Sedentary behavior (SB) is known to be an essential part of the daily routine of older adults, exceeding eight hours per day [1,2,3]^[1][2][3]. The concept is defined as any waking behavior that involves minimal energy expenditure (less than 1.5 metabolic equivalents) while sitting, leaning, or lying down ^[4]. Higher levels of daily SB have been associated with significant health outcomes for adults, particularly older adults ^[5]. Regardless of physical activity level, prolonged SB is associated with poor health outcomes, including obesity, diabetes, heart disease, cancer, and premature mortality [6,7,8]^[6][7][8]. These findings highlight the detrimental effects of a sedentary lifestyle on overall health and emphasize the importance of promoting physical activity and reducing sedentary time to mitigate these risks. Importantly, these adverse consequences persist regardless of a person’s level of physical activity, underscoring the independent effects of prolonged SB on biopsychosocial health ^[6]. Therefore, SB goes beyond simply abstaining from moderate to vigorous physical activity. It can be effectively reduced by incorporating more transitions from sitting to standing, increasing standing time, and engaging in light physical activities, including active sitting ^[9].

SB includes both passive activities (e.g., watching television) and intellectually active behaviors (e.g., reading or using a computer). These activities occur in a variety of behavioral contexts, such as work, leisure, and transportation [10,11,12]^[10][11][12]. Research with older adults suggests that certain sedentary activities, such as reading or working on a computer, can improve cognitive performance and promote mental well-being ^[13]. Intellectually stimulating tasks, for example, may contribute to better mood, lower stress levels, and improved emotional well-being [14,15]^[14][15]. Therefore, it is important to recognize that not all sedentary activities have uniformly negative effects. Rather, the effects are influenced by the context and type of activity. While excessive SB remains a health concern for older adults, it is important to recognize the potential benefits and differential effects of certain sedentary activities.

