Embedding sustainable physical activities into the everyday lives of adults with intellectual disabilities: a randomised controlled trial Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity: walk well cluster-randomised controlled trial Health Opportunities with Physical Exercise (HOPE): social contextual interventions to reduce sedentary behavior in urban settings. A structured physical activity and fitness programme for older adults with intellectual disabilities: results of a cluster‐randomised clinical trial The effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution: six-month short-term effect. An efficacy trial of ‘Steps to Your Health’, a health promotion programme for adults with intellectual disability Effecting healthy lifestyle changes in overweight and obese young adults with intellectual disability. Changes in cognitive function in a randomized trial of physical activity: results of the lifestyle interventions and independence for elders pilot study. Physical activity is associated with incident disability in community-based older persons. Promoting a healthy diet and physical activity in adults with intellectual disabilities living in community residences: Design and evaluation of a cluster-randomized intervention Physical health—a cluster randomized controlled lifestyle intervention among persons with a psychiatric disability and their staff Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines Using Ecological Momentary Assessment to Understand Where and With Whom Adults’ Physical and Sedentary Activity Occur A behaviour change intervention to reduce sedentary time in people with chronic obstructive pulmonary disease: protocol for a randomised controlled trial. Reducing Sedentary Behavior Versus Increasing Moderate-to-Vigorous Intensity Physical Activity in Older Adults A cognitive-behavioural pedometer-based group intervention on physical activity and sedentary behaviour in individuals with type 2 diabetes Multi-level support for physical activity and healthy eating.
Background Adults with intellectual disability ( ID ) are physically very inactive . This study will compare two approaches to increasing physical activity in adults with ID : a lifestyle physical activity ( light-moderate intensity ) approach and a structured exercise ( moderate-vigorous intensity ) approach . The trial will compare the short-term ( 3-month ) and long-term ( 9-month ) outcomes and sustainability of each approach with a usual-care control group . Methods / Design A three-arm r and omised controlled trial ( RCT ) will be conducted . Ninety adults with ID aged 18 - 55 will be r and omly assigned to one of three groups : 1 ) a lifestyle physical activity group ( n = 30 ) , 2 ) a structured exercise group ( n = 30 ) , or 3 ) a usual care control group ( n = 30 ) . Participants in both groups will receive a 12-week intervention delivered by exercise specialists in the community with disability service staff , after which intervention will continue for 6 months , delivered by disability service staff only . Primary outcomes are aerobic fitness , 12-hour energy expenditure , and proxy-reported everyday physical activity . Secondary outcomes include objective ly assessed physical activity and sedentary behaviour , intervention compliance , functional walking capacity , participation in domestic activities , muscle strength , body composition , psychosocial outcomes , quality of life and health care costs . Discussion The trial results will determine the effectiveness and sustainability of two approaches to increasing physical activity and exercise among adults with ID.Trial registration IS RCT N77889248 ( 18 April 2012 ) Background Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups . The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with intellectual disabilities . Methods We used a cluster r and omised controlled design and recruited participants over 18 years old and not regularly involved in physical activity from intellectual disabilities community-based organisations . Assessment s were carried out blind to allocation . Clusters of participants were r and omly allocated to the Walk Well program or a 12-week waiting list control . Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques , written re sources for participants and carers , and an individualised , structured walking programme . The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12 weeks . Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity ( MVPA ) , body mass index ( BMI ) , and subjective well being . Results One hundred two participants in 50 clusters were r and omised . 82 ( 80.4 % ) participants completed the primary outcome . 66.7 % of participants lived in the most deprived quintile on the Scottish Index of Multiple Deprivation . At baseline , participants walked 4780 ( st and ard deviation 2432 ) steps per day , spent 65.5 % ( st and ard deviation 10.9 ) of time sedentary and 59 % percent had a body mass in the obesity range . After the walking programme , the difference between mean counts of the Walk Well and control group was 69.5 steps per day [ 95 % confidence interval ( CI ) -1054 to 1193.3 ] . There were no significant between group differences in percentage time sedentary 1.6 % ( 95 % CI −2.984 to 6.102 ) , percentage time in MVPA 0.3 % ( 95 % CI −0.7 to 1.3 ) , BMI −0.2 kg/m2 ( 95 % CI −0.8 to 0.4 ) or subjective well-being 0.3 ( 95 % CI −0.9 to 1.5 ) . Conclusions This is the first published trial of a walking program for adults with intellectual disabilities . Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with intellectual disabilities . Since participants spent the majority of their time sedentary , home-based programmes to reduce sitting time may be a viable health improvement approach . Trial registration Current Controlled Trials IS RCT Physical activity interventions targeting social and physical environments of the urban poor hold promise in improving health outcomes in underserved communities . This study r and omly assigned overweight , sedentary , economically disadvantaged adults to one of three intervention conditions at The Hope and Healing Center , a large inner-city health facility providing numerous options for exercise . Within the tenets of Social Action Theory , the Health Opportunities with Physical Exercise ( HOPE ) trial will test the efficacy of two behavior change models , social support and patient-provider interaction , to increase physical activity . In addition to a st and ard care condition , in which patients have open access to Hope and Healing physical activity programming , patients were assigned to one of two behavior change interventions . Those assigned to patient-peer receive face-to-face , systematic and scheduled encouragement from study -trained ' peer ' interventionists at the facility . Patients assigned to patient-provider receive face-to-face , systematic and scheduled encouragement provided by study -trained ' provider ' interventionists also at the facility . The primary outcomes of change in exercise behavior will be documented by self-reported physical activity and confirmed by fitness testing at baseline , 6 , 12 and 24 months during the 1 year of active intervention and 1 year of relapse prevention follow-up . Intervention conditions will be compared on psychosocial mediators including motivational appraisal s , ratings of social support , rapport , problem solving and self-efficacy for overcoming barriers to increased physical activity . Novel aspects of this intervention include : ( 1 ) delivery of socially based physical activity interventions to an economically disadvantaged urban population , ( 2 ) reduction of environmental barriers to be physically active and ( 3 ) emphasis on social interactions influencing health habit change . Results of this study have the potential to identify mechanisms of behavior change that could be adopted by physical activity interventions aim ed at reducing sedentary behavior and health disparities in high-risk , underserved population BACKGROUND The physical activity level of older adults with intellectual disabilities ( ID ) is extremely low , and their fitness levels are far beneath accepted norms for older people with normal intelligence and comparable with frail older people . A physical activity programme , including an education programme , was developed for older adults with ID using behaviour change techniques . The programme aim ed at improving or maintaining adequate levels of physical activity ( primary outcome measure ) and motor fitness , cardio respiratory fitness , morphologic and metabolic fitness , activities of daily living , cognitive functioning and depressive symptoms ( secondary outcome measures ) . METHOD The programme 's efficacy was evaluated in a cluster-r and omised clinical trial among people aged 43 years and over with mild-moderate levels of ID . Five day-activity centres were r and omised to the participation group . In these centres , 81 older adults participated in groups of 8 to 10 in the programme , three times a week during 8 months . The programme was executed by physical activity instructors and staff of day-activity centres . Five other day-activity centres were r and omised to the control group ; 70 older adults in these centres received care as usual . The generalised linear model with mixed effects was used to test the programme 's effectiveness . RESULTS Significant effects were found on physical activity , muscle strength , systolic and diastolic blood pressure , serum cholesterol level and cognitive functioning , in favour of the programme 's participants . No significant improvements were found on balance , serum glucose , weight , waist circumference , walking speed , mobility , depression or instrumental activities of daily living . CONCLUSIONS The physical activity and fitness programme has established small but significant effects in this sample , but generalising the findings to other setting s is difficult due to significant participant dropout . Implementation of evidence -based physical activity programmes among older adults with ID is recommended . Further research is needed to investigate the effectiveness of physical activity on daily life functioning and the development on chronic diseases in the long run Little information is available on the provision of physical fitness and intervention program among people with intellectual disabilities . The aim of this study is to provide information of examining the effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution . There were 146 participants with intellectual disabilities ( age 19 - 67 years ) were recruited in the study . We collected information on disability condition ( type and level ) , height , weight , BMI , and physical fitness status ( includes V-shape sit and reach test , sit-up 30s , sit-up 60s , and shuttle run ) at the beginning and 6 months later of the program intervention . The results show that there were statistical decreases in individual 's weight , BMI score , BMI category , and positive improvement in V-shape sit and reach test , sit-up in 30s and 60s tests after 6-month interventions . However , the shuttle run test did not improve at the post-test among people with intellectual disabilities . The results also showed that the mild disability level group has the highest effectiveness on the healthy fitness program on decreasing body weight . Generally speaking , the preliminary study found the healthy exercise program has positive fitness effects on people with intellectual disabilities . To maximize the benefits of regular physical activity on people with ID , there is a need to evaluate the long-term effect of the intervention program and then to initiate the healthy exercise strategies in institution for this group of people Objective : Although there are evaluation and effectiveness studies of health promotion interventions for adults with intellectual disabilities ( ID ) , r and omized efficacy trials of such interventions are lacking . Design : A r and omized active control intervention trial . Setting : The participants attended the health promotion classes in local disability agency service facilities . Method : We enrolled 443 individuals and r and omly assigned them to one of two eight-week participatory classes . The ‘ Steps to Your Health ’ ( STYH ) classes emphasized moderate to vigorous physical activity ( MVPA ) , healthy eating and  body mass index ( BMI )  reduction . The control intervention focused on hygiene and safety . Results : We did not find a statistically significant difference in mean MVPA or BMI change between completers of the STYH group compared to the control group one year after the intervention was completed . We did find that participation in STYH classes had a non-significant association with odds of reduction in BMI ( odds ratio [ OR ] 2.87 , 95 % confidence interval [ CI ] 0.91–9.11 ) and completers who lived in group homes were more likely than their counterparts who lived with families or in apartments to decrease their BMI ( OR 4.61 ; 95 % CI 1.14–18.64 ) . Conclusions : This trial did not demonstrate a significant effect of STYH participation on change in mean minutes of MVPA or mean BMI 12 months after classes ended , although there was a non-significant association with odds of reduction of BMI ( p = 0.07 ) . This study has implication s for design of intervention studies in people with intellectual disability ( ID ) We evaluated a 12-week recreation center-based healthy lifestyle intervention for 30 obese home-dwelling young adults ( YA ) with intellectual disabilities . Three cohorts participated : YA only , YA and parents , and parents only . The YA cohorts received a nutrition/exercise intervention ; parents focused on modeling healthy lifestyle behaviors . Outcomes included YA blood , nutrition , anthropometric , and fitness measures at pre , post , and 3-month follow-up . Compared with wait-list controls , the YA-only cohort improved immediately postintervention in blood pressure ( BP ) , weight , and balance ( p < .05 ) . At 3-month follow-up , no intervention was consistently superior ; overall reductions in weight , BP , hip circumference , and exercise barriers were obtained ( p < .05 ) . Linear and curvilinear changes from baseline to 3 months after the intervention varied by outcome and participant . Participants with Down syndrome lost less weight BACKGROUND Cognitive impairment is an important contributor to disability . Limited clinical trial evidence exists regarding the impact of physical exercise on cognitive function ( CF ) . We report results of a pilot study to provide estimates of the relative impact of physical activity ( PA ) on 1-year changes in cognitive outcomes and to characterize relationships between changes in mobility disability and changes in cognition in older adults at increased risk for disability . METHODS Sedentary persons ( 102 ) at increased risk for disability ( aged 70 - 89 years ) were r and omized to moderate-intensity PA or health education .  