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Carr, L., Karvinen, K., Peavler, M., Smith, R. and Cangelosi, K. (2013). Multicomponent intervention to reduce daily sedentary time: a randomised controlled trial. BMJ Open, 3(10), p.e003261.

What is the background to this research?
Physical inactivity is the fourth leading cause of death worldwide and associated with many health risks such as type 2 diabetes, all-cause mortality, cardiovascular disease, metabolic syndrome and obesity. Simple ways to prevent such risks are by being active and reducing time spent sedentary. However, the majority of people in modern society, especially those with sedentary jobs do not meet the daily recommended physical activity guidelines. A cross-sectional study was conducted in 2012 to examine sedentary time, prolonged sedentary bouts and physical activity in Australian employees during their work hours. The result has shown that 77% of their working hours were spent sedentary, and combined with the recent Australian Institute of Health and Welfare data (62.5% of Australians aged between 18-64 during their non-working time did not meet the physical activity guidelines), it is clear that many Australian adults are lacking in physical activity engagements, causing them to be at a higher health risks.

The purpose of the present study was to promote sedentary adults working in sedentary jobs to engage in more physical activity or ‘active sitting’, during their working hours using multicomponent intervention. Because modern full-time workers tend to spend almost one-third of their daily life at work (at least for five days per week), promoting them to engage in physical activity during this time period can impact significantly to their health and well-being. Furthermore, a meta-analysis study conducted in 2015 has shown that prolonged sedentary time was independently associated with deleterious health outcomes regardless of physical activity. This strongly supports the reason why we need to start being more active even during our work time.

Where is the research from?
Over 5392 participants of all races and ethnic backgrounds working at a large southern university in the US were passively recruited using email advertisements. A total of 192 people responded and of which 143 were excluded from participation due to their not meeting the eligibility criteria. A voluntary written informed consent was obtained from each participant as well as permissions from their work supervisors prior to enrolment. Because the participants were chosen at random from diverse backgrounds, the findings of this study are believed to be relevant in Australia.

Lucas Carr, the lead author of this study, is an Associate Professor in the Department of Health and Human Physiology at the University of lowa. His main area of studies are health promotion and health studies, specialising in physical activity promotion and sedentary behaviour interventions. Professor Carr has conducted many research in similar areas as this research article and mainly focus on physical activity and sedentary behaviour interventions.

What kind of research was this?
The research was a randomised controlled trial meaning that the subjects were chosen at random to minimise any bias results. The participants were divided into two groups of either being an intervention group or a wait-list control group. However, the sample size of this research is too small (N=40) while compromising primarily of middle-aged women working at a single institution which limits generalisability of the results.

What did the research involve?
During the intervention, the intervention group was encouraged to reduce their time spent sedentary for 12 weeks while receiving a theory-based, internet delivered programme, a portable pedal and a pedometer at work. In contrast, the wait-list group was asked to maintain their current behaviours throughout the intervention period. The theory-based internet programmes was a motivational website (Walker Tracker, Portland, Oregon, USA) for the group to receive tips and focus on reducing sedentary behaviours throughout the day, and the pedal machine was a portable device that has been demonstrated as acceptable for use during the sedentary office work. All participants were enrolled and completed all testing sessions between June 2011 and June 2012. The primary and secondary (cardiometabolic risk factor) outcomes were measured at baseline and post intervention for both intervention (N=23) and wait-list (N=17) group, and the data was compared to measure the intervention outcome. The list of primary and secondary outcomes are as follows:

Primary
 * Objective measures of sedentary and physical activity through StepWatch

Secondary
 * Heart rate
 * Blood pressure
 * Height
 * Weight
 * Waist circumference
 * Percent body fat
 * Cardiorespiratory fitness
 * Fasting lipids

The StepWatch device used to measure the primary outcome was specifically worn at the ankles of each intervention participant. Many studies have shown that ankle-worn StepWatch is an ideal device for measuring steps, energy expenditure, pedalling time and sedentary behaviour compared to other accelerometers. Therefore, after 12 weeks completion of the intervention, primary measures were extracted from the StepWatch device, and secondary measures using separate methods to compare the results of two groups.

What were the basic results?

 * What were the important findings?
 * How did the researchers interpret the results?
 * Do they over-emphasis the implications of their findings?

What conclusions can we take from this research?

 * Provide your own insights on the conclusion (it may not quite be the same as the authors)
 * How do the findings align with other research in the area (in particular more recent publications that won't be mentioned in the paper)

Practical advice

 * What real-world implications does this research have? Examples might includes:
 * criteria for not exercising,
 * recommendations on what exercises to do, how to do them,
 * recommendations on monitoring and progressing exercises within specific populations,
 * considerations for encouraging physical activity within a specific setting, etc
 * Are there other considerations readers should know about before taking on this practical advice? Perhaps health/safety more information/resources?

Further information/resources

 * What further reading may interested readers benefit from?
 * What website, or online organisations, offer further information/support to groups that are linked to your assignment?
 * Consider the audience you are pitching this information for - are the links appropriate (e.g. links to research papers are probably not appropriate if the information is for patients, but it may be if it is for other allied health professionals)