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Meernik C, Li Q, Drope J, Shang C, Leonard T, Fennis BM, Qadan M, Barlow CE, DeFina LF, Oetjen R, DiPietro L, Shuval K. The Association between Psychological and Behavioral Economic Factors and the Rapid Assessment Disuse Index (RADI) during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1040. [PMID: 39200650 PMCID: PMC11353841 DOI: 10.3390/ijerph21081040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 08/01/2024] [Accepted: 08/05/2024] [Indexed: 09/02/2024]
Abstract
The deleterious health effects of prolonged sitting and physical inactivity are well-established, yet these behaviors are pervasive in modern culture. To inform interventions aimed at reducing sedentary behavior and increasing lifestyle activity, this study examined psychological and behavioral economic factors that may be associated with these behaviors. This cross-sectional study was conducted among 4072 adults in Israel. Participants completed a survey pertaining to lifestyle behaviors and economic preferences using an online platform in September 2020. The psychological and behavioral economic factors of interest were patience, self-control, risk-taking, grit, and general self-efficacy. Sedentary behavior and lifestyle activity (e.g., time spent moving about) was assessed using the Rapid Assessment Disuse Index (RADI) tool (higher score indicative of more sitting and less activity). Multivariable linear and logistic regression analyses examined the association between psychological and behavioral economic factors and RADI score. Among 4072 participants, those who were impatient (vs. patient, β: -1.13; 95% CI: -1.89, -0.38) had higher grit (β: -1.25, 95% CI: -1.73, -0.77), and those who were more risk-seeking (β: -0.23; 95% CI: -0.33, -0.13) had lower RADI scores (i.e., less sedentary, more active). Significant associations for grit and risk-taking were also observed when the RADI score was dichotomized, such that individuals who had higher grit or were more risk-seeking were more likely to be non-sedentary/active. No significant associations were observed for self-control or general self-efficacy. Higher grit and more risk-seeking were associated with a decreased propensity for sedentary behaviors and inactivity; these factors may provide targets for interventions aimed at reducing sedentary behavior and increasing lifestyle activity.
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Affiliation(s)
- Clare Meernik
- Department of Research, The Cooper Institute, Dallas, TX 75230, USA
| | - Qing Li
- Department of Research, The Cooper Institute, Dallas, TX 75230, USA
| | - Jeffrey Drope
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Ce Shang
- College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Tammy Leonard
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Harold C. Simmons Comprehensive Cancer Center: University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Bob M. Fennis
- Faculty of Economics and Business, University of Groningen, 9747 Groningen, The Netherlands
| | - Mahmoud Qadan
- School of Business Administration, University of Haifa, Haifa 3103301, Israel
| | | | - Laura F. DeFina
- Department of Research, The Cooper Institute, Dallas, TX 75230, USA
| | - Reid Oetjen
- School of Global Health Management and Informatics, College of Community Innovation and Education, University of Central Florida, Orlando, FL 32816, USA
| | - Loretta DiPietro
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20037, USA
| | - Kerem Shuval
- Department of Research, The Cooper Institute, Dallas, TX 75230, USA
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Brierley ML, Chater AM, Edwardson CL, Castle EM, Hunt ER, Biddle SJ, Sisodia R, Bailey DP. The Regulate your Sitting Time (RESIT) intervention for reducing sitting time in individuals with type 2 diabetes: findings from a randomised-controlled feasibility trial. Diabetol Metab Syndr 2024; 16:87. [PMID: 38659052 PMCID: PMC11040907 DOI: 10.1186/s13098-024-01336-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Reducing and breaking up sitting is recommended for optimal management of Type 2 diabetes mellitus (T2DM). Yet, there is limited evidence of interventions targeting these outcomes in individuals with this condition. The primary aim of this study was to assess the feasibility and acceptability of delivering and evaluating a tailored online intervention to reduce and break up sitting in adults with T2DM. METHODS A mixed-methods two-arm randomised controlled feasibility trial was conducted in ambulatory adults with T2DM who were randomised 1:1 to the REgulate your SItting Time (RESIT) intervention or usual care control group. The intervention included online education, self-monitoring and prompt tools (wearable devices, smartphone apps, computer apps) and health coaching. Feasibility outcomes were recruitment, attrition, data completion rates and intervention acceptability. Measurements of device-assessed sitting (intended primary outcome for definitive trial), standing and stepping, and physical function, psychosocial health and wellbeing were taken at baseline, 3 months and 6 months. Individual semi-structured interviews were conducted at six-months (post intervention) to explore acceptability, feasibility and experiences of the trial and intervention using the Framework Method. RESULTS Seventy participants aged 55 ± 11 years were recruited. Recruitment rate (proportion of eligible participants enrolled into the study) was 67% and participant retention rate at 6 months was 93% (n = 5 withdrawals). Data completion rates for daily sitting were 100% at baseline and ranged from 83 to 91% at 3 months and 6 months. Descriptive analysis demonstrated potential for the intervention to reduce device-measured sitting, which was 30.9 ± 87.2 and 22.2 ± 82.5 min/day lower in the intervention group at 3 and 6 months, respectively, compared with baseline. In the control group, sitting was 4.4 ± 99.5 and 23.7 ± 85.2 min/day lower at 3 and 6 months, respectively. Qualitative analysis identified three themes: reasons for participating in the trial, acceptability of study procedures, and the delivery and experience of taking part in the RESIT intervention. Overall, the measurement visits and intervention were acceptable to participants. CONCLUSIONS This study demonstrated the feasibility and acceptability of the RESIT intervention and evaluation methods, supporting a future definitive trial. If RESIT is found to be clinically effective, this could lead to changes in diabetes healthcare with a focus on reducing sitting. TRIAL REGISTRATION The trial was registered with ISRCTN (number ISRCTN14832389).
