Sedentary Behavior Interruptions for Sedentary Lifestyle
(SWITCH Trial)
Recruiting in Palo Alto (17 mi)
Overseen byErik Hanson, PhD
Age: 18 - 65
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of North Carolina, Chapel Hill
Must not be taking: Anti-hypertensives, Glucose-controlling
Disqualifiers: Recent heart disease, Stroke, Obesity, others
No Placebo Group
Trial Summary
What is the purpose of this trial?
There is strong evidence for the association between sedentary behaviors and cardiovascular diseases such as coronary heart disease and stroke. However, the public currently has no clear guidance on how to limit or interrupt their sedentary behaviors. This study will identify and test the physiological effects of several sedentary behavior interruption strategies and explore the feasibility (i.e., likelihood of an individual performing the requested activities) of those strategies to inform the development of public policy surrounding sedentary behavior interruption. Long-term, the findings of this study will inform a large clinical trial that can test whether sedentary behavior reduction can decrease cardiovascular disease risk.
Will I have to stop taking my current medications?
The trial requires that participants do not use anti-hypertensive drugs or glucose-controlling medication, so you may need to stop these if you are currently taking them.
What data supports the effectiveness of the treatment involving standing and walking intervals for reducing sedentary behavior?
Research shows that breaking up long periods of sitting with standing or walking can reduce sitting time and improve health. For example, using standing desks and prompts to stand increased standing time among students, and using tools to encourage sit-to-stand transitions reduced sitting time in office workers.12345
Is interrupting sedentary behavior by standing or walking generally safe for humans?
How does the treatment for sedentary lifestyle differ from other treatments?
This treatment is unique because it focuses on breaking up long periods of sitting with short, frequent breaks, known as 'activity snacks', rather than solely increasing high-intensity physical activity. This approach targets the negative health effects of prolonged sitting, which are not fully countered by traditional exercise alone.5891011
Eligibility Criteria
This trial is for adults aged 36-55 who sit for over 8 hours a day, exercise less than 90 minutes per week, can walk and climb stairs without assistance, and own a cell phone. It's not for those on glucose-controlling meds, with conditions limiting movement, heavy drinkers, very high or low blood pressure patients, recent or expecting mothers, those extremely overweight or underweight, on anti-hypertensive drugs or with recent severe cardiovascular issues.Inclusion Criteria
Possession of cellular phone able to receive text messages
I sit for more than 8 hours a day.
I can walk 4 blocks and climb 2 flights of stairs without help.
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Exclusion Criteria
My BMI is either over 40 or under 18.5.
I have had or plan to have weight loss surgery within a year.
Systolic blood pressure ≥160 mmHg or diastolic blood pressure ≥100 mmHg
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Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Intervention
Participants engage in sedentary behavior interruption strategies over 4-hour sessions, including standing and walking breaks
4 hours per session
Multiple sessions (in-person)
Focus Groups
Participants who complete the intervention phase participate in focus groups to evaluate determinants of sedentary behavior
1-2 weeks
1 visit (in-person)
Follow-up
Participants are monitored for safety and effectiveness after intervention
4 weeks
Treatment Details
Interventions
- One 15-Minute Standing Bout Each Hour (Behavioural Intervention)
- One 5-Minute Walking Bout and One 15-Minute Standing Bout Each Hour (Behavioural Intervention)
- One 5-Minute Walking Bout Each Hour (Behavioural Intervention)
- Uninterrupted Sitting (Behavioural Intervention)
Trial OverviewThe study tests how interrupting sitting time affects heart health. Participants will try different strategies: uninterrupted sitting; walking for 5 minutes each hour; standing for 15 minutes each hour; combining both walking and standing breaks every hour. The goal is to see which method works best to improve cardiovascular health.
Participant Groups
4Treatment groups
Active Control
Group I: One 15-Minute Standing Bout Each HourActive Control1 Intervention
A 4-hour sedentary behavior bout, during which the participant remains seated while watching a non-stimulatory documentary.
