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Office workers who transitioned to working from home are spending an even higher percentage of their workday sitting compared with being “in-office” and this is an emerging health concern. With many office workers continuing to work from home since the onset of the COVID-19 pandemic, it is imperative to have a validated self-report questionnaire to assess sedentary behavior, break frequency, and duration, to reduce the cost and burden of using device-based assessments. This secondary analysis study aimed to validate the modified Last 7-Day Sedentary Behavior Questionnaire (SIT-Q 7d) against an activPAL4™ device in full-time home-based “office” workers (n = 148; mean age = 44.90). Participants completed the modified SIT-Q 7d and wore an activPAL4 for a full work week. The findings showed that the modified SIT-Q 7d had low (ρ = .35–.37) and weak (ρ = .27–.28) criterion validity for accurate estimates of break frequency and break duration, respectively. The 95% limits of agreement were large for break frequency (26.85–29.01) and medium for break duration (5.81–8.47), indicating that the modified SIT-Q 7d may not be appropriate for measuring occupational sedentary behavior patterns at the individual level. Further validation is still required before confidently recommending this self-report questionnaire to be used among this population to assess breaks in sedentary time.

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BACKGROUND To date, most group-based type 2 diabetes (T2D) self-management education (DSME) programs have been delivered in-person. The rapid transition to virtual care at the outset of the COVID-19 pandemic presented opportunities to test, evaluate, and iterate a new virtual DSME program. OBJECTIVE To refine the delivery and evaluation of a multi-component virtual DSME program for adults living with T2D by examining several feasibility outcomes. METHODS Patients from a London, Canada outpatient diabetes clinic (serving high-risk, low-income adults) were recruited to participate in a six-week, single cohort feasibility study (ORBIT Phase 1b) from November 2020 to March 2021. A virtual DSME program including live video education classes, individualized physical activity (PA) prescription and counselling, as well as intermittently scanned continuous glucose and wearable PA monitoring was delivered. Several outcomes were assessed including recruitment and retention rates, program adherence, and acceptability (i.e., technology issues, exit survey feedback). PA was assessed with a FitBit Inspire 2 and estimated glycated hemoglobin (A1C) using the FreeStyle Libre. Given the small sample, data are reported descriptively and at the group and participant level. RESULTS Ten adults living with T2D were recruited (% female: 60, Age: 49.9±14.3 years, estimated A1C: 6.2±0.5%). Recruitment and retention rates were 29% and 80%, respectively. Participants attended 83% and 93% of education classes and PA counselling phone calls, respectively. There were 3.2±2.6 technology issues reported per person, mostly related to study data transfer. Exit survey responses suggest most participants (89%) were ‘satisfied’ with the program. Participants achieved 7103±2900 and 7515±3169 steps per day at baseline and Study Week 6, respectively. Estimated A1C was 6.2±0.5% and 6.2±0.6% at baseline and Study Week 6, respectively. CONCLUSIONS Though the virtual DSME program showed promise, several program and study protocol refinements are recommended before conducting a larger pilot trial (ORBIT Phase 2a). CLINICALTRIAL ClinicalTrials.gov NCT04498819

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The effects of adding choice architecture to a theory-based (Health Action Process Approach; HAPA) sedentary intervention remain unknown. To investigate whether choice architecture enhances a theory-based sedentary behaviour reduction intervention in home-based office workers. A 4-week HAPA-based intervention was conducted in London, Canada. Choice architecture was tested as an enhancement via a two (group: ‘Choice of Intervention’ vs. ‘No Choice Intervention’) by two (time: Baseline vs. Week 4) factorial repeated measure randomized comparison design. Sedentary behaviour reduction strategies focussed on obtaining a sedentary break frequency (BF) of every 30–45 min with break durations (BD) of 2–3 min. BF, BD, sitting, standing, and moving time were objectively measured (activPAL4™) at both time points. Participants (n = 148) were 44.9 ± 11.4 years old and 72.3% female. BF and total sitting time showed a time effect (P < .001), where both groups improved over the 4 weeks; there were no significant differences between groups across time. BD, standing, and moving time had a significant group by time effect where the ‘No Choice’ group showed significant increases in BD (P < .001), standing (P = .006), and moving time (P < .001) over the 4 weeks. Augmenting a theory-based intervention with choice architecture resulted in change in some sedentary behaviours in at home office workers. Specifically, while BF increased for all participants, the ‘No Choice’ group exhibited greater changes for BD, standing, and moving time compared with the ‘Choice’ group. Overall, these changes exceeded the intervention BF and BD goals.