Sedentary Behavior Interventions Research Articles

Interventions to reduce sedentary behaviour in adults with type 2 diabetes: A systematic review and meta-analysis.

Treatment and management of Type 2 Diabetes (T2D) includes physical activity, nutrition, and pharmacological management. Recently, the importance of reducing and breaking up sedentary behaviour has become recognized. This review aimed to summarize and synthesize the effectiveness of interventions in reducing and/or breaking up sedentary behaviour and cardiometabolic biomarkers in adults with T2D. A study protocol was preregistered on PROSPERO (CRD42022357281) and a database search (PubMed, EMBASE, Scopus, Web of Science, PsycINFO, SPORTDiscus, CINAHL, and Cochrane Library) was conducted on 16/09/2022 and updated on 03/01/2024. This review followed PRISMA guidelines and study quality was assessed with the Cochrane risk of Bias Tools. Twenty-eight articles were included in the review. The meta-analysis of short-term (Range: 3 hours- 4 days) sedentary behaviour interventions found significant improvement in continuous interstitial glucose measured for 24 hours after the sedentary behaviour intervention compared to control (SMD:-0.819,95%CI:-1.255,-0.383,p<0.001). Similarly, there was a significant improvement in postprandial interstitial glucose after the sedentary behaviour intervention compared to control (SMD:-0.347,95%CI:-0.584,-0.110,p = 0.004). Ten out of eleven longer-term (Range: 5 weeks- 3 years) sedentary behaviour interventions improved at least one measure of sedentary behaviour compared to control. Eight out of eight longer-term sedentary behaviour interventions improved at least one cardiometabolic biomarker compared to control. Reducing sedentary behaviour, independent of physical activity, can improve glycemic control in adults with T2D. Further, sedentary behaviour may be a feasible/ sustainable behaviour change.

Targeting exercise and sedentary behavior for the prevention of allogeneic stem cell transplant-related cardiovascular dysfunction: The ALLO-Active trial.

12018 Targeting Exercise and Sedentary Behavior to Prevent Allogeneic Stem Cell Transplant-Related Cardiovascular Dysfunction: The ALLO-Active Trial Background: Allogeneic stem cell transplantation (allo-SCT) is a potentially life-saving therapy for hematological malignancy, however, quality of life and longevity post allo-SCT are hampered by exercise intolerance, cardiac dysfunction, and cardiovascular mortality. This randomized controlled trial evaluated the efficacy of a novel multi-component activity program on cardiorespiratory fitness (peak oxygen uptake [VO2peak]) and cardiac function in adults undergoing allo-SCT. Methods: Sixty-two hematological malignancy patients scheduled for allo-SCT were randomized to a 4-month multi-component Activity program (n = 30) designed to increase aerobic and resistance exercise (3-day.week-1) and reduce sedentary time (≥30-min.day-1), or to usual care ( UC, n = 32). The Activity program was delivered over two distinct phases: ‘Inpatient’, which commenced upon admission for allo-SCT and continued until discharge (~4 weeks), and ‘Outpatient’,which commenced at discharge and continued for 12-weeks. Physiological assessments were conducted pre-admission, and 12-weeks post-discharge (4-months from baseline) and included: (1) cardiopulmonary exercise testing to quantify VO2peak, (2) exercise cardiac magnetic resonance imaging to determine peak cardiac output and stroke volume index (COIpeak and SVIpeak), (3) standard of care resting echocardiography-derived left ventricular ejection fraction and global longitudinal strain, and (4) cardiac biochemistry (troponin, B-type natriuretic peptide). Results: Fifty-two patients (84%) completed follow-up (25 Activity; 27 UC), and median (IQR) intervention adherence was 73% (50-81). Activity preserved VO2peak (-0.9ml.kg-1.min-1 [95%CI -2.5, 0.8]) which showed a marked decline with UC (-3.4ml.kg-1.min-1 [95%CI -4.9, -1.8]; interaction, p= 0.029). Activity also showed significant benefits on exercise cardiac function, as shown by a preservation of COIpeak (0.30L.min-1.m2, [95%CI -0.34, 0.41]) and SVIpeak (0.6ml.m2 [95%CI -1.3, 2.5]), both of which declined with UC (COIpeak: -0.68L.min-1.m2, [95%CI -1.3, -0.32]; interaction, p= 0.008; SVIpeak: -2.7ml.m2 [95%CI -4.6, -0.9], interaction, p =0.014). There were no treatment effects of Activity on cardiac injury biomarkers or global longitudinal strain and no changes in left ventricular ejection fraction in either group. Conclusions: Intervening early in the allo-SCT process with an exercise and sedentary behavior intervention can have significant benefits for the preservation of patient’s cardiovascular reserve capacity. Our results may have important long-term implications for cardiovascular disease incidence and mortality in allo-SCT recipients. Clinical trial information: ANZCTR12619000741189.

