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AimsSedentary behaviour (particularly television (TV) viewing) is thought to be a risk factor for cardiovascular disease. We employed a negative control outcome to explore whether the association between TV viewing and heart disease mortality is explained by confounding.MethodsThe sample was drawn from the UK Biobank study and comprised 479 658 participants (aged 56.5±8.0 years; 45.7% men) followed up over a mean of 10.4 years. TV viewing was measured from self-report.ResultsThere were 1437 ischaemic heart disease (IHD) deaths, and 214 accidental deaths (employed as the negative control outcome). TV viewing was related to the following confounding variables: age, smoking, alcohol, diet, obesity, physical inactivity, cardiovascular disease and education. The confounding structures were similar for both outcomes. TV viewing (per hour/d) was associated with IHD (hazard ratio (HR)=1.30, 95% CI, 1.27 to 1.33) and accidental death (HR=1.15, 95% CI, 1.07 to 1.24) in unadjusted models. Associations were attenuated for both outcomes and were considerably converged after adjustment for confounders; IHD (HR=1.09, 95% CI, 1.06 to 1.12) and accidental death (HR=1.06, 95% CI, 0.98 to 1.15).ConclusionThe pattern of results for TV with an implausible outcome mirrored that of IHD, suggesting that observed associations between TV and heart disease are likely to be driven by confounding.

Only 5% of Australian children and adults eat enough fruit and vegetables. Two common barriers are high cost and limited access. Food co-operatives (&lsquo, co-ops&rsquo, ) may have the potential to reduce these barriers. We conducted a scoping analysis of food co-ops in the Sydney region to describe their characteristics and objectives. We also conducted a survey of members and non-members of co-ops to assess their fruit and vegetable intake using validated questions. Fifteen food co-ops were identified in the Sydney region and the most common objective was to provide cheap affordable produce. Most co-ops (61%) were in areas of high socio-economic status (SES). Members of food co-ops had a higher vegetable intake than non-members [mean difference (MD) = 0.54 serves/daily, 95% confidence interval (CI) of 0.15 to 0.93] and were also more likely to meet the recommendations for fruit and vegetable intake [odds ratio (OR) = 4.77 (95% CI = 1.15, 19.86)]. Implications of this study are that if food co-ops can be implemented on a wider scale, they hold potential for improving fruit and vegetable intakes.

Background: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. Methods: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments. Results: Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ. Conclusions: The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals., Universidad Pablo de Olavide de Sevilla. Departamento de Deporte e Informática

Objective: To examine the effects of different sit-stand protocols on work-time sitting and physical activity (PA) of office workers. Methods: Participants (n = 26, 77% women, mean age 42) were randomly allocated to usual sitting (control) or one of three sit-stand protocols (intervention) facilitated by height-adjustable workstations for a 4-week period between June and August 2015. Sitting, standing, and stepping time were assessed by inclinometry (activPAL); leisure-time physical activity (LTPA) by self-report. One-way analysis of covariance (ANCOVA) and post-hoc (Bonferroni) tests explored between-group differences. Results: Compared with baseline, intervention groups reduced work sitting time by 113 minutes/8-hour workday (95% confidence interval [CI] [-147,-79]) and increased work standing time by 96 minutes/8-hour workday (95% CI [67,125]) without significantly impacting LTPA/sleep time. Conclusions: Sit-stand protocols facilitated by height-adjustable workstations appear to reduce office workers' sitting time without significant adverse effects on LTPA.

BACKGROUND Active Design is a relatively new concept and evaluation on its effects on healthy behaviour is lacking. OBJECTIVE To investigate Active Design influence on workplace physical activity, sedentary behaviour, musculoskeletal complaints, and perceptions of the workplace and productivity. METHODS Participants (n = 118 adults) moving from 14 workplaces into a new building completed an online questionnaire pre- and post-move. The questions related to health behaviours (physical activity, sitting time and sleep); musculoskeletal issues; perceptions of the office environment; productivity; and engagement. RESULTS After the move, 68% of participants were located in an open plan building (21% before the move). In the new workplace participants tended to sit less during their work time (72% - 66%; p

Background High levels of sitting are associated with increased risk of adverse health outcomes, including chronic disease. Extensive sitting at work is common, hence organisations should provide options to employees to reduce prolonged sitting. Objective To assess the efficacy and acceptability of a co-designed intervention to increase standing and reduce sitting in a public-sector office. Methods Forty-six adults participated in the quasi-experimental study (30 intervention; 16 control). The intervention involved providing sit-stand desks, prompts, workshops, and information emails to assist behavior change. Participants wore a thigh-mounted Actigraph GT3X+ for five working days and responded to an online questionnaire at baseline (BL), 6 (T1) and 13 weeks (T2) post intervention. Results Inclinometer-measured proportion of time standing increased in the intervention group from 14% (baseline) to 28% (T1) and 27% (T2) (67 minutes more standing over an 8-hour workday). Intervention participants reduced sitting time from 79% (BL) to 63% (T1 and T2), (80 minutes less sitting over an 8-hour workday). The control group showed no changes. The program was highly recommended (94%), and perceived to support behavior change (81%). Conclusions This Move More, Sit Less intervention appears to be efficacious and acceptable. Future interventions should be co-designed to ensure culturally appropriate components and higher acceptability.

This study evaluated the benefit of physically-active lessons for learning maths multiplication-tables. The impact of the intervention on general numeracy, physical activity (PA), aerobic fitness, body mass index (BMI) and school-day moderate to vigorous PA (MVPA) was also assessed.Randomised controlled cross-over trial.Year 3 students (n=172, mean age 8.4±0.3 years, 48% male) were recruited from 10 classes across two urban primary schools. Participants were randomly assigned to a seated classroom (Classroom) group or physically-active lessons in the playground (Playground) and crossed over to the alternative condition in the subsequent school term. The 6-week intervention comprised 3×30min sessions/week. Multiplication-tables (teacher-designed test) and general maths (standardised test) were assessed pre- and post-intervention. Aerobic fitness was assessed via the shuttle-run. Pre- to post-intervention change scores were compared for analysis and effect sizes (ES) calculated. Total PA and MVPA were assessed with accelerometers in a subset of participants.Multiplication scores improved significantly more in Playground than Classroom groups (ES=0.23; p=0.045), while no significant differences were observed in general numeracy (ES=0.05; p=0.66). Total PA and MVPA were substantially higher during Playground than Classroom lessons (ES: total PA=7.4, MVPA=6.5; p0.001) but there were no differences in PA/MVPA between the groups throughout the rest of the school day. Aerobic fitness improved more in Playground than Classroom groups (ES=0.3; p0.001) while the change in BMI was not different between groups (p=0.39).Physically-active lessons may benefit the learning of maths multiplication-tables while favourably contributing to school-day PA/MVPA.

