1
|
Cohen Elimelech O, Rosenblum S, Tsadok-Cohen M, Meyer S, Ferrante S, Demeter N. Three Perspectives on Older Adults' Daily Performance, Health, and Technology Use During COVID-19: Focus Group Study. JMIR Aging 2024; 7:e53141. [PMID: 38825851 PMCID: PMC11154653 DOI: 10.2196/53141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 03/04/2024] [Accepted: 04/10/2024] [Indexed: 06/04/2024] Open
Abstract
Background During COVID-19 lockdowns, older adults' engagement in daily activities was severely affected, causing negative physical and mental health implications. Technology flourished as a means of performing daily activities in this complex situation; however, older adults often struggled to effectively use these opportunities. Despite the important role of older adults' social environments-including their families and health professionals-in influencing their technology use, research into their unique perspectives is lacking. Objective This study aimed to explore the daily activity performance, health, and technology use experiences of healthy independent Israeli adults (aged ≥65 years) during COVID-19 from a 3-dimensional perspective: older adults, older adults' family members, and health professionals. Methods Nine online focus groups, averaging 6-7 participants per group, were conducted with older adults, family members, and health professionals (N=59). Data were analyzed using thematic analysis and constant comparative methods. Results The intertwining of daily activity performance and health emerged as a central theme, with differences between the groups. Older adults prioritized their self-fulfilling routines based on motivation and choice, especially in social-familial activities. In contrast, family members and health professionals focused on serious physical and mental health COVID-19-related consequences. A consensus among all three groups revealed the meaningful role of technology use during this period in bridging functional limitations. Participants delved into technology's transformative power, focusing on the need for technology to get engaged in daily activities. Conclusions This study illustrates the profound interplay between daily activity performances, physical and mental health, and technology use, using a 3-dimensional approach. Its focus on technology's uses and benefits sheds light on what older adults need to increase their technology use. Interventions for improving digital activity performance can be tailored to meet older adults' needs and preferences by focusing on motivational and preference-related activities.
Collapse
Affiliation(s)
- Ortal Cohen Elimelech
- The Laboratory of Complex Human Activity and Participation, Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Sara Rosenblum
- The Laboratory of Complex Human Activity and Participation, Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Michal Tsadok-Cohen
- The Laboratory of Complex Human Activity and Participation, Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Sonya Meyer
- Department of Occupational Therapy, Ariel University, Ariel, Israel
| | - Simona Ferrante
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Naor Demeter
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| |
Collapse
|
2
|
Rodriguez Roca B, Tully MA, Sansano-Nadal O, Caserotti P, Coll-Planas L, Roqué M, Brønd J, Blackburn NE, Wilson JJ, Rothenbacher D, McIntosh E, Deidda M, Andrade-Gómez E, Giné-Garriga M. Is education level, as a proxy for socio-economic position, related to device-measured and self-reported sedentary behavior in European older adults? A cross-sectional study from the SITLESS project. Front Public Health 2023; 11:1296821. [PMID: 38169596 PMCID: PMC10758416 DOI: 10.3389/fpubh.2023.1296821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024] Open
Abstract
Background Sedentary behavior (SB) is a determinant of health in older adult people. Educational level is a primary driver of health disparities and is demonstrated to be a reliable measure of socioeconomic position. We aimed to examine the associations between educational level and self-reported along with device-measured SB in older adults living in Europe and the association of mentally active and passive SB domains with the educational level and gender in these associations. Methods The design is cross-sectional. One thousand three hundred and sixty participants aged 65 and over (75.3±6.3 years old, 61.8% women) participated. Inclusion criteria were scored with the Short Physical Performance Battery. Variables that describe the sample were assessed with an interview, and device-measured SB was assessed with an accelerometer. SB was assessed with the Sedentary Behavior Questionnaire and an accelerometer. Multiple linear regression models were used to study the association between the level of education and SB. Results Participants self-reported an average of 7.82 (SD: 3.02) daily waking hours of SB during weekend days, and the average of device-measured SB was 11.39 (1.23) h. Total mentally active SB (weekdays and weekends) was associated with the education level (p < 0.000). Participants were more sedentary during the week than during weekends, regardless of level of education (p < 0.000). Education level was significantly associated with self-reported mean hours per day in 46SB (p = 0.000; R=0.026; 95%CI). Conclusion Low education level in older adults is associated with self-reported SB but not with objective SB measures.
Collapse
Affiliation(s)
- Beatriz Rodriguez Roca
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Mark A. Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
| | - Oriol Sansano-Nadal
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain
- School of Health and Sport Sciences (EUSES), Rovira i Virgili University, Amposta, Spain
| | - Paolo Caserotti
- Department of Sports Science and Clinical Biomechanics, Center for Active and Healthy Ageing (CAHA), Syddansk Universitet, Odense, Denmark
| | - Laura Coll-Planas
- Fundació Salut I Envelliment (Foundation on Health and Ageing) – UAB, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Roqué
- Iberoamerican Cochrane Centre - Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jan Brønd
- Department of Sports Science and Clinical Biomechanics, Center for Active and Healthy Ageing (CAHA), Syddansk Universitet, Odense, Denmark
| | - Nicole E. Blackburn
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
| | - Jason J. Wilson
- Sport and Exercise Sciences Research Institute, School of Sport, Ulster University, Newtownabbey, United Kingdom
| | | | - Emma McIntosh
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing (IHW), University of Glasgow, Glasgow, United Kingdom
| | - Manuela Deidda
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing (IHW), University of Glasgow, Glasgow, United Kingdom
| | - Elena Andrade-Gómez
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
| | - Maria Giné-Garriga
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain
- Department of Physical Therapy, Faculty of Health Sciences (FCS) Blanquerna, Ramon Llull University, Barcelona, Spain
| |
Collapse
|
3
|
Ten Broeke P, Gardner B, Beckers DGJ, Geurts SAE, Bijleveld E. Why do people sit? A framework for targeted behavior change. Health Psychol Rev 2023; 17:641-654. [PMID: 36343923 DOI: 10.1080/17437199.2022.2143851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022]
Abstract
To improve health and wellbeing, it is crucial that people regularly interrupt their sitting. In this paper, we propose a framework for examining and changing sitting behavior that addresses two key steps in the process towards developing effective interventions. First, we suggest that research should move away from its current focus on sitting time, which is an outcome of behavior. Rather, researchers should focus on stand-to-sit and sit-to-stand transitions, which are discrete units of behavior. Second, drawing on goal hierarchy models, we suggest that people rarely engage in stand-to-sit and sit-to-stand transitions for the purpose of being in a sitting or standing position; rather, we suggest that these transitions are means to higher-order goals (e.g., to complete work tasks, to watch television, to eat dinner). To improve adherence to and effectiveness of sitting behavior interventions, intervention designers should aim to increase the frequency of sit-to-stand (and stand-to-sit) transitions. To achieve this aim, intervention designers should capitalize on the higher-order goals that are typically served by these transitions. We suggest four concrete intervention strategies to increase sit-to-stand transitions in congruence with people's everyday goals. We also describe the implications of our framework for theory and methods in sitting behavior research.
