Assessment of Physical Activity and Sitting Time among Adults: A Mixed Methods Pilot Study

Due to rapid urbanization and lifestyle modifications, the risk of non-communicable diseases is rising sharply, thereby placing a significant burden on the healthcare system.(1) The World Health Organization (WHO) defines physical activity as “any bodily movement produced by skeletal muscles that requires energy expenditure”.(2) Regular physical activity is essential for maintaining both physical and mental health, whereas sedentary behaviour has emerged as an independent risk factor for several health problems, including diabetes, obesity, cardiovascular diseases, and cancer.(3) Despite the well-established benefits of physical activity, studies conducted in India indicate alarmingly high levels of physical inactivity.(4-8) A study conducted in 2019 reported a prevalence of 71.9% physical inactivity among adults (6), while another study conducted between 2018 and 2019 reported a prevalence of approximately 73% (8). Moreover, evidence from studies conducted in Western settings has demonstrated that a less favourable balance between physical activity and sitting time is associated with an increased risk of all-cause mortality.(9-10) These findings emphasize the need to identify the underlying reasons for such high levels of inactivity. To better understand these perceptions, conducting in-depth interviews that capture community perspectives on physical activity and sedentary behaviour is necessary. Although several studies in India have examined physical activity levels, the balance between physical activity and sitting time remains underexplored. Establishing this balance is crucial, as it is central to achieving optimal health benefits. The applicability of the Active Australia Survey has not been thoroughly studied in India. Given the cultural and lifestyle differences between India and Australia, it is important to assess the feasibility of using this tool in the Indian context. Hence, this pilot study serves as a baseline for assessing the feasibility of utilizing the Active Australia Survey Questionnaire in the Indian population.

References:

1. Motuma A, Regassa LD, Gobena T, Roba KT, Berhane Y, Worku A. Almost all working adults have at least one risk factor for non-communicable diseases: Survey of working adults in Eastern Ethiopia. PLoS One 2022;17(2 February).

2. World Health Organization. Physical activity. World Health Organization2024;

3. Le Roux E, De Jong NP, Blanc S, Simon C, Bessesen DH, Bergouignan A. Physiology of physical inactivity, sedentary behaviours and non-exercise activity: insights from the space bedrest model. Journal of Physiology2022;600(5):1037–51.

4. Jalaluddin, Nawab T, Khalique N, Ahmad A. Physical Inactivity and its Sociodemographic Determinants among Adults: A Community-Based Study. Indian Journal of Community Medicine 2024;49(6):849–54.

5. Newtonraj A, Murugan N, Singh Z, Chauhan RC, Velavan A, Mani M. Factors associated with physical inactivity among adult urban population of Puducherry, India: A population based cross-sectional study. Journal of Clinical and Diagnostic Research 2017;11(5):LC15–7.

6. Mohanty S, Sahoo J, Epari V, Ganesh GS, Panigrahi SK. Prevalence, Patterns, and Predictors of Physical Inactivity in an Urban Population of India. Cureus 2022;

7. Anjana RM, Pradeepa R, Das AK, Deepa M, Bhansali A, Joshi SR, et al. Physical activity and inactivity patterns in India - results from the ICMR-INDIAB study (Phase-1) [ICMR-INDIAB-5]. International Journal of Behavioral Nutrition and Physical Activity 2014;11(1).

8. Verma M, Kalra S, Deepa M, Venkatesan U, Sharma N, Pradeepa R, et al. Understanding Epidemiology of Physical Activity and Sedentary Behaviour Among Adults in Haryana: Insights from the ICMR-INDIAB Study [ICMR-INDIAB-19]. Adv Ther 2025;42(7):3265–84.

9. Botlero R, Sethi P, Gasevic D, Owen N, Barr E, Dunstan DW. A Physical Activity and Sitting Time Balance Index and All-Cause Mortality Risk. Am J Prev Med 2024;67(6):832–40.

10. Lian Y, Luo P. Association of Physical Activity and Sitting Time Balance Index with all-cause and cause specific mortality among cancer survivors in the USA: a cohort study. Supportive Care in Cancer 2025;33(7).