Patterns of sedentary behavior in overweight and moderately obese users of the Catalan primary-health care system

Background and objectives Prolonged sitting time (ST) has negative consequences on health. Changing this behavior is paramount in overweight/obese individuals because they are more sedentary than those with normal weight. The aim of the study was to establish the pattern of sedentary behavior and its relationship to health, socio-demographics, occupation, and education level in Catalan overweight/obese individuals. Methods A descriptive study was performed at 25 healthcare centers in Catalonia (Spain) with 464 overweight/moderately obese patients, aged25 to 65 years. Exclusion criteria were chronic diseases which contraindicated physical activity and language barriers. Face-to-face interviews were conducted to collect data on age, gender, educational level, social class, and marital status. Main outcome was ‘sitting time’ (collected by the Marshall questionnaire); chronic diseases and anthropometric measurements were registered. Results 464 patients, 58.4% women, mean age 51.9 years (SD 10.1), 76.1% married, 60% manual workers, and 48.7% had finished secondary education. Daily sitting time was 6.2 hours on working days (374 minutes/day, SD: 190), and about 6 hours on non-working ones (357 minutes/day, SD: 170). 50% of participants were sedentary 6 hours. The most frequent sedentary activities were: working/academic activities around 2 hours (128 minutes, SD: 183), followed by watching television, computer use, and commuting. Men sat longer than women (64 minutes more on working days and 54 minutes on non-working days), and individuals with office jobs (91 minutes), those with higher levels of education (42 minutes), and younger subjects (25 to 35 years) spent more time sitting. Conclusions In our study performed in overweight/moderately obese patients the mean sitting time was around 6 hours which was mainly spent doing work/academic activities and watching television. Men, office workers, individuals with higher education, and younger subjects had longer sitting time. Our results may help design interventions targeted at these sedentary patients to decrease sitting time.

The Effect of a Physical Activity Program on the Total Number of Primary Care Visits in Inactive Patients: A 15-Month Randomized Controlled Trial

Abstract Background: Effective promotion of exercise could result in substantial savings in healthcare cost expenses in terms of direct medical costs, such as the number of medical appointments. However, this is hampered by our limited knowledge of how to achieve sustained increases in physical activity. Objectives: To assess the effectiveness of a Primary Health Care (PHC) based physical activity program in reducing the total number of visits to the healthcare center among inactive patients, over a 15-month period. Research Design: Randomized controlled trial. Subjects: Three hundred and sixty-two (n = 362) inactive patients suffering from at least one chronic condition were included. One hundred and eighty-three patients (n = 183; mean (SD); 68.3 (8.8) years; 118 women) were randomly allocated to the physical activity program (IG). One hundred and seventy-nine patients (n = 179; 67.2 (9.1) years; 106 women) were allocated to the control group (CG). The IG went through a three-month standardized physical activity program led by physical activity specialists and linked to community resources. Measures: The total number of medical appointments to the PHC, during twelve months before and after the program, was registered. Self-reported health status (SF-12 version 2) was assessed at baseline (month 0), at the end of the intervention (month 3), and at 12 months follow-up after the end of the intervention (month 15). Results: The IG had a significantly reduced number of visits during the 12 months after the intervention: 14.8 (8.5). The CG remained about the same: 18.2 (11.1) (P = .002). Conclusions: Our findings indicate that a 3-month physical activity program linked to community resources is a shortduration, effective and sustainable intervention in inactive patients to decrease rates of PHC visits. Trial Registration: ClinicalTrials.gov NCT0071483

Prolonged Sitting Time: Barriers, Facilitators and Views on Change among Primary Healthcare Patients Who Are Overweight or Moderately Obese

Background and Objectives Prolonged sitting time has negative consequences on health, although the population is not well aware of these harmful effects. We explored opinions expressed by primary care patients diagnosed as overweight or moderately obese concerning their time spent sitting, willingness to change, and barriers, facilitators, goals and expectations related to limiting this behaviour. Methods A descriptive-interpretive qualitative study was carried out at three healthcare centres in Barcelona, Spain, and included 23 patients with overweight or moderate obesity, aged 25 to 65 years, who reported sitting for at least 6 hours a day. Exclusion criteria were inability to sit down or stand up from a chair without help and language barriers that precluded interview participation. Ten in-depth, semi-structured interviews (5 group, 5 individual) were audio recorded from January to July 2012 and transcribed. The interview script included questions about time spent sitting, willingness to change, barriers and facilitators, and the prospect of assistance from primary healthcare professionals. An analysis of thematic content was made using ATLAS.Ti and triangulation of analysts. Results The most frequent sedentary activities were computer use, watching television, and motorized journeys. There was a lack of awareness of the amount of time spent sitting and its negative consequences on health. Barriers to reducing sedentary time included work and family routines, lack of time and willpower, age and sociocultural limitations. Facilitators identified were sociocultural change, free time and active work, and family surroundings. Participants recognized the abilities of health professionals to provide help and advice, and reported a preference for patient-centred or group interventions. Conclusions Findings from this study have implications for reducing sedentary behaviour. Patient insights were used to design an intervention to reduce sitting time within the frame of the SEDESTACTIV clinical trial

Cómo identificar la inactividad física en atención primaria: validación de las versiones catalana y española de 2 cuestionarios breves

