Participant characteristics
The group comprised six older adults and two researchers (RT and SAH/SK). A total of 23 older adults met the eligibility criteria. The most frequently cited reasons for refusing to participate included a lack of interest (n = 9), other commitments (n = 5), and transport difficulties (n = 4). The demographic characteristics of the recruited participants are provided in Table 1. Participants had an average age of 83, five members were male (80%), and participants’ sedentary time ranged from 4 to 13 h per day.
Overview of findings
This analysis, informed by the ecological model of sedentary behaviour and the COM-B model of behaviour, identified the types of sedentary activities participants engaged in, and their perceived barriers and facilitators to reducing sedentary time. These frameworks aligned to the Behaviour Change Wheel used to guide the intervention development process [17], and provided insights into how sedentary behaviour in this population is shaped by individual, social and environmental influences. Several analytical themes emerged from this process, including shifting perceptions of sedentary behaviour throughout older adulthood, the impact of daytime sleeping on energy levels, and how social influences can promote or discourage sedentary lifestyles. These themes highlight the complex interrelationship between personal, social, and contextual factors that influence sedentary behaviour in older adults.
Descriptive theme: activities performed in sitting
Sedentary activities, mostly leisurely and home-based, were mapped to the ecological model of sedentary behaviour [31]. The reported sedentary and non-sedentary activities are provided in Table 2.
Descriptive theme: barriers and facilitators to reducing sedentary behaviour
The barriers and facilitators to reducing sedentary behaviour were charted to the COM-B Model of behaviour change (Table 3) and are described narratively below.
Physical capability
Pain, fatigue and physical health problems contributed to participants’ sedentary behaviour. Participants perceived this decline as age-related and that their sedentary behaviour had increased throughout older adulthood. Members still performed non-sedentary activities but would perform them for shorter durations or replace them with less taxing activities. Some members recognised that prolonged sitting contributed to their pain and stiffness, and reducing sedentary behaviour may improve this.
Psychological capability
Members reported that their mental health, particularly feelings of depression and anxiety, increased their sedentary behaviour. When present, members described having little motivation to engage in physical activities, instead opting for sedentary endeavours. Members also described older adults that they knew who found it difficult to leave their homes for fears of falling or following the bereavement of a spouse. Conversely, members described how reducing their sedentary time, particularly through social activities, improved their overall mood.
Physical opportunity
Participants identified barriers to reducing sedentary behaviour at home and in the external environment. Home-related barriers included lack of space, (single-storey dwellings) and the implications of downsizing the home in later life. External barriers explored how public transport, neighbourhoods, poor weather, and financial constraints contributed to increased sedentary behaviour. Home-related facilitators included the presence of stairs, larger living areas and garden access can reduce sedentary behaviour. External facilitators which promoted the reduction of their sedentary time included employment or volunteering, affordable public transport, enticing and affordable local facilities, and outdoor seating in public areas.
Social opportunity
Participants described the impact of retirement on sedentary behaviour. For some members, their work was active, and upon retiring, they continued performing non-sedentary activities which they enjoyed that kept them active. Others described using volunteering to mitigate the loss of role following retirement, as it would provide the necessary structure and organisation to their day whilst discouraging sedentary behaviour. Although not applicable to the members, social isolation was described as promoting sedentary behaviour in older adults, with participants discussing older adults they knew who were socially isolated and would use sedentary activities to pass their day. Additionally, the impact of bereavement on social support networks and social opportunities was discussed. Social support from family and friends was an important facilitator in reducing their sedentary time.
Reflective motivation
Participants described how they did not consider their sedentary time, were largely unaware and unconvinced of the negative health consequences of their sedentary behaviour, nor the benefits of reducing their sedentary time. Some members were aware of the consequences of prolonged sedentary time and could reason that reducing their sedentary time may improve their health. Additionally, upon being presented with the evidence, participants were amenable to reducing their sedentary behaviour if it would improve their well-being.
Automatic motivation
Members expressed how established routines contribute to prolonged uninterrupted sitting, particularly in the evenings. These habits were firmly ingrained in their daily lives and oftentimes included sedentary activities which they enjoyed and had little interest in changing. Conversely, some members described being habitually active following employment in non-sedentary jobs. Necessary activities of daily living such as preparing food, drinking, and getting medication were motivators to interrupting their sedentary behaviour.
