Consumer physical activity tracking devices (PATs) have gained popularity to support individuals to be more active and less sedentary throughout the day. Wearable PATs provide real-time feedback of ...various fitness-related metrics such as tracking steps, sedentary time, and distance walked. The purpose of this study was to examine the prevalence and correlates of PAT ownership and use among a population-based sample of adults. A representative sample of adults ≥18 years (N = 1,215) from Alberta, Canada were recruited through random-digit dialing and responded to a questionnaire via computer-assisted telephone interviewing methods in summer 2016. Questionnaires assessed demographic and health behaviour variables, and items were designed to assess PAT ownership and usage. Logistic regression analysis (odds ratios) was used to assess correlates of PAT ownership and use. On average, participants (N = 1,215) were 53.9 (SD 16.7) years and 50.1% were female. Of the sample, 19.6% (n = 238) indicated they currently own and use a PAT. Participants who owned a PAT wore their device on average 23.2 days within the past month. Currently owning a PAT was significantly associated with being female (OR = 1.41, CI: 1.10 to 1.82), being <60 years of age (OR = 1.86, CI: 1.37 to 2.53), having at least some post secondary education (OR = 1.88, CI: 1.36 to 2.60), having a BMI ≥25 (OR = 1.52, CI: 1.16 to 1.99), and meeting physical activity guidelines (OR = 1.45, CI: 1.12 to 1.88). Similar correlates emerged for PAT use. Correlates significantly associated with PAT use and ownership included being female, being less than 60 years of age, having a post-secondary education, meeting physical activity guidelines, and being overweight/obese. This is the first study to examine characteristics of PAT ownership and use among Canadian adults.
Background
High levels of sedentary behavior may negatively affect health outcomes in cancer survivors. A systematic review and meta‐analysis was performed to clarify whether postdiagnosis sedentary ...behavior is related to survival, patient‐reported outcomes, and anthropometric outcomes in cancer survivors.
Methods
The Ovid MEDLINE, EMBASE, CINAHL (The Cumulative Index to Nursing and Allied Health Literature), and SPORTDiscus databases were searched from study inception to June 2019. Studies of adults who had been diagnosed with cancer that examined the association between sedentary behavior and mortality, patient‐reported outcomes (eg, fatigue, depression), or anthropometric outcomes (eg, body mass index, waist circumference) were eligible for inclusion. Meta‐analyses were performed to estimate hazard ratios for the highest compared with the lowest levels of sedentary behavior for all‐cause and colorectal cancer‐specific mortality outcomes. The ROBINS‐E (Risk of Bias in Nonrandomized Studies‐of Exposures tool) and the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system were used to assess the risk of bias and the strength of evidence, respectively.
Results
Thirty‐three eligible publications from a total of 3569 identified articles were included in the review. A higher level of postdiagnosis sedentary behavior was associated with an increased risk of all‐cause mortality (hazard ratio, 1.22; 95% CI, 1.06‐1.41; heterogeneity I2 statistic, 33.8%) as well as colorectal cancer‐specific mortality (hazard ratio, 1.53; 95% CI, 1.14‐2.06; I2, 0%). No clear or consistent associations between sedentary behavior and patient‐reported or anthropometric outcomes were identified. The risk of bias in individual studies ranged from moderate to serious, and the strength of evidence ranged from very low to low.
Conclusions
Although avoiding high levels of sedentary behavior after a cancer diagnosis may improve survival, further research is required to help clarify whether the association is causal.
Higher postdiagnosis sedentary behavior is associated with increased all‐cause and colorectal cancer‐specific mortality in cancer survivors. Consistent evidence for an association between sedentary behavior and patient‐reported or anthropometric outcomes is not identified.
Despite accumulating evidence linking screen-based sedentary behaviours (i.e. screen time) with poorer health outcomes among children and youth <18 years of age, the prevalence of these behaviours ...continues to increase, with roughly half of children and youth exceeding the public health screen time recommendation of 2 h per day or less. The purpose of this article is to provide an overview of key research initiatives aimed at understanding the associations between screen time and health indicators including physical health, quality of life and psychosocial health. Available evidence suggests that screen time is deleteriously associated with numerous health indicators in child and youth populations, including adiposity, aerobic fitness, quality of life, self-esteem, pro-social behaviour, academic achievement, depression and anxiety. However, few longitudinal or intervention studies have been conducted, with most of these studies focusing on physical health indicators. While most studies have used self-reported assessments of screen time, the availability of more objective assessment methods presents important opportunities (e.g. more accurate and precise assessment of sedentary time and screen time) and challenges (e.g. privacy and participant burden). Novel statistical approaches such as isotemporal substitution modelling and compositional analysis, as well as studies using longitudinal and experimental methodologies, are needed to better understand the health impact of excessive screen time, and to develop strategies to minimise or reverse the negative impacts of these behaviours. The evidence to date suggests a clear need for policy aimed at minimising the hazardous health consequences associated with screen time among children and youth.
•Distance-based interventions may increase physical activity levels of cancer survivors.•Overall, reviewed distance-based interventions showed a very small and limited effect on physical activity ...behavior.•Studies are targeting a subset of cancer survivors which limits generalizability.•Many studies have methodological limitations that limits inferences that can be drawn.•New approaches are needed to facilitate and support physical activity levels of cancer survivors.
Physically active cancer survivors have a reduced risk of cancer recurrence and mortality. Given the health advantages of active lifestyles in cancer survivorship, as well as the barriers preventing physical activity (e.g., geography, time) there is a need to develop and evaluate effective physical activity interventions that employ distance-based (i.e., non face-to-face) approaches. The primary objective of this study was to provide a systematic review and meta-analysis of present-day (2013–2018) distance-based physical activity behaviour change interventions for cancer survivors.
PubMed and Embase databases were searched from November 2012 up to June 2018. Studies were included that met the following criteria: (1) written in English, (2) included adult cancer survivors (either undergoing or completed treatment), (3) was a controlled intervention study, and (4) the intervention was distance-based (delivered via distance) with no more than one face-to-face contact. Review Manager 5 (RevMan 5) software was used to perform a meta-analysis on all randomized controlled trials (RCTs) that presented self-reported or objectively measured physical activity post-intervention means and standard deviations. Risk of bias for each study was assessed using The Cochrane Risk of Bias Tool.
We included 29 RCTs. Across the 29 studies, the total number of participants in these studies was 5218. Median sample size was 95 and ranged from 19 to 463. Thirteen (45%) studies focused on breast cancer survivors and median months since diagnosis was 24 (range 6–79). Moderate-to-vigorous intensity physical activity data from 24 RCTs were included in the meta-analysis and indicated an overall small effect (standardized mean difference) of 0.21 (95% CI 0.11–0.32) favoring the interventions.
Intervention effects on physical activity were small. Drawing conclusions from these trials remains challenging given major limitations of these trials included poor methodological design, small sample sizes, lack of statistical power, homogeneous samples (e.g., caucasian, young, well-educated), and poor measures of physical activity (e.g., self-report). Relying on the present landscape of distance-based programs aiming to facilitate physical activity among cancer survivors may not be prudent.
This study prospectively examined patterns of objectively assessed sedentary time and moderate-to-vigorous physical activity (MVPA) during a 1-year period following completion of primary treatment ...among breast cancer survivors. The potential moderating effect of weight status on sedentary and MVPA time was also examined.
Breast cancer survivors n = 177; M(SD)age = 54.9 (11.1) years, 85% White/Caucasian; 82% stage I or II cancer; M(SD)time since treatment = 3.5 (2.4) months who were recruited into a convenience sample had weight, height, and waist circumference measured and wore Actigraph GT3X accelerometers for 1 week every 3 months for 1 year. Data were analyzed using repeated measures ANOVA.
Survivors spent nearly 78% of their day sedentary across all time points compared with less than 2% of their day engaged in MVPA. Sedentary time remained fairly stable over 12 months, whereas MVPA levels significantly decreased. Survivors with an overweight body mass index and unhealthy waist-to-height ratio engaged in significantly less MVPA than healthy weight survivors, with significant waist-to-height ratio moderator effects for both sedentary and MVPA.
Sedentary time remains high in the first year following treatment for breast cancer, and MVPA decreases. These trends are more pronounced for survivors who are overweight, with stronger effects noted when waist-to-height ratio was examined compared with body mass index.
These findings suggest that breast cancer survivors may be doing very little to improve their lifestyle behaviors following a cancer diagnosis and treatments.
Inflammatory bowel disease (IBD) is a chronic relapsing and remitting disease with high morbidity, substantial health care costs, and increasing incidence. Fatigue is one of the most common symptoms ...that impacts quality of life and is a leading concern for patients with IBD. The aim of this study was to determine the global prevalence, risk factors, and impact of fatigue in adults with IBD.
A systematic review and meta-analysis was conducted. Data were retrieved from Medline, Embase, CINAHL, and PsycINFO from database inception to October 2019. A pooled prevalence of fatigue was calculated using a random-effects model. Stratified meta-analyses explored sources of between-study heterogeneity. Study quality was assessed using an adapted checklist from Downs and Black.
The search yielded 4524 studies, of which 20 studies were included in the systematic review and meta-analysis. Overall, the studies were of good quality. The pooled prevalence of fatigue was 47% (95% confidence interval, 41%-54%), though between-study heterogeneity was high (I
= 98%). Fatigue prevalence varied significantly by the definition of fatigue (chronic: 28%; high: 48%; P < .01) and disease status (active disease: 72%; remission: 47%; P < .01). Sleep disturbance, anxiety, depression, and anemia were the most commonly reported fatigue-related risk factors.
The prevalence of fatigue in adults with IBD is high, emphasizing the importance of additional efforts to manage fatigue to improve the care and quality of life for patients with IBD.
Delivered in person, yoga is effective in managing irritable bowel syndrome (IBS) symptoms. The evidence for efficacy, feasibility, and safety of virtually delivered yoga for patients with IBS is ...unknown.
Adults diagnosed with IBS were randomized to either Hatha yoga intervention of 8 weekly online classes delivered virtually or an advice-only control group and assessed at baseline and postintervention. We used an unadjusted ANOVA to determine differences between and within groups on the primary outcome (decrease of ≥50 points in IBS Symptom Severity Scale IBS-SSS) and secondary outcomes (quality of life, anxiety and depression, fatigue, somatic symptoms, perceived stress, COVID-19 stress, and self-compassion). We assessed feasibility through recruitment and attrition rates, adherence, participant satisfaction, and safety (i.e., adverse events).
Seventy-nine people participated (mean age 45.4 years SD = 14.0, 92% women, 20% attrition rate). IBS-SSS decreased significantly in the treatment group (Δ change = 54.7, P = 0.028), but not in the control group (Δ change = 22.6, P = 0.277). Fourteen patients (37%) in the yoga group reached a clinically relevant decrease of ≥50 points on the IBS-SSS postintervention compared with 8 patients (20%) in the control group ( P = 0.242). No significant difference was found between groups in IBS-SSS score postintervention ( P = 0.149), but significant differences in favor of the treatment group for quality of life ( P = 0.030), fatigue ( P = 0.035), and perceived stress ( P = 0.040) were identified. The yoga program demonstrated feasibility. Intention to practice yoga decreased significantly in both groups from baseline to postintervention ( P < 0.001). However, the decline in intention did not correlate with practice minutes.
Virtually delivered yoga is safe and feasible, and effective in reducing IBS symptoms. Based on the primary end point, the intervention was not superior to an advice-only control group.
Cancer survival is associated with considerable physical and psychosocial burden. Broadly accessible, nonpharmacologic measures that may extend disease-free survival, limit comorbid disease, and ...enhance quality of life are required. Sedentary behavior (too much sitting) is now understood to be a health risk that is additional to, and distinct from, the hazards of too little exercise. Of particular note, it is associated with adiposity, insulin resistance, and markers of inflammation. Therefore, it is plausible that sedentary behavior may contribute to adverse cancer outcomes (disease progression, recurrence, or death) and to the development of comorbid chronic disease. Initial studies indicate that cancer survivors spend two-thirds of their waking hours sitting. Among colorectal cancer survivors, sedentary behavior may contribute to all-cause and disease-specific mortality, weight gain, comorbid cardiovascular disease, and diminished quality of life. There is a need for dose-response evidence, and for a broader understanding of the underlying mechanisms by which prolonged sitting time may affect cancer survivors' health.
Background
The benefits of an active lifestyle after a breast cancer diagnosis are well recognized, but the majority of survivors are insufficiently active. The ACTIVATE Trial examined the efficacy ...of an intervention (use of the Garmin Vivofit 2 activity monitor coupled with a behavioral feedback and goal‐setting session and 5 telephone‐delivered health coaching sessions) to increase moderate to vigorous physical activity (MVPA) and reduce sedentary behavior in breast cancer survivors.
Methods
This randomized controlled trial recruited 83 inactive, postmenopausal women diagnosed with stage I‐III breast cancer who had completed primary treatment. Participants were randomly assigned to the intervention group or to the control group, and the intervention was delivered over a 12‐week period. MVPA and sedentary behavior were measured with Actigraph and activPAL accelerometers at baseline (T1) and at the end of the intervention (T2).
Results
Retention in the trial was high, with 80 (96%) of participants completing T2 data collection. At T2, there was a significant between‐group difference in MVPA (69 min/wk; 95% CI = 22‐116) favoring the intervention group. The trial resulted in a statistically significant decrease in both total sitting time and prolonged bouts (≥20 min) of sitting, with between‐group reductions of 37 min/d (95% CI = −72 to −2) and 42 min/d (95% CI = −83 to −2), respectively, favoring the intervention group.
Conclusion
Results from the ACTIVATE Trial suggest that the use of wearable technology presents an inexpensive and scalable opportunity to facilitate more active lifestyles for cancer survivors. Whether or not such wearable technology‐based interventions can create sustainable behavioral change should be the subject of future research.
A randomized controlled trial evaluated a 12‐week wearable technology‐based intervention to increase moderate to vigorous physical activity (MVPA) and reduce sitting time in breast cancer survivors. The intervention increased total MVPA (between‐group change = 69 min/week, 95% CI = 22‐116) and decreased total sitting time (−37 min/d; 95% CI = −72 to −2).
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