A longitudinal study combining the Double Diamond framework and Behavior Change Wheel to co-create a sedentary behavior intervention in police control rooms.

Police work can be sedentary and stressful, negatively impacting health and wellbeing. In a novel co-creation approach, we used the Behavior Change Wheel (BCW) and Double Diamond (DD) design framework to guide the collaborative design and development of a sedentary behavior intervention in the control rooms of two British police forces. Multiple stakeholders participated in four phases of research. In Phase 1, a literature review, focus groups (n=20) and interviews (n=10) were conducted to 'discover' the relationship between physical activity and wellbeing in the police. In Phase 2, a steering group consolidated Phase 1 findings to 'define' a specific behavior for intervention. Phases 3 and 4 'developed' the intervention across six workshops with control room workers and six steering group workshops. The co-creation process identified contextual sedentary behavior as the target behavior, driven by behavioral regulation, social influence and social norms. The sedentary behavior intervention targeted these drivers and aimed to engage control room workers in short bursts of physical activity throughout their shifts. Key intervention features targeted involvement of staff in decision-making and embedding physical activity into work practices. The BCW and DD can be combined to co-create evidence-based and participant-informed interventions and translate science into action.

Facilitators and barriers to using a DeskCycle as a sedentary behavior intervention in the work environment.

Sedentary behavior is a public health threat with extensive health burden on society. High levels of sedentary behavior have been associated with cardiovascular diseases, diabetes, obesity, and cancer. Individuals working in desk-related occupations are more likely to be sedentary for most of the day. Health researchers have responded by implementing and promoting interventions and wellness programs in work environments to reduce this behavior. This study examined the feasibility and experience of using the DeskCycle to reduce sedentary behavior among female workers in an academic office environment. This was an intervention study where participants used the DeskCycle in two consecutive eight-week phases and uploaded DeskCycle use data daily. A questionnaire was administered after week 2 and week 8 (pre-post) of DeskCycle use in each phase to assess dimensions of feasibility, including an open-ended question for user experience. The participants (N = 78) had an average age of 44.4 (±11.3) years and were primarily non-Hispanic White (88.5%). DeskCycle daily use varied from Phase I: 84% to 64.9% (weeks 1-7), and 49.4% in week 8, to Phase II: 73.5% to 52.2% (week 1-7), and 40.2% in week 8. In Phase I, 96.6% (week 2) and 87% (week 8) agreed that the DeskCycle decreased sedentary behavior, and in Phase II, 74.3% (week 2) and 76.9% (week 8) agreed. The analysis of open-ended responses found challenges with the desk set up, cycling interfering with typing, and thinking critically, as barriers to DeskCycle use, while enjoying cycling and cycling improving mood were reported as facilitators. Using a DeskCycle in an academic office environment to reduce sedentary behavior is feasible in female office workers. Consideration should be given to the type of tasks performed while cycling.

