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

Abstract

Background: Evidence suggests that sedentary behaviour (SB) is associated with poor health outcomes. SB at any age may have significant consequences for health and well-being and interventions targeting SB are accumulating. Therefore, the need to review the effects of multicomponent, complex interventions that incorporate effective strategies to reduce SB are essential. Methods: A systematic review and meta-analysis were conducted investigating the impact of interventions targeting SB across the lifespan. Six databases were searched and two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias and complexity of each of the included studies. Results: A total of 77 adult studies (n=62, RCTs) and 84 studies (n=62, RCTs) in children were included. The findings demonstrated that interventions in adults when compared to active controls resulted in non-significant reductions in SB, although when compared to inactive controls significant reductions were found in both the short (MD-56.86; 95%CI-74.10,-39.63; n=4632; I 2 83%) and medium-to-long term (MD-20.14; 95%CI-34.13,-6.16; n=4537; I 2 65%). The findings demonstrated that interventions in children when compared to active controls may lead to relevant reductions in daily sedentary time in the short-term (MD-59.90; 95%CI-102.16,-17.65; n=267; I 2 86%), while interventions in children when compared to inactive controls may lead to relevant reductions in the short-term (MD-25.86; 95%CI-40.77,-10.96; n=9480; I 2 98%) and medium-to-long term (MD-14.02; 95%CI-19.49,-8.55; n=41, 138; I 2 98%). The assessment of complexity suggested that interventions may need to be suitably complex to address the challenges of a complex behaviour such as SB, but demonstrated that a higher complexity score is not necessarily associated with better outcomes in terms of sustained long-term changes.

Temporal trends in leisure-time sedentary behavior among adolescents aged 12-15 years from 26 countries in Asia, Africa, and the Americas

“…Following the seminal intervention study conducted two decades ago that aimed to reduce leisure screen-time in American elementary school children [38], previous evidence, mostly derived from high-income countries, have found that interventions aimed at reducing sedentary behavior in young people show small but statistically significant effects [39]. Most promising strategies to reduce sedentary behavior were multi-component strategies including behavioral (e.g., focused on theory driven approaches), and environmental (e.g., aim to modify home, school, or facilities) approaches, interventions that were conducted in community settings, and those that included the involvement of family members [39,40]. More research regarding key features or effective interventions for reducing adolescent's sedentary behavior is needed from more culturally diverse settings including LMICs.…”

I Sit but I Don’t Know Why: Integrating Controlled and Automatic Motivational Precursors Within a Socioecological Approach to Predict Sedentary Behaviors

“…This attraction may explain why sedentary behaviors are di cult to avoid (Cheval et al, 2020; and why motivational precursors alone can hardly prevent engagement in sedentary behaviors. In this view, environmental interventions (e.g., nudges) have proven to be more effective in reducing sedentary behaviors than interventions targeting motivational variables (Blackburn et al, 2020;Gardner et al, 2016).…”

Moderate-To-Vigorous Intensity Physical Activity and Sedentary Behaviour across Childhood and Adolescence, and Their Combined Relationship with Obesity Risk: A Multi-Trajectory Analysis

“…Therefore, interventions should begin early and target all these behavioural and environmental domains. Interventions to reduce sedentary time in children have been fairly successful in short term (<6 months) as well as in long term (≥6 months) studies (−25.9 (95% CI −40.8, −11.0) min and −14.0 (95% CI −19.5, −8.6) min, respectively) [35].…”