StandUPTV: Reducing Sedentary Screen Time in Adults
Condition: Sedentary Behavior; Screen Time; Physical Activity; Sleep
Study type: Interventional

Summary: 
      The goal of this study is to develop an optimized intervention for reducing leisure sedentary
      screen time (SST) in middle-aged adults with overweight or obesity. Investigators will use
      the multiphase optimization (MOST) framework to conduct a highly efficient full-factorial
      experimental study to simultaneously test the main effects for each of three intervention
      components (LOCKOUT, TEXT, EARN) and their interactions (e.g., TEXT+EARN; LOCKOUT+EARN+TEXT)
      over 16 weeks.
    

Detailed description: 
      Primary Aim: To identify which component(s) from three components under consideration for
      inclusion in StandUPTV reduce SST by >60 min per day per day at 16 weeks. The three
      components tested will be: (a) LOCKOUT (no vs. yes); (b) TEXT (no vs. yes); and (c) EARN (no
      vs. yes). The investigators will use a highly efficient experimental strategy to detect
      effects of individual components as well as all two- and three-way interactions.

      The secondary aim of this study is to examine how reductions in SST displace time into other
      active behaviors, i.e., light-intensity physical activity (LPA), moderate-to vigorous
      physical activity (MVPA) and activity type (e.g., housework, walking, exercise behaviors).
      The investigators will use both device-based (activPAL3c) and self-report (ACT24) measures to
      understand whether SST displacement can increase active behaviors, particularly MVPA.
    

Intervention name(s): Device-based feedback, self-monitoring, and education: CORE; Sedentary Screen Time lockout: LOCKOUT; Context-based prompts: TEXT; Earn sedentary screen time through moderate-vigorous physical activity: EARN
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): Participants will receive a "core" intervention which will include a basic version of the StandUPTV app on an android tablet and a Fitbit to use throughout the 16-week intervention.t. SST feedback will be provided within the smartphone application. Self-monitoring will provide passive and objective feedback regarding SST behaviors. StandUPTV will also contain basic education including information on the risks of SST and tips for reducing SST. As part of this education, all participants will be provided a behavioral target of reducing their SST by 50% from their baseline. This target will be customized for the participant within StandUPTV based on a baseline week of observation.; Sedentary Screen Time lockout: LOCKOUT Sedentary Screen Time lockout: LOCKOUT The investigators will enforce a 50% per week reduction in SST, based upon a baseline week of observation. If SST reaches the prescribed threshold, the investigators will use the limits feature to restrict screen time through the end of the week (Monday-Sunday); at which point, 50% baseline allotment will be reinstated for an additional week. Participants will be prompted to plan for their screen time and provided modest allowances for exceeding their screen time in a given week.; The TEXT component uses app-based prompts (i.e., prompts generated through StandUPTV, not text message based) that will provide simple adaptive content. Content of the prompts will be educational (i.e., based on risks of sedentary screen time) and motivational (i.e., advice to reduce sedentary screen time).; Earn sedentary screen time through moderate-vigorous physical activity: EARN Participants assigned to the EARN component will earn SST by engaging in a >5 min continuous bout of exercise (as defined by Fitbit minutes >4 metabolic equivalents). They will earn SST on a 3:1 ratio up until they reach their baseline level of MVPA (5 mins of exercise earns 15 mins of SST). They will receive behavioral strategies to reduce screen time within the app (e.g., self-efficacy, barriers, exercising safely) and a planning tool for scheduling MVPA.
Allocation: Randomized
Intervention model: Factorial Assignment
Intervention model description: Investigators will use the multiphase optimization (MOST) framework to conduct a highly efficient full-factorial experimental study to simultaneously test the main effects for each of three intervention components (LOCKOUT, TEXT, EARN) and their interactions (e.g., TEXT+EARN; LOCKOUT+EARN+TEXT) over 16 weeks.
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Multiphase optimization strategy; Mobile health