2.1. Definition and Shaping Perspectives on Sedentary Behavior

SB has significant public health implications, as noted above, particularly among older adults who are more susceptible to chronic disease. However, the precise definition of SB varies, presenting a challenge in developing effective interventions. This challenge is also underscored by qualitative studies that have examined older adults’ views of SB, revealing its nuanced and multifaceted nature. These studies emphasize the complexity of SB and the need for a comprehensive approach to address this phenomenon. Older adults show some understanding of SB, although they have difficulty distinguishing it from physical inactivity (i.e., not following recommended physical activity guidelines). Their descriptions of SB, such as “sitting around”, “chilling”, or “putting their feet up”, reflect this perception. On the other hand, they use terms like “mooching”, “brooding”, or “hanging out” to describe non-sedentary light activity. In their understanding, SB is often equated with a lack of physical activity or exercise, with sedentary and active behaviors seen as opposite ends of a linear continuum. Consequently, older adults find it difficult to imagine people engaging in high levels of physical activity while sitting for extended periods of time ^[9]. Similar results have been observed in other populations, including prostate cancer survivors receiving androgen deprivation therapy [56]^[16] and individuals with osteoarthritis and knee arthroplasty [59]^[17]. When older adults are asked about strategies to reduce SB, they often suggest increasing physical activity instead, and they have difficulty making alternative suggestions that do not involve physical activity unless specifically asked ^[9]. This confusion may be due to the negative framing of messages that focus primarily on reducing SB. While older adults are able to provide specific examples of SB, such as arts and crafts, the use of technology, gaming, and socializing, the concept of reducing SB is often perceived as ambiguous [49,59]^[17][18].  For older adults, distinguishing between SB and physical inactivity can be challenging because these behaviors overlap and there are no precise definitions or clear boundaries. This can lead to confusion [57,59]^[17][19]. SB refers to activities performed while sitting or lying down with low energy expenditure ^[4], whereas physical inactivity refers to a lack of moderate to vigorous physical activity [61]^[20]. It is important to note that a person can be sedentary and physically active at the same time. The collective findings of the studies offer insight into the widespread negative perceptions associated with SB among older adults [9^{[9][18][21][22][23]},39,44,49,58], using terms such as “doing nothing” and “not moving” to describe it [49]^[18]. Older adults report several disadvantages of sitting, including physical discomfort such as stiffness and pain, as well as feelings of boredom and a decline in overall health. They tend to associate SB with the inevitable consequences of aging and with physical limitations [44,58]^[22][23]. Older adults also believe that prolonged sitting negatively affects their mental well-being and leads to more worry and anxiety [44]^[22]. In this population, prolonged SB, especially excessive television viewing, can cause guilt, depression, boredom, and idleness [52,58]^[23][24].  Older adults are often reluctant to identify themselves as sedentary because of the negative connotations and a desire to distance themselves from this label. They prefer to emphasize their physical activity and deny that they spend an inordinate amount of time sitting compared to others. This reluctance may be due to concerns about the detrimental effects on overall well-being and feelings of inferiority associated with belonging to the sedentary group ^[9], consistent with social identity theory [62]^[25].  Several factors may contribute to the negative perception of SB in older adults. First, society places great emphasis on the importance of physical activity for health and well-being, especially in old age [63,64]^[26][27]. This societal emphasis may lead to stigmatization of sedentary habits. Older adults often distance themselves from individuals they perceive as engaging in deviant behaviors in order to maintain control over their own health decisions and demonstrate competence. However, research has shown that emphasizing individual responsibility for health management alone can contribute to stigma and may not effectively promote positive behavior change. To effectively address health behaviors, it is critical to consider the broader influence of social, cultural, and political factors. When these contextual factors are overlooked, it can limit the effectiveness of interventions [65,66]^[28][29].  In addition, ageism and negative stereotypes associated with aging influence older adults’ unfavorable views of SB. The societal ideal of an independent and active older adult further reinforces negative perceptions of SB. Research highlighting the negative health effects of prolonged sitting, such as increased risk of chronic disease and functional disability, also may contribute to the negative perception of SB [5,6]^[5][6]. In this context, terror management theory [67]^[30] suggests that ageism underlies a psychological mechanism driven by a desire to distance oneself from thoughts of mortality. The desire to distance oneself from sedentary older adults stems from fear of one’s own inevitable decline in health and functional abilities that accompany aging.  Older adults, however, may respond differently to sedentary activities that involve social interaction or cognitive engagement. Rather than turning away from these behaviors, they are more receptive and open to them. Sitting for social or cognitive activities is perceived as useful and acceptable, whereas purposeless sitting is perceived differently [44]^[22]. It is important to note that SB is not only determined by posture, as Voss and colleagues point out [58]^[23]. The specific activity performed while sitting also plays a role. 