Collapse
Affiliation(s)
- Pam Ten Broeke
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | | | - Debby G J Beckers
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Sabine A E Geurts
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Erik Bijleveld
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| |
Collapse
|
4
|
Compernolle S, Cerin E, Barnett A, Zhang CJP, Van Cauwenberg J, Van Dyck D. The role of socio-demographic factors and physical functioning in the intra- and interpersonal variability of older adults' sedentary time: an observational two-country study. BMC Geriatr 2022; 22:495. [PMID: 35681115 PMCID: PMC9178546 DOI: 10.1186/s12877-022-03186-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Insight into the variability of older adults' sedentary time is needed to inform future interventions. The aim of this study was to examine the intra- and interpersonal variability in sedentary time, and the moderating role of socio-demographics, physical functioning and geographical location in this variability. METHODS Cross-sectional data from 818 community-dwelling older adults (mean age: 74.8 years; 61.1%women) of the Active Lifestyle and the Environment in Chinese Seniors and Belgian Environmental Physical Activity Study in Seniors were used. An interview questionnaire was administered to collect socio-demographic information. The Short Physical Performance Battery was performed to evaluate physical functioning, and Actigraph GT3X( +) accelerometers were used to estimate sedentary time. Linear mixed models with random intercepts at the neighborhood, person and day levels examined the variability in sedentary time, and the moderating role of socio-demographics, physical functioning and geographical location within this variability. RESULTS Most of the variance in accelerometry-assessed sedentary time was due to intrapersonal variability across periods of the day (72.4%) followed by interpersonal variability within neighborhoods (25.6%). Those who were older, men, lived in Hong Kong, and experienced a lower level of physical functioning were more sedentary than their counterparts. Sedentary time increased throughout the day, with highest levels of sedentary time observed between 6:00 and 9:00 pm. The patterns of sedentary time across times of the day differed by gender, educational attainment, age, physical functioning and/or geographical location. No significant differences were detected between week and weekend day sedentary time. CONCLUSIONS The oldest old, men, and those with functional limitations are important target groups for sedentary behavior interventions. As sedentary time was the highest in the evening future sedentary behavior intervention should pay particular attention to the evening hours. The variations in diurnal patterns of sedentary time between population subgroups suggest that personalized just-in-time adaptive interventions might be a promising strategy to reduce older adults' sedentary time.
Collapse
Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
- Research Foundation Flanders (FWO), Brussels, Belgium.
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Casper J P Zhang
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Jelle Van Cauwenberg
- Research Foundation Flanders (FWO), Brussels, Belgium
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
5
|
Nuwere E, Barone Gibbs B, Toto PE, Taverno Ross SE. Planning for a Healthy Aging Program to Reduce Sedentary Behavior: Perceptions among Diverse Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106068. [PMID: 35627604 PMCID: PMC9140959 DOI: 10.3390/ijerph19106068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/14/2022] [Accepted: 05/15/2022] [Indexed: 12/10/2022]
Abstract
Reducing prolonged engagement in sedentary behavior is increasingly considered a viable pathway to older-adult health and continued functional ability. Community-based programs that aim to increase physical activity can improve programs' acceptability by integrating older adults' perspectives on sedentary behavior and healthy aging into their design. The purpose of this study was to better understand the perceptions of a diverse group of community-dwelling older adults regarding sedentary behavior and its influence on healthy aging. Six focus group discussions with forty-six participants took place across two senior centers in New York City. Self-report questionnaires about daily activity patterns, general health status, and typical sedentary behaviors were also completed by the participants and analyzed using descriptive statistics. The focus group discussions were audio-recorded, transcribed, and analyzed using inductive and deductive approaches and an ecological framework to identify salient themes. A qualitative analysis revealed that the participants were aware of the physical costs of engaging in prolonged sedentary behavior. However, many routine sedentary activities were perceived to be health-promoting and of psychological, cognitive, or social value. The insights gained can inform the development of senior-center programs and health-promotion messaging strategies that aim to reduce older adults' sedentary behavior.
