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

Mother-offspring correlation for pedometer-assessed physical activity (Fleurbaix-Laventie Ville-Santé II study).

<p>Data are interclass correlation coefficients (95%CI) of number of steps standardized for sex and age. Data for physical activity during leisure time are from the Modifiable Activity Questionnaire. The total number of clusters can differ from maximal number of clusters (283) because of missing data.</p

Characteristics of the subjects (Fleurbaix-Laventie Ville-Santé II study).

<p>Values are expressed as mean ± standard deviation, or median and interquartiles. Data for leisure time and walking are from the Modifiable Activity Questionnaire.</p

Pedometer counts (steps per day) (Fleurbaix-Laventie Ville-Santé II study).

<p>Values are daily medians and interquartiles.</p

Familial correlations for pedometer-assessed physical activity (Fleurbaix-Laventie Ville-Santé II study).

<p>Data are correlation coefficients (95%CI) of number of steps standardized for sex and age.</p><p>Maximal number of clusters because for each coefficient computation data could be missing.</p

Associations between time spent in sedentary behaviors (min/day) and cognitive function (N = 2,579) ^a.

<p>T2, T3: tertile of time spent in each of the sedentary behaviors.</p><p>Tertile 1 used as reference.</p>a<p>Values are mean difference (95% confidence interval) in cognitive scores, lowest category as reference.</p>b<p>P for trend across categories.</p>c<p>model a (crude): interval between sedentary behavior assessment and cognitive evaluation.</p>d<p>model b: model a + age, gender, supplementation group, education, occupational categories, retirement status.</p>e<p>model c: model b + tobacco use status, BMI, CES-D score, general health status, history of cardiovascular diseases, diabetes and hypertension.</p>f<p>model d: model c + leisure-time physical activity, remaining sedentary behaviors (TV, reading, computer according to main exposure).</p

Longitudinal associations between change in sedentary behaviors over 6 years and cognitive function after removing participants with the lowest cognitive performance scores (eg, below the education level-specific tenth percentile) (N = 2,321)^a.

<p>T2, T3: tertile of change in time spent in each of the sedentary behaviors.</p><p>Tertile 1 used as reference.</p>a<p>Values are mean difference (95% confidence interval) in cognitive scores, lowest category as reference.</p>b<p>P for trend across categories.</p>c<p>model a (crude): interval between first sedentary behavior assessment and cognitive evaluation.</p>d<p>model b: model a + age, gender, supplementation group, education, occupational categories, time-dependent retirement status + baseline value.</p>e<p>model c: model b + tobacco use status, BMI, CES-D score, general health status, history of cardiovascular diseases, diabetes and hypertension.</p>f<p>model d: model c + delta of leisure-time physical activity, delta of remaining sedentary behaviors.</p

Baseline and follow-up sociodemographic and behavioral characteristics of the participants (N = 2,579) ^a.

<p>CES-D, Center for Epidemiologic Studies Depression Scale.</p>a<p>At baseline (1994).</p>b<p>At the SU.VI.MAX 2 examination (2007–2009).</p

Iron intake and serum concentration of iron, ferritin and hemoglobin in patients undergoing GBP and AGB at baseline and during the follow-up.

<p>Results are expressed as means ± SEMs; significant differences if p<0.05. * represents significant differences between T0 and T1. ■ represents significant differences between T1 and T3.° represents significant differences between T0 and T3. * in red represents significant differences between AGB and GBP. <b>A</b>: Iron food intake in patients operated from bypass surgery at baseline and during the follow-up. <b>B</b>: Iron food intake in patients operated from AGB surgery at baseline and during the follow-up (<i>Black bars represent iron intake from food and open bars those from mineral supplementation given orally</i>. <i>Blue line represents the recommended intake per day to cover people’s need)</i>. <b>C</b>: Serum ferritin concentrations at baseline and 1 and 3 months after the surgery. Dark grey represents bypass patients and light grey AGB patients (<i>Lower red line represents the value below which iron deficiency is defined</i>, <i>the higher line represent the upper limit for normal ferritin levels)</i> <b>D</b>: Serum iron concentrations at baseline and 1 and 3 months after the surgery. Dark grey represents bypass patients and light grey AGB patients (<i>Lower red line represents the value below which defines iron deficiency</i>, <i>the higher line represent the limit for toxicity)</i>. <b>E</b>: Serum hemoglobin at baseline and 1 and 3 months after the surgery. Dark grey represents bypass patients and light grey AGB patients (<i>Lower red line represents cutoff for anemia)</i>.</p

Energy, food, and macronutrient intakes according to the surgical models at baseline and 1 and 3 months.

<p>Energy, food, and macronutrient intakes according to the surgical models at baseline and 1 and 3 months.</p