Claire M. Bernaards

A systematic review of correlates of sedentary behaviour in adults aged 18–65 years: a socio-ecological approach

BackgroundRecent research shows that sedentary behaviour is associated with adverse cardio-metabolic consequences even among those considered sufficiently physically active. In order to successfully develop interventions to address this unhealthy behaviour, factors that influence sedentariness need to be identified and fully understood. The aim of this review is to identify individual, social, environmental, and policy-related determinants or correlates of sedentary behaviours among adults aged 18–65 years.MethodsPubMed, Embase, CINAHL, PsycINFO and Web of Science were searched for articles published between January 2000 and September 2015. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour (b) correlates (c) types of sedentary behaviours (d) types of correlates. Articles were included if information relating to sedentary behaviour in adults (18–65 years) was reported. Studies on samples selected by disease were excluded. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823).Results74 original studies were identified out of 4041: 71 observational, two qualitative and one experimental study. Sedentary behaviour was primarily measured as self-reported screen leisure time and total sitting time. In 15 studies, objectively measured total sedentary time was reported: accelerometry (n = 14) and heart rate (n = 1). Individual level factors such as age, physical activity levels, body mass index, socio-economic status and mood were all significantly correlated with sedentariness. A trend towards increased amounts of leisure screen time was identified in those married or cohabiting while having children resulted in less total sitting time. Several environmental correlates were identified including proximity of green space, neighbourhood walkability and safety and weather.ConclusionsResults provide further evidence relating to several already recognised individual level factors and preliminary evidence relating to social and environmental factors that should be further investigated. Most studies relied upon cross-sectional design limiting causal inference and the heterogeneity of the sedentary measures prevented direct comparison of findings. Future research necessitates longitudinal study designs, exploration of policy-related factors, further exploration of environmental factors, analysis of inter-relationships between identified factors and better classification of sedentary behaviour domains.

A Longitudinal study on smoking in Relationship to Fitness and Heart Rate response

PURPOSE Smoking has been shown to be associated with impaired cardiovascular fitness and reduced heart rate response to exercise. It is not known whether these associations are present in adolescence and young adults, and whether they change over time. METHODS Maximal oxygen uptake ([OV0312]O(2max)), maximum treadmill slope (Slope(max)), resting heart rate (HR(rest)), heart rate at submaximal exercise (HR(submax)), heart rate reserve (HRR), and maximum heart rate (HR(max)) were measured one to nine times between ages 13 and 36 in 298 male and 334 female participants of the Amsterdam Growth and Health Longitudinal Study. Generalized estimating equation analyses were used to study the longitudinal relationship between smoking and cardiovascular fitness and heart rate response to exercise, whereas linear regression analyses were used to study the reversibility of smoking effects at age 36. RESULTS Moderate to heavy smoking (>/=10 g of tobacco per day) was longitudinally and negatively related to [OV0312]O(2max), Slope(max), HR(submax), and HR(max). With increasing age, the negative relationship between smoking and [OV0312]O(2max), Slope(max), and HR(max) became stronger in males. Cross-sectional analyses suggested that the adverse effects of smoking were reversible in 36-yr-old males. CONCLUSION Cardiovascular fitness and heart rate response to exercise are already reduced in young healthy smokers. In men, the adverse effects of smoking become stronger with increasing age but appear to be reversible at age 36.

The (cost-)effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on the recovery from neck and upper limb symptoms in computer workers

BackgroundNeck and upper limb symptoms are frequently reported by computer workers. Work style interventions are most commonly used to reduce work-related neck and upper limb symptoms but lifestyle physical activity interventions are becoming more popular to enhance workers health and reduce work-related symptoms. A combined approach targeting work style and lifestyle physical activity seems promising, but little is known on the effectiveness of such combined interventions.Methods/designThe RSI@Work study is a randomised controlled trial that aims to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention to reduce neck and upper limb symptoms in computer workers. Computer workers from seven Dutch companies with frequent or long-term neck and upper limb symptoms in the preceding six months and/or the last two weeks are randomised into three groups: (1) work style group, (2) work style and physical activity group, or (3) control group. The work style intervention consists of six group meetings in a six month period that take place at the workplace, during work time, and under the supervision of a specially trained counsellor. The goal of this intervention is to stimulate workplace adjustment and to improve body posture, the number and quality of breaks and coping behaviour with regard to high work demands. In the combined (work style and physical activity) intervention the additional goal is to increase moderate to heavy physical activity. The control group receives usual care. Primary outcome measures are degree of recovery, pain intensity, disability, number of days with neck and upper limb symptoms, and number of months without neck and upper limb symptoms. Outcome measures will be assessed at baseline and six and 12 months after randomisation. Cost-effectiveness of the group meetings will be assessed using an employers perspective.DiscussionThis study will be one of the first to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention in reducing neck and upper limb symptoms of computer workers. The results of the study are expected in 2007.