Collapse
Affiliation(s)
- Efekona Nuwere
- Department of Occupational Therapy, Long Island University, 1 University Plaza, Brooklyn, NY 11201, USA
- Correspondence:
| | - Bethany Barone Gibbs
- Department of Health and Human Development, University of Pittsburgh, 4200 Fifth Avenue, Pittsburgh, PA 15260, USA; (B.B.G.); (S.E.T.R.)
| | - Pamela E. Toto
- Department of Occupational Therapy, University of Pittsburgh, 4200 Fifth Avenue, Pittsburgh, PA 15260, USA;
| | - Sharon E. Taverno Ross
- Department of Health and Human Development, University of Pittsburgh, 4200 Fifth Avenue, Pittsburgh, PA 15260, USA; (B.B.G.); (S.E.T.R.)
| |
Collapse
|
6
|
Fernandes S, Caperchione CM, Thornton LE, Timperio A. A qualitative exploration of perspectives of physical activity and sedentary behaviour among Indian migrants in Melbourne, Australia: how are they defined and what can we learn? BMC Public Health 2021; 21:2085. [PMID: 34774007 PMCID: PMC8590373 DOI: 10.1186/s12889-021-12099-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/06/2021] [Indexed: 11/10/2022] Open
Abstract
Background Although perceptions of what constitutes physical activity (PA) may vary between culturally diverse populations, very little research has explored the perceptions of PA among Indian migrants. This study aimed to identify how PA and sedentary behaviour (SB) are defined and describe how these definitions are shaped by cultural background and migration among a sample of Indian migrants living in Australia. Methods Using an exploratory qualitative approach, semi-structured interviews were conducted with twenty-one Indian migrants living in Melbourne (10 men and 11 women; age range: 18 to 65 years). Interviews were audio-recorded and transcribed verbatim. Data were coded and analysed inductively using thematic analyses. Results Data revealed two emerging themes: 1) Holistic perspectives related to PA, where although the majority of participants described PA as “any sort of movement”, or “physical exercise”, several of these descriptions had interwoven ideas related to the mind (mind-body connect), social, cultural, and to the outdoor environment; 2) Broader perspectives for SB, where descriptions of SB as “not having movement”, “doing nothing” or “being lazy”, were shaped with ideas of purpose and duration. Women spoke about how their perspectives of PA and SB may be shaped by native Indian experiences, particularly the gender roles, social caste, and regional subcultural norms which they perceived were important to consider among women who migrate to western settings. Conclusions Cultural background is important in shaping the perspectives of PA and SB among Indian migrants in Australia. Practitioners and researchers should consider the varying perspectives of PA to communicate and promote PA among migrant populations more effectively. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12099-4.
Collapse
Affiliation(s)
- Siona Fernandes
- Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Cristina M Caperchione
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Moore Park Precinct, Sydney, NSW, Australia
| | - Lukar E Thornton
- Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Anna Timperio
- Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| |
Collapse
|
7
|
Chastin S, Gardiner PA, Harvey JA, Leask CF, Jerez-Roig J, Rosenberg D, Ashe MC, Helbostad JL, Skelton DA. Interventions for reducing sedentary behaviour in community-dwelling older adults. Cochrane Database Syst Rev 2021; 6:CD012784. [PMID: 34169503 PMCID: PMC8225503 DOI: 10.1002/14651858.cd012784.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Older adults are the most sedentary segment of society, often spending in excess of 8.5 hours a day sitting. Large amounts of time spent sedentary, defined as time spend sitting or in a reclining posture without spending energy, has been linked to an increased risk of chronic diseases, frailty, loss of function, disablement, social isolation, and premature death. OBJECTIVES To evaluate the effectiveness of interventions aimed at reducing sedentary behaviour amongst older adults living independently in the community compared to control conditions involving either no intervention or interventions that do not target sedentary behaviour. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, EPPI-Centre databases (Trials Register of Promoting Health Interventions (TRoPHI) and the Obesity and Sedentary behaviour Database), WHO ICTRP, and ClinicalTrials.gov up to 18 January 2021. We also screened the reference lists of included articles and contacted authors to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs. We included interventions purposefully designed to reduce sedentary time in older adults (aged 60 or over) living independently in the community. We included studies if some of the participants had multiple comorbidities, but excluded interventions that recruited clinical populations specifically (e.g. stroke survivors). DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts and full-text articles to determine study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. Any disagreements in study screening or data extraction were settled by a third review author. MAIN RESULTS We included seven studies in the review, six RCTs and one cluster-RCT, with a total of 397 participants. The majority of participants were female (n = 284), white, and highly educated. All trials were conducted in high-income countries. All studies evaluated individually based behaviour change interventions using a combination of behaviour change techniques such as goal setting, education, and behaviour monitoring or feedback. Four of the seven studies also measured secondary outcomes. The main sources of bias were related to selection bias (N = 2), performance bias (N = 6), blinding of outcome assessment (N = 2), and incomplete outcome data (N = 2) and selective reporting (N=1). The overall risk of bias was judged as unclear. Primary outcomes The evidence suggests that interventions to change sedentary behaviour in community-dwelling older adults may reduce sedentary time (mean difference (MD) -44.91 min/day, 95% confidence interval (CI) -93.13 to 3.32; 397 participants; 7 studies; I2 = 73%; low-certainty evidence). We could not pool evidence on the effect of interventions on breaks in sedentary behaviour or time spent in specific domains such as TV time, as data from only one study were available for these outcomes. Secondary outcomes We are uncertain whether interventions to reduce sedentary behaviour have any impact on the physical or mental health outcomes of community-dwelling older adults. We were able to pool change data for the following outcomes. • Physical function (MD 0.14 Short Physical Performance Battery (SPPB) score, 95% CI -0.38 to 0.66; higher score is favourable; 98 participants; 2 studies; I2 = 26%; low-certainty evidence). • Waist circumference (MD 1.14 cm, 95% CI -1.64 to 3.93; 100 participants; 2 studies; I2 = 0%; low-certainty evidence). • Fitness (MD -5.16 m in the 6-minute walk test, 95% CI -36.49 to 26.17; higher score is favourable; 80 participants; 2 studies; I2 = 29%; low-certainty evidence). • Blood pressure: systolic (MD -3.91 mmHg, 95% CI -10.95 to 3.13; 138 participants; 3 studies; I2 = 73%; very low-certainty evidence) and diastolic (MD -0.06 mmHg, 95% CI -5.72 to 5.60; 138 participants; 3 studies; I2 = 97%; very low-certainty evidence). • Glucose blood levels (MD 2.20 mg/dL, 95% CI -6.46 to 10.86; 100 participants; 2 studies; I2 = 0%; low-certainty evidence). No data were available on cognitive function, cost-effectiveness or adverse effects. AUTHORS' CONCLUSIONS It is not clear whether interventions to reduce sedentary behaviour are effective at reducing sedentary time in community-dwelling older adults. We are uncertain if these interventions have any impact on the physical or mental health of community-dwelling older adults. There were few studies, and the certainty of the evidence is very low to low, mainly due to inconsistency in findings and imprecision. Future studies should consider interventions aimed at modifying the environment, policy, and social and cultural norms. Future studies should also use device-based measures of sedentary time, recruit larger samples, and gather information about quality of life, cost-effectiveness, and adverse event data.
