The document provides information about an upcoming webinar on interventions to reduce sedentary time in adults. It includes details about participating in polls during the webinar, obtaining the presentation materials afterwards, and contact information. Participation in the anonymous polling questions is voluntary and intended to stimulate discussion for professional development purposes.

1. Welcome!
Interventions with potential to
reduce sedentary time in
adults: What's the evidence?
You will be placed on hold until the webinar begins.
The webinar will begin shortly, please remain on the line.

2. Poll Questions: Consent
• Participation in the webinar poll questions is voluntary
• Names are not recorded and persons will not be identified in any way
• Participation in the anonymous polling questions is accepted as an
indication of your consent to participate
Benefits:
• Results inform improvement of the current and future webinars
• Enable engagement; stimulate discussion. This session is intended for
professional development. Some data may be used for program evaluation
and research purposes (e.g., exploring opinion change)
• Results may also be used to inform the production of systematic reviews
and overviews
Risks: None beyond day-to-day living

3. After Today
• The PowerPoint presentation and audio
recording will be made available
• These resources are available at:
– PowerPoint:
http://www.slideshare.net/HealthEvidence
– Audio Recording:
https://www.youtube.com/user/healthevidence
/videos
3

4. What’s the evidence?
Martin A., Fitzsimons C., Jepson R., Saunders D.,
van der Ploeg H.P., Teixeira P.J., et al. (2015).
Interventions with potential to reduce sedentary
time in adults: Systematic review and meta-
analysis. British Journal of Sports Medicine, 0, 1-
10.
http://www.healthevidence.org/view-article.aspx?a=28660

5. Poll Question #1
What sector are you from?
1. Public Health Practitioner
2. Health Practitioner (Other)
3. Education
4. Research
5. Provincial/Territorial/Government/Ministry/
Municipality
6. Policy Analyst (NGO, etc.)
7. Other
5

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comments / questions during the
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privately to ‘Host’)
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Participant Side Panel in WebEx
Housekeeping

7. Housekeeping (cont’d)
• Audio
– Listen through your speakers
– Go to ‘Communicate > Audio Connection’
• WebEx 24/7 help line
– 1-866-229-3239

8. Poll Question #2
How many people are watching today’s session
with you?
1.Just me
2.2-3
3.4-5
4.6-10
5.Over 10

9. The Health Evidence Team
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10. What is www.healthevidence.org?
Evidence
Decision
Making
inform

11. Why use www.healthevidence.org?
1. Saves you time
2. Relevant & current evidence
3. Transparent process
4. Supports for EIDM available
5. Easy to use

12. A Model for Evidence-
Informed Decision Making
National Collaborating Centre for Methods and Tools. (revised 2012). A
Model for Evidence-Informed Decision-Making in Public Health (Fact
Sheet). [http://www.nccmt.ca/pubs/FactSheet_EIDM_EN_WEB.pdf]

13. Stages in the process of Evidence-
Informed Public Health
National Collaborating Centre for Methods and Tools. Evidence-Informed
Public Health. [http://www.nccmt.ca/eiph/index-eng.html]

14. Poll Question #3
Have you heard of PICO(S) before?
1.Yes
2.No

15. Searchable Questions Think “PICOS”
1. Population (situation)
2. Intervention (exposure)
3. Comparison (other group)
4. Outcomes
5. Setting

16. How often do you use Systematic Reviews
to inform a program/services?
A.Always
B.Often
C.Sometimes
D.Never
E.I don’t know what a systematic review is
Poll Question #4

18. Interventions can reduce sedentary time in
adults
A.Strongly agree
B.Agree
C.Neutral
D.Disagree
E.Strongly disagree
18
Poll Question #5

19. Review
Martin A., Fitzsimons C., Jepson R., Saunders D.,
van der Ploeg H.P., Teixeira P.J., et al. (2015).
Interventions with potential to reduce
sedentary time in adults: Systematic review
and meta-analysis. British Journal of Sports
Medicine, 0, 1-10.

20. Rationale
Infographic on the Chief Medical
Officers' guidelines
Source:
https://www.gov.uk/government/up
loads/system/uploads/attachment_d
ata/file/469457/Physical_activity_inf
ographic.PDF

21. Sedentary behaviour refers to any waking activity
characterized by an energy expenditure ≤ 1.5 metabolic
equivalents and a sitting or reclining posture
Definition

22. What is sedentary behaviour?
– Any waking behaviour where sitting or lying is the
dominant mode of posture
– Energy expenditure is very low
– Screen-time (TV viewing, computer use), motorised
transport, sitting at work, sitting to read, talk, or listen
to music

23. Sedentary behaviour and
Health
• Significant hazard ratio (HR) associations were found with
– all-cause mortality (HR, 1.220 [95% CI, 1.090 to 1.410])
– cardiovascular disease mortality (HR, 1.150 [CI, 1.107 to
1.195])
– cardiovascular disease incidence (HR, 1.143 [CI, 1.002 to
1.729])
– cancer mortality (HR, 1.130 [CI, 1.053 to 1.213])
– cancer incidence (HR, 1.130 [CI, 1.053 to 1.213])
– type 2 diabetes incidence (HR, 1.910 [CI, 1.642 to 2.222]
• Largely independent of PA but HR bigger with lower PA
Biswas et al. Ann Intern Med. 2015;162:123-132.

