# Sitting Interruption and Whole-body Cardiovascular Health: Linking Physiological Responses to Risk Behaviors

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2022 · $678,720

## Abstract

ABSTRACT
Sedentary behaviors (SB) are biologically distinct but understudied cardiovascular disease (CVD) risk factors.
National and international agencies have surmised that the level of evidence for an overall and dose-response
association between SB and CVD mortality is moderate-strong. These agencies do not provide specific
recommendations for breaking-up SB, though do call on the research community to facilitate policy
development by establishing biological plausibility, identifying the optimal dose for SB substitution strategies,
and conducting randomized clinical trials to test the efficacy of these strategies. Our goal is to identify
mechanism-informed, socioecological-based SB substitution recommendations to mitigate CVD risk.
Aim 1A will identify a feasible SB substitution strategy to prevent the adverse cardiovascular responses to
prolonged SB. Adverse cardiovascular responses will be measured using aortic arterial stiffness (AS), a
noninvasive test that predicts future CVD. To accomplish this aim, in 56 middle-aged (36-55 years)
participants, we will measure aortic AS and associated mechanistic responses to the following over 4 hours: (i)
SB with once/hour 5 min walk break; (ii) SB with once/hour 15 min stand break; (iii) SB with twice/hour breaks
(alternating 5 min walk and 15 min stand); and (iv) SB with no breaks (control). These strategies were selected
based on extensive prior work by our group, and because they are feasible, which is a key component of this
proposal. SB reduction strategies will only decrease CVD risk if people are willing to adhere to future SB
substitution recommendations. To increase the likelihood of feasibility and long-term adherence, Aim 1B will
evaluate the determinants of SB using a socioecological model. This recognizes that behavior change is likely
to be limited if the physical and sociocultural environments do not support the behavior change. To accomplish
Aim 1B, a combined inductive-deductive qualitative approach will be used. Participants who complete Aim 1A
will be participate in one of 6 focus groups (6-8 participants/group). Aim 2A will then test the feasibility of
implementing the strategy in the real-world via an individualized single-arm 12-week intervention (n=40, 36-64
years). The mechanistic (Aim 1A) and qualitative (Aim 1B) data from Aim 1 will guide the intervention design.
We will test the following feasibility domains: demand, acceptability, implementation, practicality, integration,
and limited-efficacy. Lastly, Aim 2B will investigate which components of the intervention worked and which
components did not work. All participants who complete Aim 2A will be asked to complete questionnaires
pertaining to our behavioral model as well as participate in a focus group. The focus groups will be used to add
context to the quantitative feasibility data. Specifically, we will address acceptability, adoption, appropriateness,
sustainability, and the perceived socioecological determinants. Cru...

## Key facts

- **NIH application ID:** 10362147
- **Project number:** 1R01HL157187-01A1
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Lee Stoner
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $678,720
- **Award type:** 1
- **Project period:** 2022-03-03 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10362147

## Citation

> US National Institutes of Health, RePORTER application 10362147, Sitting Interruption and Whole-body Cardiovascular Health: Linking Physiological Responses to Risk Behaviors (1R01HL157187-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10362147. Licensed CC0.

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