Can individual, dyadic, or collaborative planning reduce sedentary behavior? A randomized controlled trial

Physical activity planning interventions, body fat and energy-dense food intake in dyads: ripple, spillover, or compensatory effects?

OBJECTIVES

It is unclear if planning to change one behavior may prompt changes in other health behaviors or health outcomes. This study tested if physical activity (PA) planning interventions may result in (i) a body fat reduction in target persons and their dyadic partners (a ripple effect), (ii) a decrease in energy-dense food intake (a spillover effect), or an increase in energy-dense food intake (a compensatory effect).

METHOD

N = 320 adult-adult dyads were assigned to an individual ('I-for-me'), dyadic ('we-for-me'), or collaborative ('we-for-us') PA planning intervention or a control condition. Body fat and energy-dense food intake were measured at baseline and at the 36-week follow-up.

RESULTS

No Time x Condition effects were found for target persons' body fat. There was a reduction in body fat among partners participating in any PA planning intervention, compared to the control condition. Across conditions, target persons and partners reduced energy-dense food intake over time. The reduction was smaller among target persons assigned to the individual PA planning condition compared to the control condition.

CONCLUSIONS

PA planning interventions delivered to dyads may result in a ripple effect involving body fat reduction among partners. Among target persons, the individual PA planning may activate compensatory changes in energy-dense food intake.

Adding planning strategies to an experiential and conceptual knowledge-based intervention: Does it help to reduce sedentary time?

OBJECTIVE

The study compared the effects of an "active" control condition addressing conceptual and experiential knowledge about sedentary behavior, with an intervention condition combining conceptual and experiential knowledge together with action planning, coping planning, and behavioral substitution. We targeted a decrease in sedentary time as the primary outcome.

METHODS

A preregistered trial (#NCT04131270) was carried out with 603 participants aged 11-86 years (M = 33.57; 65.2% women), randomly assigned to the "planning + knowledge" condition or the "knowledge" condition. Sedentary time was assessed with ActiGraph wGT3X-BT accelerometers at baseline, 1-week, and 36-week follow-ups. Conceptual knowledge strategies involved information about health consequences and instructions on how to perform behaviors while experiential knowledge was enhanced by participants taking/discussing photographs of their home environment that has been triggering sedentary behavior. Action/coping plans referred to ways to substitute sedentary behavior with bouts of physical activity behaviors. Mixed models were fit.

RESULTS

No significant Time × Condition interaction was found. In the total sample, sedentary time estimated to be around 502.34 min/day at baseline, showed a significant linear decline over time (p = .002), by approximately -1.22 min per each month elapsing since baseline (-9.76 min/day across 8 months).

CONCLUSIONS

The findings suggest that applying behavior change techniques targeting both conceptual and experiential knowledge about antecedents, circumstances, and consequences of sedentary behavior may result in a small reduction of sedentary time. Adding action plans, coping planning, and behavioral substitution did not improve the effectiveness of the intervention.

Effects of physical activity planning interventions on reducing sedentary behavior in parent-child dyads: A randomized controlled trial

Effects of parent-child dyad interventions on behavior remain unclear. This randomized controlled trial investigated if, compared with a control condition, three types of physical activity (PA) planning interventions (individual "I-for-me," dyadic "we-for-me," and collaborative "we-for-us") would reduce sedentary behavior (SB) time in parents and their children. The study involved 247 dyads comprising parents (aged 29-66) and their children (aged 9-15), randomized into one of the three types of PA planning-intervention arms or the control condition. Mixed models were applied to analyze data from a preregistered trial (NCT02713438) with the outcome of accelerometer-measured SB time, assessed at 1-week and 36-week follow-ups. Although children's SB remained unaffected by the planning interventions, a small reduction of SB time was found among parents in the collaborative (p = .048) and individual (p = .042) planning conditions. The effects were observed at the 1-week follow-up only. While short-term reductions in parents' SB were achieved, these were not sustained long-term. PA planning interventions delivered to parent-child dyads did not substantially reduce children's SB, which may be due to young people's needs of increased independence from their parents.

