Development of a Blended Lifestyle Intervention to Promote Physical Activity, Diet, and Health in Hong Kong Older Adults

Walking; moderate physical activity; vigorous physical activity The waist-worn accelerometer will be used to objectively assess PA (GT3X+, ActiGraph Inc, Pensacola, FL, USA).

The Chinese version of the International Physical Activity Questionnaire-short form (IPAQ-C).

If there is an increase, the result means a better outcome.

To assess the fruit and vegetable intake during the past seven days, participants will be asked "how many portions of fruit they have today" and "how many portions of vegetables they have today". Participants were asked to keep a record for seven days, then to get an average for each day.

If there is an increase, the result means a better outcome.

To assess the Meat, Fish, Egg & Alternatives consumption, individuals will be asked to answer three items. To assess the Meat, Fish, Egg & Alternatives during the past seven days, participants will be asked "how many taels of meat do they have today", "how many taels of eggs do they have today" and "how many taels of Alternatives do they have today". Participants were asked to keep a record for seven days, then to get an average intake of Meat, Fish, Egg & Alternatives for each day.

If there is a change, and the follow-up result is between 5 and 6, the result is better.

The Blood pressure will be measured by an automated portable device .

If there is a change, and the follow-up result is below 120, the result is better.

The Glycosylated Hemoglobin (HbA1c) will be tested by the Point of Care Cobas b 101 system.

If there is a change, and the follow-up result is below 6.5, the result is better.

The lipid, including total cholesterol (CHOL; mmol/L), triglycerides (TG; mmol/L); high-density lipoprotein (HDL; mmol/L); and low-density lipoprotein (LDL; mmol/L)will be tested by Point of Care (POC) Cobas b 101 system.

8 Foot Up-and-Go Test (second)

Back Scratch Test (upper body; +/- cm)

Chair Sit and Reach Test (lower body; +/- cm)

2-Minute Step Test (times in two minutes)

30-Second Arm Curl test (upper body; times per 30 seconds)

30-Second Chair Stand test (lower body; times per 30 seconds);

Body mass index (kg/m2).

The Hong Kong brief version of the World Health Organization's Quality of Life questionnaire. We measured general quality of life with the question "How would you rate your quality of life?" with a 5-point scale (1=very poor; 5=very good). We also used the physical health subdomain with 7 items, such as "How satisfied are you with your ability to perform your daily living activities?" (1=very dissatisfied; 5=very satisfied).

If there is an increase, the result means a better outcome.

Geriatric Depression Scale 15-item - Cantonese Version. Participants were asked to indicate the frequency of symptoms on a yes/no questionnaire (yes=1; no=0; except items 1,5,7,9,11: yes=0; no=1) within the last week. Positively formulated items were reversed. The total score consisted of the sum of all 15 items and ranged from 0 to 15. A total score of 5 or greater indicated the likelihood of depression symptoms.

If there is an increase, the result means a worse outcome.

The Chinese translation of the 6-item De Jong Gierveld Loneliness Scale. The emotional loneliness was measured by 3 items (yes=1, moderate=1, no=0), such as "I experience a general sense of emptiness". Social loneliness was measured by 3 items (yes=0, moderate=1, no=1). A total score of 2 or greater indicated the likelihood of loneliness.

If there is an increase, the result means a better outcome.

We assessed self-efficacy for PA with 5 items on a 5-point scale (1=don't agree at all; 5=totally agree), such as "I am certain that I can permanently be physically active for at least 5 days a week for 30 minutes each day".

We assessed self-efficacy for fruit and vegetable by 5 items on the basis of the PA scale, such as "I am certain that I can eat 5 portions of fruit and vegetables a day even if it is sometimes difficult".

We assessed self-efficacy for MFEA by 5 items on the basis of the PA scale, such as "I am certain that I can eat moderate MFEA a day even if it is sometimes difficult".

If there is an increase, the result means a better outcome.

We assessed action control for PA with 6 items on a 5-point scale (1=don't agree at all; 5=totally agree), such as "I consistently monitored when, where, and how long I exercise".

We assessed action control for FVI/MFEA with 6 items separately on a 5-point scale (1=don't agree at all; 5=totally agree), such as "I consistently monitored whether I ate enough fruit and vegetable /moderate meat".

If there is an increase, the result means a better outcome.

We distinguished planning as action planning and coping planning. We assessed action planning by the stem "For the next month I have carefully planned..." followed by 3 items for PA, such as "which PA I will pursue," and followed by 1 item for FVI and 1 item for MFEA, such as "what I will eat".

We assessed coping planning by the stem "For the next month I have carefully planned..." followed by 3 items for PA, such as "what I can do in difficult situations to stick to my intentions," or followed by 3 items for FVI and 3 items for MFEA, such as "how I can eat healthy, even if something happened" . Answers were given on a 5-point scale ranging from 1=totally disagree to 5=totally agree.

If there is an increase, the result means a better outcome.

We assessed social support with 3 items for PA and with 3 items for FVI and 3 items for MFEA, such as "My partner helps me/my family helps me/my classmates and friends help me to stay physically active," or "My partner helps me/my family helps me/my classmates and friends help me to eat healthily." Answers were measured with a 5-point scale (1=not at all true; 5=exactly true).

If there is an increase, the result means a better outcome.

Items will include gender, year of birth, marital status, educational level, household income, professional status, living status, number of children, and history of chronic diseases.