Collapse
Affiliation(s)
- Sebastien Chastin
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
| | - Paul A Gardiner
- School of Health & Wellbeing, University of Southern Queensland, Ipswich, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Juliet A Harvey
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Calum F Leask
- Aberdeen City Health & Social Care Partnership, Aberdeen, UK
| | - Javier Jerez-Roig
- Department of Social Sciences and Community Health, Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia, Vic, Spain
| | - Dori Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Maureen C Ashe
- Centre for Hip Health and Mobility, Department of Family Practice, The University of British Columbia, Vancouver, Canada
| | - Jorunn L Helbostad
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dawn A Skelton
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| |
Collapse
|
8
|
Grady CL, Muirhead F, Skelton DA, Mavroeidi A. Exploring osteoporosis sufferers knowledge on sedentary behaviour in the management of their disease. J Frailty Sarcopenia Falls 2021; 6:36-42. [PMID: 34131599 PMCID: PMC8173536 DOI: 10.22540/jfsf-06-036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 11/03/2022] Open
Abstract
Objectives 1) To develop an understanding of the thoughts and opinions of older women diagnosed with osteoporosis regarding sedentary behaviour and 2) Investigate strategies used to reduce sedentary behaviour for future intervention development. Methods Eleven older women with osteoporosis (mean age=68.2y±6.6(SD)) participated in semi-structured interviews (March-May 2020). They were recruited from the Royal Osteoporosis Society (Scottish) support group networks and the Strathclyde Age-Friendly-Academy. Telephone interviews were recorded, transcribed verbatim and thematically analysed using Braun & Clarke (2006). Results Three main themes emerged: 'Older Women's Knowledge', 'Motivators to reduce Sedentary Behaviour' and 'Older Adult's and Technology'. Participants reported an increase/maintenance of physical activity levels after osteoporosis diagnosis, had a good understanding and awareness of sedentary behaviour and how it affects health holistically. Participants identified motivators to interrupt sedentary behaviour (e.g. family/friends) and facilitators of sedentary behaviour (e.g. Television). Technology appeared to be used widely among participants to track movement patterns (e.g. Fitbit) but access and usability were identified as potential barriers when using technology to reduce sedentary behaviour among older adults. Conclusion Knowledge does not appear to be a factor that needs addressing in relation to sedentary behavior in older women diagnosed with osteoporosis. Identified motivators and barriers could increase awareness of sedentary behaviour among older adults.
Collapse
Affiliation(s)
- Caera L Grady
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland
| | - Fiona Muirhead
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland
| | - Dawn A Skelton
- Department of Physiotherapy and Paramedicine, Glasgow Caledonian University, Glasgow, Scotland
| | - Alexandra Mavroeidi
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland
| |
Collapse
|
9
|
Giné-Garriga M, Sansano-Nadal O, Tully MA, Caserotti P, Coll-Planas L, Rothenbacher D, Dallmeier D, Denkinger M, Wilson JJ, Martin-Borràs C, Skjødt M, Ferri K, Farche AC, McIntosh E, Blackburn NE, Salvà A, Roqué-I-Figuls M. Accelerometer-Measured Sedentary and Physical Activity Time and Their Correlates in European Older Adults: The SITLESS Study. J Gerontol A Biol Sci Med Sci 2021; 75:1754-1762. [PMID: 31943000 PMCID: PMC7494025 DOI: 10.1093/gerona/glaa016] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Indexed: 12/18/2022] Open
Abstract
Background Sedentary behavior (SB) and physical activity (PA) are important determinants of health in older adults. This study aimed to describe the composition of accelerometer-measured SB and PA in older adults, to explore self-reported context-specific SB, and to assess sociodemographic and functional correlates of engaging in higher levels of SB in participants of a multicenter study including four European countries. Method One thousand three hundred and sixty community-dwelling older adults from the SITLESS study (61.8% women; 75.3 ± 6.3 years) completed a self-reported SB questionnaire and wore an ActiGraph accelerometer for 7 days. Accelerometer-determined compositional descriptive statistics were calculated. A fixed-effects regression analysis was conducted to assess the sociodemographic (country, age, sex, civil status, education, and medications) and functional (body mass index and gait speed) correlates. Results Older adults spent 78.8% of waking time in SB, 18.6% in light-intensity PA, and 2.6% in moderate-to-vigorous PA. Accelerometry showed that women engaged in more light-intensity PA and walking and men engaged in higher amounts of moderate-to-vigorous PA. Watching television and reading accounted for 47.2% of waking time. Older age, being a man, single, taking more medications, being obese and overweight, and having a slower gait speed were statistically significant correlates of more sedentary time. Conclusions The high amount of SB of our participants justifies the need to develop and evaluate interventions to reduce sitting time. A clinically relevant change in gait speed can decrease almost 0.45 percentage points of sedentary time. The distribution of context-specific sedentary activities by country and sex showed minor differences, albeit worth noting.
