Sedentary behaviours and health-related quality of life. A systematic review and meta-analysis

Feasibility and acceptability of general practitioners using sit-stand desks: a feasibility trial

OBJECTIVES

The primary aim of this study was to investigate the feasibility and acceptability of general practitioners (GPs) using sit-stand desks to facilitate standing during consultations. A further aim was to examine the views of patients about GPs standing for their consultations.

DESIGN

A pre-post single-group experimental trial design.

SETTING

General practices in England, UK.

PARTICIPANTS

42 GPs (working a minimum of five clinical sessions per week) and 301 patients (aged ≥18 years).

INTERVENTIONS

The intervention consisted of each GP having a sit-stand desk (Opløft Sit-Stand Platform) installed in their consultation room for 4 working weeks. Sit-stand desks allow users to switch, in a few seconds, between a sitting and standing position and vice versa, by adjusting the height of the desk.

MAIN OUTCOME MEASURES

To test feasibility and acceptability, GPs reported their views about using sit-stand desks at work at baseline and follow-up. Sitting time and physical activity were also measured via accelerometer at baseline and follow-up. Patients who attended a consultation where their GP was standing were asked to complete an exit questionnaire about the perceived impact on the consultation.

RESULTS

Most GPs reported using their sit-stand desk daily (n=28, 75.7%). 16 GPs (44.4%) used their sit-stand desk during face-to-face consultations every day. Most GPs and patients did not view that GPs standing during face-to-face consultations impacted the doctor-patient relationship (GPs; 73.5%, patients; 83.7%). GPs' sitting time during work was 121 min per day lower (95% CI: -165 to -77.58) at follow-up compared with baseline.

CONCLUSIONS

Use of sit-stand desks is acceptable within general practice and may reduce sitting time in GPs. This may benefit GPs and help reduce sitting time in patients.

TRIAL REGISTRATION NUMBER

ISRCTN76982860.

Physical activity, problematic gaming behavior, and quality of life prior and during the first 9 months of the COVID-19 pandemic: Findings from a longitudinal study among university students

BACKGROUND

Generally, there is limited information on longitudinal trends and the interrelations between physical activity (PA), problematic gaming behavior (PGB), described as a dysfunctional pattern of videogame activities, and quality of life (QoL) based on data that include measurements from both pre- and postpandemic onset. This is also the case for university students. As society faced unprecedented restrictions during this period, these aspects may have developed unfavorably.

OBJECTIVE

To examine PA, PGB, and QoL among Norwegian University students prior to and during the initial stages of the pandemic and assess their temporal interrelations.

METHOD

The data are derived from the "Students' Psychological Health Over Time" study (SPOT). Linear mixed models were used to examine the development from January 2020 to November 2020 over three time points for the total sample and across gender. A traditional cross-lagged panel model analysis was used to estimate temporal associations. Age, gender, socioeconomic status, and partner status were included as covariates.

FINDINGS

PA and QoL decreased linearly over time (Cohen's d = 0.12 and 0.35, respectively), while only male students reported a small reduction in PGB (Cohen's d = 0.03). PA levels decreased considerably more for male students than female students (Cohen's d = 0.17 and 0.09, respectively). There was a small reciprocal negative temporal association between PA and PGB (standardized β = -0.04 and -0.05, respectively). All other temporal associations were not statistically significant in the adjusted analysis.

CONCLUSION

The findings highlight gender-variant negative developments in PA and QoL and suggest a negative reciprocal interrelation between PA and PGB. The findings point to potential adverse health effects that should be taken into account when restrictive pandemic measures are considered.

The impact of the world's first regulatory, multi-setting intervention on sedentary behaviour among children and adolescents (ENERGISE): a natural experiment evaluation

BACKGROUND

Regulatory actions are increasingly used to tackle issues such as excessive alcohol or sugar intake, but such actions to reduce sedentary behaviour remain scarce. World Health Organization (WHO) guidelines on sedentary behaviour call for system-wide policies. The Chinese government introduced the world's first nation-wide multi-setting regulation on multiple types of sedentary behaviour in children and adolescents in July 2021. This regulation restricts when (and for how long) online gaming businesses can provide access to pupils; the amount of homework teachers can assign to pupils according to their year groups; and when tutoring businesses can provide lessons to pupils. We evaluated the effect of this regulation on sedentary behaviour safeguarding pupils.

METHODS

With a natural experiment evaluation design, we used representative surveillance data from 9- to 18-year-old pupils before and after the introduction of the regulation, for longitudinal (n = 7,054, matched individuals, primary analysis) and repeated cross-sectional (n = 99,947, exploratory analysis) analyses. We analysed pre-post differences for self-reported sedentary behaviour outcomes (total sedentary behaviour time, screen viewing time, electronic device use time, homework time, and out-of-campus learning time) using multilevel models, and explored differences by sex, education stage, residency, and baseline weight status.

RESULTS

Longitudinal analyses indicated that pupils had reduced their mean total daily sedentary behaviour time by 13.8% (95% confidence interval [CI]: -15.9 to -11.7%, approximately 46 min) and were 1.20 times as likely to meet international daily screen time recommendations (95% CI: 1.01 to 1.32) one month after the introduction of the regulation compared to the reference group (before its introduction). They were on average 2.79 times as likely to meet the regulatory requirement on homework time (95% CI: 2.47 to 3.14) than the reference group and reduced their daily total screen-viewing time by 6.4% (95% CI: -9.6 to -3.3%, approximately 10 min). The positive effects were more pronounced among high-risk groups (secondary school and urban pupils who generally spend more time in sedentary behaviour) than in low-risk groups (primary school and rural pupils who generally spend less time in sedentary behaviour). The exploratory analyses showed comparable findings.

CONCLUSIONS

This regulatory intervention has been effective in reducing total and specific types of sedentary behaviour among Chinese children and adolescents, with the potential to reduce health inequalities. International researchers and policy makers may explore the feasibility and acceptability of implementing regulatory interventions on sedentary behaviour elsewhere.

Internet addiction and health-related quality of life in adolescents: The mediating role of sleep disturbance

BACKGROUND

Internet addiction (IA) has emerged as a recognized risk factor associated with impaired health-related quality of life (HRQOL) in adolescents. However, the role of sleep disturbance in this association remains unclear. This study aimed to investigate the association of IA with HRQOL in Chinese adolescents and to evaluate the potential mediating role of sleep disturbance.

METHODS

A cross-sectional study was conducted among adolescents attending six randomly selected middle schools in Guangzhou, China. Adolescents self-reported their internet use using the Young Diagnostic Questionnaire. HRQOL and sleep disturbance were assessed by the Pediatric Quality of Life Inventory version 4.0 and the Pittsburgh Sleep Quality Index, respectively. Multivariate linear regression analysis was employed to assess the association between IA and HRQOL. Baron and Kenny's causal steps method was used to examine the possible mediating role of sleep disturbance.

RESULTS

Of the 6473 adolescents included, 23.5% had maladaptive internet use (MIU) and 16.6% had pathological internet use (PIU). Compared to adolescents with adaptive internet use (AIU), those with IA had significantly lower scores across all HRQOL dimensions and summary scales. Mediation analysis revealed that sleep disturbance was a significant mediator. Specifically, sleep disturbance mediated 34.55% of the effects of MIU and 34.06% of the effects of PIU on the HRQOL total scale score , respectively.

CONCLUSIONS

IA was associated with poorer HRQOL, indicating the needs of preventing IA in Chinese adolescents. Additionally, our findings underscored the importance of enhancing sleep quality to mitigate the adverse impact of IA on adolescents' well-being.

Predictors of Health-Related Quality of Life Among Women Participating in an Appointment-Based Cardiac Rehabilitation Program

BACKGROUND

An alternative patient-centered appointment-based cardiac rehabilitation (CR) program has led to significant improvements in health outcomes for patients with cardiovascular disease. However, less is known about the effects of this approach on health-related quality of life (HRQoL), particularly for women.

OBJECTIVE

We examined the effects of a patient-centered appointment-based CR program on HRQoL by sex and examined predictors of HRQoL improvements specifically for women.

METHODS

Data were used from an urban single-center CR program at Yale New Haven Health (2012-2017). We collected information on patient demographics, socioeconomic status, and clinical characteristics. The Outcome Short-Form General Health Survey (SF-36) was used to measure HRQoL. We evaluated sex differences in SF-36 scores using t tests and used a multivariate linear regression model to examine predictors of improvements in HRQoL (total SF-36 score) for women.

RESULTS

A total of 1530 patients with cardiovascular disease (23.7% women, 4.8% Black; mean age, 64 ± 10.8 years) were enrolled in the CR program. Women were more likely to be older, Black, and separated, divorced, or widowed. Although women had lower total SF-36 scores on CR entry, there was no statistically significant difference in CR adherence or total SF-36 score improvements between sexes. Women who were employed and those with chronic obstructive pulmonary disease were more likely to have improvements in total SF-36 scores.

CONCLUSION

Both men and women participating in an appointment-based CR program achieved significant improvements in HRQoL. This approach could be a viable alternative to conventional CR to optimize secondary outcomes for patients.

