Development and testing of a past year measure of sedentary behavior: the SIT-Q

Different sedentary behavior domains present distinct associations with eating-related indicators

BACKGROUND

Unhealthful dietary patterns have been consistently associated with low levels of physical activity (PA), but studies dedicated to sedentary behavior (SB) are scarce, especially in adults. The few studies that investigated the association between SB and dietary patterns focused mostly on specific types of SB, such as TV-watching or screen time. SB can be accumulated in distinct domains (i.e., work, transport, and leisure-time), thus, it is key to investigate in depth the impact that different domains of SB can have on eating-related indicators. We aimed to investigate the associations between different SB domains and eating-related indicators, in a sample of adults.

METHODS

Cross-sectional data from students, teachers, and staff from a Portuguese University was collected in November/2021 through an anonymous online survey. Data analyses were performed using the IBM SPSS software (version 28.0) and included descriptive statistics, partial correlations, and group comparisons using one-way ANOVA. Daily average SB at work/study, transport, and in leisure-time were self-reported and eating-related indicators were measured with several items from the Mediterranean Diet Score. Specific eating-related behaviors reflecting a protective eating pattern (e.g., eating breakfast regularly), and eating behavior traits (e.g., external eating) were also assessed. Body mass index (BMI) was calculated as weight (kg)/height(m)2. The International Physical Activity Questionnaire/Short-Form was used to assess PA.

RESULTS

The sample included 301 adults (60.1% women), with a mean age of 34.5 years. Overall, leisure-time SB was inversely associated with adherence to the Mediterranean diet (r = -0.20; p < 0.001) and with a protective eating profile (r = -0.31; p < 0.001). Higher transport SB was also related to lower adherence to the Mediterranean diet (r = -0.20; p < 0.001) and to an unhealthier eating profile (r = -0.22; p < 0.001), but no associations were found for work-related SB (p > 0.05). These results persisted after the adjustment for BMI, sex, and self-reported PA. These results were impacted by the age tertile.

CONCLUSIONS

Our findings suggest that adults with higher levels of SB in leisure-time and transport domains tend to report less healthy eating-related behaviors, irrespective of BMI, sex, and PA level. However, some differences in these associations were found according to the age tertile. This information may assist public health authorities in focusing their efforts in augmenting literacy on SB, namely on how SB can be accumulated via different settings. Furthermore, public health literacy efforts need to extend besides the more known deleterious effects of SB on health (e.g., diabetes, cardiovascular disease), to also include the interplay with eating indicators. Strategies to reduce SB and unhealthy eating should be particularly focused on promoting physically active forms of commuting and reducing SB in the leisure setting.

Assessment of Questionnaire of Physical Activity at Workplace Based on the Social Cognitive Theory (PAWPQ-SCT): A Psychometric Study in Iranian Gas Refinery Workers

Background

This study aimed to develop and assess the psychometric features of the Physical Activity at Workplace Questionnaire (PAWPQ) based on the Social Cognitive Theory (SCT) to evaluate employees' physical activity (PA) behaviors at the workplace.

Methods

This psychometric cross-sectional study was conducted on 455 employees working in one of the gas refineries in Iran. The participants were selected using the proportional stratified sampling method in 2019. The data collection tools were a demographic information questionnaire, the short form of the International Physical Activity Questionnaire (IPAQ), and a questionnaire developed based on the SCT, whose psychometric features were confirmed in terms of validity and reliability. Data were analyzed using SPSS22 and AMOS20 software.

Results

The first version of PAWPQ-SCT had 74 items. After evaluating content and face validity, nine items were removed. The results of the content validity index (0.98), content validity ratio (0.86), and impact score (3.62) were acceptable for the whole instrument. In exploratory factor analysis, after removing seven items-58-item final version of the scale-six factors could explain 73.54% of the total variance. The results of structural equation modeling showed the acceptable fit of the model into the data (RMSEA = 0.052, CFI = 0.917, NFI = 0.878, TLI = 0.905, IFI = 0.917, CMIN/DF = 2.818). Cronbach's alpha coefficient and Intraclass Correlation were 0.90 and 0.86, respectively.

Conclusion

This study confirmed that the psychometric features of the 58-item final version of PAWPQ-SCT constructs were acceptable in a sample of Iranian employees. This questionnaire can be used as a valid and reliable tool to evaluate Iranian employees' PA behaviors and develop effective educational interventions for workers and managers.

Psychometric properties of the Last-7-Day Sedentary Time Questionnaire (SIT-Q-7d): Testing the validity and reliability among general population

BACKGROUNDS

Sedentary behavior (SB) is an independent risk factor causing chronic diseases. Previous studies compared sitting time mostly with physical activity. The present study aimed to evaluate the validity and reliability of the Last-7-Day Sedentary Time Questionnaire (SIT-Q-7d) in Iran. Moreover, SB was assessed among the study participants.

METHODS

The current validity study was conducted among 290 subjects (51.7% males vs. 48.3% females) with a mean age of 34.81 ± 9.63 years in Poldasht, Iran. Sampling was done using simple random sampling and the data were collected using the SIT-Q-7d. To confirm the validity of the questionnaire, forward-backward translation method, content validity, and construct validity were used. Furthermore, temporal stability was calculated by the test-retest method and internal consistency coefficient (ICC).

RESULTS

Our results confirmed the content validity of the questionnaire (content validity score: 0.90 and content validity index: 0.80). Using exploratory factor analysis (EFA), seven factors of SB were identified as follows: eating while sitting down, doing domestic affairs, screen time, leisure time, studying books, watching TV, and attending family gatherings. The reliability of the questionnaire was confirmed using Cronbach's alpha (α = 0.7). In addition, temporal stability was confirmed by test-retest method and ICC was 0.9 (95% CI: 83-97).

CONCLUSION

Our results confirmed that the Persian version of SIT-Q-7d is a reliable and valid tool for assessing SB.

Association of High Blood Pressure With Physical Activity, Screen-Based Sedentary Time, and Sedentary Breaks in a 2-Year Cohort of Community Dwelling Adults

Objective: This study analyzed the association of high blood pressure (HBP) with physical activity, sedentary behavior, and sedentary breaks in 2-year follow-up.

