Physical Activity for Sedentary Lifestyle

Overseen By Rebecca E Hasson, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

Must not be taking: Iron, Metformin, Chemotherapy

Disqualifiers: Uncontrolled asthma, Heart condition, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine how different digital tools can help kids maintain a home exercise routine. It focuses on children aged 8 to 12 in Michigan who have access to a computer and the internet. The study employs online calendars, text message reminders, and virtual coaching to identify the most effective methods for keeping kids active at home. This approach suits families with less active children who need extra motivation and structure. As an unphased trial, it provides families an opportunity to explore innovative ways to enhance their children's activity levels.

Do I have to stop taking my current medications to join the trial?

Yes, if you are currently taking medications like iron, metformin, or chemotherapeutic agents that could impact your ability to engage in physical activity, you will not be eligible to participate in the trial.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that the InPACT at Home program helps kids move more by breaking up long periods of sitting. On average, children added 12–16 extra minutes of activity each day with this program. This approach has been studied for its health benefits, such as better blood sugar control and reduced sitting time, which can lower health risks.

No reports of serious side effects have emerged from using electronic calendars, text message reminders, or virtual coaching in the InPACT program. These tools effectively remind participants to stay active without causing harm. Evidence suggests this method is safe and well-tolerated for both children and adults. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these interventions for sedentary lifestyles because they leverage digital tools to encourage physical activity in a novel way. Unlike traditional approaches that often rely on in-person coaching or simple exercise recommendations, these interventions use electronic calendars, personalized text message reminders, and virtual coaching sessions to nudge people towards more movement throughout the day. This method is particularly promising because it integrates seamlessly into daily life, providing constant and personalized cues to break up prolonged sitting, which could lead to more sustainable lifestyle changes. By using technology to deliver tailored and timely prompts, these interventions have the potential to reach a broader audience and make a significant impact on reducing sedentary behavior.

What evidence suggests that this trial's interventions could be effective for improving adherence to home exercise programs?

Research shows that sitting less can lead to more physical activity and better health. Studies have found that taking short, light activity breaks during long sitting periods helps manage blood sugar levels over two days. Although this doesn't seem to affect hunger or food intake in children, it has been linked to improved thinking skills in both young and middle-aged people after just a few hours. Additionally, prolonged sitting can reduce blood flow and increase the risk of high blood pressure. This trial will explore various interventions, such as electronic calendars, text message pings, and virtual coaching, to help participants adhere to exercise routines, encouraging them to move more and sit less. ^{4 6 7 8 9}

Who Is on the Research Team?

Rebecca E Hasson, PhD

Principal Investigator

University of Michigan

Are You a Good Fit for This Trial?

This trial is for individuals who struggle with sticking to home exercise programs, possibly due to time constraints, low confidence in their abilities, or doubts about the program's effectiveness. It aims to help those who start exercising but stop when they see early results or think it's not necessary anymore. Children participating need parental support.

Inclusion Criteria

Participants must have access to a computer and internet at home

I am a child aged 8-12 from Michigan, or I am their parent/guardian.

Participants must be proficient in English

Exclusion Criteria

Potential participants who are ineligible will be informed during their screening call and will not be enrolled.

Children answering 'YES' to any question on the Physical Activity Readiness Questionnaire (PAR-Q)22 indicating heart condition, high BP, chest pains, dizziness during daily activities, or requiring a doctor's recommendation for supervision during exercise

My child has a disability that requires adult help for communication and following instructions.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Stage 1 Treatment

Participants engage in the InPACT at Home exercise program, completing three 8-minute exercise videos per day, five days a week.

4 weeks

Online engagement with exercise videos

Stage 2 Treatment

Participants continue with InPACT at Home, with some receiving additional support through text message reminders or personalized activity calendars.

4 weeks

Online engagement with exercise videos and additional support

Stage 3 Treatment

Participants receive further support through Tailoring or Coaching, based on previous assignments.

4 weeks

Online engagement with exercise videos and further support

Follow-up

Participants are monitored for adherence and effectiveness of the intervention.

1 week

What Are the Treatments Tested in This Trial?

Interventions

• Interrupting Prolonged Sitting With ACTivity (InPACT) at Home Optimization Study

Trial Overview The study tests a new way of keeping people on track with their home exercises using a SMART intervention over 12 weeks. This method adapts the exercise plan based on how well someone is doing and tries to make sure that each person gets the right kind of encouragement and changes needed over time.

How Is the Trial Designed?

Group I: Calendars + Tailored calendar Experimental Treatment 1 Intervention

Intervention is administered online (electronic calendars).

Group II: Calendars + Pings + Tailored Calendar Experimental Treatment 1 Intervention

Intervention is administered online (electronic calendars and text message pings).

Group III: Calendars + Pings + Pings Experimental Treatment 1 Intervention

Intervention is administered online (electronic calendars and text message pings).

