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 noncommunicable 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. Sixty participants were enrolled in this study and randomly assigned to the intervention group (received theory-based sedentary lifestyle change intervention) and the control group (received conventional behavioral change advice). End points were collected at baseline, immediately after the end of the 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 and moderate-to-vigorous-intensity physical activity, Measuring Change in Physical Activity Questionnaire score, Short Physical Performance Battery score, BMI, waist circumference, blood pressure, and Short-Form Health Survey-12-Version 2 score. RESULTS: The study was initiated in May 2024. As of May 2025, the project had completed participant recruitment and data collection. The 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 light-intensity physical activity, to moderate-to-vigorous-intensity physical activity, and ultimately improving the sedentary lifestyle and obtaining health benefits, to provide community-dwelling older adults with individualized behavior change programs that are easy to adhere to and more applicable to daily activity patterns.