{"paper_id":"1c2099b5-aa41-40ee-8440-c6b50e32fce1","body_text":"The rural elderly's perception of the decline in intrinsic capacity and their needs for intervention: a qualitative study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The rural elderly's perception of the decline in intrinsic capacity and their needs for intervention: a qualitative study Hong Su, Qi Li, Yuke Zhang, Yuqiu Zhou This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4982086/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 02 Mar, 2026 Read the published version in BMC Geriatrics → Version 1 posted 4 You are reading this latest preprint version Abstract Backgronud: The decline in intrinsic capacity is widespread among the elderly in rural areas.This study explored the cognitive and intervention needs of the decline in intrinsic capacity among rural elderly individuals from the perspective of the Social-Ecological Systems Theory. Methods: 14 rural elderly individuals in Dongfeng Village, Daqing City, China, were selected for semi-structured interviews from September to December 2023. The interview recordings were transcribed by the research team, and transcripts were analyzed by two independent coders with Colaizzi's descriptive analysis framework. The process employed NVivo 12 software. Findings: Three themes were extracted regarding the cognitive and intervention needs for the decline in intrinsic capacity among rural elderly individuals. Microsystem: The needs for intervention content of intrinsic capacity (knowledge needs; promotion motivation). Mesosystem: The needs for health behaviors (family involvement needs; neighborhood companionship needs). Macrosystem: The need for social and information support (social support needs; scientific and systematic health promotion information needs; diverse information formats). Conclusion: The rural elderly have insufficient awareness of intrinsic capacity and intervention, with intervention participation influenced by various factors. The needs for intrinsic capacity intervention are multidimensional and require targeted programs based on the facilitators and barriers of intervention to meet the needs of rural elderly individuals for intrinsic capacity intervention. Social-Ecological Systems Theory Rural Elderly Intrinsic Capacity Need Qualitative Research Figures Figure 1 1. Introduction By the end of 2018, the number of elderly people with disability or partial disability in China had reached 40 million, with rural elderly accounting for 64.5%. It is projected that by 2050, the number of rural elderly with disability or partial disability will reach 97.5 million[ 1 ]. Enhancing and maintaining the intrinsic capacity of the elderly is key to preventing and delaying disability and promoting healthy aging[ 2 ]. Intrinsic capacity refers to the combination of all physical and mental abilities that an individual can utilize at any time, including cognitive, psychological, sensory functions, vitality, and activity across five domains, which can reflect the overall health status of the elderly[ 3 ]. Results from a nationally representative sample survey indicate that the overall incidence rate of intrinsic capacity decline in China is 43%, and the incidence rate of intrinsic capacity decline among rural elderly is 1.36 times that of urban elderly[ 4 ]. Due to factors such as urban-rural population mobility, a decline in family care capabilities, a decrease in economic purchasing power, and insufficient service provision, the care for disabled elderly in rural areas faces more severe challenges[ 5 ]. Therefore, how to effectively prevent and delay the disability of rural elderly and extend healthy life expectancy is an urgent issue to be addressed in the process of healthy aging. Health promotion behaviors such as cognition, exercise, social interaction, and nutrition are effective intervention models for addressing the decline in intrinsic capacity. They can improve an individual's overall health level and prevent the occurrence of disability[ 6 , 7 ]. In China, there is a lack of empirical interventions regarding intrinsic capacity, and the care for the elderly in communities and rural areas still centers around disease management[ 8 ], no studies have yet delved into the intervention needs for the intrinsic capacity of the elderly in rural areas. With the development of science and technology and the advancement of informatization, the health promotion needs of the elderly have changed. Compared to quantitative research, qualitative research can more clearly understand the true thoughts and feelings of the rural elderly, thereby better analyzing and comprehending the intrinsic capacity intervention needs of the rural elderly within specific cultural contexts. The Social-Ecological Systems Theory emphasizes that individuals are nested within a series of interrelated environmental systems (such as family, community, society), and categorizes these system environments into microsystems, mesosystems, and macrosystems[ 9 ]. Environmental systems interact with and influence the development of rural elderly individuals. Based on the Social-Ecological Systems Theory, this study deeply explores the intervention needs for the intrinsic capacity of rural elderly, providing a basis for constructing an intervention framework for their intrinsic capacity, in order to improve their overall health level and reduce adverse health outcomes. 