Effectiveness of workplace interventions with digital elements to reduce sedentary behaviours in office employees: a systematic review and meta-analysis.

BACKGROUND: Digital interventions are potential tools for reducing and limiting occupational sedentary behaviour (SB) in sedentary desk-based jobs. Given the harmful effects of sitting too much and sitting for too long while working, the aim of this systematic review and meta-analysis was to examine the effectiveness of workplace interventions, that incorporated digital elements, to reduce the time spent in SB in office workers. METHODS: Randomised control trials that evaluated the implementation of workplace interventions that incorporated digital elements for breaking and limiting SB among desk-based jobs were identified by literature searches in six electronic databases (PubMed, Web of Science, Scopus, CINAHL, PsycINFO and PEDro) published up to 2023. Studies were included if total and/or occupational SB were assessed. Only studies that reported pre- and postintervention mean differences and standard deviations or standard errors for both intervention arms were used for the meta-analysis. The meta-analysis was conducted using Review Manager 5 (RevMan 5; Cochrane Collaboration, Oxford, UK). Risk of bias was assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields QUALSYST tool. RESULTS: Nineteen studies were included in the systematic review. The most employed digital elements were information delivery and mediated organisational support and social influences. Multicomponent, information, and counselling interventions measuring total and/or occupational/nonoccupational SB time by self-report or via device-based measures were reported. Multicomponent interventions were the most represented. Eleven studies were included in the meta-analysis, which presented a reduction of 29.9 (95% CI: -45.2, -14.5) min/8 h workday in SB (overall effect: Z = 3.81). CONCLUSIONS: Multicomponent interventions, using a wide range of digital features, have demonstrated effectiveness in reducing time spent in SB at the workplace among desk-based employees. However, due to hybrid work (i.e., work in the office and home) being a customary mode of work for many employees, it is important for future studies to assess the feasibility and effectiveness of these interventions in the evolving work landscape. TRIAL REGISTRATION: The review protocol was registered in the Prospero database (CRD42022377366).

A two-arm non-randomised trial of MedEx IMPACT: a community-based, physical activity behaviour change intervention for survivors of cancer.

PURPOSE: This two-arm non-randomised trial examined the short- and long-term effects of a usual care (UC) community-based exercise programme (MedEx Move On (MMO)), and UC combined with a physical activity (PA) behaviour change (BC) intervention (MedEx IMproved PA after Cancer Treatement (MedEx IMPACT)) on PA levels, cardiorespiratory fitness (CRF) and quality of life (QoL) among survivors of cancer. METHODS: Cancer survivors referred to MMO were recruited (n = 191; mean age (± SD) 56 (± 10y), 73% female). Eighty-seven participants were assigned to UC, and 104 participants were assigned to the MedEx IMPACT intervention group (MI). UC and MI both received twice-weekly supervised exercise classes for 12-weeks. MI also received an independent PA programme, 4 PA information sessions and a 1:1 exercise consultation during the 12-week programme. Assessments of physical and psycho-social health, including 6-day accelerometry, the 6-min time trial and the Functional Assessment of Cancer Therapy-General QoL questionnaire, were conducted at baseline (T1), post-intervention (T2) and 3 months following programme completion (T3). RESULTS: Linear mixed-model analyses of variance demonstrated significant main effects for time for both groups from T1 to T2 with increases in objectively measured daily steps (p < 0.05), CRF (p < .001) and QoL (p < .01), which were maintained for CRF (p < .001) at T3. MI participants also maintained increases achieved at T2, in steps and QoL, at T3 (p < 0.01). CONCLUSION: Twelve weeks of twice-weekly supervised exercise was effective in increasing PA, CRF and QoL among survivors of cancer. MI resulted in the maintenance of all improvements achieved 3 months following programme completion.

The effect of a pre- and post-operative exercise program versus standard care on physical activity and sedentary behavior of patients with esophageal and gastric cancer undergoing neoadjuvant treatment prior to surgery (the PERIOP-OG Trial): a randomized controlled trial†.

