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Smith L, López Sánchez GF, Soysal P, Veronese N, Rahmati M, Tully MA, Yon DK, Alghamdi BS, Butler L, Ahluwalia S, Ball G, Shin JI, Koyanagi A. Association between sedentary behavior and wish to die among adults aged ≥50 years: Findings from the Irish Longitudinal Study on Ageing. J Psychiatr Res 2024; 178:173-179. [PMID: 39141997 DOI: 10.1016/j.jpsychires.2024.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/22/2024] [Accepted: 07/31/2024] [Indexed: 08/16/2024]
Abstract
We investigated the association between sedentary behavior (SB) and wish to die (WTD; i.e., feeling that one would be better off dead or wishing for one's own death), and the extent to which this can be explained by sleep problems, depression, anxiety, loneliness, perceived stress, and social network in a nationally representative sample of adults aged ≥50 years from Ireland. Cross-sectional data from Wave 1 of the Irish Longitudinal Study on Ageing 2009-2011 were analyzed. WTD was defined as answering affirmatively to the question "In the last month, have you felt that you would rather be dead?" SB was used as a continuous variable (hours/day), and also as a categorical (< or ≥8 h/day) variable. Multivariable logistic regression and mediation analyses were conducted. Data on 8163 adults aged ≥50 years were analyzed [mean (SD) age 63.6 (9.1) years; 48.0% males]. Overall, ≥8 (vs. <8) hours/day of SB was associated with a significant 2.04 (95%CI = 1.50-2.76) times higher odds for WTD, while a 1-h increase in SB per day was associated with 1.11 (95%CI = 1.06-1.16) times higher odds for WTD. Mediation analysis showed that sleep problems, depression, loneliness, perceived stress, and social network explained a modest proportion of the association between SB and WTD (mediated percentage 9.3%-14.8%). The present cross-sectional study found that increasing or higher levels of SB is positively associated with WTD. Addressing the identified potential mediators may reduce WTD among people who are sedentary. However, future longitudinal and intervention studies are needed to make concrete recommendations.
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Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireland, UK
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea; Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Badrah S Alghamdi
- Department of Physiology, Neuroscience Unit, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; King Fahd Medical Research Center, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Sanjiv Ahluwalia
- School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK
| | - Graham Ball
- Medical Technology Research Centre, Anglia Ruskin University, Chelmsford, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea; Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, South Korea.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
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Fernández-Sánchez MC, Ruiz-López FJ, Ros-Lucas JA, Andújar-Espinosa R, Del Coso J, García-Pastor T. Persons With Chronic Obstructive Pulmonary Disease and High Levels of Activation Improved Their Physical Activity Skills After an Educational Session. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2024; 11:270-281. [PMID: 38527191 PMCID: PMC11216225 DOI: 10.15326/jcopdf.2023.0456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 03/27/2024]
Abstract
Background Daily physical activity is part of the self-management of patients with chronic obstructive pulmonary disease (COPD), and didactic information sessions may be insufficient for the provision of these skills. Prior activation can determine sensitivity to these sessions. We evaluated whether the activation in patients with COPD, as measured by the Patient Activation Measure (PAM)-13 questionnaire, determined their responses to an educational group session on physical activity (PA), which were measured with actigraphy by the number of steps/day. Methods We conducted an uncontrolled clinical trial in an outpatient clinic with 75 patients with nonexacerbating COPD (forced expiratory volume in 1 second 30%-80%) who were selected consecutively. Patients were provided with an actigraph that they used for 15 days and completed the PAM-13 questionnaire. On the eighth day, they attended a group educational session where they were given PA information. We compared the changes in activity after the session by pooled PAM levels and the correlation between the change in the number of steps/day and the PAM-13 questionnaire. Results A total of 26 patients had activation levels of 1-2, while 49 patients had levels of 3-4. After the session, patients in Levels 1-2 decreased their number of steps (-596±42), while those in Levels 3-4 increased them (680±253, p<0.01). The level of activation was positively correlated with change in the number of steps/day (p<0.05). Conclusion COPD patients with greater activation showed greater improvements in daily PA after a group educational session.
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Affiliation(s)
| | | | - José A Ros-Lucas
- Pneumonology Service, Arrixaca University Hospital, Murcia, Spain
| | | | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain
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Smith L, López Sánchez GF, Rahmati M, Tully MA, Pizzol D, Veronese N, Soysal P, Kostev K, Yon DK, Butler L, Shin JI, Koyanagi A. Association between sedentary behavior and dynapenic abdominal obesity among older adults from low- and middle-income countries. Aging Clin Exp Res 2024; 36:109. [PMID: 38730062 PMCID: PMC11087302 DOI: 10.1007/s40520-024-02763-1] [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: 12/08/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Sedentary behavior, or time spent sitting, may increase risk for dynapenic abdominal obesity (DAO), but there are currently no studies on this topic. AIMS Therefore, we investigated the association between sedentary behaviour and DAO in a nationally representative sample of older adults from six low- and middle-income countries. METHODS Cross-sectional data from the Study on Global AGEing and Adult Health were analysed. Dynapenia was defined as handgrip strength < 26 kg for men and < 16 kg for women. Abdominal obesity was defined as waist circumference of > 88 cm (> 80 cm for Asian countries) for women and > 102 cm (> 90 cm) for men. DAO was defined as having both dynapenia and abdominal obesity. Self-reported sedentary behavior was categorized as ≥ 8 h/day (high sedentary behaviour) or < 8 h/day. Multivariable multinomial logistic regression was conducted. RESULTS Data on 20,198 adults aged ≥ 60 years were analyzed [mean (SD) age 69.3 (13.1) years; 54.1% females]. In the overall sample, ≥ 8 h of sedentary behavior per day (vs. <8 h) was significantly associated with 1.52 (95%CI = 1.11-2.07) times higher odds for DAO (vs. no dynapenia and no abdominal obesity), and this was particularly pronounced among males (OR = 2.27; 95%CI = 1.42-3.62). Highly sedentary behavior was not significantly associated with dynapenia alone or abdominal obesity alone. DISCUSSION High sedentary behaviour may increase risk for DAO among older adults. CONCLUSIONS Interventions to reduce sedentary behaviour may also lead to reduction of DAO and its adverse health outcomes, especially among males, pending future longitudinal research.
