We describe this process in the detailed protocol sections: "a) Methods of enrollment, including procedures for patient registration and/or randomization", "b) Procedures for obtaining informed consent (including timing of consent process)", and "c) Treatment assignment and randomization".
11a-i) Specify who was blinded, and who wasn't Specify who was blinded, and who wasn't. Usually, in web-based trials it is not possible to blind the participants [1, 3] (this should be clearly acknowledged), but it may be possible to blind outcome assessors, those doing data analysis or those administering cointerventions (if any).
Does your paper address subitem 11a-i? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 11a-i) is not applicable to this study as this trial did not have a double-blind design. 11a-ii) Discuss e.g., whether participants knew which intervention was the "intervention of interest" and which one was the "comparator" Informed consent procedures (4a-ii) can create biases and certain expectations -discuss e.g., whether participants knew which intervention was the "intervention of interest" and which one was the "comparator".

Does your paper address subitem 11a-ii?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Participants were aware that the comparator was their usual "seated-desk" condition and that the interventions of interest were the "sit-to-stand" and "treadmill desks".
Does your paper address CONSORT subitem 11b? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 11b is not relevant to our trial.
12a) Statistical methods used to compare groups for primary and secondary outcomes NPT: When applicable, details of whether and how the clustering by care providers or centers was addressed subitem not at all important 1 2 3 4 5 essential Does your paper address CONSORT subitem 12a? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In our manuscript we stated: i) "Cluster effects for all outcomes were tested by calculating the intraclass correlation coefficients (ICCs) and their statistical significance (P <.05). " and ii) "The cluster effect did not significantly (all, P >.05) account for the variability in any of the outcome variables (Supplemental Table 2). "

12a-i) Imputation techniques to deal with attrition / missing values
Imputation techniques to deal with attrition / missing values: Not all participants will use the intervention/comparator as intended and attrition is typically high in ehealth trials. Specify how participants who did not use the application or dropped out from the trial were treated in the statistical analysis (a complete case analysis is strongly discouraged, and simple imputation techniques such as LOCF may also be problematic [4]). Does your paper address subitem 12a-i? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In our manuscript we stated: " Losses to follow-up were handled as intent-to-treat and missing data attributable to unsystematic factors (e.g., monitor malfunction, sickness, improper device placement, forgetfulness to wear devices and/or log work hours, etc.) were imputed using joint multiple imputation [46,47]." Does your paper address CONSORT subitem 12b? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study "Additionally, sensitivity analyses included participants who completed the one-year intervention [n's: total-day = 42 (13 controls, 13 sit-to-stand desks and 16 treadmill desks); workday = 35 (10 controls, 12 sit-to-stand desks and 13 treadmill desks)]. These analyses were conducted for all outcomes to determine if the overall treatment-response trends of the two interventions were altered when examining an ideal, but less conservative scenario of complete intervention compliance and to evaluate the sensitivity of the results to the handling of missing data and covariate adjustment [49]. "

Does your paper address subitem X26-ii?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We described these procedures in our "detailed protocol" under "b) Procedures for obtaining informed consent (including timing of consent process)".

RESULTS
13a) For each group, the numbers of participants who were randomly assigned, received intended treatment, and were analysed for the primary outcome NPT: The number of care providers or centers performing the intervention in each group and the number of patients treated by each care provider in each center

X26-iii) Safety and security procedures
Safety and security procedures, incl. privacy considerations, and any steps taken to reduce the likelihood or detection of harm (e.g., education and training, availability of a hotline) Does your paper address subitem X26-iii?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We described our workstation use safety protocols in the "detailed protocol" subsection "b) Safety monitoring".
13b) For each group, losses and exclusions after randomisation, together with reasons subitem not at all important 1 2 3 4 5 essential Does your paper address CONSORT subitem 13a? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study "Sixty-six office workers were cluster-randomized into a seated-desk control (n = 21; 8 clusters), sit-to-stand desk (n = 23; 9 clusters), or treadmill desk (n = 22; 7 clusters) group." Supplemental Figures 1 and 2 show the N that were analyzed from these randomized groups at each follow-up point.
Does your paper address CONSORT subitem 13b? (NOTE: Preferably, this is shown in a CONSORT flow diagram) * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We presented consort flow diagrams in Supplemental Figures 1 and 2.

13b-i) Attrition diagram
Strongly recommended: An attrition diagram (e.g., proportion of participants still logging in or using the intervention/comparator in each group plotted over time, similar to a survival curve) or other gures or tables demonstrating usage/dose/engagement.

