Chen Siqing, Yang Kaijie, Ko Albert, Giovannucci Edward, Stults-Kolehmainen Matthew, Yang Lili
Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
BMC Public Health. 2025 Jul 16;25(1):2472. doi: 10.1186/s12889-025-23613-3.
Prolonged sedentary behavior is a critical health risk for older adults. However, little is known about the distinct barriers and facilitators experienced by sedentary and non-sedentary older adults. Understanding these factors is essential for designing effective behavior change interventions.
The study aims to identify and categorize the barriers and facilitators to reducing sedentary behavior among sedentary and non-sedentary older adults using the Capability, Opportunity, Motivation-Behavior (COM-B) model and Theoretical Domains Framework (TDF), thereby informing future mobile health (mHealth) interventions designed to reduce sedentary time in this population.
Data were collected through semi-structured interviews with older adults, conducted at two community hospitals in China between July 2024 and September 2024. The interviews focused on older adults' psychological and physical capabilities, social and physical opportunities, and reflective and autonomous motivations related to sedentary behavior. According to the Canadian 24-Hour Movement Guidelines, participants were classified as sedentary (> 8 h/day sitting time) or non-sedentary (≤ 8 h/day) based on a participant characteristics questionnaire with verbal confirmation during the interview. The data were analyzed thematically, and the identified themes were mapped onto the COM-B model and TDF. Study procedures followed the COREQ checklist for qualitative research reporting.
The study included 29 older adults, comprising 19 sedentary (65.5%) and 10 non-sedentary (34.5%). The following ten higher-order themes were identified: Lack of Knowledge (and Limited Knowledge); Lack of Methods (and Available Methods); Sedentary Triggers (and Interruptions); Lack of Management (and Self-management); Lack of Social Support (and Available Social Support); Lack of Environmental Support (and Available Environment Support); Perceptions and Conflicts (and Importance and Effort); Lack of Confidence (and Confidence); Limited Belief (and Understanding Health Benefits); and Limited Motivation (and Sufficient Motivation).
Sedentary older adults face barriers such as low awareness of health risks, lack of regulation strategies, and insufficient social support, while non-sedentary older adults demonstrate higher confidence, better self-regulation, and engage in structured activities supported by cues such as mobile health reminders.
长期久坐行为对老年人来说是一项重大的健康风险。然而，对于久坐和非久坐老年人所面临的不同障碍和促进因素，我们知之甚少。了解这些因素对于设计有效的行为改变干预措施至关重要。
本研究旨在使用能力、机会、动机-行为（COM-B）模型和理论领域框架（TDF），识别并分类久坐和非久坐老年人减少久坐行为的障碍和促进因素，从而为未来旨在减少该人群久坐时间的移动健康（mHealth）干预措施提供参考。
2024年7月至2024年9月期间，在中国的两家社区医院对老年人进行了半结构化访谈，收集数据。访谈重点关注老年人与久坐行为相关的心理和身体能力、社会和身体机会，以及反思性和自主性动机。根据加拿大24小时运动指南，通过一份参与者特征问卷，并在访谈过程中进行口头确认，将参与者分为久坐组（每天坐姿时间>8小时）或非久坐组（每天≤8小时）。对数据进行主题分析，并将识别出的主题映射到COM-B模型和TDF上。研究程序遵循定性研究报告的COREQ清单。
该研究纳入了29名老年人，其中19名久坐者（65.5%），10名非久坐者（34.5%）。确定了以下十个高阶主题：知识缺乏（和知识有限）；方法缺乏（和可用方法）；久坐触发因素（和干扰因素）；管理缺乏（和自我管理）；社会支持缺乏（和可用社会支持）；环境支持缺乏（和可用环境支持）；认知与冲突（和重要性与努力）；信心缺乏（和信心）；信念有限（和对健康益处的理解）；动机有限（和充足动机）。
久坐的老年人面临着诸如对健康风险认识不足、缺乏调节策略和社会支持不足等障碍，而非久坐的老年人表现出更高的信心、更好的自我调节能力，并参与由移动健康提醒等提示支持的结构化活动。