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Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Masoud Rahmati
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireland, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
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Huang A, Wang E, Sanger S, Papaioannou A, Rodrigues IB. Comparison of national and international sedentary behaviour and physical activity guidelines for older adults: A systematic review and quality appraisal with AGREE II. PLoS One 2023; 18:e0294784. [PMID: 38011139 PMCID: PMC10681178 DOI: 10.1371/journal.pone.0294784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
Most older adults 65 years and older accumulate over 8.5 hours/day of sedentary time, which is associated with increased risk of metabolic syndromes and falls. The impact of increased sedentary time in older adults has prompted development of sedentary behaviour guidelines. The purpose of our review was to compare national and international sedentary behaviour and physical activity guidelines for older adults and appraise the quality of guidelines using AGREE II. We conducted our search in Medline, Embase, Global Health, Web of Science, CINAHL, and relevant grey literature. We included the most recent guidelines for older adults written in English. We identified 18 national and international guidelines; ten of the 18 guidelines included sedentary behaviour recommendations while all 18 included physical activity recommendations for older adults. The ten sedentary behaviour guidelines were developed using cohort studies, knowledge users' opinions, systematic reviews, or other guidelines while the physical activity guidelines were developed using randomized controlled trials, systematic reviews, meta-analysis, and overview of reviews. The definition of sedentary behaviour and the recommendations were inconsistent between the guidelines and were based on very low to low quality and certainty of evidence. All guidelines provided consistent recommendations for aerobic and resistance training; the recommendations were developed using moderate to high quality and certainty of evidence. Only eight physical activity guidelines provided recommendations for balance training and six on flexibility training; the balance training recommendations were consistent between guidelines and based on moderate quality evidence. Further work is needed to develop evidenced-based sedentary behaviour recommendations and flexibility training recommendations for older adults.
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Affiliation(s)
- Amy Huang
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Ellen Wang
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Vancouver, BC, Canada
| | - Stephanie Sanger
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Alexandra Papaioannou
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Health Sciences Library, McMaster University, Hamilton, ON, Canada
| | - Isabel B. Rodrigues
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Knowledge Translation Program, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
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Ma H, Wang A, Pei R, Piao M. Effects of habit formation interventions on physical activity habit strength: meta-analysis and meta-regression. Int J Behav Nutr Phys Act 2023; 20:109. [PMID: 37700303 PMCID: PMC10498635 DOI: 10.1186/s12966-023-01493-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/23/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Interventions aimed at promoting physical activity (PA) behavior through habit formation pathways are gaining popularity, as they differ from conventional interventions that rely on intention pathways. Past research has established a positive correlation between PA habits and behavior. However, the efficacy of current interventions designed to form PA habits and improve PA automaticity is not yet fully ascertained. Additionally, the intervention components that significantly impact the effectiveness of these interventions are yet to be determined. METHODS This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted a search of three databases (PubMed, Embase, and Cochrane Library) from January 2000 to December 2022, with a focus on interventions for developing PA habits. Two independent authors conducted paper selection, quality assessment, data extraction, and coding of behavior change techniques (BCTs). The effect size of interventions was calculated using standardized mean difference. Subgroup analyses were carried out based on follow-up duration, delivery method, sample characteristics, and theory. Furthermore, we employed meta-regression to investigate the association between BCTs and PA habits. RESULTS Ten eligible studies with relatively high quality were included in the final data set. Characteristics of studies varied in intervention sample and delivery way. The habit formation interventions significantly increased PA habit (SMD = 0.31, 95% CI 0.14-0.48, P < .001) compared to the control groups. Subgroup analysis demonstrated that the duration of follow-up ≤ 12 weeks have a higher effect size on PA habit than the duration > 12 weeks. Meta-regression revealed that problem solving has a significant positive association with effectiveness improvement (β = 0.36, 95% CI 0.17-0.55), while social reward is linked with a reduction in effectiveness (β = -0.40, 95% CI -0.74-0.06). CONCLUSIONS Our findings reveal that habit formation interventions are effective in fostering PA habit. Future studies could leverage the insights form this study to optimize the intervention design and achieve better effectiveness.
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Affiliation(s)
- Haoming Ma
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No 33 Ba Da Chu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Aoqi Wang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No 33 Ba Da Chu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Runyuan Pei
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No 33 Ba Da Chu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Meihua Piao
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No 33 Ba Da Chu Road, Shijingshan District, Beijing, 100144, People's Republic of China.
