Sedentary Behavior In Adults Research Articles

Systematic review of process evaluations of interventions in trials investigating sedentary behaviour in adults

ObjectivesTo systematically review and synthesise findings from process evaluations of interventions in trials which measured sedentary behaviour as an outcome in adults to explore: (1) how intervention content, implementation, mechanisms...

Physical Activity and Sedentary Behavior in Adults With Cystic Fibrosis: Association With Aerobic Capacity, Lung Function, Sleep, Well-Being, and Quality of Life.

Physical activity (PA) and sedentary behavior (SB) have marked impact on key prognostic indicators such as aerobic capacity and lung function in people with cystic fibrosis (CF) and may have associations with sleep, well-being, and health-related quality of life (HRQOL). This observational study assessed PA, SB, aerobic capacity, spirometry, sleep, well-being, and HRQOL in adults with CF at University Hospital Limerick. PA and SB were assessed using an accelerometer that was worn for 7 days. A cardiopulmonary exercise test assessed aerobic capacity. Spirometry was performed according to American Thoracic Society guidelines. Well-being was measured by the AWESCORE, sleep quality by the Pittsburgh Sleep Quality Index (PSQI), and HRQOL using the CF Questionnaire-Revised. Thirty-three participants (13 males/20 females) were recruited. Mean age was 26.2 y (± 7.1 SD), with mean FEV1 72.9% of predicted (± 26.2 SD). Mean step count was 7,788 (± 3,583 SD). Over 75% of participants did not reach recommended PA targets (> 10,000 steps), with females being 25.5% less active than males. The PSQI indicated 48.5% of participants scored > 5, indicating poor sleep quality. Number of steps and SB demonstrated a moderate significant correlation with FEV1 (r = 0.45, P = .030; r = -0.37, P = .043, respectively) and sleep quality (r = -0.85, P < .001; r = 0.77, P < .001, respectively). [Formula: see text] peak expressed relative to body weight, and as a percentage of predicted, was significantly positively correlated with step count (r = 0.48, P = .007; r = 0.42, P = .02, respectively) but did not correlate with SB (P = .96). [Formula: see text] peak (L/min) strongly correlated with FEV1 (r = 0.75, P < .001). Most participants did not meet PA targets. PA levels correlated to aerobic capacity, FEV1, and self-reported sleep quality, and this should be considered in longitudinal studies and in PA interventions.

Measuring sedentary behaviour across the spectrum of adults with intellectual disabilities: A comparison between accelerometer and international physical activity questionnaire

Purpose: Measuring sedentary behaviour in adults with intellectual disabilities (awID) is important but challenging, particularly in those with profound intellectual disabilities (ID) many of whom are pre-verbal. This study sought to evaluate the measurements of daily sedentary hours in awID across the intellectual disability spectrum, using accelerometer-derived estimates against self- or proxy-report with the International Physical Activity Questionnaire-short version (IPAQ-s).

Mobile health apps to reduce sedentary behavior: a scoping review.

Given the continued increase in mobile health applications (apps) aimed at healthcare and the recognition of sedentary behavior (SB) as a public health problem, the goal of this scoping review study was to summarize the effects of interventions based on mobile health apps designed to reduce SB in adults, with a specific focus on SB. The electronic databases PubMed, PsycINFO, SportDISCUS, Web of Science, and manual searches in reference lists were conducted on papers published up to September 2020. Nine out of the 897 studies researched were included and composed the descriptive synthesis. The investigations found in the present study showed a decrease in time spent on television viewing and in total time spent sitting, as well as an increase in the number of SB breaks after interventions based on mobile health apps. In conclusion, despite the growing interest in intervention programs in SB, only nine studies have used smartphone apps as a strategy to reduce SB in adults. Mobile health apps were proved to be effective in SB reduction, as assessed by different parameters, and should be encouraged. However, further studies are needed to verify the long-term effects of the utilization of such applications.

