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Effectiveness of a primary care-based intervention to reduce sitting time in overweight and obese patients (SEDESTACTIV): a randomized controlled trial; rationale and study design.

ABSTRACT: BACKGROUND:There is growing evidence suggesting that prolonged sitting has negative effects on people's weight, chronic diseases and mortality. Interventions to reduce sedentary time can be an effective strategy to increase daily energy expenditure. The purpose of this study is to evaluate the effectiveness of a six-month primary care intervention to reduce daily of sitting time in overweight and mild obese sedentary patients. METHOD/DESIGN:The study is a randomized controlled trial (RCT). Professionals from thirteen primary health care centers (PHC) will randomly invite to participate mild obese or overweight patients of both gender, aged between 25 and 65 years old, who spend 6 hours at least daily sitting. A total of 232 subjects will be randomly allocated to an intervention (IG) and control group (CG) (116 individuals each group). In addition, 50 subjects with fibromyalgia will be included.Primary outcome is: (1) sitting time using the activPAL device and the Marshall questionnaire. The following parameters will be also assessed: (2) sitting time in work place (Occupational Sitting and Physical Activity Questionnaire), (3) health-related quality of life (EQ-5D), (4) evolution of stage of change (Prochaska and DiClemente's Stages of Change Model), (5) physical inactivity (catalan version of Brief Physical Activity Assessment Tool), (6) number of steps walked (pedometer and activPAL), (7) control based on analysis (triglycerides, total cholesterol, HDL, LDL, glycemia and, glycated haemoglobin in diabetic patients) and (8) blood pressure and anthropometric variables. All parameters will be assessed pre and post intervention and there will be a follow up three, six and twelve months after the intervention. A descriptive analysis of all variables and a multivariate analysis to assess differences among groups will be undertaken. Multivariate analysis will be carried out to assess time changes of dependent variables. All the analysis will be done under the intention to treat principle. DISCUSSION:If the SEDESTACTIV intervention shows its effectiveness in reducing sitting time, health professionals would have a low-cost intervention tool for sedentary overweight and obese patients management. TRIAL REGISTRATION:A service of the U.S. National Institutes of Health. Developed by the National Library of Medicine. ClinicalTrials.gov NCT01729936.

SUBMITTER: Martin-Borras C

PROVIDER: S-EPMC3973868 | biostudies-literature | 2014 Mar

REPOSITORIES: biostudies-literature

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Effectiveness of a primary care-based intervention to reduce sitting time in overweight and obese patients (SEDESTACTIV): a randomized controlled trial; rationale and study design.

Martín-Borràs Carme C Giné-Garriga Maria M Martínez Elena E Martín-Cantera Carlos C Puigdoménech Elisa E Solà Mercè M Castillo Eva E Beltrán Angela Ma AM Puig-Ribera Anna A Trujillo José Manuel JM Pueyo Olga O Pueyo Javier J Rodríguez Beatriz B Serra-Paya Noemí N

BMC public health 20140305

<h4>Background</h4>There is growing evidence suggesting that prolonged sitting has negative effects on people's weight, chronic diseases and mortality. Interventions to reduce sedentary time can be an effective strategy to increase daily energy expenditure. The purpose of this study is to evaluate the effectiveness of a six-month primary care intervention to reduce daily of sitting time in overweight and mild obese sedentary patients.<h4>Method/design</h4>The study is a randomized controlled tri ...[more]

