From evidence-based research to practice-based evidence : disseminating a web-based computer-tailored workplace sitting intervention through a health promotion organisation

Prolonged sitting has been linked to adverse health outcomes; therefore, we developed and examined a web-based, computer-tailored workplace sitting intervention. As we had previously shown good effectiveness, the next stage was to conduct a dissemination study. This study reports on the dissemination efforts of a health promotion organisation, associated costs, reach achieved, and attributes of the website users. The organisation systematically registered all the time and resources invested to promote the intervention. Website usage statistics (reach) and descriptive statistics (website users' attributes) were also assessed. Online strategies (promotion on their homepage; sending e-mails, newsletters, Twitter, Facebook and LinkedIn posts to professional partners) were the main dissemination methods. The total time investment was 25.6 h, which cost approximately 845 EUR in salaries. After sixteen months, 1599 adults had visited the website and 1500 (93.8%) completed the survey to receive personalized sitting advice. This sample was 38.3 +/- 11.0 years, mainly female (76.9%), college/university educated (89.0%), highly sedentary (88.5% sat >8 h/day) and intending to change (93.0%) their sitting. Given the small time and money investment, these outcomes are positive and indicate the potential for wide-scale dissemination. However, more efforts are needed to reach men, non-college/university educated employees, and those not intending behavioural change

Work-related physical activity and psychological distress among women in different occupations : a cross-sectional study

BACKGROUND: Recent evidence suggests that work-related physical activity may not have the same mental health benefits as leisure-time physical activity. Further, work-related physical activity is likely to include a variety of different behaviours for people with different occupations. As such, the aim of this study was to determine if occupation type moderated the association between work-related physical activity and psychological distress. METHODS: A randomly selected sample of 1080 women from Melbourne, Australia completed the International Physical Activity Questionnaire (IPAQ) and General Health Questionnaire (GHQ-30), and reported their current occupation. RESULTS: Linear regression analyses indicated that occupation significantly moderated the association between work-related walking and psychological distress (F [8, 55] = 2.26, p = .036). Given evidence of moderation, we fitted linear regression models to test the associations between work-related physical activity and psychological distress for three separate groups; professionals, sales and services workers, and tradespersons. Female tradespersons who engaged in a low (B = - 3.81, p = .006) or high amount of work-related walking (B = - 3.23, p = .029), had significantly lower psychological distress symptoms than those who engaged in no work-related walking. There were no significant associations between work-related physical activity of any intensity and psychological distress for professionals, or sales and service workers. CONCLUSIONS: Given the relationship does not exist across all occupations, work-related physical activity should not be promoted above and beyond leisure-time physical activity. However, walking at work may be important in reducing psychological distress for some people and should therefore, not be discounted

Dose-dependent associations of joint aerobic and muscle-strengthening exercise with obesity: A cross-sectional study of 280,605 adults

Background Emerging epidemiological evidence suggests that compared to engaging in 1 activity mode alone, a combination of moderate-to-vigorous physical activity (MVPA: walking/jogging, cycling) and muscle-strengthening exercise (MSE: push-ups/sit-ups, using weight machines) has more favorable associations with optimal weight status. However, few studies have examined the dose-dependent and joint associations of MVPA and MSE with obesity. Methods Based on cross-sectional analyses of the European Health Interview Survey Wave 2 (2013–2014), we examined prevalence ratios (PRs) of joint and stratified associations between MVPA (4 categories: (i) 0 min/week, (ii) 1–149 min/week, (iii) 150–299 min/week, and (iv) ≥300 min/week) and MSE (3 categories: (i) 0 day/week, (ii) 1 day/week, and (iii) ≥2 days/week) with body mass index-defined obesity (body mass index of ≥30.0 kg/m2) using Poisson regression with robust error variance. PRs were examined unadjusted and adjusted for sociodemographic and lifestyle characteristics (e.g., sex, age, education, income, and smoking status). Results Data were available for 280,456 adults (≥18 years), of which 46,166 (15.5%) were obese. The interaction MVPA × MSE guideline adherence was statistically significant for obesity (p ≤ 0.05). The joint MVPA–MSE analysis showed that compared to the reference group (i.e., no MVPA and no MSE), the PRs followed a dose-dependent pattern, with the lowest observed among those reporting ≥150 MVPA min/week and ≥1 MSE days/week (PR: 0.43; 95% confidence interval: 0.41–0.46). When stratified across each MVPA strata, the PRs were mostly lower among those engaging in MSE 1 day/week, as compared to those doing MSE ≥2 days/week. Conclusion There was evidence for a dose-dependent association between joint MVPA–MSE with a reduced prevalence of obesity. Public health strategies for the prevention and management of obesity should recommend both MVPA and MSE

