The SDBT-RT Program: A Holistic Approach for Rural Older Adults We developed the Static-Dynamic Balance Training Combined with Reminiscence Therapy (SDBT-RT) program to help older adults in rural communities adopt healthier habits. This program is rooted in the Theory of Planned Behavior , which emphasizes how attitudes, social norms, and perceived control influence behavior. It was designed specifically for rural contexts, considering local policies, lifestyle habits, social networks, and individual needs. Key Components Expert Review \& Pilot Testing Before launching, the program was refined by 5 experts in sports rehabilitation, medical psychology, geriatrics, health management, and nursing. A pilot study was conducted to ensure feasibility. Static-Dynamic Balance Training (SDBT) This physical training aims to improve stability and reduce fall risks. It includes: 10-Minute Warm-Up: Stretching wrists, hips, shoulders, knees, and ankles. 15-Minute Static Balance: Standing on both feet, tandem stance, and single-leg balance. 25-Minute Dynamic Balance: Walking normally, on narrow paths, and in tandem. Difficulty increases gradually with sensory challenges (e.g., distractions) and real-time guidance to build confidence . Reminiscence Therapy (RT) Based on Erikson's theory of psychosocial development , RT helps older adults reflect on life experiences to achieve psychological "integrity" (acceptance of life) over despair. Six structured themes guide discussions: "Our Time," "My Happy Times," "Life Achievements," "Traditional Festivals," "My Hobbies," and "Nostalgic Memories." These activities foster optimism and self-acceptance, aligned with rural Chinese cultural practices . Implementation Details Trained Staff: General practitioners, community health workers, and medical students underwent 1 month of training to lead sessions. Group Structure: 32 participants were divided into 8-person groups and met at community centers (with multimedia facilities and green spaces) from 8:00-10:00 AM to align with their routines. 12-Week Intervention: Odd-Numbered Weeks: 40-minute RT + 50-minute SDBT. RT strengthens motivation (attitudes/norms), while SDBT improves physical control. Even-Numbered Weeks: 50-minute SDBT only, focusing on skill mastery without cognitive overload. Monitoring: Observation Checklists and feedback forms tracked engagement and emotions. Implementation Fidelity Checklists ensured sessions followed protocols. Supervisors reviewed 20% of checklists weekly . Behavior Log Forms recorded participants' health behaviors (e.g., supplement use, illnesses) to identify confounding factors. Follow-Up: After the 12 weeks, participants received 4 weekly phone calls (5-10 minutes) to encourage home practice and address questions. Safety \& Adaptability Facilitators were trained to recognize fatigue or distress and adjust activities as needed. Emergency protocols addressed physical/psychological incidents. Absent participants were contacted for makeup sessions, and adherence was prioritized. This program integrates psychological reflection and physical training to empower rural older adults, fostering both mental well-being and functional independence. By tailoring interventions to local contexts and using evidence-based theories, SDBT-RT aims to create sustainable behavior change.
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The Healthy Aging Instrument (HAI)
Timeframe: One month