Collapse
Affiliation(s)
- Maria Giné-Garriga
- Department of Sport Sciences, Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain.,Department of Physical Therapy, Faculty of Health Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Oriol Sansano-Nadal
- Department of Sport Sciences, Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Paolo Caserotti
- Department of Sports Science and Clinical Biomechanics, Center for Active and Healthy Ageing (CAHA), University of Southern Denmark, Odense, Denmark
| | - Laura Coll-Planas
- Fundació Salut i Envelliment, Universitat Autònoma de Barcelona, Spain
| | | | - Dhayana Dallmeier
- Institute of Epidemiology and Medical Biometry, Ulm University, Germany.,Department of Epidemiology, Boston University School of Public Health, Massachusetts
| | - Michael Denkinger
- Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University and Geriatric Center Ulm, Germany
| | - Jason J Wilson
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Carme Martin-Borràs
- Department of Sport Sciences, Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain.,Department of Physical Therapy, Faculty of Health Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Mathias Skjødt
- Department of Sports Science and Clinical Biomechanics, Center for Active and Healthy Ageing (CAHA), University of Southern Denmark, Odense, Denmark
| | - Kelly Ferri
- Department of Sport Sciences, Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Ana Claudia Farche
- Department of Sport Sciences, Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Emma McIntosh
- Department of Health Economics, University of Glasgow, UK
| | - Nicole E Blackburn
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Antoni Salvà
- Fundació Salut i Envelliment, Universitat Autònoma de Barcelona, Spain
| | | |
Collapse
|
10
|
Kringle EA, Terhorst L, Gibbs BB, Campbell G, McCue M, Skidmore ER. Activating Behavior to Reduce Sedentary Behavior After Stroke: A Nonrandomized Pilot Feasibility Study. Am J Occup Ther 2020; 74:7406205030p1-7406205030p10. [PMID: 33275563 PMCID: PMC7717647 DOI: 10.5014/ajot.2020.040345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Importance: Reducing poststroke sedentary behavior is important for reducing recurrent stroke risk, yet interventions to achieve this are scant. Objective: To assess the feasibility of, and estimate change in sedentary behavior over time associated with, a behavioral intervention. Design: Single-arm delayed baseline with postintervention and 8-wk follow-up assessment. Setting: Community based. Participants: Ambulatory, community-dwelling people with chronic stroke and reported ≥6 hr daily sitting time (N = 21). Intervention: Activating Behavior for Lasting Engagement (ABLE) was delivered by an occupational therapist 3×/wk for 4 wk. ABLE involves activity monitoring, activity scheduling, self-assessment, and collaborative problem solving. Outcomes and Measures: Feasibility (participant safety, adherence, satisfaction, and reliable intervention delivery) was assessed against preestablished benchmarks. Changes over time in sedentary behavior (assessed with an ActivPAL micro3 device) and participation (Stroke Impact Scale–Participation subscale) were described. Results: ABLE was safe (0 serious adverse events), adhered to (11.95 sessions/participant), and reliably delivered (90.00%–97.50% adherence). Participant satisfaction was unmet (Client Satisfaction Questionnaire–8, M = 28.75, SD = 3.84). ABLE was associated with a mean group reduction in prolonged sitting of 54.95 min (SD = 81.10) at postintervention and 14.08 (SD = 58.95) at follow-up. ABLE was associated with a negligible mean group increase over time in participation at postintervention (M = 1.48%, SD = 8.52) and follow-up (M = 1.33%, SD = 15.38). Conclusions and Relevance: The ABLE intervention is feasible and may be associated with within-group reduction in sedentary behavior over time. Further refinement is indicated. What This Article Adds: The ABLE intervention uses engagement in meaningful daily activities to reduce sedentary behavior after stroke. These findings suggest that ABLE can be delivered safely and consistently. Further research is required to enhance participant satisfaction and determine the effects of ABLE on stroke survivors’ sedentary behavior.
Collapse
Affiliation(s)
- Emily A Kringle
- Emily A. Kringle, PhD, OTR/L, is Postdoctoral Research Fellow, Division of Academic Internal Medicine and Geriatrics, College of Medicine, University of Illinois at Chicago. At the time of the study, she was Graduate Student Researcher, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA;
| | - Lauren Terhorst
- Lauren Terhorst, PhD, is Professor, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Bethany Barone Gibbs
- Bethany Barone Gibbs, PhD, is Associate Professor, Department of Health and Human Development, School of Education, University of Pittsburgh, Pittsburgh, PA
| | - Grace Campbell
- Grace Campbell, PhD, RN, is Assistant Professor, Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, PA
| | - Michael McCue
- Michael McCue, PhD, is Professor, Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Elizabeth R Skidmore
- Elizabeth R. Skidmore, PhD, OTR/L, is Professor, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| |
Collapse
|
11
|
Asiamah N, Petersen C, Kouveliotis K, Eduafo R. The Built Environment and Socio-Demographic Correlates of Partial and Absolute Sedentary Behaviours in Community-Dwelling Older Adults in Accra, Ghana. J Cross Cult Gerontol 2020; 36:21-42. [PMID: 33141375 DOI: 10.1007/s10823-020-09417-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 11/25/2022]
Abstract
This study examined built environmental and socio-demographic variables as correlates of sedentary behaviour in a population of older adults, and attempted to introduce the idea of measuring sedentary behaviour with two domains, namely 'partial sedentary behaviour' and 'absolute sedentary behaviour'. The study's population was community-dwelling older adults aged 60 years or more in Accra, Ghana. A self-reported questionnaire was used to gather data from 504 older people. Multiple linear regression analysis was used to present findings, with all nominal categorical variables incorporated in this analysis dummy-coded. The overall (third) regression model accounted for a variance of 55.9% and a significant F-test [F (25,454) = 22.99; p < 0.001)]. Gender was positively associated with sedentary behaviour - the sedentary behaviour of women was 28 min in excess of that of men. Sedentary behaviour decreased as the social network size and supporting social network of older people increased. Sedentary behaviour decreased as availability of spacious road pavements, secure social recreational centres for older people, and health services in the community increased. The improvement of road safety conditions at the community level and design of the built environment to support social integration of older people are major recommendations of this study.