Neoadjuvant cancer treatment (NCT) reduces both physical fitness and physical activity (PA) levels, which can increase the risk of adverse outcomes in cancer patients. This study aims to determine the effect of exercise prehabilitation on PA and sedentary behavior (SB) in patients undergoing NCT and surgery for esophagogastric malignancies. This study is a randomized pragmatic controlled multi-center trial conducted across three Irish hospitals. Participants were aged ≥18 years scheduled for esophagectomy or gastrectomy and were planned for NCT and surgery. Participants were randomized to an exercise prehabilitation group (EX) that commenced following cancer diagnosis, continued to the point of surgery, and resumed following recovery from surgery for 6 weeks or to usual care (UC) who received routine treatment. The primary outcome measures were PA and SB. Between March 2019 and December 2020, 71 participants were recruited: EX (n = 36) or UC (n = 35). No significant differences were found between the EX group and UC group on levels of PA or SBs across all measured timepoints. Significant decreases in moderate-vigorous physical activity levels (MVPAs) were found between baseline and post-surgery (P = 0.028), pre-surgery and post-surgery (P = 0.001) and pre-surgery and 6-week follow-up (P = 0.022) for all participants. Step count also significantly decreased between pre-surgery and post-surgery (P < 0.001). Baseline aerobic fitness was positively associated to PA levels and negatively associated with SB. Esophagogastric cancer patients have lower than recommended levels of PA at the time of diagnosis and this decreased further following completion of NCT. An optional home- or group-based exercise intervention was not effective in improving PA levels or behaviors across the cancer treatment journey.

Results from Ireland North and South's 2022 report card on physical activity for children and adolescents.

Background: The Ireland North and South Report Card on Physical Activity (PA) for Children and Adolescents aims to monitor progress in PA participation across a range of internationally established indicators. Methods: Data were collated for 11 indicators and graded following the harmonised Active Healthy Kids Global Alliance report card process. Six representative studies (sample size range n = 898 to n = 15,557) were primarily used in the grading, with many indicators supplemented with additional studies and reports. Data collected since the implementation of COVID-19 public health measures in March 2020 were excluded. Results: Grades were awarded as follows: 'Overall physical activity', C-; 'Organised Sport and Physical Activity', C; 'Active Play', INC; 'Sedentary Behaviours', C-; 'Physical Fitness', INC; 'Family and Peers', D+; 'School', C-; 'Physical Education', D; 'Community and Environment', B+ and 'Government', B. Separate grades were awarded for disability as follows; 'Overall physical activity', F; 'Organised Sport and Physical Activity', D; 'Sedentary Behaviours', C-; 'Family and Peers', C; 'School', C- and 'Government', B. 'Active Play', 'Physical Fitness', 'Physical Education' and 'Community and Environment' were all graded INC for disability. Since the last report card in 2016, four grades remained the same, three increased ('Overall physical activity', 'School' and 'Physical Education') and two ('Family and Peers,' and 'Government') were awarded grades for the first time. Conclusion: Grades specific to children and adolescents with disability were generally lower for each indicator. While small improvements have been shown across a few indicators, PA levels remain low across many indicators for children and adolescents.

Health promoting sports clubs: from theoretical model to logic model.

A recent literature review indicated that the settings-based approach, as it is applied to sports clubs, is poorly understood and not well implemented. The current study builds on the health promoting sports clubs (HPSC) theoretical model as a basis for a settings-based approach in the sports setting and proposes a logic model to develop and evaluate HPSC in practice. The logic model was established through qualitative, iterative methods in the form of six meetings with eight experts in the field. Qualitative thematic coding was conducted on notes taken and contributions during and between meetings. The results describe a best-practice logic model of HPSC, including inputs, activities, outcomes and impacts at each HPSC level, while case studies illustrate the interactions between levels. Results indicate that a HPSC can have an impact at each level, from individual health to social and community capital. For a sports club, the logic model helps to define how the club's board or management committee can set the conditions for club managers and coaches to support members' health. External stakeholders to clubs are also recognized for their key responsibility in providing different types of resources to support sports clubs to be health promoting. Future research should focus on monitoring and evaluating at each level, including empirical testing system interactions as a whole and interactions across levels.

This article describes a logic model for health promoting sports clubs (HPSC), informed by a settings-based approach. It demonstrates how each of the seven levels of the HPSC model can request resources, implement activities to generate outcomes and impact at their level, as well as how these levels interact. This logic model offers explicit descriptions of the resources needed by stakeholders to develop health promotion (HP) activities. It also highlights the relationships between activities and outcomes, which are often made implicitly by sports club stakeholders, supporting the understanding about how HP can enhance a sports club's core business. This logic model can be used to develop interventions, and to support monitoring and evaluation of processes, activities and results to investigate how sports clubs promote health.