2.2. Sedentary Behavior Awareness: Daily Routines and Contexts

Qualitative research plays a critical role in capturing the subjective experiences and perspectives of older people. It offers valuable insights into the factors that influence their daily lives and the contextual elements associated with SB. By exploring these factors in depth, researchers can gain valuable information and develop a deeper understanding of the complexity of SB in this population. This section highlights older adults’ perceptions of their own SB and daily lives. Although older adults have limited knowledge of the difference between SB and physical inactivity, they can still identify specific sedentary activities that they frequently engage in. In a study by McEwan and colleagues [49]^[18], older adults reported spending an average of 5.6 (±1.0) h per day engaged in SB. In addition, older women often lead more active and socially engaged lives compared to men, successfully balancing family, work, and domestic responsibilities, which contributes to higher levels of activity and sociability [50]^[31]. To effectively promote and sustain older women’s activity levels, it is critical to address their unique needs through appropriate policies and interventions that leverage their existing roles and responsibilities. In a study by Palmer and colleagues [54]^[32], older adults expressed surprise and disbelief when they discovered the extent of their SB. This finding challenged their self-perception as active individuals and caused some participants to question the accuracy of the monitoring device used in the study, as they felt it did not adequately capture their non-sedentary activities. These reactions can be explained by cognitive dissonance [70]^[33], a psychological phenomenon that occurs when individuals experience discomfort or tension due to conflicting beliefs, attitudes, or behaviors. In this case, participants’ awareness of their SB conflicted with their self-perception as active individuals.  Older adults tend to be more sedentary in the afternoon and evening than in the morning. This behavior is influenced by their desire to regulate energy levels and rest after morning activities or save energy for later tasks [39]^[21]. Energy level regulation plays an important role in prolonged sitting during these periods. In recent years, the field of time-use epidemiology has evolved with methodological advances. This approach considers physical activity, SB, and sleep as interrelated components of the 24 h day rather than independent risk factors [72,73]^[34][35]. By viewing these components as mutually exclusive and exhaustive, researchers can investigate how the reallocation of time between physical activity, SB, and sleep impacts health and determine the optimal balance for overall well-being [72]^[34]. This is an opportunity for future research to use the principles of time-use epidemiology, which may provide valuable insights into the interplay between physical activity, SB, and sleep, and their effects on health. In general, older adults engage in a variety of sedentary activities, both individually and in their communities. While watching television is the most commonly reported sedentary activity among older adults, they also engage in a number of other sedentary leisure activities, including solitary pursuits such as reading, doing crossword puzzles, knitting, and crocheting [39,49,52,57]^{[18][19][21][24]}. Other activities include listening to music, working on the computer, and playing musical instruments [49,53,57]^[18][19][36]. In addition, they participate in group activities such as bingo or card games [39,49,52]^[18][21][24]. These findings highlight the complex nature of SB in the elderly, which involves a mix of individual preferences and social dynamics. They offer valuable insights into the motivations and preferences of older people with respect to SB. Participation in solitary activities provides people with personal pleasure and mental stimulation while remaining sedentary. Given the unique daily routines and contextual factors relevant to older adults, it is possible to adapt interventions to the specific challenges of this population. These interventions can include a variety of strategies, such as promoting active alternatives to sedentary activities during specific time periods, encouraging social engagement that includes physical activity, and modifying the home environment to allow for more physical activity while reducing opportunities for prolonged sitting. The valuable findings from the qualitative research serve as the basis for developing interventions that are contextual and tailored to the needs of older adults, with the ultimate goal of reducing SB in this population.

2.3. The Dual Nature of Sedentary Behavior: Perceived Benefits and Drawbacks

A review of the qualitative literature on SB among older adults uncovered another theme related to perceptions of the advantages and disadvantages of being sedentary. Older adults were found to have unique perspectives and motivations that shape their participation in SB, and their self-perceived level of activity or inactivity has a profound impact on their interpretations. In addition, their understanding of SB was influenced by the cultural and social context in which they live, as well as their awareness of the health implications associated with it [54]^[32]. Therefore, it is critical to explore their perspectives in order to develop effective and sustainable approaches that promote active aging and improve overall health outcomes. Overall, older adults perceive the negative effects of SB primarily on their health, including poor mental health, social isolation, increased risk of disease, loss of muscle mass and strength, poor circulation, and decreased independence and mobility [9,39,49,52,58]^{[9][18][21][23][24]}. Perceptions that excessive sitting is unhealthy are primarily associated with short-term consequences such as increased pain and stiffness, difficulty getting up from a seated position, and risk of falling asleep while sitting [39,49,52,56]^{[16][18][21][24]}. Older adults also express concern about long-term consequences, including weakened bones and muscles [52]^[24], impaired heart health, and weight gain [56]^[16]. These physical limitations are attributed to the natural aging process and are recognized as factors that prevent them from engaging in more active activities [49]^[18]. It is, therefore, imperative to raise awareness of the health risks associated with SB and educate people about the methods and benefits of reducing this behavior. However, Leask and colleagues [46]^[37] emphasize that people who are unaware of or do not fully understand the consequences of their SB are unlikely to be motivated to reduce it. It is important to recognize that not all SB should be demonized, as some sedentary activities can be useful and enjoyable for individuals.  Interestingly, McGowan and colleagues ^[9] observed that older adults are aware of the reciprocal relationship between prolonged SB and its negative effects on well-being. Participants recognized that factors such as depression and poor health may contribute to their tendency to sit and spend time indoors. However, they also acknowledged that continued inactivity further exacerbated their depression and health problems, creating a self-reinforcing cycle. While participants showed understanding of the potential benefits of reducing SB, there was some ambiguity between reducing SB and increasing physical activity. When it came to reducing SB, they cited several benefits, including improved social interaction, mobility, strength, lower blood pressure, improved circulation, distraction from pain, improved sleep quality, increased mental well-being, and improved cognitive performance. Participants who were already very physically active, however, saw fewer benefits of reducing SB alone and believed that simply moving around the house would not provide significant benefits. Engaging in sedentary activities also provides older adults with opportunities to meet new people and make friends. Social engagement is seen as a way to prepare for the future, especially for those who are aging and no longer have children at home. The social aspect of sedentary activity plays a critical role in providing companionship and support during life transitions [49]^[18]. These findings underscore the importance of considering the benefits and meaningfulness of SB when developing interventions to reduce SB among older adults. In addition, sedentary activities give structure to the day, especially after retirement [52]^[24]. Older adults emphasize that any form of activity, regardless of its type, gives them a sense of purpose and motivation to start their day and fill their time. These activities can provide cognitive and physical benefits and give meaning to their daily lives [49]^[18]. Older adults tend to prefer busyness over idleness and associate negative traits such as laziness and passivity with prolonged sitting. They actively distance themselves from the idea of being lazy and emphasize avoiding passive sitting. These findings suggest that older adults rationalize and justify their sitting behavior based on cultural norms and personal values. They emphasize the importance of engaging in meaningful activity while sitting and discourage prolonged passive sitting [54]^[32].

