Using time-use diaries to track changing behavior across successive stages of COVID-19 social restrictions.

How did people change their behavior over the different phases of the UK COVID-19 restrictions, and how did these changes affect their risk of being exposed to infection? Time-use diary surveys are unique in providing a complete chronicle of daily behavior: 24-h continuous records of the populations' activities, their social context, and their location. We present results from four such surveys, collected in real time from representative UK samples, both before and at three points over the course of the current pandemic. Comparing across the four waves, we find evidence of substantial changes in the UK population's behavior relating to activities, locations, and social context. We assign different levels of risk to combinations of activities, locations, and copresence to compare risk-related behavior across successive "lockdowns." We find evidence that during the second lockdown (November 2020), there was an increase in high-risk behaviors relative to the first (starting March 2020). This increase is shown to be associated with more paid work time in the workplace. At a time when capacity is still limited both in respect of immunization and track-trace technology, governments must continue to rely on changes in people's daily behaviors to contain the spread of COVID-19 and similar viruses. Time-use diary information of this type, collected in real time across the course of the COVID-19 pandemic, can provide policy makers with information to assess and quantify changes in daily behaviors and the impact they are likely to have on overall behavioral-associated risks.

Exploring daily time-use patterns: ATUS-X data extractor and online diary visualization tool.

Time-use data can often be perceived as inaccessible by non-specialists due to their unique format. This article introduces the ATUS-X diary visualization tool that aims to address the accessibility issue and expand the user base of time-use data by providing users with opportunity to quickly visualize their own subsamples of the American Time Use Survey Data Extractor (ATUS-X). Complementing the ATUS-X, the online tool provides an easy point-and-click interface, making data exploration readily accessible in a visual form. The tool can benefit a wider academic audience, policy-makers, non-academic researchers, and journalists by removing accessibility barriers to time use diaries.

A new perspective from time use research on the effects of social restrictions on COVID-19 behavioral infection risk.

We present findings from three waves of a population-representative, UK time-use diary survey conducted both pre- and in real time during full 'lockdown', and again following the easing of social restrictions. We used an innovative online diary instrument that has proved both reliable and quick-to-field. Combining diary information on activity, location, and co-presence to estimate infection risks associated with daily behavior, we show clear changes in risk-associated behavior between the pre, full-lockdown and post full-lockdown periods. We document a shift from more to less risky daily behavior patterns (combinations of activity/location/co-presence categories) between the pre-pandemic pattern and full lockdown in May/June 2020, followed by a reversion (although not a complete reversal) of those patterns in August 2020 following the end of the first lockdown. Because, in general, a populations' time use changes relatively slowly, the behavioral changes revealed may be interpreted as a consequence of the UK COVID-19 lockdown social restrictions and their subsequent relaxation.

Improving Stylised Working Time Estimates with Time Diary Data: A Multi Study Assessment for the UK.

Accurate working time estimates represent an important component of the statistical toolbox used for economics forecasting and policy-making. The relatively good availability of such estimates may sometimes induce researchers to take them for granted and see their reliability as largely unproblematic. There is however a growing body of evidence showing that measurement errors may affect their robustness and quality, especially as far as specific but policy relevant subgroups of the population such as part-time or atypical workers are concerned. Against this background, the goal of this paper is to investigate the reliability of paid weekly working-time measurement instruments commonly available in a key UK social survey, the Labour Force Survey. It focuses on the discrepancies between estimates obtained by self-assessed/aggregated instruments-also known as stylised-and those recorded using time diaries which have been found more truthful to the time spent working in ones paid job(s). It is also to explore ways to improve the reliability of stylised estimates in datasets for which no time diary instruments are available, contrasting those where 'usual' and 'actual' hours of work are recorded. It does so by creating calibration weights based on the Work Schedule recorded in the 2000 and 2015 UK Time Use Surveys and using them to up/down scale stylised estimates in the 2000 and 2015 UK Labour Force Survey using statistical matching. Such techniques could enable significant improvements of measurement errors in large scale social surveys at a minimal cost.

A validation study of the Eurostat harmonised European time use study (HETUS) diary using wearable technology.