Methods: A sample of 331 middle-aged and older adults (mean age of 59.6 ± 17.3 years) was randomly selected and assessed at baseline and after 2 years of follow-up. HBP was considered as ≥140/90 mmHg values of systolic and diastolic blood pressure. Physical activity, sedentary behavior, and sedentary breaks were assessed by questionnaire. Age, sex, socioeconomic status, and body mass index were covariates.

Results: Continuous HBP was observed in 26.3% of sample between baseline and follow-up. Adults who reported continuously high sedentary breaks at leisure activities were less likely to have HBP (OR = 0.34, p = 0.011), as well as those who remained high physically active (OR = 0.41, p = 0.016), even after mutual adjustment. No association was observed between high sedentary behavior and HBP at follow-up.

Conclusion: Community dwelling adults who were high active and performed frequent sedentary breaks were less likely to have HBP in 2-year follow-up. Strategies for HBP control should considered both physical activities and leisure sedentary breaks in adult population.

An Arabic Sedentary Behaviors Questionnaire (ASBQ): Development, Content Validation, and Pre-Testing Findings

Background: Sedentary behaviors (SB) are very prevalent nowadays. Prolonged sitting associates with chronic disease risks and increased mortality even while controlling for physical activity. Objective measurement of SB is costly, requires technical expertise, and is challenging in terms of time and management. Currently, there is no validated self-reported instrument in the Arabic language that assesses SB among individuals and relates sedentary time to social, environmental, and health outcomes. The aim of this research was to develop a multi-item Arabic SB questionnaire (ASBQ). Methods: The ASBQ was developed through an extensive literature review and discussion by the research team (n = 5), then went through content validation (n = 10 experts) and pre-testing using cognitive interviewing procedures (n = 51 respondents, mean (SD) age was 38.3 (18.2) years, and with 49% females). Results: The ASBQ included 13 questions comprising a wide range of sedentary activities. The Arabic SB instrument showed excellent content validity for assessing sedentary time in adolescents and adults with a very high item-level and scale-level content validity index. A kappa statistic, a measure of interrater reliability, was 0.95. The pre-testing showed that the instrument was highly rated by a diverse sample of Saudi adolescents and adults. Conclusion: The ASBQ received excellent acceptance by a panel of experts with promising pre-test results. Further testing of psychometric properties, including test-retest reliability and criterion validity is required.

Questionnaires measuring movement behaviours in adults and older adults: Content description and measurement properties. A systematic review

Background

Sleep, sedentary behaviour and physical activity are constituent parts of a 24h period and there are several questionnaires to measure these movement behaviours, the objective was to systematically review the literature on content and measurement properties of self- and proxy-reported questionnaires measuring movement behaviours in adults and older adults.

Methods

The databases PubMed, CINAHL, PsycINFO and SPORTDiscus were systematically searched until April 2021. Articles were included if: the questionnaires were design for adults and older adults; the sample size for validity studies had at least 50 participants; at least, both validity and test-retest reliability results of questionnaire that were developed specifically to measure the amount of sleep, sedentary behaviour or physical activity, or their combination were reported; and articles had to be written in English, Spanish, French, Portuguese, German, Italian or Chinese.

Findings and conclusions

Data extraction, results, studies’ quality, and risk of bias were evaluated using the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Fifty-five articles were included in this review, describing 60 questionnaires. None of the questionnaires showed adequate criterion validity and adequate reliability, simultaneously; 68.3% showed adequate content validity. The risk of bias for criterion validity and reliability were very low in 72.2% and 23.6% of the studies, respectively. Existing questionnaires have insufficient measurement properties and frequent methodologic limitations, and none was developed considering the 24h movement behaviour paradigm. The lack of valid and reliable questionnaires assessing 24h movement behaviours in an integrated way, precludes accurate monitoring and surveillance systems of 24h movement behaviours.

Sedentary Lifestyle Matters as Past Sedentariness, Not Current Sedentariness, Predicts Cognitive Inhibition Performance among College Students: An Exploratory Study

Background: Currently, sedentariness is assessed over a short period of time, thus it is difficult to study its cognitive implications. To investigate the cognitive consequences of a sedentary lifestyle, the past level (i.e., the sedentary time accumulated over the years) and current level of sedentariness should be considered. This pilot study aimed to investigate the negative association between a sedentary lifestyle and cognition by considering both the current and past sedentariness. It was expected that the physical activity level moderates the potential negative association between sedentariness and cognition. Methods: 52 college students (M_age = 20.19, SD_age = 2; 36 women) participated in the study. Current sedentariness (ratio of sedentary time in the last year), past sedentariness (ratio of sedentary time accumulated in previous years), and physical activity (ratio of time spent in physical activity in years) were assessed using a questionnaire. Cognitive inhibition, cognitive flexibility, and working memory updating were measured through three specific tests. Results: Past sedentariness significantly explained the inhibition performance when controlled for physical activity, whereas current sedentariness did not. More precisely, past sedentariness only negatively predicted cognitive inhibition when the physical activity level was low (β = -3.15, z(48) = -2.62, p = 0.01). Conclusions: The impact of sedentariness on cognitive functioning might only be revealed when past sedentariness and physical activity are controlled.

Reducing sedentary time using an innovative mHealth intervention among patients with total knee replacement: Rationale and study protocol

INTRODUCTION

Although knee replacement is effective for improving pain and physical function, subsequent improvements in physical activity typically do not follow. As a result, many patients spend most of their day engaged in sedentary behavior, which may put them at higher risk of experiencing poor function and disability. Intervening on sedentary time, rather than physical activity, may be a more feasible first-step approach for modifying activity-related behaviors in adults who received knee replacement.

OBJECTIVE

The purpose of this study is to examine the use of a mobile health (mHealth) intervention to reduce sedentary time among adults who received a knee replacement at 3 and 6 months after surgery.