The prevalence of sedentary behavior among university students in Saudi Arabia

BackgroundA considerable body of research has demonstrated that reducing sitting time benefits health. Therefore, the current study aimed to explore the prevalence of sedentary behavior (SB) and its patterns.MethodsA total of 6975 university students (49.1% female) were chosen randomly to participate in a face-to-face interview. The original English version of the sedentary behavior questionnaire (SBQ) was previously translated into Arabic. Then, the validated Arabic version of the SBQ was used to assess SB. The Arabic SBQ included 9 types of SB (watching television, playing computer/video games, sitting while listening to music, sitting and talking on the phone, doing paperwork or office work, sitting and reading, playing a musical instrument, doing arts and crafts, and sitting and driving/riding in a car, bus or train) on weekdays and weekends.ResultsSBQ indicated that the total time of SB was considerably high (478.75 ± 256.60 and 535.86 ± 316.53 (min/day) during weekdays and weekends, respectively). On average, participants spent the most time during the day doing office/paperwork (item number 4) during weekdays (112.47 ± 111.11 min/day) and weekends (122.05 ± 113.49 min/day), followed by sitting time in transportation (item number 9) during weekdays (78.95 ± 83.25 min/day) and weekends (92.84 ± 100.19 min/day). The average total sitting time of the SBQ was 495.09 ± 247.38 (min/day) and 58.4% of the participants reported a high amount of sitting time (≥ 7 hours/day). Independent t-test showed significant differences (P ≤ 0.05) between males and females in all types of SB except with doing office/paperwork (item number 4). The results also showed that male students have a longer daily sitting time (521.73 ± 236.53 min/day) than females (467.38 ± 255.28 min/day). Finally, 64.1% of the males reported a high amount of sitting time (≥ 7 hours/day) compared to females (52.3%).ConclusionIn conclusion, the total mean length of SB in minutes per day for male and female university students was considerably high. About 58% of the population appeared to spend ≥7 h/day sedentary. Male university students are likelier to sit longer than female students. Our findings also indicated that SB and physical activity interventions are needed to raise awareness of the importance of adopting an active lifestyle and reducing sitting time.

Compositional associations between movement-related behaviours and functional outcomes post-stroke.

To examine the associations between the composition of movement-related behaviours (sedentary behaviour, sleep, standing, and stepping) and functional outcomes post-stroke. This study included 34 adults with stroke (mean age: 64.6 ± 12.5 years; time since stroke: 3.5 ± 1.1 months) who underwent an 8-week sedentary behaviour intervention. Functional outcomes were assessed using the timed up and go (TUG) and gait speed tests. Compositional data analysis was used to investigate the relationships between movement-related behaviours and functional outcomes. The baseline composition of movement-related behaviours showed significant associations with changes in TUG (F = 4.28, p = 0.01) and gait speed (F = 4.63, p = 0.01) after the 8-week reducing sedentary behaviour intervention. Reallocating ≥ 30 min/day to stepping, while proportionally decreasing other movement-related behaviours, was associated with a significant change in TUG. Similarly, a relative reallocation of ≥ 40 min/day to stepping was associated with a clinically meaningful change in gait speed. This study highlights the importance of considering movement-related behaviours in relation to functional outcomes post-stroke. Reallocating at least 30 min per day to stepping, relative to a reduction in other movement-related behaviours, is associated with significant and meaningful change in functional outcomes.

Relationship of the SITLESS intervention on medication use in community-dwelling older adults: an exploratory study.

Sedentary behavior (SB) and physical activity (PA) interventions in older adults can improve health outcomes. Problems related with aging include prevalent comorbidity, multiple non-communicable diseases, complaints, and resulting polypharmacy. This manuscript examines the relationship between an intervention aiming at reducing SB on medication patterns. This manuscript presents a local sub-analysis of the SITLESS trial data on medication use. SITLESS was an exercise referral scheme (ERS) enhanced by self-management strategies (SMS) to reduce SB in community-dwelling older adults. We analyzed data from the ERS + SMS, ERS and usual care (UC) groups. Patient medication records were available at baseline and at the end of the intervention (4-month period) and were analyzed to explore the effect of SITLESS on medication patterns of use. A sample of 75 participants was analyzed, mostly older overweight women with poor body composition scores and mobility limitations. There was a significant reduction of 1.6 medicines (SD = 2.7) in the ERS group (p < 0.01), but not in the UC or ERS + SMS groups. Differences were more evident in medicines used for short periods of time. The findings suggest that an exercise-based program enhanced by SMS to reduce SB might influence medication use for acute conditions but there is a need to further investigate effects on long-term medicine use in older adults.

