Sinclair School of Nursing, University of Missouri, Columbia, MO, USA.
College of Nursing - Lincoln Division, University of Nebraska, Lincoln, NE, USA.
Transl Behav Med. 2020 Oct 12;10(5):1078-1085. doi: 10.1093/tbm/ibz189.
Sedentary behavior (SB) is associated with numerous negative health outcomes, independent of physical activity behavior. Older adults are the most sedentary population in the United States. Understanding the effects and characteristics of existing interventions to reduce SB can inform practice, future research, and public health initiatives to improve older adults' health. We conducted a systematic review and meta-analysis to examine existing SB intervention research among older adults and quantitatively synthesize intervention effects. Comprehensive searches were conducted to identify studies testing interventions to reduce SB time among adults at least 60 years old. Data on study design, intervention content and delivery, and participant characteristics were extracted from eligible studies. Standardized mean difference effect sizes (Cohen's d) were synthesized using a random-effects model for two-group pretest-posttest design studies. Twenty-two reports describing 17 distinct studies were included in the narrative synthesis, with eight studies included in the meta-analysis (k = 8; n = 1,024). Most interventions were theory-driven and employed multiple strategies, including education, self-monitoring, and goal setting. Although SB interventions significantly reduced total sedentary time, the overall effect was small (d = -0.25, 95% confidence interval [-0.50, 0.00], p = .05). Studies were significantly heterogeneous (Q = 22.34, p < .01); however, the small number of comparisons prevented moderator analyses. Practitioners should employ diverse SB-specific strategies to encourage older adults to reduce time spent sedentary. To develop public health programs targeting SB in older adults, future research should include measures of time spent in specific SB and duration/number of breaks in sedentary time and investigate SB intervention effects on health outcomes.
久坐行为（SB）与许多负面健康结果有关，独立于身体活动行为。老年人是美国最久坐的人群。了解现有的减少 SB 的干预措施的效果和特点，可以为实践、未来的研究和改善老年人健康的公共卫生计划提供信息。我们进行了系统评价和荟萃分析，以检查现有的针对老年人 SB 干预研究，并对干预效果进行定量综合。进行了全面搜索，以确定测试减少至少 60 岁成年人 SB 时间的干预措施的研究。从合格的研究中提取了研究设计、干预内容和交付以及参与者特征的数据。对于两组预测试后测试设计研究，使用随机效应模型综合了标准化均数差效应大小（Cohen's d）。有 22 份报告描述了 17 项不同的研究被纳入叙述性综合，有 8 项研究纳入荟萃分析（k = 8；n = 1,024）。大多数干预措施是基于理论的，并采用了多种策略，包括教育、自我监测和目标设定。尽管 SB 干预显著减少了总久坐时间，但总体效果较小（d = -0.25，95%置信区间[-0.50，0.00]，p =.05）。研究存在显著的异质性（Q = 22.34，p <.01）；然而，由于比较数量较少，无法进行调节分析。从业者应采用各种针对 SB 的特定策略，鼓励老年人减少久坐时间。为了制定针对老年人 SB 的公共卫生计划，未来的研究应包括特定 SB 时间和久坐时间中断的持续时间/次数的测量，并研究 SB 干预对健康结果的影响。