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6
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Alessy SA, Malkin JD, Finkelstein EA, AlAhmed R, Baattaiah BA, Evenson KR, Rakic S, Cetinkaya V, Herbst CH, Al-Hazzaa HM, Alqahtani SA. Effectiveness of Interventions Promoting Physical Activity and Reducing Sedentary Behavior in Community-Dwelling Older Adults: An Umbrella Review With Application to Saudi Arabia. J Epidemiol Glob Health 2023; 13:361-373. [PMID: 37199911 PMCID: PMC10193325 DOI: 10.1007/s44197-023-00111-6] [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: 12/14/2022] [Accepted: 04/28/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND As Saudi Arabia is expected to face population aging in the future, the burden of diseases arising from inadequate physical activity (PA) and excess sedentary behavior (SB) may subsequently increase without successful interventions. The present study critically reviews the global literature on the effectiveness of PA interventions targeting community-dwelling older adults to draw on lessons and applications for future interventions in Saudi Arabia. METHODS This umbrella review of systematic reviews included interventions designed to increase PA and/or reduce SB in community-dwelling older adults. We conducted searches in July 2022 in two electronic databases-PubMed and Embase-and identified relevant peer-reviewed systematic reviews in English. RESULTS Fifteen systematic reviews focusing on community-dwelling older adults were included. Several reviews reported that PA- or SB-based interventions, including eHealth interventions (such as automated advice, tele-counseling, digital PA coaching, automated PA tracking and feedback, online resources, online social support, and video demonstrations), mHealth interventions, and non-eHealth interventions (such as goal setting, individualized feedback, motivational sessions, phone calls, face-to-face education, counseling, supervised exercise sessions, sending educational materials to participants' homes, music, and social marketing programs), were effective in the short term (e.g., ≤ 3 months) but with wide heterogeneity in findings and methodologies. There were limited studies on PA- and SB-based interventions that could be effective for one year or more after the intervention. Most reviews were heavily skewed toward studies carried out in Western communities, limiting their generalizability to Saudi Arabia and other parts of the world. CONCLUSION There is evidence that some PA and SB interventions may be effective in the short term, but high-quality evidence regarding long-term effects is lacking. The cultural, climate, and environmental barriers related to PA and SB in Saudi Arabia require an innovative approach and research to evaluate such interventions in older individuals in the long term.
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Affiliation(s)
- Saleh A. Alessy
- Public Health Department, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
- Centre for Cancer, Society and Public Health, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | | | - Eric A. Finkelstein
- Duke-NUS Medical School, Health Services and System Research Program, Singapore, Singapore
| | - Reem AlAhmed
- King Faisal Specialist Hospital & Research Center, Liver Transplant Center, Riyadh, Saudi Arabia
| | - Baian A. Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina USA
| | | | | | | | - Hazzaa M. Al-Hazzaa
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Saleh A. Alqahtani
- King Faisal Specialist Hospital & Research Center, Liver Transplant Center, Riyadh, Saudi Arabia
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD USA
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Gardner B, Arden MA, Brown D, Eves FF, Green J, Hamilton K, Hankonen N, Inauen J, Keller J, Kwasnicka D, Labudek S, Marien H, Masaryk R, McCleary N, Mullan BA, Neter E, Orbell S, Potthoff S, Lally P. Developing habit-based health behaviour change interventions: twenty-one questions to guide future research. Psychol Health 2023; 38:518-540. [PMID: 34779335 DOI: 10.1080/08870446.2021.2003362] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Habitual behaviours are triggered automatically, with little conscious forethought. Theory suggests that making healthy behaviours habitual, and breaking the habits that underpin many ingrained unhealthy behaviours, promotes long-term behaviour change. This has prompted interest in incorporating habit formation and disruption strategies into behaviour change interventions. Yet, notable research gaps limit understanding of how to harness habit to change real-world behaviours. METHODS Discussions among health psychology researchers and practitioners, at the 2019 European Health Psychology Society 'Synergy Expert Meeting', generated pertinent questions to guide further research into habit and health behaviour. RESULTS In line with the four topics discussed at the meeting, 21 questions were identified, concerning: how habit manifests in health behaviour (3 questions); how to form healthy habits (5 questions); how to break unhealthy habits (4 questions); and how to develop and evaluate habit-based behaviour change interventions (9 questions). CONCLUSIONS While our questions transcend research contexts, accumulating knowledge across studies of specific health behaviours, settings, and populations will build a broader understanding of habit change principles and how they may be embedded into interventions. We encourage researchers and practitioners to prioritise these questions, to further theory and evidence around how to create long-lasting health behaviour change.
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Affiliation(s)
- Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Madelynne A Arden
- Centre for Behavioural Science and Applied Psychology, Department of Psychology, Sociology & Politics, Sheffield Hallam University, Sheffield, UK
| | - Daniel Brown
- Department of Applied Psychology, Griffith University, Brisbane, Australia
| | - Frank F Eves
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - James Green
- School of Allied Health and Physical Activity for Health Research Cluster (Health Research Institute), University of Limerick, Limerick, Ireland
| | - Kyra Hamilton
- Griffith University and Menzies Health Institute Queensland, Mt Gravatt, Qld, Australia
| | - Nelli Hankonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Jennifer Inauen
- Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Jan Keller
- Division Health Psychology, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Dominika Kwasnicka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wrocław, Poland.,NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Sarah Labudek
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Hans Marien
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Radomír Masaryk
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University Bratislava, Bratislava, Slovakia
| | - Nicola McCleary
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Barbara A Mullan
- Behavioural Science and Health Research Group, Curtin University, Perth, Australia
| | - Efrat Neter
- Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer, Israel
| | - Sheina Orbell
- Department of Psychology, University of Essex, Essex, UK
| | - Sebastian Potthoff
- Department of Social Work, Education, and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Phillippa Lally
- Research Department of Behavioural Science and Health, University College London, London, UK
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Stone JY, Mayberry LS, Clouse K, Mulvaney S. The Role of Habit Formation and Automaticity in Diabetes Self-Management: Current Evidence and Future Applications. Curr Diab Rep 2023; 23:43-58. [PMID: 36749452 DOI: 10.1007/s11892-023-01499-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Diabetes is a chronic condition that requires consistent self-management for optimal health outcomes. People with diabetes are prone to burnout, cognitive burden, and sub-optimal performance of self-management tasks. Interventions that focus on habit formation have the potential to increase engagement by facilitating automaticity of self-management task performance. The purpose of this review is to (1) clarify the conceptualizations of habit formation and behavioral automaticity in the context of health behavior interventions, (2) review the evidence of habit in relation to behaviors relevant to diabetes self-management, and (3) discuss opportunities for incorporating habit formation and automaticity into diabetes self-management interventions. RECENT FINDINGS Modern habit research describes a habit as a behavior that results over time from an automatic mental process. Automatic behaviors are experienced as cue-dependent, goal-independent, unconscious, and efficient. Habit formation requires context-dependent repetition to form cue-behavior associations. Results of diabetes habit studies are mixed. Observational studies have shown positive associations between habit strength and target self-management behaviors such as taking medication and monitoring blood glucose, as well as glycemic outcomes such as HbA1c. However, intervention studies conducted in similar populations have not demonstrated a significant benefit of habit-forming interventions compared to controls, possibly due to varying techniques used to promote habit formation. Automaticity of self-management behaviors has the potential to minimize the burden associated with performance of self-management tasks and ultimately improve outcomes for people with diabetes. Future studies should focus on refining interventions focused on context-dependent repetition to promote habit formation and better measurement of habit automaticity in diabetes self-management.