2.4. Delving into Sedentary Behavior: Determinants and Discouraging Factors

Analysis of the factors that either discourage or promote SB in older adults is a topic of great importance in the field of aging and health research. Understanding these factors can provide invaluable insight into the complicated nature of SB in older adults and ultimately aid in the development of interventions to promote more active lifestyles in this population. Given the growing recognition that prolonged sitting has detrimental health effects and the increasing prevalence of a sedentary lifestyle in older adults, it is imperative to further explore the underlying influences that contribute to SB. By uncovering the complex interplay of these factors, researchers and clinicians can develop effective strategies to address SB and facilitate meaningful behavior change in older adults. Consequently, this comprehensive understanding holds great potential for promoting successful aging and reducing the burden of chronic disease often associated with SB.

2.4.1. Determinants

SB in older adults is influenced by a variety of factors that include personal, interpersonal, and environmental dimensions [39]^[21]. Recognition of these distinct categories is consistent with socio-ecological models [76]^[38] that emphasize the complex interplay between behavior and its surrounding influences [17,77]^[39][40]. Promoting active lifestyles and reducing SB require a comprehensive approach that considers the multifaceted nature of SB. In a personal context, physical health problems contribute to the prevalence of SB in older adults [39,43,50,52]^{[21][24][31][41]}. For example, chronic diseases such as arthritis often trigger SB, as symptoms such as pain and stiffness discourage physical activity and encourage SB [39]^[21]. Fatigue and low energy levels may also discourage physical activity and contribute to SB. Another factor is a lack of awareness of the negative health effects of prolonged sitting and the importance of regular physical activity in daily life [43]^[41]. This lack of awareness may be further influenced by mobility problems, cognitive decline, and depression, which affect decision making regarding physical activity [50,52]^[24][31]. Other factors influencing SB include a lack of motivation, a tendency toward laziness, difficulty interrupting sedentary activities with short breaks, and fear of falling or injury [44,49,51]^[18][22][42]. Negative attitudes about aging also play a role in SB [44,49,51,55]^{[18][22][42][43]}. Financial costs, enjoyment of sitting, mental stimulation from sedentary activities, ingrained habits, and limited knowledge of available programs are other personal factors that may contribute to SB [43,55,59]^[17][41][43]. These personal factors significantly influence the decision-making process and may contribute to the adoption of SB. In the interpersonal domain, negative age-related stereotypes associated with decline, devaluation, and passivity have been identified as factors promoting SB in older adults [39,49,51,55]^{[18][21][42][43]}. Lack of companionship and overworked caregivers are also SB determinants. In addition, loss of social contact due to health problems or relocation of friends may lead to SB and social isolation [50,53]^[31][36]. While social norms and everyday tasks such as housework and caregiving encourage standing activities that promote self-efficacy and independence, concerns about burdening family members or caregivers may limit older adults’ engagement in these activities.  To promote positive outcomes in the self-assessed health of older adults, it is important to implement person-centered goal setting that empowers them to make decisions about their preferred activities. By targeting the specific areas of their daily routines where they are most likely to reduce SB, individualized approaches can be effective.  Reducing SB can also be challenging due to time constraints resulting from personal or interpersonal issues. Many people struggle to find time for exercise amid their busy schedules, caregiving responsibilities, and other commitments. Similarly, social pressures and prevailing societal norms often prioritize sedentary activities over active ones, making it difficult for people to prioritize physical activity in their daily lives. Lack of support may further hinder efforts to adopt a more active lifestyle. Without the necessary encouragement, guidance, or a supportive environment, individuals may find it difficult to persevere with behavior change and overcome barriers.  