A Home-Based Mobile Health Intervention to Replace Sedentary Time With Light Physical Activity in Older Cancer Survivors: Randomized Controlled Pilot Trial

Cindy K Blair, Elizabeth Harding, Charles Wiggins, Huining Kang, Matthew Schwartz, Amy Tarnower, Ruofei Du, Anita Y Kinney, Cindy K Blair, Elizabeth Harding, Charles Wiggins, Huining Kang, Matthew Schwartz, Amy Tarnower, Ruofei Du, Anita Y Kinney

Abstract

Background: Older cancer survivors are at risk of the development or worsening of both age- and treatment-related morbidity. Sedentary behavior increases the risk of or exacerbates these chronic conditions. Light-intensity physical activity (LPA) is more common in older adults and is associated with better health and well-being. Thus, replacing sedentary time with LPA may provide a more successful strategy to reduce sedentary time and increase physical activity.

Objective: This study primarily aims to evaluate the feasibility, acceptability, and preliminary efficacy of a home-based mobile health (mHealth) intervention to interrupt and replace sedentary time with LPA (standing and stepping). The secondary objective of this study is to examine changes in objective measures of physical activity, physical performance, and self-reported quality of life.

Methods: Overall, 54 cancer survivors (aged 60-84 years) were randomized in a 1:1:1 allocation to the tech support intervention group, tech support plus health coaching intervention group, or waitlist control group. Intervention participants received a Jawbone UP2 activity monitor for use with their smartphone app for 13 weeks. Tech support and health coaching were provided via 5 telephone calls during the 13-week intervention. Sedentary behavior and physical activity were objectively measured using an activPAL monitor for 7 days before and after the intervention.

Results: Participants included survivors of breast cancer (21/54, 39%), prostate cancer (16/54, 30%), and a variety of other cancer types; a mean of 4.4 years (SD 1.6) had passed since their cancer diagnosis. Participants, on average, were 70 years old (SD 4.8), 55% (30/54) female, 24% (13/54) Hispanic, and 81% (44/54) overweight or obese. Malfunction of the Jawbone trackers occurred in one-third of the intervention group, resulting in enrollment stopping at 54 rather than the initial goal of 60 participants. Despite these technical issues, the retention in the intervention was high (47/54, 87%). Adherence was high for wearing the tracker (29/29, 100%) and checking the app daily (28/29, 96%) but low for specific aspects related to the sedentary features of the tracker and app (21%-25%). The acceptability of the intervention was moderately high (81%). There were no significant between-group differences in total sedentary time, number of breaks, or number of prolonged sedentary bouts. There were no significant between-group differences in physical activity. The only significant within-group change occurred within the health coaching group, which increased by 1675 daily steps (95% CI 444-2906; P=.009). This increase was caused by moderate-intensity stepping rather than light-intensity stepping (+15.2 minutes per day; 95% CI 4.1-26.2; P=.008).

Conclusions: A home-based mHealth program to disrupt and replace sedentary time with stepping was feasible among and acceptable to older cancer survivors. Future studies are needed to evaluate the optimal approach for replacing sedentary behavior with standing and/or physical activity in this population.

Trial registration: ClinicalTrials.gov NCT03632694; https://ichgcp.net/clinical-trials-registry/NCT03632694.

Keywords: activity monitor; cancer survivors; consumer wearable; light-intensity physical activity; mobile health; mobile phone; physical activity; sedentary behavior.

Conflict of interest statement

Conflicts of Interest: None declared.

©Cindy K Blair, Elizabeth Harding, Charles Wiggins, Huining Kang, Matthew Schwartz, Amy Tarnower, Ruofei Du, Anita Y Kinney. Originally published in JMIR Cancer (http://cancer.jmir.org), 13.04.2021.

Figures

Figure 1
Figure 1
Weekly schedule for the tech support and health coaching intervention groups.
Figure 2
Figure 2
CONSORT (Consolidated Standards of Reporting Trials) diagram.
Figure 3
Figure 3
Adherence to wearing the Jawbone UP2 activity tracker and using the smartphone app, stratified by whether the intervention participant experienced malfunctions with the Jawbone UP2 tracker.
Figure 4
Figure 4
Acceptability and participant evaluation of the mobile health intervention using the Jawbone UP2 activity tracker and smartphone app to sit less, stand more, and move more, throughout the day, and every day. Results are stratified by whether the intervention participant experienced malfunctions with the Jawbone UP2 tracker.