METHODS

Patients (n = 92) scheduled for knee replacement will be recruited and at 4 weeks after surgery, they will be randomized to either NEAT!2 or Control. NEAT!2 participants will use the NEAT!2 smartphone app, which provides a vibration and/or audible tone to interrupt prolonged bouts of sitting detected from the smartphone's internal accelerometer, until 3 months after surgery. NEAT!2 participants will receive biweekly coaching calls between 4 and 12 weeks after surgery. Control participants will receive an education control app and receive non-intervention calls to assess general surgery recovery. Both groups will receive 3 retention calls between 3 and 6 months. Data collection will occur pre-operatively and at 3 and 6 months after surgery.

DISCUSSION

The results of this study will help to determine whether an innovative remotely-delivered, mHealth sedentary reduction intervention can decrease sedentary time in adults after knee replacement.

Sedentary time among undergraduate students: A systematic review

To systematically review and synthesize all relevant literature to assess the range of average daily sedentary time (ST) of undergraduate students enrolled in university and college programs across the world. Methods: Published, peer-reviewed articles were included if they: (a) were in English; (b) had a study population that consisted entirely of undergraduate students; (c) reported a daily or weekly ST for undergraduate students; and (d) included a measure of ST using a valid sedentary behavior questionnaire or accelerometers. Results: Twenty-three studies were included in the review. A wide range of ST (0.75 to 14.35 hours per day) was reported. Mean ST as measured by domain-specific questionnaires and accelerometers was 11.10 hours per day and 10.69 hours per day, respectively. Conclusion: Findings suggest that some undergraduate students participate in high levels of ST. Additional research, as well as interventions focused on reducing ST among postsecondary students, are needed.

Sedentary Behaviors and Physical Activity of Italian Undergraduate Students during Lockdown at the Time of CoViD-19 Pandemic

Background: From March to May 2020, lockdown measures were adopted in Italy to contain the epidemic of the novel Coronavirus. People were forced to restrict their movement and social contacts, therefore having a higher risk of inactivity. This study, carried out among Italian undergraduates, explored their sedentary and physical activities (PA) during the lockdown with respect to their previous habits. Methods: An electronic questionnaire was administered once to students attending three Italian universities after the end of lockdown. Results: A total of 1430 students (mean age 22.9 ± 3.5 years, 65.5% females) completed the questionnaire. All the sedentary behaviors increased significantly, and all the physical activities decreased significantly during the lockdown. Time spent using electronic devices showed the highest increase (+52.4 min/day), and walking the greatest decrease (-365.5 min/week). Being younger than 22 years old, female, and previously active, attending the universities of Naples and Rome and having at least one graduate parent were associated with the achievement of recommended levels of PA even during the lockdown. Conclusions: This study highlights the reduction of PA among Italian undergraduates in the course of home-confinement due to the CoViD-19 pandemic. The practice of adequate PA during the lockdown was mainly associated with the previous adoption of an active lifestyle. Promoting active lifestyles during the non-pandemic period may have had positive effects also in case of lockdown.

Validity and reliability of subjective methods to assess sedentary behaviour in adults: a systematic review and meta-analysis

BACKGROUND

Subjective measures of sedentary behaviour (SB) (i.e. questionnaires and diaries/logs) are widely implemented, and can be useful for capturing type and context of SBs. However, little is known about comparative validity and reliability. The aim of this systematic review and meta-analysis was to: 1) identify subjective methods to assess overall, domain- and behaviour-specific SB, and 2) examine the validity and reliability of these methods.

METHODS

The databases MEDLINE, EMBASE and SPORTDiscus were searched up to March 2020. Inclusion criteria were: 1) assessment of SB, 2) evaluation of subjective measurement tools, 3) being performed in healthy adults, 4) manuscript written in English, and 5) paper was peer-reviewed. Data of validity and/or reliability measurements was extracted from included studies and a meta-analysis using random effects was performed to assess the pooled correlation coefficients of the validity.

RESULTS

The systematic search resulted in 2423 hits. After excluding duplicates and screening on title and abstract, 82 studies were included with 75 self-reported measurement tools. There was wide variability in the measurement properties and quality of the studies. The criterion validity varied between poor-to-excellent (correlation coefficient [R] range - 0.01- 0.90) with logs/diaries (R = 0.63 [95%CI 0.48-0.78]) showing higher criterion validity compared to questionnaires (R = 0.35 [95%CI 0.32-0.39]). Furthermore, correlation coefficients of single- and multiple-item questionnaires were comparable (1-item R = 0.34; 2-to-9-items R = 0.35; ≥10-items R = 0.37). The reliability of SB measures was moderate-to-good, with the quality of these studies being mostly fair-to-good.

CONCLUSION

Logs and diaries are recommended to validly and reliably assess self-reported SB. However, due to time and resources constraints, 1-item questionnaires may be preferred to subjectively assess SB in large-scale observations when showing similar validity and reliability compared to longer questionnaires.

REGISTRATION NUMBER

CRD42018105994.

Long-term effect of the Brazilian Workers' Food Program on the nutritional status of manufacturing workers: A population-based prospective cohort study

Background

The Brazilian Workers Food Program (WFP) is a public policy program of nutritional assistance to workers, with the main objective of improving nutritional conditions, which was implemented 40 years ago and serves over 21.4 million workers.

Objectives

To compare the long-term change in anthropometric indicators of the nutritional status and dietary intake between workers of manufacturing industries adherent to and non-adherent to the WFP.

Methods

A prospective cohort study, based on a combined stratified and multistage probability sampling, was carried out, with two waves with a 4-year interval. The change in body mass index (BMI), waist circumference (WC) and dietary intake at lunch by the 24-hour recall method were compared between groups with analysis of covariance.

Results

A total of 273 workers in 16 industries from an initial cohort of 1069 workers in 26 industries of the State of Rio Grande do Norte in Brazil were evaluated in the two waves. The mean age was 37±10 years and 53.1% were male, with no differences between groups in age and sex distribution. BMI increased in both groups (0.44 kg/m2 in non-WFP, p = 0.003, and 0.56 kg/m2 in WFP, p = 0.0006) and WC increased in the WFP group (1.50 cm, p = 0.0006). BMI change over time did not show statistical differences between groups (p = 0.54) but WC had a greater increase in the WFP group (difference 1.37 cm, p = 0.047). There were no differences between groups in the change over time of the dietary intake.