24. Football Fans in Training: a gender sensitised weight loss,
physical activity and healthy lifestyle programme for men
y
Hunt, K et al. (2014). Lancet. (13) 62420-4

25. (Error bars represent
95% confidence intervals)
Adjusted between-group difference 12 weeks 5.18kg (CI 6.00, 4.35) p<.0001
Adjusted between-group difference 12 months 4.94kg (CI 3.95,5.94) p<.0001
PPrimary outcome: Weight loss
(kg) at 12 months

26. Increase in self-reported PA
Adjusted ratio geometric means 12 weeks 2.38 (CI 1.90, 2.98) p<.0001
Adjusted ratio geometric means 12 months 1.49 (CI 1.11, 1.99) p=.008
(Error bars represent
IQ range)12 months12 weeks

27. o
FFIT to EuroFIT
http://www.ffit.org.uk/page2/index.html

28. FP7-HEALTH.2013.3.3-1-
Principal Investigator: Sally Wyke,
University of Glasgow
http://eurofitfp7.eu/http://eurofitfp7.eu/
http://www.eurofit.pthttp://www.eurofit.pt

29. WP1 - Nanette Mutrie and Anne Martin
1) Interventions to reduce sedentary time in
adults: Systematic review and meta-analysis
2) BCTs used in sitting interventions
3) Design of SitFIT device

31. Review Focus
• P - Adults (≥ 18 years)
• I - Any intervention which included an sedentary
behaviour outcome measure in free-living adults
• C- no intervention, waiting list, attention control, usual
care, alternative treatment conditions
• O - Objectively measured sedentary time obtained from
accelerometers/ inclinometers
▸ Objectively or self-reported patterns of accumulation of
sedentary behaviour
▸ Self-reported total sitting time
▸ Self-reported proxy measures of sitting time

32. Outline
1. Overview of reviews
2. Methods
3. Risk of Bias
4. Review findings
5. Implication for practice
6. Implication for research
7. Overall summary

33. Overview of Reviews
Prince et al Obes Rev 2014;15:905–19
•Modest reduction in sedentary behaviour in interventions with a
specific goal of increasing PA levels and those which combined an
increase in PA levels with a decrease in sedentary time
•Greatest reduction in interventions focusing on SB only
Shrestha N et al. Cochrane Database of Systematic Reviews 2016,
Issue 3. Art. No.: CD010912
•There is very low to low quality evidence that sit-stand desks may
decrease workplace sitting between 30-120min/day
•There were no considerable or inconsistent effects of other
interventions such as changing work organisation or information and
counselling.

34. Literature Search and Selection
We searched:
13 databases and trial
registers for randomised
controlled trials

35. Risk of Bias

36. 34 studies combined:
Reduction by 22 min/day
Lifestyle interventions
(20 studies):
Reduction by 24 min/day
Interventions targeting
sedentary behaviour (2
studies):
Reduction by 42 min/day
Findings

37. Subgroup
analysis
Heterogeneity between
studies partly explained
by
•Intervention duration
•Sex

38. Quality of evidence
Assessed using the GRADE scoring system
•Lifestyle intervention  high-moderate quality
•Targeted sedentary behaviour interventions 
low quality
•Physical activity/sedentary behaviour
interventions  moderate quality
•Targeted physical activity interventions 
moderate quality

39. Implications for research
• Further research is needed to determine the
clinical significance of changing patterns of
sedentary behaviour.
Aadahl et al., Am J Prev Med 2014;47:576–86.
• More interventions targeting sedentary
behaviour need to be developed and tested.
• Further work is needed to identify the ‘active’
intervention components.

40. Update search findings
Interventions/
studies
Participants Effect size (min/day)
[95% Confidence
interval]
All studies combined 72 20276 -21.54 [-28.20, -14.87]
Physical activity 28 11861 -13.72 [-23.49, -3.95]
Sedentary behaviour 4 264 -45.35 [-75.11, -15.60]
Physical activity & sedentary
behaviour
14 1033 -46.60 [-76.14, -17.05]
Lifestyle interventions 26 7118 -16.74 [-28.16, -5.32]

41. Implications for practice
• Findings of this review do not point to specific recommendations on
the degree of reduction in sitting time required to deliver significant
health benefits.
• Findings should encourage clinicians and public health practitioners
to provide advice about reducing the total volume of sitting time and
breaking up long periods of sitting
• This advice should not diminish or replace advice on achieving
recommended levels of physical activity.
• Interventions with a focus on physical activity should provide
additional emphasis on the importance of and barriers to reducing
sedentary behaviour.

42. OVERALL SUMMARY
• It is possible to intervene to reduce sedentary behaviour in adults by
22 min/day
• Moderate to high-quality evidence on the efficacy of lifestyle
interventions suggests a promising approach
• Targeted sedentary behaviour intervention resulted in the greatest
reduction in sedentary time (42 min/day);
• Intervention durations up to 3 months can produce significant
reductions in sedentary behaviour
• Intervention effects were evident up to 12 months follow-up
• Research is needed to determine if sedentary behaviour
interventions are sufficient to produce clinically meaningful and
sustainable reductions in sedentary time.

43. Interventions can reduce sedentary
time in adults
A.Strongly agree
B.Agree
C.Neutral
D.Disagree
E.Strongly disagree
43
Poll Question #6

44. Poll Question #7
Do you agree with the findings of this
review?
A.Strongly agree
B.Agree
C.Neutral
D.Disagree
E.Strongly disagree

45. Questions?

46. A Model for Evidence-
Informed Decision Making
National Collaborating Centre for Methods and Tools. (revised 2012). A
Model for Evidence-Informed Decision-Making in Public Health (Fact
Sheet). [http://www.nccmt.ca/pubs/FactSheet_EIDM_EN_WEB.pdf]

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