The analysis of the factors that determine SB in older adults is consistent with the Capability, Opportunity, Motivation, and Behavior (COM-B) model [82]^[44]. This model emphasizes the role of individual capability (both physical and psychological), opportunities (both social and physical), and motivations (both automatic and reflective) in shaping behavior. Regarding capabilities, age- and health-related decline in physical ability has been identified as a major cause of SB among older adults. This decline limits their ability to stand for extended periods of time or engage in moderate to vigorous physical activity. In addition, there is a lack of awareness of the negative health effects of prolonged sitting. The opportunity component of the COM-B model emphasizes the influence of the physical, cultural, and social environment on behavior. Environmental factors, including weather conditions, were also found to play a role in influencing SB. These findings demonstrate the importance of considering external factors in addition to individual motivation and capability when attempting to reduce SB. By considering environmental factors, such as providing indoor alternatives for exercise during inclement weather or creating comfortable outdoor spaces, people can be encouraged to be more active. 

2.4.2. Discouraging Factors

Reducing SB in older adults is a multifaceted process influenced by several factors. One critical aspect is the varying opinions and attitudes of older adults about the benefits of reducing SB. While some individuals express willingness and interest in reducing SB, others may believe that their age entitles them to maintain a sedentary lifestyle. Skepticism about the benefits of standing more and concerns about disrupting daily routines are also common. However, amidst these differing opinions and concerns, it appears that many older adults have a clear interest in changing their sedentary habits and incorporating more standing activities into their daily routines while they still have the ability to prioritize rest and flexibility [39]^[21]. Motivators for reducing SB in older adults include a desire for better health, increased awareness of SB, ease of integrating changes into daily life, and a desire to maintain independence and functionality [40,43,55]^[41][43][45]. Older adults place a high priority on remaining mentally and physically active to maintain overall well-being. Sedentary activities that provide social interaction, cognitive stimulation, or relaxation are highly valued, whereas passive television viewing and purposeless sedentary activities are considered of little value [53]^[36]. Participation in meaningful activities and a sense of purpose are considered essential [50,53]^[31][36]. The social and physical environment has a significant influence on SB in older adults. Research shows that affluent neighborhoods that offer more opportunities for community engagement tend to have lower rates of SB than disadvantaged neighborhoods with limited opportunities. In addition, social support and a sense of connection to the community play a critical role in encouraging older adults to participate in non-sedentary activities [50]^[31]. Strategies commonly cited by older people to reduce SB include creating opportunities for social engagement, ensuring safe environments and transportation, tailoring activities to individual preferences, and fostering a sense of caring for others. Alternatives to sitting, such as gardening, dancing, or shopping, are considered more effective than focusing solely on reducing sitting. Support from family, friends, and peers is considered beneficial.  Promoting active aging and reducing SB among older adults can be supported by a range of interventions that focus on increasing the availability, accessibility, and awareness of key resources. Effective strategies include removing financial barriers, improving transportation options, creating an age-friendly physical environment, and fostering social relationships [50]^[31]. A comprehensive social-ecological approach [76]^[38] is critical to addressing SB in older adults because it recognizes the interplay of multiple factors that influence behavior. Elements such as the physical environment, social engagement, community meals, organized activities, access to transportation, and community involvement all play important roles in reducing SB [58]^[23].  In summary, when examining the factors that influence SB in older adults, it is important to consider a number of aspects. These include exploring multiple perspectives, understanding individual motivations, recognizing the importance of meaningful activity, examining the influence of the social and physical environment, acknowledging support systems, and considering personal beliefs. Interventions that are tailored to individuals’ preferences, provide enjoyable alternatives to sitting, and consider the barriers and facilitators within the social-ecological framework [76]^[38] have been shown to reduce sedentary time and promote active lifestyles in older adults [58]^[23].

