I-STAND R21: Reducing Sedentary Time in Older Adults

Not Applicable

Completed

Brief Summary: The investigators are doing a study to learn how to support patients aged 60+ in taking more breaks from sitting and reducing total sitting time. The goal of the study is to find out if a sitting time reduction intervention reduces sitting time compared with a control group.

Detailed Description: More than one-third of American adults over 60 have a body mass index \> 30 kg/m2. These older adults have more sedentary time than any other group -- an average of 10-11 hours per day. Reducing the sedentary behavior of older adults with obesity, rather than only promoting more intensive physical activity, could provide a more feasible approach to health promotion.

This randomized control pilot trial will evaluate a 12-week intervention to decrease sitting time and increase standing time and light physical activity among sedentary older adults a body mass index \> 30 kg/m2 as compared to control group. Baseline and 12-week measurements include anthropometric measures, blood draw by finger stick, cardiovascular health assessments, physical function tasks, and a survey. The intervention will consist of two in-person visits with a health coach followed by phone-based coaching.

Recruitment & Eligibility

Inclusion Criteria

Kaiser Permanente Washington enrollees
Men and women
Age 60 - 89
BMI 30 - 50 (calculated based on most recent height ever and most recent weight taken within previous 18 months)
Primary care within Integrated Group Practice
Continuously enrolled at Kaiser Permanente Washington for previous 12 months
No record of death
Not on the No Contact list
Speaks and writes English
Able to hold a conversation by phone (no hearing or other limitations)
Self-reported sitting time of 6 hours/day or more
Self-reported ability to stand with or without an assistive device
Self-reported ability to walk one block with or without an assistive device
Available for the study duration
Able to come to Kaiser Permanente Washington Health Research Institute's research clinic for measurement visits
Willing to wear study activity monitors

Exclusion Criteria

Resides in long-term care, hospice care, or skilled nursing facility (previous 12 months)
Wheelchair bound
Diagnosis of dementia, serious mental health disorder, or substance use disorder (previous 24 months)
Use of an assistive device

Arm && Interventions

Group	Intervention	Description
Healthy Living	Healthy Living	Participants randomly assigned to the Healthy Living enhanced usual care control group will receive 1 in-person health coaching session and 5 biweekly check-in letters by mail. They will receive a workbook with general healthy living topics that are not expected to impact sitting time. All content is taken from Kaiser Permanente Washington's website and is available to all members. Participants will select topics of interest and review them on their own with no further health coaching.
I-STAND	I-STAND	Participants randomly assigned to the I-STAND intervention group will receive 2 in-person health coaching sessions and 4 biweekly phone-based health coaching sessions. They will receive a wristband that gives a mild vibration after 20 minutes of inactivity and will be encouraged to stand if possible after each inactivity alert. Participants may also choose to receive biweekly email reminders in the weeks between coaching calls. They will also receive a workbook with content around reducing sitting time.

Primary Outcome Measures

Name	Time	Method
Change in Hours of Sitting Time	12 weeks	Average hours of sitting time over the last 7 days measured at baseline and 12 weeks later

Secondary Outcome Measures

Name	Time	Method
Physical Function	12 weeks	Change in Short Physical Performance Battery (SPPB) scale score, from baseline to 12 weeks. The range of scores is 0 to 12, higher values represent better physical function.
Sit-to-stand Transitions	12 weeks	Change in average daily number of activPAL-measured sit-to-stand transitions, from baseline to 12 weeks
Periods of Sitting for 30+ Minutes	12 weeks	Change in average daily number of activPAL-measured periods of sitting for 30+ minutes without standing, from baseline to 12 weeks
Blood Pressure (Systolic Blood Pressure)	12 weeks	Change in average of second and third blood pressure reading (for systolic blood pressure), from baseline to 12 weeks
Depressive Symptoms	12 weeks	Change in Patient Health Questionnaire (PHQ-8) scale score, from baseline to 12 weeks. The scale range is 0 to 24 with higher scores representing higher depressive symptoms. Scores of 10 or more are considered major depression.
Fasting Glucose (mg/dL)	12 weeks	Change in fasting glucose (mg/dL) from finger stick blood draw, from baseline to 12 weeks
Total Cholesterol (mg/dL)	12 weeks	Change in total cholesterol (mg/dL) from finger stick blood draw, from baseline to 12 weeks

Locations (1): Kaiser Permanente Washington Health Research Institute
🇺🇸
Seattle, Washington, United States
Kaiser Permanente Washington Health Research Institute
🇺🇸Seattle, Washington, United States