***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Effective interventions to influence workplace sitting are needed , as office-based workers demonstrate high levels of continued sitting , and sitting too much is associated with adverse health effects . Therefore , we developed a theory-driven , Web-based , interactive , computer-tailored intervention aim ed at reducing and interrupting sitting at work . Objective The objective of our study was to investigate the effects of this intervention on objective ly measured sitting time , st and ing time , and breaks from sitting , as well as self-reported context -specific sitting among Flemish employees in a field-based approach . Methods Employees ( n=213 ) participated in a 3-group r and omized controlled trial that assessed outcomes at baseline , 1-month follow-up , and 3-month follow-up through self-reports . A sub sample ( n=122 ) were willing to wear an activity monitor ( activPAL ) from Monday to Friday . The tailored group received an automated Web-based , computer-tailored intervention including personalized feedback and tips on how to reduce or interrupt workplace sitting . The generic group received an automated Web-based generic advice with tips . The control group was a wait-list control condition , initially receiving no intervention . Intervention effects were tested with repeated- measures multivariate analysis of variance . Results The tailored intervention was successful in decreasing self-reported total workday sitting ( time × group : P<.001 ) , sitting at work ( time × group : P<.001 ) , and leisure time sitting ( time × group : P=.03 ) , and in increasing objective ly measured breaks at work ( time × group : P=.07 ) ; this was not the case in the other conditions . The changes in self-reported total nonworkday sitting , sitting during transport , television viewing , and personal computer use , objective ly measured total sitting time , and sitting and st and ing time at work did not differ between conditions . Conclusions Our results point out the significance of computer tailoring for sedentary behavior and its potential use in public health promotion , as the effects of the tailored condition were superior to the generic and control conditions . Trial Registration Clinical trials.gov NCT02672215 ; http:// clinical trials.gov/ct2/show/NCT02672215 ( Archived by WebCite at http://www.webcitation.org/6glPFBLWv BACKGROUND Epidemiological studies have shown television watching to be a risk factor for the development of obesity in children . The effect of reducing television watching and other sedentary behaviors as a component of a comprehensive obesity treatment program has not been thoroughly tested . OBJECTIVE To compare the influence of targeting decreases in sedentary behavior vs. increases in physical activity in the comprehensive treatment of obesity in 8- to 12-year-old children . DESIGN R and omized , controlled outcome study . SETTING Childhood obesity research clinic . DESIGN Ninety families with obese 8- to 12-year-old children were r and omly assigned to groups that were provided a comprehensive family-based behavioral weight control program that included dietary , and behavior change information but differed in whether sedentary or physically active behaviors were targeted and the degree of behavior change required . RESULTS Results during 2 years showed that targeting either decreased sedentary behaviors or increased physical activity was associated with significant decreases in percent overweight and body fat and improved aerobic fitness . Self-reported activity minutes increased and targeted sedentary time decreased during treatment . Children substituted nontargeted sedentary behaviors for some of their targeted sedentary behaviors . CONCLUSION These results support reducing sedentary behaviors as an adjunct in the treatment of pediatric obesity A Play Street is a street that is reserved for children ’s safe play for a specific period during school vacations . It was hypothesized that a Play Street near children ’s home can increase their moderate- to vigorous-intensity physical activity ( MVPA ) and decrease their sedentary time . Therefore , the aim of this study was to investigate the effect of Play Streets on children ’s MVPA and sedentary time .  