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Trial registered on ANZCTR
Registration number
ACTRN12624000371594
Ethics application status
Approved
Date submitted
10/03/2024
Date registered
28/03/2024
Date last updated
21/06/2024
Date data sharing statement initially provided
28/03/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Netflix and Move 2: Exploring the feasibility of breaking up sitting time in the evening with regular activity breaks
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Scientific title
Breaking up free living sedentary time in the evening with regular activity breaks in adults: A feasibility and pilot study
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Secondary ID [1]
310681
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Prolonged sitting
331592
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Postprandial glycemia
331593
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Poor sleep
331594
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Glycemic control
331595
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Condition category
Condition code
Diet and Nutrition
328326
328326
0
0
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Obesity
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Metabolic and Endocrine
328327
328327
0
0
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Other metabolic disorders
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Public Health
328328
328328
0
0
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Epidemiology
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Public Health
328329
328329
0
0
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Other public health
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will complete a 7 day baseline period followed by a two-week intervention period and two-week follow up period.
INTRODUCTORY SESSION
The introductory session will take place at the Department of Human Nutrition Mellor Laboratories (University of Otago, Dunedin. New Zealand), where the research assistant will:
1. Measure height, weight, and blood pressure (in triplicate 1 min apart; after 15-min seated rest) using standardised procedures. If blood pressure is greater than 140/90 mmHg and participants have not already obtained medical clearance, then they will be asked to contact their GP to gain clearance to participate in the study.
2. Discuss the participant’s typical evening to identify the period in which the participant is mostly sedentary (e.g., 1700 to 2100 hours), and the time the participant usually consumes their evening meal.
3. Fit participants with two activity monitors: an ActiGraph GT3+ accelerometer, which they will be asked to wear on their non-dominant wrist, and an ActivPal3 which is attached to the midpoint of the front of the right thigh with adhesive dressing. Participants will be instructed to wear both activity monitors continuously (24 hours a day) for a seven-day period to assess usual sleep and physical activity patterns.
4. Explain the wear time diary to the participant in which they will record times either accelerometer was removed (such as when showering or playing contact sport), time participating in physical activity (as some static activities such as cycling on a stationary bike are not captured accurately) and sleep information (time attempted sleep, time woke up).
5. Fit participants with a Freestyle Libre Pro iQ continuous glucose monitor (CGM) which will allow for a non-invasive measurement of glycaemic response every 15 minutes. In the wear time diary participants will also be asked to keep an estimated diet record of all food and drink consumed during the defined evening sedentary period, as well as a record of their large evening meal if it was outside of this time period.
INTERVENTION
After completing the seven-day baseline period participants will attend a second session at Mellor Laboratories to return the accelerometer and have the CGM removed. During this visit the research assistant will:
1. Instruct participants to complete the Pittsburgh Sleep Quality Index questionnaire to assess baseline self-perceived sleep quality.
2. Briefly discuss the evidence around prolonged sitting as a risk factor and the benefits associated with taking regular activity breaks.
3. Assist participants to download the Stretch Minder application (Better Primates Lab Limited, Hong Kong) on to their mobile device and guide the participant though the use of the application including showing links to the activity breaks exercise videos.
4. Program the application to provide alerts to complete activity breaks every 30 min during the specified evening sedentary period, for the next two-weeks (for example, if a participant identified 1700 to 2100 h as the period in which they habitually engage in sedentary time in the evening, this would be entered into the Stretch Minder Mobile application so that alerts would begin at 1700, and continue every 30-min until 2100 h, every night, for two-weeks). As this is a paid application, participants will be provided with an app store voucher to activate a one-month subscription, (participants will be guided to switch off the auto renewal to avoid further subscription fees).
5. Develop an individualised contingency plan which involves participants identifying potential barriers they may face when implementing the activity breaks and strategies to overcome these barriers.
6. Fit participants with new activity monitors (ActiGraph GT3+ and ActivPal3), and a new CGM to wear continuously over the 2-week intervention period. Wear time and information about food and beverage consumption will be monitored in the same manner as the baseline period.