PMID: 24597534

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Project description:BackgroundToo much prolonged sitting is a prevalent health risk among adults. Interventions have focused mainly on the workplace, with limited attention to non-work settings. The effectiveness of a short-term intervention to reduce and break-up sitting-time in overweight/obese adults was examined. This pilot study sought to determine the feasibility of interrupting sitting to stand/ambulate objectively with ActivPAL devices which provide a valid measurement of sit/stand transitions.MethodsThis is a cross-over randomized controlled pilot that included 10 participants (aged 37-65 years) and although a small and short-term intervention (1-week intervention; no washout) further informs on the feasibility of interventions on a larger scale. At the workplace, screen-delivered hourly alerts prompted participants to break-up sitting-time through adopting walking behaviors (approximately 30-60 minutes day(-1)). During transportation/home/leisure-time individual goals for steps day(-1) were set and sitting-reduction strategies (including behavioral self-monitoring) were delivered through daily text messages. Change in inclinometer-derived sitting-time is the main outcome. Standing, stepping, number of sit/stand transitions and participant satisfaction were also examined.ResultsFor the intervention compared to the control-week (mean difference (95 % confidence interval); p value), participants had less sitting-time (1.85 hours (0.96-2.75); p = 0.001), more standing (0.77 hours (0.06-1.48); p = 0.036), and more stepping (1.09 hours (0.79- 1.38); p < 0.001). Importantly, there was no change in the total number of sit/stand transitions (3.28 (-2.33-8.89); p = 0.218) despite successfully reducing sitting-time and increasing time spent standing and walking.ConclusionsSitting-time in overweight/obese adults can be reduced following a brief multi-component intervention based on prompts, telephone support, goal setting and behavioral self-monitoring. However, the results from this pilot study provide new insight that when overweight/obese adults attempted to reduce sedentary-time by walking and standing for approximately 2 hour day(-1) more than usual, they did not actually get up from sitting more often (i.e. increasing the number of sit/stand transitions), but instead remained on their feet for longer during each non-sitting bout. This behavioral resistance to make more sit/stand transitions (i.e. get-up from sitting more often) may have important implications for future modification programs and supports the concept that when overweight/obese people are sitting, people seem to prefer not to interrupt the sedentary behavior to get-up from sitting.Trial registration26 November 2013, ClinicalTrials.govID: NCT02007681 (first participant was randomized on 2 September 2013).

Project description:Background:Desk-based workers engage in long periods of uninterrupted sitting time, which has been associated with morbidity and premature mortality. Previous workplace intervention trials have demonstrated the potential of providing sit-stand workstations, and of administering motivational behaviour change techniques, for reducing sitting time. Yet, few studies have combined these approaches or explored the acceptability of discrete sitting-reduction behaviour change strategies. This paper describes the rationale for a sitting-reduction intervention that combines sit-stand workstations with motivational techniques, and procedures for a pilot study to explore the acceptability of core intervention components among university office workers. Methods:The intervention is based on a theory and evidence-based analysis of why office workers sit, and how best to reduce sitting time. It seeks to enhance motivation and capability, as well as identify opportunities, required to reduce sitting time. Thirty office workers will participate in the pilot study. They will complete an initial awareness-raising monitoring and feedback task and subsequently receive a sit-stand workstation for a 12-week period. They will also select from a 'menu' of behaviour change techniques tailored to self-declared barriers to sitting reduction, effectively co-producing and personally tailoring their intervention. Interviews at 1, 6, and 12 weeks post-intervention will explore intervention acceptability. Discussion:To our knowledge, this will be the first study to explore direct feedback from office workers on the acceptability of discrete tailored sitting-reduction intervention components that they have received. Participants' choice of and reflections on intervention techniques will aid identification of strategies suitable for inclusion in the next iteration of the intervention, which will be delivered in a self-administered format to minimise resource burden. Trial registration:ISRCTN29395780 (registered 21 November 2016).

Project description:Background and objectivesProlonged sitting time has negative consequences on health, although the population is not well aware of these harmful effects. We explored opinions expressed by primary care patients diagnosed as overweight or moderately obese concerning their time spent sitting, willingness to change, and barriers, facilitators, goals and expectations related to limiting this behaviour.MethodsA descriptive-interpretive qualitative study was carried out at three healthcare centres in Barcelona, Spain, and included 23 patients with overweight or moderate obesity, aged 25 to 65 years, who reported sitting for at least 6 hours a day. Exclusion criteria were inability to sit down or stand up from a chair without help and language barriers that precluded interview participation. Ten in-depth, semi-structured interviews (5 group, 5 individual) were audio recorded from January to July 2012 and transcribed. The interview script included questions about time spent sitting, willingness to change, barriers and facilitators, and the prospect of assistance from primary healthcare professionals. An analysis of thematic content was made using ATLAS.Ti and triangulation of analysts.ResultsThe most frequent sedentary activities were computer use, watching television, and motorized journeys. There was a lack of awareness of the amount of time spent sitting and its negative consequences on health. Barriers to reducing sedentary time included work and family routines, lack of time and willpower, age and sociocultural limitations. Facilitators identified were sociocultural change, free time and active work, and family surroundings. Participants recognized the abilities of health professionals to provide help and advice, and reported a preference for patient-centred or group interventions.ConclusionsFindings from this study have implications for reducing sedentary behaviour. Patient insights were used to design an intervention to reduce sitting time within the frame of the SEDESTACTIV clinical trial.

