Increasing physical activity and reducing sedentary time in middle-aged males

Abstract

The health-related benefits of regular physical activity have been well-established, as have the risks associated with insufficient physical activity. Despite the benefits, an alarming proportion of Australians fail to participate in sufficient physical activity. Males form a particularly hard-to-reach population group for the promotion of healthy lifestyles, and physical activity interventions exclusively designed for and targeting males are sparse. The primary aim of this PhD research, with a focus on males, was to increase levels of physical activity and reduce sedentary time in middle-aged (35-64 years) males employed in a university setting (University of Western Sydney, UWS). The secondary aims of this PhD research were to determine whether physical activity and sitting time are associated with chronic disease, and to understand male perceptions of physical activity and sedentary time in a university-based setting. A series of three major studies were conducted to achieve these aims. Using baseline data from the longitudinal 45 and Up Study, Study 1 examined the association between chronic disease, leisure-time physical activity and sitting time in a sample of 63,048 males aged between 45 and 64 years. The 45 and Up Study is a large-scale cohort study providing much-needed data on a range of health conditions and underlying determinants of health. Baseline data on self-reported chronic disease (including heart disease, cancer, diabetes, high blood pressure, and combined chronic disease), sitting time, physical activity, and a range of covariates including age and BMI, were used for cross-sectional analyses. Crude, partially adjusted, and fully adjusted odds ratios, and 95% confidence intervals were calculated using binary logistic regression. Findings suggest that males who were more physically active were significantly less likely to report ever having diabetes. Higher volumes of sitting time were also significantly associated with diabetes and overall chronic disease, independent of leisure-time physical activity and other potentially confounding factors. Through focus group research, Study 2 explored males' individual perceptions of physical activity and sitting time, as well as perceived barriers and motivators that influence these behaviours. A series of five semi-structured focus groups were held across two campuses at UWS, with a total of 15 participants. Health and family were commonly reported motivators for physical activity, whereas time constraints and work commitments were major barriers to physical activity participation. Sedentary time was a perceived "by-product" of participants' university employment, as a substantial proportion of their days were spent sitting, primarily at a computer. Participants believed that physical activity should be recognised as a legitimate activity at work, embedded within the university culture and endorsed using a top-down approach. Findings from this research were used to inform the final design of the following study. The third and final study for this PhD was the ManUp UWS Study, a randomised controlled trial designed to increase physical activity and reduce sedentary time in middle-aged male university employees. A total of 56 male employees from UWS were recruited and randomised to either a 12-week internet-based physical activity program or a program where participants only received printed materials on physical activity, sedentary time, and health. At 24-week follow-up, there were no significant group-by-time effects observed for any of the primary or secondary outcomes, however, modest improvements in weight, BMI, and waist circumference were observed across time for both groups. Despite employing a large number of robust strategies to recruit participants, less than half of the required sample size was recruited. Attempts to recruit participants were exhaustive, although male employees were still reluctant to participate. The difficulty in recruiting middle-aged males for this study lends support to the notion that this is a hard-to-reach population group. Most participants, however, reported several positive aspects associated with their involvement in the Study, and many reported (in the process evaluation) that they felt they had increased their physical activity and reduced their sedentary time over the 12-week intervention period. Findings from this PhD research have addressed gaps in the literature by targeting a hard-to-reach and underrepresented population group for the promotion of healthy lifestyles. These findings have contributed to a growing body of evidence on the independent health risk of both physical activity and sedentary time. The insights into barriers and motivators related to physical activity and sedentary time generated through this research emphasised the importance of encouraging breaks in sedentary time and recognising physical activity as a legitimate health-promoting activity that is supported and encouraged by employers during working hours. Health promotion initiatives should focus not only on encouraging people to lead physically active lifestyles, but also to be aware of the association between sitting time and health outcomes.

Date of Award	2013
Original language	English