The SOS-framework (Systems of Sedentary behaviours): An international transdisciplinary consensus framework for the study of determinants, research priorities and policy on sedentary behaviour across the life course: A DEDIPAC-study

© 2016 The Author(s).Background: Ecological models are currently the most used approaches to classify and conceptualise determinants of sedentary behaviour, but these approaches are limited in their ability to capture the complexity of and interplay between determinants. The aim of the project described here was to develop a transdisciplinary dynamic framework, grounded in a system-based approach, for research on determinants of sedentary behaviour across the life span and intervention and policy planning and evaluation. Methods: A comprehensive concept mapping approach was used to develop the Systems Of Sedentary behaviours (SOS) framework, involving four main phases: (1) preparation, (2) generation of statements, (3) structuring (sorting and ranking), and (4) analysis and interpretation. The first two phases were undertaken between December 2013 and February 2015 by the DEDIPAC KH team (DEterminants of DIet and Physical Activity Knowledge Hub). The last two phases were completed during a two-day consensus meeting in June 2015. Results: During the first phase, 550 factors regarding sedentary behaviour were listed across three age groups (i.e., youths, adults and older adults), which were reduced to a final list of 190 life course factors in phase 2 used during the consensus meeting. In total, 69 international delegates, seven invited experts and one concept mapping consultant attended the consensus meeting. The final framework obtained during that meeting consisted of six clusters of determinants: Physical Health and Wellbeing (71 % consensus), Social and Cultural Context (59 % consensus), Built and Natural Environment (65 % consensus), Psychology and Behaviour (80 % consensus), Politics and Economics (78 % consensus), and Institutional and Home Settings (78 % consensus). Conducting studies on Institutional Settings was ranked as the first research priority. The view that this framework captures a system-based map of determinants of sedentary behaviour was expressed by 89 % of the participants. Conclusion: Through an international transdisciplinary consensus process, the SOS framework was developed for the determinants of sedentary behaviour through the life course. Investigating the influence of Institutional and Home Settings was deemed to be the most important area of research to focus on at present and potentially the most modifiable. The SOS framework can be used as an important tool to prioritise future research and to develop policies to reduce sedentary time

A systematic review of correlates of sedentary behaviour in adults aged 18–65 years: a socio-ecological approach

Background: Recent research shows that sedentary behaviour is associated with adverse cardio-metabolic consequences even among those considered sufficiently physically active. In order to successfully develop interventions to address this unhealthy behaviour, factors that influence sedentariness need to be identified and fully understood. The aim of this review is to identify individual, social, environmental, and policy-related determinants or correlates of sedentary behaviours among adults aged 18-65 years. Methods: PubMed, Embase, CINAHL, PsycINFO and Web of Science were searched for articles published between January 2000 and September 2015. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour (b) correlates (c) types of sedentary behaviours (d) types of correlates. Articles were included if information relating to sedentary behaviour in adults (18-65 years) was reported. Studies on samples selected by disease were excluded. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Results: 74 original studies were identified out of 4041: 71 observational, two qualitative and one experimental study. Sedentary behaviour was primarily measured as self-reported screen leisure time and total sitting time. In 15 studies, objectively measured total sedentary time was reported: accelerometry (n = 14) and heart rate (n = 1). Individual level factors such as age, physical activity levels, body mass index, socio-economic status and mood were all significantly correlated with sedentariness. A trend towards increased amounts of leisure screen time was identified in those married or cohabiting while having children resulted in less total sitting time. Several environmental correlates were identified including proximity of green space, neighbourhood walkability and safety and weather. Conclusions: Results provide further evidence relating to several already recognised individual level factors and preliminary evidence relating to social and environmental factors that should be further investigated. Most studies relied upon cross-sectional design limiting causal inference and the heterogeneity of the sedentary measures prevented direct comparison of findings. Future research necessitates longitudinal study designs, exploration of policy-related factors, further exploration of environmental factors, analysis of inter-relationships between identified factors and better classification of sedentary behaviour domains

The (cost-)effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on the recovery from neck and upper limb symptoms in computer workers