2. Methods 2.1 Sampling and recruitment of participants The study was carried out in Daqing, China, from 2023.9–2023.12. We used purposive sampling to selec the elderly population from Dongfeng Village. Inclusion criteria: ① Local permanent residents (registered as rural); ② Age ≥ 60 years; ③ Conscious and able to communicate normally with the survey personnel without any barriers; ④ Informed consent and voluntary participation in the study. Exclusion criteria: ① Those with severe sensory impairments such as vision and hearing; ② Those with serious mental and physical illnesses. The sample size was determined based on the principle of data saturation, i.e., when information began to repeat and no new information emerged from the data analysis, the data collection was stopped. Ultimately, 14 rural elderly individuals were included in this study, and their general information is presented in Table 1 . This study has been approved by the Ethics Review Committee of Harbin Medical University (HMUDQ20231116110), and informed consent was obtained from all research subjects. Table 1 Sociodemographics of participants(n = 14) Number Gender Age Marital status Educational level Chronic disease Whether they live with their children P1 Male 73 Married Secondary school Yes No P2 Female 76 Married Primary school and below No Yes P3 Male 68 Married Secondary school No No P4 Male 72 Married Primary school and below Yes No P5 Female 70 Married Primary school and below Yes Yes P6 Female 63 Widowed Secondary school No Yes P7 Female 87 Married Primary school and below Yes No P8 Male 60 Married High school Yes No P9 Female 82 Widowed Primary school and below Yes Yes P10 Female 69 Married Secondary school Yes No P11 Male 71 widowed Primary school and below No No P12 Female 76 Married Primary school and below Yes Yes P13 Female 73 Married Primary school and below No No P14 Male 65 Married Secondary school No No 2.2 Data collection Contact the participants by phone to inform them about the purpose, importance, and methods of the study. Before the interview, select a local health clinic or village activity room as the meeting place. The researcher is a psychotherapist and had received specific training to conduct interviews. According to the aim of the study, the interview outline (Table 2 ) was initially formulated and revised by consulting relevant experts. The interviews were conducted in the participant's language (Chinese). During the interview, use a one-on-one, face-to-face, semi-structured in-depth interview method. Reintroduce yourself to the interviewee and explain the purpose and importance of the study. Record the interview using audio equipment and take notes, including the interviewee's movements, expressions, and other non-verbal information. If the interviewee becomes emotionally agitated, pause the interview, provide appropriate comfort, and then decide whether to continue the interview based on their wishes. After the interview, exchange contact information with the interviewee for later verification of the interview materials. At the end of the interview, express gratitude to the interviewee, with each interview lasting 30 to 40 minutes. Table 2 Outline of the interview. 1.Are you aware of the phenomenon of declining intrinsic capacity (i.e., compared to the past, recently feeling a decline in physical condition, including reduced physical function, weakness, fatigue, diminished vision or hearing, low mood, lack of desire to engage in activities, and slowed walking speed)? 2.What impact do you think the decline in intrinsic capacity will have (on the elderly themselves, their families, society, etc.)? 3.What do you think are the factors influencing intrinsic capacity, and who is at a higher risk of experiencing a decline in intrinsic capacity? 4.Do you believe that the risk of declining intrinsic capacity can be reduced? What methods do you know that can lower the risk of intrinsic capacity decline in the elderly (to prevent the decline of intrinsic capacity)? 5.Do you think these health behaviors (such as physical exercise, healthy eating, frequent socializing, cognitive training) are helpful in improving intrinsic capacity? Do you engage in these behaviors regularly? Why or why not? 6.Do you wish to acquire knowledge and information about enhancing your inner capabilities? Through what means or channels would you like to learn about this information? 2.3 Data analysis We used NVivo 12 to code and managed all interview data. This study adopts the Colaizzi descriptive analysis framework[ 10 ]. Including the following steps: (1) Transcribe the interview content into written form and review it carefully; (2) Extract key statements without introducing the researcher's personal views; (3) Identify meaningful ideas from the key statements; (4) Code the meaningful ideas; (5) Categorize and summarize similar codes into themes, and write detailed and clear descriptions; (6) Merge similar themes and distill the concept of the theme; (7) Feedback the results to the interviewees for further confirmation. 3. Results Through interviews with 14 rural elderly individuals and a comprehensive analysis of the interview data, this study has identified three themes, Microsystem: The demand for intervention content for the intrinsic capacity of rural elderly, Mesosystem: The demand for health behaviors among rural elderly, and Macrosystem: Seeking social support and information support. The conceptual framework of the themes is shown in Fig. 1 . 3.1 Microsystem: The intervention content needs for the intrinsic capacity of rural elderly individuals. 3.1.1 Knowledge needs regarding intrinsic capacity. 