The SOS-framework (systems of sedentary behaviours) : an international transdisciplinary consensus framework for the study of determinants, research priorities and policy on sedentary behaviour across the life course: A DEDIPAC-study

Ecological models are currently the most used approaches to classify and conceptualise determinants of sedentary behaviour, but these approaches are limited in their ability to capture the complexity of and interplay between determinants. The aim of the project described here was to develop a transdisciplinary dynamic framework, grounded in a system-based approach, for research on determinants of sedentary behaviour across the life span and intervention and policy planning and evaluation. A comprehensive concept mapping approach was used to develop the Systems Of Sedentary behaviours (SOS) framework, involving four main phases: (1) preparation, (2) generation of statements, (3) structuring (sorting and ranking), and (4) analysis and interpretation. The first two phases were undertaken between December 2013 and February 2015 by the DEDIPAC KH team (DEterminants of DIet and Physical Activity Knowledge Hub). The last two phases were completed during a two-day consensus meeting in June 2015. During the first phase, 550 factors regarding sedentary behaviour were listed across three age groups (i.e., youths, adults and older adults), which were reduced to a final list of 190 life course factors in phase 2 used during the consensus meeting. In total, 69 international delegates, seven invited experts and one concept mapping consultant attended the consensus meeting. The final framework obtained during that meeting consisted of six clusters of determinants: Physical Health and Wellbeing (71 % consensus), Social and Cultural Context (59 % consensus), Built and Natural Environment (65 % consensus), Psychology and Behaviour (80 % consensus), Politics and Economics (78 % consensus), and Institutional and Home Settings (78 % consensus). Conducting studies on Institutional Settings was ranked as the first research priority. The view that this framework captures a system-based map of determinants of sedentary behaviour was expressed by 89 % of the participants. Through an international transdisciplinary consensus process, the SOS framework was developed for the determinants of sedentary behaviour through the life course. Investigating the influence of Institutional and Home Settings was deemed to be the most important area of research to focus on at present and potentially the most modifiable. The SOS framework can be used as an important tool to prioritise future research and to develop policies to reduce sedentary time.

Physical activity, cardiorespiratory fitness, and body mass index in relationship to work productivity and sickness absence in computer workers with preexisting neck and upper limb symptoms

Objective: The purpose of this study was to investigate associations among three modifiable risk factors (ie, physical activity, cardiorespiratory fitness, and body mass index), work productivity, and sickness absence in computer workers. Methods: All participants were computer workers with neck and upper limb symptoms in the preceding 6 months, the last 2 weeks, or both. Productivity and sickness absence were assessed with the Health and Performance Questionnaire (HPQ). Results: Physical activity and cardiorespiratory fitness were not associated with work productivity or sickness absence. Obese male workers reported lower absolute productivity than lean workers. Lean and overweight workers reported similar productivity levels. Body mass index was not associated with sickness absence. Conclusions: In a population of white-collar workers with neck and upper limb symptoms, obese male workers showed significantly lower productivity than did lean or overweight workers.

Comparison between self-report and a dipstick method (NicCheck 1) to assess nicotine intake.

The purpose of this study was to investigate the agreement between self-reported tobacco consumption and NicCheck 1® (Dynagen Inc. Cambridge, Mass., USA) regarding smoking status and nicotine intake in a population of smokers (20.8%) and non-smokers. NicCheck 1 is a dipstick that changes colour in the presence of urinary nicotine metabolites. Smoking was assessed by self-report and NicCheck 1 in 169 males and 191 females (mean age 36.0 SD 0.7). Self-report and NicCheck 1 agreed highly on smoking status, especially in moderate to heavy smokers. With regard to nicotine intake, there was a large overlap in self-reported tobacco consumption between NicCheck 1 levels, despite a relatively high correlation coefficient between self-report and NicCheck 1 in smokers (i.e. 0.74). No effect modification by gender or BMI was found. When both methods were validated against two blood lipid parameters, self-report seemed to do equally well as NicCheck 1 in assessing nicotine intake.

Smoking behaviour and biological maturation in males and females: a 20-year longitudinal study. Analysis of data from the Amsterdam Growth and Health Longitudinal Study.

