A278: The Effects of MTM-Based Stepped Behavior Change Intervention on Sedentary Lifestyle Among Community-Dwelling Older Adults

Sedentary lifestyles 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. An experimental study was conducted to verify whether a sedentary lifestyle modification intervention based on the Multi-Theory Mode（MTM）and the staircase approach is more effective than conventional education in reducing sedentary time and improving physical activity levels, physical function, and quality of life among community-dwelling older people. Method: This trial was a multicenter, assessor-blinded, 18-week, two-arm, parallel-group, randomized controlled trial. Study participants were recruited from May to August 2024 at two community health centers in Changchun, China. A total of 60 community-dwelling older adults with sedentary lifestyles (sedentary and physically inactive) were randomly assigned to the intervention and control groups. Participants in the intervention group received an MTM-based stepped sedentary lifestyle change intervention involving three thematic sessions (biweekly) and two telephone follow-up visits. The session topics were organized in a stepped manner with a rhythm of “Sedentary behavior↓→LPA↑→MVPA↑”. Participants in the control group received the usual care. Endpoints were collected at baseline, week 6, week 12, and week 18. The primary endpoint is the change in self-reported sedentary time. Secondary endpoints include the changes in screen-based sedentary time, sedentary behavior characteristics, step count (pedometer-measured), time spent in LPA and MVPA, SPPB score, anthropometric parameters, blood pressure, and SF-12 score. Of the 60 randomized participants (70.2 ±4.3 years; 46 men [76.66%]), 51 completed outcome measurements at the four time points. Compared with the control group, participants in the intervention group showed a significant reduction(difference [95% CI]) in sedentary time (-81.8min [-130.570 to -33.135]), screen-based sedentary time (-48.4min [-88.6 to -8.1]), and longest continuous sedentary time (-40.6min [-64.3 to -16.8]) were significantly reduced; Weekly MVPA time ( 93.0min [59.0 to 126.9]), step count (2427.8step [23.0 to 4832.4]), SPPB score (0.9 [ 0.1 to 1.8])were significantly improved. Compared with conventional nursing, the MTM-based staircase approach behavior change intervention can significantly reduce sedentary behavior, increase physical activity level, promote physical function, and maintain the health-related quality of life of older adults.