Analytical themes
Theme 1: perspectives on sedentary behaviour throughout older adulthood
Participants’ perspectives on sedentary behaviour evolved throughout the discussions, which highlighted the complexity of its meaning and perceived implications across older adulthood. Initially, sedentary behaviour was often described in simple, or negative terms such as “sitting doing nothing” (P5-84 M-MoF). However, other participants introduced nuance by distinguishing between passive and mentally engaging sedentary activities, such as reading, sewing and knitting: “To be sitting occupied. Yeah, reading something… I wouldn’t want to sit a long time. Just sitting. If I was sitting sewing, I’d have accomplished something” (P1-83 F-MF).
Technology was a common point of reference in some participants’ conceptualisation of sedentary behaviour, being described as a contributor to prolonged sedentary behaviour: “I have often heard it linked to modern technology and worries about by individuals who seem to experience it directly, as for being glued to the computer but perhaps it’s inevitable.” (P6-83 M-MF). Technology was helpful in making group members more aware of their sedentary time, with two having experience with activity monitoring devices, however, the majority lacked awareness of their sedentary time: “I didn’t really think about the amount of time I spent sitting until was asked about it” (P5-84 M-MoF).
There was tension between participant’s awareness of their sedentary time, and their belief that being physically active during the day would counteract their sedentary behaviour: “I used to think if I’m active during the day, which I am that I’m doing well. I’m now reconsidering that. Only because I’ve read about this. Sitting and it’s not good for you.” (P1-83 F-MF). This view was predominantly held by group members who were more physically active, who weren’t convinced that sitting could be detrimental if otherwise active: “So I’d like to know how they come to the solution that is detrimental to anybody to sit?” (P4-82 M-SF).
Similarly, they questioned the health relevance of reducing sedentary time: “If you could prove to me that it is beneficial? And in what way would that be beneficial?” (P4-82 M-SF). Some members were aware of the health benefits of reducing their sitting time: “That must indicate that the longer you sit down that the less beneficial it is for your body?” (P3-82 M-Mod); whereas others were more amenable to change if supported by sources they deemed credible: “I would certainly if my doctor said I need to. Definitely. That’s for my health and well-being” (P1-83 F-MF). In the accompanying intervention development work, participants chose educational approaches delivered by credible sources (e.g. healthcare professionals) that addressed the distinction between physical inactivity, the health risks of prolonged sedentary behaviour and the benefits of reducing sedentary time.
Participants also believed that sedentary behaviour was a necessary component of their day during older adulthood: “I think as you get older, it’d be difficult. What could you do to keep moving? Sensibly like, what would they want us to do? Besides just sitting?” (P2-84 M-SF). They attributed this increase in sedentary time was a natural response to physical decline: “My Dad used to say the hills are getting steeper. And as I get older, I realise he wasn’t daft at all. I was the daft one.” (P6-83 M-MF). This decline resulted in them reducing the physical activities they enjoyed: “Twice a week we go out walking. And then I started to have problems with one hip, which led to another hip…over two years, we relinquished our membership of the walking club, we never really got back to long distance walking”. (P4-82 M-SF).
These physical limitations were compounded by age-related societal expectations: “She also comes by public transport as though we both come in by helicopters. Does nobody travel by bus? As though it was something quite, you know, extraordinary” (P1-83 F-MF). This quote illustrates the subtle social messaging that older adults should limit mobility or that remaining active is exceptional rather than normative. Additional perspectives on social influences on sedentary behaviour are provided later. This theme highlights how older adults’ perceptions of sedentary behaviour are influenced by their understanding, and are shaped by physical limitations, social norms and varying levels of understanding of the health consequences of sitting throughout older adulthood.
Theme 2: sleep and the energy balance
Although sedentary behaviour considers waking behaviours, participants described sleep and fatigue as key determinants of their movement and resting patterns. Fatigue, and disrupted sleep were described as normal features of ageing and framed as adaptive responses to changing energy demands and influenced their daily activity.
All participants reported experiencing daytime napping but had mixed perceptions of the activity. For some, it was something that was shameful or a source of embarrassment: “I suppose this is a confession. I hope I’m not being too awful. I tend to have a nap in the afternoon… you lot don’t” (P6-83 M-MF). Others viewed napping as an inevitable aspect of daily life: “I don’t avoid them, I can’t avoid them necessarily, it happens!” (P5-84 M-MoF). One participant reframed this rest positively by adopting terms such as “power nap,” often validated by advice from peers or health professionals: “I sometimes feel guilty over an afternoon nap. But a nurse friend of mine said don’t think that sleeping call it a power nap…” (P6-83 M-MF).