Development of the health promoting sports club-national audit tool.

BACKGROUND: Sports clubs have requested support from national governing authorities to invest in health promotion (HP), by developing policies, guidelines and dedicated funding. This article outlines the development of a national audit tool to review policies development and implementation to support HP in sports clubs. METHODS: A five-step process was undertaken by an international project team: (i) a rapid literature review to identify items assessing policies in physical activity, HP and sports, (ii) a thematic analysis to categorize items, (iii) a Delphi method to analyze item relevance, country specificity, reformulation, validation and organization, (iv) face validity through an online survey and in-depth interviews with expert representatives on physical activity and sports and (v) audit tool finalization though project team consensus. RESULTS: Eight sources were reviewed with 269 items identified. Items were coded into 25 categories with 3 broad themes: policies, actors and settings-based approach. The Delphi study extracted and refined 50 items and categorized them into 10 sections. After revisions from 22 surveys and 8 interviews, consensus was reached by the international project team on 41 items categorized into 11 sections: Role of ministry or department; Policies; Communication; Implementation and Dissemination; Evaluation and Measurement methods; Sub-national-level policies; Funding and Coordination; Participative approach; Actors and Stakeholders; National sporting events; Case studies and Implicated stakeholders. CONCLUSION: To progress HP in the sports club context it is necessary to understand existing national-level policies. This national audit tool will aid in monitoring and assessing national policies for health promoting sports clubs.

The Influence of Sitting, Standing, and Stepping Bouts on Cardiometabolic Health Markers in Older Adults.

Aside from total time spent in physical activity behaviors, how time is accumulated is important for health. This study examined associations between sitting, standing, and stepping bouts, with cardiometabolic health markers in older adults. Participants from the Mitchelstown Cohort Rescreen Study (N = 221) provided cross-sectional data on activity behaviors (assessed via an activPAL3 Micro) and cardiometabolic health. Bouts of ≥10-, ≥30-, and ≥60-min sitting, standing, and stepping were calculated. Linear regression models were fitted to examine the associations between bouts and cardiometabolic health markers. Sitting (≥10, ≥30, and ≥60 min) and standing (≥10 and ≥30 min) bouts were detrimentally associated with body composition measures, lipid markers, and fasting glucose. The effect for time spent in ≥60-min sitting and ≥30-min standing bouts was larger than shorter bouts. Fragmenting sitting with bouts of stepping may be targeted to benefit cardiometabolic health. Further insights for the role of standing need to be elicited.

Seasonal changes in the physical activity levels of youth Gaelic football players.

This study quantified changes in physical activity (PA) levels attained by adolescents during Gaelic football (GF) participation across two time points in a season and determined if these changes affected their overall daily PA levels. A total of 130 adolescents (65 females;15.3 ± 1.5 years) wore an activPAL accelerometer to determine total moderate PA (MPA), vigorous PA (VPA) and moderate-to-vigorous PA (MVPA) during a seven-day measurement period, including during GF. The PA measurement was completed at "preseason" (T1) and "in-season" (T2) timepoints. Between T1 and T2, females significantly increased time spent in MVPA daily (p < 0.001, d = 0.95), on Gaelic football days (GFDs) (p = 0.036; d = 0.30), on non-Gaelic football days (NGFDs) (p < 0.001; d = 0.43), and during GF (p < 0.001, d = 0.90). Males did not record any significant changes in PA over time (p > 0.05). At T2, there were no significant differences in time spent in MVPA daily, on GFDs and NGFDs, and during GF between the genders (p > 0.05). The results suggest that the change in daily PA levels by females is a consequence of increased MVPA during GF and reduced PA barriers across the season.

The Contribution of Gaelic Football Participation to Youth Physical Activity Levels.