Comparative assessment of ActiGraph data processing techniques for measuring sedentary behavior in adults with COPD

Objective. The ActiGraph is commonly used for measuring sedentary behavior (SB), but the best data processing technique is not established for sedentary adults with chronic illness. The purpose of this study was to process ActiGraph vertical axis and vector magnitude data with multiple combinations of filters, non-wear algorithm lengths, and cut-points and to compare ActiGraph estimates to activPAL-measured sedentary time in sedentary adults with chronic obstructive pulmonary disease (COPD). Approach. This study was a secondary analysis of adults ≥50 years (N = 59; mean age: 69.4 years; N = 31 males) with COPD. Participants wore ActiGraph GT9X and activPAL3 for 7 d. ActiGraph vertical axis and vector magnitude data were processed using combinations of filters (normal, low frequency extension (LFE)), non-wear algorithm lengths (60, 90, 120 min), and cut-points for SB previously validated in older adults (two for vertical axis and three for vector magnitude data). The Bland–Altman method was used to assess concordance between sedentary time measured with 30 ActiGraph techniques and activPAL-measured sedentary time. Main results. Agreement between the two devices was moderate to strong for all techniques; concordance correlations ranged from 0.614 to 0.838. Limits of agreement were wide. The best overall technique was vector magnitude data with LFE filter, 120 min non-wear algorithm, and <40 counts/15 s SB cut-point (concordance correlation 0.838; mean difference −11.7 min d−1). Significance. This analysis supports the use of ActiGraph vector magnitude data and LFE filter in adults with COPD, but also demonstrates that other techniques may be acceptable with appropriate cut-points. These results can guide ActiGraph data processing decisions.

Youth Leisure-Time Sedentary Behavior Questionnaire (YLSBQ): Reliability and Validity in Colombian University Students.

Sedentary behavior (SB) is influenced by variations in social, cultural and economic contexts. This study assesses the test–retest reliability and validity of the Youth Leisure-time Sedentary Behavior Questionnaire (YLSBQ), a self-report tool that examines total and domain-specific SB in a cohort of young adults from Colombia. A cross-sectional validation study was conducted among 447 Colombian college students (52.8% men; mean (± standard deviation) age of 19.55 ± 2.54 years). To assess the reliability of the YLSBQ, Kappa statistics (k) were used. A confirmatory factor analysis (CFA) was conducted to determine validity. The Cronbach alpha for the 12 behaviors of the YLSBQ showed a good-to-excellent internal consistency (0.867, ranging from 0.715–0.935). Intraclass correlation coefficient (ICC) indicated that 10 items (83.0%) and two items (17.0%) showed excellent and good reliability, respectively. Furthermore, ICC between the total sedentary time was 0.926 (95% confidence interval [CI] = 0.912 − 0.939), which was interpreted as excellent. The goodness-of-fit tests provided evidence that overall, a four-factor solution was an adequate fit with the time scores. In conclusion, the YLSBQ could be considered a reliable, valid and usable tool for the assessment of SB in young adults in a Latin American country. We found that the psychometric properties of the questionnaire were similar to those of the original Spanish validation study.

Sedentary behaviour levels in adults with an intellectual disability: a systematic review and meta-analysis

