Randomized controlled pilot of an intervention to reduce and break-up overweight/obese adults’ overall sitting-time

摘要

Background Too 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. Methods This 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. Results For 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. Conclusions Sitting-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 registration 26 November 2013, ClinicalTrials.govID: NCT02007681 (first participant was randomized on 2 September 2013).