Population health measurement of social norms for sedentary behaviour: A systematic review

Abstract Background Adults spend the majority of their waking hours sedentary. Sedentary behaviour (SB) includes any waking behaviour with low energy expenditure while sitting, lying or reclining (e.g., watching TV, sitting at a desk) and is associated with several chronic diseases and mortality. Social influence, namely SB norms may be a modifiable factor through which we can target and reduce SB. The objectives of this review were: 1) to create an inventory of measures assessing SB norms within the peer-reviewed literature and population-based health surveys; and 2) identify measures of SB norms that are both reliable and valid in relation to SB for use in population-based health surveys. Methods Four bibliographic databases and grey literature were searched to identify all studies and population-based health surveys which included participants from high-income countries. Studies were required to report measures of SB norms (descriptive or injunctive) and assess criterion validity using measures of SB. Risk of bias within and across studies was assessed. Results were summarized using a narrative synthesis. Results This review identified 32 studies for review; no population-based health surveys with SB norm measures were identified. Of the studies, about half were conducted in children/youth (n = 17) where descriptive norms or a combination of both descriptive and injunctive norms were more frequently studied. In adult studies, injunctive norms were most frequently assessed. SBs were largely assessed via self-report, where the most common SB assessed was television viewing. Overall, the nature of the relationship between SB norms and SB was mixed; however, SB norms with friends as the referent group were more consistently associated with SB. No difference was observed in associations with SB between injunctive and descriptive norms. Conclusions Based on the results, we suggest examples of SB norm measures for future validation and use in population-based health surveys. Future studies are needed to assess the validity of the proposed SB norm measures. Systematic review registration PROSPERO #CRD42018106017.