Impact of pain and adverse health outcomes on long-term US testicular cancer survivors

BACKGROUND

No study has quantified the impact of pain and other adverse health outcomes on global physical and mental health in long-term US testicular cancer survivors or evaluated patient-reported functional impairment due to pain.

METHODS

Testicular cancer survivors given cisplatin-based chemotherapy completed validated surveys, including Patient-Reported Outcomes Measurement Information System v1.2 global physical and mental health, Patient-Reported Outcomes Measurement Information System pain questionnaires, and others. Multivariable linear regression examined relationships between 25 adverse health outcomes with global physical and mental health and pain-interference scores. Adverse health outcomes with a β^  of more than 2 are clinically important and reported below.

RESULTS

Among 358 testicular cancer survivors (median age = 46 years, interquartile range [IQR] = 38-53 years; median time since chemotherapy = 10.7 years, IQR = 7.2-16.0 years), median adverse health outcomes number was 5 (IQR = 3-7). A total of 12% testicular cancer survivors had 10 or more adverse health outcomes, and 19% reported chemotherapy-induced neuropathic pain. Increasing adverse health outcome numbers were associated with decreases in physical and mental health (P < .0001 each). In multivariable analyses, chemotherapy-induced neuropathic pain (β^ = -3.72; P = .001), diabetes (β^ = -4.41; P = .037), obesity (β^ = -2.01; P = .036), and fatigue (β^ = -8.58; P < .0001) were associated with worse global mental health, while being married or living as married benefited global mental health (β^ = 3.63; P = .0006). Risk factors for pain-related functional impairment included lower extremity location (β^ = 2.15; P = .04) and concomitant peripheral artery disease (β^ = 4.68; P < .001). Global physical health score reductions were associated with diabetes (β^ = -3.81; P = .012), balance or equilibrium problems (β^ = -3.82; P = .003), cognitive dysfunction (β^ = -4.43; P < .0001), obesity (β^ = -3.09; P < .0001), peripheral neuropathy score (β^ = -2.12; P < .0001), and depression (β^ = -3.17; P < .0001).

CONCLUSIONS

Testicular cancer survivors suffer adverse health outcomes that negatively impact long-term global mental health, global physical health, and pain-related functional status. Clinically important factors associated with worse physical and mental health identify testicular cancer survivors requiring closer monitoring, counseling, and interventions. Chemotherapy-induced neuropathic pain must be addressed, given its detrimental impact on patient-reported functional status and mental health 10 or more years after treatment.

A qualitative study of perceived barriers and facilitators to interrupting sedentary behavior among adults living with obesity

Introduction

Both obesity and sedentary behavior (SB) are associated with negative health consequences including cardiovascular disease, diabetes, certain cancers and all-cause mortality. To date, perceived barriers and facilitators to interrupting SB in adults living with obesity have not been identified.

Objective

This study aimed to identify these perceived barriers and facilitators by conducting a behavioral analysis underpinned by the theoretical domains framework (TDF) and the Capability, Opportunity, Motivation-Behavior (COM-B) model to enhance knowledge and inform future intervention development.

Methods

A purposive and snowball sample (N = 21) of adults living with obesity took part in semi-structured interviews, guided by the TDF, to investigate perceived barriers or facilitators to interrupt SB. Transcribed interviews were inductively coded using reflexive thematic analysis. Key themes and subthemes were generated by grouping similar and recurring codes. Finally, subthemes were mapped to the TDF and COM-B.

Results

Five key themes were identified, which influence SB across all domains of living. These relate to (i) physical and mental wellbeing; (ii) motivational readiness; (iii) roles, responsibilities and support; (iv) weight bias and stigma; and (v) the environment. These themes were then deductively mapped to all 14 TDF domains and all six of the COM-B constructs.

Conclusion

A complex interplay of individual, societal and policy factors contributes to the development and habituation of SB patterns in adults living with obesity. Factors identified in this study could assist in the development of interventions, strategies and policies designed to interrupt or reduce sedentary behavior in this population.

Moderate-to-vigorous intensity physical activity levels of children with intellectual disability during physical education classes

Background

Physical education (PE) class is an excellent way to improve moderate-to-vigorous intensity physical activity (MVPA). Increasing number of research has explored the children's PA based on movement during PE classes, but data for children with intellectual disability (ID) is still lacking.

Purpose

The purpose of this study was to investigate the current status of MVPA levels of children with ID during PE classes in China, as well as differences of MVPA levels according to gender and grade.

Methods

Accelerometers were used to record MVPA levels of fifty-three children with severe ID from 9 to 16 years of age (mean age: 12.60 ± 1.66 years) during standard PE classes.

Results

The mean time spent in MVPA during PE classes was 8.00 ± 2.10 min, meaning only 22.88% of PE class time was spent in MVPA. As grade levels progresses, time spent in MVPA during PE classes tended to decrease; the fourth-grade children tended to spend more time in MVPA during PE classes compared with the fifth-grade and the sixth-grade (9.15 vs. 7.61 vs. 7.25 min, all p < 0.05). Boys spend significantly more time in MVPA during PE classes than girls; both in the entire sample (9.20 vs. 5.70 min) as well as in each grade (9.76 vs. 6.09 min, 9.35 vs. 5.68 min, 8.31 vs. 5.59 min, all p < 0.05).

Conclusion

Findings from this study indicate that the proportion of PE class spent in the MVPA of children with ID was lower than the 50% recommended by the U.S. Department of Health and Human Services (DHHS) and U.K. Association for Physical Education (AfPE). And the amount of MVPA participation varied by the grade and gender as well as by the activity performed. Therefore, in order to help children with ID achieve MVPA goals, educators need to reevaluate the PE curriculum as well as take due consideration of grade and gender when devising new content.

A multicomponent intervention to reduce daily sitting time in office workers: the SMART Work & Life three-arm cluster RCT

Background

Office workers spend 70-85% of their time at work sitting. High levels of sitting have been linked to poor physiological and psychological health. Evidence shows the need for fully powered randomised controlled trials, with long-term follow-up, to test the effectiveness of interventions to reduce sitting time.

Objective

Our objective was to test the clinical effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable workstation, compared with usual practice at 12-month follow-up.

Design

A three-arm cluster randomised controlled trial.

Setting

Councils in England.

Participants

Office workers.

Intervention

SMART Work & Life is a multicomponent intervention that includes behaviour change strategies, delivered by workplace champions. Clusters were randomised to (1) the SMART Work & Life intervention, (2) the SMART Work & Life intervention with a height-adjustable workstation (i.e. SMART Work & Life plus desk) or (3) a control group (i.e. usual practice). Outcome measures were assessed at baseline and at 3 and 12 months.

Main outcome measures

The primary outcome was device-assessed daily sitting time compared with usual practice at 12 months. Secondary outcomes included sitting, standing, stepping time, physical activity, adiposity, blood pressure, biochemical measures, musculoskeletal issues, psychosocial variables, work-related health, diet and sleep. Cost-effectiveness and process evaluation data were collected.

Results

A total of 78 clusters (756 participants) were randomised [control, 26 clusters (n = 267); SMART Work & Life only, 27 clusters (n = 249); SMART Work & Life plus desk, 25 clusters (n = 240)]. At 12 months, significant differences between groups were found in daily sitting time, with participants in the SMART Work & Life-only and SMART Work & Life plus desk arms sitting 22.2 minutes per day (97.5% confidence interval -38.8 to -5.7 minutes/day; p = 0.003) and 63.7 minutes per day (97.5% confidence interval -80.0 to -47.4 minutes/day; p < 0.001), respectively, less than the control group. Participants in the SMART Work & Life plus desk arm sat 41.7 minutes per day (95% confidence interval -56.3 to -27.0 minutes/day; p < 0.001) less than participants in the SMART Work & Life-only arm. Sitting time was largely replaced by standing time, and changes in daily behaviour were driven by changes during work hours on workdays. Behaviour changes observed at 12 months were similar to 3 months. At 12 months, small improvements were seen for stress, well-being and vigour in both intervention groups, and for pain in the lower extremity and social norms in the SMART Work & Life plus desk group. Results from the process evaluation supported these findings, with participants reporting feeling more energised, alert, focused and productive. The process evaluation also showed that participants viewed the intervention positively; however, the extent of engagement varied across clusters. The average cost of SMART Work & Life only and SMART Work & Life plus desk was £80.59 and £228.31 per participant, respectively. Within trial, SMART Work & Life only had an incremental cost-effectiveness ratio of £12,091 per quality-adjusted life-year, with SMART Work & Life plus desk being dominated. Over a lifetime, SMART Work & Life only and SMART Work & Life plus desk had incremental cost-effectiveness ratios of £4985 and £13,378 per quality-adjusted life-year, respectively.

Limitations

The study was carried out in one sector, limiting generalisability.

Conclusions

The SMART Work & Life intervention, provided with and without a height-adjustable workstation, was successful in changing sitting time.

Future work

There is a need for longer-term follow-up, as well as follow-up within different organisations.

Trial registration

Current Controlled Trials ISRCTN11618007.

A health behaviour pandemic: The COVID-19 pandemic has impacted the physical activity, sleep, and sedentary behaviour of already-struggling Canadians

Objectives

The Canadian 24-Hour Movement Guidelines (24HMG) provide evidence-based recommendations for health behaviours, including light physical activity, moderate-to-vigorous physical activity (MVPA), sedentary behaviour (SB), sleep, and muscle strengthening activities. These behaviours likely changed as a result of public health measures implemented throughout the COVID-19 pandemic. We aimed to understand how Canadians' health behaviours changed during the pandemic.