References

    1. Cancer Treatment & Survivorship: Facts & Figures 2019-2021. American Cancer Society. 2019. [2021-03-22]. .
    1. Avis NE, Deimling GT. Cancer survivorship and aging. Cancer. 2008 Dec 15;113(12 Suppl):3519–29. doi: 10.1002/cncr.23941. doi: 10.1002/cncr.23941.
    1. Carver JR, Shapiro CL, Ng A, Jacobs L, Schwartz C, Virgo KS, Hagerty KL, Somerfield MR, Vaughn DJ, ASCO Cancer Survivorship Expert Panel American Society of Clinical Oncology clinical evidence review on the ongoing care of adult cancer survivors: cardiac and pulmonary late effects. J Clin Oncol. 2007 Sep 01;25(25):3991–4008. doi: 10.1200/JCO.2007.10.9777.
    1. Deimling GT, Arendt JA, Kypriotakis G, Bowman KF. Functioning of older, long-term cancer survivors: the role of cancer and comorbidities. J Am Geriatr Soc. 2009;57 Suppl 2:289–92. doi: 10.1111/j.1532-5415.2009.02515.x.
    1. Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci. 2003 Jan;58(1):82–91. doi: 10.1093/gerona/58.1.m82.
    1. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995 Mar 02;332(9):556–61. doi: 10.1056/NEJM199503023320902.
    1. Yabroff KR, Kim Y. Time costs associated with informal caregiving for cancer survivors. Cancer. 2009 Sep 15;115(18 Suppl):4362–73. doi: 10.1002/cncr.24588. doi: 10.1002/cncr.24588.
    1. Guy GP Jr, Ekwueme DU, Yabroff KR, Dowling EC, Li C, Rodriguez JL, de Moor JS, Virgo KS. Economic burden of cancer survivorship among adults in the United States. J Clin Oncol. 2013 Oct 20;31(30):3749–57. doi: 10.1200/JCO.2013.49.1241.
    1. Vissers PAJ, Thong MSY, Pouwer F, Zanders MMJ, Coebergh JWW, van de Poll-Franse LV. The impact of comorbidity on Health-Related Quality of Life among cancer survivors: analyses of data from the PROFILES registry. J Cancer Surviv. 2013 Dec;7(4):602–13. doi: 10.1007/s11764-013-0299-1.
    1. Smith AW, Reeve BB, Bellizzi KM, Harlan LC, Klabunde CN, Amsellem M, Bierman AS, Hays RD. Cancer, comorbidities, and health-related quality of life of older adults. Health Care Financ Rev. 2008;29(4):41–56.
    1. George SM, Alfano CM, Groves J, Karabulut Z, Haman KL, Murphy BA, Matthews CE. Objectively measured sedentary time is related to quality of life among cancer survivors. PLoS One. 2014;9(2):-. doi: 10.1371/journal.pone.0087937.
    1. Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev. 2010 Jul;38(3):105–13. doi: 10.1097/JES.0b013e3181e373a2.
    1. Dunlop DD, Song J, Arnston EK, Semanik PA, Lee J, Chang RW, Hootman JM. Sedentary time in US older adults associated with disability in activities of daily living independent of physical activity. J Phys Act Health. 2015 Jan;12(1):93–101. doi: 10.1123/jpah.2013-0311.
    1. Healy GN, Matthews CE, Dunstan DW, Winkler EAH, Owen N. Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003-06. Eur Heart J. 2011 Mar;32(5):590–7. doi: 10.1093/eurheartj/ehq451.
    1. Lyden K, Keadle SK, Staudenmayer J, Braun B, Freedson PS. Discrete features of sedentary behavior impact cardiometabolic risk factors. Med Sci Sports Exerc. 2015 May;47(5):1079–86. doi: 10.1249/MSS.0000000000000499.
    1. Healy GN, Wijndaele K, Dunstan DW, Shaw JE, Salmon J, Zimmet PZ, Owen N. Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) Diabetes Care. 2008 Feb;31(2):369–71. doi: 10.2337/dc07-1795.
    1. Physical Activity Guidelines Advisory Committee Report 2008. U.S. Department of Health and Human Services. 2008. [2021-03-22]. .
    1. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, Lancet Physical Activity Series Working Group Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012 Jul 21;380(9838):219–29. doi: 10.1016/S0140-6736(12)61031-9.