Group IV: Calendars + Pings + Coaching Experimental Treatment 1 Intervention

Intervention is administered online (electronic calendars and text message pings) and virtually (coaching).

Group V: Calendars + Pings Experimental Treatment 1 Intervention

Intervention is administered online (electronic calendars and text message pings).

Group VI: Calendars Experimental Treatment 1 Intervention

Intervention is administered online (electronic calendars).

Group VII: Calendar + Tailored calendars + Pings Experimental Treatment 1 Intervention

Intervention is administered online (electronic calendars and text message pings).

Group VIII: Calendar + Tailored calendars + Coaching Experimental Treatment 1 Intervention

Intervention is administered online (electronic calendars) and virtually (coaching).

Group IX: Calendar + Tailored calendars Experimental Treatment 1 Intervention

Intervention is administered online (electronic calendars).

Interrupting Prolonged Sitting With ACTivity (InPACT) at Home Optimization Study is already approved in United States for the following indications:

Approved in United States as InPACT at Home for:

• Promoting physical activity in children and families

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

Published Research Related to This Trial

Sedentary behavior, especially prolonged sitting, is linked to increased risks of cardiovascular disease, highlighting the need for effective public health guidelines to reduce sitting time.

The review emphasizes the necessity for well-designed randomized controlled trials to test specific strategies for reducing sitting behavior, as current guidelines lack specificity due to insufficient evidence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Primer on Repeated Sitting Exposure and the Cardiovascular System: Considerations for Study Design, Analysis, Interpretation, and Translation. Stoner, L., Barone Gibbs, B., Meyer, ML., et al.[2023]

Sedentary behavior, characterized by prolonged sitting, is linked to negative effects on cardiometabolic health and increased risk of premature mortality, highlighting the need for interventions to reduce sitting time.

Recent studies suggest that breaking up long periods of sitting can improve health outcomes, indicating that both primary prevention and disease management strategies should focus on reducing sedentary behavior.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Managing sedentary behavior to reduce the risk of diabetes and cardiovascular disease. Dempsey, PC., Owen, N., Biddle, SJ., et al.[2022]

The GIH stationary single-item question (SED-GIH) demonstrated good concurrent validity, showing a significant correlation with device-measured stationary time, making it a reliable tool for assessing sedentary behavior in the general population.

The SED-GIH also showed strong convergent validity with other commonly used sedentary questionnaires, indicating it can effectively identify individuals with high levels of stationary time, which is crucial for public health assessments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The SED-GIH: A Single-Item Question for Assessment of Stationary Behavior-A Study of Concurrent and Convergent Validity. Kallings, LV., Olsson, SJG., Ekblom, Ö., et al.[2020]

A 1-week intervention using hourly prompts and behavioral strategies successfully reduced sitting time by an average of 1.85 hours per day in overweight/obese adults, while also increasing standing and stepping time.

Despite the reduction in sitting time, participants did not increase the frequency of sit/stand transitions, indicating a preference to remain standing longer rather than frequently interrupting sitting, which may inform future intervention designs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized controlled pilot of an intervention to reduce and break-up overweight/obese adults' overall sitting-time. Júdice, PB., Hamilton, MT., Sardinha, LB., et al.[2018]

A review of 26 studies found that interventions aimed at reducing sedentary behavior in adults were categorized as very promising (39%), quite promising (21%), and non-promising (39%), with worksite-based interventions being the most common.

The most effective strategies included environmental restructuring and self-monitoring techniques, suggesting that future interventions should focus on modifying environments and enhancing self-regulatory skills to reduce sedentary behavior.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults. Gardner, B., Smith, L., Lorencatto, F., et al.[2023]

This study aims to evaluate the effectiveness of combining structured exercise with a technology-based intervention to reduce sedentary behavior in older adults at risk for cardiovascular disease, addressing a significant public health concern.

By focusing on participants aged 60 and older with moderate to high risk of coronary heart disease, the research will assess various health outcomes, including daily activity patterns and cardiovascular function, to inform future large-scale trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Wearable technology to reduce sedentary behavior and CVD risk in older adults: design of a randomized controlled trial. Krehbiel, LM., Layne, AS., Sandesara, B., et al.[2020]

In a pilot study involving 10 sedentary, overweight or obese postmenopausal women, brief interruptions of sitting time (like standing for 2 minutes every 20 minutes or walking for 2 minutes every hour) showed potential benefits in lowering blood sugar responses after meals.

The 10-minute standing every hour condition significantly improved endothelial function, indicating vascular benefits compared to prolonged sitting, suggesting that different modalities of interrupting sitting can have specific health advantages for older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute glucoregulatory and vascular outcomes of three strategies for interrupting prolonged sitting time in postmenopausal women: A pilot, laboratory-based, randomized, controlled, 4-condition, 4-period crossover trial. Kerr, J., Crist, K., Vital, DG., et al.[2020]

Sitting for long periods has harmful effects on cardiovascular and metabolic health, even for those who meet physical activity guidelines, highlighting the need to address sedentary behavior as a serious health risk.