The primary aim of this study was to describe the contribution of Gaelic football participation to youth physical activity (PA) levels. Secondary aims were to objectively quantify the overall daily PA levels of participants across sex and age, to determine the PA levels achieved during Gaelic football practice sessions and games, and to compare PA levels on days with organized sporting activity (sports days) and days without organized sporting activity (non-sports days). One hundred and sixty adolescents (87 male, 73 female; mean age 14.5 ± 1.8 yrs.) wore an activPAL accelerometer to determine total sitting/lying time, standing time, light intensity physical activity (LIPA), moderate physical activity (MPA), vigorous physical activity (VPA) and moderate-to-vigorous physical activity (MVPA) during a seven day measurement period, including during Gaelic football participation. Participants achieved an average of 58.5 ± 23.6 minutes of MVPA daily. Males accumulated significantly more MVPA daily than females (Males=70.8±22.1 min; Females = 45.5 ± 16.5 min; p < 0.001; ηp² = 0.401) and time spent in MVPA daily significantly decreased with age (p < 0.001; ηp² = 0.299). Participants accumulated significantly more MVPA during games (36.0 ± 9.2 min/hr (60%)) than practice sessions (29.0 ± 8.3 min/hr (48%); p < 0.001; d = 0.80). On sports days, participants accumulated significantly more time in MVPA (Sports Days = 70.1 ± 36.0 min; Non-Sports Days = 54.2 ± 34.0; p < 0.001; d = 0.45) and were 2.16 times more likely to achieve 60 minutes of MVPA (OR = 2.16; 95% CI = 1.60-2.92) than on non-sports days. The results reveal that Gaelic football provides an opportunity for adolescents to accumulate PA, however, participants currently spent more than 50% of their practice time inactive or in low intensity activities. An opportunity remains to enhance the contribution of Gaelic football to overall daily PA levels, by replacing time spent inactive with time in MVPA.

A systematic literature review of reviews on techniques for physical activity measurement in adults: a DEDIPAC study.

The links between increased participation in Physical Activity (PA) and improvements in health are well established. As this body of evidence has grown, so too has the search for measures of PA with high levels of methodological effectiveness (i.e. validity, reliability and responsiveness to change). The aim of this "review of reviews" was to provide a comprehensive overview of the methodological effectiveness of currently employed measures of PA, to aid researchers in their selection of an appropriate tool. A total of 63 review articles were included in this review, and the original articles cited by these reviews were included in order to extract detailed information on methodological effectiveness.Self-report measures of PA have been most frequently examined for methodological effectiveness, with highly variable findings identified across a broad range of behaviours. The evidence-base for the methodological effectiveness of objective monitors, particularly accelerometers/activity monitors, is increasing, with lower levels of variability observed for validity and reliability when compared to subjective measures. Unfortunately, responsiveness to change across all measures and behaviours remains under-researched, with limited information available.Other criteria beyond methodological effectiveness often influence tool selection, including cost and feasibility. However, researchers must be aware of the methodological effectiveness of any measure selected for use when examining PA. Although no "perfect" tool for the examination of PA in adults exists, it is suggested that researchers aim to incorporate appropriate objective measures, specific to the behaviours of interests, when examining PA in free-living environments.

ActivPAL™ determined sedentary behaviour, physical activity and academic achievement in college students.

The aim of this study was to examine relationships between activPAL™-determined sedentary behavior (SB) and physical activity (PA) with academic achievement. A total of 120 undergraduates (N = 57 female; 20.6 ± 2.3 years) participated in the study. Academic achievement was measured as the grade point average obtained from all completed courses. Participants wore on the right tight an activPAL™ for 7 days to determine total sedentary time, total number of sedentary breaks, sedentary bouts, standing time, light and moderate-to-vigorous physical activity (MVPA). Separate multiple linear regression models were performed to examine associations between SB variables and academic achievement. Light PA, MVPA, total sedentary time, total standing time, or total number of sedentary breaks were not related to academic achievement. Independently of PA, the amount of time spent in sedentary bouts of 10-20min during weekdays was positively related to academic achievement. Given that college students spend the majority of their workday in environments that encourage prolonged sitting, these data suggest that interruptions in prolonged periods of sitting time every 10-20min via short breaks may optimize cognitive operations associated with academic performance.

Activity Profiles and the Associations With Weight Status in Population Studies of Young Children: Are There Gender Differences?

PURPOSE: Profiling activity behaviors in young children is important to understand changes in weight status over time. The purpose of this study is to identify activity profiles from self- and parental-reported Physical Activity (PA) and Sedentary Behavior (SB) variables by gender, and determine if the identified profiles are predictive of weight change from age 9-13 years. METHODS: Cluster analysis was used to generate activity profiles for the National Longitudinal Study of 8570 9-year-old children (Growing Up in Ireland). RESULTS: 5.4% of boys were found to be obese. Four cohesive activity profiles were identified for boys, with 7.3% of boys in the least active group identified as obese compared with 4.1% in the most active group. The odds of a normal weight 9-year-old boy in the least active profile becoming overweight or obese at age 13 were over twice those in most active profile (OR = 2.5, 95% CI: 1.9, 3.5). No coherent activity profiles were identified for girls. CONCLUSIONS: This study suggests that self- and parental-reported data can identify meaningful activity profiles for boys, which are predictive of weight changes over time. Future research should consider potential gender differences in self- and parental-reported PA and SB variables.