    1. Blair CK, Robien K, Inoue-Choi M, Rahn W, Lazovich D. Physical inactivity and risk of poor quality of life among elderly cancer survivors compared to women without cancer: the Iowa Women's Health Study. J Cancer Surviv. 2016 Feb;10(1):103–12. doi: 10.1007/s11764-015-0456-9.
    1. Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes. 2007 Nov;56(11):2655–67. doi: 10.2337/db07-0882.
    1. Hamilton MT, Healy GN, Dunstan DW, Zderic TW, Owen N. Too little exercise and too much sitting: inactivity physiology and the need for new recommendations on sedentary behavior. Curr Cardiovasc Risk Rep. 2008 Jul;2(4):292–8. doi: 10.1007/s12170-008-0054-8.
    1. Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, Chastin SFM, Altenburg TM, Chinapaw MJM, SBRN Terminology Consensus Project Participants Sedentary Behavior Research Network (SBRN) - Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act. 2017 Jun 10;14(1):75. doi: 10.1186/s12966-017-0525-8.
    1. Stamatakis E, Hamer M, Dunstan DW. Screen-based entertainment time, all-cause mortality, and cardiovascular events: population-based study with ongoing mortality and hospital events follow-up. J Am Coll Cardiol. 2011 Jan 18;57(3):292–9. doi: 10.1016/j.jacc.2010.05.065.
    1. Hawkes AL, Lynch BM, Owen N, Aitken JF. Lifestyle factors associated concurrently and prospectively with co-morbid cardiovascular disease in a population-based cohort of colorectal cancer survivors. Eur J Cancer. 2011 Jan;47(2):267–76. doi: 10.1016/j.ejca.2010.10.002.
    1. Arem H, Pfeiffer RM, Moore SC, Brinton LA, Matthews CE. Body mass index, physical activity, and television time in relation to mortality risk among endometrial cancer survivors in the NIH-AARP Diet and Health Study cohort. Cancer Causes Control. 2016 Nov;27(11):1403–9. doi: 10.1007/s10552-016-0813-7.
    1. Campbell MK, Demark-Wahnefried W, Symons M, Kalsbeek WD, Dodds J, Cowan A, Jackson B, Motsinger B, Hoben K, Lashley J, Demissie S, McClelland JW. Fruit and vegetable consumption and prevention of cancer: the Black Churches United for Better Health project. Am J Public Health. 1999 Sep;89(9):1390–6. doi: 10.2105/ajph.89.9.1390.
    1. Ratjen I, Schafmayer C, di Giuseppe R, Waniek S, Plachta-Danielzik S, Koch M, Burmeister G, Nöthlings Ute, Hampe J, Schlesinger S, Lieb W. Postdiagnostic physical activity, sleep duration, and TV watching and all-cause mortality among long-term colorectal cancer survivors: a prospective cohort study. BMC Cancer. 2017 Oct 25;17(1):701. doi: 10.1186/s12885-017-3697-3.
    1. Phillips SM, Awick EA, Conroy DE, Pellegrini CA, Mailey EL, McAuley E. Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer. Cancer. 2015 Nov 15;121(22):4044–52. doi: 10.1002/cncr.29620. doi: 10.1002/cncr.29620.
    1. van Roekel Elin H, Winkler EA, Bours MJ, Lynch BM, Willems PJ, Meijer K, Kant I, Beets GL, Sanduleanu S, Healy GN, Weijenberg MP. Associations of sedentary time and patterns of sedentary time accumulation with health-related quality of life in colorectal cancer survivors. Prev Med Rep. 2016 Dec;4:262–9. doi: 10.1016/j.pmedr.2016.06.022.
    1. Lynch BM, Cerin E, Owen N, Hawkes AL, Aitken JF. Television viewing time of colorectal cancer survivors is associated prospectively with quality of life. Cancer Causes Control. 2011 Aug;22(8):1111–20. doi: 10.1007/s10552-011-9786-8.
    1. Dunstan DW, Kingwell BA, Larsen R, Healy GN, Cerin E, Hamilton MT, Shaw JE, Bertovic DA, Zimmet PZ, Salmon J, Owen N. Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care. 2012 May;35(5):976–83. doi: 10.2337/dc11-1931.
    1. Howard BJ, Fraser SF, Sethi P, Cerin E, Hamilton MT, Owen N, Dunstan DW, Kingwell BA. Impact on hemostatic parameters of interrupting sitting with intermittent activity. Med Sci Sports Exerc. 2013 Jul;45(7):1285–91. doi: 10.1249/MSS.0b013e318285f57e.