Conclusion

BMI and WC increased over time in manufacturing workers of industries both adherent and non-adherent to the WFP, but with a greater increase of WC in the WFP group. In order to achieve the objectives of the WFP, there will be a need for periodic evaluation and monitoring of nutritional indicators in these workers and implementation of monitoring and enforcement actions of the WFP.

The Role of Recreational Online Activities in School-Based Screen Time Sedentary Behaviour Interventions for Adolescents: A Systematic and Critical Literature Review

Sedentary behaviours are highly associated with obesity and other important health outcomes in adolescence. This paper reviews screen time and its role within school-based behavioural interventions targeting adolescents between the years 2007 and 2019. A systematic literature review following PRISMA guidelines was conducted across five major databases to identify interventions targeting screen time—in addition to TV/DVD viewing. The review identified a total of 30 papers analysing 15 studies across 16 countries aiming at addressing reduction of recreational screen time (internet use and gaming) in addition to television/DVD viewing. All of the interventions focused exclusively on behaviour change, targeting in the majority both reduction of sedentary behaviours along with strategies to increase physical activity levels. A mix of intervention effects were found in the reviewed studies. Findings suggest aiming only for reduction in time spent on screen-based behaviour within interventions could be a limited strategy in ameliorating excessive screen use, if not targeted, in parallel, with strategies to address other developmental, contextual and motivational factors that are key components in driving the occurrence and maintenance of adolescent online behaviours. Additionally, it raises the need for a differential treatment and assessment of each online activity within the interventions due to the heterogeneity of the construct of screen time. Recommendations for enhancing the effectiveness of school-based sedentary behaviour interventions and implications for public policy are discussed.

Controversies in the Science of Sedentary Behaviour and Health: Insights, Perspectives and Future directions from the 2018 Queensland Sedentary Behaviour Think Tank

The development in research concerning sedentary behaviour has been rapid over the past two decades. This has led to the development of evidence and views that have become more advanced, diverse and, possibly, contentious. These include the effects of standing, the breaking up of prolonged sitting and the role of moderate-to-vigorous physical activity (MVPA) in the association between sedentary behaviour and health outcomes. The present aim is to report the views of experts (n = 21) brought together (one-day face-to-face meeting in 2018) to consider these issues and provide conclusions and recommendations for future work. Each topic was reviewed and presented by one expert followed by full group discussion, which was recorded, transcribed and analysed. The experts concluded that (a). standing may bring benefits that accrue from postural shifts. Prolonged (mainly static) standing and prolonged sitting are both bad for health; (b). ‘the best posture is the next posture’. Regularly breaking up of sitting with postural shifts and movement is vital; (c). health effects of prolonged sitting are evident even after controlling for MVPA, but high levels of MVPA can attenuate the deleterious effects of prolonged sitting depending on the health outcome of interest. Expert discussion addressed measurement, messaging and future directions.

Validation of Sedentary Behavior Record Instrument as a Measure of Contextual Information of Sedentary Behavior

BACKGROUND

To establish evidence for the validity of the Sedentary Behavior Record (SBR) instrument using a criterion measure through a proxy of direct observation.

METHODS

A total of 27 study participants (aged ≥18 y; 15 male) participated in this study. Throughout a 4-day measurement period, each participant recorded their sedentary behavior using the SBR in 10-minute blocks every night. During the measurement period, participants also wore wearable Autographer cameras as a proxy for direct observation. Autographer data were aggregated into 10-minute intervals. To establish evidence of validity, contingency (C) and Kappa (K) coefficients were calculated between the SBR and the Autographer data. For C and K, agreements were determined between 2 measures every cell. The coefficient C was compared across domains, types, and time of day, and K was compared across types of day and times of day.

RESULTS

Overall, the coefficients C and K were acceptable (C = .70) and substantial (K = .64), respectively. Among all domains, the highest C was reported for work-related sitting (C = .87). Values of C ranged from .49 to .91 among all activities; the highest accuracy was for work-related, screen-based sitting.

CONCLUSIONS

This study suggests that the SBR is an acceptable self-report measure of sedentary behavior in adults.

Comparison of sedentary behaviour questionnaires in people with multiple sclerosis

Background: People with multiple sclerosis are at risk of developing co-morbidities associated with sedentary behaviour. Despite an increase in studies examining sedentary behaviour in multiple sclerosis, researchers have not yet examined the appropriateness of the content or format of questionnaires assessing sedentary behaviour in multiple sclerosis.Objective: Evaluate perceptions of sedentary behaviour questionnaires for people with multiple sclerosis.Methods: Fifteen people with multiple sclerosis completed six validated sedentary behaviour questionnaires: Longitudinal Ageing Study Amsterdam, Marshall Sitting Questionnaire, International Physical Activity Questionnaire, Measure of Older Adults Sedentary Time, Sedentary Behaviour Questionnaire and SIT-Q. Participants' perceptions regarding questionnaire content and format were explored by interviews.Results: Self-reported sedentary time ranged between a mean of 470 (standard deviation 260) (Measure of Older Adults Sedentary Time) and 782 (322) min (Longitudinal Ageing Study Amsterdam) per weekday. Analysis of variance revealed a significant effect of questionnaire on mean sitting time: Longitudinal Ageing Study Amsterdam and SIT-Q yielded higher mean estimates of weekday sitting time than other questionnaires. The questionnaires were viewed as being suitable for use in multiple sclerosis but failed to capture some sedentary activities. Variability of symptoms yielded difficulties in describing a "typical day".Conclusions: The questionnaires were considered suitable for multiple sclerosis but produced variation in estimated sedentary time. Future work might validate questionnaire data with device-based assessments of sedentary time.Implications for rehabilitationSelf-reported sitting time ranged from 7.8 to 13.0 h per day in people with multiple sclerosis.Sedentary behaviour questionnaires are suitable for multiple sclerosis but yield variable estimates of sitting time.Watching television was the most prevalent sedentary activity and may have implications for interventions that break up sedentary time.

Sedentary Behaviors, TV Viewing Time, and Risk of Young-Onset Colorectal Cancer

Background

Colorectal cancer (CRC) diagnosed before age 50 years, or young-onset CRC, is increasing globally with undefined etiology. A sedentary lifestyle is an emerging risk factor for CRC after age 50 years, but its role in young-onset CRC is unknown.

