Purpose: Accumulating evidence suggests that sedentary behaviour (SB) is associated with poor health outcomes, even after adjustment for physical activity (PA) levels. SB at any age may have significant consequences for health and well-being. Therefore, the need to develop behaviour-specific, multicomponent, complex interventions that incorporate effective strategies to reduce SB are essential in addressing this novel risk factor.

Methods: A systematic review and meta-analysis was conducted investigating the impact of interventions targeting sedentary behaviour across the lifespan. Six databases were searched and two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias and complexity of each of the included studies.

Results: A total of 78 adult interventions and 83 interventions in children were included. A total of five studies conducted in community-dwelling older adults (three randomised controlled trials) were included in the meta-analyses. The overall risk of bias of these five studies was low. Results on sedentary behaviour were inconclusive due to heterogeneity (-19.61mins/day; 95% CI -66.88, 27.67; n=381; p=0.42; I2=89%). The majority of these five studies relied on education and psychological approaches.

The findings of the overall review demonstrated that interventions may induce relevant reductions in daily sedentary time; however, the heterogeneity in reported outcomes, intervention components and control arms (no intervention/alternative intervention) prevented us from drawing more firmer conclusions from the evidence provided. The complexity assessment also suggested that interventions may be complex to address the challenges of a complex system, but a higher complexity score is not necessarily associated with better outcomes in terms of sustained long-term changes.

Conclusions: Future interventions studies should apply more rigorous methods to improve research quality; considering larger sample sizes, randomised controlled designs and valid and reliable measures of SB.

Purpose: Preliminary evidence suggests that web-based interventions with tailored advice and Fitbits may be well suited for older adults. 

Methods: This study aimed to test the effectiveness of ‘Active for Life,’ a 12-week complex web-based physical activity intervention for older adults. The intervention includes 6 modules of computer-tailored physical activity advice, an action planning tool and an exercise library. A total of 243 participants were randomly assigned to one of three trial arms: 1) tailoring+ Fitbit, 2) tailoring only, or 3) wait-list control. The tailored advice was based on either participants’ Fitbit data (tailoring+ Fitbit) or self-reported physical activity (tailoring only). The Active Australia Survey was used to assess total physical activity (total PA) and moderate to vigorous physical activity (MVPA) at baseline and week 12. Intention-to-treat linear mixed model analyses were used to test for group differences on changes in total PA and MVPA. 

Results: The 12-week assessment was completed by 166 participants (32% attrition). All 6 modules were completed by 69% of tailoring+ Fitbit participants and 58% of tailoring only participants. The tailoring+ Fitbit participants increased their weekly minutes of total PA from 154.64 (103.80-205.47) to 332.20 (249.59-414.81), the tailoring only participants from 170.62 (127.53-213.72) to 322.47 (246.39-398.55) and the control from 147.95 (100.13-195.76) to 342.25 (263.77-420.73). The tailoring+ Fitbit participants' increase in total PA did not significantly differ to the tailoring only (p=.67) or control (p=.78) participants. The tailoring+ Fitbit participants increased their weekly minutes of MVPA from 57.83 (30.54-85.11) to 156.02 (106.33-205.72), the tailoring only from 58.02 (34.89-81.15) to 86.68 (40.81-132.54) and the control from 49.74 (24.08-75.40) to 81.32 (33.98-128.67). The tailoring+ Fitbit participants increased their MVPA significantly more than the tailoring only (p=.04) and control (p=.05) participants. 

Conclusions: A complex computer-tailored web-based physical activity intervention with Fitbits for older adults increased MVPA compared to the intervention without Fitbits and a wait-list control. 

Purpose: The SITLESS study aimed to design and assess a complex intervention to reduce sedentary behaviour (SB) and increase physical activity (PA) in community-dwelling older adults. Both behaviours are important determinants of health in older adults. We aimed to describe the design of the SITLESS intervention and the baseline composition of objectively measured SB and PA in older adults, and to assess socio-demographic and functional correlates of engaging in higher levels of SB in participants of a multi-center study including four European countries. We will provide preliminary results of its effect on health and function, due to be analysed in February 2020.

Methods: The SITLESS intervention was designed combining existing PA programmes with self-management strategies (outcome expectations, self-monitoring, goal setting on PA and SB and social support) that address individual, social and environmental factors. 1360 community-dwelling older adults from the SITLESS study (61.8% women; 75.3±6.3 years) completed a self-reported SB questionnaire and wore an ActiGraph accelerometer for seven days. Accelerometer-determined compositional descriptive statistics were calculated. A fixed effects regression analysis was conducted to assess the socio-demographic (country, age, sex, civil status, education and medications) and functional (BMI, and gait speed) correlates.

Results: Older adults spent 80.5% of waking time in SB, 17.8% in light-intensity PA (LPA), and 1.7% in moderate to vigorous PA (MVPA). Watching television and reading accounted for 47.2% of waking time. Older age, being a man, single, taking more medications, being obese and overweight, and having a slower gait speed were statistically significant correlates of more sedentary time.

Conclusions: Our sample showed a high proportion of daily sedentary time. With an ever ageing European population this study justifies the need to develop and evaluate interventions to reduce sitting time with non-sitting activities, especially during television viewing. The distribution of context-specific sedentary activities by country and sex showed minor differences.