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Nonworksite Interventions to Reduce Sedentary Behavior among Adults: A Systematic Review.

ABSTRACT: PURPOSE:Sedentary behavior has been identified as a major health risk. While interventions to reduce time spent sedentary have become increasingly prevalent, the vast majority of this work in adults has been focused on workplace sedentary behavior, and often pairs sedentary reduction interventions with increasing physical activity. As research designed to specifically decrease sedentary time that is not limited to the workplace becomes available, identifying strategies and approaches, along with feasibility and efficacy of these interventions, is warranted. METHODS:Electronic databases were searched for sedentary interventions with eligibility criteria including: (a) interventions designed to explicitly reduce sedentary behavior that were not limited to the workplace, (b) outcomes specific to sedentary behavior, (c) adults aged at least 18 years, and (d) written in English. RESULTS:A total of 767 full-text manuscripts were identified, with thirteen studies meeting all eligibility criteria. While intervention characteristics and methodological quality varied greatly among studies, ten of the thirteen studies observed a significant reduction in objectively measured sitting time post-intervention. In those studies that collected participant feasibility/acceptability data, all reported that the intervention was viewed as "favorable to very favorable," would use again, and that participant burden was quite low, suggesting that these interventions were feasible. CONCLUSION:Sedentary behavior interventions not limited to the workplace appear to be largely efficacious. While results varied with respect to the magnitude of the decrease in time spent sedentary, they are encouraging. However, due to the small body of evidence and the variability of study designs, our ability to make overarching statements regarding "best practices" at this time is limited. Well-controlled trials of longer duration with larger samples, using theoretically-based interventions with consistent prescriptions for limiting sedentary time are needed.

SUBMITTER: Thraen-Borowski KM

PROVIDER: S-EPMC5630153 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Nonworksite Interventions to Reduce Sedentary Behavior among Adults: A Systematic Review.

Thraen-Borowski Keith M KM Ellingson Laura D LD Meyer Jacob D JD Cadmus-Bertram Lisa L

Translational journal of the American College of Sports Medicine 20170601 12

<h4>Purpose</h4>Sedentary behavior has been identified as a major health risk. While interventions to reduce time spent sedentary have become increasingly prevalent, the vast majority of this work in adults has been focused on workplace sedentary behavior, and often pairs sedentary reduction interventions with increasing physical activity. As research designed to specifically decrease sedentary time that is not limited to the workplace becomes available, identifying strategies and approaches, al ...[more]

PMID: 28993817

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Project description:BackgroundSedentary behavior occurs largely subconsciously, and thus specific behavior change techniques are needed to increase conscious awareness of sedentary behavior. Chief amongst these behavior change techniques is self-monitoring of sedentary behavior. The aim of this systematic review and meta-analysis was to evaluate the short-term effectiveness of existing interventions using self-monitoring to reduce sedentary behavior in adults.MethodsFour electronic databases (PubMed, Embase, Web of Science, and The Cochrane Library) and grey literature (Google Scholar and the International Clinical Trials Registry Platform) were searched to identify appropriate intervention studies. Only (cluster-)randomized controlled trials that 1) assessed the short-term effectiveness of an intervention aimed at the reduction of sedentary behavior, 2) used self-monitoring as a behavior change technique, and 3) were conducted in a sample of adults with an average age???18?years, were eligible for inclusion. Relevant data were extracted, and Hedge's g was used as the measure of effect sizes. Random effects models were performed to conduct the meta-analysis.ResultsNineteen intervention studies with a total of 2800 participants met the inclusion criteria. Results of the meta-analyses showed that interventions using self-monitoring significantly reduced total sedentary time (Hedges g?=?0,32; 95% CI?=?0,14 -?0,50; p?=?0,001) and occupational sedentary time (Hedge's g?=?0,56; 95% CI?=?0,07 -?0,90; p?=?0,02) on the short term. Subgroup analyses showed that significant intervention effects were only found if objective self-monitoring tools were used (g?=?0,40; 95% CI?=?0,19 -?0,60; p?<?0,001), and if the intervention only targeted sedentary behavior (g?=?0,45; 95% CI?=?0,15-0,75; p?=?0,004). No significant intervention effects were found on the number of breaks in sedentary behavior.ConclusionsDespite the small sample sizes, and the large heterogeneity, results of the current meta-analysis suggested that interventions using self-monitoring as a behavior change technique have the potential to reduce sedentary behavior in adults. If future - preferably large-scale studies - can prove that the reductions in sedentary behavior are attributable to self-monitoring and can confirm the sustainability of this behavior change, multi-level interventions including self-monitoring may impact public health by reducing sedentary behavior.

