METHODS article
Front. Public Health
Sec. Aging and Public Health
This article is part of the Research TopicThe Role of Physical Activity in Healthy Aging: Mechanisms and InterventionsView all 20 articles
Developing a Theory-Based Intervention to Enhance Physical Activity in Older Adults with Atrial Fibrillation and Frailty: A Behavior Change Wheel Approach
Provisionally accepted
- Qingdao University Medical College, Qingdao, China
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Background：Physical activity is often insufficient in older adults with atrial fibrillation (AF) and frailty. Regular physical activity is crucial for these patients as it can improve AF symptom severity, enhance quality of life, delay frailty progression, and reduce the national healthcare burden. Theory-based behavior change interventions are necessary to promote physical activity. This study aimed to develop an intervention guided by the behavior change wheel (BCW) theory to improve physical activity in older patients with AF and frailty. Methods：Our study used a framework based on BCW theory to develop a behavior change intervention in eight steps. We conducted semi-structured interviews to identify the determinants of physical activity in older patients with AF and frailty, using the capability, opportunity, motivation, and behavior model and the theoretical domain framework. Appropriate intervention functions and policies addressing these determinants were selected based on the affordability, practicality, effectiveness, acceptability, safety, and equity (APEASE) criteria. Finally, suitable behavior change techniques (BCTs) were selected to translate the intervention functions into specific intervention content. Results：Our study identified 12 factors that promote and 12 factors that hinder physical activity. Based on these factors, we selected seven intervention functions and 15 BCTs, all meeting the APEASE criteria. We used a software application as the delivery mode. Finally, we developed behavioral change interventions for older patients with AF and frailty to increase physical activity levels and compliance. Conclusions：The BCW provides a systematic approach to designing behavioral change interventions that can improve physical activity, delay frailty in older patients with AF, and reduce healthcare burdens. Our findings indicate that interventions should focus on enhancing disease knowledge, teaching physical activity skills, providing social support, and using appropriate BCTs in older patients with AF and frailty. Our next step will be to conduct a feasibility study to assess the acceptability and effectiveness of these intervention programs.
Keywords: AF, physical activity, Moderate exercise, Behavior change wheel, Frailty
Received: 07 Aug 2025; Accepted: 14 Nov 2025.
Copyright: © 2025 zhe, Xi, xin, nan, Liu and guy. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: yang fu guy, yfuguo@126.com
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