A nonequivalent control group pretest-posttest design was used to determine the effects of Play Streets on children ’s MVPA and sedentary time . Data were collected in Ghent during July and August 2013 . The study sample consisted of 126 children ( 54 from Play streets , 72 from control streets ) . Children wore an accelerometer for 8 consecutive days and their parents fill out a question naire before and after the measurement period . During the intervention , streets were enclosed and reserved for children ’s play . Four-level ( neighborhood – household – child – time of measurement ( no intervention or during intervention ) ) linear regression models were conducted in MLwiN to determine intervention effects . Positive intervention effects were found for sedentary time ( β = -0.76 ± 0.39 ; χ2 = 3.9 ; p = 0.05 ) and MVPA ( β = 0.82 ± 0.43 ; χ2 = 3.6 ; p = 0.06 ) . Between 14h00 and 19h00 , MVPA from children living in Play Streets increased from 27 minutes during normal conditions to 36 minutes during the Play Street intervention , whereas control children ’s MVPA decreased from 27 to 24 minutes . Sedentary time from children living in the Play Street decreased from 146 minutes during normal conditions to 138 minutes during the Play Street intervention , whereas control children ’s sedentary time increased from 156 minutes to 165 minutes . The intervention effects on MVPA ( β = -0.62 ± 0.25 ; χ2 = 6.3 ; p = 0.01 ) and sedentary time ( β = 0.85 ± 0.0.33 ; χ2 = 6.6 ; p = 0.01 ) remained significant when the effects were investigated during the entire day , indicating that children did not compensate for their increased MVPA and decreased sedentary time , during the rest of the day . Creating a safe play space near urban children ’s home by the Play Street intervention is effective in increasing children ’s MVPA and decreasing their sedentary time Purpose Encouraging office workers to ‘ sit less and move more ’ encompasses two public health priorities . However , there is little evidence on the effectiveness of workplace interventions for reducing sitting , even less about the longer term effects of such interventions and still less on dual-focused interventions . This study assessed the short and mid-term impacts of a workplace web-based intervention ( Walk@WorkSpain , W@WS ; 2010 - 11 ) on self-reported sitting time , step counts and physical risk factors ( waist circumference , BMI , blood pressure ) for chronic disease . Methods Employees at six Spanish university campuses ( n=264 ; 42±10 years ; 171 female ) were r and omly assigned by worksite and campus to an Intervention ( used W@WS ; n=129 ; 87 female ) or a Comparison group ( maintained normal behavior ; n=135 ; 84 female ) . This phased , 19-week program aim ed to decrease occupational sitting time through increased incidental movement and short walks . A linear mixed model assessed changes in outcome measures between the baseline , ramping ( 8 weeks ) , maintenance ( 11 weeks ) and follow-up ( two months ) phases for Intervention versus Comparison groups . Results A significant 2 ( group ) × 2 ( program phases ) interaction was found for self-reported occupational sitting ( F[3]=7.97 , p=0.046 ) , daily step counts ( F[3]=15.68 , p=0.0013 ) and waist circumference ( F[3]=11.67 , p=0.0086 ) . The Intervention group decreased minutes of daily occupational sitting while also increasing step counts from baseline ( 446±126 ; 8,862±2,475 ) through ramping ( + 425±120 ; 9,345±2,435 ) , maintenance ( + 422±123 ; 9,638±3,131 ) and follow-up ( + 414±129 ; 9,786±3,205 ) . In the Comparison group , compared to baseline ( 404±106 ) , sitting time remained unchanged through ramping and maintenance , but decreased at follow-up ( -388±120 ) , while step counts diminished across all phases . The Intervention group significantly reduced waist circumference by 2.1cms from baseline to follow-up while the Comparison group reduced waist circumference by 1.3cms over the same period . Conclusions W@WS is a feasible and effective evidence -based intervention that can be successfully deployed with sedentary employees to elicit sustained changes on “ sitting less and moving more ” Background Excessive sitting time is a risk factor for cardiovascular disease mortality and morbidity independent of physical activity . This aim of this study was to evaluate the impact of a sit-st and workstation on sitting time , and vascular , metabolic and musculoskeletal outcomes in office workers , and to investigate workstation acceptability and feasibility . Methods A two-arm , parallel-group , individually r and omised controlled trial was conducted in one organisation . Participants were asymptomatic full-time office workers aged ≥18 years . Each participant in the intervention arm had a sit-st and workstation installed on their workplace desk for 8 weeks . Participants in the control arm received no intervention . The primary outcome was workplace sitting time , assessed at 0 , 4 and 8 weeks by an ecological momentary assessment diary . Secondary behavioural , cardiometabolic and musculoskeletal outcomes