The behavioural epidemiology of sedentary behaviour in inflammatory arthritis: where are we, and where do we need to go?

Abstract In the last decade, studies into sedentary behaviour in inflammatory arthritis have raised important questions regarding its role in this condition. Specifically, evidence is needed on whether sedentary behaviour might exacerbate adverse inflammatory arthritis outcomes, and whether reducing sedentary behaviour might offer an effective avenue for self-management in this population. Research exploring these important research questions is still very much in its infancy and lacks the direction and scientific rigour required to inform effective intervention design, delivery and evaluation. Behavioural epidemiology refers to research that aims explicitly to understand and influence health behaviour patterns to prevent disease and improve health. To this end, the Behavioural Epidemiology Framework specifies a focused approach to health behaviour research, which leads to the development of evidence-based interventions directed at specific populations. In this review, we introduce the Behavioural Epidemiology Framework in the context of research into sedentary behaviour in inflammatory arthritis and ask: where are we, and where do we need to go? Lay Summary What does this mean for patients? In the last few years, an increasing amount of research has started to investigate the links between sedentary behaviour, or sitting time, and health among people living with inflammatory arthritis. Overall, this research provides an initial indication that people living with inflammatory arthritis who spend more time sitting (and expending little energy) might experience worse outcomes, such as increased pain, fatigue and poorer physical function. However, there is still very little research being carried out in this area, and the research that has been done to date is very varied with regard to the scientific approach taken and the outcomes that have been studied. A more focused and systematic approach to research in this area is needed, so that researchers approach questions regarding the role of sitting time in inflammatory arthritis in the same way. In this way, we can generate a larger body of scientific evidence that can be used to design new ways, or interventions, that are more likely to help people living with inflammatory arthritis to reduce their sitting time and improve their health. In this article, we introduce a systematic approach to research that can be applied to understand how sitting time might be related to inflammatory arthritis-specific outcomes