Motivation and emotion/Book/2019/Sedentary behaviour change

Sedentary behaviour change:
How can sedentary behaviour be changed?

Multimedia presentation (3 min)

Overview

Figure 1. Sedentary Lifestyle

This chapter examines the determinants of sedentary behaviour, the negative consequences of sedentary behaviour, and the barriers that prevent people from engaging in a more active lifestyle. This chapter will also look at current technological efforts to make exercise more appealing for those with sedentary lifestyles, and the effectiveness of such interventions.

Sedentary behaviour in formal terms and its effects

Sedentary behaviour is defined as a period of time spent in a seated or reclining position and has been identified as a significant health risk for older individuals. Spending too much time on sedentary activities is health risk for any individual. Examples of this include using motorised transport, computer work or watching television. Sedentary behaviour has been connected with hazardous effects on health and wellbeing including increased risk of chronic disease or disablement in older people, therefore the less time spent on these activities the better for your physical health. This is because the amount of time spent on sedentary activities tends to displace or replace time spent on physical activities, therefore preventing people from receiving the various health benefits of engaging in physical activity.

Various countries have release guidelines on limiting the amount of time sitting and encouraging meeting a recommended quota of physical activity within a given timeframe. The World Health Organisation in 2000 also was concerned with rising rates of global obesity and published a report on how to treat different degrees of obesity and classifications of different levels of weight based on a body mass index calculation. This takes into consideration: height, weight, biological sex and age.

Table 1. World Health Organisation Classification of Obesity

Classification	BMI	Risk of Comorbidities
Underweight	<18.5	low (risk of other clinical problems increased)
normal	18.5-24.29	Average
Overweight	≥25
Pre-obese	25-19.9	Increased
Obese Class 1	30-34.9	Moderate
Obese Class 2	35-39.9	Severe
Obese Class 3	≥40	Very Severe

In terms of physical health, the higher you fall on this table and the more you eat, the higher the risk is of developing comorbidities. The most common comorbidities associated with obesity include coronary hypertension (high blood pressure), dyslipidemia (an abnormal amount of lipids such as cholesterol etc. in the blood), diabetes (type 2), and coronary heart disease (narrowing of the arteries). Therefore, it is in everyone’s best interest to stay within a healthy weight range.

There are also psychological health risks of obesity. One of the most common ones is depression. Individuals suffering from psychopathology with depressive symptoms tend to overeat or eat too little as a side effect. People that are obese tend to have lower self-esteem and tend to upward social comparisons, viewing those around them as far better than themselves. As a result, there is also a risk of having anxiety issues as well. The relationship between depression and obesity is quite a unique one. People who depressed are more likely to become obese due to hormone and immune system changes that occur as a side effect of depression, and because of these side effects they have a much more difficult time taking care of themselves. People with depression often have difficulty sticking to fitness programs and overeating as a response to negative thoughts. In addition, when treating obesity in depressed individuals their self-esteem tends to rise as their fat levels lower, valuing themselves more and reducing their depressive symptoms. Conversely when, when depression is treated, it tends to produce weight gain in the individual being treated; particularly when Selective Serotonin Reuptake Inhibitors (SSRIs) are used in the treatment of depression. Therefore both depression and obesity need to be addressed at the same time during treatment, if it is seen as a significant risk by the treating professional.

Determinants and barriers to behaviour change

Determinants of behaviour change vary significantly between age groups and nationalities. Young people may seek to watch television or play video games, whilst older people may engage in crosswords or knitting; both are forms of sedentary behaviour and entertainment but can be influenced by different factors such as age, interests and pre-existing conditions. For example, women aged 65 or older may choose to engage in crosswords or knitting as a way to manage chronic symptoms such as pain and stiffness, conserving energy to make life more enjoyable. Older individuals typically deem these activities as positively beneficial to their wellbeing despite recognising that sitting too much is not a healthy practice. Environment may also affect motivation to pursue physical activity and engage in healthy lifestyle practices. For instance, if there is a lack of resting places in a person's environment they are less likely to rest and more likely to remain active.

Changing sedentary behaviour

The negative consequences of physical inactivity are clear. However, ways to increase physical activity are less clear. This section explores two possible routes to decreasing sedentary behaviour: goal setting and removing barriers.

Goal setting

Setting a goal for behaviour change and monitoring the behaviour is effective in helping people to begin behaviour change as well as maintaining that change. Typically a person's focus will change from expectations of future possibilities to positive experience with results in the present although they may experience issues with self-regulation and setbacks. Setting graded tasks, feedback and highlighting results achieved along with counselling and support can assist in renewing a person's self-regulator strength and in an example of diet, developing genuine appreciation of healthy lifestyle.

Interventions that focus on changing sedentary behaviour rather than changing physical activity are more successful. Whilst interventions that focus on physical activity may achieve their goal, they might not be able to change sedentary behaviour in the process. Rather,recent research suggests that they should be treated as being independent of each other when designing interventions regarding reduction of sedentary activity time.

