Mechanisms Leading to Sedentary Behaviors among Older Adults in Chinese Residential Care Homes: The Capability, Opportunity, Motivation-Behavior Model Guided Structural Equation Modeling

Objective

To evaluate sedentary behaviors among older adults in residential care homes and explore potential mechanisms leading to sedentary behaviors based on the Capability, Opportunity, and Motivation to Behavior (COM-B) model.

Design

Cross-sectional study.

Setting and Participants

We collected data from 329 residents who lived in 11 residential care homes in China.

Method

We collected self-reported survey data on resident demographics, sedentary behavior, activities of daily living (ADLs), social support, exercise self-efficacy, and depressive symptoms. Mean and standard deviation were used to describe the sedentary behavior of older adults in care homes. We drew on the COM-B model and constructed a structural equation model to assess the interrelationships of ADLs, social support, exercise self-efficacy, depressive symptoms, and sedentary behavior.

Result

The average daily sedentary time of older adults in our sample was 11.4 hours (SD = 2.6). Social support not only directly influenced sedentary behavior of older adults in care homes (β = 0.042; P = .039; 95% CI, −0.054 to −0.031]), but also indirectly through exercise self-efficacy (β = 0.003; P < .001; 95% CI, −0.023 to −0.011]) and depressive symptoms (β = 0.003; P < .001; 95% CI, −0.018 to −0.006) affected sedentary behaviors. ADLs indirectly affected sedentary behaviors through exercise self-efficacy (β = 0.029; P < .001; 95% CI, −0.220 to −0.107) and depressive symptoms (β = 0.099; P < .001; 95% CI, −0.161 to −0.053).

Conclusions and Implications

The high levels of sedentary behaviors among our sample of residents warrant awareness among long-term care staff and managers. Potential strategies for reducing sedentary behaviors include promoting social support, enhancing exercise self-efficacy, and managing depressive symptoms.