Using information and communication technology to reduce sitting and increase physical activity in office workers

Passar-se moltes hores assegut i moure’s poc està associat al desenvolupament de malalties cròniques. Els llocs de treball d'oficina han estat considerats entorns clau per reduir aquests comportaments sedentaris amb substitució d’activitats que impliquen una major despesa energètica. Per això, l’objectiu principal de la tesi és investigar l’impacte d'una intervenció per reduir el temps assegut i augmentar l'activitat física en treballadors d'oficina a l’estat espanyol. En l’estudi 1, es va dur a terme un disseny quasi-experimental amb treballadors de sis campus universitaris espanyols (n=264). La intervenció va consistir en una pàgina web que proposava estratègies ecològiques per incrementar progressivament el nombre de passes mitjançant tasques laborals actives, rutes caminant, i l’augment de la intensitat caminant. Utilitzant un model mixt lineal, els resultats varen mostrar una interacció significativa en temps assegut, nombre de passes i perímetre de cintura. En l’estudi 2 es varen realitzar entrevistes semi-estructurades a 12 participants del programa W@WS en tres moments al llarg de la intervenció. A partir de les dades generades qualitativament mitjançant un anàlisi temàtic, els treballadors del grup intervenció (n=88) varen completar una enquesta per identificar el grau d’ús de les estratègies. Els resultats varen mostrar les tasques de treball més actives i l’augment de la intensitat caminant, com les estratègies més utilitzades. Les reunions actives i els grups de caminar a l’hora del dinar varen ser les menys utilitzades a causa la manca de temps i les normes culturals inherents als llocs de treball. Registrar el nombre de passes i el temps assegut va ser el factor facilitador més important mentre que tenir una feina basada en tasques d’ordenador va ser la barrera més prevalent. A partir de l’aprenentatge dels dos anteriors estudis, en l’estudi 3, una revisió sistemàtica va estudiar la viabilitat de l’ús dels ‘smartphones’ per mesurar i promoure estils de vida actius. Vint-i-sis articles varen ser inclosos per a la síntesi qualitativa. La fiabilitat en la precisió de mesura dels patrons d’activitat física i comportament sedentari va ser del 52-100%. Només cinc estudis varen avaluar els efectes d'intervenció: utilitzant disseny pre-post i un amb grup control. La integració d'un menú d’estratègies per seure’s menys i moure’s més a la feina (W@WS) és efectiu en l'assoliment de canvis petits però sostinguts en el nombre de passes caminant i el temps assegut ocupacional. Degut al potencial dels ‘smartphones’ per mesurar patrons d´activitat física i influir en estils de vida actius, futurs estudis amb millor disseny haurien d´avaluar l´efectivitat d´aquests dispositius en intervencions de reducció del temps assegut en els llocs de treball.Sitting too much and moving too little affects the development of many chronic diseases. Office workplaces are key settings to reduce and break up occupational sitting by replacing sedentary time with step counts. Therefore, the aim of the thesis was to investigate the impact of an intervention to reduce occupational sitting time and increase physical activity in Spanish office workers. Study One used a quasi-experimental pre-post comparison design at six Spanish university campuses (n=264). The intervention consisted of a web page that provide ecologically based strategies to progressively increase baseline step counts through incidental movement, short and long walks, and higher step count frequency and intensity. Using a linear mixed model analyses, findings identified a significant interaction for self-reported occupational sitting, daily step counts and waist circumference. Study Two conducted semi-structured interviews (n=12) throughout the intervention. Workers who finished the intervention (n=88) completed a survey rating the extent to which ‘sit less, move more’ strategies were used and those factors that enabled or limited strategy uptake. Findings indicated that ‘active work tasks’ and ‘increases in walking intensity’ were the strategies most frequently used. ‘Sitting time and step count logging’ was the most important enabler of behaviour change while ‘screen based work’ was the most significant barrier limiting the uptake of strategies. Progressing the learning of the previous studies, Study Three systematically reviewed evidence on smartphones and their viability for measuring and influencing physical activity. Twenty-six articles were included in the review. Measurement accuracy was moderate-to-excellent and smartphone strategies to influence physical activity tended to be ad-hoc. Five articles assessed physical activity intervention effects; and only one was focused on workplace setting. W@WS was effective in achieving small but sustained changes in occupational sitting and step counts by facilitating the uptake of a menu of ‘sit less and move more’ strategies, that can overcome office work environmental barriers. New smartphone technology needs to be a central feature of ICT based interventions that target occupational sitting and physical activity given the novel and engaging capabilities these devices provide for measuring and influencing behaviour change in real time

Monitoring sedentary patterns in office employees: validity of an m-health tool (Walk@Work-App) for occupational health.

