Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 17, 2025
Date Accepted: Feb 18, 2026
Telehealth Intervention to Reduce Sedentary Behavior in Older Adults With Type 2 Diabetes: Development and Feasibility Study
ABSTRACT
Background:
Sedentary behavior (SB) is a modifiable risk factor for complications in older adults with type 2 diabetes mellitus (T2DM). Despite widespread adoption of digital health platforms, theory-driven telehealth interventions specifically targeting SB reduction remain limited, particularly those incorporating cultural adaptation and behavioral change frameworks.
Objective:
This study applied the Intervention Mapping(IM) framework to systematically develop a tailored telehealth intervention for reducing sedentary behavior in older adults with T2DM in China.
Methods:
We systematically applied the Behavior Change Wheel(BCW) and IM framework to develop an intervention strategy. A mixed-methods approach identified contexts, determinants, and mechanisms of SB. We formulated behavioral outcomes, performance objectives, and change objectives, selecting appropriate intervention functions, policy categories, and Behavior Change Techniques (BCTs).
Results:
The intervention comprises five components: an electronic health education manual, motion graphics library, text message library, WeChat Q&A group, and material incentive package. These components address 'knowledge', 'social support', and 'intention' determinants through 'education', 'enablement', and 'incentivisation' functions, respectively. All components used 'service provision' policy and various BCTs. Preliminary feasibility testing (n = 30) showed reduced sedentary time by 1.12 hours/day (P < .001) and improved social connectivity scores (P = .001).
Conclusions:
This study demonstrates the feasibility and preliminary effectiveness of a systematically developed telehealth intervention for reducing SB in older adults with T2DM in China. The integration of IM with the BCW provides a replicable framework for developing theory-driven digital health interventions. With significant reductions in sedentary time and improved social connectivity, this culturally adapted approach offers a scalable model for chronic disease self-management in aging populations. The systematic methodology and positive outcomes support broader implementation of evidence-based telehealth solutions for behavioral modification in diabetes care.
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