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851. Integrating sleep, sedentary behaviour, and physical activity research in the emerging field of time-use epidemiology: definitions, concepts, statistical methods, theoretical framework, and future directions

Research Article
Pedišic Ž, Dumuid D, Olds T
November 2017

Commentary: Associate Professor Scott Duncan, Auckland University of Technology, New Zealand

Traditionally, researchers have studied physical activity, sedentary behaviour, and sleep as independent risk factors for chronic disease; however, emerging work suggests these behaviours are intrinsically linked and interact to affect health. This has prompted a global paradigm shift where an integrated movement approach focusing on complete (24-hour) days is becoming a research priority—a movement called time-use epidemiology. We are now seeing the release of national public health guidelines (for example in Canada) that integrate physical activity, sedentary behaviour, and sleep within a hypothetical 24-hour period.  

In this paper, Dr Pedišic and his colleagues make a strong case for prioritising the prevention of unhealthy time-use patterns rather than individual behaviours. They state that this approach takes into account the inevitable substitution of one behaviour for another, leading to a more intuitive (and potentially more effective) health promotion message. To facilitate this prioritisation, the authors propose a theoretical model for future studies in this area –  the Framework for Viable Integrative Research in Time-Use Epidemiology (VIRTUE). Within the VIRTUE framework, five critical research areas are identified:

Methodological research in time-use epidemiology;

Outcomes of health-related time-use compositions;

Time-use composition: optimal balance, prevalence, and trends;

Determinants of optimal time use;

Time-use interventions.

While this framework provides useful direction for a rapidly evolving field, the viability of the latter four areas is heavily dependent on progression in the first. Accurate and objective measures able to capture, in detail, all three time-use components (physical activity, sedentary behavior, sleep) over multiple days are urgently required. The recent development of open source platforms for processing and analysing multi-site motion sensors appears very promising in this regard. 

It is apparent that physical activity and sleep experts will need to come together under the banner of time-use epidemiology in order to have the greatest impact on future health outcomes. In their paper, Dr Pedišic and his colleagues have created an invaluable road map for this to happen. I therefore believe it is an obligatory read for researchers and health promoters in this area.

Source: Kinesiology, 49(2), 1-18. Access to this article may depend on your Institutional rights: Access the full article here.