O.2.3-4 A standardised core outcome set for measurement and reporting sedentary behaviour interventional research: the CROSBI consensus study

Abstract Purpose Heterogeneity of descriptors and outcomes measured and reported in sedentary behaviour (SB) research hinder the meta-analysis of data and accumulation of evidence. The objective of the Core Research Outcomes for Sedentary Behaviour Interventions (CROSBI) consensus study was to identify and validate, a core outcome set (COS) to report (what, how, when to measure) in interventional sedentary behaviour studies. Methods Outcomes, extracted from a systematic literature review, were categorized into domains and data items (COS v0.0). International experts (n = 5) provided feedback and identified additional items, which were incorporated into COS v0.1. A two round online Delphi survey was conducted to seek consensus from a wider stakeholder group and outcomes that achieved consensus in the second round COS (v0.2), were ratified by the expert panel. Results The final COS (v1.0) contains 53 data items across 12 domains, relating to demographics, device details, wear-time criteria, wear-time measures, posture-related measures, sedentary breaks, sedentary bouts and physical activity. Notably, results indicate that sedentary behaviour outcomes should be measured by devices that include an inclinometry or postural function. Conclusions The proposed standardised COS is available openly to enhance the accumulation of pooled evidence in future sedentary behaviour intervention research and practice.

Effects of lifestyle physical activity and sedentary behaviour interventions on disease activity and patient- and clinician- important health outcomes in rheumatoid arthritis: a systematic review with meta-analysis

BackgroundLifestyle physical activity (PA) is defined as any type of PA undertaken as part of daily life. It can include engagement in activities of daily living (i.e., household chores, gardening, walking to work), incidental PA, walking and/or reducing sedentary or sitting behaviours (SB). Regular PA is recommended for people with Rheumatoid Arthritis (RA) to reduce disease activity and systemic inflammation, as well as to improve patient- and clinician-important health outcomes. However, there is no summarised evidence of the effectiveness of interventions specifically targeting lifestyle PA and SB in this population. The aims of this systematic review with meta-analysis were to evaluate interventions targeting lifestyle PA and/or SB on 1) disease activity; 2) PA, SB and 3) patient- and clinician-important outcomes in people with RA.MethodsEight databases [Medline, Cochrane Library CENTRAL, Web of Science, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Scopus, Excerpta Medica database and Physiotherapy Evidence Database] were searched from inception-August 2022. Inclusion criteria required interventions to target lifestyle PA and/or SB, conducted in adults with RA, assessing patient- and/or clinician-important outcomes.ResultsOf 880 relevant articles, 16 interventions met the inclusion criteria. Meta-analyses showed statistically significant effects of interventions on disease activity (standardised mean difference = -0.12 (95% confidence interval = -0.23 to -0.01, I2 = 6%, z = 2.19, p = .03), moderate-to-vigorous PA, light/leisure PA, steps, functional ability, and fatigue. Whereas, no intervention effects were visualised for total PA, pain, anxiety or quality of life.ConclusionsLifestyle PA interventions led to increased PA, reductions in SB and improvements in disease activity and other patient- and/or clinician-important health outcomes in people with RA. Future interventions should be less heterogenous in content, structure, focus and outcome measures used to aid understanding of the most effective intervention components for improving health. More SB interventions are needed to determine their effectiveness at producing clinical benefits.

Just-In-Time Adaptive Intervention to Sit Less and Move More in People With Type 2 Diabetes: Protocol for a Microrandomized Trial.

Reducing sedentary behavior and increasing physical activity in people with type 2 diabetes (T2D) are associated with various positive health benefits. Just-in-time adaptive interventions offer the potential to target both of these behaviors through more contextually aware, tailored, and personalized support. We have developed a just-in-time adaptive intervention to promote sitting less and moving more in people with T2D. This paper presents the study protocol for a microrandomized trial to investigate whether motivational messages are effective in reducing time spent sitting in people with T2D and to determine what behavior change techniques are effective and in which context (eg, location, etc). We will use a 6-week microrandomized trial design. A total of 22 adults with T2D will be recruited. The intervention aims to reduce sitting time and increase time spent standing and walking and comprises a mobile app (iMove), a bespoke activity sensor called Sedentary Behavior Detector (SORD), a messaging system, and a secured database. Depending on the randomization sequence, participants will potentially receive motivational messages 5 times a day. Recruitment was initiated in October 2022. As of now, 6 participants (2 female and 4 male) have consented and enrolled in the study. Their baseline measurements have been completed, and they have started using iMove. The mean age of 6 participants is 56.8 years, and they were diagnosed with T2D for 9.4 years on average. This study will inform the optimization of digital behavior change interventions to support people with T2D Sit Less and Move More to increase daily physical activity. This study will generate new evidence about the immediate effectiveness of sedentary behavior interventions, their active ingredients, and associated factors. Australian New Zealand Clinical Trial Registry ACTRN12622000426785; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383664. DERR1-10.2196/41502.