BACKGROUND: The central aim was to examine the accuracy of the full range of daily activities recorded in self-report time-use diaries against data from two objective passive data collection devices (wearable camera and accelerometer) serving as criterion reference instruments. This enabled systematic checks and comparisons on the timing, sequence and duration of activities recorded from the three data sources. METHODS: Participants (n = 148) were asked to complete a single-day self-report paper time-use diary designed for use in the Harmonised European Time Use Study (HETUS), while simultaneously wearing a camera that continuously recorded images of their activities, and an accelerometer tracking physical movement. In a reconstruction interview shortly after the data collection period, participants viewed the camera images to help researchers interpret the image sequences. Of the initial 148 recruits (multi-seed snowball sample, 59% women, aged 18-91, 43% > 40) 131 returned usable diary and camera records (of whom 124 also provided a usable whole-day accelerometer record. We compare time allocation estimates from the diary and camera records, and also match the diary and camera records to the simultaneously recorded accelerometer vector magnitudes. RESULTS: The data were examined at three analytic levels: aggregate, individual diarist and timeslot. The most important finding is that the estimates of mean daily time devoted to 8 of the 10 main activities differ by < 10% in the camera and diary records. The single case of major divergence (eating) can be explained by a systematic difference between the procedures followed by the self-reporting diarist and the observer coding the camera records. There are more substantial differences at the respondent level, paired t-tests showing significant differences in time spent in the 4/10 categories. 45% of all variation in the accelerometer vector magnitudes in the timeslots is explained by camera and diary records. Detailed activity classifications perform much better than METs as predictors of actigraphy. CONCLUSIONS: The comparison of the diary with the camera and accelerometer records strongly supports using diary methodology for studying the full range of daily activity, particularly at aggregate levels. Accelerometer data could be combined with diary measures to improve estimation of METs equivalents for various types of active and sedentary behaviour.

Daily metabolic expenditures: estimates from US, UK and polish time-use data.

BACKGROUND: Behaviour has diverse economic, social and health consequences. Linking time spent in different daily activities to energy expenditure (EE) is one way of investigating the health and physiological consequences of behaviour and identifying targets to improve population health and well-being. METHODS: We estimated behaviour-related EE for respondents to time use surveys (TUS) from three countries: UK 2001, Poland 2012 and US 2003-13. The Harmonised Multinational Time Use Survey (MTUS) activity categories were matched to MET estimates from the 2011 Compendium of Physical Activities. We attach METs values to each successive activity in the TUS, together with both the original UK, Polish and US activity classifications and the 68-category MTUS activity classification. We used TUS estimates of activity durations across 24-h to estimate the Physical Activity Level (PAL) for respondents from the three countries and the average time spent and MET values for different activity categories. RESULTS: PAL values ranged from 1.59 in the US to 1.74 in Poland. The main sources of daily EE from PA were paid and unpaid work activities. Discretionary PA accounted for only a very small part (~ 3%) of adult daily energy expenditures. Using the harmonised MTUS 68-activity classification reduced the variability of the aggregate PAEE measure by ~ 20%, but the patterns of association between key demographics (age, sex, educational attainment) were unaffected. TUS data were further used to (1) identify sources of daily PA, and (2) assess adherence to physical activity guidelines (PAG) on a single-day basis. Estimated adherence levels were similar to those reported from other TUS as well as frequency based estimates. CONCLUSIONS: Comparative studies of energy expenditure based on harmonised time use activity categories could provide insight into the relative importance of different activities for energy expenditure across different countries and demographic groups. However, new observational studies combining TUS data with accelerometer, direct observation and other measures of activity intensity are required for more accurate MET assignments to activity categories in TUS.

The social disorganization of eating: a neglected determinant of the Australian epidemic of overweight/obesity.