Methods

We conducted a nationwide survey asking Canadians aged 18-64 to report their health behaviours according to the 24HMG at three timepoints: 1) immediately prior to the pandemic, 2) the most restricted timepoint of the pandemic, and 3) more recently, in March 2022.

Results

We received 494 eligible responses from across Canada. Prior to the pandemic, only 7.7% of respondents were able to meet all 24HMG, which reduced to 3.8% during the most restricted phase of the pandemic (p < 0.01). During this timepoint, self-reported MVPA decreased by -21.9 ± 55.6 weekly minutes, muscle strengthening decreased by -0.34 ± 0.94 weekly sessions, and SB increased by 0.88 ± 2.04 daily hours (p < 0.00001 for all), with nonsignificant increases in nightly sleep. At the more recent March 2022 timepoint, mild recoveries were observed in all health behaviours, however remained significantly lower than baseline levels, with the exception of sleep, which decreased significantly (-0.18 ± 1.42 nightly hours, p = 0.005).

Conclusions

Unfavourable health behaviour changes among Canadians were observed throughout the COVID-19 pandemic, which increases the risk for acute and long-term health conditions. Improved education, infrastructure, and support from public and private sectors can reverse the negative risk factors that arise from these health behaviour changes, and can improve the culture of proactive health behaviours in Canada.

The impact of parents' physical activity goals and parental attitudes on physical activity during leisure time among children in middle childhood

Introduction

Parents' supportiveness and health-promoting habits significantly affect the intensity of children's physical activity (PA) and the involvement of parents in their engagement in PA; in this domain, both the hours devoted to PA and PA goals can be assessed. The family plays an important role in shaping the physical and social organization of the environment for children aged 4-6 years.

Methods

A total of 680 families with 5-year-old children (330 girls, 350 boys) took part in the study. Data were collected from these participants, who were recruited from preschools and primary schools in the Pomeranian region of Poland. The aim of this study was to determine whether the involvement of parents in PA mediates the influence of parental attitudes on the ways in which their children spend their leisure time.

Results

The results showed that not all parental attitudes had direct impact on children's leisure time in PA and outside PA. Other aspects parental attitude had no significant impact on offspring's free time. Among fathers, only four aspects of parental attitude (namely, acceptance-rejection, inconsistency, autonomy, and overprotectiveness) had an impact on PA goals. Mothers' goals were influenced by the strength of a larger number of aspects of attitude (namely, acceptance-rejection, autonomy, inconsistency, over-demandingness, and overprotectiveness). Similarly, the strength of mothers' and fathers' acceptance-rejection attitudes, attitudes of autonomy, and overprotectiveness had an impact on their PA goals but were not directly linked to their children's leisure-time engagement in PA.

Discussion

Not all parental attitudes have a direct impact on children's PA or non-PA leisure time. However, the goals of PA parents have been recognized influence the leisure time of children in PA and outside PA. The most statistically significant relationship for both mothers and fathers was between parental attitudes and PA goals. Parental attitudes do not play a significant role in explaining involvement in PA or lack of it in leisure time among 5-year-old children.

How Have Physical Activity and Sedentary Behavior, Changed during the COVID-19 Pandemic? A Swedish Repeated Cross-Sectional Design Study

Physical activity (PA) and sedentary behavior (SB) affect people's physical and mental health. The aim was to examine changes in PA and SB in a Swedish population: at three time points: 2019, 2020, and 2022, i.e., before and during the COVID-19 pandemic. Pre-pandemic PA and SB, i.e., 2019, were assessed retrospectively in 2020. Associations between PA and SB with sex, age, occupation, COVID-19 history, weight change, health, and life satisfaction were also examined. The design was repeated cross-sectionally. The main findings demonstrate the PA levels decreased between 2019 and 2020, and between 2019 and 2022, but not between 2020 and 2022. The SB increase was most evident between 2019 and 2020. Between 2020 and 2022, results showed a decrease in SB, but SB did not reach pre-pandemic levels. Both sexes decreased their PA over time. Although men reported more PA sex, they did not have any association with PA changes. Two age groups, 19-29 years and 65-79 years, decreased their PA over time. Both PA and SB were associated with COVID-19, occupation, age, life satisfaction, health, and weight change. This study underlines the importance of monitoring changes in PA and SB as they have relevance for health and well-being. There is a risk that the levels of PA and SB do not return to pre-pandemic levels in the population.

Association between self-reported sedentary behavior and health-related quality of life among infertile women with polycystic ovary syndrome

BACKGROUND

High sedentary behavior and poor health-related quality of life (HRQoL) were common among women with polycystic ovary syndrome (PCOS). However, the association of sedentary behavior with HRQoL among infertile women with PCOS is still unknown. This study aimed to investigate the association of sedentary behavior with HRQoL among them.

METHODS

A cross-sectional study was conducted with 283 participants recruited from infertility outpatient clinic. A self-administered, structured questionnaire including the modified PCOS health-related QoL questionnaire (MPCOSQ), the International Physical Activity Questionnaire short form (IPAQ-SF), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) was used. Anthropometric and laboratory indictors related to PCOS were also collected. Multivariable linear regression analyses were performed to identify the associations. Bonferroni correction was utilized for multiple testing correction.

RESULTS

Sedentary behavior was associated with reduced HRQoL among this group. Specifically, over seven hours per day of sedentary behavior was strongly associated with total and several aspects of HRQoL (β ranged from - 0.378 to - 0.141, all P < 0.0063) after adjusting for physical activity, anxiety and depression. In addition, elevated BMI (β = - 0.407, P < 0.001) and anxiety (β ranged from - 0.410 to - 0.245, all P < 0.0063) were associated with poor HRQoL, while physical activity and depression were not.

CONCLUSION

Sedentary behavior is an important behavior among infertile women with PCOS as it was associated with poorer HRQoL. Future interventions seeking to improve HRQoL should be considered to reduce sedentary behavior and psychological burden as primary intervention targets.

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.

Association between Different Domains of Sedentary Behavior and Health-Related Quality of Life in Adults: A Longitudinal Study

Extended periods of time on screen devices and sitting are the main activities that characterize sedentary behavior (SB), which negatively impacts the quality of life. This negative influence was demonstrated mainly by cross-sectional studies performed in high-income countries in which the effects of screen time on health-related quality of life (HRQoL) is not considered. Thus, we analyzed the association between the different domains of SB (i.e., subdomains of screen time-television, computer, cellphone) and the HRQoL in adults that live in Brazil during two years of follow-up. The sample included 331 adults. Subdomains of screen time (i.e., watching television, using computers, and cellphones) and of HRQoL (i.e., physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health, and current health perception) were assessed by a structured questionnaire and SF-36, respectively. Our results indicate a significant increase in screen time during the two years of follow-up. Linear regression models indicated that although domains of SB were differently associated with HRQoL, in general, screen time was negatively associated with social functioning and positively associated with physical functioning during locomotion and activities of daily living (ADL), role-physical (i.e., physical issues during work and ADLs), and role-emotional (i.e., emotional issues during work and ADLs) after the two-year follow-up. In conclusion, screen time may positively or negatively influence some domains of HRQoL in adults.

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.

Association of daily and time-segmented physical activity and sedentary behaviour with mental health of school children and adolescents from rural Northeastern Ontario, Canada

Physical activity (PA) and sedentary behaviour (SED) have been linked to the mental health of children and adolescents, yet the timing of behaviours may play a role in this relationship and clarifying this could inform interventions. We explored cross-sectional associations of PA and SED in varying time segments throughout the school day with the mental health of school-aged children and adolescents from rural Northeastern Ontario, Canada. A total of 161 students (56% female, M = 10.3 years old) wore accelerometers for 8 days (7 nights) and completed a self-report survey (parent reported for children younger than 11). Mental health was measured using the Strengths and Difficulties Questionnaire. Accelerometer-measured SED, light PA (LPA), and moderate and vigorous PA (MVPA) were estimated in the time-segments before school (06:00–08:44), school time (08:45–15:04), after school (15:05–16:59), and evenings (17:00–21:59). Associations were tested with multilevel linear regressions while adjusting for confounding factors. Students spent 72.6 min in MVPA, 209.0 min in LPA, and 621.0 min in SED per day. Daily SED was associated with less conduct problems (β = −0.27, p &lt; 0.05). Evening LPA was inversely associated with hyperactivity (β = −1.45, p &lt; 0.05), while SED was associated with hyperactivity and with peer problems before school (β = 1.70 and β = 1.01, respectively, p &lt; 0.05), and during school (β = −0.83 and β = −0.57, respectively, p &lt; 0.05). No associations were observed for MVPA, emotional symptoms, or prosocial behaviour. In conclusion, displacing SED with LPA in some specific periods of the day may benefit the mental health of students; taking this into account could strengthen interventions.