3.1.1.1 Guidance needs for the concept of intrinsic capacity. Almost no elderly people have heard of intrinsic capacity. Some elderly individuals lack understanding of the manifestations, progression, and harms of declining intrinsic capacity, considering it a natural result of aging. P1: \"I don't know about this. I haven't read books, I'm not literate.\" P2: \"What kind of disease is this? If I can eat, drink, and move around, why should I worry about it? Isn't that just causing myself trouble?\" P4: \"For us elderly who haven't had much schooling, understand little of what's on TV, and no one explains things to us, we don't know anything about our health and healthcare knowledge.\" P14: \"What is the decline in intrinsic capacity? I've never heard of this before. Is it just getting old? Not being able to walk?\" P7: \"This is what happens when you get old; it's either discomfort here or there.\" 3.1.1.2 Cognitive needs for attributing the decline in intrinsic capacity. Most elderly people are unable to articulate the causes of the decline in intrinsic capacity, leading to misattribution of the decline. Elders P9 and P12 attribute the decline to diseases; P9: \"This condition is related to the shrinkage of the cerebellum, right?\" P12: \"This condition must be related to high blood pressure. When the blood pressure is high, one becomes confused, can't speak clearly, and can't walk properly.\" P3 and P6 believe that intrinsic capacity is related to psychology; P3: \"People with a narrow mind and unsociable personality get sick easily when they encounter problems.\" P6: \"With my children not around, I get worried over every little cold or headache, and the psychological stress is high.\" P5 attributes the decline to family life events: \"The family has been unsettled in recent years, with my spouse's poor health and frequent hospitalizations, which cost a lot of money, and then my grandson got sick. So, my decline in intrinsic capacity is purely from worry.\" P2: \"It's mainly about personal quality. Those with poor physical quality tend to suffer from such conditions.\" 3.1.1.3 Knowledge needs for adverse health outcomes Most elderly people believe that the decline in intrinsic capacity will not affect daily life nor increase the care burden on family members. The decline in intrinsic capacity has not received sufficient attention, and there is a lack of clear understanding of its consequences. P5: \"This isn't a big deal, we rural folks don't have high demands, as long as we can eat and drink.\" P7: \"What impact does this (decline in intrinsic capacity) have? We're old, and there aren't any important things to do, so it's fine if our bodies are a bit worse off.\" P11: \"It's nothing, it doesn't affect work, no need to worry about it, it might get better after some time.\" P13: \"I do feel that my body isn't as good as before, but let it be, I don't want to be a burden to my children, just muddle along.\" 3.1.2 Intrinsic capacity promotion motivation 3.1.2.1 Enhance demand perception Most rural elderly individuals have a weak perception of the need for prevention of the decline in intrinsic capacity, mainly manifested as a weak sense of health awareness and a lack of awareness of the need to improve intrinsic capacity. P10: \"When a person gets old, it's easy to have all sorts of problems; how can you prevent it? This thing can't be prevented.\" P7: \"As you get older, some health issues may naturally arise, which is hard to completely avoid.\" P3: \"At such an advanced age, the body's parts are all worn out; there's no need to worry about it.\" Some elderly people believe that the decline in intrinsic capacity can be prevented through taking measures, however, they do not have a complete understanding of specific prevention strategies and methods. P2: \"In all aspects of life, the elderly should pay attention to some details. For example, going out for a walk and relaxing is beneficial for their physical and mental health.\" P5: \"Exercising regularly is definitely beneficial. Those who don't like to exercise might be more prone to various diseases.\" P6: \"I think the decline in intrinsic capacity can be prevented. Don't always confine yourself at home; you should go out, meet friends, talk and chat, and you won't get sick.\" 3.1.2.2 Correcting the misconceptions about preventing the decline in intrinsic capacity Lack of relevant knowledge is one of the main barriers to participating in the prevention of the decline in intrinsic capacity. Some elderly people hold misconceptions, believing that the decline in intrinsic capacity is unavoidable, or they are unaware of the risk factors for such a decline. At the same time, there are elderly individuals who wish to enhance their intrinsic capacity but are unclear about the specific preventive measures. P7: \"The general public doesn't know much about these things; maintaining good living habits is enough. As for the specifics, I'm not very clear either.\" P8: \"Exercising should be able to improve this intrinsic capacity, but how exactly should one exercise?\" P11: \"I like to play cards for fun, I don't know if it's good for my health.\" Due to limited medical resources, many elderly people indicate that in rural or town areas, the rate of awareness about preventive knowledge is very low. P4: \"To be honest, in rural areas, few people understand these contents (prevention of intrinsic capacity decline); most people are not very concerned or knowledgeable about it.\" P2: \"I think it should be preventable, like regularly moving around and chatting with others. It would be nice if there was a senior activity room. Our large village doesn't even have one such place. If you want to find a place to exercise your legs, there's simply nowhere to go.