    1. Sardinha LB, Santos DA, Silva AM, Baptista F, Owen N. Breaking-up sedentary time is associated with physical function in older adults. J Gerontol A Biol Sci Med Sci. 2015 Jan;70(1):119–24. doi: 10.1093/gerona/glu193.
    1. Larsen RN, Kingwell BA, Sethi P, Cerin E, Owen N, Dunstan DW. Breaking up prolonged sitting reduces resting blood pressure in overweight/obese adults. Nutr Metab Cardiovasc Dis. 2014 Sep;24(9):976–82. doi: 10.1016/j.numecd.2014.04.011.
    1. Lynch BM, Dunstan DW, Vallance JK, Owen N. Don't take cancer sitting down: a new survivorship research agenda. Cancer. 2013 Jun 01;119(11):1928–35. doi: 10.1002/cncr.28028. doi: 10.1002/cncr.28028.
    1. Buman MP, Hekler EB, Haskell WL, Pruitt L, Conway TL, Cain KL, Sallis JF, Saelens BE, Frank LD, King AC. Objective light-intensity physical activity associations with rated health in older adults. Am J Epidemiol. 2010 Nov 15;172(10):1155–65. doi: 10.1093/aje/kwq249.
    1. Blair CK, Morey MC, Desmond RA, Cohen HJ, Sloane R, Snyder DC, Demark-Wahnefried W. Light-intensity activity attenuates functional decline in older cancer survivors. Med Sci Sports Exerc. 2014 Jul;46(7):1375–83. doi: 10.1249/MSS.0000000000000241.
    1. van Waart Hanna, Stuiver MM, van Harten Wim H, Geleijn E, Kieffer JM, Buffart LM, de Maaker-Berkhof M, Boven E, Schrama J, Geenen MM, Meerum Terwogt JM, van Bochove Aart, Lustig V, van den Heiligenberg Simone M, Smorenburg CH, Hellendoorn-van Vreeswijk Jeannette AJH, Sonke GS, Aaronson NK. Effect of low-intensity physical activity and moderate- to high-intensity physical exercise during adjuvant chemotherapy on physical fitness, fatigue, and chemotherapy completion rates: results of the PACES randomized clinical trial. J Clin Oncol. 2015 Jun 10;33(17):1918–27. doi: 10.1200/JCO.2014.59.1081.
    1. Van Roekel Elin H, Bours MJL, Breedveld-Peters JJL, Meijer K, Kant I, Van Den Brandt Piet A, Sanduleanu S, Beets GL, Weijenberg MP. Light physical activity is associated with quality of life after colorectal cancer. Med Sci Sports Exerc. 2015 Dec;47(12):2493–503. doi: 10.1249/MSS.0000000000000698.
    1. van Roekel Elin H, Duchâteau J, Bours MJL, van Delden L, Breedveld-Peters JJL, Koole JL, Kenkhuis M, van den Brandt PA, Jansen RL, Kant I, Lima Passos V, Meijer K, Breukink SO, Janssen-Heijnen MLG, Keulen E, Weijenberg MP. Longitudinal associations of light-intensity physical activity with quality of life, functioning and fatigue after colorectal cancer. Qual Life Res. 2020 Nov 2;29(11):2987–98. doi: 10.1007/s11136-020-02566-7.
    1. Dunlop DD, Song J, Semanik PA, Sharma L, Bathon JM, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Mysiw WJ, Nevitt MC, Chang RW. Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study. Br Med J. 2014 Apr 29;348:-. doi: 10.1136/bmj.g2472.
    1. Thraen-Borowski KM, Trentham-Dietz A, Edwards DF, Koltyn KF, Colbert LH. Dose-response relationships between physical activity, social participation, and health-related quality of life in colorectal cancer survivors. J Cancer Surviv. 2013 Sep;7(3):369–78. doi: 10.1007/s11764-013-0277-7.
    1. Conroy DE, Wolin KY, Blair CK, Demark-Wahnefried W. Gender-varying associations between physical activity intensity and mental quality of life in older cancer survivors. Support Care Cancer. 2017 Nov;25(11):3465–73. doi: 10.1007/s00520-017-3769-6.
    1. Matthews CE, Keadle SK, Troiano RP, Kahle L, Koster A, Brychta R, Van Domelen D, Caserotti P, Chen KY, Harris TB, Berrigan D. Accelerometer-measured dose-response for physical activity, sedentary time, and mortality in US adults. Am J Clin Nutr. 2016 Nov;104(5):1424–32. doi: 10.3945/ajcn.116.135129.
