The Effects of Multi-Theory Model–Based Behavior Change Intervention with Staircase Approach on Sedentary Lifestyle Among Community-Dwelling Older Adults: Study Protocol for a Randomized Controlled Trial

Sep 29, 2026

Sedentary lifestyle is a prevalent nursing diagnosis among community-dwelling older adults, who are notably the most sedentary and physically inactive group. Prolonged low energy expenditure during waking hours elevates risk of noncommunicable diseases and undermines physical functioning, worsening overall health outcomes. This study protocol evaluates a multi-theory model–based stepped behavior change intervention using a staircase approach, assessing self-reported sedentary time as the primary outcome and multiple physical activity, performance, anthropometric, and health survey measures as secondary endpoints.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages18

Reading Time45 min

AccessFree to download

Abstract

Background

Objective

Methods

Results

Conclusions

Introduction

Study rationale and public health context

Trial registration and identification

JMIR RESEARCH PROTOCOLS Tuerdi et al Protocol The Effects of Multi-Theory Model–Based Behavior Change Intervention with Staircase Approach on Sedentary Lifestyle Among Community-Dwelling Older Adults: Study Protocol fora Randomized Controlled Trial | Subinuer Tuerdi 1* , MMed; HuiLing Yang2* , MMed; Li He 1 , MMed; Rong Yan 1 , MMed; YaoYi Cui 1 , MMed; XingHui Wang3 , MMed; ShanShan Dong4 , MMed; JiaYu Yang1 , MMed; KeQiang Zhang5 , MMed; Feng Li1 , MD; YueWei Li 1 , MD | | --- | | 1School of Nursing, Jilin University, Changchun, China
2Operating Room, Second Affiliated Hospital of Jilin University, Changchun, Jilin Province, China 3Nursing Department, The First Hospital of Hebei Medical University, Hebei, China
4Hepatopancreatobiliary Surgery Department, General External Center, First Hospital of Jilin University, Changchun, Jilin Province, China 5Medical Department, Second Hospital of Jilin University, Changchun, Jilin Province, China
*these authors contributed equally
Corresponding Author:
YueWei Li, MD School of Nursing Jilin University
965 Xinjiang St Changchun 130000 China
Phone: +86 13578873345
Email: [yuewei@jlu.edu.cn](yuewei@jlu.edu.cn)
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. [https://www.researchprotocols.org/2026/1/e81284](https://www.researchprotocols.org/2026/1/e81284) JMIR Res Protoc 2026 | vol. 15 | e81284 | p. 1 (page number not for citation purposes) JMIR RESEARCH PROTOCOLS Tuerdi et al Trial Registration: China Clinical Trial Registry ChiCTR2400082225; [https://www.chictr.org.cn/showproj.html?proj=223351](https://www.chictr.or

FAQs

What is the primary outcome of this randomized controlled trial?

The primary endpoint is the change in self-reported sedentary time.

What intervention is being tested?

A multi-theory model–based stepped behavior change intervention with a staircase approach, designed to progress from sitting to standing and movement through increasing intensities of physical activity.

When was the study initiated and when is the manuscript expected?

The study was initiated in May 2024. As of May 2025, recruitment and data collection were completed, and the final manuscript is expected for submission in September 2025.

Sep 29, 2026

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