\" 3.2 Mesosystem: The health behavior needs of rural elderly individuals 3.2.1 Family involvement needs Some elderly individuals indicate that family members may have a direct impact on the health behaviors of the elderly, as they encourage the elderly to change their unhealthy habits. P6: \"My spouse used to cook with a lot of oil and preferred strong flavors, liking to add a lot of salt and sugar. Since I was diagnosed with this condition, we both started to eat more lightly.\" P6: \"My spouse passed away several years ago, and my children can't be around all the time, so I just make do with meals.\" P5: \"My kids always say I'm too fat and keep an eye on me, making sure I take a walk after eating.\" Some elderly people lack social support and face difficulties in promoting health behaviors. P3: \"I used to love dancing, but now that my grandson is with me and my son and daughter-in-law are out working, I really don't have the time to dance anymore, I have to take care of the child every day.\" 3.2.2 Need for companionship with neighbors Some elderly individuals express that the influence of peers can encourage them to engage in healthy behaviors. Therefore, there is an urgent need for systematic and scientific intrinsic capacity management groups to facilitate communication, discussions, and companion activities. P14: \"I go for a walk with my neighbors every night after dinner, we usually walk for about an hour or more, and if I don't go for a walk on a particular day, I feel like something is missing.\" P12: \"In my daily life, I often ask my neighbors for basic health knowledge because I can't ask a doctor at any time.\" P9: \"There are too few elderly people around me, either they have passed away or moved to the city, and I feel very lonely.\" 3.3 Macrosystem: Seeking social support and information support 3.3.1 Demand for social support. Most elderly individuals indicate that their community or primary care hospitals do not provide guidance on health behaviors. They believe that the village should promote more about the importance of intrinsic capacity and pay more attention to the overall health of the elderly. P2: \"I think there should be more dissemination and promotion of this knowledge, so that the elderly can understand better how to improve their intrinsic capacity and reduce the burden on their children.\" P7: \"If someone could freely tell us how to do it, we would follow it, and if it's good for our health, it's better than taking medicine.\" P11: \"Of course, I want to know, at this age, good health is more important than anything else. Life is so good now, I want to live a few more years.\" 3.3.2 Demand for scientific and systematic health promotion information Some elderly individuals raised concerns about the uncertainty of online information and expressed a desire for guidance from professionals. P1: \"There are all sorts of things said online, I don't know if they're true or not.\" P8: \"It's more believable and reliable when a doctor from a major hospital speaks.\" P10: \"It would be ideal if professional doctors could provide us with more information and help.\" Some elderly people believe that general health information is too broad and abstract, making it difficult to apply in real life. They hope that enhancing intrinsic capacity does not just remain at the level of education and theoretical knowledge but also includes practical guidance. Additionally, they expect to receive detailed information about health behaviors or some targeted, personalized lifestyle suggestions. P12: \"It would be best if someone could give on-site guidance, like how to exercise, for example, what kind of exercise is suitable for me with high blood pressure? The more detailed, the better.\" P5: \"It would be best if they could provide some suggestions based on our personal circumstances. I also know that exercise is important, but I have leg problems and can't do intense exercises. Can you tell me what kind of exercise I can do? For example, just sitting there and stretching my arms and legs, does that count as exercise?\" P11: \"I like to play with walnuts in my hand, does that count as exercise, is it good for my health? Sometimes I don't know what to do that is beneficial for my health.\" P9: \"I don't understand what you mentioned very clearly, and I'm not very knowledgeable about professional knowledge. I just know that exercising is good for the body, but I'm not sure where the benefits lie or how to exercise. Anyway, as long as we have the time, we will go out for a walk.\" 3.3.3 Demand for diverse forms of information Rural elderly individuals choose various methods to acquire knowledge about intrinsic capacity, including face-to-face guidance, online knowledge dissemination, and health education. P5: \"If someone from the village team could guide us every day, telling us how to eat and exercise, that would be great.\" P2: \"I think the village should promote more through broadcasts and such, which would be helpful to us elderly.\" P4: \"Now there is no fixed village doctor in the village, just one doctor for three villages, and sometimes I can't even buy medicine. If there was a fixed village doctor who could tell everyone how to do things, that would be good.\" Some elderly people hope to learn through mobile phones, televisions, and other forms. P3: \"It's still TV, everyone has a TV, and anyway, we usually watch TV when we have nothing to do.\" P7: \"I find mobile phones very convenient, I can watch them while lying on the kang (traditional Chinese bed).