The aim of this study was to examine the sensitivity to change of measures of sedentary behavior derived from body worn sensors in different intervention designs. Results from two intervention studies: Stand up for Your Health (pre-post home-based study with older adults not in paid employment) and Stand Up Comcare (non-randomized controlled trial in the workplace) were analyzed to quantify sensitivity to change of measures of total and accumulation of sedentary time obtained from hip-worn Actigraph and thigh-worn activPAL monitors. Sensitivity to change varied with intervention design and population considered. The activPAL was generally more sensitive but not consistently for all measures and designs. Measures of sedentary time accumulation, in particular half-life bout duration (W 50% ), were consistently more sensitive than total sedentary time. Measurement devices used in intervention studies need to be appropriately selected to be sensitive to changes in the behavioral target. For sedentary behavior interventions, measures of accumulation should be considered as outcomes.

Objective: The increasing health care costs associated with an ageing population and chronic disease burden are largely attributable to modifiable lifestyle factors that are complex and vary between individuals and settings. Traditional approaches to promoting healthy lifestyles have so far had limited success. Recently, co-creating public health interventions with end-users has been advocated to provide more effective and sustainable solutions. The aim of this study was to document and evaluate the co-creation of a public health intervention to reduce sedentary behaviour in older adults. Design: Community-dwelling older adults ( N = 11, mean age = 74 years) and academic researchers attended 10 interactive co-creation workshops together. Setting: Workshops took place on university campus and the co-creators completed fieldwork tasks outside the workshops. Method: Workshops were informed by the Participatory and Appreciative Action and Reflection methodology. Data were collected using field notes, video recording and worksheet tasks. Analysis was conducted using a qualitative content analysis approach. Results: The co-creators developed a tailored intervention delivered through a mode congruent with older adults’ lives. Key elements of the intervention included (1) education on sedentary behaviour, (2) resources to interrupt sedentary behaviour, (3) self-monitoring, (4) action planning and (5) evaluating the benefits of interrupting sedentary behaviour. Conclusion: Co-creation is a feasible approach to develop public health interventions; however, it is limited by the lack of a systematic framework to guide the process. Future work should aim to develop principles and recommendations to ensure co-creation can be conducted in a more scientific and reproducible way. The effectiveness and scalability of the intervention should be assessed.

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