Feasibility and preliminary efficacy of an intervention to reduce older adults’ sedentary behavior

Abstract

Older adults represent the segment of the population that sits the most. This study evaluated the feasibility, acceptability, safety, and preliminary efficacy of an intervention to reduce sedentary behavior (SB) in older adults that can be disseminated broadly for limited cost and delivered by paraprofessionals with limited training. Senior centers in Central Pennsylvania were randomized to receive one of two healthy aging programs (i.e., intervention or comparison). Participants in both groups attended three 90-min meetings over 2 weeks. Behavior change content was delivered at the second session (i.e., day 7). Forty-two participants (n intervention = 25, n comparison = 17) were recruited from five senior centers. Content for the intervention group focused on reducing SB while comparison group content focused on reducing social isolation. Self-reported SB was assessed on days 7 and 14. Repeated-measures ANOVA revealed a significant group × time interaction for total and weekday, but not weekend, SB. In the week following the delivery of group content, participants in the intervention group reported an average decrease in total SB of 837.8 min/week; however, the comparison group reported a nonsignificant average decrease of 263.0 min/week of total SB. Participants in the intervention group also reported an average decrease in weekday SB of 132.6 min/weekday (d = −0.83) in the week following the delivery of group content; however, the comparison group reported a nonsignificant decrease of 24.0 min/weekday (d = −0.16). There were no significant changes in weekend SB in either group in the week following the delivery of group content. Participants' attendance, measurement completion, and program ratings were high. Safety issues were minimal. This intervention was feasible to implement and evaluate, acceptable to older adults, and showed promise for reducing older adults' SB.

The Conceptualization of a Just-in-Time Adaptive Intervention (JITAI) for the Reduction of Sedentary Behavior in Older Adults

“…These interventions have been successful in increasing physical activity and/or reducing sedentary behavior in a few small-scale studies involving adults (66,81) and older adults (45)(46)(47). The changes in sedentary behavior were moderate and mostly comparable to the changes achieved in other interventions that did not apply a JITAI approach or were not delivered digitally (57,69,72,74,82). The shortcomings of the JITAI studies were that the integration of theory and empirical evidence to inform the development of the JITAIs was limited.…”

“…This is because older adults are less likely to abandon these technologies (78) and are more adherent to digital and other health interventions compared to younger age groups (29,83). There is another benefit of a face-to-face introductory session prior to a JITAI: Older adults can be made aware of their sedentary behavior and intentions to reduce time spent sedentary can be formed (57). The JITAI can then function as a bridge between intentions and behavior.…”

“…Third, there is evidence highlighting that sedentary behavior is associated with many health risks (53,54), and that reducing sedentary behavior is beneficial for health (55,56). Finally, sitting is habitual and active breaks are opportunistic and can be promoted in the moment (with a JITAI) (57,58).…”

“…There is only limited research on the mediators of sedentary behavior, especially in older adults (45,57,59). Theory and evidence suggests that the social-cognitive determinants of self-efficacy and social support are important for physical activity adoption and maintenance (60)(61)(62)(63)(64).…”

The conceptualization of a Just-In-Time Adaptive Intervention (JITAI) for the reduction of sedentary behavior in older adults

“…Third, there is evidence highlighting that sedentary behavior is associated with many health risks (53, 54), and that reducing sedentary behavior is beneficial for health (55,56). Finally, sitting is habitual and active breaks are opportunistic and can be promoted in the moment (with a JITAI) (57,58).…”