Emerging evidence suggests that the physiological effects of inactivity are distinct from those of regular exercise, indicating that reducing sitting time and increasing breaks from sitting should be considered in health recommendations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Too Little Exercise and Too Much Sitting: Inactivity Physiology and the Need for New Recommendations on Sedentary Behavior. Hamilton, MT., Healy, GN., Dunstan, DW., et al.[2022]

Tailored counseling for office workers effectively reduced muscle inactivity time by an average of 33 minutes, leading to an increase in light muscle activity by 21 minutes, indicating a positive shift towards more active behavior.

The intervention also resulted in a 13% increase in average muscle activity during work, suggesting that even simple counseling can have significant short-term health benefits by encouraging movement and reducing sedentary behavior.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Muscle inactivity and activity patterns after sedentary time--targeted randomized controlled trial. Pesola, AJ., Laukkanen, A., Haakana, P., et al.[2022]

A pilot study involving 30 older adults (ages 50-70) showed that reducing daily sitting time by 2 hours was feasible and effective, while increasing sit-to-stand transitions did not change overall sitting time.

Participants in the sit-to-stand transition group successfully increased their transitions, indicating that specific behavioral goals can be targeted to reduce sedentary behavior in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Two-Arm Randomized Pilot Intervention Trial to Decrease Sitting Time and Increase Sit-To-Stand Transitions in Working and Non-Working Older Adults. Kerr, J., Takemoto, M., Bolling, K., et al.[2022]

In a study of 727 adults, it was found that on average, people had 55 interruptions in their sitting time each day, but only about 20 of these were considered 'active' (involving at least 5 minutes of standing or 2 minutes of stepping).

Older adults, those with obesity, and individuals with diabetes had significantly fewer interruptions and less stepping time during active interruptions, suggesting that these groups may be less physically active in their daily routines.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Descriptive Epidemiology of Interruptions to Free-Living Sitting Time in Middle-Age and Older Adults. Blankenship, JM., Winkler, EAH., Healy, GN., et al.[2023]

Individuals with chronic health conditions, such as COPD and stroke, spent significantly more time being sedentary compared to healthy adults, with COPD patients averaging 62% of their waking hours sedentary.

The study found that the level of physiological impairment was a strong predictor of sedentary time, suggesting that targeted interventions could help reduce sedentary behavior in those with chronic conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sedentary Behavior in People with and without a Chronic Health Condition: How Much, What and When? Lewis, LK., Hunt, T., Williams, MT., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5511092/

Targeting Reductions in Sitting Time to Increase Physical ... New evidence suggests that reductions in sedentary behavior may increase physical activity and improve health.

2. sciencedirect.com sciencedirect.com/science/article/pii/S175529662500002X

Interrupting sitting with moderate-intensity physical activity ... Our recent meta-analysis suggests that 3–8 h of prolonged sitting can acutely decrease cognitive performance, including inhibitory control, in young and middle- ...

3. dom-pubs.onlinelibrary.wiley.com dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.15254

Interrupting prolonged sitting with frequent short bouts of light ... Interrupting prolonged sitting with frequent short bouts of light-intensity activity improves acute postprandial and 48-h glycaemia in adults ...

4. acc.org acc.org/Latest-in-Cardiology/Articles/2021/08/24/13/59/Sit-Less-and-Move-More

Sit Less and Move More: Is Maintaining Physical Activity ... Several studies showed reduced metabolic demand and decreased blood flow during prolonged sitting, which leads to hypertension,11 especially in ...

5. journals.plos.org journals.plos.org/plosone/article?id=10.1371/journal.pone.0188986

The effects of interrupting prolonged sitting with intermittent ... Interrupting prolonged sitting with low-intensity activity has been shown to not alter hunger, satiety, or food consumption in children, however it is unclear ...

6. journals.humankinetics.com journals.humankinetics.com/abstract/journals/jtpe/aop/article-10.1123-jtpe.2024-0017/article-10.1123-jtpe.2024-0017.xml

Assessing Children's Adherence to the Interrupting ... This study suggests that, on average, children accumulated 12–16 additional minutes of daily PA through the InPACT at Home program.

7. inpact.kines.umich.edu inpact.kines.umich.edu/

inpact: Home InPACT stands for Interrupting Prolonged sitting with ACTivity. InPACT is an evidence-based physical activity program that enables teachers to deliver 20 ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S0167876025000157

Interrupting sitting with moderate-intensity physical activity ... The aim of this study was to test the effects of regularly interrupting three hours of prolonged sitting with brief (3.5 min) MPA bouts every 30 min (MPA + SIT ...

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11427223/

Sedentarism and Chronic Health Problems - PMC Prolonged sitting can have unintended consequences for health with sitting time >7 h/d, leading to a 5% increase in all-cause mortality with ...