Background:Sedentarybehaviour(SB),which is characterised by low levels of energy expenditure,has been linked toincreased cardio-metabolic risks, obesityandmortality, as well as cancer risk.Nofirm guidelinesareestablished on safe levels ofSB. Adults with an intellectual disability(ID)have poorer health than their counterparts in the general population with higher rates of multi-morbidity, inactivity, and obesity. The reasons for this health disparity are unclearhowever it is known thatSBand overall inactivity contribute to poorer health.There is no clear picture of the levels of SB among individuals with ID therefore SBlevels in this vulnerable population need to beexamined.The aim of thissystematic reviewistoinvestigate the prevalence of sedentary behaviour in adults with anID. Methods:The PRISMA-P framework was applied to identify high quality articles. An extensive search was carried out in four databasesand grey literaturesources.In total,1,972 articleswere retrieved of which48 articles went forward for full review after duplicate removal and screening by title and abstract.The National Institute of Health's quality assessment tools were used to assess article quality. Tworeviewers independently assessed each article. An excel spreadsheetwas created to guide thedata extractionprocess.Thefinalreview included25 articles.A meta-analysis was completed using REVMAN. Results:DifferentSBassessment types were identifiedinstudies. Theseincludedsteps, time, questionnaires, and screen time. Studies were heterogeneous.Observeddaily stepsper individualranged from44toabove30,000, with an average of approximately 6,500 steps. Mean daily time spent inSBswas more than 60%of available time,with observed screen time of more than 3 hours. Conclusion:There is a high prevalence ofSBin adultswith an intellectual disability. [Registration no: Index CRD42020177225].

The impact of mental and somatic stressors on physical activity and sedentary behaviour in adults with type 2 diabetes mellitus: a diary study.

BackgroundAdopting an active lifestyle is key in the management of type 2 diabetes mellitus (T2DM). Nevertheless, the majority of individuals with T2DM fails to do so. Additionally, individuals with T2DM are likely to experience mental (e.g., stress) and somatic (e.g., pain) stressors. Research investigating the link between these stressors and activity levels within this group is largely lacking. Therefore, current research aimed to investigate how daily fluctuations in mental and somatic stressors predict daily levels of physical activity (PA) and sedentary behaviour among adults with T2DM.MethodsIndividuals with T2DM (N = 54) were instructed to complete a morning diary assessing mental and somatic stressors and to wear an accelerometer for 10 consecutive days. The associations between the mental and somatic stressors and participants’ levels of PA and sedentary behaviour were examined using (generalized) linear mixed effect models.ResultsValid data were provided by 38 participants. We found no evidence that intra-individual increases in mental and somatic stressors detrimentally affected participants’ activity levels. Similarly, levels of sedentary behaviour nor levels of PA were predicted by inter-individual differences in the mental and somatic stressors.

Characterizing Physical Activity and Sedentary Behavior in Adults With Persistent Postconcussive Symptoms After Mild Traumatic Brain Injury

ObjectiveTo evaluate physical activity (PA) and sedentary behavior and their associations with symptom and quality of life outcomes in adults with persistent postconcussive symptoms (PPCS) after mild traumatic brain injury (mTBI). DesignCross-sectional cohort study. SettingOutpatient brain injury clinic. ParticipantsConsecutive sample of adults (N=180) with a diagnosis of mTBI and PPCS. InterventionsNot applicable. Main Outcome MeasuresPA and sedentary behavior were assessed using the Godin Leisure-Time Exercise Questionnaire and Rapid Assessment Disuse Index, respectively. Participants were dichotomized according to whether they completed 150 minutes of moderate-to-vigorous PA per week, based on Canadian guidelines. Postinjury moderate-to-vigorous PA was also analyzed as a continuous variable. ResultsPrior to injury, 85% of participants reported meeting PA guidelines, compared with 28% postinjury. Individuals meeting PA guidelines postinjury reported higher quality of life (η2p=0.130; P<.001) and lower scores on measures of functional impact of headache (η2p=0.065; P=.009), fatigue (η2p=0.080; P=.004), depression (η2p=0.085; P=.001), and anxiety (η2p=0.046; P=.031), compared with those not meeting guidelines. Sedentary behavior postinjury was negatively correlated with quality of life (rs[127]=–0.252; P=.004) and positively correlated with symptom burden (rs[167]=0.227; P=.003), fatigue (rs[127]=0.288; P=.001), depression (rs[174]=0.319; P<.001), and anxiety (rs[127]=0.180; P=.042). ConclusionsPA was significantly decreased in individuals with PPCS compared to preinjury levels. Meeting PA guidelines postinjury was associated with better clinical outcomes, suggesting that returning individuals to PA should be considered in the treatment of this patient population.