Project description:PurposeExcessive sedentary time (SED) has been linked to obesity and other adverse health outcomes. However, few sedentary-reducing interventions exist and none have utilized smartphones to automate behavioral strategies to decrease SED. We tested a smartphone-based intervention to monitor and decrease SED in overweight/obese individuals, and compared 3 approaches to prompting physical activity (PA) breaks and delivering feedback on SED.Design and methodsParticipants [N = 30; Age = 47.5(13.5) years; 83% female; Body Mass Index (BMI) = 36.2(7.5) kg/m2] wore the SenseWear Mini Armband (SWA) to objectively measure SED for 7 days at baseline. Participants were then presented with 3 smartphone-based PA break conditions in counterbalanced order: (1) 3-min break after 30 SED min; (2) 6-min break after 60 SED min; and (3) 12-min break after 120 SED min. Participants followed each condition for 7 days and wore the SWA throughout.ResultsAll PA break conditions yielded significant decreases in SED and increases in light (LPA) and moderate-to-vigorous PA (MVPA) (p<0.005). Average % SED at baseline (72.2%) decreased by 5.9%, 5.6%, and 3.3% [i.e. by mean (95% CI) -47.2(-66.3, -28.2), -44.5(-65.2, -23.8), and -26.2(-40.7, -11.6) min/d] in the 3-, 6-, and 12-min conditions, respectively. Conversely, % LPA increased from 22.8% to 26.7%, 26.7%, and 24.7% [i.e. by 31.0(15.8, 46.2), 31.0(13.6, 48.4), and 15.3(3.9, 26.8) min/d], and % MVPA increased from 5.0% to 7.0%, 6.7%, and 6.3% (i.e. by 16.2(8.5, 24.0), 13.5(6.3, 20.6), and 10.8(4.2, 17.5) min/d] in the 3-, 6-, and 12-min conditions, respectively. Planned pairwise comparisons revealed the 3-min condition was superior to the 12-min condition in decreasing SED and increasing LPA (p<0.05).ConclusionThe smartphone-based intervention significantly reduced SED. Prompting frequent short activity breaks may be the most effective way to decrease SED and increase PA in overweight/obese individuals. Future investigations should determine whether these SED reductions can be maintained long-term.Trial registrationClinicalTrials.gov NCT01688804.

Project description:Over 45% of American women 20-39 years old are at risk for type 2 diabetes, cardiovascular disease, and other health conditions because they are overweight or obese. The prevalence of overweight and obesity is disproportionately high among low-income women. This paper describes the study design and rationale of a community based intervention (Mothers In Motion, MIM) aimed to prevent weight gain among low-income overweight and obese mothers 18-39 years old by promoting stress management, healthy eating, and physical activity.Peer recruiters approach participants from 5 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Michigan. The MIM delivers theory-based, culturally-sensitive intervention messages via a combination of DVDs and peer support group teleconferences (PSGTs). The DVD features African American and white overweight and obese WIC mothers who participated in a healthy lifestyle intervention patterned after MIM. The PSGTs are led by paraprofessionals from Michigan State University Extension and WIC providers in Michigan who are trained in motivational interviewing and group facilitation skills. Participants are randomly assigned to an intervention (n=350) or comparison group (n=175). The intervention group receives a 16-week intervention on a weekly or bi-weekly basis. Participants are asked to watch 10 MIM DVD chapters at home and join 10 PSGT sessions by phone. The comparison group receives printed educational materials. The primary outcome is body weight. Secondary outcomes include dietary fat, fruit, and vegetable intake; physical activity; stress, and affect. Mediators are self-efficacy, emotional coping response, social support, and autonomous motivation. Telephone interviews and in-person data collection at WIC offices occur at 3 time points: baseline, immediately, and 3 months after the 16-week intervention.If MIM shows effectiveness, it could have a favorable impact on public health and community programs. The DVDs and PSGTs will be disseminated in WIC, Extension, clinical practice that promote healthy lifestyles for similar target audiences to make a broad contribution to the prevention of weight gain in low-income mothers. Also, our methodology can be adapted by researchers and community stakeholders to help other low-income populations prevent weight gain.Clinical Trials Number: NCT01839708.

Dataset Information

Effectiveness of a primary care-based intervention to reduce sitting time in overweight and obese patients (SEDESTACTIV): a randomized controlled trial; rationale and study design.

Publications

Effectiveness of a primary care-based intervention to reduce sitting time in overweight and obese patients (SEDESTACTIV): a randomized controlled trial; rationale and study design.

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