Reducing sedentary time in adults at risk of type 2 diabetes: process evaluation of the STAND (Sedentary Time ANd Diabetes) RCT

doi:10.1186/s12889-016-3941-9

Randomized Controlled Trial

. 2017 Jan 14;17(1):80.

doi: 10.1186/s12889-016-3941-9.

Reducing sedentary time in adults at risk of type 2 diabetes: process evaluation of the STAND (Sedentary Time ANd Diabetes) RCT

Stuart J H Biddle^{1

2

3}, Charlotte L Edwardson^{4

5}, Trish Gorely⁶, Emma G Wilmot^{4

7}, Thomas Yates^{4

5}, Myra A Nimmo^{8

5

9}, Kamlesh Khunti^{4

5}, Melanie J Davies^{4

5}

Affiliations

¹ School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. stuart.biddle@vu.edu.au.
² The NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK. stuart.biddle@vu.edu.au.
³ Institute of Sport, Exercise & Active Living, Victoria University, Footscray Park, Melbourne, VIC, 8001, Australia. stuart.biddle@vu.edu.au.
⁴ Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
⁵ The NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.
⁶ School of Sport, University of Stirling, Stirling, UK.
⁷ Derby Teaching Hospitals, Derby, UK.
⁸ School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
⁹ College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.

PMID: 28088243
PMCID: PMC5237565
DOI: 10.1186/s12889-016-3941-9

Randomized Controlled Trial

Reducing sedentary time in adults at risk of type 2 diabetes: process evaluation of the STAND (Sedentary Time ANd Diabetes) RCT

Stuart J H Biddle et al. BMC Public Health. 2017.

. 2017 Jan 14;17(1):80.

doi: 10.1186/s12889-016-3941-9.

Authors

Stuart J H Biddle^{1

2

3}, Charlotte L Edwardson^{4

5}, Trish Gorely⁶, Emma G Wilmot^{4

7}, Thomas Yates^{4

5}, Myra A Nimmo^{8

5

9}, Kamlesh Khunti^{4

5}, Melanie J Davies^{4

5}

Affiliations

¹ School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. stuart.biddle@vu.edu.au.
² The NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK. stuart.biddle@vu.edu.au.
³ Institute of Sport, Exercise & Active Living, Victoria University, Footscray Park, Melbourne, VIC, 8001, Australia. stuart.biddle@vu.edu.au.
⁴ Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
⁵ The NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.
⁶ School of Sport, University of Stirling, Stirling, UK.
⁷ Derby Teaching Hospitals, Derby, UK.
⁸ School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
⁹ College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.

PMID: 28088243
PMCID: PMC5237565
DOI: 10.1186/s12889-016-3941-9

Abstract

Background: Reducing sedentary behaviour may have important health implications. This study evaluated the potential enablers and barriers for outcomes of a randomised controlled trial (RCT) designed to evaluate a pragmatic education based intervention designed to reduce sedentary (sitting) behaviour in young adults at high risk of type 2 diabetes.

Methods: Data were collected from participants in the intervention group immediately after an educational workshop addressing sedentary time and diabetes risk (n = 71), through phone interviews 6 weeks (n = 45) after the workshop, and at the conclusion of the 12-month trial (n = 10). The two education session facilitators were also interviewed about the intervention.

Results: The RCT showed no difference in sedentary time at 12 months between intervention and control arms. The lack of behaviour change appeared not to be attributed to the workshops, which were well led and very favourably received according to feedback. However, factors contributing to this lack of behaviour change include lack of perceived health risk from baseline measures feedback; the preference to adopt physically active behaviours rather than to sit less; certain barriers to sitting less; motivational drift after the 3-month follow-up measurements where participants had no contact for a further 9 months; and, for some, unreliability of the self-monitoring tool.

Conclusions: The workshop was well led and well received by the attendees but future interventions need to consider more contact with participants, discuss any specific benefits around simply standing to reduce sitting time, address the barriers to sitting less, and provide a more user-friendly and reliable self-monitoring tool.