Device-measured sedentary behavior in oldest old adults: A systematic review and meta-analysis.

Sedentary behavior contributes to health decline and frailty in older adults, especially the oldest old. The purpose of this systematic review was to synthesize evidence describing the volume of device-measured sedentary behavior and factors that influence sedentary behavior in community-dwelling adults aged 80 and older. Four electronic databases were searched in August 2018; the search was updated in September 2019 and December 2020. Twenty-one articles representing 16 unique datasets from six countries met inclusion criteria. Various devices and data processing methods were used to measure sedentary behavior; the most common device was the ActiGraph accelerometer. Sedentary time during the waking day ranged from 7.6 to 13.4h/day. Studies using similar measurement methods (hip-worn ActiGraph with uniaxial cut-point<100 counts per minute) had a weighted mean of 10.6h/day. Subgroup analyses revealed that male gender and age≥85 may contribute to increased sedentary behavior. Only seven individual articles examined factors that influence sedentary behavior in the 80 and older age group; older age, male gender, non-Hispanic white race/ethnicity, social disadvantage, and declining cognitive function (in men) were associated with increased sedentary behavior. In conclusion, the oldest old are highly sedentary and little is known about factors that influence their sedentary behavior.

Acute effects of sedentary breaks on vascular health in adults at risk for type 2 diabetes: A systematic review.

The aim of this systematic review was to evaluate the available evidence regarding the acute effects of interrupting/breaking up prolonged sedentary behavior (SB) on vascular health among individuals at elevated risk for type 2 diabetes (T2D). Searches of MEDLINE, Embase, Web of Science, and Cochrane Library databases were conducted on April 7, 2020. Included studies: (1) examined the effect of breaking up prolonged SB in adults with or at elevated risk for T2D and (2) assessed a vascular health outcome, such as blood pressure (BP), flow-mediated dilation (FMD), pulse-wave velocity, or endothelin-1. A total of 20 articles (17 unique studies) were included. Only three studies reported adequate statistical power for the specified vascular outcome. The available evidence suggests that light and moderate intensity activity breaks are effective in acutely lowering BP when compared to prolonged sitting. The small number of studies that included FMD or other vascular outcomes prohibits conclusions regarding the impact of SB breaks on these outcomes. Few studies evaluating the impact of breaking up SB among adults at risk for T2D have included and been adequately powered to examine vascular outcomes, but our preliminary finding, that certain SB breaks improve BP, provides proof-of-concept for this line of inquiry. Future studies should examine both the acute and chronic vascular effects of breaking up SB among individuals most vulnerable to the effects of SB (e.g. older adults, those with T2D), as these individuals are both highly sedentary and at greatest risk of poor health outcomes. PROSPERO ID: CRD42020183423.