    1. Matthews CE, Moore SC, Sampson J, Blair A, Xiao Q, Keadle SK, Hollenbeck A, Park Y. Mortality benefits for replacing sitting time with different physical activities. Med Sci Sports Exerc. 2015 Sep;47(9):1833–40. doi: 10.1249/MSS.0000000000000621.
    1. Reid N, Daly RM, Winkler EAH, Gardiner PA, Eakin EG, Owen N, Dunstan DW, Healy GN. Associations of monitor-assessed activity with performance-based physical function. PLoS One. 2016;11(4):-. doi: 10.1371/journal.pone.0153398.
    1. Elosua R, Redondo A, Segura A, Fiol M, Aldasoro E, Vega G, Forteza J, Martí H, Arteagoitia JM, Marrugat J. Dose-response association of physical activity with acute myocardial infarction: do amount and intensity matter? Prev Med. 2013 Nov;57(5):567–72. doi: 10.1016/j.ypmed.2013.07.022.
    1. Gourlan M, Bernard P, Bortolon C, Romain AJ, Lareyre O, Carayol M, Ninot G, Boiché J. Efficacy of theory-based interventions to promote physical activity. A meta-analysis of randomised controlled trials. Health Psychol Rev. 2016 Apr 10;10(1):50–66. doi: 10.1080/17437199.2014.981777.
    1. Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions. Annu Rev Public Health. 2010;31:399–418. doi: 10.1146/annurev.publhealth.012809.103604.
    1. McGarrigle L, Todd C. Promotion of physical activity in older people using mhealth and ehealth technologies: rapid review of reviews. J Med Internet Res. 2020 Dec 29;22(12):-. doi: 10.2196/22201.
    1. Compernolle S, DeSmet A, Poppe L, Crombez G, De Bourdeaudhuij I, Cardon G, van der Ploeg Hidde P, Van Dyck Delfien. Effectiveness of interventions using self-monitoring to reduce sedentary behavior in adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act. 2019 Aug 13;16(1):63. doi: 10.1186/s12966-019-0824-3.
    1. Stockwell S, Schofield P, Fisher A, Firth J, Jackson SE, Stubbs B, Smith L. Digital behavior change interventions to promote physical activity and/or reduce sedentary behavior in older adults: A systematic review and meta-analysis. Exp Gerontol. 2019 Jun;120:68–87. doi: 10.1016/j.exger.2019.02.020.
    1. Gardner B, Smith L, Lorencatto F, Hamer M, Biddle SJ. How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults. Health Psychol Rev. 2016;10(1):89–112. doi: 10.1080/17437199.2015.1082146.
    1. Lyons EJ, Lewis ZH, Mayrsohn BG, Rowland JL. Behavior change techniques implemented in electronic lifestyle activity monitors: a systematic content analysis. J Med Internet Res. 2014 Aug 15;16(8):e192. doi: 10.2196/jmir.3469.
    1. Duncan M, Murawski B, Short CE, Rebar AL, Schoeppe S, Alley S, Vandelanotte C, Kirwan M. Activity trackers implement different behavior change techniques for activity, sleep, and sedentary behaviors. Interact J Med Res. 2017 Aug 14;6(2):e13. doi: 10.2196/ijmr.6685.
    1. Demark-Wahnefried W, Pinto BM, Gritz ER. Promoting health and physical function among cancer survivors: potential for prevention and questions that remain. J Clin Oncol. 2006 Nov 10;24(32):5125–31. doi: 10.1200/JCO.2006.06.6175.
    1. Courneya KS, Rogers LQ, Campbell KL, Vallance JK, Friedenreich CM. Top 10 research questions related to physical activity and cancer survivorship. Res Q Exerc Sport. 2015 Jun;86(2):107–16. doi: 10.1080/02701367.2015.991265.
    1. Lynch BM, Nguyen NH, Moore MM, Reeves MM, Rosenberg DE, Boyle T, Vallance JK, Milton S, Friedenreich CM, English DR. A randomized controlled trial of a wearable technology-based intervention for increasing moderate to vigorous physical activity and reducing sedentary behavior in breast cancer survivors: The ACTIVATE Trial. Cancer. 2019 Aug 15;125(16):2846–55. doi: 10.1002/cncr.32143. doi: 10.1002/cncr.32143.