2.5. Breaking the Sedentary Spell

While most research on SB has focused primarily on quantitative studies, there are a limited number of qualitative studies that have addressed the intricacies and complexities of interventions targeting SB in older adults. These qualitative studies address three critical aspects of SB interventions: the motivators and barriers that influence older adults’ participation in SB reduction programs, the outcomes of these interventions, and older adults’ suggestions for improving interventions. By examining the subjective experiences, perceptions, and contextual factors associated with SB interventions, these studies provide insights that complement quantitative data.

2.5.1. Barriers and Facilitators to Participating in Sedentary Behavior Interventions

Older adults’ participation in SB reduction programs is influenced by a number of barriers and factors that greatly affect their interest in such interventions. Therefore, it is critical to understand these factors in order to develop effective strategies to promote active aging and successfully reduce SB in this population. Some studies have examined these factors to gain insights and develop evidence-based approaches to promote sustained participation and achieve positive outcomes in SB reduction programs for older adults. Participation in SB reduction programs may be hindered by several obstacles. One major barrier is fear of physical limitations and age-related safety concerns. Older adults may be concerned about their health or have physical limitations that prevent them from participating in SB reduction programs. They fear that participation in such programs could lead to injury or exacerbate their existing health problems. This fear stems from the idea that their bodies may be more vulnerable to strain or injury as they age [50,54]^[31][32]. Lack of motivation, a strong preference for sedentary activities, and deeply ingrained sedentary habits are also significant barriers for older adults to reduce their SB. Some studies have shown that it is difficult to motivate older adults to change their SB because they enjoy sedentary activities such as reading, watching television, or hobbies that require little physical exertion [42,43,47,48,60]^{[41][46][47][48][49]}. Therefore, it is important to find alternative, non-sedentary activities that are enjoyable and personally meaningful to older people. By providing such activities, we can encourage them to replace sedentary activities with more active ones without feeling deprived or unfulfilled. Additionally, lack of time and family obligations hinder older adults’ participation in SB interventions. They often have busy schedules that revolve around caring for loved ones, maintaining social relationships, or meeting other family obligations. These time constraints and family obligations limit their time and energy for actively participating in SB reduction programs or incorporating physical activity into their daily routines [42,43,47,48,60]^{[41][46][47][48][49]}. Limited social support and a lack of a support network may further hamper older adults’ participation in SB reduction programs. One of the biggest challenges is that older adults may not have friends or family members who share similar goals and interests in reducing SB. The lack of a support network makes it difficult for them to find guidance and encouragement on their SB reduction journey, resulting in lower motivation and poorer adherence to the program. In addition, the lack of a support network can lead to a lack of accountability, as there is no one to check progress, celebrate successes, or provide gentle reminders when motivation wanes [42,43,47,48,60]^{[41][46][47][48][49]}.  Societal expectations and norms may also act as barriers to reducing SB in older adults. The prevailing perception that SB is acceptable and appropriate for older people may contribute to a lack of motivation or social pressure to maintain a sedentary lifestyle [42]^[46].  Environmental barriers may pose an additional challenge for older adults to participate in SB reduction programs. Limited access to recreational facilities may prevent them from engaging in physical activity and finding appropriate alternatives to sitting [43]^[41].  Another barrier for older adults is limited access to professional educators who can provide guidance and support. The availability of qualified professionals who can guide and support older adults in adopting healthier behaviors may be limited, especially in certain communities or health care settings. This lack of guidance and support may prevent older adults from overcoming barriers and implementing effective strategies to reduce their SB ^[48]. Social support is widely recognized as a critical factor supporting people’s efforts to reduce their SB. Studies have shown that supportive relationships with family members, friends, or peers who participate in active behaviors have a major impact on motivation and adherence to SB reduction programs [42,43,47,48]^{[41][46][47][48]}. These relationships provide valuable elements such as encouragement, accountability, and a sense of belonging, and make the process of behavior change more enjoyable and sustainable. In addition, engagement and participation in SB reduction programs can be increased by providing activities that are enjoyable and have personal meaning. When interventions are tailored to individual preferences and provide opportunities for social interaction and cognitive engagement, this can increase intrinsic motivation and boost participation rates. These findings are consistent with self-determination theory [83^[50][51],84], which emphasizes the importance of autonomy, competence, and connectedness for behavior change [51,78]^[42][52]. By identifying and addressing individual needs and preferences, programs can be tailored to different fitness levels, interests, and goals, maximizing their effectiveness.