297 The Relationship Between Sleep and Objectively Measured Sedentary Behavior in Adults with Desk Jobs

Abstract Introduction Both poor sleep and sedentary behavior lead to negative health outcomes. While some previous studies have observed an association between poor sleep and greater sedentary behavior, few studies have assessed this relationship using an objective measure of sedentary behavior. We examined the association of both self-reported and objectively-measured sleep with objectively-measured sedentary behavior. Methods In a secondary analysis of baseline data from an ongoing clinical trial, the present analysis included 157 physically inactive adults with elevated blood pressure (120–159 mmHg systolic or 90–99 diastolic) and desk jobs (82.8% white, 65.6% female, age 45.5±12.0). To assess sedentary behavior, participants wore an accelerometer/inclinometer (activPAL3 micro) on the upper thigh continuously for 7 days. Variables included total sedentary time, prolonged sedentary time (≥30 minute bouts), and sit-to-stand transitions; these were averaged across all waking hours as well as the workday. To assess sleep, participants completed the Pittsburgh Sleep Quality Index (PSQI) and a subsample (n=57) wore an Actiwatch Spectrum for 7 nights. Variables examined included the PSQI global score, actigraphy-based total sleep time (TST) and sleep efficiency (SE). Linear regression examined associations between sleep and sedentary behavior, with adjustments for age, gender, race, body mass index, and activPAL3 wear time. Results Participants had (mean±standard deviation) 11.1±1.5 hours sedentary time per day, with 6.3±2.0 occurring in ≥30 minute bouts, and 51.3±13.4 sit-to-stand transitions. During the workday, participants had 6.6±1.3 hours sedentary time with 3.8±1.7 occurring in ≥30 minute bouts and 27.2±11.2 sit-to-stand transitions. PSQI global score was 4.9±2.9; 32.5% were classified as poor sleepers. Actigraphic TST was 6.7±0.8 hours, with SE of 85.4±6.3%.Greater SE was associated with less sit-to-stand transitions during the workday (β=-0.36, p=0.01) and during the full day (β=-0.37, p=0.01). Subjective sleep quality and actigraphic TST were not associated with sedentary behavior. Conclusion We did not find a cross-sectional association between sedentary behavior and sleep in insufficiently active adults, potentially due to restricted range of sedentary behavior and physical activity in the sample. The association between greater sleep efficiency with fewer sit-to-stand transitions is counterintuitive and warrants further exploration. Support (if any) This study was funded by National Institutes of Health (NIH) grants R01HL134809 and R01HL147610.

Validity and Reliability of IPAQ-SF and GPAQ for Assessing Sedentary Behaviour in Adults in the European Union: A Systematic Review and Meta-Analysis.

Current lifestyles are marked by sedentary behaviour; thus, it is of great importance for policymaking to have valid and reliable tools to measure sedentary behaviour in order to combat it. Therefore, the aim of this review and meta-analysis is to critically review, assess, and compile the reliability, criterion validity, and construct validity of the single-item sedentary behaviour questions within national language versions of most commonly used international physical activity questionnaires for adults in the European Union: The International Physical Activity Questionnaire-Short Form and the Global Physical Activity Questionnaire. A total of 1749 records were screened, 287 full-text papers were read, and 14 studies were included in the meta-analysis. The results and quality of studies were evaluated by the Quality Assessment of Physical Activity Questionnaires checklist. Meta-analysis indicated moderate to high reliability (rw = 0.59) and concurrent validity (rw = 0.55) of national language versions of single-item sedentary behaviour questions. Criterion validity was rather low (rw = 0.23) but in concordance with previous studies. The risk of bias analysis highlighted the poor reporting of methods and results, with a total bias score of 0.42. Thus, we recommend using multi-item SB questionnaires and smart trackers for providing information on SB rather than single-item sedentary behaviour questions in physical activity questionnaires.

Sedentary behaviour levels in adults with an intellectual disability: a systematic review protocol.

Background: Sedentary behaviour contributes to non-communicable diseases, which account for almost 71% of world deaths. Of these, cardiovascular disease is one of the largest causes of preventable death. It is not yet fully understood what level of sedentary behaviour is safe. People with an intellectual disability have poorer health than the general population with higher rates of multi-morbidity, obesity and inactivity. There is a paucity of evidence on whether this poorer health is due to sedentary behaviour or physical inactivity. This systematic review will investigate the sedentary behaviour levels of adults with an intellectual disability. Method: The PRISMA-P framework will be applied to achieve high-quality articles. An extensive search will be conducted in Medline, Embase, psycINFO and Cinahl and grey literature sources. All articles will be independently reviewed by two reviewers and a third to resolve disputes. Initially, the articles will be reviewed by title and abstract and then the full article will be reviewed using stringent inclusion criteria. All article data will be summarised in a standardised tabular format. The National Institute of Health's quality assessment tool will be used to assess article quality. GRADE will be used to assess the quality of the evidence. The primary outcome of interest is the prevalence of sedentary behaviour levels for people with an intellectual disability. The definition of sedentary behaviour to be used for the purposes of this study is: 'low physical activity as identified by metabolic equivalent (MET) or step levels or as measured by the Rapid Assessment of Physical activity questionnaire (RAPA) or the International Physical Activity questionnaire (IPAQ) or sitting for more than 3 hours per day'. Conclusion: This systematic review will provide a critical insight into the prevalence of sedentary behaviour in adults with an intellectual disability.