14a) Dates defining the periods of recruitment and follow-up
subitem not at all important 1 2 3 4 5 essential Does your paper address subitem 13b-i?
Copy and paste relevant sections from the manuscript or cite the gure number if applicable (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We presented attrition diagrams in Supplemental Figures 1 and 2. Does your paper address CONSORT subitem 14a? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In the methods section of our manuscript we stated: " Data analyzed in this study is from a 12-month three-arm cluster-randomized controlled trial titled 'Modifying the Workplace to Decrease Sedentary Behavior and Improve Health' (ClinicalTrials.gov ID No.: NCT02376504) conducted between March of 2014 and December 2016."

14a-i) Indicate if critical "secular events" fell into the study period
Indicate if critical "secular events" fell into the study period, e.g., signi cant changes in Internet resources available or "changes in computer hardware or Internet delivery resources" 14b) Why the trial ended or was stopped (early) 15) A table showing baseline demographic and clinical characteristics for each group NPT: When applicable, a description of care providers (case volume, quali cation, expertise, etc.) and centers (volume) in each group Does your paper address subitem 14a-i?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 14a-i is not applicable to our study.
Does your paper address CONSORT subitem 14b? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study The trial was carried out to completion as designed. subitem not at all important 1 2 3 4 5 essential Does your paper address CONSORT subitem 15? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We present these details in our results: " The control group comprised of 20 females and one male (eight African American/Black, 12 non-Hispanic Caucasians, and one Hispanic Caucasian; age= 41.9 ± 11.5 years; BMI= 33.3 ± 5.9 kg/m2). The sit-to-stand desk group comprised of 21 females and two males (two African American/Black, 16 non-Hispanic Caucasians, three Hispanic Caucasians, one Asian, and one other race/ethnicity; age= 43.6 ± 12.2 years; BMI= 30.8 ± 6.0 kg/m2). The treadmill desk group comprised of 18 females and four males (five African Americans/Black, 15 non-Hispanic Caucasians, one Hispanic Caucasian, and one other race/ethnicity; age= 50.4 ± 12.0 years; BMI= 33.5 ± 4.9 kg/m2). Self-reporting of medical history showed a prior or current history of hypertension in 11 participants (eight sit-tostand desk, two treadmill desk and one control), diabetes in five participants (three sit-tostand desk and two treadmill desk), cardiovascular disease in two participants (two treadmill desk), and musculoskeletal conditions in 24 participants (six sit-to-stand desk, nine treadmill desk and nine controls)."

15-i) Report demographics associated with digital divide issues
In ehealth trials it is particularly important to report demographics associated with digital divide issues, such as age, education, gender, social-economic status, computer/Internet/ehealth literacy of the participants, if known.

16) For each group, number of participants (denominator) included in each analysis and whether the analysis was by original assigned groups
subitem not at all important 1 2 3 4 5 essential Does your paper address subitem 15-i? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 15-i is not applicable to our trial.

16-i) Report multiple "denominators" and provide definitions
Report multiple "denominators" and provide de nitions: Report N's (and effect sizes) "across a range of study participation [and use] thresholds" [1], e.g., N exposed, N consented, N used more than x times, N used more than y weeks, N participants "used" the intervention/comparator at speci c pre-de ned time points of interest (in absolute and relative numbers per group). Always clearly de ne "use" of the intervention.
Does your paper address subitem 16-i? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In our manuscript we reported N's for the primary analyses and sensitivity analysis, which had a different N (i.e., complete-case analyses).

16-ii) Primary analysis should be intent-to-treat
Primary analysis should be intent-to-treat, secondary analyses could include comparing only "users", with the appropriate caveats that this is no longer a randomized sample (see 18-i).
Does your paper address subitem 16-ii?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study In our methods we stated: "Losses to follow-up were handled as intent-to-treat".