BACKGROUND: Over the last 150 years, advanced economies have seen the burden of disease shift to non-communicable diseases. The risk factors for these diseases are often co-morbidities associated with unhealthy weight. The prevalence of overweight/obesity among adults in the advanced countries of the English-speaking world is currently more than two-thirds of the adult population. However, while much attention has concentrated on changes in diet that might have provoked this rapid increase in unhealthy weight, changes in patterns of eating have received little attention. METHODS: This article examines a sequence of large-scale, time use surveys in urban Australia stretching from 1974 to 2006. The earliest survey in 1974 (conducted by the Cities Commission) was limited to respondents aged between 18 and 69 years, while the later surveys (by the Australian Bureau of Statistics) included all adult (15 years of age or over) living private dwellings. Since time use surveys capture every activity in a day, they contain much information about mealtimes and the patterns of eating. This includes duration of eating, number of eating occasions and the timing of eating. Inferential statistics were used to test the statistical significance of these changes and the size of the effects. RESULTS: The eating patterns of urban Australian adults have changed significantly over a 32-year period and the magnitude of this change is non-trivial. Total average eating time as main activity has diminished by about a third, as have eating occasions, affecting particularly luncheon and evening meals. However, there is evidence that eating as secondary activity that accompanies another activity is now almost as frequent as eating at mealtimes. Moreover, participants seem not to report it. CONCLUSIONS: Contemporary urban Australians are spending less time in organized shared meals. These changes have occurred the over same period during which there has been a public health concern about the prevalence of unhealthy weight. Preliminary indications are that societies that emphasize eating as a commensal, shared activity through maintaining definite, generous lunch breaks and prioritizing eating at mealtimes, achieve better public health outcomes. This has implications for a strategy of health promotion, but to be sure of this we need to study countries with these more socially organized eating patterns.

A short history of time use research; implications for public health.

BACKGROUND: This section defined time use (TU) research, illustrating its relevance for public health. TUR in the health context is the study of health-enhancing and health-compromising behaviours that are assessed across a 24 h day. The central measurement is the use of Time Use Diaries, which capture 24-48 h, typically asking about behaviour in each 15-min period. TUR is used for understanding correlates of health behaviours, and as a form of population surveillance, assessing behavioural trends over time. MAIN BODY: This paper is a narrative review examining the history of time use research, and the potential uses of TU data for public health research. The history of TUR started in studies of the labour force and patterns of work in the late 19th and early twentieth century, but has more recently been applied to examining health issues. Initial studies had a more economic purpose but over recent decades, TU data have been used to describe the distribution and correlates of health-enhancing patterns of human time use. These studies require large multi-country population data sets, such as the harmonised Multinational Time Use Study hosted at the University of Oxford. TU data are used in physical activity research, as they provide information across the 24-h day, that can be examined as time spent sleeping, sitting/standing/light activity, and time spent in moderate-vigorous activities. TU data are also used for sleep research, examining eating and dietary patterns, exploring geographic distributions in time use behaviours, examining mental health and subjective wellbeing, and examining these data over time. The key methodological challenge has been the development of harmonised methods, so population TU data sets can be compared within and between-countries and over time. CONCLUSIONS: TUR provides new methods for examining public health research questions where a temporal dimension is important. These time use surveys have provided unique data over decades and in many countries that can be compared. They can be used for examining the effects of some large public health interventions or policies within and between countries.

Sleep differences in the UK between 1974 and 2015: Insights from detailed time diaries.

It is often stated that sleep deprivation is on the rise, with work suggested as a main cause. However, the evidence for increasing sleep deprivation comes from surveys using habitual sleep questions. An alternative source of information regarding sleep behaviour is time-use studies. This paper investigates changes in sleep time in the UK using the two British time-use studies that allow measuring "time in bed not asleep" separately from "actual sleep time". Based upon the studies presented here, people in the UK sleep today 43 min more than they did in the 1970s because they go to bed earlier (~30 min) and they wake up later (~15 min). The change in sleep duration is driven by night sleep and it is homogeneously distributed across the week. The former results apply to men and women alike, and to individuals of all ages and employment status, including employed individuals, the presumed major victims of the sleep deprivation epidemic and the 24/7 society. In fact, employed individuals have experienced a reduction in short sleeping of almost 4 percentage points, from 14.9% to 11.0%. There has also been a reduction of 15 percentage points in the amount of conflict between workers work time and their sleep time, as measured by the proportion of workers that do some work within their "ideal sleep window" (as defined by their own chronotype).

Patient work from a context and time use perspective: a mixed-methods study protocol.