Sedentary behaviour levels in adults with an intellectual disability: a systematic review protocol

Background: Sedentary behaviour contributes to non-communicable diseases, which account for almost 71% of world deaths. Of these, cardiovascular disease is one of the largest causes of preventable death. It is not yet fully understood what level of sedentary behaviour is safe. People with an intellectual disability have poorer health than the general population with higher rates of multi-morbidity, obesity and inactivity. There is a paucity of evidence on whether this poorer health is due to sedentary behaviour or physical inactivity. This systematic review will investigate the sedentary behaviour levels of adults with an intellectual disability. Method: The PRISMA-P framework will be applied to achieve high-quality articles. An extensive search will be conducted in Medline, Embase, psycINFO and Cinahl and grey literature sources. All articles will be independently reviewed by two reviewers and a third to resolve disputes. Initially, the articles will be reviewed by title and abstract and then the full article will be reviewed using stringent inclusion criteria. All article data will be summarised in a standardised tabular format. The National Institute of Health’s quality assessment tool will be used to assess article quality. GRADE will be used to assess the quality of the evidence. The primary outcome of interest is the prevalence of sedentary behaviour levels for people with an intellectual disability. The definition of sedentary behaviour to be used for the purposes of this study is: ‘low physical activity as identified by metabolic equivalent (MET) or step levels or as measured by the Rapid Assessment of Physical activity questionnaire (RAPA) or the International Physical Activity questionnaire (IPAQ) or sitting for more than 3 hours per day’. Conclusion: This systematic review will provide a critical insight into the prevalence of sedentary behaviour in adults with an intellectual disability.

Antidepressant medication use and objectively measured physical activity and sedentary behaviors in adults: A cross-sectional analysis of a nationally representative sample of Canadian adults

BackgroundAntidepressant medication is one of the most prescribed medications among Canadians. This medication class has been previously associated with adverse effects. To date, far too little attention has been paid to physical activity (PA) and sedentary behaviors (SB) in adults using antidepressant medication. The study aims to compare objectively measured time in PA and SB behaviors in a population-based sample of adults using antidepressant medication compared to a group of adults not using any psychotropic medication, and to investigate whether these behaviors differ according to four antidepressant classes. MethodsWe used representative data from the Canadian Health Measures Survey (2007–2013). Medication use was documented during an in-house visit. PA and SB were measured by accelerometer. We included 7680 participants aged 18–79 years. A set of weighted analyses of covariance with adjustments for sex, age, body-mass index, income, education level, season, smoking and marital status was conducted to compare mean differences in PA and SB variables between adults using antidepressants and controls. ResultsThe cross-sectional weighted prevalence of antidepressant use was 9.3%. Adults using antidepressants completed significantly fewer minutes of moderate to vigorous PA and steps daily compared to adults without psychotropic medication. Daily time spent in light PA and SB were not significantly different between both groups. Sensitivity analyses controlling for self-reported mental and physical health showed no significant difference except smaller time spent in moderate to vigorous PA in adults using SSRI antidepressants than control. ConclusionDue to the potential negative side effects associated with antidepressant usage, and the present findings demonstrating lower levels of MVPA in those taking SSRIs, care providers should consider assessing levels of MVPA and if relevant promoting physical activity when prescribing this class of antidepressants.