Methods

We prospectively evaluated sedentary behaviors, primarily time watching television (TV), and risk of young-onset CRC among 89 278 women in the Nurses' Health Study II ages 25-42 years at recruitment (1991-2011). We used Cox proportional hazards modelling to estimate relative risks (RR) and 95% confidence intervals (CIs). Statistical tests were two-sided.

Results

We documented 118 young-onset CRCs over 1 262 540 person-years. Sedentary TV viewing time was statistically significantly associated with increased risk of young-onset CRC, after adjusting for putative risk factors, including obesity and physical activity. Compared 7 hours, women with 7.1-14 hours per week of TV time had a multivariable relative risk (RR) of 1.12 (95% confidence interval [CI] = 0.72 to 1.75), further increased for greater than14 hours per week (RR = 1.69, 95% CI = 1.07 to 2.67, P _trend = .03). This association was observed among participants without a CRC family history and was more pronounced for rectal cancer (RR for >14 vs <7 hours per week 2.44, 95% CI = 1.03 to 5.78, P _trend = .04). Overweight or obese participants may be more susceptible.

Conclusion

Independent of exercise and obesity, prolonged sedentary TV viewing time, a surrogate for a more inactive lifestyle, was associated with increased risk of young-onset CRC, particularly of the rectum. These findings provide further evidence on the importance of maintaining an active lifestyle.

Domain-Specific Adult Sedentary Behaviour Questionnaire (ASBQ) and the GPAQ Single-Item Question: A Reliability and Validity Study in an Asian Population

This study examined the validity and reliability of a domain-specific Adult Sedentary Behaviour Questionnaire (ASBQ) and the Global Physical Activity Questionnaire (GPAQ) single-item sitting question using self- and interviewer-administered modes of administration against the triaxial ActiGraph wGT3X-BT accelerometer. The ASBQ and the GPAQ were administered twice, seven days apart. Participants were asked to put on the waist-worn accelerometer for seven days. Convergent validity was assessed using Spearman’s rho, mean absolute error (MAE), and Bland-Altman analysis (n = 78). Reliability was assessed using the Spearman’s rho and intraclass correlation coefficient (ICC) (n = 84). Participants were adults aged 20–65 years and identifying as Chinese, Malay, or Indian. Only the self-administered GPAQ was significantly correlated with accelerometry-based measures (rho: 0.46), but not the interviewer-administered version (rho: 0.12). MAE for GPAQ was 207.5–218.3 min/day in relation to the accelerometer and for ASBQ was 154.7–174.6 min/day. Bland-Altman plots demonstrated large limits of agreement between questionnaire and accelerometry-based measures. While the self-administered GPAQ demonstrated a moderate correlation with accelerometry, the mean bias and the limits of agreement were large. The GPAQ (rho: 0.68–0.79; ICC: 0.68–0.78) and the ASBQ (rho: 0.53–0.64; ICC: 0.66–0.74) showed moderate-to-good reliability for total sedentary time using either self- or interviewer-administration. Future research should incorporate accelerometers to generate useful sedentary behaviour measures.

Self-reported domain-specific and accelerometer-based physical activity and sedentary behaviour in relation to psychological distress among an urban Asian population

Background

The interpretation of previous studies on the association of physical activity and sedentary behaviour with psychological health is limited by the use of mostly self-reported physical activity and sedentary behaviour, and a focus on Western populations. We aimed to explore the association of self-reported and devise-based measures of physical activity and sedentary behaviour domains on psychological distress in an urban multi-ethnic Asian population.

Methods

From a population-based cross-sectional study of adults aged 18–79 years, data were used from an overall sample (n = 2653) with complete self-reported total physical activity/sedentary behaviour and domain-specific physical activity data, and a subsample (n = 703) with self-reported domain-specific sedentary behaviour and accelerometry data. Physical activity and sedentary behaviour data were collected using the Global Physical Activity Questionnaire (GPAQ), a domain-specific sedentary behaviour questionnaire and accelerometers. The Kessler Screening Scale (K6) and General Health Questionnaire (GHQ-12) were used to assess psychological distress. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals, adjusted for socio-demographic and lifestyle characteristics.

Results

The sample comprised 45.0% men (median age = 45.0 years). The prevalence of psychological distress based on the K6 and GHQ-12 was 8.4% and 21.7%, respectively. In the adjusted model, higher levels of self-reported moderate-to-vigorous physical activity (MVPA) were associated with significantly higher odds for K6 (OR = 1.47 [1.03–2.10]; p-trend = 0.03) but not GHQ-12 (OR = 0.97 [0.77–1.23]; p-trend = 0.79), when comparing the highest with the lowest tertile. Accelerometry-assessed MVPA was not significantly associated with K6 (p-trend = 0.50) nor GHQ-12 (p-trend = 0.74). The highest tertile of leisure-time physical activity, but not work- or transport-domain activity, was associated with less psychological distress using K6 (OR = 0.65 [0.43–0.97]; p-trend = 0.02) and GHQ-12 (OR = 0.72 [0.55–0.93]; p-trend = 0.01). Self-reported sedentary behaviour was not associated with K6 (p-trend = 0.90) and GHQ-12 (p-trend = 0.33). The highest tertile of accelerometry-assessed sedentary behaviour was associated with significantly higher odds for K6 (OR = 1.93 [1.00–3.75]; p-trend = 0.04), but not GHQ-12 (OR = 1.34 [0.86–2.08]; p-trend = 0.18).

Conclusions

Higher levels of leisure-time physical activity and lower levels of accelerometer-based sedentary behaviour were associated with lower psychological distress. This study underscores the importance of assessing accelerometer-based and domain-specific activity in relation to mental health, instead of solely focusing on total volume of activity.

Electronic supplementary material

The online version of this article (10.1186/s12966-018-0669-1) contains supplementary material, which is available to authorized users.

