By Laura Mcgowan
The World We Sit In
Do you spend hours every day sitting at a computer at work? Does your daily commute involve sitting in a car, or on a train or bus? Do you sit and watch TV or a film to wind down on an evening (Netflix and Chill, anyone?) or have your fingers constantly glued to a tablet/smartphone? Likelihood is many of you will answer yes to most of these questions, and you are not alone: technology has revolutionised contemporary lifestyles and makes the ‘slothogenic’ society of today a far cry from our hunter-gatherer ancestors.
The magnitude of the dangers of prolonged sitting for public health have recently been compared to that of smoking – you may have heard the phrase ‘sitting is the new smoking’ circulating within the media. Prolonged sitting, or ‘sedentary behaviour’, is now believed to increase our risk of heart disease, diabetes, obesity, and even premature death.
My PhD addresses the issue of sedentary behaviour in older adults. Statistics show that older adults are the most sedentary age group but also the age group where even the smallest of changes can have the biggest impact.
I am now into my second year of my research, and much of this time has been spent in my office. My modest PhD budget doesn’t quite cover the cost of a sit-stand desk, so over the past year I’ve only been filling my water bottle half-full, meaning that in order to drink a desired amount of water I have to get up twice as frequently and walk down the corridor to the water dispenser. It’s not exactly racking up the miles, but it gets my bum off my desk-chair and lets my feet know they’re still needed. Well, it did for a while: I’m now chronically dehydrated and working on my next strategy (possibly a ‘bring your dog to work’ scheme – though not sure I can make this fly with the porters). But I thought I should at least attempt to practice what I preach.
The fact that a relatively young/relatively fit adult such as myself can find something which in essence sounds so simple so difficult, really puts in perspective to me just what my PhD is about. Older adults have far more challenges to moving around than I do – frailty, chronic illness, and fatigue to mention but a few. So it’s really important to find ways to reduce sedentary behaviour in older adults that are as acceptable to them as possible.
“There was only one catch and that was Catch 22”: Recruitment
In my quest to secure funding for this project I had three interviews, and in each one the question always came up: what do you think the toughest part of your PhD will be? And I always offered the same answer. Recruitment. In truth though, I hadn’t really understood just how much of a slog this would be.
My first study of the project was an interview study with older adults. As I spent day after day, week after week, hanging out at community centresand craft groups, libraries and luncheon clubs, desperately on the hunt to find the older people of Manchester, the title of one of my favourite novels loomed in my mind: Catch 22. It occurred to me that the people who need help don’t want help, and the ones willing to help don’t need help. What’s more, by targeting social/community groups for recruitment, I was only reaching older adults who were typically more actively connected to their communitie
s, and not the ones sitting at home for the majority of the day. How do you reach people who aren’t visible in the community? And so many of my early interviews involved people telling me how active they are, how they can hike Scafell Pike in 8.4 minutes (give or take), and how they couldn’t fathom being like ‘Betty’ or ‘Bob’ who just sat on
the couch all day ‘wasting away’. They were healthy and they were happy; they were active and proud. I was inspired by their stories, and their reflections on what keeps them from living sedentary lives were clearly valuable to my research. But my problem was this: if I can’t recruit sedentary older adults now, what’s the point in then designing an intervention specifically for these people?
Luckily, I managed to find a contact who seemed to have the solution to my recruitment puzzle. Tony (as I’ll refer to him) was involved with a small non-for-profit group in a notoriously rough area of Manchester, where he’d been born and raised. He seemed to have a special affinity with the community, and through his projects in the neighbourhood he had gained the respect and trust of many of the elderly community members.
My interactions with Tony were unlike any I’ve experienced in my short academic career so far. There were no airs and graces. He swore a lot and used colloquialisms I’d never heard, even though I’ve lived in the city for almost 7 years now. In our initial meeting, I quickly realised that any reference to academia wasn’t going to impress – all he cared about was that I was passionate about my research and the people I was trying to reach. I think I convinced him. His support was crucial in recruiting older members of this community. When he spoke to people on my behalf he used the terms ‘we’, ‘us’ and ‘our’ and the trust people had in him seemed to transfer to me. It struck me that the community spirit in this area was stronger than other, less deprived areas I’d recruited from, yet there was less funding and less opportunities for community activities. So the people I interviewed from this area tended to be more socially isolated and more sedentary, and their views have undoubtedly added richness to my data.
So, what do older adults think?
Having recently finished data collection, I thought I’d share a few early insights from my interviews. A lot of older people felt that if they sat down for too long then their body would cease up and they eventually wouldn’t be able to get up again, which motivated them to stand. As you’d expect, a common reason older people sat for long periods of the day was bodily aches and pains, though interestingly a few realised that sitting was only making these worse, but felt they needed more help to get up and about more often.
I also had an elderly lady attribute being physically active at 65 to her experience of the culture of recreational drugs and casual sex in the 60’s – not sure it’s wise to build a health campaign around that notion, but point is I heard a lot of interesting ideas through speaking to older people, which I would never have considered otherwise. To me, this highlights the value of qualitative work and end-user involvement in behaviour change research projects.
The next stages of my PhD involve intervention development and refinement based on participant feedback (more recruitment!). I’m sure it won’t all be plain sailing, but I’m strangely looking forward to all the bumps along the road.
A Final Thought
Reducing sedentary behaviour in older adults is an important goal for public health interventions, and I’m excited about the new avenues my research might lead to. But remember, the consequences of being sedentary do not discriminate based on age, so no matter how old or young you are, if you’ve been sitting whilst reading this, now is a great time to get up and stick the kettle on, lunge, cartwheel, play with the cat… Whatever it is, just get on your feet!
And if you need a little more convincing, check out this short video!
If you want to read more of Laura’s research, follow this link to her recently published paper on ‘how acceptable older adults find the concept of being physically active, a systematic review and meta-synthesis’.