Barriers

One of the biggest barriers to behaviour change as a whole, is mindset and risk; or the way an individual thinks about risk in relation to the actions they may take. People need to be persistant and sustain motivation to adopt a new behaviour or it is unlikely that anything will change. Many different mindsets or approaches may be able to create behaviour change in the short term. For example, a child with a fixed mindset may believe doing their homework is pointless as they will never improve. They would not seek out change for fear of failure. Whereas someone with a growth mindset would be happy to risk failure in order to obtain that change. It has been evident that it is very difficult to change someone’s mindset from the outside in, rather it is the individual themselves that must find the drive within them to exercise and maintain persistent motivation to fulfil that drive, in order to actually obtain what they are seeking. It is a battle of both internal forces such as mindset and external forces like pain or stamina that are fighting each other to kill off an individuals motivation to satisfy a drive.  Unfortunately, it is evident that individuals are not susceptible to outside advice during the moment of decision making upon a drive, instead one of the more unique methods is to try and inspire a drive to be better. This is done by inspiring someone to switch to a growth mindset and seek to better themself. This drive creation is often done through presentation of new and interesting interventions.

Recent sedentary behaviour interventions

There are multiple interventions that aim to decrease sedentary behaviours and increase physical activity. These include workplace interventions and technology interventions.

Application in the workplace

One of the most difficult areas to change sedentary behaviour is in the workplace, as many jobs require individuals to be seated for long periods of time. There have been many different attempts to create sedentary behaviour change. Previous interventions have included standing desks and gyms within the workplace. There have also been attempts such as “treadmill” workstations that would involve walking whilst completing day-to-day tasks at a desk, pedal based exercise machine workstations, and even an elliptical machine based workstation. These were successful in increasing physical activity and heart rate, but also resulted in decreased performance. Overall, the most effective form of workplace intervention, as of 2014, was a standing desk. Employees that have used this type of workstation have reported feeling like they have a lighter workload, and had higher performance, but with subjective feelings of fatigue. Using this type of intervention reduced sedentary behaviour by between 66-143 minutes per day. However, it is worth noting that across various studies, a "break in" period of 4 weeks to 4 months can be necessary for employees to feel comfortable in this work style change. There have been several meta-analyses of studies done on workplace interventions, and results have been fairly consistent across the board with office workers. The approach would be much more difficult, if not impossible, to apply in a group of construction workers. By definition, their work would be "sedentary behaviour", as they need to sit within construction vehicles to do their daily tasks; different groups of people need different interventions. This is one area that is currently very limited in that it is hard to apply an effective intervention and has little research available; it is an area that requires focus on in further research.  

The impact of modern entertainment

One of the largest contributions towards sedentary behaviour, particularly in young adults and children, is the rise of video games as an entertainment form. However, this is completely avoidable, not by avoiding video games, but rather by changing what games are played. In the last few years, video game develops have trialed “excer-gaming” as way to get individuals into growth mindset (to want to improve themselves) and feel good about exercise through the use of exercise based/incorporated video games. These often use motion controllers that are a combination of accelerometers and gyroscopes, allowing the speed and angle of each controller held in hand to be monitored and produce an in-game response. Devices so far have included the Xbox Kinect and Nintendo Wii. Overall, the most noteworthy games that have a significant impact are dance simulation games, with around 108% increase of energy expenditure. However, too little data currently circulates to have a clear idea of if these are purely short term benefits, or if an individual's attention paid to these exercise games can be long term as well.

Conclusion

In summary, there are many negative side effects of spending too much time on sedentary behaviour, such as depression and obesity which have a cyclic effect on each other which is difficult to break. The amount of time spent on sedentary behaviour depends on an individual's age, nationality and other demographics whilst the activity that they engage in during their sedentary time could be vastly different between them; from motorbike riding to videogames, chess or even study. One of the most effective workplace interventions has been desks that can swap between sitting and standing posture. These standing desks have had a positive impact on wellbeing of their users.The biggest barrier to sedentary behaviour change is an individual's mindset regarding risk and failure. Individuals with growth mindsets are more likely to be able to sustain their motivation to fulfil the drive of become more active, accepting the risk of failure and being resilient in the face of failure. Recent interventions developed to combat sedentary behaviour time is repurposing a once sedentary activity (video games) and making them more active by combining them with exercise (exergaming). Whilst they have been reasonably effective within that niche sample, it is still a major contributor to sedentary behaviour overall. There still needs to further research into if the benefits of exergaming are long or short term, removal of barriers to behaviour change and investigating the cross cultural significance of these new interventions

See also

• An insight into self-efficacy theory (Book chapter, 2011)

External Links

• Pokemon GO, and exercise (forbes.com)
• Making Mindset Change Stick (linkedin.com)