\" P12: \"Anyway, if someone teaches us, we will learn. Whatever they say, we will do as they instruct.\" 4. Discussion 4.1 The knowledge of intrinsic capacity among rural elderly individuals is in urgent need of improvement Rural elderly individuals have a limited understanding of intrinsic capacity, and their comprehension of the specific manifestations, etiology, and risk factors of its decline is not comprehensive, often leading to misunderstandings. The analysis may include the following reasons. Firstly, the nationwide knowledge of intrinsic capacity is low, especially in rural areas where the overall level of education among the elderly is relatively low, and the access to information is limited[11]. Currently, the main sources of health information for the elderly are relatively limited, primarily including family members, friends, and online resources[12]. However, the accuracy of information on the internet is often insufficient, which leads to doubts among the public about certain health knowledge. Given that health knowledge is constantly evolving, sometimes ambiguous, and may vary, obtaining information from reliable sources is crucial for enhancing the health literacy of the elderly[13]. Electronic health tools and online resources can be used to promote the intrinsic capacity of the elderly by providing accurate and credible information through various platforms to encourage them to improve their lifestyle[14]. In addition, time constraints can be a barrier to acquiring health knowledge. Family responsibilities may make it difficult for some elderly individuals to find time to learn about health management, affecting their ability to take health measures[15]. At the same time, faced with the competition of multiple health issues, elderly people may focus more on urgent diseases that need to be treated, such as diabetes or chronic pain, and neglect the importance of intrinsic capacity. 4.2 Establishing a diversified health promotion model to promote the health behaviors of rural elderly individuals in multiple aspects Promoting health behaviors is a key method to enhance the intrinsic capacity of the elderly[16]. This study found that, from a mesosystem analysis, the health behaviors of rural elderly individuals require family support and peer support. Social Cognitive Theory points out that health behaviors are the result of the combined influence of personal intrinsic factors and external environmental factors. Therefore, on one hand, it is necessary to enhance the intrinsic motivation of the elderly, by education and increasing their understanding of the benefits of health, to strengthen their willingness to participate[17]. Knowledge enhancement is crucial for enhancing intrinsic capacity. Studies show that knowledge is a key motivating factor for behavior change and enhancing the freedom of choice[18]. Perceived benefits are not only important factors in promoting behavior change but also potential motivations for participating in interventions[19]. People are more likely to actively participate in certain health behaviors if they believe they can prevent diseases. The neglect of some elderly people in rural areas to enhance their intrinsic capacity may be related to their weakened sense of value and reduced expectations for the future. In addition, enhancing external support is also key, with systematic strategies to drive behavioral change among the elderly. In this study, the elderly generally believe that increasing exercise is the main preventive measure for enhancing intrinsic capacity, but they are unfamiliar with specific methods. Future intervention measures should promote daily activities that are beneficial to the overall health of the elderly, while clearly defining the content and execution methods of the activities. In terms of physical activity, although the elderly generally recognize its importance, their types of activity are usually quite limited, such as outdoor walking, and they lack detailed information about appropriate types of activity and optimal activity levels[20]. It is necessary to assist the elderly in developing more systematic intervention plans in the future. Peer health influence is particularly significant in the elderly population. Group activities, as a form of social interaction, have a positive impact on health behaviors, emotional support, and cognitive functions, and may be an important strategy for enhancing intrinsic capacity[21]. At the same time, the attention of family members to the health of the elderly will significantly affect the attitude of the elderly towards their health behaviors[22]. Educating family members about the risks of declining intrinsic capacity can encourage them to better remind and supervise the elderly, thereby enhancing their health promotion behaviors. Therefore, in interventions, emphasis should be placed on group interventions and peer influence to promote the health behaviors of the elderly, actively developing group and small group activities. 