Healthy Aging Resources to Thrive (HART)

Randomized Trial to Reduce Sitting Time and Improve Cardiometabolic Health in Obese Older Adults

Healthy Aging Resources to Thrive (HART) uses a rigorous two-stage randomized control design, adapted and refined based on pilot studies, to test a novel intervention to reduce sitting time in older adults. Half the participants will be randomized to the intervention aimed at decreasing sitting time, and the other half will be randomized to a healthy living control that does not focus on reduced sitting time. After 6 months, the intervention group will be further randomized so that half continue with the intervention and the other half receive no further intervention. All participants will be followed for 12 months.

Healthy Aging Resources to Thrive (HART) is a two-stage randomized controlled trial (RCT) of adults over age 60 with obesity to determine the efficacy of a novel sitting-reduction intervention and its impact on cardiometabolic risk markers. Participants will be randomized to a 6-month sitting reduction intervention (termed I-STAND) or healthy-living attention control (Stage 1). All participants will be mailed a scale and a blood pressure monitor (to keep) which will be used during the phone-based measurement visits at Baseline, 3, 6 and 12 months. All participants will have phone-based Coaching sessions.

After 6 months, I-STAND participants will be re-randomized to receive either booster sessions or no further intervention (Stage 2). Attention control participants will receive no further intervention. All participants will be followed for 12 months total with phone-based assessments at baseline, 3, 6, and 12 months. Primary outcomes are reduction in sitting time at 6 months, objectively measured using the activPAL device, and blood pressure. The design will answer novel questions about the impact of sitting reduction on cardiometabolic risk markers as well as maintenance of sitting reduction.

UPDATE: As of 3/31/31, (final year 5) of the study, participants randomized to the i-STAND intervention will no longer be re-randomized at 6 months. We will no longer follow participants to the 12-month timepoint & will end all activities after 6-months.

Inclusion Criteria: • Self-reported sitting time of 6+ hours per day

• BMI ≥30 and <50 kg/m2
• men and women of all races and ethnicities from anywhere in the KPWA region (state-wide)
• We will oversample people of color statewide
• Able to walk one block
• Able to speak and read English,
• no self-reported vision limitations, sedentary time, use of an assistive device, able to stand.
• no cognitive impairment that is perceived by the study staff during phone screening
• Willingness to wear device (activPAL)
• Willingness to participate in study for a full year
• Continuously enrolled at KP for previous 12 months
• Not on the No Contact list
• Not previously enrolled in ISTAND or TABS
• Not currently enrolled in ACT, STOP-FALLS or SMARRT studies

Exclusion Criteria:

• unable to speak and read English (phone screen)
• unable to walk 1 block (with or without assistive devices) (phone screen)
• self-reported sitting time less than 6 hours per day (phone screen)
• diagnosis codes indicating hearing loss, dementia or serious mental illness (e.g., schizophrenia, bipolar disorder), or a terminal or serious illness (e.g., cancer) in the past 2 years (from the EMR)