Reducing sedentary behavior and increasing physical activity among low active, underserved adults: A staircase approach

Authors: MAMA, SCHEREZADE - Md Anderson Cancer Center; SOLTERO, ERICA - Children'S Nutrition Research Center (CNRC); JOSEPH, RODNEY - Arizona State University

Submitted to: Journal of Physical Activity and Health
Publication Type: Other
Publication Acceptance Date: 4/18/2023
Publication Date: 6/6/2023
Citation: Mama, S.K., Soltero, E.G., Joseph, R.P. 2023. Reducing sedentary behavior and increasing physical activity among low active, underserved adults: A staircase approach. Journal of Physical Activity and Health. https://doi.org/10.1123/jpah.2023-0171.
DOI: https://doi.org/10.1123/jpah.2023-0171

Interpretive Summary:

Technical Abstract: Physical activity (PA) is a first line approach to disease prevention. According to the national recommendations, adults should engage in 150 minutes of moderate-intensity or 75 minutes of vigorous intensity to reduce their risk for disease. However, many high-risk, underserved adults including older, ethnic, and racial minorities, do not meet current recommendations. Furthermore, most evidence-based PA interventions have had limited success among high-risk, underserved subgroups, and even fewer have led to sustained levels of moderate or vigorous physical activity. Thus, the focus of this commentary is to recommend that physical activity researchers shift from an 'elevator' to a 'staircase' approach. An elevator approach attempts to quickly move participants from being inactive to meeting the national recommendations to improve their health. However, as this approach has been met with limited success, it is time to start considering the staircase approach, which attempts to move participants towards an active lifestyle, one step at a time. The staircase approach focuses first on reducing sitting time and prioritizes small increases in light physical activities such as doing household chores or leisurely walking. The 'sit less, move more' message found in the staircase approach is more readily receivable for participants because it puts forth behavioral benchmarks that are more achievable increasing the opportunities for successful behavior change. Lastly, it is believed that small movements can serve as gateway leading to longer periods of more and more vigorous activity over time, ultimately assisting participants in meeting national recommendations and achieving better health.