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Affiliation(s)
- Jenine Y Stone
- Vanderbilt University, 461 21st Avenue South, Nashville, TN, 37240, USA.
- AMCR Institute, Escondido, CA, USA.
| | | | - Kate Clouse
- Vanderbilt University, 461 21st Avenue South, Nashville, TN, 37240, USA
| | - Shelagh Mulvaney
- Vanderbilt University, 461 21st Avenue South, Nashville, TN, 37240, USA
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9
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Ashizawa R, Honda H, Take K, Yoshizawa K, Kameyama Y, Yoshimoto Y. Effects on sedentary behaviour of an approach to reduce sedentary behaviour in patients with minor ischaemic stroke: A randomised controlled trial. Clin Rehabil 2023; 37:545-556. [PMID: 36357967 DOI: 10.1177/02692155221135412] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To determine the effects on sedentary behaviour of an approach that promotes reduction in sedentary behaviour in patients with minor ischaemic stroke after intervention and at follow-up. DESIGN A randomised controlled trial. SETTING During hospitalisation and after hospital discharge. SUBJECTS In total, 86 patients with minor ischaemic stroke admitted to an acute care hospital were assigned to the intervention (n = 43) and control (n = 43) groups. INTERVENTION An intervention group that received an approach to reduce sedentary behaviour upon hospital admission until 3 months after discharge (education, self-monitoring, phone calls, etc.) and a control group that received the usual care during hospitalisation. From 3 to 6 months after discharge, no group received any intervention. MAIN OUTCOME The primary outcome was the change (%) in sedentary behaviour from baseline to post-intervention (3 months after discharge) and follow-up (6 months after discharge). Sedentary behaviour was measured at baseline (upon hospital admission), post-intervention, and at follow-up using accelerometers. RESULTS At the post-intervention stage, the intervention group showed a significantly greater change in sedentary behaviour from baseline than that shown by the control group (sedentary behaviour: intervention group, -22.7%; control group, -14.9%; P = 0.013; effect size = 0.58). At follow-up too, the intervention group showed a significantly greater change in sedentary behaviour from baseline than that shown by the control group (sedentary behaviour: intervention group, -20.4%; control group, -13.6%; P = 0.025; effect size = 0.54). CONCLUSIONS An approach to reduce sedentary behaviour in patients with minor ischaemic stroke effectively reduces sedentary behaviour, which is sustained up to follow-up. TRIAL REGISTRATION This study is registered at www.umin.ac.jp/ctr/index/htm UMIN000038616.
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Affiliation(s)
- Ryota Ashizawa
- Department of Rehabilitation, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Hiroya Honda
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu, Japan.,Department of Rehabilitation, Hanadaira Care Center, Hamamatsu, Japan
| | - Koki Take
- Visiting Nurse Station Sumiyoshi-daini, Seirei Care Center Sumiyoshi-daini, Hamamatsu, Japan
| | - Kohei Yoshizawa
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu, Japan.,Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Yuto Kameyama
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu, Japan.,Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Yoshinobu Yoshimoto
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu, Japan
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Vogelsang A, Hinrichs C, Fleig L, Pfeffer I. Study protocol for the description and evaluation of the "Habit Coach" - a longitudinal multicenter mHealth intervention for healthy habit formation in health care professionals. BMC Public Health 2022; 22:1672. [PMID: 36058904 PMCID: PMC9440859 DOI: 10.1186/s12889-022-13986-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The adoption of a healthy lifestyle plays a crucial role for the health and well-being of health care professionals. Previous e- and mHealth interventions relied on deliberative psychological processes (e.g., intention, planning) to target lifestyle changes, while revealing mixed efficacy. The additional potential of non-deliberative, automatic processes (i.e., habits) for behavior change has been understudied in interventions so far. The Habit Coach mHealth intervention combines deliberative and non-deliberative processes to support health care professionals in forming healthy physical activity, nutrition and mindfulness habits in daily life. The aim of this paper is to outline the study protocol including a detailed description of the mHealth intervention, evaluation plan, and study design. The purpose of this trial is to understand healthy habit formation in health care professionals over time. METHODS A one-arm, multicenter mHealth intervention study will be conducted. Behavioral and psychosocial predictors will be collected via within-app questionnaires across a 100-day period at baseline, post, as well as at weekly assessments. To understand habit formation across time, linear mixed models will be used. DISCUSSION This trial aims to unravel the role of motivational and volitional determinants for healthy habit formation across multiple health behaviors in health care professionals embedded in a mHealth intervention. TRIAL REGISTRATION This trial is registered in the German Clinical Trials Register, DRKS-ID DRKS00027156. Date of registration 17 November 2021.