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Affiliation(s)
- Marsha L Brierley
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue, MK41 9EA, Bedford, UK
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, WC1E 7HB, London, UK
| | - Charlotte L Edwardson
- Leicester Lifestyle and Health Research Group, Diabetes Research Centre, University of Leicester, Leicester General Hospital, LE5 4PW, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester General Hospital, LE5 4PW, Leicester, UK
| | - Ellen M Castle
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Physiotherapy Division, Department of Health Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 4PH, Uxbridge, UK
- Curtin School of Allied Health, School of Health Sciences, Curtin University, Western Australia, 6845, Bentley, Australia
| | - Emily R Hunt
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
| | - Stuart Jh Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, 4300, Springfield, QLD, Australia
- Faculty of Sport & Health Sciences, University of Jyväskylä, FI-40014, Jyväskylä, Finland
| | - Rupa Sisodia
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
| | - Daniel P Bailey
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK.
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK.
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Edwardson CL, Abell L, Clarke-Cornwell A, Dunstan DW, Gray LJ, Healy GN, Hadjiconstantinou M, Wilson P, Maylor B, Munir F, Biddle SJ. Implementation and engagement of the SMART Work & Life sitting reduction intervention: an exploratory analysis on intervention effectiveness. Int J Behav Nutr Phys Act 2023; 20:148. [PMID: 38115044 PMCID: PMC10729557 DOI: 10.1186/s12966-023-01548-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/09/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND To enhance the impact of interventions, it is important to understand how intervention engagement relates to study outcomes. We report on the level of implementation and engagement with the SMART Work & Life (SWAL) programme (delivered with (SWAL plus desk) and without a height-adjustable desk (SWAL)) and explore the effects of different levels of this on change in daily sitting time in comparison to the control group. METHODS The extent of intervention delivery by workplace champions and the extent of engagement by champions and participants (staff) with each intervention activity was assessed by training attendance logs, workplace champion withdrawal dates, intervention activities logs and questionnaires. These data were used to assess whether a cluster met defined criteria for low, medium, or high implementation and engagement or none of these. Mixed effects linear regression analyses tested whether change in sitting time varied by: (i) the number of intervention activities implemented and engaged with, and (ii) the percentage of implementation and engagement with all intervention strategies. RESULTS Workplace champions were recruited for all clusters, with 51/52 (98%) attending training. Overall, 12/27 (44.4%) SWAL and 9/25 (36.0%) SWAL plus desk clusters implemented all main intervention strategies. Across remaining clusters, the level of intervention implementation varied. Those in the SWAL (n = 8 (29.6%) clusters, 80 (32.1%) participants) and SWAL plus desk (n = 5 (20.0%) clusters, 41 (17.1%) participants) intervention groups who implemented and engaged with the most intervention strategies and had the highest percentage of cluster implementation and engagement with all intervention strategies sat for 30.9 (95% CI -53.9 to -7.9, p = 0.01) and 75.6 (95% CI -103.6 to -47.7, p < 0.001) fewer minutes/day respectively compared to the control group at 12 month follow up. These differences were larger than the complete case analysis. The differences in sitting time observed for the medium and low levels were similar to the complete case analysis. CONCLUSIONS Most intervention strategies were delivered to some extent across the clusters although there was large variation. Superior effects for sitting reduction were seen for those intervention groups who implemented and engaged with the most intervention components and had the highest level of cluster implementation and engagement. TRIAL REGISTRATION ISRCTN11618007. Registered on 24 January 2018. https://www.isrctn.com/ISRCTNISRCTN11618007 .
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Affiliation(s)
- Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK.
- NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK.
| | - Lucy Abell
- Department of Population Health Sciences, University of Leicester, Leicester, LE1 7RH, UK
| | - Alex Clarke-Cornwell
- School of Health & Society, University of Salford, Salford, Greater Manchester, M6 6PU, UK
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, 3125, Australia
| | - Laura J Gray
- NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK
- Department of Population Health Sciences, University of Leicester, Leicester, LE1 7RH, UK
| | - Genevieve N Healy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | | | - Panna Wilson
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, LE5 4PW, UK
| | - Benjamin Maylor
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Stuart Jh Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, QLD, 4300, Australia
- Faculty of Sport & Health Sciences, University of Jyväskylä, Jyväskylä, FI-40014, Finland
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