Collapse
Affiliation(s)
- Nestor Asiamah
- Department of Gerontology and Geriatrics, Africa Centre for Epidemiology, P.O. Box AN 18462, Accra North, Ghana.
| | - Carl Petersen
- Department of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Kyriakos Kouveliotis
- Department of Health Management, International Telematic University Uninettuno, Rome, Italy
| | - Richard Eduafo
- Department of Gerontology and Geriatrics, Africa Centre for Epidemiology, Accra, Ghana
| |
Collapse
|
12
|
Kotlarczyk MP, Hergenroeder AL, Gibbs BB, Cameron FDA, Hamm ME, Brach JS. Personal and Environmental Contributors to Sedentary Behavior of Older Adults in Independent and Assisted Living Facilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176415. [PMID: 32899196 PMCID: PMC7504320 DOI: 10.3390/ijerph17176415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 01/13/2023]
Abstract
Sedentary behavior is associated with negative health outcomes and unhealthy aging. Older adults are the most sedentary age group, and decreasing sitting time represents an intervention target for improving health. Determinants of sedentary behavior have been examined in older adults living in their own homes, yet less is known about sedentary behavior of older adults in residential care facilities. The purpose of this study was to explore factors contributing to sedentary behavior among residents of independent and assisted living facilities. We conducted eight focus groups with residents (n = 44) and semi-structured interviews with staff (n = 6) across four living facilities. Audio recordings were transcribed and analyzed using an iterative, inductive approach. Three salient themes were identified. Residents and staff both viewed sedentary behavior negatively unless it was in the context of social engagement. Additionally, fear of falling was discussed as a significant contributor to sedentary behavior. Finally, residents felt the community living environment contributed to their sedentary behavior while staff did not. Our findings provide valuable insight for designing targeted interventions for older adults in residential facilities and suggest thinking beyond the individual and considering environmental influences on sedentary behavior in the residential care setting.
Collapse
Affiliation(s)
- Mary P. Kotlarczyk
- Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Correspondence:
| | - Andrea L. Hergenroeder
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA 15260, USA; (A.L.H.); (J.S.B.)
| | - Bethany Barone Gibbs
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Flor de Abril Cameron
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA; (F.d.A.C.); (M.E.H.)
| | - Megan E. Hamm
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA; (F.d.A.C.); (M.E.H.)
| | - Jennifer S. Brach
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA 15260, USA; (A.L.H.); (J.S.B.)
| |
Collapse
|
13
|
Moraes SAD, Furlanetto EC, Ricci NA, Perracini MR. Sedentary behavior: barriers and facilitators among older adults after hip fracture surgery. A qualitative study. Braz J Phys Ther 2020; 24:407-414. [PMID: 31345662 PMCID: PMC7563798 DOI: 10.1016/j.bjpt.2019.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/23/2019] [Accepted: 07/02/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Understand the experience of older adults after hip fracture surgery considering barriers and facilitators related to sedentary behavior. METHODS A qualitative study using a semi-structured interview with three men and eight women aged 60 years or older after hip fracture surgery. RESULTS Five barriers emerged: physical complaints, lack of accessibility, fear of falling, demotivation and negative social representation of old age, and two facilitators: overcoming dependency and having a caregiver. CONCLUSION Our results highlight that physical complaints commonly addressed by physical therapists on their interventions are not the only impediments to reduce sedentary behavior. Important individual and social barriers should not be neglected when physical therapists conduct interventions to reduce sedentary behavior to maximize functional recovery in older adults after hip fracture surgery. Future clinical trials are required to investigate the effectiveness of more comprehensive interventions to reduce sedentary behavior in this population.
Collapse
Affiliation(s)
| | | | - Natalia Aquaroni Ricci
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Monica Rodrigues Perracini
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
14
|
Olanrewaju O, Stockwell S, Stubbs B, Smith L. Sedentary behaviours, cognitive function, and possible mechanisms in older adults: a systematic review. Aging Clin Exp Res 2020; 32:969-984. [PMID: 32026419 DOI: 10.1007/s40520-019-01457-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 12/18/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Physical activity can improve cognitive function of older adults, but the influence of sedentary behaviour on cognition is less clear. This systematic review investigated associations between sedentary behaviour and cognitive function in older adults without dementia, and possible mechanisms involved. METHODS Major databases were searched for studies in English between 01/01/1999 and 31/10/2019. The systematic review followed COSMOS-E guideline and a pre-registered protocol (CRD42019122229). Risk of bias was assessed using NICE Quality appraisal checklist. Findings were narratively synthesized and presented. FINDINGS Eighteen studies comprised of 13 cross-sectional and five longitudinal analyses (n = 40,228). Evidence suggested varied associations between varied sedentary behaviours and cognitive function in older adults. 50% of study analyses did not control for physical activity. 3/18 studies demonstrated associations between higher sedentary levels and lower levels of brain biomarkers, while 1/18 showed auto-regulatory effect in the left hippocampus. Conducting a meta-analysis was not justifiable due to considerable methodological, participant, outcome and exposure heterogeneity. CONCLUSION There is a lack of clarity about the overall and independent association between sedentary behaviour and cognition in older age. Underlying mechanisms are similar to physical activity and probably multi-modal. More studies with robust designs and methodology are needed to confirm effect of sedentary behaviour on cognition.
Collapse
Affiliation(s)
| | | | - B Stubbs
- Positive Ageing Research Institute, FHSCME, Anglia Ruskin University, South London and Maudsley Foundation NHS Trust, London, UK
| | - L Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| |
Collapse
|
15
|
Hughes SL, Tussing-Humphreys L, Schiffer L, Smith-Ray R, Marquez DX, DeMott AD, Berbaum ML, Fitzgibbon ML. Fit & Strong! Plus Trial Outcomes for Obese Older Adults with Osteoarthritis. THE GERONTOLOGIST 2020; 60:558-570. [PMID: 30476065 PMCID: PMC7350412 DOI: 10.1093/geront/gny146] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES We compared the effectiveness of standard Fit & Strong! (F&S!; targets physical activity [PA]) to Fit & Strong! Plus (F&S! Plus; targets PA and dietary weight loss) on weight, diet quality, and PA outcomes. RESEARCH DESIGN AND METHODS We randomly assigned 413 overweight older adults with OA to the F&S! or F&S! Plus programs and assessed outcomes at 2 and 6 months. RESULTS The F&S! Plus group lost -2.0 ± 0.2 kg (mean ± SE, 2% of starting weight) at 2 months that was maintained at 6 months. Two- and 6-month BMI and waist circumference improved significantly in the F&S! Plus group (p < .001). Diet quality at 2 months showed greater improvement in the F&S! Plus group: 4.6 ± 0.7 versus 2.0 ± 0.7, p = .006, with no significant difference between groups at 6 months. The F&S! Plus group differentially improved on PA engagement at 2 months and at 2 and 6 months in joint pain (6-month mean ± SE: -1.5 ± 0.3 vs -0.6 ± 0.3, p = .02), function (-4.7 ± 0.9 vs -1.5 ± 0.9, p = .01), and 6-min walk test (29.5 ± 5.1 m vs 14.1 ± 5.2 m, p = .04). DISCUSSION AND IMPLICATIONS Adding a dietary weight loss component to F&S! achieved weight and waist circumference benefits that were maintained at 6 months. Importantly, the weight loss was accompanied by clinically meaningful improvements in OA symptoms and mobility. Future work should investigate minimum thresholds for weight reduction that improve long-term function in this population.
Collapse
Affiliation(s)
- Susan L Hughes
- Institute for Health Research and Policy, School of Public Health
- Center for Research on Health and Aging
- Division of Community Health Sciences, University of Illinois at Chicago
| | - Lisa Tussing-Humphreys
- Institute for Health Research and Policy, School of Public Health
- University of Illinois Cancer Center, Chicago
- Department of Medicine, University of Illinois at Chicago
| | - Linda Schiffer
- Institute for Health Research and Policy, School of Public Health
| | - Renae Smith-Ray
- Institute for Health Research and Policy, School of Public Health
- Health Analytics, Research and Reporting, Walgreen Co., Deerfield, Illinois
| | - David X Marquez
- Institute for Health Research and Policy, School of Public Health
- Center for Research on Health and Aging
- Department of Kinesiology and Nutrition
| | - Andrew D DeMott
- Institute for Health Research and Policy, School of Public Health
- Center for Research on Health and Aging
| | - Michael L Berbaum
- Institute for Health Research and Policy, School of Public Health
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago
| | - Marian L Fitzgibbon
- Institute for Health Research and Policy, School of Public Health
- University of Illinois Cancer Center, Chicago
- Department of Pediatrics, University of Illinois at Chicago
| |
Collapse
|
16
|
Gardner B, Flint S, Rebar AL, Dewitt S, Quail SK, Whall H, Smith L. Is sitting invisible? Exploring how people mentally represent sitting. Int J Behav Nutr Phys Act 2019; 16:85. [PMID: 31606040 PMCID: PMC6790031 DOI: 10.1186/s12966-019-0851-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 09/25/2019] [Indexed: 01/14/2023] Open
Abstract
Background Growing evidence suggests that prolonged uninterrupted sitting can be detrimental to health. Much sedentary behaviour research is reliant on self-reports of sitting time, and sitting-reduction interventions often focus on reducing motivation to sit. These approaches assume that people are consciously aware of their sitting time. Drawing on Action Identification Theory, this paper argues that people rarely identify the act of sitting as ‘sitting’ per se, and instead view it as an incidental component of more meaningful and purposeful typically-seated activities. Methods Studies 1 and 2 explored whether people mentioned sitting in written descriptions of actions. Studies 3–5 compared preferences for labelling a typically desk-based activity as ‘sitting’ versus alternative action identities. Studies 6 and 7 used card-sort tasks to indirectly assess the prioritisation of ‘sitting’ relative to other action descriptions when identifying similar actions. Results Participants rarely spontaneously mentioned sitting when describing actions (Studies 1–2), and when assigning action labels to a seated activity, tended to offer descriptions based on higher-order goals and consequences of action, rather than sitting or other procedural elements (Studies 3–5). Participants primarily identified similarities in actions based not on sitting, but on activities performed while seated (e.g. reading; Studies 6–7). Conclusion ‘Sitting’ is a less accessible cognitive representation of seated activities than are representations based on the purpose and implications of seated action. Findings suggest that self-report measures should focus on time spent in seated activities, rather than attempting to measure sitting time via direct recall. From an intervention perspective, findings speak to the importance of targeting behaviours that entail sitting, and of raising awareness of sitting as a potential precursor to attempting to reduce sitting time.
