Maintaining an active lifestyle is a key health behavior in people with type 2 diabetes (T2D). This study assessed the feasibility and acceptability of a socio-ecological Nordic walking intervention (SENWI) to enhance healthy behaviors in primary healthcare settings. Participants included individuals with T2D (n = 33; age 70 (95% CI 69–74)) and healthcare professionals (HCPs, n = 3). T2D participants were randomly assigned to a SENWI, active comparator, or control group for twelve weeks. Feasibility and acceptability were evaluated based on a mixed methodology. Quantitative data reported adherence information, differences between follow-up and dropout participants and pre- and post-intervention on physical activity, sedentary behavior, and health outcomes. Qualitative data acquisition was performed using focus groups and semi-structured interviews and analyzed using thematic analysis. Thirty-three T2D invited participants were recruited, and twenty-two (66.7%) provided post-intervention data. The SENWI was deemed acceptable and feasible, but participants highlighted the need to improve options, group schedules, gender inequities, and the intervention’s expiration date. Healthcare professionals expressed a lack of institutional support and resources. Nevertheless, no significant difference between the SENWI follow-up and dropout participants or pre- and post- intervention was found (only between the active comparator and control group in the physical quality of life domain). Implementing the SENWI in primary healthcare settings is feasible and acceptable in real-world conditions. However, a larger sample is needed to assess the program’s effectiveness in improving healthy behaviors and its impact on health-related outcomes in the long term.

Objective: To describe age-related differences in Sit-to-Stand Test (STST) performance (5 repetitions, 30 s, and 1 min) and their association with PA levels. Design: We estimated age-related trajectories for 3 STST across physical activity (PA) strata defined by self-reported IPAQ-SF (low, moderate, high) and quantified the PA effects. In a multicenter cross-sectional study from 12 cities in three BLINDED countries (n=1283; 56% women; 18 to 80 y), performance was assessed with 5rep-STST (seconds), 30s-STST (repetitions), and 1min-STST (repetitions). Primary analyses used generalized additive models with a common age spline, adjusted for sex, BMI, and smoking; multiplicity-adjusted pairwise contrasts were computed. An age-equivalent advantage (high vs. low PA) was derived using a parametric bootstrap; distribution-aware models were tested for robustness. STST performance declined nonlinearly with age. Results: Higher PA was associated with better performance in repetition-based tests; 5rep-STST effects were small. In 1min-STST, high exceeded low by ~2.5 repetitions, yielding an age-equivalent advantage of ~5 to 7 years; for 30s-STST, advantages were ~3 to 5 years. Sensitivity analyses corroborated these findings. Conclusions: In this Latin American cohort, STST performance declined nonlinearly with age but was consistently better in those with higher habitual PA, regardless of sex, BMI, or smoking.

Sustained adherence is essential for the effectiveness of community-based multidomain interventions aimed at preventing disability in older adults with initial frailty. This study explores the perspectives of older adults and primary care professionals involved in the + AGIL Barcelona programme to understand the factors that facilitate or hinder sustained adherence and provide evidence for improving its implementation and scalability. A qualitative descriptive study was conducted in three primary care centres in Barcelona implementing the + AGIL programme. Participants were purposively selected to ensure information-rich perspectives. Six homogeneous focus groups were conducted with older adults meeting criteria for initial frailty (n = 22; mean age 82 years) and primary care professionals (n = 18), facilitated by two experienced qualitative researchers. Discussions were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis. Rigour was ensured through independent coding, reflexive discussion, consensus, and data saturation confirmation. Adherence emerged as a multidimensional and context-dependent process shaped by professional, personal, and community-related factors. Empathetic communication, individualised exercise prescription, and group cohesion acted as key facilitators for motivation, autonomy, and the adoption of new healthy routines. Conversely, caregiving responsibilities, socioeconomic vulnerability, and limited access to community resources hindered the maintenance of behaviours over time. Organisational continuity and stronger healthcare-community coordination were perceived as essential for sustainability. Adherence to multidomain interventions depends not only on programme content but also on delivery processes and contextual embedding within participants' lived realities. Strengthening behavioural support and healthcare-community integration is vital to enhance long-term sustainability and scalability in primary care settings.