BackgroundIt is estimated that global dementia rates will more than triple by 2050 and result in a staggering economic burden on families and societies. Dementia carries significant physical, psychological and social challenges for individuals and caregivers. Informal caregiving is common and increasing as more people with dementia are being cared for at home instead of in nursing homes. Caregiver burden is associated with lower perceived health, lower social coherence, and increased risk of morbidity and mortality. The aim of this trial is to evaluate the effects of information and communication technology (ICT) on caregiver burden among informal caregivers of people with dementia by reducing the need for supervision.Methods/designThis randomized controlled trial aims to recruit 320 dyads composed of people with dementia living in community settings and their primary informal caregivers. In the intervention group, people with dementia will have a home monitoring kit installed in their home while dyads in the control group will receive usual care. The ICT kit includes home-leaving sensors, smoke and water leak sensors, bed sensors, and automatic lights that monitor the individual’s behavior. Alerts (text message and/or phone call) will be sent to the caregiver if anything unusual occurs. All study dyads will receive three home visits by project administrators who have received project-specific training in order to harmonize data collection. Home visits will take place at enrollment and 3 and 12 months following installation of the ICT kit. At every home visit, a standardized questionnaire will be administered to all dyads to assess their health, quality of life and resource utilization. The primary outcome of this trial is the amount of informal care support provided by primary informal caregivers to people with dementia.DiscussionThis is the first randomized controlled trial exploring the implementation of ICT for people with dementia in a large sample in Sweden and one of the first at the international level. Results hold the potential to inform regional and national policy-makers in Sweden and beyond about the cost-effectiveness of ICT and its impact on caregiver burden.Trial RegistrationClinicalTrials.gov, NCT02733939. Registered on 10 March 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1796-8) contains supplementary material, which is available to authorized users.

In the past decade, sedentary behaviour has emerged as a distinct health concern, 1 yet health promotion researchers, policy makers and practitioners have only begun to pay attention to it quite recently. Importantly, sedentary behaviour is distinct from both physical activity and physical inactivity. Whereas physical inactivity is a broad category that can be used to characterize groups of people whose level of activity falls below a given threshold, sedentary behaviours are specific practices characterized by little physical movement and low energy expenditure such as sitting and watching television, using a computer, reading, occupational sitting and using motorized transportation.2 A review of promising interventions in sedentary behaviour conducted by the British Columbia Centre of Excellence for Women's Health in 2012/2013 suggests that there are currently few health promotion interventions targeting sedentary behaviour; in fact, the majority of interventions in the field focus on increasing physical activity, not reducing sedentary time or sedentary behaviours per se.In 2011, the Canadian Society for Exercise Physiology (CSEP), in collaboration with ParticipACTION and with support from the Public Health Agency of Canada, undertook a literature review on sedentary behaviour that informed the world's first evidence-based sedentary behaviour guidelines.3 Designed for children and youth aged 0-17 years, the guidelines suggest that children and youth should spend no more than 1-2 hours per day on recreational screen time (depending on age) and that time spent on sedentary transportation and extended sitting should be limited throughout the day.3 Although guidelines on sedentary behaviour are encouraging, we note that the CSEP guidelines do not consider adults, despite data suggesting that the majority of adults spend a considerable amount of time being sedentary each day, nor sex and gender, despite compelling evidence for the integration of a sex-and gender-based approach to research and policy on sedentary behaviour. We argue that the current guidelines need to be expanded to consider the impact of sex and gender in sedentary behaviour and that guidelines for adults should be developed in order to increase the efficacy of research, policy and practice in reducing sedentary behaviours and their negative health outcomes. We also argue that there is a need to consider women's and men's diversity as well as to address their differential access to resources, opportunities and power as these factors may shape sedentary behaviour. "One-sizefits-all" approaches that do not understand and address unfair differences may not only lead to ineffective interventions but also to policies and practices that deepen health disparities and inequities. Sex and gender considerations in sedentary behaviourAccelerometer results from the Canadian Health Measures Survey (CHMS) [2007][2008][2009] suggest that women and men are equally sedentary: men spend on average 9.6 hours per day sedentary and women spend 9.8 hours.4 Girls and bo...

This review examined the breadth of gender-sensitive tobacco and alcohol interventions that target girls and women. A comprehensive review of databases and websites was conducted in 2011/2012 for interventions that focused on girls and women health, incorporated an understanding of sex and/or gender, engaged with the determinants of women's health, and sought to reduce gender-related social and health inequities. Results of the review suggest that interventions designed with an understanding of the effect of gender roles, norms, and behaviors on women's health are limited and that much work remains to encourage practitioners to use a gender-sensitive approach when designing interventions.