The association of socioeconomic status with sedentary behaviour and moderate-to-vigorous intensity physical activity among children with intellectual disability

Background: While socioeconomic status (SES) has been shown to be an important determinant of sedentary behaviour (SB) and moderate-to-vigorous intensity physical activity (MVPA) in typically developing children, similar data on those with intellectual disability (ID) are lacking. This study explored the association of SES with SB and MVPA among Chinese children with ID. Method: Data were collected from 275 children aged 7-16 with mild to severe ID. Children's Leisure Activities Study Survey assessed SB and MVPA for a week. SES was assessed using the six indicators. Multiple linear regression was used to analyse the associations of SES variables with SB and MVPA on schooldays and on weekends. Results: Parental education level was positively associated with SB on weekends, and MVPA on schooldays and weekends; family's combined annual income was positively associated MVPA on schooldays and weekends; parental occupation was positively associated with SB on schooldays and weekends; Family Affluence Scale was positively associated with SB on schooldays (all p < 0.05). Conclusion: SES plays a significant role in influencing SB and MVPA in children with ID. Results suggest that interventions should focus on increasing MVPA for children with lower SES, while families with higher SES should limit their children's SB.

Influence of Alpine Skiing on Health-Related Quality of Life and Physical Self-Concept in Physically Active Adults over 55 Years of Age

Background: Older adults have the highest rates of a sedentary lifestyle. Alpine skiing could be considered a suitable activity to encourage continued sports practice and improve the health of this population in winter. The aim of this study was to analyse the relationship between the practice of alpine skiing and health-related quality of life (HRQoL), physical self-concept (PSC), and sport motivation. Methods: The study design was cross-sectional and descriptive, involving 280 Spanish adults aged over 55 years and physically active (75.35% skiers). To assess physical activity, PSC, HRQoL, and sport motivation, we used the Rapid Assessment of Physical Activity Questionnaire (RAPA-Q), the Physical Self-Perception Profile (PSPP 30), the Health-Related Quality of Life (SF-36), and the Sport Motivation Scale (SMS) questionnaires, respectively. Results: In the skier’s group, higher values were found for PSC (p < 0.001; d = 0.64), the physical component of HRQoL (p < 0.001, d = 0.48), physical function (p < 0.001, d = 61), and intrinsic motivation (p < 0.001; d = 0.85). The practice of alpine skiing was associated with higher levels of the physical health component (ORadj = 2.13, 95% CI 1.18−3.95, p = 0.013), PSC (ORadj = 2.92, 95% CI 1.58−5.52, p < 0.001), and intrinsic motivation (ORadj = 2.24, 95% CI 1.22−4.23, p = 0.010). Conclusions: The practice of alpine skiing is positively associated with higher values of HRQoL, PSC, and intrinsic motivation, and based on the above, it seems that alpine skiing can contribute to healthy ageing and improve the quality of life of older adults.

Psychological-health correlates of physical activity and sedentary behaviour during the COVID pandemic

BACKGROUND

While physical inactivity is associated with adverse psychological outcomes, less is known about the psychological outcomes associated with sedentary behaviour, and specifically, its mentally active and passive forms. The COVID-19 pandemic represents a unique opportunity to study associations between these variables in light of widespread stay-at-home mandates and restrictions on outdoor exercise/social activities. Using a cross-sectional dataset acquired during the COVID-19 pandemic in Australia, we examined whether physical activity and sedentary behaviour were associated with subjective quality of life (sQoL) and subjective cognitive dysfunction, and whether these associations were mediated by depressive symptoms.

METHODS

658 participants (males = 169, females = 489) self-reported data on physical activity and sedentary behaviour in an online survey during May 2020-May 2021. Data on physical activity and sedentary behaviour (both mentally active and passive types) was compared according to whether it was collected during or out of a lockdown period. Regression models were used to test associations of physical activity and sedentary behaviour with sQoL and subjective cognitive dysfunction, and whether these associations were mediated by depression severity.

RESULTS

Physical activity was beneficially associated with sQoL, whereas sedentary behaviour (both total hours and the reduction of mentally active/increase in mentally passive behaviour) was detrimentally associated with sQoL. These associations were mediated by depression severity. Physical activity and sedentary behaviour were also indirectly associated with subjective cognitive dysfunction by virtue of their associations with depression severity.

CONCLUSIONS

There are important differences in the psychological correlates of mentally passive and active sedentary behaviours. Our findings suggest that health promotion strategies should focus on not only increasing physical activity but also reducing passive sedentary behaviours as a means of maintaining good psychological health.

Family factors associated with physical activity in children with intellectual disability: A systematic review

This systematic review aimed to explore the influence of family factors on physical activity in children with intellectual disability. How and what family factors that specifically influence physical activity has not been compiled and reviewed previously. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was performed for articles published in English and Chinese without any year limits in six databases. Ten studies met the eligibility criteria and were included in the review. All studies were qualitatively integrated to identify and compare positive and negative family factors. A total of 1135 participants, of which 497 were children with intellectual disability while the other 638 participants were family members (parents, siblings and caregivers). The family factors of 6 themes and 18 sub-themes (10 positive, 7 negative and 1 inconclusive factors) were extracted. Overall, these results highlight the importance of encouragement, support and involvement by family members, concurrently it points out that parental psychological factors, socioeconomic status, responsibilities and electronic devices could both promote and hinder engagement in physical activity for children with intellectual disability. The findings accentuate the role of the family unit in helping determine the activity levels of children with intellectual disability. Future studies should include a wider range of participants and be longitudinal in nature, utilizing more accurate monitoring tools.

Effectiveness of an intervention for reducing sitting time and improving health in office workers: three arm cluster randomised controlled trial

OBJECTIVES

To evaluate the effectiveness of an intervention, with and without a height adjustable desk, on daily sitting time, and to investigate the relative effectiveness of the two interventions, and the effectiveness of both interventions on physical behaviours and physical, biochemical, psychological, and work related health and performance outcomes.

DESIGN

Cluster three arm randomised controlled trial with follow-up at three and 12 months.

SETTING

Local government councils in Leicester, Liverpool, and Greater Manchester, UK.

PARTICIPANTS

78 clusters including 756 desk based employees in defined offices, departments, or teams from two councils in Leicester, three in Greater Manchester, and one in Liverpool.

INTERVENTIONS

Clusters were randomised to one of three conditions: the SMART Work and Life (SWAL) intervention, the SWAL intervention with a height adjustable desk (SWAL plus desk), or control (usual practice).

MAIN OUTCOMES MEASURES

The primary outcome measure was daily sitting time, assessed by accelerometry, at 12 month follow-up. Secondary outcomes were accelerometer assessed sitting, prolonged sitting, standing and stepping time, and physical activity calculated over any valid day, work hours, workdays, and non-workdays, self-reported lifestyle behaviours, musculoskeletal problems, cardiometabolic health markers, work related health and performance, fatigue, and psychological measures.

RESULTS

Mean age of participants was 44.7 years, 72.4% (n=547) were women, and 74.9% (n=566) were white. Daily sitting time at 12 months was significantly lower in the intervention groups (SWAL -22.2 min/day, 95% confidence interval -38.8 to -5.7 min/day, P=0.003; SWAL plus desk -63.7 min/day, -80.1 to -47.4 min/day, P<0.001) compared with the control group. The SWAL plus desk intervention was found to be more effective than SWAL at changing sitting time (-41.7 min/day, -56.3 to -27.0 min/day, P<0.001). Favourable differences in sitting and prolonged sitting time at three and 12 month follow-ups for both intervention groups and for standing time for the SWAL plus desk group were observed during work hours and on workdays. Both intervention groups were associated with small improvements in stress, wellbeing, and vigour, and the SWAL plus desk group was associated with improvements in pain in the lower extremity, social norms for sitting and standing at work, and support.

CONCLUSIONS

Both SWAL and SWAL plus desk were associated with a reduction in sitting time, although the addition of a height adjustable desk was found to be threefold more effective.

TRIAL REGISTRATION

ISRCTN Registry ISRCTN11618007.

Development of a General Health Score Based on 12 Objective Metabolic and Lifestyle Items: The Lifestyle and Well-Being Index

Healthy and unhealthy lifestyles are tightly linked to general health and well-being. However, measurements of well-being have failed to include elements of health and easy to interpret information for patients seeking to improve lifestyles. Therefore, this study aimed to create an index for the assessment of general health and well-being along with two cut-off points: the lifestyle and well-being index (LWB-I). This was a cross-sectional analysis of 15,168 individuals. Internally valid multivariate linear models were constructed using key lifestyle features predicting a modified Short Form 36 questionnaire (SF-36) and used to score the LWB-I. Categorization of the LWB-I was based on self-perceived health (SPH) and analyzed using receiver operating characteristic curve analysis. Optimal cut-points identified individuals with poor and excellent SPH. Lifestyle and well-being were adequately accounted for using 12 lifestyle items. SPH groups had increasingly healthier lifestyle features and LWB-I scores; optimal cut-point for poor SPH were scores below 80 points (AUC: 0.80 (0.79, 0.82); sensitivity 75.7%, specificity 72.3%)) and above 86 points for excellent SPH (AUC: 0.67 (0.66, 0.69); sensitivity 61.4%, specificity 63.3%). Lifestyle and well-being were quantitatively scored based on their associations with a general health measure in order to create the LWB-I along with two cut points.