Trial registration: Current controlled trials ISRCTN08434554 , MRC project 91409. Registered retrospectively on 22 February 2011.

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Figures

**Fig. 1**
Health feedback chart used in workshops

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References

1. Sedentary Behaviour Research Network Letter to the Editor: Standardized use of the terms “sedentary” and “sedentary behaviours”. App Physiol Nutr Metab. 2012;37:540–2. doi: 10.1139/h2012-024. - DOI - PubMed
1. Wilmot EG, Edwardson CL, Achana FA, Davies MJ, Gorely T, Gray LJ, Khunti K, Yates T, Biddle SJH. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia. 2012;55(11):2895–905. doi: 10.1007/s00125-012-2677-z. - DOI - PubMed
1. Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, Alter DA. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med. 2015;162:123–32. doi: 10.7326/M14-1651. - DOI - PubMed
1. Petersen CB, Bauman A, Tolstrup JS. Total sitting time and the risk of incident diabetes in Danish adults (the DANHES cohort) over 5 years: a prospective study. Brit J Sport Med. 2016. - PubMed
1. Biddle SJH, O’Connell S, Braithwaite RE. Sedentary behaviour interventions in young people: a meta-analysis. Brit J Sport Med. 2011;45:937–42. doi: 10.1136/bjsports-2011-090205. - DOI - PubMed

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[1] Sedentary Behaviour Research Network Letter to the Editor: Standardized use of the terms “sedentary” and “sedentary behaviours”. App Physiol Nutr Metab. 2012;37:540–2. doi: 10.1139/h2012-024. - DOI - PubMed

[2] Sedentary Behaviour Research Network Letter to the Editor: Standardized use of the terms “sedentary” and “sedentary behaviours”. App Physiol Nutr Metab. 2012;37:540–2. doi: 10.1139/h2012-024. - DOI - PubMed

[3] Wilmot EG, Edwardson CL, Achana FA, Davies MJ, Gorely T, Gray LJ, Khunti K, Yates T, Biddle SJH. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia. 2012;55(11):2895–905. doi: 10.1007/s00125-012-2677-z. - DOI - PubMed

[4] Wilmot EG, Edwardson CL, Achana FA, Davies MJ, Gorely T, Gray LJ, Khunti K, Yates T, Biddle SJH. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia. 2012;55(11):2895–905. doi: 10.1007/s00125-012-2677-z. - DOI - PubMed

[5] Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, Alter DA. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med. 2015;162:123–32. doi: 10.7326/M14-1651. - DOI - PubMed

[6] Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, Alter DA. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med. 2015;162:123–32. doi: 10.7326/M14-1651. - DOI - PubMed

[7] Petersen CB, Bauman A, Tolstrup JS. Total sitting time and the risk of incident diabetes in Danish adults (the DANHES cohort) over 5 years: a prospective study. Brit J Sport Med. 2016. - PubMed

[8] Petersen CB, Bauman A, Tolstrup JS. Total sitting time and the risk of incident diabetes in Danish adults (the DANHES cohort) over 5 years: a prospective study. Brit J Sport Med. 2016. - PubMed

[9] Biddle SJH, O’Connell S, Braithwaite RE. Sedentary behaviour interventions in young people: a meta-analysis. Brit J Sport Med. 2011;45:937–42. doi: 10.1136/bjsports-2011-090205. - DOI - PubMed

[10] Biddle SJH, O’Connell S, Braithwaite RE. Sedentary behaviour interventions in young people: a meta-analysis. Brit J Sport Med. 2011;45:937–42. doi: 10.1136/bjsports-2011-090205. - DOI - PubMed

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Reducing sedentary time in adults at risk of type 2 diabetes: process evaluation of the STAND (Sedentary Time ANd Diabetes) RCT

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Reducing sedentary time in adults at risk of type 2 diabetes: process evaluation of the STAND (Sedentary Time ANd Diabetes) RCT

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