Enhancing physical activity and reducing symptoms of patients with osteoarthritis of the knee: a randomized controlled trial of the PrevOP-Psychological Adherence Program

BACKGROUND

This primary analysis evaluated the "PREVenting the impairment of primary Osteoarthritis by high-impact long-term Physical exercise regimen-Psychological Adherence Program" (PrevOP-PAP), designed to support patients with osteoarthritis of the knee (OAK) to engage in regular moderate-to-vigorous physical activity (MVPA) to reduce OAK symptoms (WOMAC scores). Theory-based on the health action process approach (HAPA), the intervention targeted volitional precursors of MVPA change: action and coping planning, maintenance and recovery self-efficacy, action control, and social network formation. We hypothesized that compared to an active control condition, increases in MVPA at the end of the 12-month intervention would translate into lower WOMAC scores at 24 months in the intervention condition.

METHODS

Participants with radiographically verified moderate OAK (N = 241; 62.66% female; M(SD) = 65.60(7.61) years) were randomly assigned to the intervention (51%) or the active control condition. WOMAC scores (24 months) were the primary -, accelerometer-assessed MVPA (12 months) the key secondary outcomes. The PrevOP-PAP was a 12-month intervention with computer-assisted face-to-face and phone-based sessions designed to increase HAPA-proposed volitional precursors of MVPA change (up to 24 months; secondary outcomes). Intent-to-treat analyses included multiple regression and manifest path models.

RESULTS

MVPA (12 months) did not mediate effects of the PrevOP-PAP on WOMAC scores (24 months). Compared to the active control condition, WOMAC scores (24 months) were lower in the intervention condition, but this effect did not remain stable in sensitivity analyses (b(SE) = -8.41(4.66), 95%-CI [-17.53; 0.71]). However, exploratory analyses revealed significantly stronger reductions in WOMAC-pain (24 months) in the intervention condition (b(SE) = -2.99(1.18), 95%-CI [-5.36; -0.63]). Groups did not differ in MVPA at 12 months (b(SE) = -3.78(3.42), 95%-CI [-10.80; 2.58]). Of the proposed precursors of MVPA change, action planning was higher in the intervention than in the control condition (24 months; b(SE) = 0.64(0.26), 95%-CI [0.14; 1.15]).

CONCLUSIONS

Compared to an active control condition, the PrevOP-PAP did not produce reliable effects on WOMAC scores and none on preceding MVPA. Of the HAPA-proposed volitional precursors, only action planning was sustainably increased. Future interventions should use m-health applications to digitally support long-term changes in proposed volitional precursors of MVPA change.

TRIAL REGISTRATION

German Clinical Trials Register; https://drks.de/search/de/trial/DRKS00009677 ; also available at http://apps.who.int/trialsearch/ ; registration number: DRKS00009677; date of registration: 26/01/2016.

The Dyadic Interplay Between Relationship Satisfaction, Perceived Positive and Negative Social Control, and a Reduction of Sedentary Behavior Time

BACKGROUND

Both the close relationship processes and health model and the dyadic health influence model posit that beliefs about the relationship (e.g., relationship satisfaction) and influence strategies (e.g., social control) serve as mediators of health behavior change. The evidence for such mediation is limited.

PURPOSE

This study investigated two competing hypotheses that arise from these models: (1) perceived use of positive and negative social control (attempts to influence the partner's behaviors) predict sedentary behavior (SB) indirectly, via relationship satisfaction; or (2) relationship satisfaction predicts SB indirectly, via positive and negative social control.

METHODS

Data from 320 dyads (target persons and their partners, aged 18-90 years), were analyzed using mediation models. SB time was measured with GT3X-BT accelerometers at Time 1 (T1; baseline) and Time 3 (T3; 8 months following baseline). Relationship satisfaction and social control were assessed at T1 and Time 2 (T2; 2 months following baseline).

RESULTS

Higher T1 relationship satisfaction among target persons predicted target persons' reporting of higher T2 negative control from partners, which in turn predicted lower T3 SB time among target persons. Lower T1 relationship satisfaction among partners predicted target persons' reporting of higher T2 perceived negative control from partners, which predicted lower T3 SB time among target persons. On average, both members of the dyad reported moderate-to-high relationship satisfaction and low-to-moderate negative control.

CONCLUSIONS

In contrast to very low levels of negative control, its low-to-moderate levels may be related to beneficial behavioral effects (lower SB time) among target persons reporting moderate-to-high relationship satisfaction.

