JMIR Publications

ABSTRACT

Background:

Sedentary lifestyles as a nursing diagnosis are prevalent in the life patterns of community-dwelling older adults, who have been shown to be the most sedentary and physically inactive subgroup. Prolonged low energy expenditure during waking hours leads to an increased risk of non-communicable diseases and impairs physical functioning in older adults, negatively impacting their health outcomes. Therefore, interventions targeting changes in sedentary lifestyles are necessary to improve health behaviors in older adults.

Objective:

This study aimed to investigate the effect of the Multi-Theory Model based stepped behavior change intervention on sedentary lifestyle among community-dwelling older adults.

Methods:

This study is designed as a community-based, parallel-arm, assessor-blinded randomized controlled trial. 56 participants will be enrolled in this study and randomly assigned to the intervention group (receive theory-based sedentary lifestyle change intervention) and the control group (receive conventional behavioral change advice). Endpoints will be collected at baseline, immediately after the end of intervention, week 12 and week 18. The primary endpoint is the change in self-reported sedentary time. Secondary endpoints include the changes in step count, time spent in light-intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity(MVPA), MCPAQ score, SPPB score, BMI, waist circumference, blood pressure, and SF-12 score.

Results:

The study was initiated in May 2024. As of May 2025, the project has completed participant recruitment and data collection. Final manuscript with findings is expected to be submitted for publication in September 2025.

Conclusions:

This study uses a Multi-Theory Model as its theoretical framework, and adopts stepped sedentary lifestyle change as the intensity gradient of exercise behavior, creating a behavioral change pattern from sitting to standing and movement, to LPA, to MVPA, and ultimately improving the sedentary lifestyle and obtaining health benefits. To provide community-dwelling older people with individualized behavior change programs that are easy to adhere to and more applicable to daily activity patterns. Clinical Trial: The trial was registered in the China Clinical Trial Registry on 25 Mar 2024 (ChiCTR2400082225)