BACKGROUND: Neck and upper limb symptoms are frequently reported by computer workers. Work style interventions are most commonly used to reduce work-related neck and upper limb symptoms but lifestyle physical activity interventions are becoming more popular to enhance workers health and reduce work-related symptoms. A combined approach targeting work style and lifestyle physical activity seems promising, but little is known on the effectiveness of such combined interventions. METHODS/DESIGN: The RSI@Work study is a randomised controlled trial that aims to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention to reduce neck and upper limb symptoms in computer workers. Computer workers from seven Dutch companies with frequent or long-term neck and upper limb symptoms in the preceding six months and/or the last two weeks are randomised into three groups: (1) work style group, (2) work style and physical activity group, or (3) control group. The work style intervention consists of six group meetings in a six month period that take place at the workplace, during work time, and under the supervision of a specially trained counsellor. The goal of this intervention is to stimulate workplace adjustment and to improve body posture, the number and quality of breaks and coping behaviour with regard to high work demands. In the combined (work style and physical activity) intervention the additional goal is to increase moderate to heavy physical activity. The control group receives usual care. Primary outcome measures are degree of recovery, pain intensity, disability, number of days with neck and upper limb symptoms, and number of months without neck and upper limb symptoms. Outcome measures will be assessed at baseline and six and 12 months after randomisation. Cost-effectiveness of the group meetings will be assessed using an employer's perspective. DISCUSSION: This study will be one of the first to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention in reducing neck and upper limb symptoms of computer workers. The results of the study are expected in 2007

The SOS-framework (Systems of Sedentary behaviours): an international transdisciplinary consensus framework for the study of determinants, research priorities and policy on sedentary behaviour across the life course: a DEDIPAC-study.

BACKGROUND: Ecological models are currently the most used approaches to classify and conceptualise determinants of sedentary behaviour, but these approaches are limited in their ability to capture the complexity of and interplay between determinants. The aim of the project described here was to develop a transdisciplinary dynamic framework, grounded in a system-based approach, for research on determinants of sedentary behaviour across the life span and intervention and policy planning and evaluation. METHODS: A comprehensive concept mapping approach was used to develop the Systems Of Sedentary behaviours (SOS) framework, involving four main phases: (1) preparation, (2) generation of statements, (3) structuring (sorting and ranking), and (4) analysis and interpretation. The first two phases were undertaken between December 2013 and February 2015 by the DEDIPAC KH team (DEterminants of DIet and Physical Activity Knowledge Hub). The last two phases were completed during a two-day consensus meeting in June 2015. RESULTS: During the first phase, 550 factors regarding sedentary behaviour were listed across three age groups (i.e., youths, adults and older adults), which were reduced to a final list of 190 life course factors in phase 2 used during the consensus meeting. In total, 69 international delegates, seven invited experts and one concept mapping consultant attended the consensus meeting. The final framework obtained during that meeting consisted of six clusters of determinants: Physical Health and Wellbeing (71% consensus), Social and Cultural Context (59% consensus), Built and Natural Environment (65% consensus), Psychology and Behaviour (80% consensus), Politics and Economics (78% consensus), and Institutional and Home Settings (78% consensus). Conducting studies on Institutional Settings was ranked as the first research priority. The view that this framework captures a system-based map of determinants of sedentary behaviour was expressed by 89% of the participants. CONCLUSION: Through an international transdisciplinary consensus process, the SOS framework was developed for the determinants of sedentary behaviour through the life course. Investigating the influence of Institutional and Home Settings was deemed to be the most important area of research to focus on at present and potentially the most modifiable. The SOS framework can be used as an important tool to prioritise future research and to develop policies to reduce sedentary time