Project description:BackgroundTraditional psychological theories are inadequate to fully leverage the potential of smartphones and improve the effectiveness of physical activity (PA) and sedentary behavior (SB) change interventions. Future interventions need to consider dynamic models taken from other disciplines, such as engineering (eg, control systems). The extent to which such dynamic models have been incorporated in the development of interventions for PA and SB remains unclear.ObjectiveThis review aims to quantify the number of studies that have used dynamic models to develop smartphone-based interventions to promote PA and reduce SB, describe their features, and evaluate their effectiveness where possible.MethodsDatabases including PubMed, PsycINFO, IEEE Xplore, Cochrane, and Scopus were searched from inception to May 15, 2019, using terms related to mobile health, dynamic models, SB, and PA. The included studies involved the following: PA or SB interventions involving human adults; either developed or evaluated integrated psychological theory with dynamic theories; used smartphones for the intervention delivery; the interventions were adaptive or just-in-time adaptive; included randomized controlled trials (RCTs), pilot RCTs, quasi-experimental, and pre-post study designs; and were published from 2000 onward. Outcomes included general characteristics, dynamic models, theory or construct integration, and measured SB and PA behaviors. Data were synthesized narratively. There was limited scope for meta-analysis because of the variability in the study results.ResultsA total of 1087 publications were screened, with 11 publications describing 8 studies included in the review. All studies targeted PA; 4 also included SB. Social cognitive theory was the major psychological theory upon which the studies were based. Behavioral intervention technology, control systems, computational agent model, exploit-explore strategy, behavioral analytic algorithm, and dynamic decision network were the dynamic models used in the included studies. The effectiveness of quasi-experimental studies involved reduced SB (1 study; P=.08), increased light PA (1 study; P=.002), walking steps (2 studies; P=.06 and P<.001), walking time (1 study; P=.02), moderate-to-vigorous PA (2 studies; P=.08 and P=.81), and nonwalking exercise time (1 study; P=.31). RCT studies showed increased walking steps (1 study; P=.003) and walking time (1 study; P=.06). To measure activity, 5 studies used built-in smartphone sensors (ie, accelerometers), 3 of which used the phone's GPS, and 3 studies used wearable activity trackers.ConclusionsTo our knowledge, this is the first systematic review to report on smartphone-based studies to reduce SB and promote PA with a focus on integrated dynamic models. These findings highlight the scarcity of dynamic model-based smartphone studies to reduce SB or promote PA. The limited number of studies that incorporate these models shows promising findings. Future research is required to assess the effectiveness of dynamic models in promoting PA and reducing SB.Trial registrationInternational Prospective Register of Systematic Reviews (PROSPERO) CRD42020139350; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=139350.

