Exploring the context of sedentary behaviour in older adults (what, where, why, when and with whom)

BACKGROUND: Older adults are the most sedentary segment of the population. Little information is available about the context of sedentary behaviour to inform guidelines and intervention. There is a dearth of information about when, where to intervene and which specific behaviours intervention should target. The aim of this exploratory study was to obtain objective information about what older adults do when sedentary, where and when they are sedentary and in what social context. METHODS: The study was a cross-sectional data collection. Older adults (Mean age = 73.25, SD ± 5.48, median = 72, IQR = 11) volunteers wore activPAL monitors and a Vicon Revue timelapse camera between 1 and 7 days. Periods of sedentary behaviour were identified using the activPAL and the context extracted from the pictures taken during these periods. Analysis of context was conducted using the Sedentary Behaviour International Taxonomy classification system. RESULTS: In total, 52 days from 36 participants were available for analysis. Participants spent 70.1 % of sedentary time at home, 56.9 % of sedentary time on their own and 46.8 % occurred in the afternoon. Seated social activities were infrequent (6.9 % of sedentary bouts) but prolonged (18 % of sedentary time). Participants appeared to frequently have vacant sitting time (41 % of non-screen sedentary time) and screen sitting was prevalent (36 % of total sedentary time). CONCLUSIONS: This study provides valuable information to inform future interventions to reduce sedentary behaviour. Interventions should consider targeting the home environment and focus on the afternoon sitting time, though this needs confirmation in a larger study. Tackling social isolation may also be a target to reduce sedentary time

Reliability and validity of three questionnaires measuring context-specific sedentary behaviour and associated correlates in adolescents, adults and older adults

BACKGROUND: Reliable and valid measures of total sedentary time, context-specific sedentary behaviour (SB) and its potential correlates are useful for the development of future interventions. The purpose was to examine test-retest reliability and criterion validity of three newly developed questionnaires on total sedentary time, context-specific SB and its potential correlates in adolescents, adults and older adults. METHODS: Reliability and validity was tested in six different samples of Flemish (Belgium) residents. For the reliability study, 20 adolescents, 22 adults and 20 older adults filled out the age-specific SB questionnaire twice. Test-retest reliability was analysed using Kappa coefficients, Intraclass Correlation Coefficients and/or percentage agreement, separately for the three age groups. For the validity study, data were retrieved from 62 adolescents, 33 adults and 33 older adults, with activPAL as criterion measure. Spearman correlations and Bland-Altman plots (or non-parametric approach) were used to analyse criterion validity, separately for the three age groups and for weekday, weekend day and average day. RESULTS: The test-retest reliability for self-reported total sedentary time indicated following values: ICC = 0.37-0.67 in adolescents; ICC = 0.73-0.77 in adults; ICC = 0.68-0.80 in older adults. Item-specific reliability results (e.g. context-specific SB and its potential correlates) showed good-to-excellent reliability in 67.94%, 68.90% and 66.38% of the items in adolescents, adults and older adults respectively. All items belonging to sedentary-related equipment and simultaneous SB showed good reliability. The sections of the questionnaire with lowest reliability were: context-specific SB (adolescents), potential correlates of computer use (adults) and potential correlates of motorized transport (older adults). Spearman correlations between self-reported total sedentary time and the activPAL were different for each age group: rho = 0.02-0.42 (adolescents), rho = 0.06-0.52 (adults), rho = 0.38-0.50 (older adults). Participants over-reported total sedentary time (except for weekend day in older adults) compared to the activPAL, for weekday, weekend day and average day respectively by +57.05%, +46.29%, +53.34% in adolescents; +40.40%, +19.15%, +32.89% in adults; +10.10%, -6.24%, +4.11% in older adults. CONCLUSIONS: The questionnaires showed acceptable test-retest reliability and criterion validity. However, over-reporting of total SB was noticeable in adolescents and adults. Nevertheless, these questionnaires will be useful in getting context-specific information on SB

Developing a systems-based framework of the factors influencing dietary and physical activity behaviours in ethnic minority populations living in Europe - a DEDIPAC study