Primary objective : (1) Describe the longitudinal smoking behaviour of boys and girls during adolescence in relation to calendar age, skeletal age, years from peak height velocity (PHV) and years from menarche (in girls). (2) and (3) Investigate the timing of biological maturation (early or late maturation) in relation to smoking behaviour in adolescence and in adulthood (i.e. calendar age 32/33). Hypothesis : We hypothesized skeletal age, years from PHV and years from menarche to be better predictors of smoking than calendar age. Research design : This study is part of the Amsterdam Growth and Health Longitudinal Study (AGAHLS) that was started in 1977 with 619 pupils from two secondary schools (mean age 13.0 SD 0.6). Methods and procedures : Smoking behaviour was assessed four times between 1977 and 1980 and once in 1996/1997. Calendar age and skeletal age were measured annually whereas height and menarche were measured every 4 months. Maturation rate (skeletal age minus calendar age), age at PHV and age at menarche were used to estimate timing of biological maturation. Generalized Estimating Equation (GEE) analysis was used to study maturation rate in relation to smoking during adolescence, whereas logistic regression analyses were used to study mean maturation rate, years from PHV and years from menarche in relation to smoking in adulthood. Outcomes and results : Skeletal age, years from PHV and years from menarche are no better predictors of smoking during adolescence than calendar age. The prevalence of smoking rises gradually with the increase in all four estimates of biological maturation. Timing of biological maturation was positively related to smoking but only at calendar age 13 (OR 3.34, CI 1.58, 7.07). None of the three measures to estimate timing of biological maturation was significantly related to smoking status in adulthood.

Longitudinal Relationship Between Sitting Time on a Working Day and Vitality, Work Performance, Presenteeism, and Sickness Absence

Objective: The aim of this study was to explore the longitudinal relationship between sitting time on a working day and vitality, work performance, presenteeism, and sickness absence. Methods: At the start and end of a five-month intervention program at the workplace, as well as 10 months after the intervention, sitting time and work-related outcomes were measured using a standardized self-administered questionnaire and company records. Generalized linear mixed models were used to estimate the longitudinal relationship between sitting time and work-related outcomes, and possible interaction effects over time. Results: A significant and sustainable decrease in sitting time on a working day was observed. Sitting less was significantly related to higher vitality scores, but this effect was marginal (b = −0.0006, P = 0.000). Conclusions: Our finding of significant though marginal associations between sitting time and important work-related outcomes justifies further research.

Position statement: Langdurig zitten: een nieuwe bedreiging voor onze gezondheid!

Dat onvoldoende lichaamsbeweging ernstige gezondheidsrisico’s met zich meebrengt, is al geruime tijd bekend. Nog vrijwel onbekend bij het grote publiek is dat langdurig achtereen zitten eveneens gezondheidsrisico’s kent, onafhankelijk van het feit of iemand voldoende sport of beweegt. In een maatschappij waarin we steeds vaker worden verleid langdurig te zitten, zowel op het werk als thuis, vormt dit een probleem dat aandacht vraagt van beleidsmakers, werkgevers, werknemers en professionals in preventie en zorg, alsmede de burgers zelf. Met name ons werk, vroeger een belangrijke bron van lichaamsbeweging, is in vele sectoren een bron van bewegingsarmoede geworden, waarbij de aard van het werk ons dwingt urenlang achtereen te zitten. In feite hebben we hier te maken met een nieuw arbeidsrisico, want deze gedwongen bewegingsarmoede brengt ons gezondheidsschade toe. Het goede nieuws is dat dit arbeidsrisico mogelijk met relatief eenvoudige middelen beheersbaar kan worden.Sedentary behaviour: a new threat to our health Prolonged sitting is a risk factor for mortality and is associated with deleterious health outcomes, independent of physical activity. When occurring at the worksite, sedentary behaviour should be regarded as a modern occupational health risk. As the exposure to this risk is very high and seems to expand in the coming years, attention of authorities and business is needed. Although it’s too early for a quantitative guideline, the recommendation is to avoid prolonged periods of sedentary behaviour and break up periods of sitting. Developing sustainable setting specific (cost-)effective interventions targeting high risk groups is an important challenge for the future.

Cross-cultural adaptation of the Individual Work Performance Questionnaire

BACKGROUND The Individual Work Performance Questionnaire (IWPQ), measuring task performance, contextual performance, and counterproductive work behavior, was developed in The Netherlands. OBJECTIVES To cross-culturally adapt the IWPQ from the Dutch to the American-English language, and assess the questionnaires internal consistency and content validity in the American-English context. METHODS A five stage translation and adaptation process was used: forward translation, synthesis, back-translation, expert committee review, and pilot-testing. During the pilot-testing, cognitive interviews with 40 American workers were performed, to examine the comprehensibility, applicability, and completeness of the American-English IWPQ. RESULTS Questionnaire instructions were slightly modified to aid interpretation in the American-English language. Inconsistencies with verb tense were identified, and it was decided to consistently use simple past tense. The wording of five items was modified to better suit the American-English language. In general, participants were positive on the comprehensibility, applicability and completeness of the questionnaire during the pilot-testing phase. Furthermore, the study showed positive results concerning the internal consistency (Cronbachs alphas for the scales between 0.79-0.89) and content validity of the American-English IWPQ. CONCLUSION The results indicate that the cross-cultural adaptation of the American-English IWPQ was successful and that the measurement properties of the translated version are promising.