Participants were administered the  Digit Symbol Substitution Test ( DSST ) , Rey Auditory Verbal Learning Test ( RAVLT ) , modified Stroop test , and Modified Mini-Mental State Examination  at baseline and 1 year . RESULTS Group differences were not significant but improvements in cognitive scores were associated with improvements in physical function . Specifically , the DSST significantly correlated with change in the Short Physical Performance Battery score ( r = .38 , p = .0002 ) , in chair st and score ( r = .26 , p = .012 ) , in balance score ( r = .21 , p = .046 ) , and in 400-m gait speed ( r = .15 , p = .147 ) . Change recall on the RAVLT and in the Stroop test was also positively correlated with changes in chair st and and balance , respectively . CONCLUSIONS These results provide further support for the benefits of exercise on CF in older adults . An adequately powered clinical trial of PA involving older adults at increased risk for cognitive disability is needed to exp and the indications for prescribing exercise for prevention of decline in brain function OBJECTIVES To examine the association between physical activity and the risk of incident disability , including impairment in activities of daily living ( ADLs ) and instrumental activities of daily living ( IADLs ) , in community-based older persons free of dementia . DESIGN Prospect i ve , observational cohort study . SETTING Approximately 40 retirement communities across the Chicago metropolitan area . PARTICIPANTS More than 1,000 older persons from the Rush Memory and Aging Project , an ongoing longitudinal clinical -pathological study of common chronic conditions of old age . MEASUREMENTS All participants underwent detailed annual clinical evaluations that included assessment s of  physical activity , ADLs , IADLs , and gait performance . The associations between  physical activity , mortality , and incident disability were examined using a series of Cox proportional hazards models controlled for age , sex , education , and baseline gait . RESULTS At baseline , participants spent a mean+/-st and ard deviation of 3.0+/-3.5 hours per week engaging in physical activity ( range 0 - 35 ) . In a proportional hazards model , the risk of death decreased 11 % ( hazard ratio (HR)=0.89 , 95 % confidence interval (CI)=0.83 - 0.95 ) for each additional hour of physical activity per week . For those who were not disabled at baseline , the risk of developing disability in ADLs decreased 7 % ( HR=0.93 , 95 % CI=0.88 - 0.98 ) for each additional hour of physical activity per week . Similarly , the risk of disability in IADLs decreased 7 % ( HR=0.93 , 95 % CI=0.89 - 0.99 ) for each additional hour of physical activity . CONCLUSION For community-based older persons without dementia , physical activity is associated with maintenance of functional status , including a reduced risk of developing impairment in ADLs and IADLs Background Many adults with intellectual disabilities have poor dietary habits , low physical activity and weight disturbances . This study protocol describes the design and evaluation of a health intervention aim ing to improve diet and physical activity in this target group . In Sweden , adults with intellectual disabilities often live in community residences where the staff has insufficient education regarding the special health needs of residents . No published lifestyle interventions have simultaneously targeted both residents and staff . Methods / Design The intervention is design ed to suit the ordinary work routines of community residences . It is based on social cognitive theory and takes 12 - 15 months to complete . The intervention includes three components : 1 ) Ten health education sessions for residents in their homes ; 2 ) the appointment of a health ambassador among the staff in each residence and formation of a network ; and 3 ) a study circle for staff in each residence . The intervention is implemented by consultation with managers , training of health educators , and coaching of health ambassadors . Fidelity is assessed based on the participation of residents and staff in the intervention activities . The study design is a cluster-r and omised trial with physical activity as primary outcome objective ly assessed by pedometry . Secondary outcomes are dietary quality assessed by digital photography , measured weight , height and waist circumference , and quality of life assessed by a quality of life scale . Intermediate outcomes are changes in work routines in the residences assessed by a question naire to managers . Adults with mild to moderate intellectual disabilities living in community residences in Stockholm County are eligible for inclusion .  Multilevel analysis is used to evaluate effects on primary and secondary outcomes . The impact of the intervention on work routines in community residences is analysed by ordinal regression analysis . Barriers and facilitators of implementation are identified in an explorative qualitative study through observations and semi-structured interviews . Discussion Despite several challenges it is our hope that the results from this intervention will lead to new and improved health promotion programs to the benefit of the target group . Trial registration numberIS RCT The objective was to explore the impact on physical health of a lifestyle programme among persons with psychiatric disabilities , and their caregivers . Their satisfaction with the intervention was also assessed . Somatic comorbidity and an increased mortality related to the lifestyle among persons with psychiatric disabilities are well known . Few r and omized controlled trials have been aim ed specifically at lifestyle issues among persons with a psychiatric disability . This trial includes clients with psychiatric disabilities living in supported housing and their staff . Forty-one persons with a DSM-?V diagnosis of severe mental illness from psychiatric disability from 10 supported