A descriptive epidemiology of screen-based devices by children and adolescents: a scoping review of 130 surveillance studies since 2000

Excessive use of screen-based devices can be detrimental for child and adolescent health. While epidemiological reviews have been focusing on traditional screen-based activities (e.g., television, computer use), the availability of newer screen-based devices (e.g., mobile phones, tablets) has increased considerably in recent years. However, there is limited understanding of the descriptive epidemiology of these newer devices and their contribution towards health-related screen time guidelines (≤2 h/day). This systematic scoping review synthesizes the descriptive epidemiology of screen-based devices, incorporating newer forms of screens, among 5–18-year-olds. Medline, Web of Science, PsycINFO, SPORTDiscus, ERIC, Science Direct, and Scopus databases were searched for articles published in English since year 2000. Search terms included terms that related to screen time and target population. Data were extracted from 130 population-based surveillance studies (minimum sample size N = ≥5000). Screening and data extraction (study characteristics, estimates of prevalence rates and screen time-use point-estimates) were performed in duplicate for accuracy. Television viewing (64.3%) was the most common measure of screen time, whilst fewer reported on newer screen-based devices (mobile phones: 4.6%, active gaming consoles: <1%). On average, 52.3% of participants (k = 19 studies) exceeded 2 h/day of screen time and total screen time was 3.6 h/day (1.3–7.9 h/day). Findings can inform and facilitate future research and policy designed to limit overall screen time among children and adolescents for health gains where appropriate. Moreover, policy makers can use this information to track and monitor screen time among children and adolescents

Muscle-strengthening exercise epidemiology: a new frontier in chronic disease prevention

This current opinion provides an overview of the emerging discipline of muscle-strengthening exercise epidemiology. First, we define muscle-strengthening exercise, and discuss its recent addition into the global physical activity guidelines, which were historically mainly focused on aerobic physical activity (walking, running, cycling etc.). Second, we provide an overview of the current clinical and epidemiological evidence on the associations between muscle-strengthening exercise and health, showing a reduced mortality risk, and beneficial cardiometabolic, musculoskeletal, functional and mental health-related outcomes. Third, we describe the latest epidemiological research on the assessment, prevalence, trends and correlates of muscle-strengthening exercise. An overview of recent population estimates suggests that the proportion of adults meeting the current muscle-strengthening exercise guideline (10-30%; >= 2 sessions/week) is far lower than adults reporting meeting the aerobic exercise guideline (similar to 50%; >= 150 min/week). Fourth, we discuss the complexity of muscle-strengthening exercise promotion, highlighting the need for concurrent, coordinated, and multiple-level strategies to increase population-level uptake/adherence of this exercise modality. Last, we explore key research gaps and strategies that will advance the field of muscle-strengthening exercise epidemiology. Our objective is to provide a case for increased emphasis on the role of muscle-strengthening exercise for chronic disease prevention, and most importantly, stimulate more research in this currently understudied area of physical activity epidemiology

The epidemiology of aerobic physical activity and muscle-strengthening activity guideline adherence among 383,928 U.S. adults

