Understanding for whom, under which circumstances and how sedentary behaviour interventions for older adults work: a realist review

Objectives Reducing sedentary behaviour (SB) in older adults is a promising strategy to promote healthy ageing. However, to develop more effective interventions, more in-depth information is needed on how existing interventions work. The present realist review aims to identify the working mechanisms...

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Main Authors: Greet Cardon, Sofie Compernolle, Geert Crombez, Sebastian Chastin, Delfien Van Dyck, Emelien Lauwerier, Laura Van de Velde, Femke De Meester, Fientje Mertens, Sanne Stegen
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/8/e095775.full
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author Greet Cardon
Sofie Compernolle
Geert Crombez
Sebastian Chastin
Delfien Van Dyck
Emelien Lauwerier
Laura Van de Velde
Femke De Meester
Fientje Mertens
Sanne Stegen
author_facet Greet Cardon
Sofie Compernolle
Geert Crombez
Sebastian Chastin
Delfien Van Dyck
Emelien Lauwerier
Laura Van de Velde
Femke De Meester
Fientje Mertens
Sanne Stegen
author_sort Greet Cardon
collection DOAJ
description Objectives Reducing sedentary behaviour (SB) in older adults is a promising strategy to promote healthy ageing. However, to develop more effective interventions, more in-depth information is needed on how existing interventions work. The present realist review aims to identify the working mechanisms and contextual preconditions to guide the development of future interventions.Design A realist review was conducted following the iterative process of Pawson and Tilley and reported following the RAMESES publication standards.Data sources Evidence was searched in four databases: EMBASE, PubMed, Web of Science and Scopus, and in the grey literature.Eligibility criteria All study types and designs were included. Studies conducted in older adults with a mean age of 60 years or older, providing information on the context, mechanisms and/or outcomes of interventions aimed at the reduction of SB were eligible for inclusion and appraised for relevance and rigour.Data extraction and synthesis All data were coded by two independent reviewers. Sections that contained relevant information to refine, refute or confirm the initial programme theory were given a code. Based on these codes, context-mechanism-outcome configurations were made, and a final programme theory was developed.Results In total, 58 studies, from 61 articles, were eligible. The review revealed three important contexts for changes in SB: the (1) motivation, (2) opportunities and (3) capabilities of older adults. Depending on the context, other behaviour change techniques should be used to trigger specific mechanisms and, in turn, reduce SB. Especially, the impact of the underlying automatic processes of SB on the effectiveness of SB interventions became clear. Existing interventions primarily focus on the reflective processes guiding SB, without taking into account that SB is often an automatic response that occurs unconsciously, with little reasoning.Conclusions The effectiveness of SB interventions in older adults highly depends on the context in which the interventions occur. In particular, the context of automatic motivation should receive more attention to break the ingrained habit of SB in older adults.
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spelling doaj-art-01482b5b803141c580ecbf44dc41dde02025-08-20T04:02:32ZengBMJ Publishing GroupBMJ Open2044-60552025-08-0115810.1136/bmjopen-2024-095775Understanding for whom, under which circumstances and how sedentary behaviour interventions for older adults work: a realist reviewGreet Cardon0Sofie Compernolle1Geert Crombez2Sebastian Chastin3Delfien Van Dyck4Emelien Lauwerier5Laura Van de Velde6Femke De Meester7Fientje Mertens8Sanne Stegen9Department of Movement and Sports Sciences, Ghent University, Ghent, BelgiumDepartment of Movement and Sports Sciences, Ghent University, Ghent, BelgiumDepartment of Experimental Clinical and Health Psychology, University of Ghent, Gent, BelgiumDepartment of Movement and Sports Sciences, Ghent University, Ghent, BelgiumDepartment of Movement and Sports Sciences, Ghent University, Ghent, BelgiumDepartment of Experimental Clinical and Health Psychology, University of Ghent, Gent, BelgiumDepartment of Movement and Sports Sciences, Ghent University, Ghent, BelgiumFlanders Institute for Healthy Living, Brussels, BelgiumDepartment of Public Health and Primary Care, Ghent University, Gent, BelgiumDepartment of Movement and Sports Sciences, Ghent University, Ghent, BelgiumObjectives Reducing sedentary behaviour (SB) in older adults is a promising strategy to promote healthy ageing. However, to develop more effective interventions, more in-depth information is needed on how existing interventions work. The present realist review aims to identify the working mechanisms and contextual preconditions to guide the development of future interventions.Design A realist review was conducted following the iterative process of Pawson and Tilley and reported following the RAMESES publication standards.Data sources Evidence was searched in four databases: EMBASE, PubMed, Web of Science and Scopus, and in the grey literature.Eligibility criteria All study types and designs were included. Studies conducted in older adults with a mean age of 60 years or older, providing information on the context, mechanisms and/or outcomes of interventions aimed at the reduction of SB were eligible for inclusion and appraised for relevance and rigour.Data extraction and synthesis All data were coded by two independent reviewers. Sections that contained relevant information to refine, refute or confirm the initial programme theory were given a code. Based on these codes, context-mechanism-outcome configurations were made, and a final programme theory was developed.Results In total, 58 studies, from 61 articles, were eligible. The review revealed three important contexts for changes in SB: the (1) motivation, (2) opportunities and (3) capabilities of older adults. Depending on the context, other behaviour change techniques should be used to trigger specific mechanisms and, in turn, reduce SB. Especially, the impact of the underlying automatic processes of SB on the effectiveness of SB interventions became clear. Existing interventions primarily focus on the reflective processes guiding SB, without taking into account that SB is often an automatic response that occurs unconsciously, with little reasoning.Conclusions The effectiveness of SB interventions in older adults highly depends on the context in which the interventions occur. In particular, the context of automatic motivation should receive more attention to break the ingrained habit of SB in older adults.https://bmjopen.bmj.com/content/15/8/e095775.full
spellingShingle Greet Cardon
Sofie Compernolle
Geert Crombez
Sebastian Chastin
Delfien Van Dyck
Emelien Lauwerier
Laura Van de Velde
Femke De Meester
Fientje Mertens
Sanne Stegen
Understanding for whom, under which circumstances and how sedentary behaviour interventions for older adults work: a realist review
BMJ Open
title Understanding for whom, under which circumstances and how sedentary behaviour interventions for older adults work: a realist review
title_full Understanding for whom, under which circumstances and how sedentary behaviour interventions for older adults work: a realist review
title_fullStr Understanding for whom, under which circumstances and how sedentary behaviour interventions for older adults work: a realist review
title_full_unstemmed Understanding for whom, under which circumstances and how sedentary behaviour interventions for older adults work: a realist review
title_short Understanding for whom, under which circumstances and how sedentary behaviour interventions for older adults work: a realist review
title_sort understanding for whom under which circumstances and how sedentary behaviour interventions for older adults work a realist review
url https://bmjopen.bmj.com/content/15/8/e095775.full
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