Active gaming in Dutch adolescents: a descriptive study

Background: Adequate levels of physical activity are part of a healthy lifestyle and in this way linked to better health outcomes. For children and adolescents, the physical activity guideline recommends at least 60 minutes of moderate-to-vigorous physical activity every day. However, many adolescents are not physically active enough and they spend a lot of their time on sedentary activities (such as video games). A new generation of video games that require body movements to play them, so-called "active games", could serve to increase physical activity in adolescents. The activity level while playing these games is comparable to light-to-moderate intensity physical activity. The current study aims to increase our understanding of 1) the demographic characteristics of adolescents who play active games regularly (≥ 1 hour per week) and non-regularly (<; 1 hour per week), 2) time spent on active games, 3) the contribution of active games to daily physical activity and 4) the type and amount of activities being replaced by active gaming.Methods: A cross-sectional survey was conducted in a Dutch internet panel, questioning adolescents in conjunction with one of their parents. A random sample of 320 households (with stratification on gender of the parent and the adolescent, the age of the adolescent and the region of the household) was selected that owned a console or application for active video games and that had a child aged 12 through 16 years. 201 child-parent couples (63% response) completed an internet survey with questions about demographics, physical activity and sedentary behaviour, and gaming behaviour. The questionnaire also contained questions designed to assess whether and how active gaming replaces other activities. Besides descriptive analyses, independent t-test, Pearson's chi-square and Mann-Whitney test (when data were not normally distributed) were used for comparisons between regular and non-regular active gamers.Results: Eleven percent of the adolescents with an active game in their household never used the game. There were no significant differences in gender, education level (of adolescent and parent), ethnicity and sedentary behaviour between regular (n = 65) and non-regular active gamers (n = 114). Adolescents' (regular and non-regular active gamers) meantime spent on active gaming was 80 (± 136) minutes a week; this potentially amounts to 11% of total physical activity. When time spent on active gaming was included in the calculation of the percentage of adolescents that met the physical activity guideline, the percentage increased significantly (p <; 0.05) from 67 to 73%. According to the adolescents, active gaming mainly replaces sedentary screen time such as TV viewing, internet and non-active gaming. Parental opinions concurred with this appraisal.Conclusions: The results of this study confirm the idea that active gaming may contribute to an active lifestyle in adolescents, primarily because it potentially contributes substantially to time spent on physical activity. Secondly, active gamers indicate that they spent time on active games which they would have spent otherwise on less active activities

Competencies for supporting a healthy sexual development of young people in care: interviews with a selection of professionals in Belgium, Denmark and The Netherlands

This report describes the results of the interviews that were held with professionals, policy makers, and researchers (working in the field of sexuality and/or residential and foster care) in three countries in order to answer the following question: ‘Which competencies (i.e. knowledge, skills, and attitude) do professionals working in care need in order to support healthy sexual development of young people in care? Chapter 3 describes the characteristics of young people growing up in care. Young people in care are generally more vulnerable than their peers living in normal families since they have grown up in unsafe family environments. They are often insecurely attached, have a lack of positive role models and positive sexual experiences, have not grown up with clear norms and values concerning sexuality, have low self-esteem and little knowledge about (healthy) sexuality. This set of characteristics makes them more likely to cross their own boundaries and that of others and to make unhealthy choices with regard to sexuality. Therefore, young people in care have special needs with regard to sexuality that professionals working in care should know about and act upon. To meet the special needs of young people in care, professionals should create a safe environment and be there for the young people, in order to make them feel safe and secure again. In addition, they should act as positive role models, set boundaries, help young people to gain self-confidence, and give them space to have positive sexual experiences and to discover their own norms and values. Professionals working in care should provide sexual education that supports young people in their knowledge, skills, and attitudes concerning sexual development and teaches them to make wise and responsible decisions for themselves. Professionals need to put aside prejudices about boys and girls and treat them equally. Chapter 4 describes opportunities to start a conversation with young people in care about sex, intimacy and relationship and what professionals should teach foster parents. Opportunities to start a conversation with young people in care are: 1. When one of the boys or girls spontaneously starts to talk about sexuality; 2. When young people have discussions about boyfriends, girlfriends, or sex. 3. When young people watch clips on social media in which sexuality plays a role. Important topics to discuss are: healthy sexual behaviour, relationships, wishes, boundaries, making your own decisions, changing behaviour after regretting something, norms and values, and social media. Professionals working in foster care should teach foster parents that: 1. It is their task to speak about this topic with their foster child; 2. They should already start talking about this topic to toddlers; 3. It is normal to have difficulties talking about this topic; 4. They should not only speak about the risks of sex but also about sexual pleasure, desire, love, and respect. Chapter 5 describes the personal characteristics and general competencies that professionals working in care should have in order to support the sexual development of young people in care. These are: 1. Have a high degree of self-awareness concerning their own limits, norms and values, and how this influences the way they work, 2. Know that norms and values are dependent on time and culture, 3. Treat children, young people, and parents with respect, 4. Have a good sense of professional judgment, 5. Feel responsible for one’s actions, 6. Have knowledge about trauma theory. Chapter 6 describes what organisations can do to support healthy sexual development of young people in care. Organisations can do the following on the organizational level: 1. Provide structural resources for training and reflection, 2. Create a safe environment and reflective culture, 3. Create diversity among team members, 4. Create access to experts on the topic of sexuality, 5. Pay attention to competencies during hiring processes, 6. Have organisational and institutional policies on the topic of sexuality, 7. Have organisational structures and tools to support relationships and conversations with young people. Chapter 7 describes factors at the professional, organisational, and societal level that may contribute to sexuality-related difficulties in both residential and foster care. Some of these factors are not specifically related to residential or foster care, such as low self-efficacy of professionals, insufficient time for reflection and negative media influences. Other factors are specifically related to residential care, such as having insufficient possibilities to experiment with sexuality (in residential care) and fear of foster parents being accused (in foster care)

