Stomp Out Sitting. A sedentary behaviour reduction intervention for older adults living in sheltered housing

Stomp Out Sitting A sedentary behaviour reduction intervention for older adults living in sheltered housing

WELCOME Welcome to our programme aimed at reducing sedentary behaviour (prolonged sitting) in older adults. I am delighted that you have chosen to join our study and hope you will gain real benefit from taking part. Over the next few months we will work together to help you make positive changes to your life. You have the choice as to how far to take the programme. There will be ups and downs over the next few months, so we should expect that, and together, will work through any difficulties, that crop up. After the 3 sessions we hope you will have the skills and the confidence to maintain the positive changes you choose to make. Your participation in the programme will be a valuable contribution to understanding how we can reduce prolonged sitting in older adults and what the health benefits of doing this might be. I look forward to working with you over the next few months. Julie Julie Harvey Principle Researcher PhD Research Student/Chartered Physiotherapist Glasgow Caledonian University Juliet.Harvey@gcu.ac.uk Office: 0141 2731663 Mobile: 07598 165235 Director of Studies: Professor Dawn Skelton (0141 331 8792) Supervisor: Dr. Sebastien Chastin (0141 331 3744) 2

PROGRAMME PLAN Interview Session 1 Today! Introduction to Sedentary Behaviour Where we are now Where do you want to go? Interview Session 2 In one month Review of month Discuss ideas What s next Interview Session 3 In two months Review of month Discuss ideas What s next Weekly Equipment Change Between sessions I will pop into to change the activity monitor. In three months Review the effects of the programme On the final day we will re.do the tests we did on the first week 3

Session One 4

INTRODUCTION What is sedentary behaviour? Sedentary behaviour is sitting for long periods of time in a day. Over 4 hours of sitting a day is considered to be sedentary. It is a separate concern to not doing enough exercise. Often people find it easier to reduce sitting time, rather than choosing to do more exercise. Over the past half century or so, as we have become more technologically advanced we spend more time sitting and do less activity. Why reduce sedentary behaviour? Prolonged periods of sedentary behaviour have been linked to: Disease, such as, heart disease, diabetes and certain cancers Frailty Obesity Premature death Poor quality of life When we sit for long periods, we become: Stiff & sore Sluggish (both mentally and physically) Perhaps, lonely & depressed When sitting for long periods we don t challenge our balance, muscles and bones. If we don t challenge these systems they become weak. By being on our feet more, these systems are challenged and become stronger, we and feel more energized. Can you relate to some of these issues? Have you noticed things that happen to you when you sit for long periods? 5

Self-Evaluation Last week you did some physical test. Let s take a look at the results of these and compare them to the averages person of your age. Timed Up & Go - for general mobility Your Score: seconds Normal Ranges Age Gender Average Range 60-69 Male 8s 7-8 Female 8s 7-9 70-79 Male 9s 7-11 Female 9s 8-10 80-89 Male 10s 9-11 Female 11s 9-12 (Source: Steffen, et al., 2002) Chair Reach for flexibility (important for posture, walking, stair climbing and can be related to back pain). Your Score: inches Age Gender Lower Upper 60-64 Male -2.5 + 4.0 Female -0.5 + 5.0 65-69 Male -3.0 + 3.0 Female -0.5 + 4.5 70-74 Male -3.5 + 2.5 Female -1.0 + 4.0 75-79 Male -4.0 + 2.0 Female -1.5 + 3.5 80-84 Male -5.5 + 1.5 Female -2.0 + 3.0 85-89 Male -5.5 + 0.5 Female -2.5 + 2.5 90-94 Male -6.5-0.5 Female -4.5 + 1.0 (Source: Jones & Rikli, 2002) 6

30s Chair Sit-to-Stand for lower body strength (helping with walking, stair climbing, getting on/off toilet, in and out of bath/shower/car) Your Score: stands Age Gender Lower Upper 60-64 Male 14 19 Female 12 17 65-69 Male 12 18 Female 11 17 70-74 Male 12 17 Female 10 15 75-79 Male 11 17 Female 10 15 80-84 Male 10 15 Female 9 14 85-89 Male 8 14 Female 8 13 90-94 Male 7 12 Female 4 11 (Source: Jones & Rikli, 2002) Single Leg Stand for balance (helping avoid trips, reaching for things from cupboards and general maintenance of independence) Your Score: seconds (leg with longest time chosen) Left/Right Age Average Lower Upper 60-69 27.0 20.4 33.7 70-79 17.2 11.6 22.8 80-99 8.5 1.0 16.1 (Source: Bohannon, et al., 2006) 7

Review your Sitting Time Please complete the sitting time interview with Julie This is your average sitting time as reported. TV: Socialising: Computer: Driving: Reading: Hobbies: Other: Other: TOTAL: What time (s) of the day is (are) your longest periods of sitting? AM Noon Evening 9-10 10-11 11-12 12-13 13-14 14-15 15-16 16-17 17-18 18-19 20-21 21-22 22-23 Can you think of why this might be? 8

Review your Sitting Time We will now take a look at your sitting behaviour. The activity monitor, which you have worn for the last week, has measured your sitting throughout the week. Sitting/Lying in the last week Day Mon Tues Wed Thur Fri Sat Sun Sitting or Lying (% of day) % % % % % % % Over an average day you sit for made up of bouts of sitting, with an average sitting time of. What s everyone else doing? Over 4hrs per day is considered sedentary and has been linked with negative health outcomes. On average, older people sit for around 5hrs per day when you include other sitting activities. The average Scottish older adult spends 3.5-4hrs per day in front of a screen (a TV or computer screen). 9

Your Sitting Time Do you sit more or less that the average older adult? More - Less Do you sit more or less than 4 hrs per day (associated with negative health outcomes)? More - Less Do you sit more or less than when you were 30? More - Less Do you sit more or less than you remember you parents doing when they were older? More - Less Do you frequently sit for more than 30mins at a time? Yes - No Would you like to make a change to your sitting behaviour? Yes - No If YES, continue onto the next page. If NO, perhaps you need more time to think about it and we will have another chat in a month s time. 10

Assessment of Importance How important is it to you personally to change your sitting behaviour? Motivation Review If 1 was not important and 5 was very important, what number would you give at this time? Assessment of Confidence If you decided right now to do reduce sitting, how confident do you feel about succeeding with this? Confidence Review If 1 was not confident and 5 was very confident what number would you give at this time? Improvement as a series of small steps, rather than an all or nothing shift. 11

Excellent! You have decided you reduce your sitting time! Let s get started! Common Barriers to Reducing Sitting Tiredness I m too tired to do anything other than sit Possible Solution Sometimes we are tired and need to sit down, this is fine. It s the long periods of sitting that become a problem - more rest does not equal more energy. It can actually be energizing to stand and perhaps do a few stretches. If you feel like you do not wish to stand why not do a couple of exercises in your chair? You could do simple stretches, seated marching, or leg and arm movements for five minutes. Consider why you are feeling tired, did you do too much in one go, could this be split up into smaller tasks with a short sitting rest between. The longer we sit the more tired we become. Standing up and sitting back down again is better than just sitting. It can be useful to review how we use our energy using a diary (see later in the pack). Add your own solutions below: 12

Pain I m too sore to do anything other than sit Possible Solution Again a short rest can be helpful, but long periods of not moving much increase pain and stiffness. In fact we often find movement helps to manage pain. Add your own solutions below: Weather I sit a lot because the weather is too bad for me to venture outside Possible Solution There are plenty of things to do indoors. We will discuss this further on the next page. Add your own solutions below: Television Watching I love TV and don t want to give it up Possible Solution There is no reason for you to stop watching TV. If you like watching TV, let s make it more active and more purposeful. I feel lonely when the TV is not on Possible Solution Try the radio/listen to music you are perhaps more likely to move when music is on. Let s take a look at TV in more detail 13

TV Viewing & Our Life s People often watch more TV than they plan, reasons for this may be: Flicking though the channels to see what is on Watching TV at the same time daily, regardless of what is on Continuing to watch TV after the programme you wanted to watch is finished Have not planned to do anything else Do you do any of these habits? Could you change some of these? Ideas to Reduce Sedentary TV Watching Try to avoid automatically having the TV on Plan what you what to watch & when you are going to watch it Plan what you want to do with your non-tv time Make TV time more active Do some chores whilst watching TV, e.g. folding washing, preparing vegetables, ironing. Do some gentle exercise when the TV is on e.g. Marching on the spot, stretching, leg movements, arm movements. Leave the remote control on top of the TV Take a walk around your home during the adverts Stand up when someone gets a quiz question wrong 14

What other things could you try? In an ideal world we would break sitting time every 30 minutes during the waking day. At the moment this may be unrealistic. Here are a few more ideas to break sitting: Tell people what you are doing Taking frequent walks to the window Stand when talking on the telephone Walk to the door to get some fresh air Arrange with friends that you are all going to stand at a particular point of a group activity e.g. o When the dealer changes in a game of cards o before each game of bingo o when to someone talks about a particular subject/word Split big tasks (such as housework) into smaller more manageable parts, having more frequent sitting rests during the task, rather than trying to do it all at once. Use a prompt such as your kitchen timer/alarm clocks to remind you to take a break from sitting, leave yourself a notes. Plan you time If we plan what we do we can usually spend our day more effectively. Whilst working your way through the programme try to see if you can see benefits/rewards you gain from sitting less. Don t stop your sitting hobbies, adapt them. Stand/walk after completing: o each chapter of a book o 10 rows of knitting o 5 crossword clues o think about your own hobby 15

Have a Goal (s) Setting your goals is not something you should rush, you need to take time to consider what you would like to achieve from this programme. Your goal should be something you really think you can achieve, try to be as specific as you can be. For Example Mary, 76 I really enjoy watching TV. Over the next week, I am going to standing up for at least 1min every time the adverts come on the telly. If I find this ok after 2 week, I am going to march on the spot for 2mins. My aim for next month would be this: I am going to try to march the spot for the duration of the adverts, which is about 5mins! After 3 months, I want go for a walk along the path to the bench for 5mins with my daughter on every other evening when she visits instead of sitting in the house. She will be very proud of me if I can do this and I will be proud of myself too. I might be able to get out a bit more? I find ironing quite tiring, I am going to do that in 3 or 4 5min chunks of time and have a seat for 10 min between, hopefully I won t feel so tired then and need to sit less overall, will give it a go! Short Term Goal 1 week 1 minute stand at adverts 2 weeks 2 minutes march at adverts 4 weeks Marching for 5 minutes at each advert break 1 week split ironing into 5 min minute bouts with 10min rests between. Long Term Goal Go for a 5 min walk with daughter daughter when she visits every 2 nd day. 16

Would you like to make any goals just now? Today, I would like to make the following goals: Goal Short Term Goal: How important is it that you meet this goal? Please circle your response How confident are you that you will meet this goal? Notes: Please circle your response When would you like to have achieved this? How are you going to actually do it? 17

Goal Short Term Goal: How important is it that you meet this goal? Please circle your response How confident are you that you will meet this goal? Please circle your response Notes: When would you like to have achieved this? How are you going to actually do it? 18

Goal Long Term Goal: How important is it that you meet this goal? Please circle your response How confident are you that you will meet this goal? Please circle your response Notes: When would you like to have achieved this? How are you going to actually do it? 19

You might find it useful to put your plan into a diary. Take time to do this once today session is over. If each day follows the same pattern you only need complete one day. You can also use the diary to review your plan Monday AM PM EVENING 20

Tuesday AM PM EVENING 21

Wednesday AM PM EVENING 22

Thursday AM PM EVENING 23

Friday AM PM EVENING 24

Saturday AM PM EVENING 25

Sunday AM PM EVENING 26

After today s session, please take time to review this pack and all the information relation you. Think about what you would like to do, add goal(s) below as you need to. You may also use these pages if you decide to change your goals between sessions. Additional Goals How important is it that you meet this goal? Please circle your response How confident are you that you will meet this goal? Please circle your response Notes: When would you like to have achieved this? How are you going to actually do it? Don t worry if you don t think of anymore goals. Don t have too many goals either. 27

Additional Goals How important is it that you meet this goal? Please circle your response How confident are you that you will meet this goal? Please circle your response Notes: When would you like to have achieved this? How are you going to actually do it? Don t worry if you don t think of anymore goals. Don t have too many goals either. 28

