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Abstract

Background: As school days among adolescents include long periods of prolonged sitting, teachers are key agents to deliver interventions to reduce youth sedentary behavior. To develop an intervention, acceptability and feasibility of alternative strategies should be tested. We aimed to examine teachers' current use and willingness to use various strategies to decrease student sitting and potential barriers and facilitators of use. Method: Mixed-methods design with college teachers using an online cross-sectional survey (n = 192) and focus group interviews (n = 13). Findings: Although a vast majority (87%) of the teachers found reducing prolonged sitting an important goal, only 47% were actually including practices to reduce sitting in their classroom. 89% of the teachers reported willingness to use at least one of the five alternative strategies presented. Focus groups revealed a discussion emphasis on environmental opportunity and motivation as key to implementation. Teachers also generated additional ideas for intervention content. Discussion: Despite low levels of current sitting reduction, teachers were willing to try at least one strategy to reduce sitting. Results informed intervention development regarding parameters of use for each strategy. When possible, interventions should provide teachers with a variety of alternative strategies that are easy to use to reduce prolonged sitting.

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... The TDF is a simple tool developed through review and consensus methods to describe the most common explanatory constructs in behavioral theories organized into 14 domains: knowledge, skills, social influences, memory, attention and decision processes, social/professional role and identity, reinforce- ment, beliefs about capabilities, beliefs about conse- quences, optimism, intention, goals, behavioral regulation, emotion, environmental context and resources (Cane, O'Connor, & Michie, 2012;Michie et al., 2005). The TDF can be used to inform both qualitative and quantitative studies with the aim to understand key predictors of behav- ior and to identify the most relevant theoretical approach (Beenstock et al., 2012;Laine, Ara?jo-Soares, Haukkala, & Hankonen, 2017;Presseau, Schwalm, et al., 2017). ...
... For example, some might not be willing to engage in planning interventions unless key modifications are implemented to increase acceptability and feasibility (Witteman et al., 2017). Anticipated acceptability of candi- date features can be empirically examined to inform deci- sions, for example, teachers' views on potential strategies to reduce student sitting in schools was examined using a mixed-methods approach ( Laine et al., 2017). This example also illustrates that in addition to the main target group (stu- dents), the environmental agents or "providers" (teachers) ...
... Further, quantitative analyses informed by the Therectical Domain Framework ( Francis et al., 2012) aimed to identify the key correlates of these behaviors (Hankonen, Heino, Kujala, et al., 2017). As some parts of the intervention were to be delivered by teachers, a mixed-methods study to examine accep- tability of potential intervention strategies was conducted among teachers ( Laine et al., 2017). We conducted e.g., scenario work with a group of experts and stakeholders, and with a student panel, did practical small trials of e.g., discussion exercises with students in order to get rapid feedback of alternative practical strategies within the student program. ...
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... College instructors have exhibited high agreement regarding the importance for their school to make efforts to reduce students' sitting time, indicating that classroom efforts to reduce sitting should be natural and easy (Laine et al., 2017). An adjustable tabletop standing desk could serve as a convenient strategy to reduce or interrupt sitting on college campuses that are already equipped with tables in classrooms. ...
... Furthermore, studies of standing desks in classrooms have provided a largely positive consensus among students and teachers, with very little negative feedback regarding their use (Sherry et al., 2016). Others have found acceptability for using standing desks in college classrooms (Benzo et al., 2016;Laine et al., 2017) and university libraries (Bastien Tardif et al., 2018), and in this study, all but one student reported they would use a standing desk in a classroom. ...