housing facilities and 41 of their caregivers participated in this 12-month study during 2005–2006 in Sweden . The supported housing facilities with residents and staff were r and omly assigned to either a health intervention programme or a control programme with an aesthetic content . The presence of metabolic syndrome and changes in the mean of physiological parameters such as Hba1c , P-glucose , P-insulin , lipids , blood pressure , physical working capacity , body mass index , Heart Score were investigated and participants ’ satisfaction assessed . There was a significant reduction in the mean of metabolic syndrome criteria in the intervention group compared with the control group at the follow-up . The participants expressed satisfaction with the programme . The results indicate that health interventions on lifestyle issues when involving carers are appreciated , feasible and could be successful in reducing some health-related risk factors among persons with psychiatric disabilities Background The purpose was to conduct systematic review s of the relationship between physical activity of healthy community-dwelling older ( > 65 years ) adults and outcomes of  functional limitations , disability , or loss of independence .  Methods Prospect i ve cohort studies with an outcome related to functional independence or to cognitive function  were search ed , as well as exercise training interventions that reported a functional outcome . Electronic data base search strategies were used to identify citations which were screened ( title and abstract ) for inclusion . Included articles were review ed to complete st and ardized data extraction tables , and assess study quality . An established system of assessing the level and grade of evidence for recommendations was employed . Results Sixty-six studies met inclusion criteria for the relationship between physical activity and functional independence , and 34 were included with a cognitive function outcome . Greater physical activity of an aerobic nature ( categorized by a variety of methods ) was associated with higher functional status ( expressed by a host of outcome measures ) in older age . For functional independence , moderate ( and high ) levels of physical activity appeared effective in conferring a reduced risk ( odds ratio ~0.5 ) of functional limitations or disability . Limitation in higher level performance outcomes was reduced ( odds ratio ~0.5 ) with vigorous ( or high ) activity with an apparent dose-response of moderate through to high activity . Exercise training interventions ( including aerobic and resistance ) of older adults showed improvement in physiological and functional measures , and suggestion of longer-term reduction in incidence of mobility disability . A relatively high level of physical activity was related to better cognitive function and reduced risk of developing dementia ; however , there were mixed results of the effects of exercise interventions on cognitive function indices . Conclusions There is a consistency of findings across studies and a range of outcome measures related to functional independence ; regular aerobic activity and short-term exercise programmes confer a reduced risk of functional limitations and disability in older age . Although a precise characterization of a minimal or effective physical activity dose to maintain functional independence is difficult , it appears moderate to higher levels of activity are effective and there may be a threshold of at least moderate activity for significant outcomes Purpose This study used Ecological Momentary Assessment ( EMA ) , a real-time self-report strategy , to describe the physical and social context s of adults ’ physical activity and sedentary activity during their everyday lives and to determine whether these patterns and relationships differ for men and women . Methods Data from 114 adults were collected through mobile phones across 4 days . Eight electronic EMA surveys were r and omly prompted each day asking about current activities ( e.g. , physical or sedentary activity ) , physical and social context s , and perceived outdoor environmental features ( e.g. , greenness/vegetation , safety , and traffic ) . All participants also wore accelerometers during this period to objective ly measure moderate-to-vigorous physical activity ( MVPA ) and sedentary activity . Results Home was the most common physical context for EMA-reported physical and sedentary activity . Most of these activities occurred when participants were alone . When alone , the most commonly EMA-reported physical activity and sedentary activity was walking and reading/using computer , respectively . When in outdoor home locations ( e.g. , yard and driveway ) women demonstrated higher levels of MVPA , whereas men demonstrated higher levels of MVPA when in outdoor park setting s ( ps < .05 ) . Men but not women demonstrated higher levels of MVPA in setting s with a greater degree of perceived greenness and vegetation ( p < .05 ) . Conclusions The current study shows how EMA via mobile phones and accelerometers can be combined to offer an innovative approach to assess the context s of adults ’ daily physical and sedentary activity . Future studies could consider utilizing this method in more representative sample s to gather context -specific information to inform the development of physical activity interventions INTRODUCTION Replacing sedentary behaviour with light intensity physical activity ( ie , activities classified as less than three metabolic equivalents , such as slow-paced walking ) may be a more realistic strategy for reducing cardiometabolic risk in people with chronic obstructive pulmonary disease than only aim ing to increase levels of moderate-vigorous intensity physical activity . Behaviour change interventions to reduce sedentary behaviour in people with chronic obstructive pulmonary disease have not yet been developed or tested . RESEARCH QUESTIONS Is a 6-week behaviour change intervention effective and feasible in reducing sedentary time in people with chronic obstructive pulmonary disease ? DESIGN This study will be a multi-centre , r and omised , controlled trial with concealed allocation , assessor blinding , and intention-to-treat analysis , comparing a 6-week behaviour change intervention aim ed at reducing sedentary time with a sham intervention in people with chronic obstructive pulmonary disease . PARTICIPANTS AND SETTING Seventy participants will be recruited from the waiting lists for pulmonary rehabilitation programs at Royal Prince Alfred Hospital and Prince of Wales Hospital , Sydney , Australia . INTERVENTION The behaviour change intervention aims to reduce sedentary time through a process of guided goal setting with participants to achieve two target behaviours : ( 1 ) replace sitting and lying down with light-intensity physical activity where possible , and ( 2 ) st and up and move for 2minutes after 30minutes of continuous sedentary time . Three face-to-face sessions and three phone sessions will be held with a physiotherapist over the 6-week intervention period . The ' capability ' , ' opportunity ' , ' motivation ' and ' behaviour ' ( COM-B ) model will be applied to each participant to determine which components of behaviour ( capability , opportunity or motivation ) need to change in order to reduce sedentary time . Based on this ' behavioural diagnosis ' , the Behaviour Change Wheel will be used to systematic ally select appropriate behaviour change techniques to assist participants in achieving their weekly goals . Behaviour change techniques will include providing information about the health consequences of sedentary behaviour , self-monitoring and review of weekly goals , problem-solving of barriers to achieving weekly goals , and providing feedback on sedentary time using the Jawbone UP3 activity monitor . CONTROL The sham intervention will consist of weekly phone calls for 6 weeks , to enquire whether the participants ' health status has changed over the intervention period ( eg , hospitalised for an acute exacerbation ) . No instructions regarding physical activity or exercise will be given . MEASUREMENTS Outcomes will be assessed at baseline , at the end of the 6-week intervention period , and at the 3-month follow-up . Primary outcome measures will be : ( 1 ) total sedentary time , including the pattern of accumulation of sedentary time , assessed by the activPAL3 activity monitor , and ( 2 ) feasibility of the intervention assessed by uptake and retention of participants , participant compliance , self-reported achievement of weekly goals , and adverse events . Secondary outcome measures will include functional exercise capacity , health-related quality of life , domain-specific and behaviour-specific sedentary time , patient activation , and anxiety and depression .  Semi-structured interviews will be conducted with participants who receive the behaviour change intervention to explore acceptability and satisfaction with the different components of the intervention . ANALYSIS Analysis of covariance ( ANCOVA ) will be used to calculate between-group comparisons of total sedentary time and the number of bouts of sedentary time>30minutes after adjusting baseline values . Uncertainty about the size of the mean between-group differences will be quantified with 95 % CI . Within-group comparisons will be examined using paired t-tests and described as mean differences with 95 % CIs . Secondary outcome measures will be analysed similarly . The feasibility measures will be analysed descriptively . Semi-structured interviews will be conducted until data saturation is achieved and there are no new emerging themes . De-identified interview transcripts will be coded independently by two research ers and analysed alongside data collection using the COM-B model as a thematic framework . DISCUSSION / SIGNIFICANCE If behaviour change interventions are found to be an effective and feasible method for reducing sedentary time , such interventions may be used to reduce cardiometabolic risk in people with chronic obstructive pulmonary disease . An approach that emphasises participation in light-intensity physical activity may increase the confidence and willingness of people with chronic obstructive pulmonary disease to engage in more intense physical activity , and may serve as an intermediate goal to increase uptake of pulmonary rehabilitation Objective : To compare the effects of behavioral interventions targeting decreased sedentary