End of Session - Well Done! Your ve made it! Thanks for all the effort you have put in today. Well done for setting the goals that you have. If you need a bit more time to plan what you are doing that s fine, but as soon as you can, get started on making the transition into sitting less. Please work really hard at it and we will review how you are getting on in one months time. Checklist for next month: Take time to review the pack Really think about how you can realistically make these important changes Use the diary to chart your plans Complete goals list, if you have not already done this Tell people what you are doing Make a list of useful ideas that might help others on the next page. Stomp Out (prolonged) Sitting! Use what you have, Start where you are, Do what you can. I will be back next week, briefly to change your activity monitor on your leg. If you have any questions you can call me at the office (0141 273 1663) or on my mobile (07598 163 235) 29

Your Own Ideas: What do think of the name on the pack Stomp Out Sitting? Any suggestions for a better name? 30

Session 2 31

Review of Goal (Short Term Goal) Review ideas page on page Have you achieved your target? If not, why do you think this is? If you have met your goal, what is the next step? Let s review the importance of this goal. Please circle your response Let s review your confidence around meeting this goal? How confident are you that you will meet this goal? Please circle PLAN: 32

Review of Goal (Short Term Goal) Have you achieved your target? If not, why do you think this is? If you have met your goal, what is the next step? Let s review the importance of this goal. Please circle your response Let s review your confidence around meeting this goal? PLAN: How confident are you that you will meet this goal? Please circle 33

Review of Goal (Long Term Goal) Are you on track to achieving your target? If not, why do you think this is? If you are, how are you going to ensure you keep going? Let s review the importance of this goal. Please circle your response Let s review your confidence around meeting this goal? How confident are you that you will meet this goal? Please circle PLAN: 34

Goal (if applicable) Are you on track to achieving your target? If not, why do you think this is? If you are, how are you going to ensure you keep going? Let s review the importance of this goal. Please circle your response Let s review your confidence around meeting this goal? How confident are you that you will meet this goal? Please circle PLAN: 35

Review of Your Sitting Time Using Activity Monitors Let s discuss you sitting time in relation to the discussion on the goals that we have just had. Sitting/Lying Week 1 After Stomp Out Sitting Day Mon Tues Wed Thur Fri Sat Sun Sitting or Lying % % % % % % % Sitting/Lying Week 2 After Stomp Out Sitting Day Mon Tues Wed Thur Fri Sat Sun Sitting or Lying % % % % % % % Sitting/Lying Week 3 After Stomp Out Sitting Day Mon Tues Wed Thur Fri Sat Sun Sitting or Lying % % % % % % % Over an average day you sit for made up of bouts of sitting, with an average sitting time of. NOTES: 37

Rounding Up Thanks for all the effort you have put in over the last month. You may realize by now that making a lifestyle change is not easy. Well done with everything you have achieved so far, keep going, at changing your daily habits for the better. Please keep up the hard work really hard at it and we will review how you are getting on in one months time. Checklist for next month: Take time to review what we have discussed today. Really think about how you can realistically make these important changes to your life (not just for the period of the study!) Are you getting towards that long term goal? Keep going! Stomp Out (prolonged) Sitting! Use what you have, Start where you are, Do what you can. As usual, I will be back next week, briefly to change your activity monitor on your leg. If you have any questions you can call me at the office (0141 273 1663) or on my mobile (07598 163 235) 38

Session 3 39

Review of Goal (Short Term Goal) Have you achieved your target? If not, why do you think this is? If you have met your goal, what is the next step? Let s review the importance of this goal. Please circle your response Let s review your confidence around meeting this goal? How confident are you that you will meet this goal? Please circle PLAN: 40

Review of Goal (Long Term Goal) Have you achieved your target? If not, why do you think this is? If you are, how are you going to ensure you keep going? Let s review the importance of this goal. Please circle your response Let s review your confidence around meeting this goal? How confident are you that you will meet this goal? Please circle PLAN: 42

Final Session Time flies when you are having fun!! We have reached our final session. I really hope that you now have all the tools that you need to maintain what you have achieved and continue to make positive changes to your sitting time. Please keep up the hard work! As usual, I will be back next week, briefly to change your activity monitor on your leg. If you have any questions you can call me at the office (0141 273 1663) or on my mobile (07598 163 235). In 1 months time we will repeat the measurement that we did on week 1. Stomp Out (prolonged) Sitting! Use what you have, Start where you are, Do what you can. Thank you so much for the time and effort you have put in to this study, I really appreciate it. The information you have given is invaluable. Julie 46

Juliet Harvey, GCU: 0141 273 1663 / 07598 163 235 Stomp Out Sitting (2013) 47