Which population groups are most unaware of CVD risks associated with sitting time?☆
Introduction
Sitting is a key component of sedentary behaviour which is defined as any activity that has a metabolic cost less than 1.5 METS (Pate et al., 2008). Accumulating evidence indicates that prolonged sitting time may be associated with several poor health outcomes including cardiovascular disease (CVD) mortality (George et al., 2013, Patel et al., 2010, Pavey et al., 2012, Thorp et al., 2010, van der Ploeg et al., 2012). These associations remain evident following adjustment for a number of socio-demographic factors and health behaviours including physical activity (George et al., 2013, Patel et al., 2010, Pavey et al., 2012, Thorp et al., 2010, van der Ploeg et al., 2012).
While sitting is required to perform some daily tasks and for rest, the adverse health consequences of sitting are driven by the prolonged and uninterrupted nature of sitting performed by many individuals. Sitting is a ubiquitous aspect of modern lifestyle, with many adults spending between 7 and 9 h of their waking day sitting in work, travel or leisure contexts (Thorp et al., 2010, van der Ploeg et al., 2012). In light of this evidence, reducing the amount of prolonged sitting and increasing the amount of movement time are recommended to improve health outcomes (Owen et al., 2008).
One factor influencing an individual's decision to engage with an intervention or change behaviour is to acknowledge that they are at risk or participating in a risky behaviour (Schwarzer, 2008). The association between risk recognition and behaviour change has been documented in relation to numerous health behaviours (Brewer et al., 2007, Carpenter, 2010). Whilst knowledge and awareness of health risks associated with a behaviour are not sufficient to change behaviour alone, they are an important perquisite needed for change (Schwarzer, 2008). Given the evidence of health risks associated with long periods of sitting and its endemic occurrence in everyday activities it is important to identify those population groups who are most unaware of its health risks (Owen et al., 2008, Patel et al., 2010, Pavey et al., 2012, Thorp et al., 2010, van der Ploeg et al., 2012). This is highlighted by qualitative research in office workers that identified that increasing awareness of the health risks associated with sitting may be an important driver for changing sitting behaviours (Gilson et al., 2011).
There is limited evidence of risk awareness related to sitting in the general population and these data are needed to inform future population level interventions directed at reducing sitting. Consequently this study aims to identify population subgroups that have the highest levels of unawareness regarding the potential for increased health risk associated with prolonged and uninterrupted sitting.
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Design
Data were obtained from a cross-sectional omnibus telephone survey, the Queensland Social Survey, conducted in July–August 2011 by the Population Research Laboratory of CQUniversity. Participants were adults aged 18 and over residing in the state of Queensland, Australia who were able to be contacted by direct dialled landline telephone. Participants were randomly selected from the electronic white pages (Scott and Happell, 2012). A minimum of five call-back attempts were made to a household if
Results
A total of 4009 people were invited to take part in the survey and a total of 1265 completed the survey; the response rate was 32%. The two most common reasons for not completing the survey were refusal to take part (n = 2309) and unable to be contacted (n = 276). Table 1 provides an overview of participant characteristics in the total sample and characteristics of those who were aware and unaware for each outcome variable. The proportion of the sample who were unaware of the risks associated with
Discussion
This study examined the prevalence of being unaware of the CVD risks associated with sitting behaviour and used socio-demographic and behavioural variables to identify the population sub-groups who had the lowest and highest prevalence of unawareness. The current findings demonstrate that over two thirds of the adult population is unaware of the risks associated with at least one of the sitting behaviours examined. Study outcomes also provide insight on the particular sub-groups who had the
Conflict of interest statement
The authors declare that there are no conflicts of interests.
Acknowledgments
The authors would like to thank the Population Research Laboratory (PRL) for the data collection and Ms Christine Hanley manager of the PRL for her supervision of the data collection process and assistance in formulating the questions.
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