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Affiliation(s)
- Anna Vogelsang
- Faculty of Humanities, MSH Medical School Hamburg - University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany. .,Faculty of Sport Science - Department of eHealth and Sports Analytics, Ruhr-University Bochum, Gesundheitscampus - Nord 10, 44801, Bochum, Germany.
| | - Clara Hinrichs
- Faculty of Humanities, MSH Medical School Hamburg - University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Lena Fleig
- Faculty of Natural Sciences- Department of Psychology, Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
| | - Ines Pfeffer
- Faculty of Humanities, MSH Medical School Hamburg - University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany
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11
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Gardner B, Rebar AL, Lally P. How does habit form? Guidelines for tracking real-world habit formation. COGENT PSYCHOLOGY 2022. [DOI: 10.1080/23311908.2022.2041277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Amanda L. Rebar
- Physical Activity Research Group, Appleton Institute, School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Phillippa Lally
- Research Department of Behavioural Science and Health, University College London, London, UK
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12
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Chastin S, Gardiner PA, Harvey JA, Leask CF, Jerez-Roig J, Rosenberg D, Ashe MC, Helbostad JL, Skelton DA. Interventions for reducing sedentary behaviour in community-dwelling older adults. Cochrane Database Syst Rev 2021; 6:CD012784. [PMID: 34169503 PMCID: PMC8225503 DOI: 10.1002/14651858.cd012784.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Older adults are the most sedentary segment of society, often spending in excess of 8.5 hours a day sitting. Large amounts of time spent sedentary, defined as time spend sitting or in a reclining posture without spending energy, has been linked to an increased risk of chronic diseases, frailty, loss of function, disablement, social isolation, and premature death. OBJECTIVES To evaluate the effectiveness of interventions aimed at reducing sedentary behaviour amongst older adults living independently in the community compared to control conditions involving either no intervention or interventions that do not target sedentary behaviour. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, EPPI-Centre databases (Trials Register of Promoting Health Interventions (TRoPHI) and the Obesity and Sedentary behaviour Database), WHO ICTRP, and ClinicalTrials.gov up to 18 January 2021. We also screened the reference lists of included articles and contacted authors to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs. We included interventions purposefully designed to reduce sedentary time in older adults (aged 60 or over) living independently in the community. We included studies if some of the participants had multiple comorbidities, but excluded interventions that recruited clinical populations specifically (e.g. stroke survivors). DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts and full-text articles to determine study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. Any disagreements in study screening or data extraction were settled by a third review author. MAIN RESULTS We included seven studies in the review, six RCTs and one cluster-RCT, with a total of 397 participants. The majority of participants were female (n = 284), white, and highly educated. All trials were conducted in high-income countries. All studies evaluated individually based behaviour change interventions using a combination of behaviour change techniques such as goal setting, education, and behaviour monitoring or feedback. Four of the seven studies also measured secondary outcomes. The main sources of bias were related to selection bias (N = 2), performance bias (N = 6), blinding of outcome assessment (N = 2), and incomplete outcome data (N = 2) and selective reporting (N=1). The overall risk of bias was judged as unclear. Primary outcomes The evidence suggests that interventions to change sedentary behaviour in community-dwelling older adults may reduce sedentary time (mean difference (MD) -44.91 min/day, 95% confidence interval (CI) -93.13 to 3.32; 397 participants; 7 studies; I2 = 73%; low-certainty evidence). We could not pool evidence on the effect of interventions on breaks in sedentary behaviour or time spent in specific domains such as TV time, as data from only one study were available for these outcomes. Secondary outcomes We are uncertain whether interventions to reduce sedentary behaviour have any impact on the physical or mental health outcomes of community-dwelling older adults. We were able to pool change data for the following outcomes. • Physical function (MD 0.14 Short Physical Performance Battery (SPPB) score, 95% CI -0.38 to 0.66; higher score is favourable; 98 participants; 2 studies; I2 = 26%; low-certainty evidence). • Waist circumference (MD 1.14 cm, 95% CI -1.64 to 3.93; 100 participants; 2 studies; I2 = 0%; low-certainty evidence). • Fitness (MD -5.16 m in the 6-minute walk test, 95% CI -36.49 to 26.17; higher score is favourable; 80 participants; 2 studies; I2 = 29%; low-certainty evidence). • Blood pressure: systolic (MD -3.91 mmHg, 95% CI -10.95 to 3.13; 138 participants; 3 studies; I2 = 73%; very low-certainty evidence) and diastolic (MD -0.06 mmHg, 95% CI -5.72 to 5.60; 138 participants; 3 studies; I2 = 97%; very low-certainty evidence). • Glucose blood levels (MD 2.20 mg/dL, 95% CI -6.46 to 10.86; 100 participants; 2 studies; I2 = 0%; low-certainty evidence). No data were available on cognitive function, cost-effectiveness or adverse effects. AUTHORS' CONCLUSIONS It is not clear whether interventions to reduce sedentary behaviour are effective at reducing sedentary time in community-dwelling older adults. We are uncertain if these interventions have any impact on the physical or mental health of community-dwelling older adults. There were few studies, and the certainty of the evidence is very low to low, mainly due to inconsistency in findings and imprecision. Future studies should consider interventions aimed at modifying the environment, policy, and social and cultural norms. Future studies should also use device-based measures of sedentary time, recruit larger samples, and gather information about quality of life, cost-effectiveness, and adverse event data.