7. Provide participants with a booklet which will include the contingency plan and space for participants to record 1) sleep/wake and wear time, 2) evening meal, beverage, and snack consumption and 3) what helped or hindered them to performing breaks each day.
During the personalised evening period participants will receive alerts on their mobile phone from the Stretch Minder application. Before beginning the activity break, participants will be able to select one, three-minute exercise video to complete (of light-moderate intensity). Available exercise videos built into the Stretch Minder app will be restricted to those that include simple body weight resistance exercises (e.g., squats, calf raises and lunges), therefore excluding static stretching or movements designed to be done while sitting at a desk such as neck rotations. The exercise videos depict the exercises participants should complete, so they can follow along. Additionally, the videos contain a timer and the ability to mute the instructions so that breaks could be completed without the audio instruction interrupting television viewing. This overcomes one of the reported barriers to performing the activity breaks reported from our previous work.
Participants will receive two follow up phone calls during the two-week intervention period (on day three and day seven). During these calls the research assistant will discuss how the participant is finding the intervention and to revisit any contingency plans, if needed. After the two-week period participants will attend a visit to Mellor Laboratories to return all equipment including the accelerometer, sleep, wear time and evening food diary and CGM and to complete the final Pittsburgh Sleep Quality and COM-B questionnaires.
FOLLOW UP PERIOD
At the end of the 2-week intervention period, participants will be reminded to use the StretchMinder mobile application over the next two weeks (weeks 3 and 4). Together with the research assistant, participants will revise their contingency plan to discuss the key factors that hindered them to perform the activity breaks during the 2-week active intervention period and encouraged to use strategies that they identified as helpful over the previous two weeks. Application engagement will be measured as the average number of time per week the application is opened and an activity breaks video is started. This information will be provided from the developers of the Mobile Application via a Data Sharing Agreement, and with consent from the participants
QUALITATIVE FEEDBACK
At the end of the follow up period participants will participate in a face-to-face semi-structured interview where they will be asked about their overall experience completing the activity breaks at home. Questions will explore participants’ experiences of the intervention, what helped and what hindered them to perform the intervention and what was missing from the intervention as it is currently designed. Questions will specifically ask what supported or hindered their ability to perform the breaks, explore the use of the mobile application during the intervention, and during the follow up period, as well as asking participants to reflect on potential positive and/or negative outcomes experienced from performing the activity breaks (Appendix I). Interviews will be recorded, and transcripts analyzed using inductive thematic analysis (Braun & Clarke, 2006). At the end of the interview participants will be provided with a $100 supermarket voucher in recognition of the actual or reasonable costs associated with participating in this study.
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Intervention code [1]
327087
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Lifestyle
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Intervention code [2]
327088
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Behaviour
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Comparator / control treatment
Participants will be their own control and the findings will be compared to the 7-day baseline period where no intervention is made to their habitual evening sitting time.
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Control group
Active
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Outcomes
Primary outcome [1]
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The change in the average daily number of activity breaks performed during the evening, between the 7-day baseline period and 2-week intervention period.
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Assessment method [1]
336180
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This will be assessed using self-reported activity breaks data and/or activity break data collected from the Accelerometers (Actigraph GT3+ and ActivPal3)
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Timepoint [1]
336180
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Baseline (7 days), end of 2-week intervention.
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Secondary outcome [1]
427221
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The consistency of the increase in the number of regular activity breaks performed, during the evening, across the two-week intervention period.
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Assessment method [1]
427221
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This will be assessed using self-reported activity breaks data and/or activity break data collected from the Accelerometers (Actigraph GT3+ and ActivPal3)
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Timepoint [1]
427221
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Baseline (7 days), end of 2-week intervention.
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Secondary outcome [2]
431210
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The change in sleep patterns between the baseline period (7-days) and 2-week intervention.
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Assessment method [2]
431210
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The change in sleep patterns (sleep period time, efficiency, wake after sleep onset and latency), will be measured by an ActiGraph accelerometer worn continuously on the non-dominant wrist first three days of the baseline period, the first three days and the final three days of the intervention period.
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Timepoint [2]
431210
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Baseline (first 3 days), beginning of intervention (first 3 days) and end of intervention (final 3 days).
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Secondary outcome [3]
431211
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The change in physical activity patterns between the baseline period (7-days) and 2-week intervention.
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Assessment method [3]
431211
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The change in physical activity patterns will be measured by two ActiGraph accelerometers (worn on the hip and non-dominant wrist) and one ActivPAL3 accelerometer (worn on the thigh) which will be worn for the first three days of the baseline period, the first three days and the final three days of the intervention period.
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Timepoint [3]
431211
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Baseline (first 3 days), beginning of intervention (first 3 days) and end of intervention (final 3 days).
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Secondary outcome [4]
431212
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The difference in glycemic control between the baseline period (7-days) and 2-week intervention.
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Assessment method [4]
431212
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The difference in glycemic control (as measured by average glucose concentration and incremental and total area under the curve) will be assessed by collecting interstitial glucose levels every 15 minutes via a continuous glucose monitor during baseline and the 2-week intervention period.
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Timepoint [4]
431212
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Baseline, end of 2-week intervention
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Secondary outcome [5]
431213
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The difference in glycemic variability between the baseline period (7-days) and 2-week intervention.
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Assessment method [5]
431213
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The difference in glycemic variability (as measured by standard deviation of glucose, time in range and continuous overall net glycemic action at 1 hour) will be assessed by collecting interstitial glucose levels every 15 minutes via a continuous glucose monitor during baseline and the 2-week intervention period.
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Timepoint [5]
431213
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Baseline, end of 2-week intervention
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Secondary outcome [6]
431214
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Validity of an activity breaks detection algorithm
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Assessment method [6]
431214
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To assess the validity of an activity breaks detection algorithm, the agreement, sensitivity, and specificity between self-reported activity breaks and the algorithm detected activity breaks (number of activity breaks) will be calculated. Self-reported activity breaks will be collected in the study-specific participant booklet/diary. Bland-Altman plots will also be used to assess agreement for duration of activity breaks.
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Timepoint [6]
431214
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Baseline, beginning of intervention (first 4 days) end of intervention (final 4 days)
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Secondary outcome [7]
431215
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Barriers to performing activity breaks in a free-living environment.
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Assessment method [7]
431215
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The barriers participants identify as hindering the performance of regular activity breaks at home, and participant reflections on the intervention (including what aspects weren’t useful and suggestions for improvements / changes), will be discussed through semi-structured interviews at the end of the 2-week follow up period (end of the study).
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Timepoint [7]
431215
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Completion of the study
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Secondary outcome [8]
432660
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The change in participants’ capability to perform activity breaks in the evening at home.
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Assessment method [8]
432660
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The change in participants’ capability to perform activity breaks in the evening at home will be assessed using an adapted COM-B questionnaire (Niven et al., 2021) at baseline and at the end of the 2-week intervention.
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Timepoint [8]
432660
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Baseline (7-days) and the 2-week intervention period.
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Secondary outcome [9]
432661
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The difference in engagement with the mobile application, between the 2-week intervention period and 2 week follow up.
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Assessment method [9]
432661
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The difference in engagement with the mobile application, between the 2-week intervention period and 2 week follow up will be measured as the average number of times per week participants a) open the app and b) start an activity breaks video. Information will be provided from the Strength Minder application developers.
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Timepoint [9]
432661
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2-week intervention period and 2-week follow up period.
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Secondary outcome [10]
433125
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The difference in daytime glycemic control between the baseline period (7-days) and 2-week intervention.
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Assessment method [10]
433125
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The difference in daytime glycemic control (as measured by average daytime glucose concentration and daytime incremental and total area under the curve) will be assessed by collecting interstitial glucose levels every 15 minutes via a continuous glucose monitor during baseline and the 2-week intervention period. The daytime will be defined by self reported participant sleep and was times in the study-specific participant booklet/diary.).
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Timepoint [10]
433125
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Baseline, end of 2-week intervention
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Secondary outcome [11]
433126
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The difference in evening glycemic control between the baseline period (7-days) and 2-week intervention.
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Assessment method [11]
433126
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The difference in glycemic evening control (as measured by average evening glucose concentration and evening incremental and total area under the curve) will be assessed by collecting interstitial glucose levels every 15 minutes via a continuous glucose monitor during baseline and the 2-week intervention period. The evening period will be defined by an individualised 4-hour period between 1700 h and participant bedtime (bedtime will be self reported in the study-specific participant booklet/diary).
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Timepoint [11]
433126
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Baseline, end of 2-week intervention
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Secondary outcome [12]
433127
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The difference in nocturnal glycemic control between the baseline period (7-days) and 2-week intervention.
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Assessment method [12]
433127
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The difference in nocturnal glycemic control (as measured by average nocturnal glucose concentration and nocturnal incremental and total area under the curve) will be assessed by collecting interstitial glucose levels every 15 minutes via a continuous glucose monitor during baseline and the 2-week intervention period. The nocturnal period will be defined by self-reported participant sleep and wake times in the study-specific participant booklet/diary.
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Timepoint [12]
433127
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Baseline, end of 2-week intervention
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Secondary outcome [13]
433128
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The difference in daytime glycemic variability between the baseline period (7-days) and 2-week intervention.
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Assessment method [13]
433128
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The difference in daytime glycemic variability (as measured by standard deviation of glucose, time in range and continuous overall net glycemic action at 1 hour) will be assessed by collecting interstitial glucose levels every 15 minutes via a continuous glucose monitor during baseline and the 2-week intervention period. The daytime will be defined by self reported participant sleep and was times in the study-specific participant booklet/diary.).
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Timepoint [13]
433128
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Baseline, end of 2-week intervention
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Secondary outcome [14]
433129
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The difference in evening glycemic variability between the baseline period (7-days) and 2-week intervention.
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Assessment method [14]
433129
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The difference in evening glycemic variability (as measured by standard deviation of glucose, time in range and continuous overall net glycemic action at 1 hour) will be assessed by collecting interstitial glucose levels every 15 minutes via a continuous glucose monitor during baseline and the 2-week intervention period. The evening period will be defined by an individualised 4-hour period between 1700 h and participant bedtime (bedtime will be self reported in the study-specific participant booklet/diary).
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Timepoint [14]
433129
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Baseline, end of 2-week intervention
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Secondary outcome [15]
433130
0
The difference in nocturnal glycemic variability between the baseline period (7-days) and 2-week intervention.
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Assessment method [15]
433130
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The difference in nocturnal glycemic variability (as measured by standard deviation of glucose, time in range and continuous overall net glycemic action at 1 hour) will be assessed by collecting interstitial glucose levels every 15 minutes via a continuous glucose monitor during baseline and the 2-week intervention period. The nocturnal period will be defined by self-reported participant sleep and wake times in the study-specific participant booklet/diary.
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Timepoint [15]
433130
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Baseline, end of 2-week intervention
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Secondary outcome [16]
433131
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Facilitators to performing activity breaks in a free-living environment.
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Assessment method [16]
433131
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The facilitators participants identify as helping the performance of regular activity breaks at home, and participant reflections on the intervention (including what aspects were useful and suggestions for improvements / changes), will be discussed through semi-structured interviews at the end of the 2-week follow up period (end of the study).
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Timepoint [16]
433131
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Completion of the study
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Secondary outcome [17]
433132
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The change in participants’ opportunity to perform activity breaks in the evening at home.
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Assessment method [17]
433132
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The change in participants’ opportunity to perform activity breaks in the evening at home will be assessed using an adapted COM-B questionnaire (Niven et al., 2021) at baseline and at the end of the 2-week intervention.
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Timepoint [17]
433132
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Completion of the study
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Secondary outcome [18]
433133
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The change in participants’ motivation to perform activity breaks in the evening at home.
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Assessment method [18]
433133
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The change in participants’ motivation to perform activity breaks in the evening at home will be assessed using an adapted COM-B questionnaire (Niven et al., 2021) at baseline and at the end of the 2-week intervention.
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Timepoint [18]
433133
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Completion of the study
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Secondary outcome [19]
433134
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The change in self-rated sleep quality and sleep disturbances.