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Objective To examine if Arduino microcontrollers and Fitbits can serve as proxy measures for the direct observation of sitting and standing time in college students using height-adjustable standing desks. The preferred type of standing desks and reasons to use the desks were also assessed. Design Classroom-based intervention, plus cross-sectional survey. Setting Mid-sized Midwestern US university classroom. Method Students were randomised to either a tabletop or stand-alone height-adjustable standing desk. They followed an alternating sit/stand protocol, then completed an 11-item questionnaire on preferences and reasons for or against using the desks. Data were collected in October 2018. Results Twenty-two students completed the protocol (16 women; 15 in third or fourth year of study). Arduinos provided accurate representation of sitting. Correlations between Fitbits and Arduinos were moderate (.23–.49). Sixteen of the 22 participants preferred tabletop (vs stand-alone) height-adjustable desks. Main reasons to use standing desks were to improve health and preferring to stand. Main reasons for not using them were being tired and preferring to sit. Conclusion Arduinos served as an adequate stand-in for direct observation, which has implications for studying the sedentary behaviours of large numbers of students simultaneously. More research is needed on using Fitbits for assessing sitting and standing time. Student preferences and reasons for/against using standing desks provide foundational evidence for standing desk interventions in this population.
... All classes that teachers identified to involve students sitting most of the time (e.g. mathematics) were targeted (for more information on the development of the teacher intervention, see [21]). Sample size target was defined by practical and resource considerations as 60 students and 20 teachers, and was deemed adequate for the study's purpose. ...
... Teachers had a chance for further personalised support from the facilitator via email and phone. The intervention was informed by formative research in another sample of teachers [21]. ...
... All classes that teachers identified to involve students sitting most of the time (e.g. mathematics) were targeted (for more information on the development of the teacher intervention, see [21]). Sample size target was defined by practical and resource considerations as 60 students and 20 teachers, and was deemed adequate for the study's purpose. ...
... Teachers had a chance for further personalised support from the facilitator via email and phone. The intervention was informed by formative research in another sample of teachers [21]. ...
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... The wrong material and ergonomic design of men's underwear will cause great male health problems for this group [12]. It can cause vascular disease or discomfort not only in the lower back, but also in the male private parts, groin and buttocks [13,14]. For example, in a long-time sitting state, the scrotum is hot, wet and squeezed, which seriously affect the temperature of the testicles or fertility [15]; on the other hand, in a long-time standing state, the problem of genital support causes uncomfortable falling feelings or varicocele, etc. [16]. ...
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... After the diagnostic evaluation and the presentation of reports to the different schools, the priority schools for in-Acceptability and feasibility of interventions should, therefore, be examined with the experiences and views of key agents, such as teachers or children, using qualitative methods (Laine et al., 2017). Different focus groups were conducted with children, parents, teachers, the principal, and the facilitator of each school to assess acceptability and feasibility of the intervention at every school. ...
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The school setting is presented as an ideal context for behavioral interventions. Accordingly, evidence shows that school-based interventions positively impact on Active Transportation to School (ATS). However, behavioral interventions are rarely developed in a systematic way. The aim of this manuscript is to describe the content and development process of the ProATS (Promoting Active Transportation to School) intervention. For this purpose, an Intervention Mapping Protocol (IMP) is used for the design, implementation, and evaluation of ProATS. This intervention aims to increase ATS in children aged 10 to 12 years is used. ProATS is based on a literature review and is developed by a multidisciplinary team. There is input from experts (Local Working Group), school representatives (Planning Committee), and a facilitator in each school (a member of the research team). The ProATs intervention results in the following two components (i) curricular path, (ii) non-curricular path. In parallel, a guide is elaborated, which includes the strategies and activities to design and implement the ProATs project. The results of the pilot study seem promising, showing a significant increase in ATS (i.e., the frequency of ATS). IMP, targeting behavioral changes such as ATS, is a complex and time-consuming process. Yet, it helped us to carry out the planning and development of the ProATs intervention to make it feasible, effective, and sustainable. The process explanation followed with the IMP allows replication of the intervention in other school contexts.
... High school and vocational school teachers in Finland identified students not volunteering as a disadvantage of student-led PABs. 29 General recognition or inexpensive yet significant incentives can increase student interest in participating in PABs, being facilitators, or leading the program. ...
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... The item was "I intend to reduce students' sitting during my lessons in the future" and it was answered on two scales: 1 (unlikely) to 7 (likely) and 1 (absolutely not) to 7 (absolutely yes). Outcome expectations were measured with 10 items based on teachers' focus group interviews ( Laine et al., 2017). Item stem was "If I reduced students' sitting during my lessons, as a result…", and the items included e.g. ...
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Creating active classroom environments and reducing excessive student sitting requires changes in teachers' behaviours. This study examines a teacher training intervention, which aimed to increase the extent to which teachers use strategies to interrupt prolonged periods of students' sitting, as well as strategies to reduce total sitting time. The training was part of the Let's Move It (LMI) multi-level school-based intervention that aimed to reduce sedentary behaviour and increase physical activity among older adolescents, drawing on insights from social psychological theories, such as the reasoned action approach, self-regulation approaches and habit formation. We explore (1) whether the intervention increased teachers' use of sitting reduction strategies, (2) whether theoretical mechanisms mediated these changes, and (3) how teachers utilized habit formation. This pragmatic experimental study of vocational school teachers (n = 234) was embedded within a cluster-randomized controlled trial evaluating LMI, in which schools were randomized to intervention or no-treatment control arms. Three intervention workshops targeted skills and motivation to use sitting reduction strategies in class (e.g., active teaching methods, activity breaks). Participants self-reported sitting reduction activities, theoretical mediators, and use of behaviour change techniques (BCTs) at baseline and 8-weeks follow-up. Compared to controls, intervention schools' teachers increased breaks to interrupt sitting, but not their outcome expectations, perceived behavioural control or intentions – potentially due to ceiling effects. Effects were mediated by BCT use and perceived behavioural control. Descriptive norms mediated the effects of the intervention on intention, which in turn mediated the intervention effects on BCT use. BCT use and intention were positively related to reducing students' sitting.
... 84screen of choice (i.e., phone, pad, or laptop). Interest is high among college instructors for 85 implementing some type of movement break, yet few have actually done so (Laine, Araújo-86Soares,Haukkala, & Hankonen, 2017). ...
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As health education specialists, we are called to practice what we promote. American adult physical activity levels are low, and too much time is spent sedentary. New habits can be learned early in adult life in the higher education setting. Most time students and faculty spend in higher education learning environments is spent while sedentary—this norm must change. Brain breaks in formal learning environments have worked well in K-12 schools; they can be incorporated into higher education in order to reengage students and improve their academic achievement. Brain Breaks are short (2-5 minutes), movement-based activities to break-up prolonged periods of sitting by students, thus increasing physical activity. Health and health-related college courses provide an ideal platform to begin adding back in brain breaks and active learning strategies where there has traditionally been little to none.
... The item was "I intend to reduce students' sitting during my lessons in the future" and it was answered on two scales: 1 (unlikely) to 7 (likely) and 1 (absolutely not) to 7 (absolutely yes). Outcome expectations were measured with 10 items based on teachers' focus group interviews ( Laine et al., 2017). Item stem was "If I reduced students' sitting during my lessons, as a result…", and the items included e.g. ...
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Creating active classroom environments and reducing excessive student sitting requires changes in teachers’ behaviours. This study examines a teacher training intervention, which aimed to increase the extent to which teachers use strategies to interrupt prolonged periods of students’ sitting, as well as strategies to reduce total sitting time. The training was part of the Let’s Move It (LMI) multi-level school-based intervention that aimed to reduce sedentary behaviour and increase physical activity among older adolescents, drawing on insights from social psychological theories, such as the reasoned action approach, self-regulation approaches and habit formation. We explore (1) whether the intervention increased teachers’ use of sitting reduction strategies, (2) whether theoretical mechanisms mediated these changes, and (3) how teachers utilized habit formation. This pragmatic experimental study of vocational school teachers (n=234) was embedded within a cluster-randomized controlled trial evaluating LMI, in which schools were randomized to intervention or no-treatment control arms. Three intervention workshops targeted skills and motivation to use sitting reduction strategies in class (e.g., active teaching methods, activity breaks). Participants self-reported sitting reduction activities, theoretical mediators, and use of behaviour change techniques (BCTs) at baseline and 8-weeks follow-up. Compared to controls, intervention schools’ teachers increased breaks to interrupt sitting, but not their outcome expectations, perceived behavioural control or intentions – potentially due to ceiling effects. Effects were mediated by BCT use and perceived behavioural control. Descriptive norms mediated the effects of the intervention on intention, which in turn mediated the intervention effects on BCT use. BCT use and intention were positively related to reducing students’ sitting.
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Article
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Schools are an attractive and popular setting for implementing interventions for children. There is a growing body of empirical research exploring the efficacy of school-based obesity prevention programs. While there have been several reviews on the topic, findings remain mixed. To examine the quality of evidence and compare the findings from existing systematic reviews and meta-analyses of school-based programs in the prevention and control of childhood obesity. This paper systematically appraises the methodology and conclusions of literature reviews examining the effectiveness of school-based obesity interventions published in English in peer-reviewed journals between January 1990 and October 2010. Eight reviews were examined, three meta-analyses and five systematic reviews. All of the reviews recognized that studies were heterogeneous in design, participants, intervention and outcomes. Intervention components in the school setting associated with a significant reduction of weight in children included long-term interventions with combined diet and physical activity and a family component. Several reviews also found gender differences in response to interventions. Of the eight reviews, five were deemed of high quality and yet limited evidence was found on which to base recommendations. As no single intervention will fit all schools and populations, further high-quality research needs to focus on identifying specific program characteristics predictive of success.
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OWEN, N., G.N. HEALY, C.E. MATTHEWS, and D.W. DUNSTAN. Too much sitting: the population health science sedentary behavior. Exerc. Sport Sci. Rev., Vol. 38, No. 3, pp. 105-113, 2010. Even when adults meet physical activity guidelines, sitting for prolonged periods can compromise metabolic health. Television (TV) time and objective measurement studies show associations, and breaking up sedentary time is beneficial. Sitting time, TV time, and time sitting in automobiles increase premature mortality risk. Further evidence from prospective studies, intervention trials, and population-based behavioral studies is required.
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It is not uncommon for people to spend one-half of their waking day sitting, with relatively idle muscles. The other half of the day includes the often large volume of nonexercise physical activity. Given the increasing pace of technological change in domestic, community, and workplace environments, modern humans may still not have reached the historical pinnacle of physical inactivity, even in cohorts where people already do not perform exercise. Our purpose here is to examine the role of sedentary behaviors, especially sitting, on mortality, cardiovascular disease, type 2 diabetes, metabolic syndrome risk factors, and obesity. Recent observational epidemiological studies strongly suggest that daily sitting time or low nonexercise activity levels may have a significant direct relationship with each of these medical concerns. There is now a need for studies to differentiate between the potentially unique molecular, physiologic, and clinical effects of too much sitting (inactivity physiology) separate from the responses caused by structured exercise (exercise physiology). In theory, this may be in part because nonexercise activity thermogenesis is generally a much greater component of total energy expenditure than exercise or because any type of brief, yet frequent, muscular contraction throughout the day may be necessary to short-circuit unhealthy molecular signals causing metabolic diseases. One of the first series of controlled laboratory studies providing translational evidence for a molecular reason to maintain high levels of daily low-intensity and intermittent activity came from examinations of the cellular regulation of skeletal muscle lipoprotein lipase (LPL) (a protein important for controlling plasma triglyceride catabolism, HDL cholesterol, and other metabolic risk factors). Experimentally reducing normal spontaneous standing and ambulatory time had a much greater effect on LPL regulation than adding vigorous exercise training on top of the normal level of nonexercise activity. Those studies also found that inactivity initiated unique cellular processes that were qualitatively different from the exercise responses. In summary, there is an emergence of inactivity physiology studies. These are beginning to raise a new concern with potentially major clinical and public health significance: the average nonexercising person may become even more metabolically unfit in the coming years if they sit too much, thereby limiting the normally high volume of intermittent nonexercise physical activity in everyday life. Thus, if the inactivity physiology paradigm is proven to be true, the dire concern for the future may rest with growing numbers of people unaware of the potential insidious dangers of sitting too much and who are not taking advantage of the benefits of maintaining nonexercise activity throughout much of the day.
Do short physical activity breaks in classrooms work?
  • M Whitt-Glover
  • A Porter
  • T Yancey
Whitt-Glover, M., Porter, A., & Yancey, T. (2013). Do short physical activity breaks in classrooms work? (Research Brief).