A Sedentary Behaviour Intervention To Reduce Sitting Time In Patients With Coronary Artery Disease

A Sedentary Behaviour Intervention To Reduce Sitting Time In Patients With Coronary Artery Disease

Day-of-the-Week and Time-of-the-Day Patterns of Sedentary Behavior in the Hispanic Community Health Study/Study of Latinos.

Existing sedentary behavior interventions have largely achieved mixed results. Conventionally, interventions have attempted to reduce sedentary behavior using a full-day approach. An alternative strategy may be to target specific periods during the day and/or week. This study examined the day-of-the-week (Monday to Sunday) and time-of-the-day patterns (3-and 6-h periods) of sedentary behavior among U.S. Hispanics/Latinos adults. Participants ( n = 12,241) from the Hispanic Community Health Study/Study of Latinos, a multisite community-based prospective cohort study of Hispanic/Latino adults, were studied. Sedentary behavior was assessed for 1 wk using a hip-mounted accelerometer through total sedentary time, sedentary time in bouts ≥60 min, and total number of sedentary breaks. The temporal patterns of sedentary behavior metrics were evaluated using linear mixed effect models accounting for the Hispanic Community Health Study/Study of Latinos complex survey design. There were statistically significant variations in temporal patterns across day-of-the-week and time-of-the-day periods for all three metrics ( P < 0.001). Adults were more sedentary on weekends than on weekdays and most sedentary on Sundays. The time-of-the-day patterns had a U-curve pattern wherein adults were most sedentary late at night, became less sedentary throughout the day, reached peak activeness around noon, then gradually became more sedentary into the evening. These patterns were largely robust across seasonality and most sociodemographic characteristics, including age, employment status, work shift schedule, acculturation, and field center. Our findings suggest that early mornings, evenings, and weekends were the more sedentary periods in this cohort of Hispanic/Latino adults, characterized by higher volumes of sedentary time, higher volumes of time in prolonged sedentary bouts, and fewer number of sedentary breaks than other time periods, highlighting important windows of opportunity to reduce sedentary behavior.

Cost-effectiveness analysis of sedentary behaviour interventions in offices to reduce sitting time in Australian desk-based workers: A modelling study.

Sedentary behaviour (SB) is associated with increased incidence of chronic diseases such as type 2 diabetes (T2D), cardiovascular disease, cancers, and premature mortality. SB interventions in workplaces are effective in reducing sitting time. Previous economic evaluations have not specifically used changes in sitting time to estimate the long-term impact of SB on chronic disease-related health and cost outcomes. This research evaluated the cost-effectiveness of three hypothetical SB interventions: behavioural (BI), environmental (EI) and multi-component intervention (MI), implemented in the Australian context, using a newly developed epidemiological model that estimates the impact of SB as a risk factor on long-term population health and associated cost outcomes. Pathway analysis was used to identify the resource items associated with implementing each of the three interventions using a limited societal perspective (included costs: health sector, individuals and industry; excluded costs: productivity). The effectiveness of the modelled interventions in reducing daily sitting time (informed by published meta-analyses) was modelled for the Australian working population aged 20-65 years. A multi-cohort Markov model was developed to simulate the 2019 Australian population and estimate the incidence, prevalence and mortality of five diseases causally related to excessive sitting time, over the life course. Monte-Carlo simulations were used to calculate each intervention's mean incremental costs and benefits (quantified as health adjusted life years HALYs) compared to a do-nothing comparator. When implemented at the national level, the interventions were estimated to reach 1,018 organisations with 1,619,239 employees. The estimated incremental cost of SB interventions was A$159M (BI), A$688M (EI) and A$438M (MI) over a year. Incremental health-adjusted life years (HALYs) gained by BI, EI and MI were 604, 919 and 349, respectively. The mean ICER for BI was A$251,863 per HALY gained, A$737,307 for EI and A$1,250,426 for MI. Only BI had any probability (2%) of being cost-effective at a willingness-to-pay threshold of A$50,000 per HALY gained from a societal perspective. SB interventions are not cost-effective when a reduction in sitting time is the outcome measure of interest. The cost-effectiveness results are heavily driven by the cost of the sit-stand desks and the small HALYs gained from reducing sitting time. Future research should focus on capturing non-health-benefits of these interventions, such as productivity, work satisfaction, and other health benefits: metabolic, physical, and musculoskeletal outcomes. Importantly, the health benefits of simultaneously reducing sitting time and increasing standing time for such interventions should be captured with the joint effects of these risk factors appropriately considered.