OBJECTIVE: This study validated the Walk@Work-Application (W@W-App) for measuring occupational sitting and stepping. METHODS: The W@W-App was installed on the smartphones of office-based employees (n=17; 10 women; 26±3 years). A prescribed 1-hour laboratory protocol plus two continuous hours of occupational free-living activities were performed. Intra-class correlation coefficients (ICC) compared mean differences of sitting time and step count measurements between the W@W-App and criterion measures (ActivPAL3TM and SW200Yamax Digi-Walker). RESULTS: During the protocol, agreement between self-paced walking (ICC=0.85) and active working tasks step counts (ICC=0.80) was good. The smallest median difference was for sitting time (1.5seconds). During free-living conditions, sitting time (ICC=0.99) and stepping (ICC=0.92) showed excellent agreement, with a difference of 0.5minutes and 18 steps respectively. CONCLUSIONS: The W@W-App provided valid measures for monitoring occupational sedentary patterns in real life conditions; a key issue for increasing awareness and changing occupational sedentariness

Validation study of the Spanish version of the Last-7-d Sedentary Time Questionnaire (SIT-Q-7d-Sp) in young adults.

There are few valid instruments to assess domain-specific sedentary behaviours (SB) among Spanish-speaking populations. This study validated the original English version of the last 7 days SB questionnaire (SIT-Q-7d) into Spanish (Castilian). A total of 151 undergraduates (52% male, 21.19±2.57 yrs.) wore an activPAL3M (AP3M) for 7 days and subsequently completed the Spanish version of the SIT-Q-7d (SIT-Q-7d-Sp). A subsample of 30 participants (70% male, 22.89±1.54 yrs.) simultaneously wore the AP3M and used a domain-log to register the context where the SB occurred. The SIT-Q-7d-Sp differed significantly from the AP3M, overestimating sitting time by an average of 60.69 mins.d-1 (all p0.016). However, screen-based and other leisure-based sitting activities were significantly overestimated (ranging from 94.68 mins.d-1 to 234.08 mins.d-1, p<0.001). The SIT-Q-7d-Sp appears to provide acceptable estimates of sitting time during transportation, occupational and meal-based domains. The SIT-Q-7d-Sp is not an appropriate measure of SB when examining total sitting time and leisure-based SB in young adults. For total sitting time and leisure-based SB, the use of objective measures is recommended.KW was supported by the UK Medical Research Council (unit programme number MC_UU_12015/3). The authors like to thank Kate Westgate for their cooperation and for sharing their materials. In addition, the authors would like to thank the undergraduate students from the UVic-UCC to voluntary participated in the study

Multiple Cardiac Disease Detection from Minimal-Lead ECG Combining Feedforward Neural Networks with a One-vs-Rest Approach

[EN] Although standard 12-lead ECG is the primary technique in cardiac diagnostic, detecting different cardiac diseases using single or reduced number of leads is still challenging. The purpose of our team, itaca-UPV, is to provide a method able to classify ECG records using minimal lead information in the context of the 2021 PhysioNet/Computing in Cardiology Challenge, also using only a single-lead. We resampled and filtered the ECG signals, and extracted 109 features mostly based on Hearth Rhythm Variability (HRV). Then, we used selected features to train one feed-forward neural network (FFNN) with one hidden layer for each class using a One-vs-Rest approach, thus allowing each ECG to be classified as belonging to none or more than one class. Finally, we performed a 3-fold cross validation to assess the model performance. Our classifiers received scores of 0.34, 0.34, 0.27, 0.30, and 0.34 (ranked 26th, 21th, 29th, 25th, and 22th out of 39 teams) for the 12, 6, 4, 3 and 2-lead versions of the hidden test set with the Challenge evaluation metric. Our minimal-lead approach may be beneficial for novel portable or wearable ECG devices used as screening tools, as it can also detect multiple and concurrent cardiac conditions. Accuracy in detection can be improved adding more disease-specific features.Jiménez-Serrano, S.; Rodrigo Bort, M.; Calvo Saiz, CJ.; Castells, F.; Millet Roig, J. (2021). Multiple Cardiac Disease Detection from Minimal-Lead ECG Combining Feedforward Neural Networks with a One-vs-Rest Approach. 1-4. https://doi.org/10.22489/CinC.2021.1091