INTRODUCTION: Self-management is widely promoted but less attention is focused on the work required from patients. To date, many individuals struggle to practise self-management. 'Patient work', a concept that examines the 'work' involved in self-management, is an approach to understanding the tasks, effort, time and context from patient perspective. The purpose of our study is to use a novel approach combining non-obstructive observations via digital devices with in-depth qualitative data about health behaviours and motivations, to capture the full range of patient work experienced by people with type 2 diabetes and chronic comorbidities. It aims to yield comprehensive insights about 'what works' in self-management, potentially extending to populations with other chronic health conditions. METHODS AND ANALYSIS: This mixed-methods observational study involves a (1) prestudy interview and questionnaires, (2) a 24-hour period during which participants wear a camera and complete a time-use diary, and a (3) poststudy interview and study feedback. Adult participants living with type 2 diabetes with at least one chronic comorbidity will be recruited using purposive sampling to obtain a balanced gender ratio and of participants using insulin and those using only oral medication. Interviews will be analysed using thematic analysis. Data captured by digital devices, diaries and questionnaires will be used to analyse the duration, time, context and patterns of health-related behaviours. ETHICS AND DISSEMINATION: The study was approved by the Macquarie University Human Research Ethics Committee for Medical Sciences (reference number 5201700718). Participants will carry a wallet-sized card that explains the purpose of the study to third parties, and can remove the camera at any stage. Before the poststudy interview begins, participants will view the camera images in private and can delete any images. Should any images be used in future publications or presentations, identifying features such as human faces and names will be obscured.

Using New Technologies for Time Diary Data Collection: Instrument Design and Data Quality Findings from a Mixed-Mode Pilot Survey.

Recent years have witnessed a steady growth of time-use research, driven by the increased research and policy interest in population activity patterns and their associations with long-term outcomes. There is recent interest in moving beyond traditional paper-administered time diaries to use new technologies for data collection in order to reduce respondent burden and administration costs, and to improve data quality. This paper presents two novel diary instruments that were employed by a large-scale multi-disciplinary cohort study in order to obtain information on the time allocation of adolescents in the United Kingdom. A web-administered diary and a smartphone app were created, and a mixed-mode data collection approach was followed: cohort members were asked to choose between these two modes, and those who were unable or refused to use the web/app modes were offered a paper diary. Using data from a pilot survey of 86 participants, we examine diary data quality indicators across the three modes. Results suggest that the web and app modes yield an overall better time diary data quality than the paper mode, with a higher proportion of diaries with complete activity and contextual information. Results also show that the web and app modes yield a comparable number of activity episodes to the paper mode. These results suggest that the use of new technologies can improve diary data quality. Future research using larger samples should systematically investigate selection and measurement effects in mixed-mode time-use survey designs.

Developing a Method to Test the Validity of 24 Hour Time Use Diaries Using Wearable Cameras: A Feasibility Pilot.

Self-report time use diaries collect a continuous sequenced record of daily activities but the validity of the data they produce is uncertain. This study tests the feasibility of using wearable cameras to generate, through image prompted interview, reconstructed 'near-objective' data to assess their validity. 16 volunteers completed the Harmonised European Time Use Survey (HETUS) diary and used an Autographer wearable camera (recording images at approximately 15 second intervals) for the waking hours of the same 24-hour period. Participants then completed an interview in which visual images were used as prompts to reconstruct a record of activities for comparison with the diary record. 14 participants complied with the full collection protocol. We compared time use and number of discrete activities from the diary and camera records (using 10 classifications of activity). In terms of aggregate totals of daily time use we found no significant difference between the diary and camera data. In terms of number of discrete activities, participants reported a mean of 19.2 activities per day in the diaries, while image prompted interviews revealed 41.1 activities per day. The visualisations of the individual activity sequences reveal some potentially important differences between the two record types, which will be explored at the next project stage. This study demonstrates the feasibility of using wearable cameras to reconstruct time use through image prompted interview in order to test the concurrent validity of 24-hour activity time-use budgets. In future we need a suitably powered study to assess the validity and reliability of 24-hour time use diaries.

Domestic outsourcing and multitasking: How much do they really contribute?