BACKGROUND: The World Health Organization's 'Global Recommendations on Physical Activity for Health' state that adults should engage in regular moderate-to-vigorous intensity aerobic physical activity (MVPA; e.g. walking, running, cycling) and muscle-strengthening activity (MSA; e.g. strength/resistance training). However, assessment of both MVPA and MSA is rare in physical activity surveillance. The aim of this study is to describe the prevalence, correlates and chronic health conditions associated with meeting the combined MVPA-MSA guidelines among a population representative sample of U.S. adults. METHODS: In this cross-sectional study, data were drawn from the U.S. 2015 Behavioral Risk Factor Surveillance System. During telephone interviews, MVPA and MSA were assessed using validated questionnaires. We calculated the proportions meeting both the global MVPA and MSA physical activity guidelines (MVPA >/=150 min/week and MSA >/=2 sessions/week). Poisson regressions with a robust error variance were used to assess: (i) prevalence ratios (PR) for meeting both guidelines across sociodemographic factors (e.g. age, sex, education, income, race/ethnicity); and (ii) PRs of 12 common chronic health conditions (e.g. diabetes, coronary heart disease, hypertension, depression) across different categories of physical activity guideline adherence (met neither [reference]; MSA only; MVPA only; met both). RESULTS: Among 383,928 adults (aged 18-80 years), 23.5% (95% CI: 20.1, 20.6%) met the combined MVPA-MSA guidelines. Those with poorer self-rated health, older adults, women, lower education/income and current smokers were less likely to meet the combined guidelines. After adjustment for covariates (e.g. age, self-rated health, income, smoking) compared with meeting neither guidelines, MSA only and MVPA only, meeting the combined MVPA-MSA guidelines was associated with the lowest PRs for all health conditions (APR range: 0.44-0.76), and the clustering of >/=6 chronic health conditions (APR = 0.33; 95% CI: 0.31-0.35). CONCLUSIONS: Eight out of ten U.S. adults do not meet the global physical activity guidelines. This study supports the need for comprehensive health promotion strategies to increase the uptake and adherence of MVPA-MSA among U.S. adults. Large-scale interventions should target specific population sub-groups including older adults, women, those with poorer health and lower education/income

The prevalence and correlates of sitting in European adults - a comparison of 32 Eurobarometer-participating countries

Background Prolonged sitting is an emerging health risk. However, multi-country comparative sitting data are sparse. This paper reports the prevalence and correlates of sitting time in 32 European countries. Methods Data from the Eurobarometer 64.3 study were used, which included nationally representative samples (n = 304-1,102) from 32 European countries. Face-to-face interviews were conducted during November and December 2005. Usual weekday sitting time was assessed using the International Physical Activity Questionnaire (short-version). Sitting time was compared by country, age, gender, years of education, general health status, usual activity and physical activity. Multivariable-adjusted analyses assessed the odds of belonging to the highest sitting quartile. Results Data were available for 27,637 adults aged 15–98 years. Overall, mean reported weekday sitting time was 309 min/day (SD 184 min/day). There was a broad geographical pattern and some of the lowest amounts of daily sitting were reported in southern (Malta and Portugal means 194–236 min/day) and eastern (Romania and Hungary means 191–276 min/day) European countries; and some of the highest amounts of daily sitting were reported in northern European countries (Germany, Benelux and Scandinavian countries; means 407–335 min/day). Multivariable-adjusted analyses showed adults with low physical activity levels (OR = 5.10, CI95 = 4.60-5.66), those with high sitting in their main daily activity (OR = 2.99, CI95 = 2.74-3.25), those with a bad/very bad general health state (OR = 1.87, CI95 = 1.63-2.15) and higher education levels (OR = 1.48, CI95 = 1.38-1.59) were more likely to be in the highest quartile of daily sitting time. Adults within Greece (OR = 2.91, CI95 = 2.51-3.36) and Netherlands (OR = 2.56, CI95 = 2.22-2.94) were most likely to be in the highest quartile. High-sit/low-active participants comprised 10.1% of the sample. Adults self-reporting bad/very bad general health state (OR = 4.74, CI95 = 3.97-5.65), those within high sitting in their main daily activities (OR = 2.87, CI95 = 2.52-3.26) and adults aged ≥65 years (OR = 1.53, CI95 = 1.19-1.96) and were more likely to be in the high-sit/low-active group. Conclusions Weekday sitting time and its demographic correlates varied considerably across European countries, with adults in north-western European countries sitting the most. Sitting is prevalent across Europe and merits attention by preventive interventions

Too much sitting and all-cause mortality: is there a causal link?