Minimum Wear Duration for the activPAL Professional Activity Monitor in Adolescent Females.

OBJECTIVES: This study aims to determine the minimum number of days of monitoring required to reliably predict sitting/lying time, standing time, light intensity physical activity (LIPA), moderate-to-vigorous intensity physical activity (MVPA) and steps in adolescent females. METHOD: 195 adolescent females (mean age = 15.7 years; SD = 0.9) participated in the study. Participants wore the activPAL activity monitor for a seven day protocol. The amount of time spent sitting/lying, standing, in LIPA and in MVPA and the number of steps per day were quantified. Spearman-Brown Prophecy formulae were used to predict the number of days of data required to achieve an intraclass correlation coefficient of both 0.7 and 0.8. RESULTS: For the percentage of the waking day spent sitting/lying, standing, in LIPA and in MVPA, a minimum of 9 days of accelerometer recording is required to achieve a reliability of ≥ 0.7, while a minimum of 15 days is required to achieve a reliability of ≥ 0.8. For steps, a minimum of 12 days of recording is required to achieve a reliability of ≥ 0.7, with 21 days to achieve a reliability of ≥ 0.8. CONCLUSION: Future research in adolescent females should collect a minimum of 9 days of accelerometer data to reliably estimate sitting/lying time, standing time, LIPA and MVPA, while 12 days is required to reliably estimate steps.

The Development of Activity Profiles in Adolescent Females and their Association with Adiposity.

OBJECTIVES: This study aims to (1) use the objective activPAL activity monitor to assess physical activity behaviors, including sitting/lying, standing, and both light (LIPA) and moderate-to-vigorous physical activity (MVPA); (2) to develop distinct activity profiles based on time spent in each behavior in a sample of adolescent females; and (3) examine whether levels of adiposity differ across these activity profiles. METHODS: Female adolescents (n = 195; 14-18 y) had body mass index (median = 21.7 [IQR = 5.2] kg/m2) and 4-site skinfold thickness (median 62.0 mm; IQR = 37.1) measured. Physical activity behaviors were measured using the activPAL. Hierarchical cluster analysis grouped participants into activity profiles based on similar physical activity characteristics. Linear mixed models explored differences in body composition across activity profiles. RESULTS: Three activity profiles were identified, a low (n = 35), moderate (n = 110), and a high activity profile (n = 50). Significant differences across activity profiles were observed for skinfold thickness (p = .046), with higher values observed in the low activity profile compared with the high activity profile. CONCLUSIONS: Profiling free-living activity using behaviors from across the activity intensity continuum may account for more of the variability in energy expenditure then examining specific activity intensities, such as MVPA alone. The use of activity profiles may enable the identification of individuals with unhealthy activity behaviors, leading to the development and implementation of more targeted interventions.

Health promoting sports federations: theoretical foundations and guidelines.

Background: Researchers and policy-makers have highlighted that the potential for organized sports to promote health has been underexploited. Sports clubs have limited capacity to promote health due to their voluntary nature and have called for support from their national sports federations. The present article provides guidelines, based on the theoretical principles of health promoting sports clubs and an analysis of practical tools and proven strategies, to support national sports federations to invest in health promotion (HP). Methods: A qualitative iterative study was undertaken, based on five 2-h meetings of a group of 15 international researchers in HP in sports clubs. Notes and minutes from meetings, as well as shared outputs were analyzed based on the health promoting sports club framework. Results: Guidelines developed for national sports federations to promote health includes a definition of a health promoting sports federation (HPSF), a description of how the settings-based approach to HP adapts to national sports federations, as well as practical applications of health promoting sports club's intervention strategies. The analysis of existing tools also demonstrated that most tools are centered on a single dimension of health (social, mental, physical, spiritual or community), and often on a specific health topic. Furthermore, they do not cover HP as a continuous long-lasting process, but are generally short-term programs. The HPSF clarifies theoretical concepts, their practical implementation via case studies and outlines intervention components and tools useful for sports federations in their implementation of HP. Conclusion: The guidelines developed in this study are intended to facilitate national sports federations to acknowledge/understand, reinforce/underpin and foster current and further investment in HP.