Effectiveness of a Sedentary Behaviour Intervention as a Personalised Secondary Prevention Strategy (SIT LESS) for patients with coronary artery disease: primary outcomes of the SIT LESS trial

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Dutch Heart Foundation. Background High levels of time spent sedentary are associated with increased risk of cardiovascular disease morbidity and mortality, even after accounting for traditional risk factors. A sedentary lifestyle is highly prevalent among patients with coronary artery disease (CAD). Purpose This clinical trial aimed to determine whether a multicomponent, hybrid (center- and home-based), sedentary behaviour change intervention as a personalized secondary prevention strategy (SIT LESS) reduces daily sedentary time among patients with CAD participating in cardiac rehabilitation. Methods Patients were randomised to usual care (n=104) or SIT LESS (n=108). Both groups received a comprehensive 12-week centre-based cardiac rehabilitation programme with face-to-face consultations and supervised exercise sessions, whereas SIT LESS participants additionally received a 12-week, nurse-delivered, hybrid behaviour change intervention in combination with an activity tracker connected to a smartphone application. Primary outcome was the change in objectively measured sedentary time between pre- to post-rehabilitation. Results Patients (77% male) were 63±10 years and primarily diagnosed with myocardial infarction (78%). Sedentary time decreased in SIT LESS (−1.6 [−2.1 to −1.1] hours/day) and controls (−1.2 [ ─1.7 to −0.8]), but between group differences did not reach statistical significance (─0.4 [─1.0 to 0.3]) hours/day, Central Figure). The post-rehabilitation proportion of patients with a sedentary time above the upper limit of normal (≥9.5 hours/day) was significantly lower in SIT LESS versus controls (48% versus 72%, baseline-adjusted odds-ratio 0.4 (0.2-0.8)). No differences were observed in the other predefined secondary outcomes. Conclusions Among patients with coronary artery disease participating in cardiac rehabilitation, SIT LESS did not induce significantly greater reductions in sedentary time compared to controls, but delivery was feasible and a reduced odds of a sedentary time ≥9.5 hours/day was observed.

Interventions to promote healthy lifestyle behaviors in children and adolescents in summer day camps: a scoping review

BackgroundChildren and adolescents have suboptimal physical activity and eating habits during summer breaks. Unlike the school setting, there is little evidence on interventions to promote healthy lifestyle behaviors in Summer Day Camps (SDCs).MethodsThe aim of this scoping review was to examine physical activity, healthy eating, and sedentary behavior interventions in the SDCs. A systematic search on four platforms (EBSCOhost, MEDLINE, EMBASE, and Web of Science) was performed in May 2021 and was updated in June 2022. Studies related to promoting healthy behaviors, physical activity, sedentary behaviors and/or healthy eating among campers aged 6 to 16 in Summer Day Camps were retained. The protocol and writing of the scoping review were done according to the guidelines of the “Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR)”.ResultsMost interventions had a positive effect on the behavioral determinants or the behaviors themselves (i.e., physical activity, sedentary behaviors, or healthy eating). Involving counsellors and parents, setting camp goals, gardening, and education are all relevant strategies in promoting healthy lifestyle behaviors in SDCs.ConclusionsSince only one intervention directly targeted sedentary behaviors, it should strongly be considered for inclusion in future studies. In addition, more long-term and experimental studies are needed to establish cause-and-effect relationships between healthy behavior interventions in SDCs and behaviors of children and young adolescents.