Insights into effects of individual, dyadic, and collaborative planning interventions on automatic, conscious, and social process variables

OBJECTIVE

Going beyond the effects of individual planning ("I-for-me"), we investigate the associations of dyadic ("we-for-me") and collaborative ("we-for-us") planning with automatic, conscious, and social process variables that may elucidate the differences through which these three types of planning operate. We tested the effects of three planning interventions on: (1) habit strength, representing an automatic process, (2) the use of individual planning, representing a conscious process, (3) the use of collaborative planning, representing conscious and social processes, and (4) collaborative social control, representing a social process.

METHODS

N = 320 adults were randomly assigned to one of four conditions: (1) the active control condition, (2) the individual planning condition, (3) the dyadic planning condition, or (4) the collaborative planning condition. Self-reported data on habit strength, the use of individual planning, the use of collaborative planning, and collaborative social control were assessed at baseline and at the 9-week follow-up. Analyses used linear mixed modelling.

RESULTS

Compared to the control group, participants in the individual planning condition had stronger habits at the 9-week follow-up. Those in the dyadic planning condition reported higher levels of the use of collaborative planning and higher levels of collaborative social control at the follow-up. Finally, compared to those assigned to the control group, participants in the collaborative planning condition reported stronger habits, higher levels of the use of both individual and collaborative planning, and higher levels of collaborative social control at the follow-up.

CONCLUSIONS

Individual, dyadic, and collaborative planning interventions may result in distinct patterns of changes in the variables representing automatic, conscious, and social processes. In particular, changes in automatic, conscious and social process variables, evoked by the collaborative "we-for-us" planning intervention may reflect the major regulatory effort of forming joint plans and subsequently integrating regular joint exercise into the weekly schedule.

Dyadic reciprocal associations between self-efficacy and planning predict sedentary behaviour

OBJECTIVES

There are two alternative hypotheses regarding bidirectional associations between self-efficacy and planning in predicting health behaviour change: self-efficacy may establish planning (cultivation hypothesis) or planning may enable the formation of self-efficacy (enabling hypothesis). This study investigates the order in which these two social cognitions are linked in adult-adult dyads in the context of sedentary behaviours (SB).

DESIGN

A longitudinal study with 4 measurement points, spanning 8 months.

METHODS

A total of 320 dyads (age: 18-90 years) were enrolled. Dyads included a focus person (who received the recommendation to reduce SB and intended to change their SB), and their partners, who were willing to support the focus persons and intended to reduce their own SB as well. Data were collected at Time 1 (T1), Time 2 (1 week later, T2), Time 3 (T3, 2 months after T1) and Time 4 (T4, 8 months after T1). SB was measured with accelerometers at (T1 and T4). Mediation models with individual and dyadic reciprocal effects were tested with path analyses.

RESULTS

Only one indirect effect was found: A higher level of partners' SB reduction-specific self-efficacy at T2 was related to the focus person's more frequent planning to reduce SB at T3, which, in turn, predicted lower SB time among partners at T4.

CONCLUSIONS

The findings provide partial support for the cultivation model (self-efficacy prompting planning) and for dyadic reciprocal associations in the context of SB time reduction among adult dyads.

The Effectiveness of Interventions to Reduce Sedentary Time in Different Target Groups and Settings in Germany: Systematic Review, Meta-Analysis and Recommendations on Interventions

BACKGROUND

Sedentary behavior is an important risk factor for several chronic diseases and is associated with an increased risk of mortality. We assessed the effectiveness of interventions to reduce sedentary time in Germany and provide recommendations on interventions to reduce sedentary time in children and adults.

METHODS

We comprehensively searched PubMed, Web of Science and the German Clinical Trials Register up to April 2022 for intervention studies targeting sedentary behavior in Germany. We performed a systematic review and qualitative synthesis of the interventions and a meta-analysis in children.

RESULTS

We included 15 studies comprising data from 4588 participants. The results of included primary studies in adults and children showed inconsistent evidence regarding change in sedentary time, with a majority of studies reporting non-significant intervention effects. The meta-analysis in children showed an increase in sedentary time for children in the control and intervention groups.

CONCLUSION

We found inconsistent evidence regarding the effectiveness of interventions to reduce time spent sedentary and our meta-analysis showed an increase in sedentary time in children. For children, we recommend physical and social environment interventions with an active involvement of families. For adults, we recommend physical environment interventions, such as height-adjustable desks at work.