2.5.2. Impacts of Sedentary Behavior Interventions

Qualitative research examining the experiences of older adults in SB reduction programs has provided valuable insights into the factors that contribute to their engagement and success in these interventions. A key finding from these programs is that participants have developed a greater awareness of the negative consequences of SB, which has led to greater motivation to make positive lifestyle changes and find simple ways to reduce sitting time. Realizing the importance of being active and the impact SB has on their health was a driving force for their participation [42,43,47,48]^{[41][46][47][48]}. In a study led by Greenwood-Hickman and colleagues [43]^[41], overweight and obese older adults participated in a program that resulted in significant changes in their daily routines and exercise habits. Participants reported spending more time standing, especially during sedentary activities such as watching television. They actively built in breaks from sitting, which led them to engage in various activities and chores throughout the day.  Participation in these SB reduction programs had a positive effect on the physical and mental health of the older adults. They further perceived the health benefits of the program, supported by their belief in its effectiveness. Reported improvements included higher energy levels, mobility, flexibility, strength, pain management, reduced stiffness, balance, sleep quality, and overall physical fitness. In addition to the physical benefits, social support and a sense of engagement within these programs emerged as critical factors for older adults. The group settings created a supportive and inclusive environment in which participants felt a sense of belonging. They valued the opportunity for social interaction and formed meaningful friendships with both their peers and program leaders [43]^[41]. This social support network played an important role in maintaining their motivation and commitment to the program as participants received encouragement and inspiration from their peers and leaders. Participation in these programs not only promoted social contact, but also counteracted social isolation as older adults participated in group activities, interacted with peers, and pursued common goals [43,48,60]^[41][48][49]. Tailored and enjoyable activities were highly valued by participants as they contributed to sustained engagement and motivation. Participants appreciated interventions that offered a variety of activities tailored to their specific needs and preferences, allowing them to select activities that matched their interests and abilities. This personalized approach increased their satisfaction with the programs and the overall experience. These findings underscore the importance of a personalized approach to intervention acceptance and participation.

