Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 6;24(1):502.
doi: 10.1186/s12877-024-05076-0.

Determinants of sedentary behavior in community-dwelling older adults with type 2 diabetes based on the behavioral change wheel: a path analysis

Xiaoyan Zhang #  1 , Dan Yang #  2 , Jiayin Luo  1 , Meiqi Meng  2 , Sihan Chen  2 , Xuejing Li  2 , Yiyi Yin  2 , Yufang Hao  3 , Chao Sun  4
Affiliations

Determinants of sedentary behavior in community-dwelling older adults with type 2 diabetes based on the behavioral change wheel: a path analysis

Xiaoyan Zhang et al. BMC Geriatr. .

Abstract

Background: Sedentary behavior (SB) is deeply ingrained in the daily lives of community-dwelling older adults with type 2 diabetes mellitus (T2DM). However, the specific underlying mechanisms of the determinants associated with SB remain elusive. We aimed to explore the determinants of SB based on the behavior change wheel framework as well as a literature review.

Methods: This cross-sectional study recruited 489 community-dwelling older adults with T2DM in Jinan City, Shandong Province, China. Convenience sampling was used to select participants from relevant communities. This study used the Measure of Older Adults' Sedentary Time-T2DM, the Abbreviated-Neighborhood Environment Walkability Scale, the Social Support Rating Scale, the Lubben Social Network Scale 6, the Subjective Social Norms Questionnaire for Sedentary Behavior, the Functional Activities Questionnaire, the Numerical Rating Scale, the Short Physical Performance Battery, and the Montreal Cognitive Assessment Text to assess the levels of and the determinants of SB. Descriptive statistical analysis and path analysis were conducted to analyze and interpret the data.

Results: Pain, cognitive function, social isolation, and social support had direct and indirect effects on SB in community-dwelling older adults with T2DM (total effects: β = 0.426, β = -0.171, β = -0.209, and β = -0.128, respectively), and physical function, walking environment, and social function had direct effects on patients' SB (total effects: β = -0.180, β = -0.163, and β = 0.127, respectively). All the above pathways were statistically significant (P < 0.05). The path analysis showed that the model had acceptable fit indices: RMSEA = 0.014, χ 2/df = 1.100, GFI = 0.999, AGFI = 0.980, NFI = 0.997, RFI = 0.954, IFI = 1.000, TLI = 0.996, CFI = 1.000.

Conclusion: Capability (physical function, pain, and cognitive function), opportunity (social isolation, walking environment, and social support), and motivation (social function) were effective predictors of SB in community-dwelling older adults with T2DM. Deeper knowledge regarding these associations may help healthcare providers design targeted intervention strategies to decrease levels of SB in this specific population.

Keywords: Behavior change wheel; Community; Determinants; Older adults; Path analysis; Sedentary behavior; Type 2 diabetes.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The hypothetical path model based on the BCW (COM-B and TDF) and literature review
Fig. 2
Fig. 2
The relationship diagram for preliminary model validation
Fig. 3
Fig. 3
The modified path model of the relationship between SB and its determinants
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Alberti KGMM, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a who consultation. Diabet Med. 1998;15(7):539–53. doi: 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S. - DOI - PubMed
    1. Sinclair A, Saeedi P, Kaundal A, Karuranga S, Williams R. Diabetes and global ageing among 65-99-year-old adults: findings from the international diabetes federation diabetes atlas, 9th edition. Diabetes Res Clin Pract. 2020;162:108078. doi: 10.1016/j.diabres.2020.108078. - DOI - PubMed
    1. Chinese Diabetes Society. Guideline for the prevention and treatment of type 2 diabetes mellitus in China(2020 edition)(part 1). Chin J Practical Intern Med. 2021(008):41.
    1. Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Arto PJ. Sedentary Behavior Research Network (SBRN) – terminology Consensus Project process and outcome. INT J BEHAV NUTR PHY. 2017;14(75):2–17. - PMC - PubMed
    1. Lee I, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–29. doi: 10.1016/S0140-6736(12)61031-9. - DOI - PMC - PubMed