Motivational counseling to reduce sitting time: A community-based randomized controlled trial in adults

Background Sedentary behavior is regarded as a distinct risk factor for cardiometabolic morbidity and mortality, but knowledge of the efficacy of interventions targeting reductions in sedentary behavior is limited.

Purpose To investigate the effect of an individualized face-to-face motivational counseling intervention aimed at reducing sitting time.

Design A randomized, controlled, observer-blinded, community-based trial with two parallel groups using open-end randomization with 1:1 allocation.

Setting/participants A total of 166 sedentary adults were consecutively recruited from the population-based Health2010 Study.

Intervention Participants were randomized to a control (usual lifestyle) or intervention group with four individual theory-based counseling sessions.

Main outcome measures Objectively measured overall sitting time (ActivPAL 3TM, 7 days); secondary measures were breaks in sitting time, anthropometric measures, and cardiometabolic biomarkers, assessed at baseline and after 6 months. Data were collected in 2010-2012 and analyzed in 2013-2014 using repeated measures multiple regression analyses.

Results Ninety-three participants were randomized to the intervention group and 73 to the control group, and 149 completed the study. The intervention group had a mean sitting time decrease of -0.27 hours/day, corresponding to 2.9% of baseline sitting time (hours/day); the control group increased mean sitting time by 0.06 hours/day. The between-group difference in change, -0.32 hours/day (95% CI=-0.87, 0.24, p=0.26), was not statistically significant. Significant differences in change in fasting serum insulin of -5.9 pmol/L (95% CI=-11.4, -0.5, p=0.03); homeostasis model assessment-estimated insulin resistance of -0.28 (95% CI=-0.53, -0.03, p=0.03); and waist circumference of -1.42 cm (95% CI=-2.54, -0.29, p=0.01) were observed in favor of the intervention group.

Conclusions Although the observed decrease in sitting time was not significant, a community-based, individually tailored, theory-based intervention program aimed at reducing sitting time may be effective for increasing standing and improving cardiometabolic health in sedentary adults. Trial registration This study is registered at Clinicaltrials.gov (NCT00289237). Medicine.