Abstract MP69: Day-of-the-Week and Time-of-the-Day Temporal Patterns of Sedentary Behavior Among Hispanic / Latino Adults: Hispanic Community Health Study / Study of Latinos

Objectives: Existing sedentary behavior interventions have largely achieved modest results. Conventionally, interventions have attempted to reduce sedentary time using a full-day approach. An alternative strategy is to target specific periods when sedentary behavior is most prevalent. However, little is known when sedentary time is most likely to occur in adults. This study examined the day-of-the-week and time-of-the-day patterns of sedentary behavior among U.S. Hispanic/Latino adults. Methods: Participants (n=12,241) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multi-site prospective cohort study of Hispanic/Latino adults, were studied. Sedentary time was measured for one week using a hip-mounted accelerometer. Three sedentary metrics were quantified: total sedentary time, sedentary time in bouts ≥ 60 minutes, and number of sedentary breaks. Results: Temporal patterns across days of the week were statistically significant for all three sedentary metrics (Figure, Panels A-C, p &lt; .001). Total sedentary time decreased from 719±2 mins/d on Mondays to 710±3 mins/d on Fridays the lowest and increased over weekends with Sundays (733±3 mins/d) the highest. Temporal patterns across 3-h periods of the day were statistically significant for all sedentary metrics (Figure, Panels D-F, p &lt; .001). Time-of-the-day patterns had a U-curve pattern wherein adults were most sedentary late at night, became less sedentary throughout the day, reached peak activeness around noon, then became more sedentary into the evening. Day-of-the-week and time-of-the-day patterns were robust across age, employment, work shift, and acculturation subgroups. Conclusions: Mornings, evenings, and weekends were the most sedentary periods in this cohort of Hispanic/Latino adults, characterized by higher volumes of sedentary time, more prolonged sedentary bouts, and fewer sedentary breaks. These time periods should be considered as important windows for behavioral interventions targeting sedentary behavior.

Feasibility and Acceptability of an Internet of Things-Enabled Sedentary Behavior Intervention: Mixed Methods Study.

Encouraging office workers to break up prolonged sedentary behavior (SB) at work with regular microbreaks can be beneficial yet challenging. The Internet of Things (IoT) offers great promise for delivering more subtle and hence acceptable behavior change interventions in the workplace. We previously developed an IoT-enabled SB intervention, called WorkMyWay, by applying a combination of theory-informed and human-centered design approaches. According to the Medical Research Council's framework for developing and evaluating complex interventions such as WorkMyWay, process evaluation in the feasibility phase can help establish the viability of novel modes of delivery and identify facilitators and barriers to successful delivery. This study aims to evaluate the feasibility and acceptability of the WorkMyWay intervention and its technological delivery system. A mixed methods approach was adopted. A sample of 15 office workers were recruited to use WorkMyWay during work hours for 6 weeks. Questionnaires were administered before and after the intervention period to assess self-report occupational sitting and physical activity (OSPA) and psychosocial variables theoretically aligned with prolonged occupational SB (eg, intention, perceived behavioral control, prospective memory and retrospective memory of breaks, and automaticity of regular break behaviors). Behavioral and interactional data were obtained through the system database to determine adherence, quality of delivery, compliance, and objective OSPA. Semistructured interviews were conducted at the end of the study, and a thematic analysis was performed on interview transcripts. All 15 participants completed the study (attrition=0%) and on average used the system for 25 tracking days (out of a possible 30 days; adherence=83%). Although no significant change was observed in either objective or self-report OSPA, postintervention improvements were significant in the automaticity of regular break behaviors (t14=2.606; P=.02), retrospective memory of breaks (t14=7.926; P<.001), and prospective memory of breaks (t14=-2.661; P=.02). The qualitative analysis identified 6 themes, which lent support to the high acceptability of WorkMyWay, though delivery was compromised by issues concerning Bluetooth connectivity and factors related to user behaviors. Fixing technical issues, tailoring to individual differences, soliciting organizational supports, and harnessing interpersonal influences could facilitate delivery and enhance acceptance. It is acceptable and feasible to deliver an SB intervention with an IoT system that involves a wearable activity tracking device, an app, and a digitally augmented everyday object (eg, cup). More industrial design and technological development work on WorkMyWay is warranted to improve delivery. Future research should seek to establish the broad acceptability of similar IoT-enabled interventions while expanding the range of digitally augmented objects as the modes of delivery to meet diverse needs.

