A Hybrid Online Intervention for Reducing Sedentary Behavior in Obese Women

Sedentary behavior (SB) has emerged as an independent risk factor for cardiovascular disease and type 2 diabetes. While exercise is known to reduce these risks, reducing SB through increases in non-structured PA and breaks from sitting may appeal to obese women who have lower self-efficacy for PA. This study examined effects of a combined face-to-face and online intervention to reduce SB in overweight and obese women. A two-group quasi-experimental study was used with measures taken pre and post. Female volunteers (M age = 58.5, SD = 12.5 years) were enrolled in the intervention (n = 40) or waitlisted (n = 24). The intervention, based on the Social Cognitive Theory, combined group sessions with email messages over 6 weeks. Individualized feedback to support mastery and peer models of active behaviors were included in the emails. Participants self-monitored PA with a pedometer. Baseline and post measures of PA and SB were assessed by accelerometer and self-report. Standard measures of height, weight, and waist circumference were conducted. Repeated measures ANOVA was used for analyses. Self-reported SB and light PA in the intervention group (I) changed significantly over time [SB, F(1, 2) = 3.81, p = 0.03, light PA, F(1, 2) = 3.39, p = 0.04]. Significant Group × Time interactions were found for light PA, F(1, 63) = 5.22, p = 0.03, moderate PA, F(1, 63) = 3.90, p = 0.05, and for waist circumference, F(1, 63) = 16.0, p = 0.001. The intervention group decreased significantly while the comparison group was unchanged. Hybrid computer interventions to reduce SB may provide a non-exercise alternative for increasing daily PA and potentially reduce waist circumference, a risk factor for type 2 diabetes. Consumer-grade accelerometers may aide improvements to PA and SB and should be tested as part of future interventions.

[1]  David M Williams,et al.  Feasibility of using computer-tailored and internet-based interventions to promote physical activity in underserved populations. , 2010, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[2]  N. Durant,et al.  Internet-Based Physical Activity Interventions , 2014, American journal of lifestyle medicine.

[3]  S. Clemes,et al.  Evaluation of a commercially available pedometer used to promote physical activity as part of a national programme , 2009, British Journal of Sports Medicine.

[4]  Carolyn S. Dewa,et al.  Walking for Wellness: Using Pedometers to Decrease Sedentary Behaviour and Promote Mental Health , 2009 .

[5]  Stewart G Trost,et al.  Conducting accelerometer-based activity assessments in field-based research. , 2005, Medicine and science in sports and exercise.

[6]  A. Peters Faculty Opinions recommendation of Exercise does not feel the same when you are overweight: the impact of self-selected and imposed intensity on affect and exertion. , 2006 .

[7]  W. Kraus,et al.  Minimal versus Umbilical Waist Circumference Measures as Indicators of Cardiovascular Disease Risk , 2007, Obesity.

[8]  P. Ekkekakis,et al.  Exercise does not feel the same when you are overweight: the impact of self-selected and imposed intensity on affect and exertion , 2006, International Journal of Obesity.

[9]  Catrine Tudor-Locke,et al.  Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese U.S. men and women , 2010, The international journal of behavioral nutrition and physical activity.

[10]  Gregory J Welk,et al.  Differences in Daily Energy Expenditure in Lean and Obese Women: The Role of Posture Allocation , 2008, Obesity.

[11]  Ronald C. Plotnikoff,et al.  Efficacy of an E-Mail Intervention for the Promotion of Physical Activity and Nutrition Behavior in the Workplace Context , 2005, American journal of health promotion : AJHP.

[12]  A. Dunn,et al.  Lifestyle physical activity interventions. History, short- and long-term effects, and recommendations. , 1998, American journal of preventive medicine.

[13]  C. Matthews,et al.  Too much sitting: the population health science of sedentary behavior. , 2010, Exercise and sport sciences reviews.

[14]  Gregory P. Samsa,et al.  Effects of the Amount of Exercise on Body Weight, Body Composition, and Measures of Central Obesity STRRIDE—A Randomized Controlled Study , 2004 .

[15]  W. K. Mummery,et al.  A Comparison of Face-to-Face or Internet-Delivered Physical Activity Intervention on Targeted Determinants , 2009, Health education & behavior : the official publication of the Society for Public Health Education.

[16]  C. Matthews,et al.  Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003-06. , 2011, European heart journal.

[17]  J. Shaw,et al.  Breaks in Sedentary Time , 2008, Diabetes Care.

[18]  A. Sanabria,et al.  Randomized controlled trial. , 2005, World journal of surgery.

[19]  Jo Salmon,et al.  Physical activity and sedentary behavior: a population-based study of barriers, enjoyment, and preference. , 2003, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[20]  Genevieve N Healy,et al.  Feasibility of reducing older adults' sedentary time. , 2011, American journal of preventive medicine.

[21]  J. Carroll,et al.  Computerized tailored physical activity reports. A randomized controlled trial. , 2010, American journal of preventive medicine.

[22]  Benjamin Littenberg,et al.  Effects of television viewing reduction on energy intake and expenditure in overweight and obese adults: a randomized controlled trial. , 2009, Archives of internal medicine.

[23]  P. Freedson,et al.  Amount of time spent in sedentary behaviors in the United States, 2003-2004. , 2008, American journal of epidemiology.

[24]  Nicholas D Gilson,et al.  Do walking strategies to increase physical activity reduce reported sitting in workplaces: a randomized control trial , 2009, The international journal of behavioral nutrition and physical activity.

[25]  Melody Oliver,et al.  Identification of Accelerometer Nonwear Time and Sedentary Behavior , 2011, Research quarterly for exercise and sport.

[26]  N. Owen,et al.  Measuring older adults' sedentary time: reliability, validity, and responsiveness. , 2011, Medicine and science in sports and exercise.

[27]  Russell R. Pate,et al.  The Evolving Definition of "Sedentary" , 2008, Exercise and sport sciences reviews.

[28]  Catrine Tudor-Locke,et al.  U.S. population profile of time-stamped accelerometer outputs: impact of wear time. , 2011, Journal of physical activity & health.

[29]  D. Allison,et al.  Waist circumference and cardiometabolic risk : a consensus statement from Shaping America ’ s Health : Association for Weight Management and Obesity Prevention , 2007 .

[30]  D. Allison,et al.  Waist Circumference and Cardiometabolic Risk , 2007, Diabetes Care.

[31]  N. Owen,et al.  Too little exercise and too much sitting: Inactivity physiology and the need for new recommendations on sedentary behavior , 2008, Current cardiovascular risk reports.

[32]  J. Shaw,et al.  Deleterious Associations of Sitting Time and Television Viewing Time With Cardiometabolic Risk Biomarkers , 2009, Diabetes Care.

[33]  Roy J. Shephard,et al.  Leisure Time Exercise Questionnaire , 2015 .

[34]  William E Kraus,et al.  Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE--a randomized controlled study. , 2004, Archives of internal medicine.

[35]  P S Freedson,et al.  Calibration of the Computer Science and Applications, Inc. accelerometer. , 1998, Medicine and science in sports and exercise.

[36]  M. Clark,et al.  Interindividual Variation in Posture Allocation: Possible Role in Human Obesity , 2005, Science.

[37]  R. Shephard,et al.  A simple method to assess exercise behavior in the community. , 1969, Canadian journal of applied sport sciences. Journal canadien des sciences appliquees au sport.

[38]  J Brug,et al.  Effectiveness of an online computer-tailored physical activity intervention in a real-life setting. , 2006, Health education research.

[39]  Charles E Matthew,et al.  Calibration of accelerometer output for adults. , 2005, Medicine and science in sports and exercise.