Perspectives on intervention strategies for influencing physical activity and sedentary behavior among Ethiopian office workers: a qualitative study

The rising burden of non-communicable diseases (NCDs) in low- and middle-income countries, including Ethiopia, necessitates evidence-based and locally relevant public health interventions that target modifiable risk factors, such as low levels of physical activity (PA) and high levels of sedentary behavior (SB). However, little is known about the intervention strategies that can be used to effectively and feasibly achieve the desired goals in these movement behaviors. This qualitative study aimed to explore stakeholders’ views and perspectives on potential intervention strategies to increase PA and reduce SB among Ethiopian office-based employees. In-depth interviews were conducted with 33 participants, including office workers, NCD program coordinators, and exercise coaches, in Hawassa, southern Ethiopia. Participants were asked to suggest strategies and support systems for increasing PA and reducing SB. The interviews were audio-recorded, transcribed verbatim, translated into English, coded, and analyzed using reflexive thematic analysis. Findings were interpreted as individual (‘i-frame’) and system-level (‘s-frame’) intervention strategies. Analysis identified nine overarching themes, representing five individual-level and four system-level strategies. Individual-level strategies included educational support to raise awareness about PA and SB, personalized follow-up support, promoting regular moderate-to-vigorous PA as a better strategy to increase total daily PA, promoting walking, and supporting with physical exercise skills. Those system-level strategies included organizational support, introducing practical workplace health promotion policies and initiatives, office reminder messages, and integrating behavioral interventions with NCD prevention and screening services. This study uncovered relevant insights and views on promising intervention strategies to increase PA and reduce SB among office-based working adults in the Ethiopian context, which can be used to inform intervention design. Furthermore, the findings imply that integrating both individual and system-level strategies in PA and SB interventions is important for maximizing intervention outcomes.