Collapse
Affiliation(s)
- Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Guy's Campus, London, SE1 1UL, UK.
| | - Stuart Flint
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Amanda L Rebar
- Physical Activity Research Group, Appleton Institute, School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Stephen Dewitt
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Guy's Campus, London, SE1 1UL, UK.,Department of Experimental Psychology, Division of Psychology of Language Sciences, University College London, London, UK
| | - Sahana K Quail
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Guy's Campus, London, SE1 1UL, UK
| | - Helen Whall
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Guy's Campus, London, SE1 1UL, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Department of Life Sciences, Anglia Ruskin University, Cambridge, UK
| |
Collapse
|
17
|
Sousa AS, Mendes J, Guerra RS, Padrão P, Moreira P, Santos A, Borges N, Afonso C, Martins C, Ferro G, Amaral TF. Sitting time and associated factors among Portuguese older adults: results from Nutrition UP 65. Eur J Ageing 2019; 17:321-330. [PMID: 32904787 DOI: 10.1007/s10433-019-00532-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Older adults are particularly susceptible to sedentary behaviours. Sitting time has been increasingly referred to as a potentially modifiable risk factor in the prevention of chronic diseases. Identifying factors associated with sitting time, particularly those that are modifiable, will allow for more effective public health strategies. This study aimed to describe sitting time among Portuguese older adults and to evaluate associated factors. A cross-sectional study including 1423 older adults ≥ 65 years old was conducted. Sitting time was assessed with the International Physical Activity Questionnaire. Socio-demographic, health, anthropometric and functional variables were collected. Bivariate and multivariate linear regression models were conducted to study the association between these variables and sitting time. The median of sitting time was 300 min/day (interquartile range = 240 min/day), which is equal to 5 h/day. The following factors were directly associated with longer sitting time: being male, age ≥ 80 years, living in Central or Southern Portugal, being retired from work, as well as presenting low physical activity, obesity or longer time to walk 4.6 metres. On the other hand, being married, having higher education and higher household income were inversely associated with longer sitting time. It can be concluded that Portuguese older adults spend a considerable amount of time sitting per day. Potentially modifiable risk factors associated with longer sitting time in this population were related to nutritional status and functional ability.
Collapse
Affiliation(s)
- Ana Sofia Sousa
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,Faculty of Health Sciences (Nutrition Sciences), Fernando Pessoa University, Praça de 9 de Abril 349, 4249-004 Porto, Portugal.,ciTechCare - Center for Innovative Care and Health Technology, IP Leiria, Rua General Norton de Matos, Apartado 4133, 2411-901 Leiria, Portugal
| | - Joana Mendes
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal.,I3S - Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
| | - Rita S Guerra
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,Faculty of Health Sciences (Nutrition Sciences), Fernando Pessoa University, Praça de 9 de Abril 349, 4249-004 Porto, Portugal.,UISPA-IDMEC, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Patrícia Padrão
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal.,The Research Centre in Physical Activity, Health and Leisure, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
| | - Alejandro Santos
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,I3S - Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
| | - Nuno Borges
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Cátia Martins
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Graça Ferro
- Alto Minho Local Health Unit, EPE, Estrada de Santa Luzia, 4904-858 Viana do Castelo, Portugal
| | - Teresa F Amaral
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,UISPA-IDMEC, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| |
Collapse
|
18
|
Rawlings GH, Williams RK, Clarke DJ, English C, Fitzsimons C, Holloway I, Lawton R, Mead G, Patel A, Forster A. Exploring adults' experiences of sedentary behaviour and participation in non-workplace interventions designed to reduce sedentary behaviour: a thematic synthesis of qualitative studies. BMC Public Health 2019; 19:1099. [PMID: 31409324 PMCID: PMC6692932 DOI: 10.1186/s12889-019-7365-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 07/24/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sedentary behaviour is any waking behaviour characterised by an energy expenditure of ≤1.5 metabolic equivalent of task while in a sitting or reclining posture. Prolonged bouts of sedentary behaviour have been associated with negative health outcomes in all age groups. We examined qualitative research investigating perceptions and experiences of sedentary behaviour and of participation in non-workplace interventions designed to reduce sedentary behaviour in adult populations. METHOD A systematic search of seven databases (MEDLINE, AMED, Cochrane, PsychINFO, SPORTDiscus, CINAHL and Web of Science) was conducted in September 2017. Studies were assessed for methodological quality and a thematic synthesis was conducted. Prospero database ID: CRD42017083436. RESULTS Thirty individual studies capturing the experiences of 918 individuals were included. Eleven studies examined experiences and/or perceptions of sedentary behaviour in older adults (typically ≥60 years); ten studies focused on sedentary behaviour in people experiencing a clinical condition, four explored influences on sedentary behaviour in adults living in socio-economically disadvantaged communities, two examined university students' experiences of sedentary behaviour, two on those of working-age adults, and one focused on cultural influences on sedentary behaviour. Three analytical themes were identified: 1) the impact of different life stages on sedentary behaviour 2) lifestyle factors influencing sedentary behaviour and 3) barriers and facilitators to changing sedentary behaviour. CONCLUSIONS Sedentary behaviour is multifaceted and influenced by a complex interaction between individual, environmental and socio-cultural factors. Micro and macro pressures are experienced at different life stages and in the context of illness; these shape individuals' beliefs and behaviour related to sedentariness. Knowledge of sedentary behaviour and the associated health consequences appears limited in adult populations, therefore there is a need for provision of accessible information about ways in which sedentary behaviour reduction can be integrated in people's daily lives. Interventions targeting a reduction in sedentary behaviour need to consider the multiple influences on sedentariness when designing and implementing interventions.
Collapse
Affiliation(s)
- G H Rawlings
- Department of Clinical Psychology, University of Sheffield, Sheffield, UK
| | - R K Williams
- Academic Unit of Elderly Care and Rehabilitation, Leeds Institute of Health Sciences, Temple Bank House, University of Leeds, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
| | - D J Clarke
- Academic Unit of Elderly Care and Rehabilitation, Leeds Institute of Health Sciences, Temple Bank House, University of Leeds, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK.
| | - C English
- School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia
| | - C Fitzsimons
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - I Holloway
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - R Lawton
- School of Psychology, University of Leeds, Leeds, UK
| | - G Mead
- Geriatric Medicine, Division of Health Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - A Patel
- Anita Patel Health Economics Consulting Ltd, London, UK
| | - A Forster
- Academic Unit of Elderly Care and Rehabilitation, Leeds Institute of Health Sciences, Temple Bank House, University of Leeds, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
| |
Collapse
|
19
|
|