Objetivo: El Brief Physical Activity Assessment Tool (BPAAT) y General Practice Physical Activity Questionnaire (GPPAQ) son instrumentos breves y válidos para identificar pacientes «físicamente inactivos» en consulta. Este estudio evalúa la fiabilidad y validez de su versión catalana (CBPAAT-CGPPAQ) y espa˜nola (CBPAAT-EGPPAQ) ante la inexistencia de instrumentos similares validados en nuestro medio. Dise˜no: Evaluación psicométrica de la adaptación cultural y lingüística al catalán/espa˜nol de 2 instrumentos de medida. Emplazamiento: centros de atención primaria. Participantes: La carga de administración de los cuestionarios se evaluó en 7 profesionales sanitarios y 44 pacientes. Su validez de constructo y fiabilidad test-retest se evaluó en 105 pacientes (58 a˜nos ± 20; 37% hombres) sin contraindicaciones para hacer actividad física (AF). Mediciones principales: Después de efectuar la traducción directa e inversa, la validez de constructo midió el grado de acuerdo de dichas versiones con el Cuestionario Internacional de AF (IPAQ) versión corta. La fiabilidad test-retest se evaluó repitiendo el cuestionario en un intervalo de 14-28 días.Resultados: El CBPAAT-EBPAAT mostró un grado de acuerdo moderado con el IPAQ coincidiendo en un 80 y 83% de los casos «inactivos». Presentaron una buena fiabilidad test-retest, coincidiendo en un 86 y un 88% de la clasificación. El CGPPAQ-EGPPAQ mostró un grado de acuerdo moderado con el IPAQ, coincidiendo en un 70 y 60% de los casos «inactivos». Presentaron una buena fiabilidad test-retest, coincidiendo en la clasificación de un 82 y 72% de los casos. Conclusiones: El CBPAAT-CGPPAQ y EBPAAT-EGPPAQ presentan una validez aceptable para identificar en consulta a pacientes físicamente inactivos.Objective: The Brief Physical Activity Assessment Tool (BPAAT) and the General Practice Physical Activity Questionnaire (GPPAQ) are valid and reliable assessment tools to identify ‘‘inactive’’ patients in primary care. No similar tools exist for the Spanish population. The study aimed to evaluate the reliability and validity of the Catalan and Spanish versions (CBPAAT-CGPPAQ; CBPAAT-EGPPAQ) of such tools. Design: Validation study of the linguistic and cultural adaptation of two questionnaires into Catalan/Spanish. Setting: Centres of Primary Care. Participants: The load for administering the questionnaires was evaluated by 7 general practitioners and 44 patients. Construct validity and reliability was assessed in 105 patients (58 years old ± 20; 37% men) without any contraindication for physical activity (PA). Main variables: After carrying out the translation and back-translation, construct validity was assessed against the International Physical Activity Questionnaire (IPAQ short form). Reliability was assessed administering the questionnaires again within 14 to 28 days. Results: The validity of the CBPAAT-EBPAAT showed a moderate percentage agreement, correctly classifying over 80% and 83% of the ‘‘inactive’’ cases. Reliability was also good, correctly classifying over 86% and 88% of the cases. The validity of the CGPPAQ-EGPPAQ showed a moderate percentage agreement, correctly classifying over 70% and 60% of the ‘‘inactive’’ cases. Reliability was good, correctly classifying over 82% and 72% of the cases. Conclusions: The CBPAAT-CGPPAQ and EBPAAT-EGPPAQ are valid instruments to identify ‘‘inactive’’ patients that should receive advice on PA

Prolonged Sitting Time: Barriers, Facilitators and Views on Change among Primary Healthcare Patients Who Are Overweight or Moderately Obese

Prolonged sitting time has negative consequences on health, although the population is not well aware of these harmful effects. We explored opinions expressed by primary care patients diagnosed as overweight or moderately obese concerning their time spent sitting, willingness to change, and barriers, facilitators, goals and expectations related to limiting this behaviou

Prolonged Sitting Time : Barriers, Facilitators and Views on Change among Primary Healthcare Patients Who Are Overweight or Moderately Obese

Background and Objectives: Prolonged sitting time has negative consequences on health, although the population is not well aware of these harmful effects. We explored opinions expressed by primary care patients diagnosed as overweight or moderately obese concerning their time spent sitting, willingness to change, and barriers, facilitators, goals and expectations related to limiting this behaviour. Methods: A descriptive-interpretive qualitative study was carried out at three healthcare centres in Barcelona, Spain, and included 23 patients with overweight or moderate obesity, aged 25 to 65 years, who reported sitting for at least 6 hours a day. Exclusion criteria were inability to sit down or stand up from a chair without help and language barriers that precluded interview participation. Ten in-depth, semi-structured interviews (5 group, 5 individual) were audio recorded from January to July 2012 and transcribed. The interview script included questions about time spent sitting, willingness to change, barriers and facilitators, and the prospect of assistance from primary healthcare professionals. An analysis of thematic content was made using ATLAS.Ti and triangulation of analysts. Results: The most frequent sedentary activities were computer use, watching television, and motorized journeys. There was a lack of awareness of the amount of time spent sitting and its negative consequences on health. Barriers to reducing sedentary time included work and family routines, lack of time and willpower, age and sociocultural limitations. Facilitators identified were sociocultural change, free time and active work, and family surroundings. Participants recognized the abilities of health professionals to provide help and advice, and reported a preference for patient-centred or group interventions. Conclusions: Findings from this study have implications for reducing sedentary behaviour. Patient insights were used to design an intervention to reduce sitting time within the frame of the SEDESTACTIV clinical trial