The interruption strategy includes breaking up the 4-hour sitting bout with one 15-minute standing bout each hour. Each participant will be re-randomized to any of the non-completed arms after completion of the initial 4-hour sitting bout and interruption strategy until all arms have been completed.
Group II: One 5-Minute Walking Bout and One 15-Minute Standing Bout Each HourActive Control1 Intervention
A 4-hour sedentary behavior bout, during which the participant remains seated while watching a non-stimulatory documentary.
The interruption strategy includes breaking up the 4-hour sitting bout with one 5-minute light intensity walking bout and one 15-minute standing bout each hour. Each participant will be re-randomized to any of the non-completed arms after completion of the initial 4-hour sitting bout and interruption strategy until all arms have been completed.
Group III: Uninterrupted SittingActive Control1 Intervention
A 4-hour sedentary behavior bout, during which the participant remains seated while watching a non-stimulatory documentary.
This uninterrupted sedentary bout will serve as a control. Each participant will be re-randomized to any of the non-completed arms after completion of the initial 4-hour sitting bout and interruption strategy until all arms have been completed.
Group IV: One 5-Minute Walking Bout Each HourActive Control1 Intervention
A 4-hour sedentary behavior bout, during which the participant remains seated while watching a non-stimulatory documentary.
The interruption strategy includes breaking up the 4-hour sitting bout with one 5-minute light intensity walking bout each hour. Each participant will be re-randomized to any of the non-completed arms after completion of the initial 4-hour sitting bout and interruption strategy until all arms have been completed.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of North Carolina at Chapel HillChapel Hill, NC
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Who Is Running the Clinical Trial?
University of North Carolina, Chapel HillLead Sponsor
National Heart, Lung, and Blood Institute (NHLBI)Collaborator
References
When it comes to sedentary behaviour modification, should people be told what to do? A randomized comparison trial among home-based office workers living in Ontario, Canada. [2023]The effects of adding choice architecture to a theory-based (Health Action Process Approach; HAPA) sedentary intervention remain unknown. To investigate whether choice architecture enhances a theory-based sedentary behaviour reduction intervention in home-based office workers. A 4-week HAPA-based intervention was conducted in London, Canada. Choice architecture was tested as an enhancement via a two (group: 'Choice of Intervention' vs. 'No Choice Intervention') by two (time: Baseline vs. Week 4) factorial repeated measure randomized comparison design. Sedentary behaviour reduction strategies focussed on obtaining a sedentary break frequency (BF) of every 30-45 min with break durations (BD) of 2-3 min. BF, BD, sitting, standing, and moving time were objectively measured (activPAL4™) at both time points. Participants (n = 148) were 44.9 ± 11.4 years old and 72.3% female. BF and total sitting time showed a time effect (P
College Classroom Instructors Can Effectively Promote Standing among Students Provided with Standing Desks. [2022]Standing desks may reduce sedentary behaviors in college students. Students at one mid-size urban university in the Midwestern United States were randomized into intervention (n = 21) and control groups (n = 27) to assess standing time when given access to standing desks. The intervention group received visual and oral instructor prompts to stand, while the control received no prompts during a 50 min lecture. All students were provided with adjustable tabletop standing desks. ActivPAL accelerometers measured sitting and standing time. A brief survey assessed student preferences, including facilitators and barriers to standing. Mean standing time was greater in the intervention vs. control group (26 vs. 17 min, p = 0.023). Students tended to stand in the corners and edges of the room. Main facilitators for standing included to break up sitting, reduce back pain, and increase attention and focus; main barriers were not wanting to distract others or be the only one standing. In total, 87.5% of intervention group participants found five prompts to stand were adequate. Students increased standing time in class when provided with standing desks and instructor prompts to stand. Findings can inform the layout of classrooms and when and how to promote standing desks during lectures.
Acceptability of a sitting reduction intervention for older adults with obesity. [2019]Older adults spend more time sitting than any other age group, contributing to poor health outcomes. Effective behavioral interventions are needed to encourage less sitting among older adults, specifically those with obesity, but these programs must be acceptable to the target population. We explored participant acceptance of a theory-based and technology-enhanced sitting reduction intervention designed for older adults (I-STAND).
How Does Definition of Minimum Break Length Affect Objective Measures of Sitting Outcomes Among Office Workers? [2018]Harmful health effects associated with sedentary behavior may be attenuated by breaking up long periods of sitting by standing or walking. However, studies assess interruptions in sitting time differently, making comparisons between studies difficult. It has not previously been described how the definition of minimum break duration affects sitting outcomes. Therefore, the aim was to address how definitions of break length affect total sitting time, number of sit-to-stand transitions, prolonged sitting periods and time accumulated in prolonged sitting periods among office workers.
The search for the ejecting chair: a mixed-methods analysis of tool use in a sedentary behavior intervention. [2022]Research is needed on interventions targeting sedentary behavior with appropriate behavior-change tools. The current study used convergent sequential mixed methods (QUAN + qual) to explore tool use during a edentary behavior intervention. Data came from a two-arm randomized sedentary behavior pilot intervention. Participants used a number of intervention tools (e.g., prompts and standing desks). Separate mixed-effects regression models explored associations between change in number of tools and frequency of tool use with two intervention targets: change in sitting time and number of sit-to-stand transitions overtime. Qualitative data explored participants' attitudes towards intervention tools. There was a significant relationship between change in total tool use and sitting time after adjusting for number of tools (β = -12.86, p = .02), demonstrating that a one-unit increase in tool use was associated with an almost 13 min reduction in sitting time. In contrast, there was a significant positive association between change in number of tools and sitting time after adjusting for frequency of tool use (β = 63.70, p = .001), indicating that increasing the number of tools without increasing frequency of tool use was associated with more sitting time. Twenty-four semistructured interviews were coded and a thematic analysis revealed four themes related to tool use: (a) prompts to disrupt behavior; (b) tools matching the goal; (c) tools for sit-to-stand were ineffective; and (d) tool use evolved over time. Participants who honed in on effective tools were more successful in reducing sitting time. Tools for participants to increase sit-to-stand transitions were largely ineffective. This study is registered at clincialtrials.gov. Identifier: NCT02544867.
Sitting to standing postural changes: Energy expenditure and a possible mechanism to alleviate sedentary behavior. [2018]Background and aims Sedentary lifestyles have recently been identified as potential mechanism for obesity and associated metabolic diseases linked to ill health. The aim of this study was to investigate the effects of standing and sitting-standing positional changes on energy cost and consequently interrupting sedentary sitting time while working. Methods A total of 26 healthy male volunteers performed normal typing and editing work for 100 min under three conditions. The conditions included sustained sitting, sustained standing, and sitting-standing alternation every 20 min using a sit-stand desk. Respiratory parameters measured included minute ventilation (VE), oxygen consumption (VO2), and energy expenditure (EE). Measurements were recorded using a calibrated Cosmed K4b2 portable gas analysis system. Results The mean value for VE was the highest in the standing position (VE = 13.33 ± 0.71), followed by sitting-standing alternation (VE = 12.04 ± 0.62). Both were significantly different from sitting (VE = 10.59 ± 0.69). The maximum VE and EE for standing (VE = 14.81 ± 0.43 and EE = 1.84 ± 0.10) and sitting-standing alternation (VE = 14.80 ± 0.40 and EE = 1.93 ± 0.08) were significantly higher than that of sitting (VE = 12.15 ± 0.42 and EE = 1.67 ± 0.07). No significant differences were observed in the mean VO2 among the three conditions. However, the maximum VO2 for both standing (VO2 = 5.40 ± 0.20) and sitting-standing alternation (VO2 = 5.14 ± 0.17) had shown to be significantly higher than sitting (VO2 = 4.50 ± 0.18). There were no significant differences observed in the mean EE levels between sitting (EE = 1.43 ± 0.07) and sitting-standing alternation (EE = 1.55 ± 0.08). However, the mean EE while standing (EE = 1.62 ± 0.09) significantly increased compared to sitting. Conclusions The findings of this study indicate that sitting-standing alternations may be implemented as an effective intervention to interrupt prolonged sitting while working.