behavior versus increased moderate-to-vigorous intensity physical activity ( MVPA ) in older adults . Method : Inactive older adults ( N = 38 , 68 ± 7 years old , 71 % female ) were r and omized to 12-week interventions targeting decreased sedentary behavior ( Sit Less ) or increased MVPA ( Get Active ) . The SenseWear armb and was used to objective ly assess activity in real time . Assessment s included a blinded armb and , the Community Health Activites Model Program for Senior ( CHAMPS ) question naire , 400-meter walk , and the Short Physical Performance Battery ( SPPB ) . Results : Objective ly measured MVPA increased in Get Active ( 75 ± 22 min/week , p < .001 ) ; self-reported MVPA increased in both groups ( p < .05 ) . Sedentary behavior did not change in either group ( all p > .05 ) . Only the Sit Less group improved the SPPB score ( 0.5 ± 0.3 , p = .046 ) . Discussion : Targeting reduced sedentary behavior had a greater effect on physical function among inactive but high functioning older adults over 12 weeks . Future studies of longer duration and combining increased MVPA with reduced sedentary behavior are needed The purpose of this study was to investigate the benefits of a pedometer and a cognitive-behavioural group intervention for promoting physical activity ( PA ) in type 2 diabetes patients . We recruited 41 participants and r and omized them into an intervention group ( IG ) ( n = 20 ) and a control group ( CG ) ( n = 21 ) . The intervention consisted of five sessions within 12 weeks , a booster session after 22 weeks and a pedometer . Primary outcome was PA assessed by accelerometer ( minutes per day ) and pedometer ( steps per day ) . Secondary outcomes were weight , body mass index , blood pressure , haemoglobin A1c and total cholesterol . After 12 weeks , the IG increased with more than 2000 steps day−1 compared with the CG , whereas sedentary behaviour decreased more than 1 hour day−1 in the IG and showed no change in the CG . There was no intervention effect on the accelerometer-based PA nor on health measurements . After 1 year , the increase in steps per day remained significant in the IG , but sedentary activity increased again to baseline levels . This pilot study showed that the combination of a 12-week cognitive-behavioura intervention and a pedometer has a significant short-term impact on daily steps and sedentary behaviour but that the effects on total PA and long-term effects were limited AIM This paper reports a study evaluating the relationship between social and community level supports and  physical activity and dietary behaviours  among a low-income Latino population with multiple chronic conditions . BACKGROUND With consistently lower physical activity than whites and documented nutritional deficiencies , Latinos in the United States of America represent a disproportionate share of the population with chronic illness . This pattern of health disparities is seen across countries , where there is a struggle to raise the health status of low-income , immigrant and aboriginal communities . Social-ecological theories of health behaviour stress the importance of considering social and community support for health behaviour , and represent a useful framework for considering ways to improve physical activity and nutrition for immigrant and aboriginal groups . METHOD We report here on data from a baseline assessment of 200 patients from a health clinic in the United States of America serving a low-income , primarily Latino population . Participants were enrolled in Re sources for Health , a r and omized controlled trial to promote multi-level support for chronic illness self-management . Measures included  self-reported physical activity , dietary behaviour and multi-level support for chronic illness management  as well as demographic data . Baseline data reported on here were collected between February 2002 and September 2003 . FINDINGS Use of multi-level supports ( e.g. family , individual and healthcare provider ) was statistically significantly associated with meeting physical activity guidelines and better dietary behaviours . Being female and having multiple chronic conditions were also associated with better dietary behaviour . These variables explained 20 % of the variance in dietary behaviour . CONCLUSION Results support a social-ecological approach for promoting healthy behaviour in this low-income , primarily Latino sample with multiple chronic conditions . Addressing multiple levels of support for healthy behaviour is important in interventions to improve physical activity and diet , and nurses may be particularly well placed to address such issues for low-income , aboriginal and immigrant patients with chronic conditions
None of the studies reported the reliability and validity of the methods used to measure sedentary behaviour .
Supporting positive change in lifestyle behaviours is a priority in tackling the health inequalities experienced by adults with intellectual disabilities .
In this systematic review , we examine the evidence on the definition , measurement and epidemiology of sedentary behaviour of adults with intellectual disabilities .
Many research ers do not distinguish between insufficient physical activity and sedentary behaviour .