Effects of prescribed aerobic exercise volume on physical activity and sedentary time in postmenopausal women: a randomized controlled trial

BACKGROUND

Physical activity has emerged as an important lifestyle factor for primary prevention of numerous diseases, including postmenopausal breast cancer. No study to date has assessed the acute and long-term effects of year-long aerobic exercise programs differing in prescribed exercise volume on physical activity and sedentary time in postmenopausal women. Therefore, we aimed to examine the effects of two moderate-vigorous intensity exercise doses on total, light and moderate-vigorous intensity physical activity times, and sedentary time in postmenopausal women during the year-long intervention and one year later.

METHODS

The Breast Cancer and Exercise Trial in Alberta (BETA) was a two-center, two-arm, 12-month randomized controlled trial that included 400 previously inactive postmenopausal women randomized to either 150 (MODERATE) or 300 (HIGH) minutes/week of aerobic exercise. Physical activity and sedentary time were assessed at baseline, 6- (intervention mid-point), 12- (prior to end of intervention) and 24-months (follow-up) with waist-mounted accelerometers (Actigraph GTX3®). Self-reported activity and sedentary time at baseline, 12- and 24-months was also assessed (Past Year Total Physical Activity Questionnaire and SIT-Q). Intention-to-treat analyses were conducted using linear mixed models and adjusted for baseline variables.

RESULTS

Both physical activity interventions led to increases in objective and subjective measures of total and moderate-vigorous intensity/recreational physical activity time, coupled with decreases in sedentary time, at 6- and 12-months compared to baseline. Additionally, greater increases in accelerometry-derived total physical activity time at 6- and 12-months, and self-reported recreational activity time at 12-months, compared to baseline were noted in the HIGH versus MODERATE groups. Decreases in total, light and moderate-vigorous intensity physical activity time, and an increase in sedentary time, in both groups were noted at 24-months compared to 12-months. A decrease in light intensity physical activity time in both groups at 24-months compared to baseline was also noted.

CONCLUSION

These findings have important health implications, suggesting that total physical activity time can be increased with greater volumes of prescribed exercise, but that additional support and resources could be used to promote the maintenance of these high levels of aerobic exercise participation following study completion.

TRIAL REGISTRATION

clinicaltrials.gov identifier: NCT01435005 (BETA Trial). Registred September 15th 2011 (retrospectively registered).

Physical activity, sedentary behaviour and colorectal cancer risk in the UK Biobank

This corrects the article DOI: 10.1038/bjc.2017.85.

Taxonomy-based content analysis of sedentary behavior questionnaires: A systematic review

Background

Health effects of sedentary behaviors (SB) may vary depending on their characteristics such as type, purpose, duration, and intensity of the behavior. While a growing number of questionnaires assess sedentary behaviors, it is unclear which characteristics of SB are measured. The aim of this review was to examine the content of self-report SB questionnaires.

Methods

Three databases were searched for sedentary behavior questionnaires published before January 1^st, 2016. Based on the inclusion criteria, 82 articles out of 1369 were retrieved for a total of 60 questionnaires. For each questionnaire, the sedentary behavior characteristics identified were reported and analyzed.

Results

Most of the questionnaires assessed the time (n = 60), posture (n = 54), purpose (n = 46) and the types (n = 45) of SB performed. Fewer questionnaires assessed the environment (n = 20) social context (n = 11), status (n = 2), and associated behaviors (n = 2) related to sedentary behaviors. All the questionnaires except two assessed time spent in SB with 17 assessing frequency and 6 assessing breaks in SB. The most frequent characteristics identified in the questionnaires were the categories of sitting (90%), a day (95%), watching television (65%) and using a computer (55%). Many characteristics of SB were not measured.

Conclusions

By knowing the breadth of SB included in questionnaires, this review provides support to shape the design of new questionnaires designed to reduce the gaps in measuring sedentary behaviors.

Measurement of sedentary behaviour in population health surveys: a review and recommendations

Background

The purpose of this review was to determine the most valid and reliable questions for targeting key modes of sedentary behaviour (SB) in a broad range of national and international health surveillance surveys. This was done by reviewing the SB modules currently used in population health surveys, as well as examining SB questionnaires that have performed well in psychometric testing.

Methods

Health surveillance surveys were identified via scoping review and contact with experts in the field. Previous systematic reviews provided psychometric information on pediatric questionnaires. A comprehensive search of four bibliographic databases was used to identify studies reporting psychometric information for adult questionnaires. Only surveys/studies published/used in English or French were included.

Results

The review identified a total of 16 pediatric and 18 adult national/international surveys assessing SB, few of which have undergone psychometric testing. Fourteen pediatric and 35 adult questionnaires with psychometric information were included. While reliability was generally good to excellent for questions targeting key modes of SB, validity was poor to moderate, and reported much less frequently. The most valid and reliable questions targeting specific modes of SB were combined to create a single questionnaire targeting key modes of SB.

Discussion

Our results highlight the importance of including SB questions in survey modules that are adaptable, able to assess various modes of SB, and that exhibit adequate reliability and validity. Future research could investigate the psychometric properties of the module we have proposed in this paper, as well as other questionnaires currently used in national and international population health surveys.

TAxonomy of Self-reported Sedentary behaviour Tools (TASST) framework for development, comparison and evaluation of self-report tools: content analysis and systematic review

OBJECTIVE

Sedentary behaviour (SB) has distinct deleterious health outcomes, yet there is no consensus on best practice for measurement. This study aimed to identify the optimal self-report tool for population surveillance of SB, using a systematic framework.

DESIGN

A framework, TAxonomy of Self-reported Sedentary behaviour Tools (TASST), consisting of four domains (type of assessment, recall period, temporal unit and assessment period), was developed based on a systematic inventory of existing tools. The inventory was achieved through a systematic review of studies reporting SB and tracing back to the original description. A systematic review of the accuracy and sensitivity to change of these tools was then mapped against TASST domains.

DATA SOURCES

Systematic searches were conducted via EBSCO, reference lists and expert opinion.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

The inventory included tools measuring SB in adults that could be self-completed at one sitting, and excluded tools measuring SB in specific populations or contexts. The systematic review included studies reporting on the accuracy against an objective measure of SB and/or sensitivity to change of a tool in the inventory.