Background Relatively little is known about how total sedentary time is accumulated in different domains and if correlates of sedentary time differ across domains. Time use surveys present a unique opportunity to study sedentary time in more detail. This study aimed to use the 2006 Dutch time use survey to 1) describe the (sedentary) time use of Dutch adults, and 2) explore socio-demographic and health-related correlates of total (non-occupational) and domain-specific sedentary time. Methods The Dutch time use survey randomly selected participants from a population-representative research sample of Dutch households. Participants reported daily activities on seven consecutive days using a time use diary and socio-demographic and health-related characteristics during telephone interviews. All reported activities were coded for activity domain (i.e. education; household; leisure; occupation; sleep; transport; voluntary work) and activity intensity (i.e. sedentary; light intensity physical activity; moderate-to-vigorous intensity physical activity). As occupational activities were not specified in sufficient detail, the intensity of these activities was unknown. We described the time spent in different domains and intensities, and assessed the socio-demographic and health-related correlates of high levels of total (non-occupational), household, leisure, and transport sedentary time using logistic regression analyses. Results The final dataset consisted of 1614 adult (18+) participants. On average, participants spent 8.0 h (61.1%) of their daily waking non-occupational time on sedentary activities. More than 87% of leisure time was spent sedentary. Men, participants aged 18–34 and 65+ years, full-time employed participants and obese participants had higher levels of total non-occupational sedentary time. The correlates of household, leisure and transport sedentary time differed by domain. Conclusions This study reports high levels of total non-occupational sitting time of Dutch adults. The large proportion of sedentary leisure activities might indicate the potential of strategies aiming to reduce leisure sedentary time. The difference in correlates across sedentary behaviour domains demonstrates the importance of targeting these domains differently in interventions and policies.

BACKGROUND Occupying new, active design office buildings designed for health promotion and connectivity provides an opportunity to evaluate indoor environment effects on healthy behaviour, sedentariness and workplace perceptions. AIMS To determine if moving to a health-promoting building changed workplace physical activity, sedentary behaviour, workplace perceptions and productivity. METHODS Participants from four locations at the University of Sydney, Australia, relocated into a new active design building. After consent, participants completed an online questionnaire 2 months before moving and 2 months after. Questions related to health behaviours (physical activity and sitting time), musculoskeletal issues, perceptions of the office environment, productivity and engagement. RESULTS There were 34 participants (60% aged 25-45, 78% female, 84% employed full-time); 21 participants provided complete data. Results showed that after the move participants spent less work time sitting (83-70%; P < 0.01) and more time standing (9-21%; P < 0.01), while walking time remained unchanged. Participants reported less low back pain (P < 0.01). Sixty per cent of participants in the new workplace were in an open-plan office, compared to 16% before moving. Participants perceived the new work environment as more stimulating, better lit and ventilated, but noisier and providing less storage. No difference was reported in daily physical activity, number of stairs climbed or productivity. CONCLUSIONS Moving to an active design building appeared to have physical health-promoting effects on workers, but workers' perceptions about the new work environment varied. These results will inform future studies in other new buildings.

This study aimed to explore the trend in population levels, as well as the correlates, of occupational and leisure sitting time in full-time employed Australian adults between 2007 and 2015. We used data from the 2007/08, 2011/12 and 2014/15 Australian Health Surveys, in which nationally representative samples of the Australian population were interviewed. Full-time (35 hours/week) employed respondents reported sitting time at work and during leisure on a usual workday. Trends over time and associations between socio-demographic and health-related characteristics and sitting time were analysed in the combined dataset using multivariable logistic regression models. Over 21,000 observations were included in the analyses. Across the three surveys, approximately 51% of the respondents reported 4 hours/workday occupational sitting time, 40% reported 4 hours/workday leisure sitting time, and 55% reported 7 hours/workday combined occupational and leisure sitting time. There were no clear trends over time. All potential correlates were associated with occupational sitting time and all but educational level were associated with leisure sitting time. The directions of the associations with gender, age and leisure-time physical activity were reversed for occupational sitting time and leisure sitting time. These findings show that the average levels of occupational and leisure sitting time on workdays were high but stable over the past decade. The observed differences in correlates of occupational and leisure sitting time demonstrate the need to assess and address sedentary behaviour domains separately in research and policy.

Background: Sedentary behaviour is a potential risk factor for chronic-ill health and mortality, that is, independent of health-enhancing physical activity. Few studies have investigated the risk of mortality associated with multiple contexts of sedentary behaviour. Objective: To examine the prospective associations of total sitting time, TV-viewing time and occupational sitting with mortality from all causes and cardiometabolic diseases. Methods: Data from 50 817 adults aged ≥20 years from the Nord-Trøndelag Health Study 3 (HUNT3) in 2006-2008 were linked to the Norwegian Cause of Death Registry up to 31 December 2010. Cox proportional hazards models examined all-cause and cardiometabolic disease-related mortality associated with total sitting time, TV-viewing and occupational sitting, adjusting for multiple potential confounders including physical activity. Results: After mean follow-up of 3.3 years (137 315.8 person-years), 1068 deaths were recorded of which 388 were related to cardiometabolic diseases. HRs for all-cause mortality associated with total sitting time were 1.12 (95% CI 0.89 to 1.42), 1.18 (95% CI 0.90 to 1.57) and 1.65 (95% CI 1.24 to 2.21) for total sitting time 4

Objective Occupational sitting time in white-collar workers represents a prominent contributor to overall daily sitting time, which is associated with various health risks. Workplace interventions intending to reduce sitting time during work typically focus on replacing sitting with standing. The aim was to investigate and compare actual and desired proportions of time spent sitting, standing, walking, and doing physically demanding tasks at work reported by desk-based workers. Cross-sectional data were collected from German desk-based workers (n = 614; 53.3% men; 40.9 ± 13.5 years). All were interviewed about their self-reported actual and desired level of sitting, standing, walking and physically demanding tasks at work. Results Desk-based workers reported to sit 73.0%, stand 10.2%, walk 12.9% and do physically demanding tasks 3.9% of their working hours. However, the individuals desire to sit, stand, walk and do physically demand tasks significantly different [53.8% sit, 15.8% stand, 22.8% walk, physically demanding tasks (7.7%), p