were assessed . Acceptability and feasibility were assessed via question naire and interview . ANCOVA and magnitude-based inferences examined intervention effects relative to controls at 4 and 8 weeks . Participants and research ers were not blind to group allocation . Results Forty-seven participants were r and omised ( intervention n = 26 ; control n = 21 ) . Relative to the control group at 8 weeks , the intervention group had a beneficial decrease in sitting time ( −80.2 min/8-h workday ( 95 % CI = −129.0 , −31.4 ) ; p = 0.002 ) , increase in st and ing time ( 72.9 min/8-h workday ( 21.2 , 124.6 ) ; p = 0.007 ) and decrease in total cholesterol ( −0.40 mmol/L ( −0.79 , −0.003 ) ; p = 0.049 ) . No harmful changes in musculoskeletal discomfort/pain were observed relative to controls , and beneficial changes in flow-mediated dilation and diastolic blood pressure were observed . Most participants self-reported that the workstation was easy to use and their work-related productivity did not decrease when using the device . Factors that negatively influenced workstation use were workstation design , the social environment , work tasks and habits . ConclusionS hort-term use of a feasible sit-st and workstation reduced daily sitting time and led to beneficial improvements in cardiometabolic risk parameters in asymptomatic office workers . These findings imply that if the observed use of the sit-st and workstations continued over a longer duration , sit-st and workstations may have important ramifications for the prevention and reduction of cardiometabolic risk in a large proportion of the working population .Trial registration Clinical Trials.gov NCT02496507 Background Patients with rheumatoid arthritis ( RA ) spend a high proportion of their waking time in sedentary behaviour ( SB ) and have an increased risk of cardiovascular disease . Reduction of SB and increase in light intensity physical activity has been suggested as a means of improvement of health in patients with mobility problems . Short-term intervention studies have demonstrated that SB can be reduced by behavioural interventions in sedentary population s. To evaluate descriptively the feasibility of recruitment , r and omisation , outcome assessment s , retention and the acceptability of an individually tailored , theory-based behavioural intervention targeting reduction in daily sitting time in patients with RA . Methods A r and omised , controlled trial with two parallel groups . RA patients > 18 years of age and Health Assessment Question naire ( HAQ ) score < 2.5 were consecutively invited and screened for daily leisure time sitting > 4 h. The 16-week intervention included 1 ) three individual motivational counselling sessions and 2 ) individual text message reminders aim ed at reducing daily sitting time . The control group was encouraged to maintain their usual lifestyles . Outcomes were assessed at baseline and after the 16 week intervention . Daily sitting time was measured using  an ActivPAL3TM activity monitor .  The study was not powered to show superiority ; rather the objective was to focus on acceptability among patients and clinical health professionals . Results In total , 107 patients were invited and screened before 20 met eligibility criteria and consented ; reasons for declining study participation were mostly flares , lack of time and co-morbidities . One patient from the control group dropped out before end of intervention ( due to a RA flare ) . Intervention participants completed all counselling sessions . All procedures regarding implementation of the trial protocol were feasible . The daily sitting time was reduced on average by 0.30 h in the intervention group unlike the control group that tended to increase it by 0.15 h after 16 weeks . Conclusions This study shows that an individually tailored behavioural intervention targeting reduction of SB was feasible and acceptable to patients with RA.Trial registration The Danish Data Protection Agency ( ref.nb . 711 - 1 - 08 - 20 March 2011 ) , the Ethics Committee of the Capital Region of Denmark ( ref.nb . H-2 - 2012 - 112- 17 October 2012 ) , clinical trials.gov ( NCT01969604 - October 17 2013 , retrospectively registered ) Aims Type 2 diabetes mellitus ( T2DM ) , a serious and prevalent chronic disease , is traditionally associated with older age . However , due 
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The assessment of complexity suggested that interventions may need to be suitably complex to address the challenges of a complex behaviour such as SB , but demonstrated that a higher complexity score is not necessarily associated with better outcomes in terms of sustained long-term changes .