    1. Gomersall SR, Skinner TL, Winkler E, Healy GN, Eakin E, Fjeldsoe B. Feasibility, acceptability and efficacy of a text message-enhanced clinical exercise rehabilitation intervention for increasing 'whole-of-day' activity in people living with and beyond cancer. BMC Public Health. 2019 Jun 03;19(Suppl 2):542. doi: 10.1186/s12889-019-6767-4.
    1. Trinh L, Arbour-Nicitopoulos KP, Sabiston CM, Berry SR, Loblaw A, Alibhai SMH, Jones JM, Faulkner GE. RiseTx: testing the feasibility of a web application for reducing sedentary behavior among prostate cancer survivors receiving androgen deprivation therapy. Int J Behav Nutr Phys Act. 2018 Jun 07;15(1):49. doi: 10.1186/s12966-018-0686-0.
    1. Visser M, Koster A. Development of a questionnaire to assess sedentary time in older persons - a comparative study using accelerometry. BMC Geriatr. 2013 Jul 30;13:80. doi: 10.1186/1471-2318-13-80.
    1. Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvão DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen Vivian E, Schwartz AL, American College of Sports Medicine American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010 Jul;42(7):1409–26. doi: 10.1249/MSS.0b013e3181e0c112.
    1. Surveillance, Epidemiology, and End Results (SEER) Program. National Cancer Institute. [2020-02-23].
    1. Bandura A. Social learning theory. Prentice Hall, N. J: Englewood Cliffs; 1977.
    1. Bandura A. Social foundations of thought and action : a social cognitive theory. Prentice-Hall, N.J: Englewood Cliffs; 1986. p. A.
    1. Gardiner PA, Eakin EG, Healy GN, Owen N. Feasibility of reducing older adults' sedentary time. Am J Prev Med. 2011 Aug;41(2):174–7. doi: 10.1016/j.amepre.2011.03.020.
    1. Tudor-Locke C, Craig CL, Aoyagi Y, Bell RC, Croteau KA, De Bourdeaudhuij Ilse, Ewald B, Gardner AW, Hatano Y, Lutes LD, Matsudo SM, Ramirez-Marrero FA, Rogers LQ, Rowe DA, Schmidt MD, Tully MA, Blair SN. How many steps/day are enough? For older adults and special populations. Int J Behav Nutr Phys Act. 2011 Jul 28;8:80. doi: 10.1186/1479-5868-8-80.
    1. Buman MP, Winkler EAH, Kurka JM, Hekler EB, Baldwin CM, Owen N, Ainsworth BE, Healy GN, Gardiner PA. Reallocating time to sleep, sedentary behaviors, or active behaviors: associations with cardiovascular disease risk biomarkers, NHANES 2005-2006. Am J Epidemiol. 2014 Feb 01;179(3):323–34. doi: 10.1093/aje/kwt292.
    1. Chastin SFM, Granat MH. Methods for objective measure, quantification and analysis of sedentary behaviour and inactivity. Gait Posture. 2010 Jan;31(1):82–6. doi: 10.1016/j.gaitpost.2009.09.002.
    1. Kozey-Keadle S, Libertine A, Lyden K, Staudenmayer J, Freedson PS. Validation of wearable monitors for assessing sedentary behavior. Med Sci Sports Exerc. 2011 Aug;43(8):1561–7. doi: 10.1249/MSS.0b013e31820ce174.
    1. Grant PM, Ryan CG, Tigbe WW, Granat MH. The validation of a novel activity monitor in the measurement of posture and motion during everyday activities. Br J Sports Med. 2006 Dec;40(12):992–7. doi: 10.1136/bjsm.2006.030262.
    1. Sellers C, Dall P, Grant M, Stansfield B. Validity and reliability of the activPAL3 for measuring posture and stepping in adults and young people. Gait Posture. 2016 Jan;43:42–7. doi: 10.1016/j.gaitpost.2015.10.020.
    1. Lyden K, Keadle SK, Staudenmayer J, Freedson PS. The activPALTM accurately classifies activity intensity categories in healthy adults. Med Sci Sports Exerc. 2017 May;49(5):1022–8. doi: 10.1249/MSS.0000000000001177.
    1. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994 Mar;49(2):85–94. doi: 10.1093/geronj/49.2.m85.
    1. George SM, Alfano CM, Wilder Smith A, Irwin ML, McTiernan A, Bernstein L, Baumgartner KB, Ballard-Barbash R. Sedentary behavior, health-related quality of life, and fatigue among breast cancer survivors. J Phys Act Health. 2013 Mar;10(3):350–8. doi: 10.1123/jpah.10.3.350.
    1. Balboa-Castillo T, León-Muñoz LM, Graciani A, Rodríguez-Artalejo F, Guallar-Castillón P. Longitudinal association of physical activity and sedentary behavior during leisure time with health-related quality of life in community-dwelling older adults. Health Qual Life Outcomes. 2011 Jun 27;9:47. doi: 10.1186/1477-7525-9-47.
    1. Baker F, Haffer SC, Denniston M. Health-related quality of life of cancer and noncancer patients in Medicare managed care. Cancer. 2003 Feb 01;97(3):674–81. doi: 10.1002/cncr.11085. doi: 10.1002/cncr.11085.
    1. Walters SJ, Munro JF, Brazier JE. Using the SF-36 with older adults: a cross-sectional community-based survey. Age Ageing. 2001 Jul;30(4):337–43. doi: 10.1093/ageing/30.4.337.
    1. Johnston RI. Quality Metric. [2021-04-07].
    1. PROMIS: Patient-Reported Outcomes Measurement Information System. [2021-03-22]. .
    1. FACIT Measurement System. [2021-03-22].
    1. Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum. 2003 Apr 15;49(2):156–63. doi: 10.1002/art.10993. doi: 10.1002/art.10993.
    1. Lyden K. Package 'activpalProcessing'. [2021-03-22]. .
    1. Edwardson CL, Yates T, Biddle SJH, Davies MJ, Dunstan DW, Esliger DW, Gray LJ, Jackson B, O'Connell SE, Waheed G, Munir F. Effectiveness of the Stand More AT (SMArT) Work intervention: cluster randomised controlled trial. Br Med J. 2018 Oct 10;363:-. doi: 10.1136/bmj.k3870.
    1. Edwardson CL, Winkler EA, Bodicoat DH, Yates T, Davies MJ, Dunstan DW, Healy GN. Considerations when using the activPAL monitor in field-based research with adult populations. J Sport Health Sci. 2017 Jun;6(2):162–78. doi: 10.1016/j.jshs.2016.02.002.
    1. Fitzsimons CF, Kirk A, Baker G, Michie F, Kane C, Mutrie N. Using an individualised consultation and activPAL™ feedback to reduce sedentary time in older Scottish adults: results of a feasibility and pilot study. Prev Med. 2013 Nov;57(5):718–20. doi: 10.1016/j.ypmed.2013.07.017.
    1. Rosenberg DE, Gell NM, Jones SMW, Renz A, Kerr J, Gardiner PA, Arterburn D. The feasibility of reducing sitting time in overweight and obese older adults. Health Educ Behav. 2015 Oct;42(5):669–76. doi: 10.1177/1090198115577378.
    1. 2018 Physical Activity Guidelines Advisory Committee Scientific Report. U.S. Department of Health and Human Services. 2018. [2021-03-22]. .
    1. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, Carty C, Chaput J, Chastin S, Chou R, Dempsey PC, DiPietro L, Ekelund U, Firth J, Friedenreich CM, Garcia L, Gichu M, Jago R, Katzmarzyk PT, Lambert E, Leitzmann M, Milton K, Ortega FB, Ranasinghe C, Stamatakis E, Tiedemann A, Troiano RP, van der Ploeg HP, Wari V, Willumsen JF. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020 Dec 25;54(24):1451–62. doi: 10.1136/bjsports-2020-102955.
    1. Hays RD, Morales LS. The RAND-36 measure of health-related quality of life. Ann Med. 2001 Jul;33(5):350–7. doi: 10.3109/07853890109002089.
    1. Kwon S, Perera S, Pahor M, Katula JA, King AC, Groessl EJ, Studenski SA. What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study) J Nutr Health Aging. 2009 Jun;13(6):538–44. doi: 10.1007/s12603-009-0104-z.
    1. Lyons EJ, Swartz MC, Lewis ZH, Martinez E, Jennings K. Feasibility and acceptability of a wearable technology physical activity intervention with telephone counseling for mid-aged and older adults: a randomized controlled pilot trial. JMIR Mhealth Uhealth. 2017 Mar 06;5(3):e28. doi: 10.2196/mhealth.6967.
    1. Wu HS, Gal R, van Sleeuwen Niek C, Brombacher AC, IJsselsteijn WA, May AM, Monninkhof EM. Breast cancer survivors' experiences with an activity tracker integrated into a supervised exercise program: qualitative study. JMIR Mhealth Uhealth. 2019 Feb 21;7(2):-. doi: 10.2196/10820.
    1. Matson TE, Renz AD, Takemoto ML, McClure JB, Rosenberg DE. Acceptability of a sitting reduction intervention for older adults with obesity. BMC Public Health. 2018 Jun 07;18(1):706. doi: 10.1186/s12889-018-5616-1.
    1. Gardner B, Lally P, Wardle J. Making health habitual: the psychology of 'habit-formation' and general practice. Br J Gen Pract. 2012 Dec;62(605):664–6. doi: 10.3399/bjgp12X659466.
    1. Lally P, Wardle J, Gardner B. Experiences of habit formation: a qualitative study. Psychol Health Med. 2011 Aug;16(4):484–9. doi: 10.1080/13548506.2011.555774.
    1. Matson TE, Anderson ML, Renz AD, Greenwood-Hickman MA, McClure JB, Rosenberg DE. Changes in self-reported health and psychosocial outcomes in older adults enrolled in sedentary behavior intervention study. Am J Health Promot. 2019 Sep;33(7):1053–57. doi: 10.1177/0890117119841405.
    1. Lynch BM, Dunstan DW, Healy GN, Winkler E, Eakin E, Owen N. Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: findings from NHANES (2003-2006) Cancer Causes Control. 2010 Feb;21(2):283–8. doi: 10.1007/s10552-009-9460-6.
    1. Lynch BM, Dunstan DW, Winkler E, Healy GN, Eakin E, Owen N. Objectively assessed physical activity, sedentary time and waist circumference among prostate cancer survivors: findings from the National Health and Nutrition Examination Survey (2003-2006) Eur J Cancer Care (Engl) 2011 Jul;20(4):514–9. doi: 10.1111/j.1365-2354.2010.01205.x.
    1. Dall PM, McCrorie PRW, Granat MH, Stansfield BW. Step accumulation per minute epoch is not the same as cadence for free-living adults. Med Sci Sports Exerc. 2013 Oct;45(10):1995–2001. doi: 10.1249/MSS.0b013e3182955780.
    1. Stansfield B, Hajarnis M, Sudarshan R. Characteristics of very slow stepping in healthy adults and validity of the activPAL3™ activity monitor in detecting these steps. Med Eng Phys. 2015 Jan;37(1):42–7. doi: 10.1016/j.medengphy.2014.10.003.
    1. Brickwood KJ, Watson G, O'Brien J, Williams AD. Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis. JMIR Mhealth Uhealth. 2019 Apr 12;7(4):-. doi: 10.2196/11819.
    1. Martin A, Fitzsimons C, Jepson R, Saunders DH, van der Ploeg Hidde P, Teixeira PJ, Gray CM, Mutrie N, EuroFIT consortium Interventions with potential to reduce sedentary time in adults: systematic review and meta-analysis. Br J Sports Med. 2015 Aug;49(16):1056–63. doi: 10.1136/bjsports-2014-094524.
    1. Prince SA, Saunders TJ, Gresty K, Reid RD. A comparison of the effectiveness of physical activity and sedentary behaviour interventions in reducing sedentary time in adults: a systematic review and meta-analysis of controlled trials. Obes Rev. 2014 Nov;15(11):905–19. doi: 10.1111/obr.12215. doi: 10.1111/obr.12215.
    1. Edwardson CL, Henson J, Biddle SJH, Davies MJ, Khunti K, Maylor B, Yates T. activPAL and Actigraph assessed sedentary behavior and cardiometabolic health markers. Med Sci Sports Exerc. 2020 Feb;52(2):391–7. doi: 10.1249/MSS.0000000000002138.
    1. Swain CTV, Nguyen NH, Eagles T, Vallance JK, Boyle T, Lahart IM, Lynch BM. Postdiagnosis sedentary behavior and health outcomes in cancer survivors: a systematic review and meta-analysis. Cancer. 2020 Feb 15;126(4):861–9. doi: 10.1002/cncr.32578. doi: 10.1002/cncr.32578.
    1. Chia GLC, Anderson A, McLean LA. Behavior change techniques incorporated in fitness trackers: content analysis. JMIR Mhealth Uhealth. 2019 Jul 23;7(7):-. doi: 10.2196/12768.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe