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      An Intervention for Changing Sedentary Behavior Among African Americans With Multiple Sclerosis: Protocol


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          Sedentary behavior is a major concern among patients with multiple sclerosis (MS), as it may accelerate disease progression and exacerbate physical disability. This is especially concerning among African Americans, a segment of the MS population who present with greater neurological disability and higher odds of physical comorbidities than their Caucasian counterparts.


          To date, researchers have not proposed interventions that focus on changing sedentary behavior in African Americans with MS.


          This paper describes a pilot study that examines the feasibility and efficacy of using text messaging along with theory-driven newsletters and behavioral coaching for changing sedentary behavior in African Americans with MS. We herein present the methods, procedures, and outcomes for our ongoing study.


          Enrollment began in February 2018 and is expected to conclude in April 2019. Study results will be reported in the fall of 2019.


          After completion of this pilot intervention, we will summarize our study results in manuscripts for publication in peer-reviewed journals that will provide critical information on the feasibility and efficacy of our strategy. These results will inform future studies and, potentially, larger interventions for remotely reducing sedentary behavior in African Americans with MS.

          Trial Registration

          ClinicalTrials.gov NCT03671499; https://clinicaltrials.gov/ct2/show/NCT03671499 (Archived by WebCite at http://www.webcitation.org/77MZnxyNy)

          International Registered Report Identifier (IRRID)


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          Most cited references35

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          Design and analysis of pilot studies: recommendations for good practice.

          Pilot studies play an important role in health research, but they can be misused, mistreated and misrepresented. In this paper we focus on pilot studies that are used specifically to plan a randomized controlled trial (RCT). Citing examples from the literature, we provide a methodological framework in which to work, and discuss reasons why a pilot study might be undertaken. A well-conducted pilot study, giving a clear list of aims and objectives within a formal framework will encourage methodological rigour, ensure that the work is scientifically valid and publishable, and will lead to higher quality RCTs. It will also safeguard against pilot studies being conducted simply because of small numbers of available patients.
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            Sedentary Behavior and Health Outcomes: An Overview of Systematic Reviews

            Objective 1) To synthesize the current observational evidence for the association between sedentary behavior and health outcomes using information from systematic reviews. 2) To assess the methodological quality of the systematic reviews found. Methodology/Principal Findings Medline; Excerpta Medica (Embase); PsycINFO; and Web of Science were searched for reviews published up to September 2013. Additional publications were provided by Sedentary Behaviour Research Network members. The methodological quality of the systematic reviews was evaluated using recommended standard criteria from AMSTAR. For each review, improper use of causal language in the description of their main results/conclusion was evaluated. Altogether, 1,044 review titles were identified, 144 were read in their entirety, and 27 were included. Based on the systematic reviews with the best methodological quality, we found in children and adolescents, strong evidence of a relationship between time spent in sedentary behavior and obesity. Moreover, moderate evidence was observed for blood pressure and total cholesterol, self-esteem, social behavior problems, physical fitness and academic achievement. In adults, we found strong evidence of a relationship between sedentary behavior and all-cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes and metabolic syndrome. In addition, there is moderate evidence for incidence rates of ovarian, colon and endometrial cancers. Conclusions This overview based on the best available systematics reviews, shows that sedentary behavior may be an important determinant of health, independently of physical activity. However, the relationship is complex because it depends on the type of sedentary behavior and the age group studied. The relationship between sedentary behavior and many health outcomes remains uncertain; thus, further studies are warranted.
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              Point-of-choice prompts to reduce sitting time at work: a randomized trial.

              Prolonged sitting is prevalent in the workplace and is associated with adverse health markers. Investigate the effects of point-of-choice (PoC) prompting software, on the computer used at work (PC), to reduce long uninterrupted sedentary periods and total sedentary time at work. Assessor-blinded, parallel group, active-controlled randomized trial. A convenience sample of office workers from Glasgow, United Kingdom. Data were collected April to June 2010, and analyzed October 2010 to June 2011. The education group (n=14) received a brief education session on the importance of reducing long sitting periods at work. The PoC group (n=14) received the same education along with prompting software on their PC for 5 workdays, which reminded them to stand up every 30 minutes. Sitting time was measured objectively using the activPAL™ activity monitor for 5 workdays at baseline and 5 workdays during the intervention. The number and time spent sitting in events >30 minutes' duration were the main outcome measures. At baseline, participants spent 5.7±1.0 hours/day (76%±9%) of their time at work sitting. Of that time, 3.3±1.3 hours/day was spent sitting in 3.7±1.4 events >30 minutes. There was a significant difference between the groups in the change (intervention to baseline) of both the number (ANCOVA; -6.8%, p=0.014) and duration (-15.5%, p=0.007) of sitting events >30 minutes. During the intervention, compared with baseline, the PoC group reduced the number (paired t-test; -0.11 events/hour, p=0.045) and duration (-12.2%, p=0.035) of sitting events >30 minutes. However, there was no significant difference in total sitting time between groups (-4.4%, p=0.084). Point-of-choice prompting software on work computers recommending taking a break from sitting plus education is superior to education alone in reducing long uninterrupted sedentary periods at work. This trial was registered at ClinicalTrials.govNCT01628861. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

                Author and article information

                JMIR Res Protoc
                JMIR Res Protoc
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                May 2019
                01 May 2019
                : 8
                : 5
                : e12973
                [1 ] University of Alabama at Birmingham Birmingham, AL United States
                [2 ] Federal University of Triangulo Mineiro Uberaba Brazil
                Author notes
                Corresponding Author: Robert W Motl robmotl@ 123456uab.edu
                Author information
                ©Jessica F Baird, Jeffer Eidi Sasaki, Brian M Sandroff, Gary Cutter, Robert W Motl. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 01.05.2019.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org.as well as this copyright and license information must be included.

                : 28 November 2018
                : 28 February 2019
                : 13 March 2019
                : 24 March 2019

                african americans,multiple sclerosis,sedentary behavior,intervention


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