Healthy Aging Resources to Thrive (HART)

Not Applicable

Completed

Conditions: Sedentary Lifestyle

Interventions: Behavioral: i-STAND
Other: Healthy Living control

Registration Number: NCT03739762

Lead Sponsor: Kaiser Permanente

Brief Summary: Healthy Aging Resources to Thrive (HART) uses a rigorous two-stage randomized control design, adapted and refined based on pilot studies, to test a novel intervention to reduce sitting time in older adults. Half the participants will be randomized to the intervention aimed at decreasing sitting time, and the other half will be randomized to a healthy living control that does not focus on reduced sitting time. After 6 months, the intervention group will be further randomized so that half continue with the intervention and the other half receive no further intervention. All participants will be followed for 12 months.

Detailed Description: Healthy Aging Resources to Thrive (HART) is a two-stage randomized controlled trial (RCT) of adults over age 60 with obesity to determine the efficacy of a novel sitting-reduction intervention and its impact on cardiometabolic risk markers. Participants will be randomized to a 6-month sitting reduction intervention (termed I-STAND) or healthy-living attention control (Stage 1). All participants will be mailed a scale and a blood pressure monitor (to keep) which will be used during the phone-based measurement visits at Baseline, 3, 6 and 12 months. All participants will have phone-based Coaching sessions.

After 6 months, I-STAND participants will be re-randomized to receive either booster sessions or no further intervention (Stage 2). Attention control participants will receive no further intervention. All participants will be followed for 12 months total with phone-based assessments at baseline, 3, 6, and 12 months. Primary outcomes are reduction in sitting time at 6 months, objectively measured using the activPAL device, and blood pressure. The design will answer novel questions about the impact of sitting reduction on cardiometabolic risk markers as well as maintenance of sitting reduction.

UPDATE: As of 3/31/31, (final year 5) of the study, participants randomized to the i-STAND intervention will no longer be re-randomized at 6 months. We will no longer follow participants to the 12-month timepoint \& will end all activities after 6-months.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 283

Inclusion Criteria

• Self-reported sitting time of 6+ hours per day

BMI ≥30 and <50 kg/m2
men and women of all races and ethnicities from anywhere in the KPWA region (state-wide)
We will oversample people of color statewide
Able to walk one block
Able to speak and read English,
no self-reported vision limitations, sedentary time, use of an assistive device, able to stand.
no cognitive impairment that is perceived by the study staff during phone screening
Willingness to wear device (activPAL)
Willingness to participate in study for a full year
Continuously enrolled at KP for previous 12 months
Not on the No Contact list
Not previously enrolled in ISTAND or TABS
Not currently enrolled in ACT, STOP-FALLS or SMARRT studies

Exclusion Criteria

unable to speak and read English (phone screen)
unable to walk 1 block (with or without assistive devices) (phone screen)
self-reported sitting time less than 6 hours per day (phone screen)
diagnosis codes indicating hearing loss, dementia or serious mental illness (e.g., schizophrenia, bipolar disorder), or a terminal or serious illness (e.g., cancer) in the past 2 years (from the EMR)

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
i-STAND	i-STAND	i-STAND participants have a Baseline visit followed by the 1st Coaching visit. They receive wristbands that vibrate every 15 minutes to prompt a standing break, standing desks, workbook \& 10 phone-based coaching calls focused on sitting less/standing more. There is a 3 month measurement visit. Program ends at 6 months when they wear an activPAL \& have a measurement visit. Coach provides feedback on activPAL sitting time after all activPAL wears (Bsln, 3, 6 \& 12 month). They may opt to wear activPAL at 6 weeks \& get feedback. They are re-randomized at 6 months; half to be assigned to intervention boosters (5 more phone sessions/a 9-month optional activPAL) before the 12 month final activPAL \& final measurement visit. Those not randomized to boosters will have no contact until the 12 month visit. UPDATE: As of 3/31/2022, (final year 5), i-STAND ppts will no longer be re-randomized at 6 months. We will no longer follow to the 12-month timepoint \& will end all activities after 6-months.
Healthy Living control	Healthy Living control	In this arm, participants have a phone-based Baseline visit followed by the 1st phone-based Coaching visit. No prompting devices/desks are offered; coaching focuses on topics related to healthy living, but with no focus on sitting less/standing more. They have 10 phone calls with a health coach. Participants receive a workbook. All content is from KaiserPermanente WA and is available to all members. Participants select topics \& review them with their health coach. At 3 months, participants have a measurement visit. The program ends at 6 months where participants will wear an activPAL and have a measurement visit. After that, there is no contact with the study team until 12 months when they will again wear an activPAL \& have a final measurement visit. UPDATE: As of 3/31/2022, our final year (year 5) of the study, participants randomized to the control arm will no longer be followed to the 12-month timepoint and will end all activities after the 6-month timepoint.

Primary Outcome Measures

Name	Time	Method
Change in Time Spent Sitting or Lying Down at 6 Months	Change from Baseline at 6 months	Time (minutes) spent sitting/lying during waking hours will be measured objectively by the activPAL worn for one week following each measurement visit.
Change in SystolicBlood Pressure at 6 Months	Change from Baseline at 6 months	Another primary outcome is change in systolic blood pressure. This will be measured at the measurement visits using blood pressure monitors mailed to the participant
Change in Diastolic Blood Pressure at 6 Months	Change from Baseline at 6 months	Another primary outcome is change in diastolic blood pressure

Secondary Outcome Measures

Name	Time	Method
Change in Waist Circumference at 6 Months	Change from Baseline at 6 months	Participants provided their waist circumference at each measurement visit. Waist circumference was measured at the superior border of the iliac crest.
Change in Weight at 6 Months	Change from Baseline at 6 months	Participants provide their weight at each measurement visit. Weight is measured in pounds using a scale mailed to the participant.
Change in BMI at 6 Months	Change from Baseline at 6 months	BMI was calculated as \[weight in kg\]/\[height in m\]2.