Background: Some ethnic minority populations have a higher risk of non-communicable diseases than the majority European population. Diet and physical activity behaviours contribute to this risk, shaped by a system of inter-related factors. This study mapped a systems-based framework of the factors influencing dietary and physical activity behaviours in ethnic minority populations living in Europe, to inform research prioritisation and intervention development. Methods: A concept mapping approach guided by systems thinking was used: i. Preparation (protocol and terminology); ii. Generating a list of factors influencing dietary and physical activity behaviours in ethnic minority populations living in Europe from evidence (systematic mapping reviews) and ‘eminence’ (89 participants from 24 academic disciplines via brainstorming, an international symposium and expert review) and; iii. Seeking consensus on structuring, rating and clustering factors, based on how they relate to each other; and iv. Interpreting/utilising the framework for research and interventions. Similar steps were undertaken for frameworks developed for the majority European population. Results: Seven distinct clusters emerged for dietary behaviour (containing 85 factors) and 8 for physical activity behaviours (containing 183 factors). Four clusters were similar across behaviours: Social and cultural environment; Social and material resources; Psychosocial; and Migration context. Similar clusters of factors emerged in the frameworks for diet and physical activity behaviours of the majority European population, except for ‘migration context’. The importance of factors across all clusters was acknowledged, but their relative importance differed for ethnic minority populations compared with the majority population. Conclusions: This systems-based framework integrates evidence from both expert opinion and published literature, to map the factors influencing dietary and physical activity behaviours in ethnic minority groups. Our findings illustrate that innovative research and complex interventions need to be developed that are sensitive to the needs of ethnic minority populations. A systems approach that encompasses the complexity of the inter-related factors that drive behaviours may inform a more holistic public health paradigm to more effectively reach ethnic minorities living in Europe, as well as the majority host population

The frequency of osteogenic activities and the pattern of intermittence between periods of physical activity and sedentary behaviour affects bone mineral content: the cross-sectional NHANES study

BACKGROUND: Sedentary behaviours, defined as non exercising seated activities, have been shown to have deleterious effects on health. It has been hypothesised that too much sitting time can have a detrimental effect on bone health in youth. The aim of this study is to test this hypothesis by exploring the association between objectively measured volume and patterns of time spent in sedentary behaviours, time spent in specific screen-based sedentary pursuits and bone mineral content (BMC) accrual in youth. METHODS: NHANES 2005–2006 cycle data includes BMC of the femoral and spinal region via dual-energy X-ray absorptiometry (DEXA), assessment of physical activity and sedentary behaviour patterns through accelerometry, self reported time spent in screen based pursuits (watching TV and using a computer), and frequency of vigorous playtime and strengthening activities. Multiple regression analysis, stratified by gender was performed on N = 671 males and N = 677 females aged from 8 to 22 years. RESULTS: Time spent in screen-based sedentary behaviours is negatively associated with femoral BMC (males and females) and spinal BMC (females only) after correction for time spent in moderate and vigorous activity. Regression coefficients indicate that an additional hour per day of screen-based sitting corresponds to a difference of −0.77 g femoral BMC in females [95% CI: -1.31 to −0.22] and of −0.45 g femoral BMC in males [95% CI: -0.83 to −0.06]. This association is attenuated when self-reported engagement in regular (average 5 times per week) strengthening exercise (for males) and vigorous playing (for both males and females) is taken into account. Total sitting time and non screen-based sitting do not appear to have a negative association with BMC, whereas screen based sedentary time does. Patterns of intermittence between periods of sitting and moderate to vigorous activity appears to be positively associated with bone health when activity is clustered in time and inter-spaced with long continuous bouts of sitting. CONCLUSIONS: Some specific sedentary pursuits (screen-based) are negatively associated with bone health in youth. This association is specific to gender and anatomical area. This relationship between screen-based time and bone health is independent of the total amount of physical activity measured objectively, but not independent of self-reported frequency of strengthening and vigorous play activities. The data clearly suggests that the frequency, rather than the volume, of osteogenic activities is important in counteracting the effect of sedentary behaviour on bone health. The pattern of intermittence between sedentary periods and activity also plays a role in bone accrual, with clustered short bouts of activity interspaced with long periods of sedentary behaviours appearing to be more beneficial than activities more evenly spread in time

Utilization and Harmonization of Adult Accelerometry Data: Review and Expert Consensus.

PURPOSE: This study aimed to describe the scope of accelerometry data collected internationally in adults and to obtain a consensus from measurement experts regarding the optimal strategies to harmonize international accelerometry data. METHODS: In March 2014, a comprehensive review was undertaken to identify studies that collected accelerometry data in adults (sample size, n ≥ 400). In addition, 20 physical activity experts were invited to participate in a two-phase Delphi process to obtain consensus on the following: unique research opportunities available with such data, additional data required to address these opportunities, strategies for enabling comparisons between studies/countries, requirements for implementing/progressing such strategies, and value of a global repository of accelerometry data. RESULTS: The review identified accelerometry data from more than 275,000 adults from 76 studies across 36 countries. Consensus was achieved after two rounds of the Delphi process; 18 experts participated in one or both rounds. The key opportunities highlighted were the ability for cross-country/cross-population comparisons and the analytic options available with the larger heterogeneity and greater statistical power. Basic sociodemographic and anthropometric data were considered a prerequisite for this. Disclosure of monitor specifications and protocols for data collection and processing were deemed essential to enable comparison and data harmonization. There was strong consensus that standardization of data collection, processing, and analytical procedures was needed. To implement these strategies, communication and consensus among researchers, development of an online infrastructure, and methodological comparison work were required. There was consensus that a global accelerometry data repository would be beneficial and worthwhile. CONCLUSIONS: This foundational resource can lead to implementation of key priority areas and identification of future directions in physical activity epidemiology, population monitoring, and burden of disease estimates.This work, and authors involved in this work were supported by the UK Medical Research Council (grants MC_UU_12015/3 and MRC Centenary Award to KWi, SB); the British Heart Foundation (grant FS/12/58/29709 to KWi); the Australian Heart Foundation (grant PH 12B 7054 to GNH); the Australian National Health and Medical Research Council (Fellowship to NO; Program grant to NO; NHMRC Centre for Research Excellence Grant in the Translational Science of Sedentary Behaviour APP1041056 to GNH, NO, DD); an Australian Postgraduate Award (to SS); The Coca-Cola Company, Body Media, U.S. National Institutes of Health, and Technogym (to SB); MRC, Chartered Society of Physiotherapy, EPSRC, Greater Manchester Academic Health Science Network (to MG); Australian Research Council (Future Fellowship: FT100100918 to DD).This is the final published version. It first appeared at http://dx.doi.org/10.1249/MSS.000000000000066

Measuring group and individual relationship between patterns in sedentary behaviour and glucose in type 2 diabetes adults

The aim of this study was to explore the relationship between patterns in sedentary behaviour and glucose in adults with type 2 diabetes. Thirty‐seven adults with type 2 diabetes managed with diet and/or anti‐diabetes medication (not insulin) were recruited. Participants wore an activPAL accelerometer and FreeStyle Libre flash glucose monitor for continuous measurement of activity and glucose for 24 hours/day for three to 14 days while documenting sleep, food and medication. The relationship between daily patterns of sedentary behaviour and sedentary breaks with glucose was investigated using correlation analysis. Regression analysis was used to investigate these relationships at an individual level. Participants (mean age 62.8±10.5 years, BMI 29.6±6.8kg/m2) spent 64% of their day sedentary, 44.7% of sedentary bouts were 30–60 minutes in duration and mean bout duration was 47.2 minutes. No association between mean glucose and sedentary proportion (total sedentary time) was identified. Mean glucose and glucose standard deviation were positively correlated with sedentary bout duration (both p<0.05). Individual regression analysis showed increased sedentary time is associated with increased mean glucose in 25 (68%) of the participants, with a negative association being shown in 12 (32%) of the participants. In analysis of the whole group, sedentary bout duration but not sedentary proportion was associated with mean glucose and glucose variability. Individual regression analysis identified a different relationship pattern for the majority of participants. This is the first study to identify an individualised response to activity behaviour and highlights the importance of conducting individual analysis when using continuous measurement methods

A systematic review of determinants of sedentary behaviour in youth: a DEDIPAC- study