Impacts of COVID-19 lockdown on time allocation for sedentary and physical activities - The context of Indian university students

Introduction

Covid-19 pandemic has impacted individuals' time allocation decisions. As it is known that university students display behaviors different from the general population, very few studies have examined their activity participation and time allocation behavior during the pandemic. The present study investigates the changes in time allocations to sedentary, physically active, and eat-sleep activities before and during the pandemic.

Methods

The study hypothesizes that active mode (walk, bicycle) and transit users would compensate for the physical efforts by increasing physical activities at home during the lockdown. Students' perception of personal well-being, anxiety, and individual leisure during the pandemic and their impacts on time allocation decisions after controlling for demographic variables and temporal effects are also explored. A pan India behavioral data of 203 samples collected using an online survey conducted between May to July 2020, during India's lockdown phase, is used for analysis. A series of segmented analyses (using ANOVA's and Kruskal-Wallis Test) and empirical modeling (linear mixed-effect regression) were conducted based on the time use distribution.

Results

Findings showed that university students from low-income households and students who own a bicycle show a higher tendency to spend time in physical activities during lockdown periods. Students accessing college using active modes (before lockdown) allocate less time to sedentary and eat-sleep activities than physical activities during the lockdown period. Students' perception of Leisure items among those who use active modes is significantly different from those of private and public mode users.

Conclusions

From a policy viewpoint, such investigation would help implicitly understand and publicize the health benefits of active modes and transit and encourage their use. For instance, policymakers and transport planners can temporarily allocate less-used motorized streets (due to the pandemic) to students who prefer walking and cycling as universities still function online in India.

Assessment of Bidirectional Relationships between Leisure Sedentary Behaviors and Neuropsychiatric Disorders: A Two-Sample Mendelian Randomization Study

(1) Background: Increasing evidence shows that sedentary behaviors are associated with neuropsychiatric disorders (NPDs) and thus may be a modifiable factor to target for the prevention of NPDs. However, the direction and causality for the relationship remain unknown; sedentary behaviors could increase or decrease the risk of NPDs, and/or NPDs may increase or decrease engagement in sedentary behaviors. (2) Methods: This Mendelian randomization (MR) study with two samples included independent genetic variants related to sedentary behaviors (n = 408,815), Alzheimer's disease (AD; n = 63,926), schizophrenia (SCZ; n = 105,318), and major depressive disorder (MDD; n = 500,199), which were extracted from several of the largest non-overlapping genome-wide association studies (GWASs), as instrumental variables. The summarized MR effect sizes from each instrumental variable were combined in an IVW (inverse-variance-weighted) approach, with various approaches (e.g., MR-Egger, weighted median, MR-pleiotropy residual sum and outlier), and sensitivity analyses were performed to identify and remove outliers and assess the horizontal pleiotropy. (3) Results: The MR evidence and linkage disequilibrium score regression revealed a consistent directional association between television watching and MDD (odds ratio (OR), 1.13 for MDD per one standard deviation (SD) increase in mean television watching time; 95% CI, 1.06-1.20; p = 6.80 × 10^-5) and a consistent relationship between computer use and a decrease in the risk of AD (OR, 0.52 for AD per one SD increase in mean computer use time; 95% CI, 0.32-0.84; p = 8.20 × 10^-3). In the reverse direction, MR showed a causal association between a reduced risk of SCZ and an increase in driving time (β, -0.016; 95% CI, -0.027--0.004; p = 8.30 × 10^-3). (4) Conclusions: Using genetic instrumental variables identified from large-scale GWASs, we found robust evidence for a causal relationship between long computer use time and a reduced risk of AD, and for a causal relationship between long television watching time and an increased risk of MDD. In reverse analyses, we found that SCZ was causally associated with reduced driving time. These findings fit in with our observations and prior knowledge as well as emphasizing the importance of distinguishing between different domains of sedentary behaviors in epidemiologic studies of NPDs.

The views of general practitioners about using sit-stand desks: An observational study

BACKGROUND

Occupational sitting is associated with negative health outcomes. Sit-stand workstations have been shown to reduce sitting time in office workers, although there is no evidence on whether this change to practice would be acceptable to GPs.

AIM

To investigate GPs views about the use of sit-stand desks within general practice and the potential impact they may have on the nature and quality of consultations with adult patients.

DESIGN & SETTING

Observational study involving GPs located across the United Kingdom.

METHOD

A online survey was emailed to members of the Royal College of General Practitioners and shared on social media. Only GPs working in the UK were eligible. The survey included questions on socio-demographics, GPs views about the use of sit-stand desks within their work, their levels of physical activity, total time spent sitting each day at work and time spent at work.

RESULTS

14,142 surveys were sent by RCGP to their members with 810 GPs responding with a further 33 responding via social media. 60.6% of GPs would like a sit-stand desks in their consultation room, while 19.2% already had one. Most GPs thought sit-stand desks could be used for telephone consultations (91.9%) and administration tasks (92.3%). There was less agreement about whether they could be used during face-to-face consultations (35% agreed), with the potential impact on the doctor-patient relationship raised as the primary concern.

CONCLUSION

The implementation of sit-stand desks had support from GPs, but their possible impact on the doctor-patient relationship should be considered in future research.

Increased Risks of Mental Disorders: Youth with Inactive Physical Activity

Before COVID-19, one of the most dangerous pandemics of the 21st century was physical inactivity (PI). Sedentary habits had increased in the last decades, reducing physical condition and increasing non-communicable diseases and mental disorders in the population. This study aimed to analyse the relationships between physical activity level (PAL) and the prevalence of anxiety, depression, and other mental disorders in Spanish young aged 15-35 years and to calculate the odd ratio (OR) of developing from these mental disorders in inactive young people, based on PAL.

METHODS

A cross-sectional study based on data from the Spanish National Health Survey 2017 with 4195 participants was conducted. A descriptive analysis was performed. Possible differences between groups were analysed using the non-parametric statistical tests. OR and relative risks for mental disorders in inactive versus others PAL were calculated.

RESULTS

Dependence relationships were found between PAL and the prevalence of anxiety, depression, and other mental disorders (p < 0.001). In addition, the risk of developing: anxiety (OR: 6.14. 95% CI: 3.28-11.50), depression (OR: 5.35. 95% CI: 2.40-11.96), and other mental disorders (OR: 8.52. 95% CI: 2.90-25.06) was higher in inactive young people.

CONCLUSIONS

PI is associated to high risk of mental disorders in Spanish young people.

Associations of objectively measured physical activity and sedentary time with pregnancy-specific health-related quality of life

PURPOSE

To examine associations of objectively measured moderate-to-vigorous-intensity physical activity (MVPA) and sedentary behavior (SED) with pregnancy-specific health-related quality of life (QoL) across pregnancy trimesters.

MATERIALS AND METHODS

Women (N=131, mean age 30.9 years ± 4.9) were recruited from two large health care systems in the United States. MVPA and SED were estimated using a waist-worn ActiGraph GT3X and thigh-worn activPAL3 micro, respectively, for seven days in each trimester of pregnancy. Questionnaires were administered in each trimester to assess pregnancy-specific health-related QoL using the Nausea and Vomiting of Pregnancy Specific health Related Quality of Life (NVPQoL) questionnaire. Mixed effects linear regression examined associations of MVPA and SED with the NVPQoL total score and domain-specific scores (physical symptoms, fatigue, emotions, and limitations) across trimesters.

RESULTS

The NVPQoL total score and domain-specific scores significantly varied across trimesters, with highest scores (indicating worse QoL) observed in the first trimester and lowest scores (indicating better QoL) in the second trimester. A 1-standard deviation (SD) increment in MVPA (16.0 min/day or 1.8%) was associated with better QoL as indicated by the lower NVPQoL total score (β=-4.06, p=0.024) and limitations score (β = -2.80, p<0.001). A 1-SD increment in SED (1.5 hr/day or 10.0%) was associated with worse QoL as indicated by the higher fatigue score (β = 0.82, p=0.041).

CONCLUSIONS

Pregnancy-specific health-related QoL varies across trimesters. Both lower SED, and to a greater extent higher MVPA are potential behavioral targets for improving pregnancy-specific health-related QoL.

Association of Self-Reported and Device-Measured Sedentary Behaviour and Physical Activity with Health-Related Quality of Life among European Older Adults

Human movement behaviours such as physical activity (PA) and sedentary behaviour (SB) during waking time have a significant impact on health-related quality of life (HRQoL) in older adults. In this study, we aimed to analyse the association between self-reported and device-measured SB and PA with HRQoL in a cohort of community-dwelling older adults from four European countries. A subsample of 1193 participants from the SITLESS trial (61% women and 75.1 ± 6.2 years old) were included in the analysis. The association between self-reported and objective measures of SB and PA with HRQoL were quantified using Spearman’s Rho coefficients. The strength of the associations between self-reported and device-measured PA and SB with self-rated HRQoL (mental composite score, MCS; physical composite score, PCS) were assessed through multivariate multiple regression analysis. Self-reported and device-measured PA and SB levels showed significant but poor associations with PCS (p < 0.05). The association with MCS was only significant but poor with self-reported light PA (LPA) and moderate-to-vigorous PA (MVPA). In conclusion, the findings of this study suggest that both self-reported and device-measured PA of all intensities were positively and significantly associated, while SB was negatively and significantly associated with the PCS of the SF-12.