Effectiveness of an intervention to reduce sedentary behaviour as a personalised secondary prevention strategy for patients with coronary artery disease: main outcomes of the SIT LESS randomised clinical trial

BackgroundA high sedentary time is associated with increased mortality risk. Previous studies indicate that replacement of sedentary time with light- and moderate-to-vigorous physical activity attenuates the risk for adverse outcomes and improves cardiovascular risk factors. Patients with cardiovascular disease are more sedentary compared to the general population, while daily time spent sedentary remains high following contemporary cardiac rehabilitation programmes. This clinical trial investigated the effectiveness of a sedentary behaviour intervention as a personalised secondary prevention strategy (SIT LESS) on changes in sedentary time among patients with coronary artery disease participating in cardiac rehabilitation.MethodsPatients were randomised to usual care (n = 104) or SIT LESS (n = 108). Both groups received a comprehensive 12-week centre-based cardiac rehabilitation programme with face-to-face consultations and supervised exercise sessions, whereas SIT LESS participants additionally received a 12-week, nurse-delivered, hybrid behaviour change intervention in combination with a pocket-worn activity tracker connected to a smartphone application to continuously monitor sedentary time. Primary outcome was the change in device-based sedentary time between pre- to post-rehabilitation. Changes in sedentary time characteristics (prevalence of prolonged sedentary bouts and proportion of patients with sedentary time ≥ 9.5 h/day); time spent in light-intensity and moderate-to-vigorous physical activity; step count; quality of life; competencies for self-management; and cardiovascular risk score were assessed as secondary outcomes.ResultsPatients (77% male) were 63 ± 10 years and primarily diagnosed with myocardial infarction (78%). Sedentary time decreased in SIT LESS (− 1.6 [− 2.1 to − 1.1] hours/day) and controls (− 1.2 [ ─1.7 to − 0.8]), but between group differences did not reach statistical significance (─0.4 [─1.0 to 0.3]) hours/day). The post-rehabilitation proportion of patients with a sedentary time above the upper limit of normal (≥ 9.5 h/day) was significantly lower in SIT LESS versus controls (48% versus 72%, baseline-adjusted odds-ratio 0.4 (0.2–0.8)). No differences were observed in the other predefined secondary outcomes.ConclusionsAmong patients with coronary artery disease participating in cardiac rehabilitation, SIT LESS did not induce significantly greater reductions in sedentary time compared to controls, but delivery was feasible and a reduced odds of a sedentary time ≥ 9.5 h/day was observed.Trial registrationNetherlands Trial Register: NL9263.Graphical Outcomes of the SIT LESS trial: changes in device-based sedentary time from pre-to post-cardiac rehabilitation (control group) and cardiac rehabilitation + SIT LESS (intervention group). SIT LESS reduced the odds of patients having a sedentary time >9.5 hours/day (upper limit of normal), although the absolute decrease in sedentary time did not significantly differ from controls. SIT LESS appears to be feasible, acceptable and potentially beneficial, but a larger cluster randomised trial is warranted to provide a more accurate estimate of its effects on sedentary time and clinical outcomes. CR: cardiac rehabilitation.

Sedentary Behaviour—A Target for the Prevention and Management of Cardiovascular Disease

Cardiovascular disease (CVD) is highly prevalent and can lead to disability and premature mortality. Sedentary behaviour, defined as a low energy expenditure while sitting or lying down, has been identified as an independent risk factor for CVD. This article discusses (1) the association of total sedentary time and patterns of accumulating sedentary time with CVD risk markers, CVD incidence and mortality; (2) acute experimental evidence regarding the acute effects of reducing and breaking up sedentary time on CVD risk markers; and (3) the effectiveness of longer-term sedentary behaviour interventions on CVD risk. Findings suggest that under rigorously controlled laboratory and free-living conditions, breaking up sedentary time improves cardiovascular risk markers in individuals who are healthy, overweight or obese, or have impaired cardiovascular health. Breaking up sedentary time with walking may have the most widespread benefits, whereas standing breaks may be less effective, especially in healthy individuals. There is also growing evidence that sedentary behaviour interventions may benefit cardiovascular risk in the longer term (i.e., weeks to months). Reducing and breaking up sedentary time may, therefore, be considered a target for preventing and managing CVD. Further research is needed to determine the effectiveness of sedentary behaviour interventions over the long-term to appropriately inform guidelines for the management of CVD.

Transform-Us! cluster RCT: 18-month and 30-month effects on children’s physical activity, sedentary time and cardiometabolic risk markers

ObjectiveTo test the efficacy of the Transform-Us! school- and home-based intervention on children’s physical activity (PA), sedentary behaviour (SB) and cardiometabolic risk factor profiles.MethodsA 30-month 2×2 factorial design cluster randomised...