17a-i) Presentation of process outcomes such as metrics of use and intensity of use
In addition to primary/secondary (clinical) outcomes, the presentation of process outcomes such as metrics of use and intensity of use (dose, exposure) and their operational de nitions is critical. This does not only refer to metrics of attrition (13-b) (often a binary variable), but also to more continuous exposure metrics such as "average session length". These must be accompanied by a technical description how a metric like a "session" is de ned (e.g., timeout after idle time) [1] (report under item 6a).
17b) For binary outcomes, presentation of both absolute and relative effect sizes is recommended 18) Results of any other analyses performed, including subgroup analyses and adjusted analyses, distinguishing pre-specified from exploratory Does your paper address subitem 17a-i?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Item 17a-i is not applicable to our study.
Does your paper address CONSORT subitem 17b? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We did not report binary outcomes. Does your paper address CONSORT subitem 18? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We presented a sensitivity analyses in the manuscript and described this in detail: " Additionally, sensitivity analyses included participants who completed the one-year intervention [N's: total-day = 42 (13 controls, 13 sit-to-stand desks and 16 treadmill desks); workday = 35 (10 controls, 12 sit-to-stand desks and 13 treadmill desks)]. These analyses were conducted for all outcomes to determine if the overall treatment-response trends of the two interventions were altered when examining an ideal, but less conservative scenario of complete intervention compliance and to evaluate the sensitivity of the results to the handling of missing data and covariate adjustment [49]. "

18-i) Subgroup analysis of comparing only users
A subgroup analysis of comparing only users is not uncommon in ehealth trials, but if done, it must be stressed that this is a self-selected sample and no longer an unbiased sample from a randomized trial (see 16-iii).

Does your paper address subitem 18-i?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We did not perform such sub group analysis. Does your paper address CONSORT subitem 19? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study There were no adverse events to report as a consequence of the intervention.

19-i) Include privacy breaches, technical problems
Include privacy breaches, technical problems. This does not only include physical "harm" to participants, but also incidents such as perceived or real privacy breaches Does your paper address subitem 19-i?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study There were no privacy breaches nor technical problems to report. However, we do report the observed unintended effect of treadmill desk users choosing to stand for prolonged periods of time. We discussed this in the "Standing Bout Patterns" subsection of our manuscript's discussion: "Standing Bout Patterns While the treadmill desk group engaged in more prescribed bouts (i.e., 10-30 min) relative controls after M6 and M12 both over the total-day and workday (~0.6-1.0 bout/day), an unintended response of engaging in more prolonged duration (i.e., >30 min) standing bouts was prominent among treadmill desk-users. Specifically, treadmill desk-users demonstrated trends of engaging in ~0.6-0.9 more prolonged standing bouts per day, relative to controls and sit-to-stand desk groups both over the total-day and workday after M3 and sustained after M12. On the contrary, sit-to-stand desk-users were more compliant with the intended intervention by increasing standing in prescribed bouts or shorter (i.e., 1-10 min) after M3 and sustained this after M12 both over the total-day (i.e., ~1-2 bouts/day) and workday (~3-8 bouts/day). These findings are noteworthy because prolonged static standing may be detrimental to cardiovascular health [39,40]. We are unsure as to why users of treadmill-workstations preferred to engage in a much higher number of prolonged standing bouts as compared to the sit-to-stand desk group. Post-study interviews were unable to discern a cause for such behavior. While prolonged standing was not an issue in our sit-to-stand group, future active-workstation interventions should consider more frequent reinforcing messaging to dissuade prolonged standing bouts along with messaging about avoiding prolonged sitting amongst users of both desk types."

DISCUSSION
Does your paper address subitem 19-ii?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study While we did not conduct formal qualitative evaluations of the intervention from participants, we did communicate with participants to provide them with feedback on their progress every three months. We discussed anecdotal observations the researchers had from these face-to-face check-ins to speculate as to why treadmill desk users may have chosen to stand for prolonged periods of time. We stated: "A possible explanation for the observed variability in the observed trends of sit-to-stand and treadmill desks on standing and stepping bout patterns may be the impact of the desk type on the ability to perform work. For example, when treadmill desk users were provided with feedback after M6 that they reversed positive stepping gains observed after M3, several participants in the treadmill-workstation group indicated a heavy work cycle between these two timepoints limited their ability to walk and work on the treadmill. Participants indicated that this particular work cycle required increased multitasking involving reading, writing, and typing. This reluctance to use the treadmill desk when performing office work that likely places a higher demand on cognitive function and involves multitasking coincides with prior evidence that treadmill desks may result in decreased performance of mouse proficiency, and typing and fine motor movement tasks [39,51]. Another study showed that these interventions may result in minor declines in overall work performance within the first 3-5 months that may then return to and/or exceed baseline performance within a year of use [30]. It is likely that treadmill desk-users may have failed to outlast this temporary productivity adjustment period and chose to engage in prolonged standing bouts as a compensatory behavior to decreased use of the treadmill for walking after three months in order to maintain their work productivity. Given this learning curve, future active-workstation studies should consider the types of tasks office workers regularly engage in as barriers to replacing sedentary behavior with standing and stepping appropriately. Interventionists may need to design strategies to promote positive behavior change around such bouts of work during the first few months of commencing workstations use." Does your paper address subitem 22-i? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We discussed the comparisons between results of our trial and prior work in the "Sedentary Bout Patterns" subsection of our manuscript's discussion where we stated: "Patterns of sedentary behavior bout accumulation observed in the sit-to-stand desk group were consistent with those reported in prior studies [27, 28] (i.e., sit-to-stand desk reducing prolonged sedentary bouts in relation to controls), but our study resulted in larger differences in usual sedentary bout duration relative to controls. Published findings from two cluster-randomized sit-to-stand desk trials with a follow-up of at least 12 months reported significant short-and long-term differences in workday time spent in prolonged bouts of sedentary behavior, which was defined as >30 min, favoring the intervention groups (i.e., 73 less min/workday after 3 months [28], and 35 and 45 less min/workday after 6 and 12 months, respectively in such bouts [27]). This is consistent with our finding that sit-tostand desks reduced the accumulation of prolonged sedentary bouts. One of these studies also reported significant short-term differences in the duration of workday usual sedentary bouts in sit-to-stand desk users relative to controls (i.e., -4.4 min) [28], which is consistent with but shorter than the duration found in our study, which was -20.3 min.
Our study is the first to report the impact of treadmill desks on both the distribution of sedentary bouts across temporal categories and usual sedentary bout duration, as well as a head-to-head comparison of such metrics with sit-to-stand desks."

