The effectiveness of sedentary behaviour interventions on sitting time and screen time in children and adults: an umbrella review of systematic reviews

Abstract

Background There is increasing concern about the time people spend in sedentary behaviour, including screen time, leisure and occupational sitting. The number of both primary research studies (published trials) and reviews has been growing rapidly in this research area. A summary of the highest level of evidence that provides a broader quantitative synthesis of diverse types of interventions is needed. This research is to articulate the evidence of efficacy of sedentary behaviour interventions to inform interventions to reduce sitting time. The umbrella review, therefore, synthesised systematic reviews that conducted meta-analyses of interventions aiming at reducing sedentary behaviour outcomes across all age group and settings. Method A systematic search was conducted on six databases (MEDLINE Complete, PsycINFO, CINAHL, Global Health via EBSCOhost platform, EMBASE, and Cochrane Central Register of Systematic Reviews). Included articles were systematic reviews with meta-analysis of interventions aiming at reducing sedentary behaviour (screen time, sitting time or sedentary time) in the general population across all age group. Results Seventeen reviews met the inclusion criteria (7 in children and adolescent, 10 in adults). All reviews of sedentary behaviour interventions in children and adolescents investigated intervention effectiveness in reducing screen time. Six out of 11 meta-analyses (reported in 7 reviews) showed small but significant changes in viewing time. All reviews of sedentary behaviour interventions in office workplaces indicated substantial reduction in occupational sitting time (range: 39.6 to 100 min per 8-h workday). Sub-group analyses reported a trend favouring environmental change components such as sit-stand desks, active permissive workstations etc. Meta-analyses indicated that sedentary behaviour interventions were superior to physical activity alone interventions or combined physical activity and sedentary behaviour interventions in reducing sitting time. Conclusion The current systematic reviews and meta-analyses supported sedentary behaviour interventions for reducing occupational sitting time in particular, with small changes seen in screen time in children and adolescents. Future research should explore approaches to maintaining behaviour change beyond the intervention period and investigate the potential of sedentary behaviour reduction interventions in older age groups in non-occupational settings.

Efficacy, characteristics, behavioural models and behaviour change strategies, of non-workplace interventions specifically targeting sedentary behaviour; a systematic review and meta-analysis of randomised control trials in healthy ambulatory adults

“…A rigorous methodology from search strategy to data coding, extraction, analysis and reporting was used. Other reviews to date have included interventions designed to change PA, with sedentary behaviour a secondary outcome [ 35 , 38 , 39 ]. The criteria for inclusion in this review were deliberately narrow in order to find the most efficacious interventions for reducing sedentary behaviour.…”

“…Of the systematic reviews and meta-analyses synthesising sedentary behaviour interventions that have been published over the past decade [ 30 – 40 ], most report interventions which primarily target other behaviours e.g. physical activity or lifestyle [ 31 , 35 , 36 , 38 ] and sedentary behaviour is a secondary or combined outcome; focus on, or include children in their analyses [ 33 , 37 , 39 ]; or focus on changes in workplace sitting time [ 34 , 40 ]. In a review of interventions to reduce sitting time, sixty-three percent of studies focused solely on physical activity, while only twenty-one percent (eight studies) focused solely on sedentary behaviour reduction, and of those, six are workplace based [ 36 ].…”

“…In a review of interventions to reduce sitting time, sixty-three percent of studies focused solely on physical activity, while only twenty-one percent (eight studies) focused solely on sedentary behaviour reduction, and of those, six are workplace based [ 36 ]. Furthermore, the majority of reviews include non-randomised or non-controlled clinical trials which do not elucidate the highest level evidence [ 30 – 32 , 34 , 36 , 39 , 40 ]. One of the seminal systematic reviews published in 2014 [ 32 ] which compared interventions targeting physical activity, or co- targeting physical activity and sedentary behaviour, with interventions solely targeting sedentary behaviour, concluded that sedentary behaviour reduction was best achieved by interventions which specifically and solely targeted sedentary behaviour reduction in their design and implementation.…”

How to Reduce Sedentary Behavior at All Life Domains

“…Different classifications have been proposed for reducing sedentary behavior in the free time [50]: 1) environmental interventions such as devices that limit the time of television use), and 2) behavioral interventions like education campaigns about the harms of prolonged sedentary behavior; 3) multi-component interventions which include both types mentioned above.…”

“…The absence of control in the domains makes it difficult to control the changes since the decrease of sedentary time in a domain does not imply its replacement by physical activity since it could simply shift to sedentary behavior in another domain. Those interventions aimed exclusively at reducing sedentary behavior have better results than those that also focused on increasing physical activity [50].…”