Core competencies for safeguarding young people in care

Since October 2015, four European universities of applied sciences and three youth care organisations in Belgium, Denmark, Netherlands and Scotland, have been working as partners to develop education and training for (future) professionals. The goal of this partnership is to help (future) professionals: 1. To support healthy sexual development of young people in care; 2. To interact with young people, their (foster) parents, colleagues, and other professionals, concerning the topics of sexual behaviour, intimacy, and inter-personal relationships, in order to prevent sexual abuse of young people in care. This report shows the steps taken to develop a set of core competencies that form the basis of the education and training for (future) professionals. The study described in this report resulted in a list of 61 competency items (knowledge, skills and attitudes) that (future) professionals need in order to support healthy sexual development of young people in care. The most relevant items were grouped into the following clusters: 1. Discussing sexuality, 2. Supporting the needs of young people concerning sexuality, 3. Act professionally in relation to the topic of sexuality, 4. Dealing with different norms, values and cultures with regard to sexuality, 5. Recognizing and responding to offensive sexual behaviour, including sexual abuse

Correlates of sedentary time in different age groups: results from a large cross sectional Dutch survey

Abstract Background Evidence shows that prolonged sitting is associated with an increased risk of mortality, independent of physical activity (PA). The aim of the study was to identify correlates of sedentary time (ST) in different age groups and day types (i.e. school-/work day versus non-school-/non-work day). Methods The study sample consisted of 1895 Dutch children (4–11 years), 1131 adolescents (12–17 years), 8003 adults (18–64 years) and 1569 elderly (65 years and older) who enrolled in the Dutch continuous national survey ‘Injuries and Physical Activity in the Netherlands’ between 2006 and 2011. Respondents estimated the number of sitting hours during a regular school-/workday and a regular non-school/non-work day. Multiple linear regression analyses on cross-sectional data were used to identify correlates of ST. Results Significant positive associations with ST were observed for: higher age (4-to-17-year-olds and elderly), male gender (adults), overweight (children), higher education (adults ≥ 30 years), urban environment (adults), chronic disease (adults ≥ 30 years), sedentary work (adults), not meeting the moderate to vigorous PA (MVPA) guideline (children and adults ≥ 30 years) and not meeting the vigorous PA (VPA) guideline (4-to-17-year-olds). Correlates of ST that significantly differed between day types were working hours and meeting the VPA guideline. More working hours were associated with more ST on school-/work days. In children and adolescents, meeting the VPA guideline was associated with less ST on non-school/non-working days only. Conclusions This study provides new insights in the correlates of ST in different age groups and thus possibilities for interventions in these groups. Correlates of ST appear to differ between age groups and to a lesser degree between day types. This implies that interventions to reduce ST should be age specific. Longitudinal studies are needed to draw conclusions on causality of the relationship between identified correlates and ST

Business car owners are less physically active than other adults: A cross-sectional study

Active transport contributes to increased daily physical activity (PA). Car ownership is associated with less frequent active transport and less PA. For business car ownership this relation is unknown. Therefore, we explored whether business car owners and their adult household members comply less with the Dutch moderate to vigorous physical activity (MVPA) guideline and are more sedentary than private car owners and persons without a car. From October 2011 to September 2012 questions about use and availability of cars in the household were included in the survey Injuries and Physical Activity in the Netherlands. Multiple linear regression was used to compare six mutual exclusive groups of ownership and availability of (business and/or private) cars in the household. Business car owners complied less (15.8 percent points) with the MVPA guideline than the other respondents. They also reported 1.5 h more sitting time during workdays than the other respondents, but after adjusting for covariates, this difference was no longer significant. We concluded that owners of a business car in the Netherlands are at higher risk of not complying with the MVPA guideline and tend to spend more hours sitting during workdays than other adults. Further research in this group, e.g. with objective instruments to measure physical activity and sedentary behavior, is recommended. Policy makers on transport and fiscal arrangements, employers, employees, occupational health professionals and car lease companies should be aware of this possible health risk