22-ii) Highlight unanswered new questions, suggest future research
Highlight unanswered new questions, suggest future research. Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Subitem 22-ii was addressed in the conclusions section of the manuscript's discussion.

20-i) Typical limitations in ehealth trials
Typical limitations in ehealth trials: Participants in ehealth trials are rarely blinded. Ehealth trials often look at a multiplicity of outcomes, increasing risk for a Type I error. Discuss biases due to non-use of the intervention/usability issues, biases through informed consent procedures, unexpected events.
Does your paper address subitem 20-i? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We discussed both strengths and limitations of our study in a the final subsection of the discussion.

21-i) Generalizability to other populations
Generalizability to other populations: In particular, discuss generalizability to a general Internet population, outside of a RCT setting, and general patient population, including applicability of the study results for other organizations Does your paper address subitem 21-i?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We addressed the generalizability and limitations thereof in the "Strength and Limitations" subsection of our manuscript's discussion.

21-ii) Discuss if there were elements in the RCT that would be different in a routine application setting
Discuss if there were elements in the RCT that would be different in a routine application setting (e.g., prompts/reminders, more human involvement, training sessions or other cointerventions) and what impact the omission of these elements could have on use, adoption, or outcomes if the intervention is applied outside of a RCT setting.

OTHER INFORMATION
23) Registration number and name of trial registry 24) Where the full trial protocol can be accessed, if available Does your paper address subitem 21-ii?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study Given the exploratory nature of our study, we chose not to speculate on how the elements of our RCT would be different in a routine application study. Before such a recommendation can be made, more research is warranted with larger trials powered to statistically confirm the treatment responses observed in our trial.
Does your paper address CONSORT subitem 23? * Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study We included this information in the "Acknowledgements" subsection at the end of the manuscript. "This trial is registered in ClinicalTrials.gov under the identifier number NCT02376504 and title, "Modifying the workplace to decrease sedentary behavior and improve health." In addition to the usual declaration of interests ( nancial or otherwise), also state the relation of the study team towards the system being evaluated, i.e., state if the authors/evaluators are distinct from or identical with the developers/sponsors of the intervention.
Does your paper address subitem X27-i?
Copy and paste relevant sections from the manuscript (include quotes in quotation marks "like this" to indicate direct quotes from your manuscript), or elaborate on this item by providing additional information not in the ms, or brie y explain why the item is not applicable/relevant for your study What were the most important changes you made as a result of using this checklist?
Title and abstract detail modifications and inclusion of a full protocol document in our supplementary material.
How much time did you spend on going through the checklist INCLUDING making changes in your manuscript * Approximately eight to ten hours.
As a result of using this checklist, do you think your manuscript has improved? * Would you like to become involved in the CONSORT EHEALTH group? Your answer must have a minimum of 25 characters.
STOP -Save this form as PDF before you click submit To generate a record that you lled in this form, we recommend to generate a PDF of this page (on a Mac, simply select "print" and then select "print as PDF") before you submit it.
When you submit your (revised) paper to JMIR, please upload the PDF as supplementary le.
Don't worry if some text in the textboxes is cut off, as we still have the complete information in our database. Thank you!