RESULTS

The systematic review initially identified 32 distinct tools (141 questions), which were used to develop the TASST framework. Twenty-two studies evaluated accuracy and/or sensitivity to change representing only eight taxa. Assessing SB as a sum of behaviours and using a previous day recall were the most promising features of existing tools. Accuracy was poor for all existing tools, with underestimation and overestimation of SB. There was a lack of evidence about sensitivity to change.

CONCLUSIONS

Despite the limited evidence, mapping existing SB tools onto the TASST framework has enabled informed recommendations to be made about the most promising features for a surveillance tool, identified aspects on which future research and development of SB surveillance tools should focus.

TRIAL REGISTRATION NUMBER

International prospective register of systematic reviews (PROPSPERO)/CRD42014009851.

Wearable monitors criterion validity for energy expenditure in sedentary and light activities

BACKGROUND

Wearable monitors (WMs) are used to estimate the time spent in sedentary behaviors (SBs) and light-intensity physical activities (LPAs) and their associated energy cost; however, the accuracy of WMs in measuring behaviors on the lower end of the intensity spectrum is unclear. The aim of this study was to assess the validity of 3 WMs (ActiGraph GT3X+; activPAL, and SenseWear 2) in estimating the intensity of SB and LPA in adults as compared with the criterion measure of oxygen uptake (VO₂) measured by indirect calorimetry.

METHODS

Sixteen participants (age: 25.38 ± 8.58 years) wore the ActiGraph GT3X+, activPAL, and SenseWear 2 devices during 7 sedentary-to-light activities. VO₂ (mL/kg/min) was estimated by means of a portable gas analyzer, Oxycon Mobile (Carefusion, Yorba Linda, CA, USA). All data were transformed into metabolic equivalents and analyzed using mean percentage error, equivalence plots, Bland-Altman plots, kappa statistics, and sensitivity/specificity.

RESULTS

Mean percentage error was lowest for the activPAL for SB (14.9%) and LPA (9.3%) compared with other WMs, which were >21.2%. None of the WMs fell within the equivalency range of ±10% of the criterion mean value. Bland-Altman plots revealed narrower levels of agreement with all WMs for SB than for LPA. Kappa statistics were low for all WMs, and sensitivity and specificity varied by WM type.

CONCLUSION

None of the WMs tested in this study were equivalent with the criterion measure (VO₂) in estimating sedentary-to-light activities; however, the activPAL had greater overall accuracy in measuring SB and LPA than did the ActiGraph and SenseWear 2 monitors.

Walking, Sedentary Time and Health-Related Quality Life Among Kidney Transplant Recipients: An Exploratory Study

OBJECTIVES

The primary objectives of this study were to: 1) establish walking and physical activity prevalence and sedentary time estimates; and 2) determine associations of health-related quality of life (HRQoL) with objectively assessed walking, self-reported physical activity, and sedentary time among kidney transplant recipients.

METHODS

Using a cross-sectional design, kidney transplant recipients received a survey package containing measures of sedentary time, moderate-to-vigorous physical activity, and HRQoL, and a step pedometer.

RESULTS

Thirty-two participants returned a completed survey, for a response rate of 82% (32 of 39 interested participants). The average steps per day were 9752 steps (SD = 3685) and 59% achieved public health guidelines of at least 150 minutes of moderate-to-vigorous physical activity per week. Total sedentary time during the week was 11.6 h/d whereas total sedentary time during the weekend was 8.9 h/d. Compared to those not achieving at least 10,000 steps/d, respondents who were achieving at least 10,000 steps/d had a significantly higher physical component score for HRQoL (Mdiff = 7.8, P = .018). Similar patterns emerged for meeting physical activity guidelines and sedentary time.

CONCLUSION

For kidney transplant recipients, greater participation in walking, overall physical activity, and lower engagement in sedentary activity, was associated with better HRQoL.

'Let's Move It' - a school-based multilevel intervention to increase physical activity and reduce sedentary behaviour among older adolescents in vocational secondary schools: a study protocol for a cluster-randomised trial

Background

Physical activity (PA) has been shown to decline during adolescence, and those with lower education have lower levels of activity already at this age, calling for targeted efforts for them. No previous study has demonstrated lasting effects of school-based PA interventions among older adolescents. Furthermore, these interventions have rarely targeted sedentary behaviour (SB) despite its relevance to health. The Let’s Move It trial aims to evaluate the effectiveness and the cost-effectiveness of a school-based, multi-level intervention, on PA and SB, among vocational school students. We hypothesise that the intervention is effective in increasing moderate-to-vigorous-intensity physical activity (MVPA), particularly among those with low or moderate baseline levels, and decreasing SB among all students.

Methods

The design is a cluster-randomised parallel group trial with an internal pilot study. The trial is conducted in six vocational schools in the Helsinki Metropolitan area, Finland. The intervention is carried out in 30 intervention classes, and 27 control classes retain the standard curriculum. The randomisation occurs at school-level to avoid contamination and to aid delivery.

Three of the six schools, randomly allocated, receive the ‘Let’s Move It’ intervention which consists of 1) group sessions and poster campaign targeting students’ autonomous PA motivation and self-regulation skills, 2) sitting reduction in classrooms via alterations in choice architecture and teacher behaviour, and 3) enhancement of PA opportunities in school, home and community environments. At baseline, student participants are blind to group allocation. The trial is carried out in six batches in 2015–2017, with main measurements at pre-intervention baseline, and 2-month and 14-month follow-ups. Primary outcomes are for PA, MVPA measured by accelerometry and self-report, and for SB, sedentary time and breaks in sedentary time (accelerometry).

Key secondary outcomes include measured body composition, self-reported well-being, and psychological variables. Process variables include measures of psychosocial determinants of PA (e.g. autonomous motivation) and use of behaviour change techniques. Process evaluation also includes qualitative interviews. Intervention fidelity is monitored.

Discussion

The study will establish whether the Let’s Move It intervention is effective in increasing PA and reducing SB in vocational school students, and identify key processes explaining the results.

Trial registration

ISRCTN10979479. Registered: 31.12.2015

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3094-x) contains supplementary material, which is available to authorized users.

