On Your Feet to Earn Your Seat: pilot RCT of a theory-based sedentary behaviour reduction intervention for older adults

Abstract

BackgroundOf all age groups, older adults spend most of the time sitting and are least physically active. This sequential, mixed-methods feasibility study used a randomised controlled trial design to assess methods for trialling a habit-based intervention to displace older adults’ sedentary behaviour with light activity and explore impact on behavioural outcomes.MethodsEligibility criteria were age 60–74 years, retired, and ≥6 h/day leisure sitting. Data were collected across four sites in England. The intervention comprised a booklet outlining 15 ‘tips’ for disrupting sedentary habits and integrating activity habits into normally inactive settings, and eight weekly self-monitoring sheets. The control was a non-habit-based factsheet promoting activity and sedentary reduction. A computer-generated 1:1 block-randomisation schedule was used, with participants blinded to allocation. Participants self-reported sedentary behaviour (two indices), sedentary habit, physical activity (walking, moderate, vigorous activity) and activity habit, at pre-treatment baseline, 8- and 12-week follow-ups and were interviewed at 12 weeks. Primary feasibility outcomes were attrition, adverse events and intervention adherence. The secondary outcome was behavioural change.ResultsOf 104 participants consented, 103 were randomised (intervention N = 52, control N = 51). Of 98 receiving allocated treatment, 91 (93%; intervention N = 45; control N = 46) completed the trial. One related adverse event was reported in the intervention group. Mean per-tip adherence across 7 weeks was ≥50% for 9/15 tips. Qualitative data suggested acceptability of procedures, and, particularly among intervention recipients, the allocated treatment. Both groups appeared to reduce sedentary behaviour and increase their physical activity, but there were no apparent differences between groups in the extent of change.ConclusionsTrial methods were acceptable and feasible, but the intervention conferred no apparent advantage over control, though it was not trialled among the most sedentary and inactive population for whom it was developed. Further development of the intervention may be necessary prior to a large-scale definitive trial. One possible refinement would combine elements of the intervention with an informational approach to enhance effectiveness.Trial registration ISRCTN47901994 (registration date: 16th January 2014; trial end date 30th April 2015)Electronic supplementary materialThe online version of this article (doi:10.1186/s40814-017-0139-6) contains supplementary material, which is available to authorized users.

Intervention to Modify Habits: A Scoping Review

“…Habit formation was the primary outcome in three studies (Fleig et al, 2013; Fournier et al, 2017; Fritz et al, 2019; McGowan et al, 2013). Feasibility was the primary outcome in three studies (Fleig et al, 2016; Fritz et al, 2019; White et al, 2017). Other primary outcomes included glycemic control and diabetes self-care (Pyatak et al, 2018), water intake (Gomez, Mariani, Lambert, & Monrozier, 2013), fruit and vegetable consumption (McGowan et al, 2013; Rompotis, Grove, & Byrne, 2014), and frequency of microwaving sponges or dishcloths (Mullan, Allom, Fayn, & Johnston, 2014).…”

“…Of the studies that focused on physical activity and/or physical activity habit formation, five studies demonstrated positive gains in physical activity engagement and/or physical activity habit formation (Fleig et al, 2016; Fleig et al, 2013; Fournier et al, 2017; Fritz et al, 2019; Kaushal et al, 2017; White et al, 2017). The study by Fournier et al (2018) included a much longer follow-up (12 months) and did not observe any significant between-group difference in objective physical activity or automaticity of outcomes, but participants in the habit formation treatment arm did attend a greater number of physical exercise sessions when compared with the control condition.…”

“…The one nonphysical activity study that focused on habit formation as a primary outcome reported that treatment group participants experienced greater gains in habit formation for the targeted dietary habits than the control group participants (McGowan et al, 2013). The four studies that targeted the primary outcomes of food hygiene (Mullan et al, 2014), fruit consumption (White et al, 2017), water intake (Gomez et al, 2013), and glycemic control (Pyatak et al, 2018), respectively, reported greater gains in behavioral frequency and glycemic control when compared with controls.…”

A novel behavioural INTErvention to REduce Sitting Time in older adults undergoing orthopaedic surgery (INTEREST): results of a randomised-controlled feasibility study

“…There are at least ten sedentary behaviour interventions in older adults, eight of which are feasibility studies [ 17 , 18 , 41 – 48 ]. Our feasibility results are similar to results from the aforementioned studies, which have also been found to be acceptable.…”

(How) Does Affect Influence the Formation of Habits in Exercise?

“…Participants were asked to rate how strongly they agreed with the following statement on a scale of 1 (not at all) to 10 (absolutely): "I arrived at the decision to attend the class today completely automatically (without thinking)." This single automaticity item is based on a similar measure employed by White et al (2017) and derived from the automaticity subscale of the Self-Report Habit Index (SRHI) (Verplanken and Orbell, 2003;Gardner et al, 2012). This single item has shown adequate content and predictive validity (Verplanken and Orbell, 2003;Gardner et al, 2012), and was therefore chosen in order to keep the weekly questionnaire short for reasons of feasibility.…”