Background Current evidence concerning sedentary behaviour and mortality risk has used single time point assessments of sitting. Little is known about how changes in sitting levels over time affect subsequent mortality risk. Aim To examine the associations between patterns of sitting time assessed at two time points 11 years apart and risk of all-cause and cardio-metabolic disease mortality. Methods Participants were 25,651 adults aged > =20 years old from the Nord-Trøndelag Health Study with self-reported total sitting time in 1995-1997 (HUNT2) and 2006-2008 (HUNT3). Four categories characterised patterns of sitting: (1) low at HUNT2/ low at HUNT3, ‘consistently low sitting’; (2) low at HUNT2/high at HUNT3, ‘increased sitting’; (3) high at HUNT2/low at HUNT3, ‘reduced sitting’; and (4) high at HUNT2 /high at HUNT3, ‘consistently high sitting’. Associations of sitting pattern with all-cause and cardio-metabolic disease mortality were analysed using Cox regression adjusted for confounders. Results Mean follow-up was 6.2 years (158880 person-years); 1212 participants died. Compared to ‘consistently low sitting’, adjusted hazard ratios for all-cause mortality were 1.51 (95% CI: 1.28–2.78), 1.03 (95% CI: 0.88–1.20), and 1.26 (95% CI: 1.06–1.51) for ‘increased sitting’, ‘reduced sitting’ and ‘consistently high sitting’ respectively. Conclusions Examining patterns of sitting over time augments single time-point analyses of risk exposures associated with high sitting time. Whilst sitting habits can be stable over a long period, life events (e.g., changing jobs, retiring or illness) may influence sitting trajectories and therefore sitting-attributable risk. Reducing sitting may yield mortality risks comparable to a stable low-sitting pattern. © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Pokémon Go has been subject to much attention – from both the players that download the augmented reality game and the news media. Amid the exaggerated media reports, Pokémon Go may have unintended health benefits. Players have reported walking more, spending more time with family, experiencing improvements in their mental health and feeling more connected to their communities. It is hard to imagine public health researchers developing a similar game that is fun, taps into pop culture, reaches a wide target audience, makes use of physical and virtual environments, creates a sense of both competition and community, and has spin-off health benefits. Companies that endanger public health immediately recognised the value of the Pokémon Go app, and exploited it to advertise and promote consumption of unhealthy foods. Public health stakeholders need to develop mobile-based interventions within a framework that embraces pleasure, rewards, participation and community. Public health agencies need to be just as nimble and responsive as companies that are harmful to health, or forever be creating games that nobody plays.

Objective Socioeconomic position (SEP) is associated with health-related behaviours but little is known about the socioeconomic gradient of sedentary behaviour. This study aims to assess the associations between SEP and multiple indicators of sedentary behaviour among Australian mid-to-older age adults. Method Multivariate analysis of 60,404 (> 47 years, 26,366 in paid employment) participants in the Social, Economic, and Environmental Factor Study, examining the associations between SEP (educational attainment, household income, and an area-level index of socioeconomic advantage) and self-reported daily time for total sitting, TV viewing, computer use, and car driving. Data was collected in 2010 in New South Wales, Australia. Results For participants in paid employment, we found positive associations with all SEP indicators for total sitting and computer use time, and inverse associations for TV viewing. Driving time was inversely associated with education level only. We observed similar but less pronounced patterns of associations among participants not in paid employment. Conclusion Higher SEP is linked to higher total sitting and computer time, particularly among those in paid employment, and lower TV viewing time.

Objectives: To examine associations of total sitting time, TV-viewing and leisure-time computer use with cardiometabolic risk biomarkers in adults. Design: Population based cross-sectional study. Methods: Waist circumference, BMI, total cholesterol, HDL cholesterol, blood pressure, non-fasting glucose, gamma glutamyltransferase (GGT) and triglycerides were measured in 48,882 adults aged 20 years or older from the Nord-Trøndelag Health Study 2006-2008 (HUNT3). Adjusted multiple regression models were used to test for associations between these biomarkers and self-reported total sitting time, TV-viewing and leisure-time computer use in the whole sample and by cardiometabolic disease status sub-groups. Results: In the whole sample, reporting total sitting time ≥10. h/day was associated with poorer BMI, waist circumference, total cholesterol, HDL cholesterol, diastolic blood pressure, systolic blood pressure, non-fasting glucose, GGT and triglyceride levels compared to those reporting total sitting time

Objective To determine the association between standing time and all-cause mortality. Methods Prospective questionnaire data from 221,240 individuals from the 45 and Up Study were linked to mortality data from the New South Wales Registry of Deaths (Australia) from February 1, 2006 to June 17, 2012. Hazard ratios for all-cause mortality according to standing time at baseline were estimated in 2013 using Cox regression modelling, adjusted for sex, age, education, urban/rural residence, physical activity, sitting time, body mass index, smoking status, self-rated health and disability. Results During 937,411 person years (mean follow-up = 4.2 yr) 8009 deaths occurred. All-cause mortality hazard ratios were 0.90 (95% CI 0.85–0.95), 0.85 (95% CI 0.80–0.95), and 0.76 (95% CI 0.69–0.95) for standing 2–≤ 5 h/d, 5 – ≤ 8 h/d, or > 8 h/d respectively, compared to standing two or less hours per day. Further analyses revealed no significant interactions between standing and sex (p = 0.93), the presence/absence of cardiovascular disease or diabetes (p = 0.22), BMI (p = 0.78), physical activity (p = 0.16) and sitting time (p = 0.22). Conclusion This study showed a dose–response association between standing time and all-cause mortality in Australian adults aged 45 years and older. Increasing standing may hold promise for alleviating the health risks of prolonged sitting.

Objective: To examine trends in leisure time physical activity and inactivity in Australians aged 15 years or older from 1989 to 2011. Method: We used data from six Australian National Health Surveys conducted from 1989/90 to 2011/12 in which physical activity was assessed using comparable questions. Analyses examined trends in the prevalence of sufficient physical activity (≥150 minutes/week moderate-to-vigorous physical activity) and of inactivity (

Issue addressed Ecological momentary assessment (EMA) involves repeated sampling of current behaviours and experiences in real-time at random intervals. EMA is an innovative measurement method for program evaluation, using mobile technology (e.g. smartphones) to collect valid contextual health promotion data with good compliance. The present study examined the feasibility of using EMA for measuring workplace health outcomes. Methods Twenty-two office-based adults were prompted at four random times per work-day during a 5-day period to respond to a short survey via a smartphone application. The prompting stopped when participants had either responded 12 times or the 5-day period had ended. The questions pertained to posture, task currently being undertaken, social interactions, musculoskeletal issues, mood, and perceptions of engagement and creativity. Results In total 156 responses were collected. Nine participants completed all 12 surveys; the average completion rate was 58% (7/12). The average completion time was initially 50s and reduced to 24s during the later surveys. On average the participants were sitting and standing in 79% and 14% of survey instances, respectively. The participants reported they were working alone at their desks in 68% of instances. Reported productivity and stress were on average 6 and 3 out of 10, respectively, but varied up to 6-8 points within one person, hence the method appears sensitive to temporal variations in perceptions and mood. Conclusion Given the rich real-time data, minimal participant burden and use of readily available technology, EMA has substantial potential in workplace health promotion evaluation through the measurement of participants' well being, activities, and behaviour change. So what? An in-the-moment method using readily available mobile technology to assess participants' perceptions, mood and activity that provides rich information with minimal participant burden is a promising way to evaluate future health promotion programs.