Background: Sedentary behaviours (time spent sitting, with low energy expenditure) are associated with deleterious health outcomes, including all-cause mortality. Whether this association can be considered causal has yet to be established. Using systematic reviews and primary studies from those reviews, we drew upon Bradford Hill's criteria to consider the likelihood that sedentary behaviour in epidemiological studies is likely to be causally related to all-cause (premature) mortality. Methods: Searches for systematic reviews on sedentary behaviours and all-cause mortality yielded 386 records which, when judged against eligibility criteria, left eight reviews (addressing 17 primary studies) for analysis. Exposure measures included self-reported total sitting time, TV viewing time, and screen time. Studies included comparisons of a low-sedentary reference group with several higher sedentary categories, or compared the highest versus lowest sedentary behaviour groups. We employed four Bradford Hill criteria: strength of association, consistency, temporality, and dose-response. Evidence supporting causality at the level of each systematic review and primary study was judged using a traffic light system depicting green for causal evidence, amber for mixed or inconclusive evidence, and red for no evidence for causality (either evidence of no effect or no evidence reported). Results: The eight systematic reviews showed evidence for consistency (7 green) and temporality (6 green), and some evidence for strength of association (4 green). There was no evidence for a dose-response relationship (5 red). Five reviews were rated green overall. Twelve (67 %) of the primary studies were rated green, with evidence for strength and temporality. Conclusions: There is reasonable evidence for a likely causal relationship between sedentary behaviour and all-cause mortality based on the epidemiological criteria of strength of association, consistency of effect, and temporality

The prevalence and correlates of sitting in European adults -a comparison of 32 Eurobarometer-participating countries

Abstract Background: Prolonged sitting is an emerging health risk. However, multi-country comparative sitting data are sparse. This paper reports the prevalence and correlates of sitting time in 32 European countries. Methods: Data from the Eurobarometer 64.3 study were used, which included nationally representative samples (n = 304-1,102) from 32 European countries. Face-to-face interviews were conducted during November and December 2005. Usual weekday sitting time was assessed using the International Physical Activity Questionnaire (short-version). Sitting time was compared by country, age, gender, years of education, general health status, usual activity and physical activity. Multivariable-adjusted analyses assessed the odds of belonging to the highest sitting quartile. Results: Data were available for 27,637 adults aged 15-98 years. Overall, mean reported weekday sitting time was 309 min/day (SD 184 min/day). There was a broad geographical pattern and some of the lowest amounts of daily sitting were reported in southern (Malta and Portugal means 194-236 min/day) and eastern (Romania and Hungary means 191-276 min/day) European countries; and some of the highest amounts of daily sitting were reported in northern European countries (Germany, Benelux and Scandinavian countries; means 407-335 min/day). Multivariable-adjusted analyses showed adults with low physical activity levels (OR = 5.10, CI 95 = 4.60-5.66), those with high sitting in their main daily activity (OR = 2.99, CI 95 = 2.74-3.25), those with a bad/very bad general health state (OR = 1.87, CI 95 = 1.63-2.15) and higher education levels (OR = 1.48, CI 95 = 1.38-1.59) were more likely to be in the highest quartile of daily sitting time. Adults within Greece (OR = 2.91, CI 95 = 2.51-3.36) and Netherlands (OR = 2.56, CI 95 = 2.22-2.94) were most likely to be in the highest quartile. High-sit/low-active participants comprised 10.1% of the sample. Adults self-reporting bad/very bad general health state (OR = 4.74,, those within high sitting in their main daily activities (OR = 2.87, CI 95 = 2.52-3.26) and adults aged ≥65 years (OR = 1.53, CI 95 = 1.19-1.96) and were more likely to be in the high-sit/low-active group. Conclusions: Weekday sitting time and its demographic correlates varied considerably across European countries, with adults in north-western European countries sitting the most. Sitting is prevalent across Europe and merits attention by preventive interventions