The bulk of responsibility for domestic work and childcare in heterosexual couples falls on women. But the means they find to cope with this load, and how these means relate to the factors underpinning the division of labor are not often studied. Two much-cited ways of reducing overall work time are purchasing domestic assistance (outsourcing) and the multitasking of domestic/caring tasks. Using UK 2000/2001 time-use data (N=4196 couples), we find domestic outsourcing is related to having dependent children and to partners' resources, but has little impact on the total domestic/caring workload of either partner. Nor can outsourcing account for the reduction in women's unpaid labor with increasing economic resources. Wives spend more time multitasking than husbands, but their proportion of multitasked domestic time is similar, and is not affected by resources or dependent children. Domestic multitasking seems to be more related to opportunity (time at home) than to time pressure.

Leisure inequality in the United States: 1965-2003.

This article exploits the complex sequential structure of the diary data in the American Heritage Time Use Study (AHTUS) and constructs three classes of indicators that capture the quality of leisure (pure leisure, co-present leisure, and leisure fragmentation) to show that the relative growth in leisure time enjoyed by low-educated individuals documented in previous studies has been accompanied by a relative decrease in the quality of that leisure time. These results are not driven by any single leisure activity, such as time spent watching television. Our findings may offer a more comprehensive picture of inequality in the United States and provide a basis for weighing the relative decline in earnings and consumption for the less-educated against the simultaneous relative growth of leisure.

Walking behaviours from the 1965-2003 American Heritage Time Use Study (AHTUS).

BACKGROUND: The American Heritage Time Use Study (AHTUS) represents a harmonised historical data file of time use by adults, amalgamating surveys collected in 1965-66, 1975-76, 1985, 1992-94, and 2003. The objectives of time-use studies have ranged from evaluating household and other unpaid production of goods and services, to monitoring of media use, to comparing lifestyles of more and less privileged social groups, or to tracking broad shifts in social behaviour. The purpose of this paper is to describe the process and utility of identifying and compiling data from the AHTUS to describe a range of walking behaviours collected using time-use survey methods over almost 40 years in the USA. METHODS: This is a secondary data analysis of an existing amalgamated data set. Noting source survey-specific limitations in comparability of design, we determined age-standardized participation (and associated durations) in any walking, walking for exercise, walking for transport, walking the dog, sports/exercise (excluding walking), and all physical activity for those survey years for which sufficient relevant data details were available. RESULTS: Data processing revealed inconsistencies in instrument administration, coding various types of walking and in prompting other sport/exercise across surveys. Thus for the entire period, application of inferential statistics to determine trend for a range of walking behaviours could not be done with confidence. Focusing on the two most comparable survey years, 1985 and 2003, it appears that walking for exercise in America has increased in popularity on any given day (from 2.9 to 5.4% of adults) and accumulated duration amongst those who walk for exercise (from 30 to 45 mins/day). Dog walking has decreased in popularity over the same time period (from 9.4 to 2.6%). Associated duration amongst dog walkers was stable at 30 mins/day. CONCLUSION: The noted and sometimes substantial differences in methods between the various survey administrations preclude stringent interpretation of these trends in walking behaviours and the use of conventional application of inferential statistics to evaluate significance of time trends. Although the AHTUS offers the most comprehensive attempt at harmonization yet undertaken with these individual time-use surveys, we found that any noted cross-time changes in walking and physical activity behaviour are not easily interpreted in terms of conventional epidemiological approaches and could be true changes, artefact related to instrument and method changes, or both. Public health utilization of the AHTUS, could be enhanced with greater attention to methodological issues known to influence estimation of physical activity behaviour in population. This could be achieved with cross-disciplinary collaboration between groups of experts in the various stages of these surveys.

GENDER CONVERGENCE IN THE AMERICAN HERITAGE TIME USE STUDY (AHTUS).

We present evidence from a new comprehensive database of harmonized national time-diary data that standardizes information on almost 40 years of daily life in America. The advantages of the diary method over other ways of calculating how time is spent are reviewed, along with its ability to generate more reliable and accurate measures of productive activity than respondent estimates or other alternatives. We then discuss the various procedures used to develop these harmonized data, both to standardize reporting detail and to match with Census Bureau population characteristics. We then use these data to document historical shifts in Americans' use of time, particularly focusing on gendered change in paid and unpaid work. We explore these data to find new and more complex evidence of continuing gender convergence, not just in aggregated totals of hours worked, but also in (1) the distributions of activity through the day and the week, (2) the sorts of activities that marital partners do together, as well as (3) the processes of construction of the diary accounts themselves.