Prevalence and patterns of physical activity, sedentary behaviour, and their association with health-related quality of life within a multi-ethnic Asian population

OBJECTIVE

The study aimed to examine the prevalence and sociodemographic correlates of physical activity and sedentary behaviour in the general population of the multi-ethnic nation of Singapore as part of the Knowledge, Practice and Attitudes towards Diabetes study, a cross-sectional and population-based survey. It also examined the relationship between physical activity, sedentary behaviour, and health-related quality of life (HRQoL).

METHODS

Physical activity and sedentary behaviour were assessed via the Global Physical Activity Questionnaire (GPAQ), while physical and mental HRQoL was assessed via the Short Form Health Survey (SF-12v2). Survey weights were employed to account for complex survey design. Multivariable logistic regression models were utilized to examine sociodemographic correlates of physical activity (insufficient vs. sufficient physical activity) and sedentary behaviour (< 7 h/day vs ≥7 h/day). Descriptive statistics were calculated to examine the percentage of time spent in different domains of physical activity. Multivariable linear regressions were conducted to examine the association between physical activity and sedentary behaviour with physical and mental HRQoL.

RESULTS

Two thousand eight hundred sixty seven participants recruited from February 2019 to March 2020 (prior to COVID-19 lockdown and related restrictions in Singapore) were included in the analyses. 83.3% of respondents had sufficient physical activity. Age (65 years and above) and income (SGD 2000 to 3999) were associated with a higher likelihood of insufficient physical activity. In contrast, those of Malay ethnicity and having one chronic physical condition were associated with a lower likelihood of insufficient physical activity. 47.7% reported that they had sedentary behaviour of ≥7 h/day. Older age and a primary school education were related to a lower likelihood of sedentary behaviour, while being single, having higher income, obesity, and multimorbidity were associated with higher sedentary behaviour. Insufficient physical activity was significantly associated with lower physical HRQoL but was not significantly associated with mental HRQoL. Sedentary behaviour was not significantly associated with mental or physical HRQoL.

CONCLUSION

About 17% of the population did not meet the minimum requirements for physical activity, while around half of the population spent a considerable time being sedentary. As insufficient physical activity was associated with poorer physical HRQoL, policymakers should promote moderate physical activity and encouraging the breaking up of prolonged sedentary periods within the middle- and high-income groups, especially at the workplace. Increased leisure-time exercise should be encouraged for those in the lower- income group.

The Moderating Role of Sociodemographic Factors in the Relationship between Physical Activity and Subjective Well-Being in Chilean Children and Adolescents

Background: The relationship between physical activity habits and well-being is widely recognized; however, the interaction that these variables have with sociodemographic factors throughout life is only partially addressed in the literature, particularly in children and adolescents. The aim of this article is to analyze the moderating effect of sociodemographic factors and the possible interaction of these moderations in the relationship between physical activity and subjective well-being in children and adolescents. Methods: This cross-sectional study considered a sample of 9572 children and adolescents from 10 to 19 years of age, students of primary and secondary schools in all regions of Chile. Subjective well-being and physical activity habits were measured using self-report questionnaires. Socioeconomic level was established from the school vulnerability index (SVI) of each student’s school. Results: Simple moderation analyses revealed that the higher the age and the lower the SVI, the stronger the relationship between physical activity habits and subjective well-being. From a double moderation analysis, it could be observed that the age of the subjects is the most relevant moderator in the relationship between physical activity habits and perceived well-being in young people. Conclusions: This study highlights the importance of considering these factors and their interaction when generating programs or public policies to improve physical activity habits and well-being in children and adolescents.

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

RATIONALE

Although effects of individual planning interventions on physical activity (PA) are well established, less is known about the relationships between planning and sedentary behavior (SB).

OBJECTIVE

This study evaluated the efficacy of individual planning, dyadic planning (i.e., joint planning, targeting the behavior of one person only: the target person), and collaborative planning (i.e., joint planning and joint behavioral performance) on sedentary behavior among dyads.

METHODS

Dyads (N = 320 target persons and their partners, aged 18-90 years) were randomized into three PA planning conditions (individual, dyadic, or collaborative) or an active (education) control condition. Main outcomes, i.e., sedentary time, proportion of time spent in SB and light-intensity PA, proportion of time spent in SB and total PA were measured with GT3X-BT accelerometers at baseline, 1-week follow-up, and 36-week follow-up. Two-level models with measurement points nested in participants were fit, separately for target persons and partners.

RESULTS

Findings for target persons obtained at 1-week follow-up indicated that in the collaborative planning condition SB time significantly decreased, compared to the control condition (p = .013). There was an improvement in the proportion of time spent in SB and light-intensity PA (p = .019), and the proportion of time spent in SB and total PA (p = .018), indicating that SB time was displaced by PA. Effects of individual and dyadic planning were not significant, compared to the control condition. None of interventions had a significant effect on SB indices at 36-week follow-up. Regarding dyadic partners, there were no effects of planning interventions at 1-week follow-up or 36-week follow-up, compared to the control condition.

CONCLUSIONS

Collaborative planning may prompt a short-term reduction of SB time and result in a shift towards a healthier balance between SB time and PA time among target persons, who did not adhere to PA guidelines at baseline.

Sedentary behaviour and health in adults: an overview of systematic reviews

The purpose of this overview of systematic reviews was to determine the relationship between different types and patterns of sedentary behaviour and selected health outcomes in adults and older adults. Five electronic databases were last searched in May, 2019, with a 10-year search limit. Included reviews met the a priori population (community-dwelling adults aged 18 years and older), intervention/exposure/comparator (various types and/or patterns of sedentary behaviour), and outcomes criteria. Eighteen systematic reviews were included in the evidence synthesis. High levels of sedentary behaviour are unfavourably associated with cognitive function, depression, function and disability, physical activity levels, and physical health-related quality of life in adults. Reducing or breaking up sedentary behaviour may benefit body composition and markers of cardiometabolic risk. Total sedentary behaviour and TV viewing were most consistently associated with unfavourable health outcomes, while computer and Internet use may be favourably associated with cognitive function for older adults. The quality of evidence within individual reviews (as assessed by review authors) varied from low to high, while the certainty of evidence was low to very low. These findings have important public health implications, suggesting that adults should avoid high levels of sedentary behaviour and break-up periods of prolonged sitting. (PROSPERO registration nos.: CRD42019123121 and CRD42019127157.) Novelty High levels of sedentary behaviour are unfavourably associated with important health outcomes in adults. Reducing or breaking up sedentary behaviour may benefit body composition and markers of cardiometabolic risk. Computer and Internet use may be favourably associated with cognitive function in older adults.

A systematic review of physical activity and quality of life and well-being

Maintaining or improving quality of life (QoL) and well-being is a universal goal across the lifespan. Being physically active has been suggested as one way to enhance QoL and well-being. In this systematic review, conducted in part for the 2018 U.S. Health and Human Services Physical Activity Guidelines for Americans Scientific Advisory Committee Report, we examined the relationship between physical activity (PA) and QoL and well-being experienced by the general population across the lifespan and by persons with psychiatric and neurologic conditions. Systematic reviews, meta-analyses, and pooled analyses from 2006 to 2018 were used for the evidence base. Strong evidence (predominantly from randomized controlled trials [RCTs]) demonstrated that, for adults aged 18-65 years and older adults (primarily 65 years and older), PA improves QoL and well-being when compared with minimal or no-treatment controls. Moderate evidence indicated that PA improves QoL and well-being in individuals with schizophrenia and Parkinson's disease, and limited evidence indicated that PA improves QoL and well-being for youth and for adults with major clinical depression or bipolar disorder. Insufficient evidence existed for individuals with dementia because of a small number of studies with mixed results. Future high-quality research designs should include RCTs involving longer interventions testing different modes and intensities of PA in diverse populations of healthy people and individuals with cognitive (e.g., dementia) and mental health conditions (e.g., schizophrenia) to precisely characterize the effects of different forms of PA on aspects of QoL and well-being.

Sedentary behavior and health outcomes in patients with heart failure: a systematic review and meta-analysis

A better understanding of the association between sedentary behavior and heart failure is essential for the development of interventions to improve patients' outcomes. Therefore, a systematic review was conducted to determine the association between sedentary behavior and all-cause mortality, health-related quality of life, and depression in heart failure patients. We searched Web of Science, PubMed, Embase, and Cochrane Library and articles in references on 7 May 2021. The search results were limited to articles on heart failure patients over the age of 18, observational studies investigating the association between sedentary behavior and heart failure, and studies reporting one or more outcomes of interest. Two reviewers independently screened the literature and extracted data. Strengthening the Reporting of Observational Studies in Epidemiology was used to assess the quality of articles. Nine observational studies were included, of which, four were of high quality. Four cohort studies indicated that sedentary behavior was significantly associated with increased all-cause mortality (hazard ratio: 1.97; 95% confidence interval: 1.60 to 2.44; I² = 38.9%). In addition, subgroup analysis based on geographical regions was conducted (hazard ratio: 1.82; 95% confidence interval: 1.46 to 2.29; I² = 0%). Sedentary behavior was associated with worse health-related quality of life in patients with heart failure, and the regression coefficients ranged from 0.004 to 0.033 (95% confidence interval: 0.0004 to 0.055). Although sedentary behavior was associated with increased all-cause mortality and worse quality of life in patients with heart failure, further studies are needed to determine whether this association is causal.

Characterizing Physical Activity and Sedentary Behavior in Adults With Persistent Postconcussive Symptoms After Mild Traumatic Brain Injury

OBJECTIVE

To evaluate physical activity (PA) and sedentary behavior and their associations with symptom and quality of life outcomes in adults with persistent postconcussive symptoms (PPCS) after mild traumatic brain injury (mTBI).

DESIGN

Cross-sectional cohort study.

SETTING

Outpatient brain injury clinic.

PARTICIPANTS

Consecutive sample of adults (N=180) with a diagnosis of mTBI and PPCS.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

PA and sedentary behavior were assessed using the Godin Leisure-Time Exercise Questionnaire and Rapid Assessment Disuse Index, respectively. Participants were dichotomized according to whether they completed 150 minutes of moderate-to-vigorous PA per week, based on Canadian guidelines. Postinjury moderate-to-vigorous PA was also analyzed as a continuous variable.

RESULTS

Prior to injury, 85% of participants reported meeting PA guidelines, compared with 28% postinjury. Individuals meeting PA guidelines postinjury reported higher quality of life (η²_p=0.130; P<.001) and lower scores on measures of functional impact of headache (η²_p=0.065; P=.009), fatigue (η²_p=0.080; P=.004), depression (η²_p=0.085; P=.001), and anxiety (η²_p=0.046; P=.031), compared with those not meeting guidelines. Sedentary behavior postinjury was negatively correlated with quality of life (r_s[127]=-0.252; P=.004) and positively correlated with symptom burden (r_s[167]=0.227; P=.003), fatigue (r_s[127]=0.288; P=.001), depression (r_s[174]=0.319; P<.001), and anxiety (r_s[127]=0.180; P=.042).

CONCLUSIONS

PA was significantly decreased in individuals with PPCS compared to preinjury levels. Meeting PA guidelines postinjury was associated with better clinical outcomes, suggesting that returning individuals to PA should be considered in the treatment of this patient population.

Changes in Physical Activity and Sedentary Behaviour Due to Enforced COVID-19-Related Lockdown and Movement Restrictions: A Protocol for a Systematic Review and Meta-Analysis

Prolonged lockdown/restriction measures due to the COVID-19 pandemic have reportedly impacted opportunities to be physically active for a large proportion of the population in affected countries globally. The exact changes to physical activity and sedentary behaviours due to these measures have not been fully studied. Accordingly, the objective of this PROSPERO-registered systematic review is to evaluate the available evidence on physical activity and sedentary behaviours in the general population during COVID-19-related lockdown/restriction measures, compared to prior to restrictions being in place. Defined searches to identify eligible studies published in English, from November 2019 up to the date of submission, will be conducted using the following databases: CENTRAL, MEDLINE, EMBASE, CINAHL, SPORTDiscus, PSYCinfo, Coronavirus Research Database, Public Health Database, Publicly Available Content Database, SCOPUS, and Google Scholar. The applied inclusion criteria were selected to identify observational studies with no restrictions placed on participants, with outcomes regarding physical activity and/or sedentary behaviour during lockdown/restriction measures, and with comparisons for these outcomes to a time when no such measures were in place. Where appropriate, results from included studies will be pooled and effect estimates will be presented in random effects meta-analyses. To the best of our knowledge, this will be the first systematic review to evaluate one complete year of published data on the impact of COVID-19-related lockdown/restriction measures on physical activity and sedentary behaviour. Thus, this systematic review and meta-analysis will constitute the most up-to-date synthesis of published evidence on any such documented changes, and so will comprehensively inform clinical practitioners, public health agencies, researchers, policymakers and the general public regarding the effects of lockdown/restriction measures on both physical activity and sedentary behaviour.

Association Between Self-Reported Sedentary Behavior and Health-Related Quality of Life Among Multimorbidity Patients in Singapore

BACKGROUND

The study examined the association between sedentary behavior and self-rated health-related quality of life (HRQoL) in a sample of patients with multimorbidity in Singapore recruited from a primary care clinic.

METHODS

Sedentary behavior and physical activity were assessed with the International Physical Activity Questionnaire short form (IPAQ-SF). HRQoL was assessed with EuroQol-5 Dimension (EQ-5D) utility index, visual analogue scale (EQ-VAS) and its 5 subscales (Mobility, Self-care, Usual Activities, Pain/Discomfort, and Anxiety/Depression). Depression was assessed via Patient Health Questionnaire (PHQ-9). Logistic and linear regression analyses adjusting for the effect of physical activity, depression, and sociodemographic variables (i.e., age, gender, ethnicity, education) were conducted.

RESULTS

932 patients participated in the study (mean age:64.5±8.5 years, range: 35-80) and 55% were men. Results indicated that women were less likely to have sedentary behavior (≥7 hrs/day) than men. Results indicated sedentary behavior was associated with lower EQ-5D index scores, but not EQ-VAS scores. Participants who were sedentary for ≥7 hrs/day were more likely to endorse having problems with mobility, self-care, and usual activities, but not with pain/discomfort, nor anxiety/depression.

CONCLUSION

Sedentary behavior was associated with poorer HRQoL. There is a need for interventions and health promotions to reduce sedentary behavior in patients with multimorbidity.

An mHealth Workplace-Based "Sit Less, Move More" Program: Impact on Employees' Sedentary and Physical Activity Patterns at Work and Away from Work

BACKGROUND

Most workplace interventions that aim to reduce sedentary behaviour have 38 focused on employees' sedentary patterns at-work but less have focused on understanding the 39 impact beyond working time. The aim of this study was to evaluate the impact of a 13-week m-40 health workplace-based 'sit less, move more' intervention (Walk@WorkApp; W@W-App) on 41 physical activity (PA) and sitting in desk-based employees at-work and away from work.

METHODS

Participants (n = 141) were assigned by hospital to an intervention group (IG; used the W@W-App; n = 90) or an active comparison group (A-CG; monitored occupational activity; n = 51). The W@W-App, installed on the participants´ own smartphones, provided real-time feedback for occupational sitting, standing, and stepping, and gave access to automated strategies to sit less and move more at work. Changes between groups were assessed for total sitting time, sedentary bouts and breaks, and light and moderate-to-vigorous PA (activPAL3TM; min/day) between the baseline and after program completion.

RESULTS

Compared to the A-CG, employees that used the W@W-App program increased their number of daily breaks and the time spent on short sedentary bouts (<20 min, p = 0.047) during weekends. Changes in shortest sedentary bouts (5-10 min) during weekends were also statistically significant (p < 0.05). No changes in workday PA or sitting were observed.

CONCLUSION

Desk-based employees seemed to transfer the W@W-App program knowledge outside of work. Evaluating the impact of workplace (mHealth-based or not) interventions at work but also away from work would provide a better understating of the impact of such interventions.

Relationships between changes in self-reported physical activity, sedentary behaviour and health during the coronavirus (COVID-19) pandemic in France and Switzerland

To assess whether changes in physical activity and sedentary behaviour during the COVID-19 lockdown are associated with changes in mental and physical health. Observational longitudinal study. Participants living in France or Switzerland responded to online questionnaires measuring physical activity, physical and mental health, anxiety, and depressive symptoms. Paired sample t-tests were used to assess differences in physical activity and sedentary behaviour before and during lockdown. Multiple linear regressions were used to investigate associations between changes in physical activity and changes in mental and physical health during lockdown. 267 (wave1) and 110 participants (wave2; 2 weeks later) were recruited. Lockdown resulted in higher time spent in walking and moderate physical activity (~10min/day) and in sedentary behaviour (~75min/day), compared to pre COVID-19. Increased physical activity during leisure time from week 2 to week 4 of lockdown was associated with improved physical health (β=.24, p=.002). Additionally, an increase in sedentary behaviour during leisure time was associated with poorer physical health (β=-.35, p=.002), mental health (β=-.25, p=.003), and subjective vitality (β=-.30, p=.004). Ensuring sufficient levels of physical activity and reducing sedentary time can play a vital role in helping people to cope with a major stressful event, such as the COVID-19 pandemic.

Associations between sedentary behavior and happiness: An analysis of influential factors among middle-aged and older adults from six low- and middle-income countries

OBJECTIVES

Higher levels of sedentary behavior (SB) may be associated with decreased happiness but there are no studies on this topic. Thus, we investigated this association, and its influential factors among middle-aged and older adults using nationally representative datasets from six low- and middle-income countries (LMICs).

STUDY DESIGN

Community-based cross-sectional data from the Global Ageing and Adult Health study were analyzed. SB was assessed with the Global Physical Activity Questionnaire. Multivariable ordinal logistic regression and mediation analyses were performed.

MAIN OUTCOME MEASURES

Happiness was assessed with a cross-culturally validated single-item question (5-point scale) with higher scores indicating higher levels of happiness.

