Sedentary Lifestyle
Conditions
Brief summary
Epidemiological findings indicate that older adults do not meet physical activity (PA) guidelines & spend up to 11 hrs/day sitting. Given the high prevalence of sedentary behavior (SB), the higher chronic disease risk in this population, & the age-associated challenges of meeting traditional PA guidelines, involving longer bouts of moderate PA, the investigators hypothesize that older adult health will benefit from new strategies to interrupt sitting. This protocol Sedentary Behavior Interrupted: A randomized trial of 3-month effects on biomarkers of healthy aging and physical functioning in the real world (Project 2) is part of a National Institutes of Aging Program Grant called Sedentary Time & Aging Mortality and Physical Function (STAR). The overall purpose of the STAR program to is to better understand how to interrupt sitting time and the consequences for healthy aging in postmenopausal women. This protocol (also referred to Project 2 of the STAR program) is a 3-arm randomized control trial designed to assess ways of interrupting sitting in 405 overweight, postmenopausal women.
Detailed description
Primary Aims: In our primary biomarker outcomes of glucose regulation (fasting insulin & glucose, HbA1c, HOMA-IR) & blood pressure (BP): 1. Investigate the 12 week effects of increased standing and additional brief sit-to-stand compared to attention controls. 2. Investigate the dose-response effects of behavioral change on the biomarkers & BP. Secondary aims 1. Assess the effect of changes in standing and sit-to-stand transitions at 12 weeks on physical, emotional & cognitive functioning. 2. Assess the effect of changes in standing and sit-to-stand transitions at 12 weeks on in vivo skeletal muscle mitochondrial function. Exploratory aims 1. Explore the possible modifying effect of age on the relationship between intervention conditions & primary & secondary outcomes. 2. Explore the psychosocial & environmental mediators & moderators of changes in sitting time, standing time, and transitions. 3. Explore differences in outcomes between the 2 sitting interruption conditions.
Interventions
BEHAVIORALHealth Coaching
Health Coaching sessions will be aimed at goal setting, implementing strategies, overcoming barriers, & relapse prevention.
DEVICEactivPAL inclinometer
Participants in the intervention study arms (B & C) will wear the ActivPAL device for the first 4 weeks of the program and then again in weeks 8 and 9. The device will monitor their sitting and standing time and will allow Health Coaches to provide feedback and will assist the participant in developing an action plan.
OTHERTools to Prompt Standing or Prompt Sit-to-Stand Transitions.
Participants in the intervention study arms (B & C) will receive tools to prompt standing or sit-to-stand transitions such as wearable wrist devices, standing desks or tables (Group B only), mechanical and/or electronic timers, or access to mobile apps or computer programs.
Sponsors
University of California, San Diego
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
55 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Female; 2. 55 years of age and above; 3. any ethnicity or race; 4. screened to sit for 7 or more hours per day, perform less than 70 sit-to-stand transitions per day 5. ambulatory; 6. medically stable without any health conditions that would inhibit standing or PA; 7. able to give informed consent & comply with study protocols; 8. able to read and write fluently in English; 9. able to travel to study visits; and 10. no menstruation for at least one year; 11. BMI 25-45 12. able to walk, stand and transition without high risk of falling.
Exclusion criteria
1. Male; 2. younger than 55 years of age; 3. sit for less than 7 hours per day, perform 71 or more sit-to-stand transitions per day 4. mental state that would preclude complete understanding of the protocol or compliance; 5. physical limitations to completing any of the study conditions; 6. menstruation less than one year prior; 7. unable to complete the Short Physical Performance Battery, 8. Active cancer 9. body Mass Index \<25 or \>45kg/m2, 10. use of insulin
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Insulin Regulation (mU/L) | 3 months | Mean Insulin (mU/L) collected via fasting blood draw at Baseline and 3-Months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Self-Reported Physical Functioning | 3 months | Self-reported physical functioning was assessed using the Rand SF 36-Item Health Survey that assesses 8 health concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions. The range of scores is 0 - 100 with higher scores meaning better physical functioning. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Health Living Attention Control Participants in the attention control condition will receive a healthy aging educational intervention. This group will receive one in-person health coaching sessions and 6 phone counseling sessions.
Health Coaching: Health Coaching sessions will be aimed at goal setting, implementing strategies, overcoming barriers, & relapse prevention. | 135 |
| Reduce Sitting Participants in the Reduce Sitting condition will receive an intervention aimed at reducing daily sitting time. This group will receive five in-person health coaching sessions and two phone counseling sessions.
Health Coaching: Health Coaching sessions will be aimed at goal setting, implementing strategies, overcoming barriers, & relapse prevention.
activPAL inclinometer: Participants in the intervention study arms (B & C) will wear the ActivPAL device for the first 4 weeks of the program and then again in weeks 8 and 9. The device will monitor their sitting and standing time and will allow Health Coaches to provide feedback and will assist the participant in developing an action plan.