A steps/minute value for moderate intensity physical activity in adolescent females.

The number of steps/minute (i.e., cadence) that equates to moderate intensity in adolescents is not known. To that end, 31 adolescent females walked on a treadmill at 5 different speeds while wearing an ActivPAL accelerometer and oxygen uptake was recorded by indirect calorimetry. The relationship between metabolic equivalents (METs) and cadence was explored using 3 different analytical approaches. Cadence was a significant predictor of METs (r = .70; p < .001). Moderate intensity (3 METs) corresponded to 94 or 114 steps/minute based on the mixed model and ROC analysis, respectively. These two values, and a practical value of 100 steps/minute, were cross-validated on an independent sample of 33 adolescent females during over-ground walking at 3 speeds. The sensitivity and specificity of each value correctly identifying 3 METs were 98.5% and 87.2% for 94 steps/minute, 72.9% and 98.8 for 114 steps/minute and 96.5% and 95.7% for 100 steps/minute. Compromising on a single cadence of 100 steps/minute would be a practical value that approximates moderate intensity in adolescent females and can be used for physical activity interpretation and promotion.

Study protocol for the investigation of the clinical effectiveness of a physical activity behaviour change intervention for individuals living with and beyond cancer.

Most individuals living with and beyond cancer are not sufficiently active to achieve the health benefits associated with regular physical activity (PA). The purpose of this study was to describe the study protocol for a two-arm non-randomised comparison trial conducted within a community-based setting, which aimed to investigate the clinical effectiveness of a cancer-specific PA behaviour change (BC) intervention, namely MedEx IMPACT (IMprove Physical Activity after Cancer Treatment), compared to a general exercise rehabilitation programme, among survivors of cancer. Individuals who had completed active-cancer treatment who were referred to a community-based exercise rehabilitation programme were invited to participate in the trial. Participants in the control group (CG) attended twice-weekly supervised exercise classes for 12 weeks. Classes were delivered as part of a chronic illness exercise rehabilitation programme. Participants in the MedEx IMPACT intervention group (IG) also attended the twice-weekly supervised exercise classes for 12 weeks and received cancer-specific materials, namely an independent PA programme, 4 PA information sessions and a 1:1 exercise consultation. The primary outcome was PA levels measured by 6-day accelerometry and self-report PA. Secondary outcomes included cardiorespiratory fitness (CRF), quality of life (QoL) and sedentary behaviour. Outcomes were measured at baseline and months 3, 6 and 12. Few effective PA BC interventions for individuals living with and beyond cancer have been identified. The results of this study will have implications for the planning and provision of community-based exercise oncology rehabilitation programmes for individuals living with and beyond cancer.

A Standardised Core Outcome Set for Measurement and Reporting Sedentary Behaviour Interventional Research: The CROSBI Consensus Study.

Heterogeneity of descriptors and outcomes measured and reported in sedentary behaviour (SB) research hinder the meta-analysis of data and accumulation of evidence. The objective of the Core Research Outcomes for Sedentary Behaviour Interventions (CROSBI) consensus study was to identify and validate, a core outcome set (COS) to report (what, how, when to measure) in interventional sedentary behaviour studies. Outcomes, extracted from a systematic literature review, were categorized into domains and data items (COS v0.0). International experts (n = 5) provided feedback and identified additional items, which were incorporated into COS v0.1. A two round online Delphi survey was conducted to seek consensus from a wider stakeholder group and outcomes that achieved consensus in the second round COS (v0.2), were ratified by the expert panel. The final COS (v1.0) contains 53 data items across 12 domains, relating to demographics, device details, wear-time criteria, wear-time measures, posture-related measures, sedentary breaks, sedentary bouts and physical activity. Notably, results indicate that sedentary behaviour outcomes should be measured by devices that include an inclinometry or postural function. The proposed standardised COS is available openly to enhance the accumulation of pooled evidence in future sedentary behaviour intervention research and practice.

Cross-sectional analysis of levels and patterns of objectively measured sedentary time in adolescent females.

