Environmental, behavioural and multicomponent interventions to reduce adults' sitting time: a systematic review and meta-analysis

Abstract

ObjectiveTo examine the overall effectiveness of interventions for reducing adult sedentary behaviour and to directly compare environmental, behavioural and multicomponent interventions.DesignIntervention systematic review with meta-analysis.Data sourcesOvid PsycINFO, Ovid MEDLINE, EBSCOHost CINAHL, EBSCOHost SPORTDiscus and PubMed were searched from inception to 26 July 2017.Eligibility criteriaTrials including randomised controlled trials, quasi-randomised, cluster-randomised, parallel group, prepost, factorial and crossover trials where the primary aim was to change the sedentary behaviour of healthy adults assessed by self-report (eg, questionnaires, logs) or objective measures (eg, accelerometry).ResultsThirty-eight trials of 5983 participants published between 2003 and 2017 were included in the qualitative synthesis; 35 studies were included in the quantitative analysis (meta-analysis). The pooled effect was a significant reduction in daily sitting time of −30.37 min/day (95% CI −40.86 to −19.89) favouring the intervention group. Reductions in sitting time were similar between workplace (−29.96 min/day; 95% CI −44.05 to –15.87) and other settings (−30.47 min/day; 95% CI −44.68 to –16.26), which included community, domestic and recreational environments. Environmental interventions had the largest reduction in daily sitting time (−40.59 min/day; 95% CI −61.65 to –19.53), followed by multicomponent (−35.53 min/day; 95% CI −57.27 to –13.79) and behavioural (−23.87 min/day; 95% CI −37.24 to –10.49) interventions.ConclusionInterventions targeting adult sedentary behaviour reduced daily sitting time by an average of 30 min/day, which was likely clinically meaningful.

The effectiveness and complexity of interventions targeting sedentary behaviour across the lifespan: a systematic review and meta-analysis

“…Our findings are supported by previous systematic reviews in adults [23,27,29,30], demonstrating that the interventions had a positive effect on reducing SB. In line with the findings from Peachey et al which included studies published up to July 2017 [27], the findings from this review demonstrated the greatest reduction in sitting time from environmental interventions. These findings are interesting considering that the global complexity scores in environmental interventions were considerably lower than that of behavioural and mixed interventions.…”

“…They found significant associations with sitting-to-standing reallocations included small-to-medium reductions in fasting plasma glucose (2%), triglycerides (11%) and total/HDLcholesterol ratio (6%) while sitting-to-stepping reallocations were significantly associated with medium reductions in body mass index (11%), waist circumference (7.5cm), triglycerides (14%) and two-hour plasma glucose (11%) [193]. Despite the comparatively smaller reductions in SB time found in our review, these changes in SB could still have a clinically meaningful impact on adult's health as a 30-minute per day reduction in daily sitting time has been suggested as an effective target for observing long-term health benefits in another systematic review [27].…”

“…While there is limited information about the minimal amount of SB change required to produce meaningful health benefits, a recent systematic review by Peachey et al [27] suggested that a 30-minute per day reduction in SB could be an effective threshold for observing longterm health benefits, such as improving cardiometabolic risk biomarkers. One of the main challenges when assessing the effectiveness of interventions, is addressing the issues that arise when a range of approaches have been applied and a variety of components are included in the intervention design to improve the same outcome.…”

“…reduce SB) that can be applied to intervention development. Although a number of previous reviews have been conducted on the effectiveness of SB interventions, most focus on specific settings [23] or population groups [27,29,30]. Interventions in these reviews vary in their complexity, but this has not previously been investigated.…”

Factors influencing sedentary behaviours after stroke: findings from qualitative observations and interviews with stroke survivors and their caregivers

“…Sedentary behaviours have been shown to be amenable to change in the general population, with a recent meta-analysis showing a reduction in daily sitting time of 30 minutes/day [13]. However, evidence from stroke survivors is limited and inconclusive with one Canadian home-based feasibility study (single group, N=34) showing promising findings in relation to a reduction in sedentary time post intervention [14], and one community-based Australian phase II pilot randomised controlled trial (N=35) demonstrating it is safe and feasible to intervene [15].…”