Abstract Sedentary behaviour (SB) has emerged as a potential risk factor for metabolic health in youth. Knowledge on the determinants of SB in youth is necessary to inform future intervention development to reduce SB. A systematic review was conducted to identify predictors and determinants of SB in youth. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched, limiting to articles in English, published between January 2000 and May 2014. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour, (b) determinants, (c) types of sedentary behaviours, (d) types of determinants. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Cross-sectional studies were excluded. The analysis was guided by the socio-ecological model. 37 studies were selected out of 2654 identified papers from the systematic literature search. Most studies were conducted in Europe (n = 13), USA (n = 11), and Australia (n = 10). The study quality, using the Qualsyst tool, was high with a median of 82 % (IQR: 74-91 %). Multiple potential determinants were studied in only one or two studies. Determinants were found at the individual, interpersonal, environmental and policy level but few studies examined a comprehensive set of factors at different levels of influences. Evidence was found for age being positively associated with total SB, and weight status and baseline assessment of screen time being positively associated with screen time (at follow-up). A higher playground density and a higher availability of play and sports equipment at school were consistently related to an increased total SB, although these consistent findings come from single studies. Evidence was also reported for the presence of safe places to cross roads and lengthening morning and lunch breaks being associated with less total SB. Future interventions to decrease SB levels should especially target children with overweight or obesity and should start at a young age. However, since the relationship of many determinants with SB remains inconsistent, there is still a need for more longitudinal research on determinants of SB in youth

Lisää ja enemmän! : Perheiden kokemuksia avoimesta varhaiskasvatustoiminnasta Limingassa

Opinnäytetyön tavoitteena oli kartoittaa, minkälaisia kokemuksia asiakasperheillä on avoimen varhaiskasvatustoiminnan perheryhmistä ja lasten ryhmistä Limingan kunnassa. Tarkoituksena oli myös tutkia, minkälaisia kehittämisehdotuksia perheillä on toiminnalle. Limingan kunta sai tutkimuksen avulla tietoa siitä, onko avoimen varhaiskasvatustoiminnan järjestäminen vastannut sille asetettuihin tavoitteisiin. Tutkimuksen aineisto koottiin lomakekyselyllä kaikilta avoimia varhaiskasvatuspalveluita käyttäneiltä perheiltä. Aineisto analysoitiin sekä määrällisiä menetelmiä käyttäen että luokittelemalla ja teemoittelemalla. Opinnäytetyön tulosten mukaan avoin varhaiskasvatustoiminta on vastannut hyvin sille asetettuihin tavoitteisiin. Vanhemmat arvostavat kovasti omia ja lastensa sosiaalisia suhteita ja ne ovatkin suurin yksittäinen syy avoimeen varhaiskasvatustoimintaan osallistumiselle Limingassa. Vertaisryhmä koetaan tärkeäksi sekä perheryhmässä että lasten leikkitoiminnan ryhmissä. Tutkimustulosten mukaan ryhmässä toimimisen taidot ja kaveritaidot ovat niitä asioita, joiden oppimisen vuoksi liminkalaiset vanhemmat haluavat lastensa osallistuvan avoimeen varhaiskasvatustoimintaan ja näihin taitoihin liittyviin toimintoihin oltiin hyvin tyytyväisiä. Vastaajat olivat tyytyväisiä toimintaan tällaisenaan. Avointa varhaiskasvatustoimintaa toivottiin kuitenkin lisää. Vanhemmat toivovat myös kasvatuskeskusteluja lastentarhanopettajan kanssa sekä kasvatusaiheisia luentoja.The aim of the thesis was to identify what kind of experiences families had of open early childhood education activities for both family groups and children’s groups in the municipality of Liminka. The aim was also to examine what kind of development proposals the families had for the service. With the help of the study the municipality of Liminka received information on how the open early childhood education activities had reached the goals set for them. The research data was collected by using a questionnaire addressed to all the families that had used the open early childhood education services. The data was analysed by using quantitative methods as well as classification and themes. According to the results of the thesis, the open early childhood education services had reached the set targets quite well. The parents highly appreciated their own and their children's social relationships, and this was the biggest single reason for participating in the open early childhood education activities in Liminka. A peer group was considered important both in family groups and in the children's play groups. According to the results, it was because of learning group work and friendship skills that the parents wanted their children to participate in the open early childhood education activities. Moreover, the parents were satisfied with the activities related to these skills. The respondents were satisfied with the services as they were. However, they also wanted more open early childhood education services. The parents also wanted educational discussions with the kindergarten teachers as well as educational lectures