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Affiliation(s)
- Sebastien Chastin
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
| | - Paul A Gardiner
- School of Health & Wellbeing, University of Southern Queensland, Ipswich, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Juliet A Harvey
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Calum F Leask
- Aberdeen City Health & Social Care Partnership, Aberdeen, UK
| | - Javier Jerez-Roig
- Department of Social Sciences and Community Health, Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia, Vic, Spain
| | - Dori Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Maureen C Ashe
- Centre for Hip Health and Mobility, Department of Family Practice, The University of British Columbia, Vancouver, Canada
| | - Jorunn L Helbostad
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dawn A Skelton
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
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13
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Feil K, Allion S, Weyland S, Jekauc D. A Systematic Review Examining the Relationship Between Habit and Physical Activity Behavior in Longitudinal Studies. Front Psychol 2021; 12:626750. [PMID: 33746848 PMCID: PMC7969808 DOI: 10.3389/fpsyg.2021.626750] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: To explain physical activity behavior, social-cognitive theories were most commonly used in the past. Besides conscious processes, the approach of dual processes additionally incorporates non-conscious regulatory processes into physical activity behavior theories. Habits are one of various non-conscious variables that can influence behavior and thus play an important role in terms of behavior change. The aim of this review was to examine the relationship between habit strength and physical activity behavior in longitudinal studies. Methods: According to the PRISMA guidelines, a systematic search was conducted in three databases. Only peer-reviewed articles using a longitudinal study design were included. Both, habit and physical activity were measured at least once, and habit was related to physical activity behavior. Study quality was evaluated by assessment tools of the NHLBI. Results: Of 3.382 identified publications between 2016 and 2019, fifteen studies with different study designs were included. Most studies supported that positive correlations between habit and physical activity exist. Some positive direct and indirect effects of habit on physical activity were detected and only a minority of studies showed the influence of physical activity on habit strength. Studies differentiating between instigation and execution habit found positive correlations and revealed instigation habit as a stronger predictor of physical activity. The quality of studies was rated as reasonable using assessment tools of the NHLBI. Conclusion: This review revealed a bidirectional relationship between habit and physical activity. Whether habit predicts physical activity or vice versa is still unclear. The observation of habit influencing physical activity may be most appropriate in studies fostering physical activity maintenance while the influence of physical activity on habit may be reasonable in experimental studies with physical activity as intervention content to form a habit. Future investigations should differentiate between habit formation and physical activity maintenance studies depending on the research objective. Long-term study designs addressing the complexity of habitual behavior would be beneficial for establishing cue-behavior associations for the formation of habits. Furthermore, studies should differentiate between instigation and execution habit in order to investigate the influence of both variables on physical activity behavior independently.
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Affiliation(s)
- Katharina Feil
- Department of Health Education and Sport Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Sarah Allion
- Department of Health Education and Sport Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Susanne Weyland
- Department of Health Education and Sport Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Darko Jekauc
- Department of Health Education and Sport Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Aunger JA, Greaves CJ, Davis ET, Asamane EA, Whittaker AC, Greig CA. A novel behavioural INTErvention to REduce Sitting Time in older adults undergoing orthopaedic surgery (INTEREST): results of a randomised-controlled feasibility study. Aging Clin Exp Res 2020; 32:2565-2585. [PMID: 31975288 PMCID: PMC7680324 DOI: 10.1007/s40520-020-01475-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 01/08/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Osteoarthritis is a prevalent condition in older adults that causes many patients to require a hip or knee replacement. Reducing patients' sedentariness prior to surgery may improve physical function and post-operative outcomes. METHODS We conducted a pragmatic randomised-controlled feasibility study with 2:1 allocation into intervention or usual care groups. The intervention, based on Self-Determination Theory, involved techniques to reduce sedentary behaviour, including motivational interviewing, setting of behavioural goals, and more. The primary outcome was feasibility, assessed using mixed methods. We included exploratory measures to inform a future definitive trial, such as ActivPal3 accelerometry to measure movement, the Short Physical Performance Battery (SPPB), Basic Psychological Needs, and cardiometabolic biomarkers. Assessments were at baseline, 1-week pre-surgery, and 6-week post-surgery. RESULTS We recruited 35 participants aged ≥ 60 years approximately 8 weeks before hip or knee arthroplasty. Participant uptake rate was 14.2%, and retention rate 85.7%. Participants were very satisfied with the study which was found to be feasible with some modifications. Exploratory within-group comparisons found that the intervention has potential to improve SPPB by 0.71 points from baseline to pre-surgery, a clinically significant increase, and reduce sedentary time by up to 66 min d-1. CONCLUSION In this older surgical population, it is feasible to use behavioural techniques to displace sedentary time to activity and to conduct a trial spanning the period of surgical intervention. This may improve physical function and surgical outcomes. The INTEREST intervention is now ready for evaluation in a full-scale randomised-controlled trial. REGISTRATION This trial was registered on Clinicaltrials.gov on 13/11/2018. ID: NCT03740412.
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Affiliation(s)
- Justin Avery Aunger
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT, UK.
- Health Services Management Centre, University of Birmingham, Edgbaston, B15 2TT, UK.
| | - Colin J Greaves
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT, UK
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Edward T Davis
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT, UK
- The Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Northfield, Birmingham, B31 2AP, UK
| | - Evans Atiah Asamane
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT, UK
- School of Primary, Community, and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - Anna C Whittaker
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT, UK
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | - Carolyn Anne Greig
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT, UK
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, B15 2TT, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2GW, UK
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15
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Weyland S, Finne E, Krell-Roesch J, Jekauc D. (How) Does Affect Influence the Formation of Habits in Exercise? Front Psychol 2020; 11:578108. [PMID: 33192892 PMCID: PMC7645026 DOI: 10.3389/fpsyg.2020.578108] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/30/2020] [Indexed: 12/20/2022] Open
Abstract
Objectives: Habitually instigated exercise is thought to increase health behavior maintenance. Previous research has explored several aspects of habit formation. However, there is a lack of longitudinal research investigating affective determinants, especially post-exercise affective states. Therefore, the present study aimed to investigate (a) if behavior frequency will enhance automaticity, (b) if positive affect will enhance automaticity, and (c) if positive affect will moderate the relationship between behavior frequency and automaticity. Methods: 226 participants (64% females, mean age 24 years) who attended weekly sports and gym classes at two universities were followed for 13 weeks. Class attendance was documented on a weekly basis (behavior frequency) during the semester. Before, during and immediately after each class, participants filled in the Feeling Scale (affective valence). Furthermore, at the beginning of each class, they answered a question about their automaticity in arriving at the decision to attend the class (instigation habit). We used a two-level modeling approach to predict subsequent automaticity by the different constructs at the previous attendance. Results: The cumulative frequency of prior class attendance did not significantly enhance the automaticity of the decision to re-attend the class. There were significant effects of valence on automaticity on the between-subject level, i.e., a one-point higher mean valence score was associated with a 0.62 point increase in automaticity (p = 0.001). No moderation effects of affect on the association between behavior frequency and automaticity were observed. Conclusion: Behavior repetition, albeit not significant, and positive affective states at the end of an exercise class may be beneficial in building exercise instigation habits. Practitioners and researchers alike may thus want to emphasize the importance of behavior repetition and affective response for health behavior maintenance.