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Assessment method [19]
433134
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The change in self-rated sleep quality and sleep disturbances over a 2-week time interval between the baseline period and 2-week intervention period will be assessed by the Pittsburgh Sleep Quality Index (adapted for a 2-week period).
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Timepoint [19]
433134
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Baseline period and end of 2-week intervention.
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Secondary outcome [20]
436616
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Change in blood pressure
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Assessment method [20]
436616
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The change in blood pressure will be measured using an automated sphygmomanometer, between baseline, the end of the two week intervention and four-week follow up period.
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Timepoint [20]
436616
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Secondary outcome [21]
436617
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Change in blood pressure
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Assessment method [21]
436617
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The change in blood pressure will be measured using an automated sphygmomanometer, between baseline, the end of the two week intervention and four-week follow up period.
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Timepoint [21]
436617
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Baseline period, end of 2-week intervention and end of 4-week follow up.
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Eligibility
Key inclusion criteria
Self report habitually accumulating more than 3 hours of sitting time in the evening.
Have a smart phone that is compatible with the Stretch Minder Application.
Must be able to ambulate unaided (i.e., not using a wheel chair, crutches or other assisted device)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Self report habitually accumulating less than 3 hours of sitting time in the evening.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
29/04/2024
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Actual
3/05/2024
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
1
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Final
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Recruitment outside Australia
Country [1]
25815
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New Zealand
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State/province [1]
25815
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Otago
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Funding & Sponsors
Funding source category [1]
314900
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Charities/Societies/Foundations
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Name [1]
314900
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Otago Medical Research Foundation
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Address [1]
314900
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P.O. Box 5726 Dunedin 9054 New Zealand
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Country [1]
314900
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Meredith Peddie
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Address
P.O. Box 5726 Dunedin 9054 New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
317149
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Individual
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Name [1]
317149
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Jennifer Gale
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Address [1]
317149
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Country [1]
317149
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
313894
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Univeristy of Otago Human Ethics Committee
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Ethics committee address [1]
313894
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University of Otago PO Box 56 Dunedin, 9018
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Ethics committee country [1]
313894
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New Zealand
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Date submitted for ethics approval [1]
313894
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11/09/2023
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Approval date [1]
313894
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01/10/2023
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Ethics approval number [1]
313894
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H23/105
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Summary
Brief summary
Greater time spent sitting and sleeping for less than 7 hours a night, are both associated with an increased risk of developing of a number of diseases, such as heart disease and type 2 diabetes. Our group was among the first to show that in a laboratory setting, interrupting sitting during the day improves uptake of sugar from the blood stream after a meal. More recently we have also been the first to show that interrupting sitting in the evening not only improves blood sugar uptake, but it can also improve sleep duration. This study will explore the feasibility of reducing sitting time, in the evening, with body weight resistance exercises in a real-life setting.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Meredith Peddie
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Address
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Department of Human Nutrition University of Otago PO Box 56 Dunedin 9018
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Country
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New Zealand
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Phone
129702
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+6434798358
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Fax
129702
0
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Email
129702
0
[email protected]
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Contact person for public queries
Name
129703
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Jennifer Gale
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Address
129703
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Department of Human Nutrition University of Otago PO Box 56 Dunedin 9018
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Country
129703
0
New Zealand
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Phone
129703
0
+643 479 7959
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Fax
129703
0
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Email
129703
0
[email protected]
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Contact person for scientific queries
Name
129704
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Meredith Peddie
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Address
129704
0
Department of Human Nutrition University of Otago PO Box 56 Dunedin 9018
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Country
129704
0
New Zealand
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Phone
129704
0
+64 34798358
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Fax
129704
0
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Email
129704
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
De-identified individual participant data underlying the published results.
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When will data be available (start and end dates)?
Will be available immediately following publication and will end five years following the publication.
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Available to whom?
Data will be available on a case by case basis at the discretion of the primary investigator.
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Available for what types of analyses?
IPD meta-analysis
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How or where can data be obtained?
Access will be subject to approval by the primary investigator. Contact via email:
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF