Background. Sedentary behaviour (SB) is an important risk factor for several health-related outcomes. The prevalence of SB is alarmingly high in older adults, who spend on average 9.4 h being sedentary each day, making them the most sedentary of all age groups. Objectives. The primary objective of this review is to assess the impact of interventions aimed at reducing SB in older adults (aged 60 years and older) living in long-term care facilities (LTCFs). The research question for this systematic review is as follows: in older people living in LTCFs, do interventions aimed at reducing SB, compared to usual care, result in a decrease in SB daily time or a reduction in the length of prolonged and uninterrupted sitting bouts? Data sources. Only peer-reviewed articles will be included in this systematic review, articles will be identified using the PICO method in seven different databases. Participants and interventions. Any primary intervention study (including randomized controlled trials, non-randomized controlled trials, and cohort studies) with the aim to reduce SB daily time or shorten the length of prolonged and uninterrupted sitting bouts in older adults living in LTCFs will be included. After searching databases, abstracts of the studies will be screened, and, after retrieving full text articles, data extraction will be conducted by two independent reviewers. Study appraisal and synthesis methods. The review will adhere to PRISMA reporting guidelines. Risk of bias (RoB) will be assessed using ROBINS-I or the RoB 2.0 tool and will be discussed with a third reviewer. The data will be grouped according to study design, with separate analysis for randomised and non-randomised designs. Results. The primary outcomes will be SB or time spent sedentary, assessed before and after the intervention. For the outcomes with the same measurement units, the pooled mean differences will be calculated. Standardised mean differences will be calculated for the outcomes with different measurement units. The data not suitable in numbers will be synthesised narratively. The strength of evidence of the outcomes will be assessed using GRADE assessment. If the data are suitable for quantitative analysis, we plan to use the Revman software to conduct a meta-analysis. Conclusions and implications of key findings. This protocol can serve as a valuable resource for other researchers interested in conducting similar systematic reviews or meta-analyses in the field of SB and older adult health.

Introduction Programmes for older people aimed at increasing physical activity (PA) and reducing sedentary behaviour (SB) traditionally focus on achieving functional and health improvements. Focusing on enjoyment and social inclusion could strengthen adherence and help reach older people with social disadvantages. The aim of this study is to assess the feasibility and acceptability of the Join4Joy approach in PA programmes and its assessment tools. Methods and analysis A multicentric, pragmatic, pre-post feasibility study using mixed methods will be conducted. The intervention will consist of a PA programme boosting enjoyment and social inclusion, grounded on a co-creation process. Trainers will offer twelve, 1-hour weekly sessions of structured, supervised, group-based PA. Participants will be encouraged to increase activity in daily living. 144 older people will be recruited from the community and nursing homes in Spain, Denmark, Italy, Germany, and France. Additionally, participants and trainers will be invited to join virtual communities of practice to share their experiences across settings and countries. Qualitative procedures will be used to explore the acceptability of the design via interviews and focus groups with participants and trainers. Quantitative methods will be used to assess uptake, adherence, retention, reach, satisfaction, enjoyment (PACES questionnaire), physical function (e.g., Short Physical Performance Battery), quality of life (EQ-5D-5L scale), perceived improvement (Patient Global Impression of Improvement scale-I), activities of daily living (Barthel index) and SB and PA patterns (IPAQ and accelerometry). The degree and type of participation in virtual communities of practice will also be assessed. SPSS software will be used for the analysis of quantitative variables. Qualitative data will be analysed using reflective thematic analysis following Braun and Clarke (2006). Ethics and dissemination A favourable report by the Research Ethics Committee of UVic-UCC (282/2023) was obtained on 26 June 26th, 2023. Participation and withdrawal will be voluntary. Participants’ (or their legal guardians’, when necessary) written permission will be required. Results of the study will be disseminated through publication of scientific articles, presentations at sport and health-related professional conferences and congresses, as well as through social media and via the Join4Joy website. Study registration ClinicalTrials.gov, NCT06100835.

UNSTRUCTURED Abstract Introduction: Urinary incontinence (UI) is the most prevalent pelvic floor dysfunction, with incidence increasing with age. Numerous studies have demonstrated the effectiveness of pelvic floor exercises in improving UI and reducing urine leakage. However, access to pelvic floor treatment remains limited due to barriers such as lengthy waiting lists and poor adherence to prescribed exercises. Digital solutions incorporating behaviour change techniques (BCTs) and gamification elements may support self-management of bladder health, particularly for individuals aged 50 and over who may face challenges in accessing conventional treatments. Methods: A rapid review was conducted to identify mobile applications and websites integrating BCTs and gamification elements to facilitate bladder health self-management among adults aged 50 and above. The search was initiated in July 2024 and updated in January 2025 across three sources: (1) mobile app stores (Google Play Store and Apple App Store in Spain, Lithuania, and the United Kingdom (UK)) using the keywords "pelvic floor," "urinary incontinence," and "bladder"; (2) websites (the first 80 results in Google for each country); and (3) academic databases (PubMed, Scopus, CINAHL, and Google Scholar) for journal articles, book chapters, and conference papers published in English, Spanish, or Lithuanian. Inclusion criteria required that solutions be independently usable without healthcare supervision, incorporate at least one BCT (e.g., training, education, monitoring, prompting), be evidence-informed (i.e., include participants aged ≥50 years in their design or piloting phase or explicitly target this demographic), and be available in Spain, the UK, or Lithuania. The Mobile App Rating Scale (MARS) was employed to assess app quality, and the taxonomy of 93 BCTs by Michie et al. was used for BCT classification. All review and data extraction processes were conducted in duplicate. Results: Twenty-one studies met the inclusion criteria, identifying eight eligible mobile applications and one website. Among the eight apps, only two were available on either Google Play or the Apple App Store. No apps were identified in Lithuania, whereas one was found in Spain and three in the UK. Of these, one UK app was accessible on both Google Play and the Apple App Store, while the others were limited to a single platform. The website search did not identify any scientifically validated platforms across the three countries, except for one website mentioned in a scientific publication. Conclusions: There is a limited availability of evidence-based digital solutions for individuals aged 50 and over. Existing applications suggest potential benefits in UI reduction and quality of life improvement; however, further research and development are needed to enhance accessibility and efficacy. Trial registration: The protocol for this review is registered on PROSPERO (Reference: CRD42024597624)

Background: Urinary incontinence (UI) is the most prevalent pelvic floor dysfunction, with incidence increasing with age. Numerous studies have demonstrated the effectiveness of pelvic floor exercises in improving UI. However, access to pelvic floor treatment remains limited due to lengthy waiting lists and poor adherence to prescribed exercises. Digital solutions incorporating behavior change techniques (BCTs), including gamification elements, may support self-management of bladder health for individuals aged 50 years and older who may face challenges in accessing conventional treatments. Objective: This study aimed to identify mobile apps and websites integrating BCTs, including gamification elements, to facilitate bladder health self-management among adults aged 50 years and older. Methods: The search was initiated in July 2024 and updated in January 2025 across three sources: (1) mobile app stores (Google Play Store and Apple App Store available in Spain, Lithuania, and the United Kingdom) using the keywords “pelvic floor,” “urinary incontinence,” and “bladder”; (2) websites; and (3) academic databases (PubMed, Scopus, CINAHL, and Google Scholar) for journal articles, book chapters, and conference papers published in English, Spanish, or Lithuanian. Inclusion criteria required that solutions be independently usable without health care supervision, incorporate at least one BCT (eg, training, education), be evidence-informed (ie, include participants aged ≥50 years in their design or piloting phase or explicitly target this demographic), and be available in Spain, the United Kingdom, or Lithuania. The Mobile App Rating Scale (MARS) was used to assess app quality, and the taxonomy of 93 BCTs was used for BCT classification. All review and data extraction processes were conducted in duplicate. Results: Twenty-one studies met the inclusion criteria, identifying 8 eligible mobile apps and 1 website. Among the apps, only 2 were available on either Google Play or the Apple App Store. No apps were identified in Lithuania, whereas 1 app was found in Spain and 3 apps in the United Kingdom. Of these, 1 UK app was accessible on both Google Play and the Apple App Store, whereas the others were limited to a single platform. BCT extraction showed that the apps included between 9 and 16 BCTs (mean 12, SD 3.27). Regarding quality, all assessed apps obtained MARS scores ranging from 3 to 4 out of 5. Website searches did not identify any scientifically validated platforms across the 3 countries, except for 1 website cited in a scientific publication. UI reduction on the International Consultation on Incontinence Questionnaire ranged from –3.9 to –2.1 points, while perceived improvement reached 91.7% in the Tät app. Conclusions: Evidence-based digital interventions for individuals aged 50 years and older remain limited. Existing apps suggest potential benefits in UI reduction and quality of life improvement; however, further research and development are needed to enhance accessibility and efficacy.