2.5.3. Interests and Preferences for a Sedentary Behavior Intervention

Recent studies have begun to examine older adults’ perspectives on interventions to reduce SB. While previous research has focused primarily on quantitative measures, qualitative studies offer valuable insights into the suggestions and preferences expressed by older adults themselves. This section summarizes the findings of qualitative studies that have examined older adults’ interests and preferences regarding interventions to reduce SB. The results of the studies highlight important recommendations from older adults on strategies to reduce SB. Tailored interventions that address individual abilities emerge as important [42,45,46,47,48,56]^{[16][37][46][47][48][53]}. Older adults emphasize the need for personalized approaches that consider their unique circumstances and motivations. They recognize the significant differences between different situations, such as age, and emphasize the need for multiple solutions to meet different preferences [45]^[53]. Overall, it is paramount to develop tailored interventions that fit seamlessly into the lives of older adults and provide them with the education, resources, self-monitoring tools, goal setting, and assessment they need to effectively reduce their SB [46]^[37]. By applying the COM-B model [82]^[44] in this context, one can gain insight into the various factors that contribute to behavior and explore the assets that individuals possess in terms of their abilities, opportunities, and motivations. For example, in the context of SB, individuals have the ability to interrupt sitting if they want to reduce their stiffness or if they do not value a particular sedentary activity. The ability to interrupt SB can take several forms, including social options such as getting up to answer the door or physical options such as taking medication. These findings underscore the importance of considering multiple options appropriate to the context of SB. Providing a range of options that can be used at different times of the day and for different reasons can help people reduce SB. Educational components also play a critical role in interventions. Research studies have shown the importance of providing information about the health benefits associated with reducing SB and offering practical tips and strategies to incorporate physical activity into daily life [45,46]^[37][53]. Older adults express that they need this knowledge because it enables them to make informed decisions and take control of their own health. When they understand the potential positive effects of reducing SB and have access to practical guidance, older adults are more likely to be motivated and able to change their sedentary habits. Educational components provide the necessary foundation for older adults to actively engage in SB reduction programs and increase their self-efficacy and confidence in healthier behaviors. It is important to educate people about the health risks and benefits of reducing SB, but this should occur in a way that considers their understanding and motivation. Incorporating social interaction into programs for older adults is of paramount importance, as shown by some studies [42,46,47,48,56,60]^{[16][37][46][47][48][49]}. These studies show that older adults want programs that provide group activities and promote social interactions. Such programs not only help reduce sedentary activities, but also foster social relationships and combat feelings of isolation and loneliness. It is evident that enjoyable and engaging activities that promote social interactions are highly valued by older adults. Program accessibility and convenience are critical factors influencing participation. Older adults prefer on-site programs that are easily accessible and meet their specific mobility needs. Flexible scheduling of activities based on individual preferences and daily routines is also important for engagement [60]^[49]. Convenience and simplicity are highlighted as important factors in activity design. Older people want individualized adaptations and options based on their preferences and activity levels. Key features include goal setting, notifications, self-monitoring, ease of use, and social support [56]^[16]. Older adults’ views on the use of technology in interventions to reduce SB have been explored in some studies that offer valuable insights into their preferences. Matson and colleagues ^[47] conducted a study that focused on obese older adults and their perceptions of a technology-based SB reduction intervention. Participants in thise study expressed positive attitudes toward the intervention and considered it acceptable and easy to incorporate into their daily lives. A similar study by Trinh and colleagues [56]^[16] with prostate cancer survivors receiving androgen deprivation therapy found that some men were initially hesitant to use the SB technology for weight loss. However, after understanding that the intervention would be tailored to their needs and preferences, they expressed interest in trying it. Participants indicated a preference for wearable devices such as tablets or cell phones to deliver the intervention. In contrast, Leask and colleagues [45]^[53] found that participants preferred non-technological methods to change their SB. They cited previous negative experiences and concerns about discomfort and unwanted attention as reasons for their preference. Tangible approaches, such as keeping a diary to track activity, were preferred to technological solutions. These studies highlight older people’s differing views on the use of technology in SB reduction interventions. While some people are reluctant or prefer non-technological methods, others find technology-based interventions acceptable and easy to integrate into their lives. Therefore, it is important to consider individual preferences when developing interventions to reduce SB in older adults. In summary, interventions to reduce SB in older adults should emphasize individual adaptation, social interaction, choice, and education. By incorporating these elements, programs can effectively address the individual needs and preferences of older adults, promote active aging, enhance well-being, and empower individuals to adopt and maintain healthier lifestyles. A person-centered, inclusive approach to developing and implementing programs to reduce SB is critical to the success and long-term impact of these interventions.