StandUpTV: Reducing sedentary screen time in adults

项目摘要 久坐不动的行为(即清醒时低能量消耗的坐/卧)会增加患癌症的风险， 心血管疾病和死亡率，特别是在那些没有从事建议水平的 中等强度体力活动(MVPA)。久坐屏幕时间(SST；即观看电视和/或视频 在工作和教育活动之外流动)消耗了一半以上的可自由支配时间 这是美国人在工作和睡眠之外最普遍的一种时间利用方式。有效的策略来 我们的团队和其他人已经开发出了在其他环境(如工作场所)中减少久坐时间的方法。海温 比其他久坐追求的健康风险大得多，然而只有两项干预研究专门 重点是降低海温。此外，SST产生的数量和背景发生了巨大的变化 因为这些研究都是在。成年人(23-)只有一半的时间在SST上观看 传统电视-另一半花在移动流媒体平台(如Netflix)上，这些平台可能会 推广“狂欢观看”。需要有创新的方法来降低成年人的SST， 对当前和新兴技术的反应。我们将利用我们现有的理论驱动和经验- 基于mHealth平台，专注于减少成年人的总久坐时间，以测试应用程序StandUPTV 现在将专门针对SST。核心标准电视干预将包括被动和客观的自我 监测SST和一个将SST降低50%的行为目标。基于我们的初步数据和之前 研究表明，我们已经确定了将添加到StandUPTV的三个不同的行为组件：(1) 每周达到50%限制后电子禁止SST；(2)基于MOST的自适应短信 最近的SST回合；以及(3)通过10分钟的MVPA回合赢得30分钟的额外SST。我们将使用多阶段 优化策略(MOST)进行为期16周的析因实验，以确定哪个成分(S)来自 正在考虑纳入StandUPTV的三种成分使成年人的SST每天减少60分钟 (23岁-)超重和肥胖。我们还将研究光强度的体力活动 (LPA)、MVPA、其他因素(如饮食摄入量)和疾病风险标记物(如体重)在以下情况下发生变化 海温降低。我们将检查行为改变的主持人(例如，年龄、性别、种族/民族)和调解人 (即，社会认知结构)。这项提议的创新方面是使用最先进的mHealth 旨在设计高度可扩展的干预措施，以响应当前媒体使用的趋势，最 有效识别有效成分的框架(S)，并利用SST的减少作为机会 增加LPA、MVPA及相关健康行为。这项研究将直接导致优化干预- 一种最有效和最高效的方法--在长期随机对照试验中进行测试，以确定SST的因果作用 在降低慢性病风险方面。这些发现将为促进健康产生新的目标，并影响美国 公共卫生指南，目前没有明确的降低SST的建议。

Project Summary Sedentary behaviors (i.e., sitting/lying with low energy expenditure while awake) increase risk for cancer, cardiovascular disease, and mortality, particularly among those who do not engage in recommended levels of moderate-vigorous physical activity (MVPA). Sedentary screen time (SST; i.e., television viewing and/or video streaming outside of work and educational pursuits) consumes more than half of available discretionary time and is the single most prevalent use of time for Americans outside of work and sleep. Efficacious strategies to reduce sedentary time in other contexts (i.e., workplace) have been developed by our team and others. SST poses far greater health risks than other sedentary pursuits, yet just two intervention studies have exclusively focused on reducing SST. Moreover, the amount and context in which SST is accrued has dramatically shifted since these studies were conducted. Adults (23-64 years of age) only spend half of their SST viewing a traditional television - the other half is spent on mobile streaming platforms (e.g., Netflix) that are likely to promote “binge-watching.” There is a need for innovative approaches to reduce SST among adults that are responsive to current and emerging technologies. We will leverage our existing theory-driven and empirically- based mHealth platform, which focuses on reducing total sedentary time in adults, to test StandUPTV, an app that will now specifically target SST. The core StandUPTV intervention will include passive and objective self- monitoring of SST and a behavioral target to reduce SST by 50%. Based on our preliminary data and prior research, we have identified three distinct behavioral components that we will add to StandUPTV: (1) electronically prohibiting SST after weekly 50% limit is reached; (2) adaptive text-messaging based on most recent SST bout; and (3) earning 30 min of additional SST with 10 min bout of MVPA. We will use a multiphase optimization strategy (MOST) to conduct a 16-week factorial experiment to identify which component(s) from the three components under consideration for inclusion in StandUPTV reduce SST by >60 min/day in adults (23-64 years of age) with overweight and obesity. We will also examine how light-intensity physical activity (LPA), MVPA, other factors (e.g., dietary intake), and markers of disease risk (e.g., body weight) change when SST is reduced. We will examine moderators (e.g., age, sex, race/ethnicity) and mediators of behavior change (i.e., social cognitive constructs). Innovative aspects of this proposal are the use of state-of-the-art mHealth design to design a highly-scalable intervention that is responsive to current trends in media use, the MOST framework to efficiently identify efficacious component(s), and leveraging reductions in SST as opportunities to increase LPA, MVPA, and related health behaviors. This study will directly lead to an optimized intervention – one that is most effective and efficient – to be tested in a longer-term RCT to determine the causal role of SST in lowering chronic disease risk. These findings will produce new targets for health promotion and impact US public health guidelines, which currently do not include explicit recommendations for lowering SST.