Objective: To examine the associations of physical activity (PA) and sitting time (sit) with cardio-metabolic diseases. Methods: Cross-sectional data from the Australian National Nutrition and Physical Activity Survey 2011–2012 (n=9,435) were used to classify adults into low and high risk groups based on their physical activity and sitting behaviour profiles. Logistic regression models examined associations between low and high risk classifications (high PA-low sit; high PA-high sit; low PA-low sit; low PA-high sit;) and socio-demographic factors, and associations between low and high risk classifications and the prevalence of cardiovascular disease, Type 2 diabetes and metabolic syndrome. Results: These results characterise chronic disease risk based on both physical activity and sitting behaviour. Adults with the highest risk lifestyle behaviour pattern (low PA-high sit) tended to be middle aged, male, at greater social disadvantage, smoke, report fair health, be abdominally obese and employed in administrative and driver occupations. These individuals had a substantially greater risk of cardiovascular disease and metabolic syndrome (OR=1.41, 95% CI 1.13, 1.75; OR= 2.37, 95% CI 1.63, 3.45, respectively). Conclusions: The findings highlight the importance of both sufficient physical activity and low sitting time for cardio-metabolic health. Implications for public health: Primary prevention focus should consider physical activity and reduced sitting time as well as provision of relevant advice for cardio-metabolic health.

PURPOSE: Sitting at work is an emerging occupational health risk. Few instruments designed for use in population-based research measure occupational sitting and standing as distinct behaviors. This study aimed to develop and validate brief measure of occupational sitting and physical activity. METHODS: A convenience sample (n = 99, 61% female) was recruited from two medium-sized workplaces and by word-of-mouth in Sydney, Australia. Participants completed the newly developed Occupational Sitting and Physical Activity Questionnaire (OSPAQ) and a modified version of the MONICA Optional Study on Physical Activity Questionnaire (modified MOSPA-Q) twice, 1 wk apart. Participants also wore an ActiGraph accelerometer for the 7 d in between the test and retest. Analyses determined test-retest reliability with intraclass correlation coefficients and assessed criterion validity against accelerometers using the Spearman ρ. RESULTS: The test-retest intraclass correlation coefficients for occupational sitting, standing, and walking for OSPAQ ranged from 0.73 to 0.90, while that for the modified MOSPA-Q ranged from 0.54 to 0.89. Comparison of sitting measures with accelerometers showed higher Spearman correlations for the OSPAQ (r = 0.65) than for the modified MOSPA-Q (r = 0.52). Criterion validity correlations for occupational standing and walking measures were comparable for both instruments with accelerometers (standing: r = 0.49; walking: r = 0.27-0.29). CONCLUSIONS: The OSPAQ has excellent test-retest reliability and moderate validity for estimating time spent sitting and standing at work and is comparable to existing occupational physical activity measures for assessing time spent walking at work. The OSPAQ brief instrument measures sitting and standing at work as distinct behaviors and would be especially suitable in national health surveys, prospective cohort studies, and other studies that are limited by space constraints for questionnaire items.

Background Sitting time is an emerging health risk, and many working adults spend large amounts of time sitting each day. It is important to have reliable and accurate measurement tools to assess sitting time in different contexts. Objective To validate the Workforce Sitting Questionnaire (WSQ), an adapted measure of total and domain-specifi c sitting time based on work and nonworkdays for use in working adults. Methods A convenience sample (N=95, 63.2% women) was recruited from two workplaces and by word-ofmouth in Sydney, Australia. Participants completed the WSQ, which asked about sitting time (1) while travelling to and from places; (2) while at work; (3) while watching TV; (4) while using a computer at home; and (5) while doing other leisure activities on work and non-workdays on two occasions, 7 days apart. Participants also wore an accelerometer for the 7 days between test and retest. They recorded the times they wore the accelerometer, the days they worked and their work times in a logbook. Analyses determined test-retest reliability with intraclass correlation coeffi cients (ICCs) and assessed criterion validity against accelerometers using Spearman's r and Bland-Altman plots. Results Measuring total sitting time based on a workday, non-workday and on average had fair to excellent test-retest reliability (ICC=0.46-0.90) and had suffi cient criterion validity against accelerometry in women (r=0.22-0.46) and men (r=0.18-0.29). Measuring domain-specifi c sitting at work on a workday was also reliable (ICC=0.63) and valid (r=0.45). Conclusions The WSQ has acceptable measurement properties for measuring sitting time at work on a workday and for assessing total sitting time based on work and non-workdays. This questionnaire would be suitable for use in research investigating the relationships between sitting time and health in working populations.

Objective: Trends on Australian free-to-air television show children continue to be exposed to a disproportionate amount of unhealthy food advertising. This study describes the nature and extent of food marketing on the Australian subscription television channels most popular with children. Methods: Advertisements broadcast on the six subscription television channels most popular with children were recorded over four days in February 2009. Advertised foods were coded as core/healthy, non-core/unhealthy or miscellaneous/other, and for persuasive marketing techniques (promotional characters, premium offers and nutrition claims). Results: The majority of foods advertised were non-core (72%), with a mean rate of 0.7 non-core food advertisements broadcast per hour, per channel. The frequency of non-core food advertisements differed significantly across channels. Persuasive techniques were used to advertise non-core foods less frequently than core and miscellaneous foods. Conclusions and implications: Non-core foods make up the majority of foods advertised on children's popular subscription channels. However, Australian children currently view less non-core food advertising on subscription television compared with free-to-air. Unlike free-to-air television, subscription services have the unique opportunity to limit inappropriate food marketing to children, given they are less reliant on advertising revenue.

Objective To examine population trends in lifestyle walking in New South Wales (NSW), Australia between 1998 and 2006. Methods Computer Assisted Telephone Interviewing surveys were conducted in 1998 and annually from 2002 to 2006. The weighted and standardized prevalence estimates of any walking (AW) for exercise, recreation or travel (i.e. ≥ 10 min/week) and of regular walking (RW) (i.e. ≥ 150 mins/week over ≥ 5 occasions) in population sub-groups were determined for each year. Adjusted annual change was calculated using multiple regression analyses. Results The prevalence of AW was high in 1998 (80.0%, 95% CI: 79.4%–80.6%) and increased to 83.5% (95% CI: 82.7%–84.3%) in 2006. The prevalence of RW was stable between 1998 and 2003 (∼ 29%), and gradually increased between 2004 (32.9%, 95% CI: 32.0%–33.8%) and 2006 (36.5%, 95% CI: 35.4%–37.6%). The yearly increases differed in magnitude but were significant for all population sub-groups including 75 years and older, the obese, people living in remote locations and those in the most disadvantaged socio-economic status quintile. Socio-economic differential in RW was no longer significant in 2006. Conclusion Over time, everyday walking has the potential to reduce health inequalities that is due to inactivity. Public health efforts to promote active living and address obesity, as well as a rise in gasoline prices, might have contributed to this trend.

Objective: To examine recent trends in sufficient physical activity among New South Wales adults aged 16 years and over. Method: Data were obtained from New South Wales population health surveys conducted in 1998 and from 2002 to 2005. Analyses examined trends in the proportions of adults achieving sufficient physical activity and trends in different modes of activity. Results: The proportion of adults achieving sufficient physical activity was stable between 1998 (47.6%) and 2002 (46.5%), declined in 2003 (44.7%), increased substantially in 2004 (50.5%), and remained steady in 2005 (51.3%). This increase was evident across different population groups. Adults who did any walking were 18 times more likely to be active than those who did no walking. Conclusion: Findings indicate that in recent years physical activity participation has begun to increase, and that this increase occurred across population segments. The increases occurred especially in walking behaviours. Implications: Given the known health benefits of being physically active, continued investment in physical activity promotion policies and programs is necessary to maintain these early gains.

Background Sedentary behaviour, sleeping, and physical activity are thought to be independently associated with health outcomes but it is unclear whether these associations are due to the direct physiological effects of each behaviour or because, across a finite 24-hour day, engagement in one behavior requires displacement of another. The aim of this study was to examine the replacement effects of sedentary behaviour (total sitting, television/computer screen time combined), sleeping, standing, walking, and moderate-to-vigorous physical activity on all-cause mortality using isotemporal substitution modelling. Methods Longitudinal analysis (4.22 ± 0 · 9 years follow-up/849,369 person-years) of 201,129 participants of the 45 and Up study aged ≥45 years from New South Wales, Australia. Results Seven thousand four hundred and sixty deaths occurred over follow-up. There were beneficial associations for replacing total sitting time with standing (per-hour HR: 95 % CI: 0.95, 0.94–0.96), walking (0.86, 0.81–0.90), moderate-to-vigorous physical activity (0.88, 0.85–0.90), and sleeping in those sleeping ≤ 7 h/day (0.94, 0.90–0.98). Similar associations were noted for replacing screen time. Replacing one hour of walking or moderate-to-vigorous physical activity with any other activity class was associated with an increased mortality risk by 7–18 %. Excluding deaths in the first 24 months of the follow up and restricting analyses to those who were healthy at baseline did not materially change the above observations. Conclusion Although replacing sedentary behaviour with walking and moderate-to-vigorous physical activity are associated with the lowest mortality risk, replacements with equal amounts of standing and sleeping (in low sleepers only) are also linked to substantial mortality risk reductions. Electronic supplementary material The online version of this article (doi:10.1186/s12966-015-0280-7) contains supplementary material, which is available to authorized users.

Population aging is associated with a rising burden of non-communicable disease, profoundly impacting health policy and practice. Adopting and adhering to healthy lifestyles in middle or older age can protect against morbidity and mortality. Retirement brings opportunities to reconfigure habitual lifestyles and establish new routines. This study examines the longitudinal association between retirement and a range of lifestyle risk behaviors among a large population-based sample of Australian adults.Study sample included working adults aged ≥45 years at baseline (2006-2009, N=23,478-26,895). Lifestyle behaviors, including smoking, alcohol use, physical activity, diet, sedentary behavior, and sleep, were measured at both baseline and follow-up (2010). Logistic regression models estimated the odds of having each risk factor at follow-up and multiple linear regression models calculated the change in the total number of risk factors, adjusted for baseline risk and other covariates. Sociodemographic characteristics and reasons for retirement were tested as potential effect modifiers.During the 3.3-year follow-up, about 11% of respondents retired. Retirement was associated significantly with reduced odds of smoking (AOR=0.74); physical inactivity (AOR=0.73); excessive sitting (AOR=0.34); and at-risk sleep patterns (AOR=0.82). There was no significant association between retirement and alcohol use or fruit and vegetable consumption. Change in the total number of lifestyle risk factors differed significantly by reason for retirement.In a large population-based Australian cohort, retirement was associated with positive lifestyle changes. Health professionals and policymakers should consider developing special programs for retirees to capitalize on the healthy transitions through retirement.

Background: Mental health disorders are major contributors to the global burden of disease and their inverse relationship with physical activity is widely accepted. However, research on the association between physical activity and positive mental health outcomes is limited. Happiness is an example of a positive construct of mental health that may be promoted by physical activity and could increase resilience to emotional perturbations. The aim of this study is to use a large multi-country dataset to assess the association of happiness with physical activity volume and its specificity to intensity and/or activity domain.Methods: We analysed Eurobarometer 2002 data from 15 countries (n = 11,637). This comprised one question assessing self-reported happiness on a six point scale (dichotomised: happy/unhappy) and physical activity data collected using the IPAQ-short (i.e. walking, moderate, vigorous) and four domain specific items (i.e. domestic, leisure, transport, vocation). Logistic regression was used to examine the association between happiness and physical activity volume adjusted for sex, age, country, general health, relationship status, employment and education. Analyses of intensity and domain specificity were assessed by logistic regression adjusted for the same covariates and physical activity volume.Results: When compared to inactive people, there was a positive dose-response association between physical activity volume and happiness (highly active: OR = 1.52 [1.28-1.80]; sufficiently active: OR = 1.29 [1.11-1.49]; insufficiently active: OR = 1.20 [1.03-1.39]. There were small positive associations with happiness for walking (OR = 1.02 [1.00-1.03]) and vigorous-intensity physical activity (OR = 1.03 [1.01-1.05). Moderate-intensity physical activity was not associated with happiness (OR = 1.01 [0.99-1.03]). The strongest domain specific associations with happiness were found for "a lot" of domestic (OR = 1.42 [1.20-1.68]) and "some" vocational (OR = 1.33 [1.08-1.64]) physical activity. Happiness was also associated with "a lot" of leisure physical activity (OR = 1.15 [1.02-1.30]), but there were no significant associations for the transport domain.Conclusions: Increasing physical activity volume was associated with higher levels of happiness. Although the influence of physical activity intensity appeared minimal, the association with happiness was domain specific and was strongest for "a lot" of domestic and/or "some" vocational physical activity. Future studies to establish causation are indicated and may prompt changes in how physical activity for improving mental health is promoted.

BackgroundObesity campaign evaluations have used campaign awareness to assess impact, yet have not compared unprompted campaign recallers, with prompted recallers and those with no campaign recall. Using data from an Australian mass-media obesity prevention campaign linking waist circumference and chronic disease we examined whether those with different degrees of campaign recall are distinct groups demographically and for subsequent campaign effects.MethodsA national cross-sectional telephone survey of randomly selected adults aged 18 to 65 years was conducted post- campaign (n = 2812) covering campaign recall, self-reported diet and physical activity (PA) and waist-measuring knowledge, behaviours and intentions to make lifestyle changes. Respondents were divided into three groups indicating campaign recall: Unprompted Recallers (n=1154); Prompted Recallers (n=1284); and No Recallers (n=374) and compared on demographic, knowledge, and behavioural risk factors for obesity/chronic disease.ResultsUnprompted Recallers were more likely to speak English at home (pConclusionsUnprompted recallers were more knowledgeable about campaign messages; behaviour change and intentions to change were stronger for the two recall groups compared with the No Recall group but not different between them. The current analysis revealed subtle differences in campaign exposure and/or attendance by different demographic subgroups that would not be apparent in a simple aware/unaware dichotomy.