Sleep-related fatigue was associated with a number of causes, including poor nighttime sleeping: “I like to have a good night’s sleep I’m a really bad sleeper. It’d be nice if I woke up and felt refreshed” (P6-83 M-MF); medication side effects: “I have my breakfast, and I have my tablets and those tablets that I’ve got make you drowsy and I find I go off to sleep again having only got out of bed in an hour or so beforehand” (P5-84 M-MoF); or evening tiredness: “If I haven’t slept, I can sit down probably about half past five. And just nod off, you know, just go for about half an hour.” (P4-82 M-SF). This tiredness oftentimes affected participants’ activity planning: “I’ll sleep for half an hour or something like that. And then I feel awful because I wanted to get on or I wanted to go out” (P1-83 F-MF).
Post-nap experiences also varied considerably among participants. Some described napping as akin to pacing strategies, and was used to revitalise them physically: “When you’ve got a nap like that, even if it’s only for five minutes you find that that has revived you mentally physically for more than two-three hours” (P4-82 M-SF), whereas others felt disorientated and sluggish: “For a good 10 minutes, I feel dreadful and don’t know where I am when I wake up.” (P5-84 M-MoF). These accounts highlight how daytime napping can serve as a self-regulation strategy but may not always have positive outcomes, illustrating the importance of individual contexts in how sleep and fatigue influence sedentary behaviour. This suggests that both energy management and activity promotion should be considered when attempting to reduce sedentary behaviour in older adults.
Theme 3: sedentary behaviour and social connectedness
Throughout the series of focus groups, social connectedness emerged as a key influence on sedentary behaviour, potentially due to the group members being socially active. To participants, movement was seen as a means to facilitate social interaction, not just to meet a physical goal. Socially interacting with others can provide both motivation and opportunities for movement: “We’re social animals. We need each other. And to be with other people you have to make the effort to move, which means moving and getting up and getting out of the chair at home” (P6-83 M-MF).
The perceived benefits of social activity for healthy ageing were highlighted by participants: “I think being in the company of other people, whether old or young, preferably, the whole mix, I think it keeps you young” (P1-83 F-MF). Social interaction was described as a facilitator to reducing sedentary time and commonly arose through interactions with loved ones: “I have two sons that are married. With kids. It’s like almost having three houses now. Because I do the decorating, and all three, painting and everything. So you have the opportunity.” (P4-82 M-SF). Even if social activities were sedentary, participants could recognise how this reduced their sedentary behaviour: “I’ll do a sewing group. But you see, we’re sitting down with that. But even with that, commuting across and getting there” (P1-83 F-MF).
Conversely, the absence of social support was seen as a barrier to reducing sedentary, especially among those who lived alone: “Yeah. Difficult. Because there’s nobody there to disturb you.” (P1-83 F-MF), one participant replied when asked about the impact of living alone. Other barriers included reduced social support due to bereavements in their social network, which was reported by all participants and contributed to declining physical and social activity: “I think one of the worst things is that when you reach our age. You lose some of your close friends.” (P4-82 M-SF). Participants noted that loneliness was increasingly common following the COVID-19 pandemic: “What struck me was the number of people that said they felt so lonely” (P6-83 M-MF). In the absence of this social interaction, older adults can readily find themselves becoming socially isolated: “I do know people that do just sit and sort of look out the window because they don’t know what to do, they have no hobbies” (P1-83 F-MF).
Although discussions were initially framed around sitting, by the end of the focus group series, participants began to recognise the broader psychosocial factors that influence sedentary behaviour: “Although this is on the surface, about physical acts, sitting down, actually it’s about the way we think and act, isn’t it?” (P6-83 M-MF). Participants did not view excessive sedentary behaviour as a purely physical issue, but instead, as an interaction between physical, social and mental well-being: “We could separate social care, from physical and mental challenges, but we shouldn’t really separate them, because it’s all a part of us, in our minds and our bodies and our circumstances.” (P3-82 M-MoF). Social contact, even when sedentary, provided both meaning and satisfaction to participants’ lives: “I’m always pleased when I get home that I’ve been in the company of people” (P1-83 F-MF). Social interaction was also described as beneficial for wellbeing, and a lens through which activities were experienced: “I think it’s, it’s quite apparent that being in other people’s company is really, really beneficial” (P6-83 M-MF). These findings highlight the interactions between social connectedness and sedentary behaviour in community-dwelling older adults, suggesting that promoting social engagement may be important for reducing sedentary behaviour in this population.