Online psychological interventions to improve symptoms in multiple sclerosis : A systematic review

The aim of this systematic review was to assess the effectiveness of Internet-based psychological interventions in the treatment of physical, socio-affective and cognitive symptoms and quality of life (QoL) in people with multiple sclerosis (pwMS) to provide currently available evidence. Systematic searches for eligible studies were carried out in four databases (August 2021) using key words. Studies were screened, data extracted, quality appraised and analysed by three independent reviewers, using predefined criteria and following the PRISMA rules. Study quality was assessed using Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields QUALSYST tool. Physical, socio-affective and cognitive symptoms and QoL were the primary outcomes. Thirteen studies were included. Two principal approaches were reported: Cognitive behavioural therapy (CBT) and mindfulness-based interventions (MBI). Interventions varied from tailored versions to videoconference by a clinician, duration mean 8 weeks, delivered via individually and groups, all online. The review found that iCBT interventions were effective for improve depression, anxiety, fatigue and QoL, and slightly in cognitive functioning in pwMS, whereas MBI interventions reported benefits in depression, anxiety, stress and QoL, and less evidence in fatigue. Generally, study quality was acceptable in most studies; eleven of the studies scored a low risk of bias on all items in the Qualsyst Tool, whereas only two studies were considered unacceptable. Psychological online interventions may improve physical, socio-affective and cognitive symptoms as well as QoL in pwMS, overcoming the face-to-face barriers (i.e. disability). Contact with the therapist and groups sessions have been identified as enablers of the online interventions. Nevertheless, the limited number of studies and the heterogeneity of health outcomes reported made difficult to afford robust conclusions on psychological intervention effects in pwMS

Assessing the Feasibility and Acceptability of a Primary Care Socio-Ecological Approach to Improve Physical Activity Adherence among People with Type 2 Diabetes : The SENWI Project

Ajuts: This research was funded by Col·legi de Fisioterapeutes de Catalunya (CFC), grant number R05/21.Maintaining an active lifestyle is a key health behavior in people with type 2 diabetes (T2D). This study assessed the feasibility and acceptability of a socio-ecological Nordic walking intervention (SENWI) to enhance healthy behaviors in primary healthcare settings. Participants included individuals with T2D (n = 33; age 70 (95% CI 69-74)) and healthcare professionals (HCPs, n = 3). T2D participants were randomly assigned to a SENWI, active comparator, or control group for twelve weeks. Feasibility and acceptability were evaluated based on a mixed methodology. Quantitative data reported adherence information, differences between follow-up and dropout participants and pre- and post-intervention on physical activity, sedentary behavior, and health outcomes. Qualitative data acquisition was performed using focus groups and semi-structured interviews and analyzed using thematic analysis. Thirty-three T2D invited participants were recruited, and twenty-two (66.7%) provided post-intervention data. The SENWI was deemed acceptable and feasible, but participants highlighted the need to improve options, group schedules, gender inequities, and the intervention's expiration date. Healthcare professionals expressed a lack of institutional support and resources. Nevertheless, no significant difference between the SENWI follow-up and dropout participants or pre- and post- intervention was found (only between the active comparator and control group in the physical quality of life domain). Implementing the SENWI in primary healthcare settings is feasible and acceptable in real-world conditions. However, a larger sample is needed to assess the program's effectiveness in improving healthy behaviors and its impact on health-related outcomes in the long term

Differences in Free-Living Patterns of Sedentary Behaviour between Office Employees with Diabetes and Office Employees without Diabetes: A Principal Component Analysis for Clinical Practice