Background: Evidence on the detrimental health effects of prolonged sedentary behavior is accumulating. Interventions need to have a specific focus on sedentary behavior in order to generate clinically meaningful decreases in sedentary time. When evaluating such intervention, the question whether a participant improved or deteriorated their behavior is fundamental and instruments that are able to detect those changes are essential. Therefore, the aim of this study was to determine the criterion validity against activPAL and responsiveness to change of two activity monitors (ActiGraph and activPAL) and two questionnaires for the assessment of occupational sitting and standing time. Methods: 42 participants took part in the Stand@Work intervention trial. Six (T0) and two (T1) weeks before they received a sit-stand workstation and three weeks thereafter (T2), participants wore an ActiGraph and an activPAL activity monitor, and completed the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) and the Workforce Sitting Questionnaire (WSQ). The activPAL was used as the criterion validity measure. Results: The ActiGraph showed strong validity for occupational sedentary time at T0 and T1 (Spearman rho = 0.77 and 0.69), but its validity dropped substantially after introduction of the sit-stand workstation (rho = 0.19). Correlations between occupational light-intensity activity assessed by the ActiGraph and occupational standing time assessed by the activPAL varied between 0.25-0.63. The occupational sitting validity correlation of the OSPAQ and WSQ varied from 0.35-0.48 and 0.25-0.30, respectively, and between 0.16-0.68 for the OSPAQ for occupational standing time. The intervention-induced changes in occupational sitting and standing time were well detected by the activPAL, OSPAQ and WSQ (sitting only), but not by the ActiGraph, which had the lowest responsiveness to change. Conclusions: This study suggests that studies aimed at determining differences in occupational sitting and standing time should use activPAL-type inclinometers as a preferred type of objective measure. Simple questionnaires showed sufficient validity and are usable in addition to an objective measure or alone when objective monitoring is not possible. The hip-worn ActiGraph was unable to distinguish between occupational sitting and standing time, when using uniaxial data and traditional cut-points for sedentary time and light-intensity activity. Trial registration: The study was registered with the Australian New Zealand Clinical Trials Registry (No. ACTRN 12612000072819).

Background Prolonged sitting time is detrimental for health. Individuals with desk-based occupations tend to sit a great deal and sit-stand workstations have been identified as a potential strategy to reduce sitting time. Hence, the objective of the current study was to examine the effects of using sit-stand workstations on office workers’ sitting time at work and over the whole day. Methods We conducted a randomized controlled trial pilot with crossover design and waiting list control in Sydney, Australia from September 2011 to July 2012 (n = 42; 86% female; mean age 38 ± 11 years). Participants used a sit-stand workstation for four weeks in the intervention condition. In the time-matched control condition, participants received nothing and crossed over to the intervention condition after four weeks. The primary outcomes, sitting, standing and walking time at work, were assessed before and after using the workstations with ActivPALs and self-report questionnaires. Secondary outcomes, domain-specific sitting over the whole day, were assessed by self-report. Linear mixed models estimated changes in outcomes adjusting for measurement time, study grouping and covariates. Results Intervention participants significantly reduced objectively assessed time spent sitting at work by 73 min/workday (95% CI: −106,-39) and increased standing time at work by 65 min/workday (95% CI: 47, 83); these changes were significant relative to controls (p = 0.004 and p

Background: Prolonged sitting time has been identified as a health risk factor. Sit-stand workstations allow desk workers to alternate between sitting and standing throughout the working day, but not much is known about their acceptability and feasibility. Hence, the aim of this study was to qualitatively evaluate the acceptability, feasibility and perceptions of using sit-stand workstations in a group of desk-based office workers. Methods. This article describes the qualitative evaluation of the randomized controlled cross-over Stand@Work pilot trial. Participants were adult employees recruited from a non-government health agency in Sydney, Australia. The intervention involved using an Ergotron Workfit S sit-stand workstation for four weeks. After the four week intervention, participants shared their perceptions and experiences of using the sit-stand workstation in focus group interviews with 4-5 participants. Topics covered in the focus groups included patterns of workstation use, barriers and facilitators to standing while working, effects on work performance, physical impacts, and feasibility in the office. Focus group field notes and transcripts were analysed in an iterative process during and after the data collection period to identify the main concepts and themes. Results: During nine 45-min focus groups, a total of 42 participants were interviewed. Participants were largely intrinsically motivated to try the sit-stand workstation, mostly because of curiosity to try something new, interest in potential health benefits, and the relevance to the participant's own and organisation's work. Most participants used the sit-stand workstation and three common usage patterns were identified: task-based routine, time-based routine, and no particular routine. Common barriers to sit-stand workstation use were working in an open plan office, and issues with sit-stand workstation design. Common facilitators of sit-stand workstation use were a supportive work environment conducive to standing, perceived physical health benefits, and perceived work benefits. When prompted, most participants indicated they were interested in using a sit-stand workstation in the future. Conclusions: The use of a sit-stand workstation in this group of desk-based office workers was generally perceived as acceptable and feasible. Future studies are needed to explore this in different desk-based work populations and settings.

Background There is mounting evidence for associations between sedentary behaviours and adverse health outcomes, although the data on occupational sitting and mortality risk remain equivocal. The aim of this study was to determine the association between occupational sitting and cardiovascular, cancer and all-cause mortality in a pooled sample of seven British general population cohorts. Methods The sample comprised 5380 women and 5788 men in employment who were drawn from five Health Survey for England and two Scottish Health Survey cohorts. Participants were classified as reporting standing, walking or sitting in their work time and followed up over 12.9 years for mortality. Data were modelled using Cox proportional hazard regression adjusted for age, waist circumference, self-reported general health, frequency of alcohol intake, cigarette smoking, non-occupational physical activity, prevalent cardiovascular disease and cancer at baseline, psychological health, social class, and education. Results In total there were 754 all-cause deaths. In women, a standing/walking occupation was associated with lower risk of all-cause (fully adjusted hazard ratio [HR] = 0.68, 95% CI 0.52–0.89) and cancer (HR = 0.60, 95% CI 0.43–0.85) mortality, compared to sitting occupations. There were no associations in men. In analyses with combined occupational type and leisure-time physical activity, the risk of all-cause mortality was lowest in participants with non-sitting occupations and high leisure-time activity. Conclusions Sitting occupations are linked to increased risk for all-cause and cancer mortality in women only, but no such associations exist for cardiovascular mortality in men or women.