BACKGROUND: Adolescent females have been highlighted as a particularly sedentary population and the possible negative effects of a sedentary lifestyle are being uncovered. However, much of the past sedentary research is based on self-report or uses indirect methods to quantity sedentary time. Total time spent sedentary and the possible intricate sedentary patterns of adolescent females have not been described using objective and direct measure of body inclination. The objectives of this article are to examine the sedentary levels and patterns of a group of adolescent females using the ActivPAL™ and to highlight possible differences in sedentary levels and patterns across the week and within the school day. A full methodological description of how the data was analyzed is also presented. METHODS: One hundred and eleven adolescent females, age 15-18 yrs, were recruited from urban and rural areas in the Republic of Ireland. Participants wore an ActivPAL physical activity monitor for a 7.5 day period. The ActivPAL directly reports total time spent sitting/lying every 15 seconds and accumulation (frequency and duration) of sedentary activity was examined using a customized MATLAB(®) computer software programme. RESULTS: While no significant difference was found in the total time spent sitting/lying over the full 24 hour day between weekday and weekend day (18.8 vs. 18.9 hours; p = .911), significantly more sedentary bouts of 1 to 5 minutes and 21 to 40 minutes in duration were accumulated on weekdays compared to weekend days (p < .001). The mean length of each sedentary bout was also longer (9.8 vs. 8.8 minutes; p < .001). When school hours (9 am-3 pm) and after school hours (4 pm-10 pm) were compared, there was no difference in total time spent sedentary (3.9 hours; p = .796) but the pattern of accumulation of the sedentary time differed. There were a greater number of bouts of > 20 minutes duration during school hours than after school hours (4.7 vs. 3.5 bouts; p < .001) while after school time consisted of shorter bouts < 20 minutes. CONCLUSIONS: School is highlighted as a particularly sedentary setting for adolescent females. Interventions to decrease sedentary time at school and the use of wearable devices which distinguish posture should be encouraged when examining sedentary patterns and behaviors in this population.

Monitoring Occupational Sitting, Standing, and Stepping in Office Employees With the W@W-App and the MetaWearC Sensor: Validation Study.

BACKGROUND: Replacing occupational sitting time with active tasks has several proposed health benefits for office employees. Mobile phones and motion sensors can provide objective information in real time on occupational sitting behavior. However, the validity and feasibility of using mobile health (mHealth) devices to quantify and modify occupational sedentary time is unclear. OBJECTIVE: The aim of this study is to validate the new Walk@Work-Application (W@W-App)-including an external motion sensor (MetaWearC) attached to the thigh-for measuring occupational sitting, standing, and stepping in free-living conditions against the activPAL3M, the current gold-standard, device-based measure for postural behaviors. METHODS: In total, 20 office workers (16 [80%] females; mean age 39.5, SD 8.1 years) downloaded the W@W-App to their mobile phones, wore a MetaWearC sensor attached to their thigh using a tailored band, and wore the activPAL3M for 3-8 consecutive working hours. Differences between both measures were examined using paired-samples t tests and Wilcoxon signed-rank tests. Agreement between measures was examined using concordance correlation coefficients (CCCs), 95% CIs, Bland-Altman plots (mean bias, 95% limits of agreement [LoA]), and equivalence testing techniques. RESULTS: The median recording time for the W@W-App+MetaWearC and the activPAL3M was 237.5 (SD 132.8) minutes and 240.0 (SD 127.5) minutes, respectively (P<.001). No significant differences between sitting (P=.53), standing (P=.12), and stepping times (P=.61) were identified. The CCC identified substantial agreement between both measures for sitting (CCC=0.98, 95% CI 0.96-0.99), moderate agreement for standing (CCC=0.93, 95% CI 0.81-0.97), and poor agreement for stepping (CCC=0.74, 95% CI 0.47-0.88). Bland-Altman plots indicated that sitting time (mean bias -1.66 minutes, 95% LoA -30.37 to 20.05) and standing time (mean bias -4.85 minutes, 95% LoA -31.31 to 21.62) were underreported. For stepping time, a positive mean bias of 1.15 minutes (95% LoA -15.11 to 17.41) was identified. Equivalence testing demonstrated that the estimates obtained from the W@W-App+MetaWearC and the activPAL3M were considered equivalent for all variables excluding stepping time. CONCLUSIONS: The W@W-App+MetaWearC is a low-cost tool with acceptable levels of accuracy that can objectively quantify occupational sitting, standing, stationary, and upright times in real time. Due to the availability of real-time feedback for users, this tool can positively influence occupational sitting behaviors in future interventions. TRIAL REGISTRATION: ClinicalTrials.gov NCT04092738; https://clinicaltrials.gov/ct2/show/NCT04092738.