Impact of changes in television viewing time and physical activity on longevity: a prospective cohort study

BACKGROUND

Television viewing is a highly prevalent sedentary behavior among older adults, yet the mortality risks associated with hours of daily viewing over many years and whether increasing or decreasing viewing time affects mortality is unclear. This study examined: 1) the long-term association between mortality and daily viewing time; 2) the influence of reducing and increasing in television viewing time on longevity and 3) combined effects of television viewing and moderate-to-vigorous physical activity (MVPA) on longevity.

METHODS

Participants included 165,087 adults in the NIH-AARP Diet and Health (aged 50-71 yrs) who completed questionnaires at two-time-points (Time 1: 1994-1996, and Time 2: 2004-2006) and were followed until death or December 31, 2011. Multivariable-adjusted Cox proportional hazards regression was used to estimate Hazard Ratios and 95% confidence intervals (CI) with self-reported television viewing and MVPA and all-cause mortality.

RESULTS

Over 6.6 years of follow-up, there were 20,104 deaths. Compared to adults who watched < 3 h/day of television at both time points, mortality risk was 28% greater (CI:1.21,1.34) those who watched 5+ h/day at both time-points. Decreasing television viewing from 5 + h/day to 3-4 h/d was associated with a 15% reduction in mortality risk (CI:0.80, 0.91) and decreasing to <3 h/day resulted in an 12% lower risk (CI:0.79, 0.97). Conversely, adults who increased their viewing time to 3-4 h/day had an 17% greater mortality risk (CI:1.10, 1.24) and those who increased to 5+ h/day had a 45% greater risk (CI:1.32, 1.58), compared to those who consistently watched <3 h/day. The lowest mortality risk was observed in those who were consistently active and watched < 3 h/day of television.

CONCLUSIONS

We confirm that prolonged television viewing time was associated with greater mortality in older adults and demonstrate for the first time that individuals who reduced the amount of time they spent watching television had lower mortality. Our findings provide new evidence to support behavioral interventions that seek to reduce sedentary television viewing in favor of more physically active pursuits, preferably MVPA. Given the high prevalence of physical inactivity and prolonged television viewing in older adults, favorable changes in these two modifiable behaviors could have substantial public health impact.

TRIAL REGISTRATION

ClinicalTrials.gov number, NCT00340015.

Study design and methods for the Breast Cancer and Exercise Trial in Alberta (BETA)

Background

Exercise has favorable effects on biomarkers associated with a lower risk of breast cancer, however it is unclear if higher doses of exercise provide additional effects. No clinical trial has systematically examined how different exercise volumes influence the mechanisms underlying breast cancer etiology. The Breast Cancer and Exercise Trial in Alberta (BETA) - a follow-up study to the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial - is examining how a one-year, high versus moderate volume aerobic exercise intervention influences several biomechanisms hypothesized to influence breast cancer risk in a group of postmenopausal women. Secondary aims are to compare intervention effects on psychosocial and quality of life outcomes as well as understand exercise adherence at 12 and 24 months, and maintenance of all study outcomes at 24 months.

Methods/Design

The BETA Trial is a two-center, two-armed randomized controlled exercise intervention trial conducted in 400 previously inactive, postmenopausal women aged 50–74 years, in Alberta, Canada. Participants were randomly assigned to a one-year aerobic exercise intervention of either high volume (300 minutes/week) or moderate volume (150 minutes/week). Blood draws and accelerometry were performed at baseline, six and 12 months. Baseline and 12-month measurements were taken of adiposity (including dual energy X-ray absorptiometry and computed tomography scans), physical fitness, dietary intake, self-reported physical activity and sedentary behavior, quality of life, perceived stress, happiness, sleep, and determinants of exercise adherence. Exercise maintenance was assessed and all study measurements were repeated at 24 months. Blood will be analyzed for endogenous estrogens, insulin resistance indicators, and inflammatory markers.

Discussion

The BETA Trial will compare the impact of a high versus moderate volume of aerobic exercise on a variety of biological, physiological, and psychological outcomes of relevance to postmenopausal women. A tightly controlled exercise intervention and objective outcome measurements are methodological strengths. The BETA Trial will inform future prevention initiatives by assessing adherence to a high volume of exercise over 12 months by postmenopausal women, and the ability of these women to maintain activity over the longer-term. The ultimate objective is to inform public health guidelines for reducing breast cancer risk through physical activity.

Trial registration

Clinical Trials Registration Number: NCT01435005

Workplace Sitting Breaks Questionnaire (SITBRQ): an assessment of concurrent validity and test-retest reliability

Background

Breaks in prolonged sitting may have beneficial cardiometabolic and musculoskeletal health outcomes. Desk-based work settings are an important environment to promote and support breaks in sitting time. However, few studies have reported the psychometric properties of self-report measures to assess the frequency and duration of breaks from sitting. This study examined the concurrent validity and test-retest reliability of the Workplace Sitting Breaks Questionnaire (SITBRQ) designed to assess frequency and duration of breaks in sitting within desk-based work settings.

Methods

To assess the concurrent validity, a sample of 147 desk-based employees completed the SITBRQ and wore an Actigraph GT1M accelerometer for seven consecutive days. To establish test-retest reliability, SITBRQ was administered on two separate occasions 7–14 days apart to a separate sample of 96 desk-based employees.

Results

A low relative agreement with accelerometry (Spearman’s r = 0.24 [95% CI 0.07 - 0.40]) was determined for self-reported frequency, but not for the duration of sitting breaks (Spearman’s r = 0.05 [95% CI −0.12 - 0.22]). Adequate reliability was determined for both self-reported frequency (Spearman’s r = 0.71 [95% CI 0.59 - 0.79], Cohen’s kappa = 0.74 [95% CI 0.64 - 0.84]) and duration of sitting breaks (Spearman’s r = 0.59 [95% CI 0.45 - 0.71], Cohen’s kappa = 0.61 [95% CI 0.38 - 0.85]).

Conclusion

SITBRQ may be used for assessment of the frequency of sitting breaks within desk-based work settings with validity and reliability similar to other self-reports in the field of sedentary behaviour research. However, until adequately improved and re-evaluated, it should not be used to collect data about the duration of breaks in sitting time.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2458-14-1249) contains supplementary material, which is available to authorized users.