RESULTS

The final sample included 34,129 adults aged 50 years or more (mean age = 62.4 ± SD 16 years; 51.9 % female). After adjusting for multiple confounders, increased time spent in SB (hours/day) was associated with lower happiness levels (OR = 0.96; 95 % CI = 0.94-0.98). Mobility limitations, cognitive complaints, pain/discomfort, sleep problems and disability explained the largest proportion of the association between SB and happiness.

CONCLUSIONS

SB was linked with lower levels of happiness in middle-aged and older adults from LMICs, although a high level of between-country heterogeneity was observed. Longitudinal and interventional studies among older people in LMICs are warranted to assess directionality and the potential for reduction in SB to improve mental well-being in this population.

Association between Lifestyle Behaviors and Health-Related Quality of Life in a Sample of Brazilian Adolescents

This study aimed to analyze the association between lifestyle behaviors and health-related quality of life (HRQoL) among Brazilian adolescents. We evaluated 739 adolescents (51.0% girls; mean age, 16.4 ± 1.0 years) from the mesoregion Grande Florianópolis, Brazil. Participants were asked to complete an online questionnaire and sex, age, mother's education, health-related quality of life, physical activity, screen time indicators, sleep duration, diet, cigarette smoking, alcohol drinking, and drug experimentation were retrieved. Health-related quality of life was assessed using the Kidscreen-10 instrument. Measures of body mass and height were taken by trained researchers. Mixed-effects linear regression models were used. Self-reported health-related quality of life was higher in males (β = 3.68, 95%CI: 2.75; 4.61) compared to females, and no association was observed for age and mother's education level. Practicing sports (β = 1.19, 95%CI: 0.29; 2.08) was associated with better HRQoL, while processed food score (β = -0.45, 95%CI: -0.78; -0.13), working using screen devices for more than 4 h/day (β = -2.38, 95%CI: -4.52; -0.25), having experimented illicit drugs (β = -2.05, 95%CI: -3.20; -0.90), and sleeping less than 8 h/night (β = -1.35, 95%CI: -2.27; -0.43) were unfavorably associated with HRQoL. Non-sport physical activities, unprocessed food, studying, watching videos, playing videogames, using social media, alcohol drinking, and smoking were not associated with health-related quality of life. These findings suggest that promoting sports and adequate sleep, and preventing excessive workloads and the use of drugs among adolescents may be effective strategies to improve HRQoL.

The physical activity at work (PAW) study protocol: a cluster randomised trial of a multicomponent short-break intervention to reduce sitting time and increase physical activity among office workers in Thailand

BACKGROUND

High levels of sedentary behaviour (SB) are associated with non-communicable diseases. In 2016, the estimated total healthcare expenditure from physical activity (PA) in Thailand added up to $190 million in international dollars. The challenge to reduce SB and increase PA among office workers is more urgent now than ever as Thailand is transforming itself from a predominantly rural country to an increasingly urban one. This study will investigate the effectiveness of a multicomponent short break intervention on the reduction of SB during office hours.

METHODS/DESIGN

This two-armed Physical Activity at Work (PAW) cluster randomised controlled trial will recruit 360 office workers from 18 offices in the Thailand's Ministry of Public Health (MOPH). Offices will be randomised to either the intervention group or the control group. The multicomponent intervention is informed by the Social Ecological Model and Behaviour Change Techniques (BCTs) and contains four components: (i) organisational, including heads of the participating divisions leading exercises, sending encouragement text messages and acknowledging efforts; (ii) social, including team movement breaks and team-based incentives; (iii) environmental, including posters to encourage exercise; and (iv) individual components including real-time PA feedback via an individual device. The main intervention component will be a short break intervention. The primary outcome of this study is the sedentary time of office workers. Secondary outcomes include time spent on PA, cardiometabolic outcomes, work productivity, musculoskeletal pain, and quality of life. The study also includes process and economic evaluations from the individual and societal perspective.

DISCUSSION

The study will be the first experimental study in Thailand to investigate the effect of a short-break intervention at the workplace on SBs of office workers and health outcomes. The study will also include a cost-effectiveness analysis to inform investments on short break interventions under the Universal Healthcare Coverage in Thailand, which includes health promotion and disease prevention component.

TRIAL REGISTRATION

The PAW study has been registered at the Thai Clinical Trials Registry (TCTR) under the study ID TCTR20200604007 . Registered 02 June 2020,.

Associations between self-efficacy and sedentary behaviour: a meta-analysis

Objective: The study sought to synthesize research on the relationship between time spent engaged in sedentary behaviours (SB) and self-efficacy. Analyses investigated whether such associations are moderated by age, conceptualization of self-efficacy, conceptualization of SB, and/or SB measurement.Design and Main Outcome Measures: The review was registered with PROSPERO (no. CRD42018086899). Studies including associations between self-efficacy and SB were identified through a systematic search of six databases. Inclusion criteria were met by k = 26 original studies.Results: A random effect meta-analysis showed that higher levels of self-efficacy were associated with lower levels of SB (r = -.158, 95% CI [-.220, -.094]). Moderator analyses indicated that associations between self-efficacy and SB may be similar in strength across age groups, the conceptualizations of self-efficacy or SB and SB measurements.Conclusion: The findings provide preliminary guidance for future interventions targeting reduction of SB, although more longitudinal research is needed to draw causal inferences.

Prevalence, clustering and combined effects of lifestyle behaviours and their association with health after retirement age in a prospective cohort study, the Nord-Trøndelag Health Study, Norway

Background

Lifestyle behaviours are potential risk factors for disease and mortality, but less is known about the association with health in retirement age. The aim of this paper was to study the prevalence, clustering and combined effects of lifestyle behaviours and their association with health outcomes in the first decade after retirement in a Norwegian cohort.

Methods

Participants were 55–64-year-olds at baseline in the Nord-Trøndelag Health Survey 2 (HUNT2, 1995–97) who also participated in HUNT3 (2006–08). Logistic regression analyses were used to investigate the association of daily smoking, physical inactivity, risky alcohol consumption, disturbed sleep duration, excessive sitting time and low social participation before retirement with self-rated health (n = 4022), life satisfaction (n = 5134), anxiety (n = 4461) and depression (n = 5083) after retirement, 11 years later.

Results

Low social participation and physical inactivity were the most prevalent lifestyle behaviours (41.1 and 40.6%). Risky alcohol consumption and disturbed sleep were the lifestyle behaviours most strongly associated with poor self-rated health, poor life satisfaction and anxiety after retirement (OR’s = 1.39–1.92). Physical inactivity was additionally associated with depression (OR = 1.44 (1.12–1.85)). Physical inactivity had the largest population attributable fractions for reducing poor self-rated health and depression (14.9 and 8.8%). An increasing number of lifestyle risk behaviours incrementally increased the risk for the adverse health outcomes.

Conclusions

Risky alcohol consumption and disturbed sleep duration were most strongly associated with poor health outcomes after retirement age. On a population level, increased physical activity before retirement had the largest potential for reducing adverse health outcomes after retirement age.

[Effect of activities profile variations on health-related quality of life among breast cancer patients: Secondary exploratory analysis from PASAPAS study data]

INTRODUCTION

Lifestyle changes in breast cancer patients, by physical activity increasing, are becoming a main objective in supportive care. The objective of this study was to explore the impact of the daily activity profile evolution on the quality of life among this public.

METHODS

Sixty patients (18 to 75 years) with non-metastatic breast cancer were randomized to a 2:1 ratio (physical activity intervention; control) in the PASAPAS randomized clinical trial. Multiple linear regression analyzes were computed to explain quality of life scores 6 months after the start of adjuvant therapy. Variables retained were the baseline quality of life scores, the anxiety trait, the randomization arm, the variations of time spent in different physical activity classes ([3-4 [MET, [4-6 [MET, ≥6 MET) and in sedentary behaviors.

RESULTS

Only the decrease in time spent in sedentary behaviors really appeared as a predictor of the quality of physical life. Participation in the intervention group appeared as a predictor of quality of mental life.

DISCUSSION

Results plead in favor of sedentary life style decrease as part of the objectives of care program for women with breast cancer. It also highlights the need of collective supervised sessions implemented by competent staff. This research also suggests that the dynamics of daily activity profile variations should be studied further in association to quality of life.

Correlates of sedentary behaviour in Asian adults: A systematic review

The objective of this study is to systematically review the evidence on correlates of sedentary behaviour (SB) among Asian adults. We searched for studies that examined individual, environmental, and political/cultural correlates of total and domain-specific SB (transport, occupation, leisure, and screen time) in Asian adults published from 2000 onwards in nine scientific databases. Two reviewers independently screened identified references. Following quality assessment of included studies, we performed narrative synthesis that considered differences based on SB measurements, regions, and population characteristics (PROSPERO: CRD42018095268). We identified 13 249 papers of which we included 49, from four regions and 12 countries. Researchers conducted cross-sectional analyses and most relied on SB self-report for SB measurement. Of the 118 correlates studied, the following associations were consistent: higher age, living in an urban area (East Asia), and lower mental health with higher total SB; higher education with higher total and occupational SB; higher income with higher leisure-time SB; higher transit density with higher total SB in older East Asians; and being an unmarried women with higher SB in the Middle East. We encourage more research in non-high-income countries across regions, further exploration of important but neglected correlates using longitudinal designs and qualitative research, and the use of objective instruments to collect SB data.