Aims: To identify principal components of free-living patterns of sedentary behaviour in office employees with type 2 diabetes (T2D) compared to normal glucose metabolism (NGM) office employees, using principal component analysis (PCA). Methods: 213 office employees (n = 81 with T2D; n = 132 with NGM) wore an activPAL inclinometer 24 h a day for 7 consecutive days. Comparions of sedentary behaviour patterns between adults with T2D and NGM determined the dimensions that best characterise the sedentary behaviour patterns of office employees with T2D at work, outside work and at weekends. Results: The multivariate PCA technique identified two components that explained 60% of the variability present in the data of sedentary behaviour patterns in the population with diabetes. This was characterised by a fewer number of daily breaks and breaks in time intervals of less than 20 min both at work, outside work and at weekends. On average, adults with T2D took fewer 31 breaks/day than adults without diabetes. Conclusion: Effective interventions from clinical practice to tackle prolonged sedentary behaviour in office employees with T2D should focus on increasing the number of daily sedentary breaks.The study was funded by Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (PI17/01788), the Spanish Ministry of Science and Innovation (DEP2021-37169), grant Jose Luís Torres from redGDPS Foundation (redgdps/BJLTB/02/2022), the predoctoral research grant Isabel Fernández 2020 from the Spanish Society of Family and Community Medicine (semFYC) and another grant from the Càtedra Autonomous University of Barcelona (UAB)—Novartis for research in Family and Community Medicine. The funders had no role in the design, analysis, data interpretation or writing of the manuscript

Effectiveness of a healthcare-based mobile intervention on sedentary patterns, physical activity, mental well-being and clinical and productivity outcomes in office employees with type 2 diabetes: study protocol for a randomized controlled trial

Background: Prolonged sedentary time is associated with an increased incidence of chronic disease including type 2 diabetes mellitus (DM2). Given that occupational sedentary time contributes signifcantly to the total amount of daily sedentariness, incorporating programmes to reduce occupational sedentary time in patients with chronic disease would allow for physical, mental and productivity benefts. The aim of this study is to evaluate the short-, medium- and long-term efectiveness of a mHealth programme for sitting less and moving more at work on habitual and occupational sedentary behaviour and physical activity in ofce staf with DM2. Secondary aims. To evaluate the efectiveness on glycaemic control and lipid profle at 6- and 12-month follow-up; anthropometric profle, blood pres‑ sure, mental well-being and work-related post-intervention outcomes at 3, 6 and 12months. Methods: Multicentre randomized controlled trial. A sample size of 220 patients will be randomly allocated into a control (n=110) or intervention group (n=110), with post-intervention follow-ups at 6 and 12months. Health professionals from Spanish Primary Health Care units will randomly invite patients (18–65 years of age) diagnosed with DM2, who have sedentary ofce desk-based jobs. The control group will receive usual healthcare and information on the health benefts of sitting less and moving more. The intervention group will receive, through a smartphone app and website, strategies and real-time feedback for 13weeks to change occupational sedentary behaviour. Variables: (1) Subjective and objective habitual and occupational sedentary behaviour and physical activity (Workforce Sit‑ ting Questionnaire, Brief Physical Activity Assessment Tool, activPAL3TM); 2) Glucose, HbA1c; 3) Weight, height, waist circumference; 4) Total, HDL and LDL cholesterol, triglycerides; (5) Systolic, diastolic blood pressure; (6) Mental well being (Warwick-Edinburgh Mental Well-being); (7) Presenteeism (Work Limitations Questionnaire); (8) Impact of work on employees´ health, sickness absence (6th European Working Conditions Survey); (9) Job-related mental strain (Job Content Questionnaire). Diferences between groups pre- and post- intervention on the average value of the vari‑ ables will be analysed. Discussion: If the mHealth intervention is efective in reducing sedentary time and increasing physical activity in ofce employees with DM2, health professionals would have a low-cost tool for the control of patients with chronic disease.The study was funded by Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (PI17/01788) and the predoctoral research grant Isabel Fernández 2020 from the Spanish Society of Family and Community Medicine (semFYC). The funders had no role in the design, analysis, data interpretation or writing of the manuscript