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Affiliation(s)
- Susanne Weyland
- Department of Health Education and Sport Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Emily Finne
- Department Prevention and Health Promotion, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Janina Krell-Roesch
- Department of Health Education and Sport Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Darko Jekauc
- Department of Health Education and Sport Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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16
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Chase JAD, Otmanowski J, Rowland S, Cooper PS. A systematic review and meta-analysis of interventions to reduce sedentary behavior among older adults. Transl Behav Med 2020; 10:1078-1085. [DOI: 10.1093/tbm/ibz189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Abstract
Sedentary behavior (SB) is associated with numerous negative health outcomes, independent of physical activity behavior. Older adults are the most sedentary population in the United States. Understanding the effects and characteristics of existing interventions to reduce SB can inform practice, future research, and public health initiatives to improve older adults’ health. We conducted a systematic review and meta-analysis to examine existing SB intervention research among older adults and quantitatively synthesize intervention effects. Comprehensive searches were conducted to identify studies testing interventions to reduce SB time among adults at least 60 years old. Data on study design, intervention content and delivery, and participant characteristics were extracted from eligible studies. Standardized mean difference effect sizes (Cohen’s d) were synthesized using a random-effects model for two-group pretest–posttest design studies. Twenty-two reports describing 17 distinct studies were included in the narrative synthesis, with eight studies included in the meta-analysis (k = 8; n = 1,024). Most interventions were theory-driven and employed multiple strategies, including education, self-monitoring, and goal setting. Although SB interventions significantly reduced total sedentary time, the overall effect was small (d = −0.25, 95% confidence interval [−0.50, 0.00], p = .05). Studies were significantly heterogeneous (Q = 22.34, p < .01); however, the small number of comparisons prevented moderator analyses. Practitioners should employ diverse SB-specific strategies to encourage older adults to reduce time spent sedentary. To develop public health programs targeting SB in older adults, future research should include measures of time spent in specific SB and duration/number of breaks in sedentary time and investigate SB intervention effects on health outcomes.
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Affiliation(s)
- Jo-Ana D Chase
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
| | | | - Sheri Rowland
- College of Nursing – Lincoln Division, University of Nebraska, Lincoln, NE, USA
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17
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McGowan LJ, Powell R, French DP. Older adults' construal of sedentary behaviour: Implications for reducing sedentary behaviour in older adult populations. J Health Psychol 2020; 26:2186-2199. [PMID: 32114825 PMCID: PMC8438784 DOI: 10.1177/1359105320909870] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Older adults are the most sedentary age group, with sedentary behaviour having negative health-related consequences. There is currently limited understanding of how older adults view sedentary behaviour. This study investigated older adults' understanding of the concept of sedentary behaviour. Semi-structured interviews were conducted with 22 community-dwelling older adults in urban North-West England, selected to be diverse in socio-economic background and activity levels. Interviews were recorded and transcribed verbatim. An inductive thematic analysis was conducted. Participants often construed sedentary behaviour as synonymous with a lack of physical activity, and many perceived reducing sedentary behaviour and increasing moderate-to-vigorous physical activity to be the same thing. Participants perceived the term 'sedentary' to have negative connotations and were often judgemental of people who engaged in high levels of sedentary behaviour. Most participants considered reducing sedentary behaviour to be of value, though more active individuals were unconvinced that reducing sedentary behaviour has value beyond the benefits of being physically active. Interventions may wish to provide education to address the misconception that increasing moderate-to-vigorous physical activity is necessary in order to reduce sedentary behaviour. Educating older adults on the independent health consequences of sedentary behaviour may also prove beneficial.
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18
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Fritz H, Hu YL, Gahman K, Almacen C, Ottolini J. Intervention to Modify Habits: A Scoping Review. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2019; 40:99-112. [PMID: 31642394 DOI: 10.1177/1539449219876877] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Intervening to change clients' habits in the course of their everyday occupations could improve health. Habit formation interventions are an emerging area of science, however, and there is a need to better understand the current state of habit intervention research. The objective of this study is to examine the evidence related to habit formation interventions to modify health habits among adults. We performed a scoping review of peer-review articles published since January 1, 2008. The majority of the 18 studies included in the review were randomized control trials using one of two measures to assess habit change. Studies targeted a range of habits. Trial results were mixed but supportive of habit formation approaches. Through habit formation interventions, a range of everyday behaviors can become a habit. Occupational therapy professionals can use data and results generated from this review to inform the development of occupation-based habit formation treatments.