Objective: To quantify the association between daily total sitting and all-cause mortality risk and to examine dose-response relationships with and without adjustment for moderate-to-vigorous physical activity. Methods: Studies published from 1989 to January 2013 were identified via searches of multiple databases, reference lists of systematic reviews on sitting and health, and from authors' personal literature databases. We included prospective cohort studies that had total daily sitting time as a quantitative exposure variable, all-cause mortality as the outcome and reported estimates of relative risk, or odds ratios or hazard ratios with 95% confidence intervals. Two authors independently extracted the data and summary estimates of associations were computed using random effects models. Results: Six studies were included, involving data from 595,086 adults and 29,162 deaths over 3,565,569 person-years of follow-up. Study participants were mainly female, middle-aged or older adults from high-income countries; mean study quality score was 12/15 points. Associations between daily total sitting time and all-cause mortality were not linear. With physical activity adjustment, the spline model of best fit had dose-response HRs of 1.00 (95% CI: 0.98-1.03), 1.02 (95% CI: 0.99-1.05) and 1.05 (95% CI: 1.02-1.08) for every 1-hour increase in sitting time in intervals between 0-3, >3-7 and >7 h/day total sitting, respectively. This model estimated a 34% higher mortality risk for adults sitting 10 h/day, after taking physical activity into account. The overall weighted population attributable fraction for allcause mortality for total daily sitting time was 5.9%, after adjusting for physical activity. Conclusions: Higher amounts of daily total sitting time are associated with greater risk of all-cause mortality and moderate-to-vigorous physical activity appears to attenuate the hazardous association. These findings provide a starting point for identifying a threshold on which to base clinical and public health recommendations for overall sitting time, in addition to physical activity guidelines. © 2013 Chau et al.

Background: Epidemiological research has established sitting as a new risk factor for the development of non-communicable chronic disease. Sit-stand desks have been proposed as one strategy to reduce occupational sedentary time. This formative research study evaluated the acceptability and usability of manually and electrically operated sit-stand desks in a medium-sized government organisation located in Sydney, Australia. Methods. Sitting time pre- and three months post -installation of the sit-stand desks was measured using validated self-report measures. Additionally, three group interviews and one key-informant interview were conducted with staff regarding perceptions about ease of, and barriers to, use and satisfaction with the sit-stand desks. All interviews were recorded, transcribed and analysed for themes regarding usability and acceptability. Results: Of 31 staff, 18 completed baseline questionnaires, and 13 completed follow-up questionnaires. The median proportion of sitting time for work was 85% (range 50%-95%) at baseline and 60% (range 10%-95%) at follow-up. Formal statistical testing of paired data (n=11) showed that the change from baseline to follow-up in time spent sitting (mean change=1.7 hours, p=.014) was statistically significant. From the qualitative data, reasons given for initiating use of the desks in the standing position were the potential health benefits, or a willingness to experiment or through external prompting. Factors influencing continued use included: concern for, and experience of, short and long term health impacts; perceived productivity whilst sitting and standing; practical accommodation of transitions between sitting and standing; electric or manual operation height adjustment. Several trajectories in patterns of initiation and continued use were identified that centered on the source and timing of commitment to using the desk in the standing position. Conclusions: Sit-stand desks had high usability and acceptability and reduced sitting time at work. Use could be promoted by emphasizing the health benefits, providing guidance on appropriate set-up and normalizing standing for work-related tasks. © 2013 Grunseit et al.; licensee BioMed Central Ltd.

Evidence is accumulating that sedentary behaviors have detrimental health effects. Comprehensive data on population changes in various sedentary behaviors over time are scarce.This study aimed to determine changes in non-occupational sedentary behaviors in the Dutch adult population between 1975 and 2005.The National Time Use Survey of the Netherlands was used, which has been collected in 5-year intervals since 1975 (seven time points, n range=1017-2845). Adult participants completed a 7-day time-use diary in which they recorded their primary activity in 15-minute intervals throughout or at the end of the day. A validated method was used to determine time spent in various non-occupational sedentary behaviors. Population-weighted analyses determining changes over time in various sedentary behaviors were carried out in 2011 and 2012.Between 1975 and 2005, the proportion of non-occupational time spent sedentary remained relatively constant at ~60%. However, absolute time decreased, because of a 4.7-hour/week increase in occupational time. Sedentary occupational time could not be studied but has likely increased over these 3 decades. Most non-occupational sedentary behavior was during leisure, and the proportion of sedentary leisure time that comes from screen time increased from 26% in 1975 to 43% in 2005. Between 1975 and 2005, sedentary transport increased by 2 hours/week.The nature and distribution of sedentary behaviors in the Dutch adult population changed substantially over 3 decades. Screen-based activities are playing an increasingly dominant role.

Aim To examine associations between occupational and leisure-time sitting, physical activity and obesity in working adults. Methods We analyzed data from workers from the 2007–08 Australian National Health Survey (n = 10,785). Participants reported their activity at work (mostly sitting, standing, walking, or heavy labor), transport-related walking, leisure-time sitting and physical activity. Body mass index was objectively measured. Adjusted Cox proportional hazard regression models examined associations between occupational activity category, leisure-time sitting, physical activity and obesity risk. Results Substantial proportions of men (42%) and women (47%) mostly sit at work. Workers with sitting jobs were significantly more likely to be sufficiently active during leisure-time than workers with mostly standing, walking or heavy labor jobs (RR = 0.88, 0.80, 0.86 respectively). Workers with mostly sitting jobs had significantly higher overweight/obesity risk than workers with mostly standing jobs (RR = 0.88, 95% CI: 0.82–0.95) independent of physical activity and leisure-time sitting. Workers with leisure-time sitting of less than four hours per day had significantly lower obesity risk than workers with four or more hours per day of leisure-time sitting (RR = 0.77, 95%CI: 0.69–0.87) independent of physical activity and occupational activity. Conclusions Sitting time and physical activity are independently associated with obesity. Leisure-time sitting may have a stronger association with obesity risk than occupational sitting.

Many countries conduct regular national time use surveys, some of which date back as far as the 1960s. Time use surveys potentially provide more detailed and accurate national estimates of the prevalence of sedentary and physical activity behavior than more traditional self-report surveillance systems. In this study, the authors determined the reliability and validity of time use surveys for assessing sedentary and physical activity behavior. In 2006 and 2007, participants (n = 134) were recruited from work sites in the Australian state of New South Wales. Participants completed a 2-day time use diary twice, 7 days apart, and wore an accelerometer. The 2 diaries were compared for test-retest reliability, and comparison with the accelerometer determined concurrent validity. Participants with similar activity patterns during the 2 diary periods showed reliability intraclass correlations of 0.74 and 0.73 for nonoccupational sedentary behavior and moderate/vigorous physical activity, respectively. Comparison of the diary with the accelerometer showed Spearman correlations of 0.57-0.59 and 0.45-0.69 for nonoccupational sedentary behavior and moderate/vigorous physical activity, respectively. Time use surveys appear to be more valid for population surveillance of nonoccupational sedentary behavior and health-enhancing physical activity than more traditional surveillance systems. National time use surveys could be used to retrospectively study nonoccupational sedentary and physical activity behavior over the past 5 decades.