Tools to Prompt Standing or Prompt Sit-to-Stand Transitions.: Participants in the intervention study arms (B & C) will receive tools to prompt standing or sit-to-stand transitions such as wearable wrist devices, standing desks or tables (Group B only), mechanical and/or electronic timers, or access to mobile apps or computer programs. | 136 |
| Sit-to-Stand Transition Participants in the Sit-to-Stand Transition condition will receive an intervention aimed at increasing the daily number of brief sit-to-stand transitions. This group will receive five in-person health coaching sessions and two phone counseling sessions.
Health Coaching: Health Coaching sessions will be aimed at goal setting, implementing strategies, overcoming barriers, & relapse prevention.
activPAL inclinometer: Participants in the intervention study arms (B & C) will wear the ActivPAL device for the first 4 weeks of the program and then again in weeks 8 and 9. The device will monitor their sitting and standing time and will allow Health Coaches to provide feedback and will assist the participant in developing an action plan.
Tools to Prompt Standing or Prompt Sit-to-Stand Transitions.: Participants in the intervention study arms (B & C) will receive tools to prompt standing or sit-to-stand transitions such as wearable wrist devices, standing desks or tables (Group B only), mechanical and/or electronic timers, or access to mobile apps or computer programs. | 136 |
| Total | 407 |
Baseline characteristics
| Characteristic | Health Living Attention Control | Total | Sit-to-Stand Transition | Reduce Sitting |
|---|---|---|---|---|
| Age, Continuous | 67.76 years STANDARD_DEVIATION 7.43 | 67.81 years STANDARD_DEVIATION 32.13 | 67.29 years STANDARD_DEVIATION 6.55 | 68.39 years STANDARD_DEVIATION 4.66 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 12 Participants | 35 Participants | 10 Participants | 13 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 123 Participants | 370 Participants | 124 Participants | 123 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 2 Participants | 2 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 2 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 3 Participants | 10 Participants | 5 Participants | 2 Participants |
| Race (NIH/OMB) Black or African American | 7 Participants | 15 Participants | 4 Participants | 4 Participants |
| Race (NIH/OMB) More than one race | 2 Participants | 5 Participants | 1 Participants | 2 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 2 Participants | 4 Participants | 0 Participants | 2 Participants |
| Race (NIH/OMB) White | 120 Participants | 371 Participants | 125 Participants | 126 Participants |
| Region of Enrollment United States | 135 participants | 407 participants | 136 participants | 136 participants |
| Sex: Female, Male Female | 135 Participants | 407 Participants | 136 Participants | 136 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 135 | 0 / 136 | 0 / 136 |
| other Total, other adverse events | 8 / 135 | 28 / 136 | 26 / 136 |
| serious Total, serious adverse events | 0 / 135 | 0 / 136 | 0 / 136 |
Outcome results
Primary
Insulin Regulation (mU/L)
Mean Insulin (mU/L) collected via fasting blood draw at Baseline and 3-Months
Time frame: 3 months
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Health Living Attention Control | Insulin Regulation (mU/L) | Baseline Mean | 15.93 mU/L |
| Health Living Attention Control | Insulin Regulation (mU/L) | 3-Month Mean | 16.72 mU/L |
| Reduce Sitting | Insulin Regulation (mU/L) | Baseline Mean | 15.68 mU/L |
| Reduce Sitting | Insulin Regulation (mU/L) | 3-Month Mean | 15.85 mU/L |
| Sit-to-Stand Transition | Insulin Regulation (mU/L) | Baseline Mean | 15.27 mU/L |
| Sit-to-Stand Transition | Insulin Regulation (mU/L) | 3-Month Mean | 14.84 mU/L |
Secondary
Self-Reported Physical Functioning
Self-reported physical functioning was assessed using the Rand SF 36-Item Health Survey that assesses 8 health concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions. The range of scores is 0 - 100 with higher scores meaning better physical functioning.
Time frame: 3 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Health Living Attention Control | Self-Reported Physical Functioning | Baseline Mean | 74.9 score on a scale | Standard Error 1.81 |
| Health Living Attention Control | Self-Reported Physical Functioning | 3-Months Mean | 75.9 score on a scale | Standard Error 1.83 |
| Reduce Sitting | Self-Reported Physical Functioning | Baseline Mean | 72.8 score on a scale | Standard Error 1.81 |
| Reduce Sitting | Self-Reported Physical Functioning | 3-Months Mean | 74.6 score on a scale | Standard Error 1.83 |
| Sit-to-Stand Transition | Self-Reported Physical Functioning | Baseline Mean | 75.8 score on a scale | Standard Error 1.81 |
| Sit-to-Stand Transition | Self-Reported Physical Functioning | 3-Months Mean | 80.5 score on a scale | Standard Error 1.84 |