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Affiliation(s)
| | - Yi-Ling Hu
- Wayne State University, Detroit, MI, USA
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19
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How Acceptable is Reducing Sedentary Behavior to Older Adults? Perceptions and Experiences Across Diverse Socioeconomic Areas. J Aging Phys Act 2019; 27:642–652. [DOI: 10.1123/japa.2018-0274] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Sedentary behavior is associated with negative health outcomes, and older adults represent the most sedentary age group. There is currently little qualitative evidence to inform the development of sedentary behavior interventions targeting older adults. This study explored factors affecting older adults’ sedentary behaviors and the acceptability of potential strategies to reduce sedentary time. Semistructured interviews with 22 older adults with diverse socioeconomic backgrounds in Manchester, England were conducted. An inductive thematic analysis was structured using the framework approach. Limited availability of community resources was identified in deprived areas. Local environments impacted sedentary behavior, including sense of community belonging, crime, and physical infrastructure. Enjoyment, socializing, and feeling a sense of achievement were key motivations to engage in nonsedentary activities. As older adults desire social interaction and enjoyment, community interventions in urban settings should try to reduce sedentary behavior by offering group-based activities, particularly in deprived areas where current provision is limited.
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20
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Compernolle S, DeSmet A, Poppe L, Crombez G, De Bourdeaudhuij I, Cardon G, van der Ploeg HP, Van Dyck D. Effectiveness of interventions using self-monitoring to reduce sedentary behavior in adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2019; 16:63. [PMID: 31409357 PMCID: PMC6693254 DOI: 10.1186/s12966-019-0824-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/24/2019] [Indexed: 11/16/2022] Open
Abstract
Background Sedentary behavior occurs largely subconsciously, and thus specific behavior change techniques are needed to increase conscious awareness of sedentary behavior. Chief amongst these behavior change techniques is self-monitoring of sedentary behavior. The aim of this systematic review and meta-analysis was to evaluate the short-term effectiveness of existing interventions using self-monitoring to reduce sedentary behavior in adults. Methods Four electronic databases (PubMed, Embase, Web of Science, and The Cochrane Library) and grey literature (Google Scholar and the International Clinical Trials Registry Platform) were searched to identify appropriate intervention studies. Only (cluster-)randomized controlled trials that 1) assessed the short-term effectiveness of an intervention aimed at the reduction of sedentary behavior, 2) used self-monitoring as a behavior change technique, and 3) were conducted in a sample of adults with an average age ≥ 18 years, were eligible for inclusion. Relevant data were extracted, and Hedge’s g was used as the measure of effect sizes. Random effects models were performed to conduct the meta-analysis. Results Nineteen intervention studies with a total of 2800 participants met the inclusion criteria. Results of the meta-analyses showed that interventions using self-monitoring significantly reduced total sedentary time (Hedges g = 0,32; 95% CI = 0,14 − 0,50; p = 0,001) and occupational sedentary time (Hedge’s g = 0,56; 95% CI = 0,07 − 0,90; p = 0,02) on the short term. Subgroup analyses showed that significant intervention effects were only found if objective self-monitoring tools were used (g = 0,40; 95% CI = 0,19 − 0,60; p < 0,001), and if the intervention only targeted sedentary behavior (g = 0,45; 95% CI = 0,15-0,75; p = 0,004). No significant intervention effects were found on the number of breaks in sedentary behavior. Conclusions Despite the small sample sizes, and the large heterogeneity, results of the current meta-analysis suggested that interventions using self-monitoring as a behavior change technique have the potential to reduce sedentary behavior in adults. If future – preferably large-scale studies – can prove that the reductions in sedentary behavior are attributable to self-monitoring and can confirm the sustainability of this behavior change, multi-level interventions including self-monitoring may impact public health by reducing sedentary behavior. Electronic supplementary material The online version of this article (10.1186/s12966-019-0824-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.
| | - Ann DeSmet
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
| | - Louise Poppe
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health Amsterdam Public Health research institute Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
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21
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Bauer IE, Kiropoulos LA, Crist NP, Hamilton JE, Soares JC, Meyer TD. A qualitative study investigating bipolar patients' expectations of a lifestyle intervention: A self-management program. Arch Psychiatr Nurs 2018; 32:555-560. [PMID: 30029747 DOI: 10.1016/j.apnu.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 02/17/2018] [Accepted: 03/06/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND There is some evidence supporting the efficacy of lifestyle interventions in changing unhealthy habits and reduce the risk of developing comorbid conditions in Bipolar Disorder (BD). AIMS This qualitative study aimed to identify what an optimal lifestyle intervention would look like for individuals with BD. METHODS The current findings are based on one focus group and two paired interviews including a total of 10 individuals with BD (44.20 ± 11.11 years; 6 females). Groups' transcripts were analyzed using a narrative approach. Primary themes included facilitating factors and barriers, general content, outcomes, format of the intervention, and background factors. RESULTS Participants were in favor of a group-based lifestyle intervention as part of their usual treatment. The optimal group format would include 4 to 10 individuals, and comprise of 12 to 18 sessions lasting 1 to 1.5 h each. Accountability, motivation, interaction, and group activities were identified as contributing to the success of a lifestyle intervention. CONCLUSIONS This qualitative study provides important information regarding aspects of lifestyle intervention format and delivery for individuals with BD. We identified barriers and facilitating factors that should be addressed in health promotion interventions delivered within community mental health settings.
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Affiliation(s)
- Isabelle E Bauer
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.
| | - Litza A Kiropoulos
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Nicholas P Crist
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Jane E Hamilton
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Thomas D Meyer
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
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Ku PW, Liu YT, Lo MK, Chen LJ, Stubbs B. Higher levels of objectively measured sedentary behavior is associated with worse cognitive ability: Two-year follow-up study in community-dwelling older adults. Exp Gerontol 2017; 99:110-114. [DOI: 10.1016/j.exger.2017.09.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 09/18/2017] [Accepted: 09/23/2017] [Indexed: 01/08/2023]
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