Project description:BackgroundChildren and adolescents increasingly do not meet physical activity (PA) recommendations. Hence, insufficient PA (IPA) and sedentary behavior (SB) among children and adolescents are relevant behavior change domains for using individualized mobile health (mHealth) interventions.ObjectiveThis review and meta-analysis investigated the effectiveness of mHealth interventions on IPA and SB, with a special focus on the age and level of individualization.MethodsPubMed, Scopus, Web of Science, SPORTDiscus, and Cochrane Library were searched for randomized controlled trials published between January 2000 and March 2021. mHealth interventions for primary prevention in children and adolescents addressing behavior change related to IPA and SB were included. Included studies were compared for content characteristics and methodological quality and summarized narratively. In addition, a meta-analysis with a subsequent exploratory meta-regression examining the moderating effects of age and individualization on overall effectiveness was performed.ResultsOn the basis of the inclusion criteria, 1.3% (11/828) of the preliminary identified studies were included in the qualitative synthesis, and 1.2% (10/828) were included in the meta-analysis. Trials included a total of 1515 participants (mean age (11.69, SD 0.788 years; 65% male and 35% female) self-reported (3/11, 27%) or device-measured (8/11, 73%) health data on the duration of SB and IPA for an average of 9.3 (SD 5.6) weeks. Studies with high levels of individualization significantly decreased insufficient PA levels (Cohen d=0.33; 95% CI 0.08-0.58; Z=2.55; P=.01), whereas those with low levels of individualization (Cohen d=-0.06; 95% CI -0.32 to 0.20; Z=0.48; P=.63) or targeting SB (Cohen d=-0.11; 95% CI -0.01 to 0.23; Z=1.73; P=.08) indicated no overall significant effect. The heterogeneity of the studies was moderate to low, and significant subgroup differences were found between trials with high and low levels of individualization (χ21=4.0; P=.04; I2=75.2%). Age as a moderator variable showed a small effect; however, the results were not significant, which might have been because of being underpowered.ConclusionsEvidence suggests that mHealth interventions for children and adolescents can foster moderate reductions in IPA but not SB. Moreover, individualized mHealth interventions to reduce IPA seem to be more effective for adolescents than for children. Although, to date, only a few mHealth studies have addressed inactive and sedentary young people, and their quality of evidence is moderate, these findings indicate the relevance of individualization on the one hand and the difficulties in reducing SB using mHealth interventions on the other.Trial registrationPROSPERO CRD42020209417; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209417.

Project description: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 of impact and context influence outcomes and (2) how these interventions are experienced from different perspectives (participants, carers, staff).DesignSystematic review and narrative synthesis underpinned by the Medical Research Council process evaluation framework.Data sourcesDatabases searches were conducted in March 2019 then updated in May 2020 and October 2021 in: CINAHL, SPORTDiscus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, AMED; EMBASE, PsycINFO, MEDLINE, Web of Science and ProQuest Dissertations & Theses.Eligibility criteriaWe included: Process evaluations of trials including interventions where sedentary behaviour was measured as an outcome in adults aged 16 or over from clinical or non-clinical populations. We excluded studies if interventions were delivered in educational or workplace settings, or if they were laboratory studies focused on immediate effects of breaking sitting.Data extraction and synthesisTwo independent reviewers extracted and coded data into a framework and assessed the quality of studies using the Mixed Methods Appraisal Tool. We synthesised findings using a narrative approach.Results17 process evaluations were included. Five interventions focused on reducing sedentary behaviour or sitting time, 12 aimed to increase physical activity or promote healthier lifestyles. Process evaluations indicated changes in sedentary behaviour outcomes were shaped by numerous factors including: barriers (eg, staffing difficulties and scheduling problems) and facilitators (eg, allowing for flexibility) to intervention delivery; contextual factors (eg, usual lifestyle and religious events) and individual factors (eg, pain, tiredness, illness, age and individual preferences).DiscussionIntervention requires careful consideration of different factors that could influence changes in sedentary behaviour outcomes to ensure that interventions can be tailored to suit different individuals and groups.Prospero registration numberCRD42018087403.

Dataset Information

Nonworksite Interventions to Reduce Sedentary Behavior among Adults: A Systematic Review.

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Nonworksite Interventions to Reduce Sedentary Behavior among Adults: A Systematic Review.

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