Stand Up, Students! Decisional Cues Reduce Sedentary Behavior in University Students. [2020]Background: University students are prone to sedentary behavior (SB) which is associated with multiple negative health outcomes. Sit-stand desks may allow for a reduction of SB through standing bouts. To promote standing in university students, decisional cues might be a low-cost approach that can easily be implemented. Purpose: To investigate the effects of decisional cues on students' SB, standing, and active behavior. Method: Over 3 weeks, students were observed in a building on a German university campus, which provides sit-stand-desks in study areas, using an adapted version of the SOPLAY protocol. Baseline data was collected in the first week (T1), before posters and table plaques containing decisional cues were set up in the study areas. Effects were measured in the following 2 weeks (T2 and T3). Results: 2,809 (33% female) students were observed. Sitting decreased from 92.9% [SD = 14.9] to 84.5% [SD = 22.1] from T1 to T3 [F (1, 141) = 15.6; p < 0.01; η2 = 0.10]. Standing increased from 5.6% [SD = 13.5] to 10.9% [SD = 14.4] [F (1, 141) = 9.0; p < 0.01; η2 = 0.06] and being active from 1.5% [SD = 6.9] to 4.5% [SD = 14.8] from T1 to T3 [F (1, 141) = 4.2; p < 0.05; η2 = 0.03). Main effect analyses revealed more students standing in the afternoon compared to morning and lunchtime [F (2, 140) = 3.2; p < 0.05; η2 = 0.04). Discussion: Decisional cues could decrease students' SB and promote standing or being active as alternatives. Future research should use a more rigorous study design. The content of the decisional cues should be explored more and expanded to other health promotion areas on campus.
Descriptive Epidemiology of Interruptions to Free-Living Sitting Time in Middle-Age and Older Adults. [2023]To describe the frequency and characteristics (i.e., duration, stepping time, and estimated intensity) of all interruptions and physically active interruptions to adults' free-living sitting time (i.e., transitions from sitting to upright posture) across segments of the population.
[A PARADIGM SHIFT IN THE PERCEPTION OF HEALTH MAINTENANCE FROM INCREASING PHYSICAL ACTIVITY TO DECREASING PHYSICAL INACTIVITY]. [2018]Modern man spends most of his waking hours (50-70%) in one form or another of sedentary behavior, defined as activity conducted in a sitting or reclining position involving low energy expenditure. The remaining waking hours are spent performing low intensity physical activity (25-45%) and medium-high intensity physical activity (less than 5%): Despite this distribution, medical research has focused on the impact of increasing medium-high intensity physical activity and many health organizations' recommendations are in accordance. In recent years, research conducted has begun to examine the effect inactivity has on health and has shown that excess sedentary behaviour is an independent risk factor for a wide range of medical problems such as obesity, metabolic syndrome, poor cardiovascular health profile, diabetes mellitus, and possibly cancer. Although the higher risk brought on by sedentary behaviour is partially reduced by increasing medium-high intensity physical activity, it is not completely neutralized. One way to diminish the harm caused by long hours of sitting is to take short breaks during periods of prolonged sitting in order to walk. According to these findings, it is worthwhile to recommend reducing the hours spent in sedentary behaviour, or at least to take frequent short breaks ("activity snacks") during periods of prolonged sitting to get up and walk around.
Breaks in sedentary time during childhood and adolescence: Iowa bone development study. [2021]The frequency of interruptions in sedentary time (sedentary breaks) is an aspect of sedentary behaviors that may be associated with metabolic health outcomes. The aim of this study was to describe the change in the frequency of sedentary breaks during a 10-yr period from ages 5 to 15 yr.
Energy expenditure during common sitting and standing tasks: examining the 1.5 MET definition of sedentary behaviour. [2022]Sedentary behavior is defined as any waking behavior characterized by an energy expenditure of 1.5 METS or less while in a sitting or reclining posture. This study examines this definition by assessing the energy cost (METs) of common sitting, standing and walking tasks.