Convergent Validity of the Fitbit Charge 2 to Measure Sedentary Behavior and Physical Activity in Overweight and Obese Adults

Activity trackers provide real-time sedentary behavior (SB) and physical activity (PA) data enabling feedback to support behavior change. The validity of activity trackers in an obese population in a free-living environment is largely unknown. This study determined the convergent validity of the Fitbit Charge 2 in measuring SB and PA in overweight adults. The participants (n = 59;M ± SD: age = 48 ± 11 years; body mass index = 34 ± 4 kg/m2) concurrently wore a Charge 2 and ActiGraph GT3X+ accelerometer for 8 days. The same waking wear periods were analyzed, and standard cut points for GT3X+ and proprietary algorithms for the Charge 2, together with a daily step count, were used. Associations between outputs, mean difference (MD) and limits of agreement (LOA), and relative differences were assessed. There was substantial association between devices (intraclass correlation coefficients from .504, 95% confidence interval [.287, .672] for SB, to .925, 95% confidence interval [.877, .955] for step count). In comparison to the GT3X+, the Charge 2 overestimated SB (MD = 37, LOA = −129 to 204 min/day), moderate to vigorous PA (MD = 15, LOA = −49 to 79 min/day), and steps (MD = 1,813, LOA = −1,066 to 4,691 steps/day), and underestimated light PA (MD = −32, LOA = −123 to 58 min/day). The Charge 2 may be a useful tool for self-monitoring of SB and PA in an overweight population, as mostly good agreement was demonstrated with the GT3X+. However, there were mean and relative differences, and the implications of these need to be considered for overweight adult populations who are already at risk of being highly sedentary and insufficiently active.

Bidirectional relationship between sleep and sedentary behavior in adults with overweight or obesity: A secondary analysis.

Study ObjectivesThe relationships between daytime sedentary behavior and that night’s sleep and sleep and next day’s sedentary behavior are unknown. The purpose of this analysis was to examine these potentially bidirectional associations.MethodsThis study was a secondary analysis of baseline data from an ecological momentary assessment study to determine the triggers for dietary lapses during a weight loss intervention. Sedentary behavior, physical activity, and sleep were objectively measured using accelerometers. Linear mixed modeling was used to examine the bidirectional multivariate associations between activity and sleep characteristics for each outcome examined separately. The models included sex, age, body mass index (BMI), education, and day of the week (weekday vs. weekend).ResultsParticipants were predominantly white (81.5%) and female (88.9%) with a mean age of 51.2 ± 10.6 years. Longer previous night’s total sleep time (TST) (b = −0.320, standard error [SE] = 0.060; p < .001) and being a weekend (b = −63.845, SE = 9.406; p < .001) were associated with less sedentary time the next day. More daytime sedentary time was associated with less wake after sleep onset (b = −0.018, SE = 0.008; p = .016), fewer awakenings (b = −0.010, SE = 0.004; p = .016), and less TST (b = −0.060, SE = 0.028; p = .029) that night.ConclusionsThe bidirectional relationships between sedentary time and sleep characteristics are complex and may vary depending on participant characteristics and duration of sedentary and sleep time. Interventions to decrease sedentary behavior may benefit by targeting sleep duration and weekday activity.

Agreement of sedentary behaviour metrics derived from hip-worn and thigh-worn accelerometers among older adults: with implications for studying physical and cognitive health.

