Understanding Goal Setting and Behavior Change Mechanics in an Older Adult Sitting Reduction Intervention

Purpose We explored intervention fidelity, participant satisfaction, and the goals and reminder strategies participants chose to reduce sitting. Approach Mixed methods approach leveraging data collected during study coaching and fidelity monitoring. Setting A successful 6-month randomized controlled trial of a sedentary behavior (SB) intervention for adults ≥60 years in Washington, USA. Participants N = 283 (140 intervention, 143 attention control); mean age 69, 66% women, 69% Non-Hispanic White. Intervention Theory-based SB reduction intervention structured around phone-based health coaching and goal setting. Attention control received equal coaching on non-SB health topics. Method Coaches tracked all participant goals, and 8% of visits were randomly observed and fidelity coded using a structured template. Participants completed a satisfaction questionnaire at study end. Goals data were qualitatively grouped by reminder strategy and topic. Fidelity and satisfaction data were summarized and compared by study arm using two-sided paired t-tests. Results Both participants’ satisfaction (>90% satisfied, between-group P = .195) and coach fidelity to intervention content and techniques were high (96% sessions set SMART goals, P = .343) across both arms. Intervention participants primarily set goals leveraging outward (e.g., fitness band prompts) and habit (e.g., adding standing to a daily meal) reminder strategies highly tailored to individual preferences and lifestyle. Conclusion Participants’ SB-related goals varied widely, suggesting tailored intervention approaches are important to change sitting behavior, particularly for older adults with chronic conditions.