Background:This paper reviewed a) mass media campaigns and b) ‘new media’ interventions to promote physical activity. They are different kinds of interventions, with campaigns being mass-reach communications efforts to increase population awareness of physical activity. ‘New media’ interventions assess the impact of web-based, internet, other ’new media’ and e-mail-delivered interventions to increase physical activity.Methods:Previous reviews of mass media campaigns and ‘new media’ interventions were assessed, and more recent peer-reviewed publications identified using routine electronic databases. For each area, a framework for interventions was described, and evidence for the effectiveness of these interventions, the main outcomes of interest, and methodological strengths and weaknesses were identified.Key recommendations:For mass media campaigns, key recommendations were to use consistent and well-branded messages, and for campaigns to be integrated across local, State and national levels, with sufficient resources to purchase sufficient media. Mass media campaigns should be subject to rigorous formative, process and impact evaluation. For ‘new media’ interventions, there is clear evidence of effectiveness, but efforts should be made to increase the reach and generalizability of these interventions. They should be provided as a low cost component of integrated communitywide physical activity programs.

BACKGROUND: Self-reported confidence ratings have been used in other research disciplines as a tool to assess data quality, and may be useful in epidemiologic studies. METHODS: We examined whether self-reported confidence in recall of physical activity was a predictor of the validity and retest reliability of physical activity measures from the European Prospective Investigation into Cancer and Nutrition (EPIC) past-year questionnaire and the International Physical Activity Questionnaire (IPAQ) last-7-day questionnaire.During 2005-2006 in Sydney, Australia, 97 men and 80 women completed both questionnaires at baseline and at 10 months and wore an accelerometer as an objective comparison measure for three 7-day periods during the same timeframe. Participants rated their confidence in recalling physical activity for each question using a 5-point scale and were dichotomized at the median confidence value. RESULTS: Participants in the high-confidence group had higher validity and repeatability coefficients than those in the low-confidence group for most comparisons. The differences were most apparent for validity of IPAQ moderate activity: Spearman correlation ρ = 0.34 (95% confidence interval [CI] = 0.08 to 0.55) and 0.01 (-0.17 to 0.20) for high- and low-confidence groups, respectively; and repeatability of EPIC household activity: ρ = 0.81 (0.72 to 0.87) and 0.63 (0.48 to 0.74), respectively, and IPAQ vigorous activity: ρ = 0.58 (0.43 to 0.70) and 0.29 (0.07 to 0.49), respectively. Women were less likely than men to report high recall confidence of past-year activity (adjusted odds ratio = 0.38; 0.18 to 0.80). CONCLUSIONS: Confidence ratings could be useful as indicators of recall accuracy (ie, validity and repeatability) of physical activity measures, and possibly for detecting differential measurement error and identifying questionnaire items that require improvement.

Background Prolonged sitting is an emerging health risk. However, multi-country comparative sitting data are sparse. This paper reports the prevalence and correlates of sitting time in 32 European countries. Methods Data from the Eurobarometer 64.3 study were used, which included nationally representative samples (n = 304-1,102) from 32 European countries. Face-to-face interviews were conducted during November and December 2005. Usual weekday sitting time was assessed using the International Physical Activity Questionnaire (short-version). Sitting time was compared by country, age, gender, years of education, general health status, usual activity and physical activity. Multivariable-adjusted analyses assessed the odds of belonging to the highest sitting quartile. Results Data were available for 27,637 adults aged 15–98 years. Overall, mean reported weekday sitting time was 309 min/day (SD 184 min/day). There was a broad geographical pattern and some of the lowest amounts of daily sitting were reported in southern (Malta and Portugal means 194–236 min/day) and eastern (Romania and Hungary means 191–276 min/day) European countries; and some of the highest amounts of daily sitting were reported in northern European countries (Germany, Benelux and Scandinavian countries; means 407–335 min/day). Multivariable-adjusted analyses showed adults with low physical activity levels (OR = 5.10, CI95 = 4.60-5.66), those with high sitting in their main daily activity (OR = 2.99, CI95 = 2.74-3.25), those with a bad/very bad general health state (OR = 1.87, CI95 = 1.63-2.15) and higher education levels (OR = 1.48, CI95 = 1.38-1.59) were more likely to be in the highest quartile of daily sitting time. Adults within Greece (OR = 2.91, CI95 = 2.51-3.36) and Netherlands (OR = 2.56, CI95 = 2.22-2.94) were most likely to be in the highest quartile. High-sit/low-active participants comprised 10.1% of the sample. Adults self-reporting bad/very bad general health state (OR = 4.74, CI95 = 3.97-5.65), those within high sitting in their main daily activities (OR = 2.87, CI95 = 2.52-3.26) and adults aged ≥65 years (OR = 1.53, CI95 = 1.19-1.96) and were more likely to be in the high-sit/low-active group. Conclusions Weekday sitting time and its demographic correlates varied considerably across European countries, with adults in north-western European countries sitting the most. Sitting is prevalent across Europe and merits attention by preventive interventions.

Background Current epidemiological data highlight the potential detrimental associations between sedentary behaviours and health outcomes, yet little is known about temporal trends in adult sedentary time. This study used time use data to examine population trends in sedentary behaviours in non-occupational domains and more specifically during leisure time. Methods We conducted secondary analysis of population representative data from the Australian Time Use Surveys 1992, 1997 and 2006 involving respondents aged 20 years and over with completed time use diaries for two days. Weighted samples for each survey year were: n = 5851 (1992), n = 6419 (1997) and n = 5505 (2006). We recoded all primary activities by domain (sleep, occupational, transport, leisure, household, education) and intensity (sedentary, light, moderate). Adjusted multiple linear regressions tested for differences in time spent in non-occupational sedentary behaviours in 1992 and 1997 with 2006 as the reference year. Results Total non-occupational sedentary time was slightly lower in 1997 than in 2006 (mean = 894 min/2d and 906 min/2d, respectively; B = −11.2; 95%CI: -21.5, -0.9). Compared with 2006, less time was spent in 1997 in sedentary transport (B-6.7; 95%CI: -10.4, -3.0) and sedentary education (B = −6.3; 95%CI: -10.5, -2.2) while household and leisure sedentary time remained stable. Time engaged in different types of leisure-time sedentary activities changed between 1997 and 2006: leisure-time computer use increased (B = −26.7; 95%CI: -29.5, -23.8), while other leisure-time sedentary behaviours (e.g., reading, listening to music, hobbies and crafts) showed small concurrent reductions. In 1992, leisure screen time was lower than in 2006: TV-viewing (B = −24.2; 95%CI: -31.2, -17.2), computer use (B = −35.3; 95%CI: -37.7, -32.8). In 2006, 90 % of leisure time was spent sedentary, of which 53 % was screen time. Conclusions Non-occupational sedentary time has increased slightly from 1997 to 2006 in the Australian adult population. This seems to be the result of small increases in sedentary transport and education time while sedentary household and leisure time were stable over this time period. However, almost all leisure time is spent sedentary and the composition of sedentary leisure time changed between 1992 and 2006 towards a larger proportion being screen-based activities. This could be an important observation for public health, as most of the evidence on the detrimental effects of sedentary behaviour is around watching television and health.