Little is known about how sedentary behaviour (SB) metrics derived from hip-worn and thigh-worn accelerometers agree for older adults. Thigh-worn activPAL micro monitors were concurrently worn with hip-worn ActiGraph GT3X+ accelerometers (with SB measured using the 100 count-per-minute (cpm) cut-point; ActiGraph100cpm) by 953 older adults (age 77±6.6, 54% women) for 4-to-7 days. Device agreement for sedentary time and 5 SB pattern metrics was assessed using mean error and correlations. Logistic regression tested associations with 4 health outcomes using standardized (i.e., z-scores) and unstandardized SB metrics. Mean errors (activPAL-ActiGraph100cpm) and 95% limits of agreement were: sedentary time -54.7(-223.4,113.9) min/d; time in 30+ minute bouts 77.6(-74.8,230.1) min/d; mean bout duration 5.9(0.5,11.4) min; usual bout duration 15.2(0.4,30) min; breaks in sedentary time -35.4(-63.1,-7.6) breaks/d; and alpha -0.5(-0.6,-0.4). Respective Pearson correlations were: 0.66, 0.78, 0.73, 0.79, 0.51, 0.40. Concordance correlations were: 0.57, 0.67, 0.40, 0.50, 0.14, 0.02. The statistical significance and direction of associations was identical for ActiGraph100cpm and activPAL metrics in 46 of 48 tests, though significant differences in the magnitude of odds ratios were observed among 9 of 24 tests for unstandardized and 2 of 24 for standardized SB metrics. Caution is needed when interpreting SB metrics and associations with health from ActiGraph100cpm due to the tendency for it to overestimate breaks in sedentary time relative to activPAL. However, high correlations between activPAL and ActiGraph100cpm measures and similar standardized associations with health outcomes suggest that studies using ActiGraph100cpm are useful, though not ideal, for studying SB in older adults.

Associations Between Digital Health Intervention Engagement, Physical Activity, and Sedentary Behavior: Systematic Review and Meta-analysis.

BackgroundThe effectiveness of digital health interventions is commonly assumed to be related to the level of user engagement with the digital health intervention, including measures of both digital health intervention use and users’ subjective experience. However, little is known about the relationships between the measures of digital health intervention engagement and physical activity or sedentary behavior.ObjectiveThis study aims to describe the direction and strength of the association between engagement with digital health interventions and physical activity or sedentary behavior in adults and explore whether the direction of association of digital health intervention engagement with physical activity or sedentary behavior varies with the type of engagement with the digital health intervention (ie, subjective experience, activities completed, time, and logins).MethodsFour databases were searched from inception to December 2019. Grey literature and reference lists of key systematic reviews and journals were also searched. Studies were eligible for inclusion if they examined a quantitative association between a measure of engagement with a digital health intervention targeting physical activity and a measure of physical activity or sedentary behavior in adults (aged ≥18 years). Studies that purposely sampled or recruited individuals on the basis of pre-existing health-related conditions were excluded. In addition, studies were excluded if the individual engaging with the digital health intervention was not the target of the physical activity intervention, the study had a non–digital health intervention component, or the digital health interventions targeted multiple health behaviors. A random effects meta-analysis and direction of association vote counting (for studies not included in meta-analysis) were used to address objective 1. Objective 2 used vote counting on the direction of the association.ResultsOverall, 10,653 unique citations were identified and 375 full texts were reviewed. Of these, 19 studies (26 associations) were included in the review, with no studies reporting a measure of sedentary behavior. A meta-analysis of 11 studies indicated a small statistically significant positive association between digital health engagement (based on all usage measures) and physical activity (0.08, 95% CI 0.01-0.14, SD 0.11). Heterogeneity was high, with 77% of the variation in the point estimates explained by the between-study heterogeneity. Vote counting indicated that the relationship between physical activity and digital health intervention engagement was consistently positive for three measures: subjective experience measures (2 of 3 associations), activities completed (5 of 8 associations), and logins (6 of 10 associations). However, the direction of associations between physical activity and time-based measures of usage (time spent using the intervention) were mixed (2 of 5 associations supported the hypothesis, 2 were inconclusive, and 1 rejected the hypothesis).ConclusionsThe findings indicate a weak but consistent positive association between engagement with a physical activity digital health intervention and physical activity outcomes. No studies have targeted sedentary behavior outcomes. The findings were consistent across most constructs of engagement; however, the associations were weak.