4.3 Improve the external system to meet the intervention needs and preferences of rural elderly individuals for intrinsic capacity Rural elderly individuals generally lack understanding of intrinsic capacity, and they yearn for professional help and guidance. They hope that someone can accompany them to promote healthy behaviors. Cognitive behavioral interventions can help elderly individuals explore and resolve contradictions, correct their misconceptions about unhealthy behaviors, and subsequently lead to behavioral changes, effectively enhancing health behaviors that promote intrinsic capacity[23]. Traditional cognitive-behavioral intervention models have weak penetration, focusing primarily on individual factors and neglecting the influence of professional support, peer support, and social cultural factors. This results in a gradual decrease or disappearance of behavioral compliance when individuals cannot obtain professional and sustained support. Studies have shown that group health management models can provide long-term support, encouragement, and collaborative management for intervention subjects, effectively improving clinical indicators and quality of life[24]. However, the group health management currently led by medical staff often places patients in a passive compliance and passive change position, lacking intrinsic motivation and making it difficult to maintain the long-term effects of the intervention. Moreover, there is a lack of suitable carriers for its application and promotion in rural areas. Therefore, how to adopt more targeted intervention methods and mobilize the intrinsic motivation of individual and group health behaviors among rural elderly is the key to continuously improving their health behaviors[25]. Health coaching techniques, as an active health intervention method, refer to helping individuals acquire the knowledge, skills, and confidence to become active participants in self-health management, thereby promoting behavior change. Among rural elderly populations, they are decisive factors for changing health behaviors[26]. Rural elderly individuals are grouped into teams based on their residence location and type of chronic diseases, and team leaders are selected. As high-quality individuals and active members in the group, the team leaders play a crucial role as a bridge between medical staff and the elderly. Through the guidance, demonstration, supervision, and promotion of the team leaders, the health behaviors of the elderly within the group can transition from \"short-term passive individual compliance behaviors\" to \"sustained active group interaction behaviors.\" Conclusion This study conducted semi-structured interviews with 14 elderly individuals in rural areas. Based on the social ecological system theory, it aimed to understand the rural elderly's cognitive decline in intrinsic capacity and their needs for intervention, and distilled three themes: the microsystem – the needs for intervention content in the intrinsic capacity of rural elderly, the mesosystem – the needs for health behaviors of rural elderly, and the macrosystem – the needs for seeking social support and information support. Nursing staff should accurately assess the intervention needs for declining intrinsic capacity, pay attention to the individual needs of rural elderly, as well as their needs for family or peer support and social support. They should develop personalized and comprehensive health education programs targeting the intrinsic capacity of rural elderly, construct a multi-dimensional health education model, and integrate various resources to provide social support. This study did not employ quantitative research for validation. In future studies, mixed-method research can be conducted to further explore the intervention model for the intrinsic capacity of rural elderly in China, contributing to the promotion of healthy aging. Declarations Acknowledgements We thank the participants and staff involved in the data collection. Author Contributions Hong Su, conception and design of the study, drafting the article and approval of the version to be published; Qi Li,contributed to data collection; Yuke Zhang, contributed to data collection; Yuqiu Zhou, interpretation of data, drafting the article and approval of the version to be published. All authors have read and approved the final version of the manuscript. Funding This research was supported by Heilongjiang Provincial Natural Science Foundation of China (grant no.: LH2022G015) , National Natural Science Foundation of China(grant no.: 72304078). Data Availability Statement Datasets are available on request by the corresponding author. Ethics approval and consent to participate This study has been approved by the Ethics Review Committee of Harbin Medical University (HMUDQ20231116110), and informed consent was obtained from all research subjects. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Clinical Trial Number in the manuscript Clinical trial number: not applicable References National Health Commission. Transcript of the Press Conference Held by the Office of the Healthy China Action Promotion Committee on July 29, 2019.[EB/OL].(2019-07-29). [2022-02-16].http://www.nhc.gov. cn/ xcs /s7 847/ 201907/ 520f21e5ac2785bc c363a286866fb0.shtml. John B, Alana O, Andrew C. World Report on Ageing and Health. World Health Organization, 2015. Stolz E, Mayerl H, Freidl W, Roller-Wirnsberger R, Gill TM. Intrinsic capacity predicts negative health outcomes in older adults. Journals of Gerontology Series a-Biological Sciences and Medical Sciences, 2022, 77（1）: 101-105. 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Cite Share Download PDF Status: Published Journal Publication published 02 Mar, 2026 Read the published version in BMC Geriatrics → Version 1 posted Editorial decision: Revision requested 26 Sep, 2024 Editor assigned by journal 18 Sep, 2024 Submission checks completed at journal 18 Sep, 2024 First submitted to journal 27 Aug, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-4982086\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":359508362,\"identity\":\"6e6ef661-7c87-4882-bbcd-44961fadcf37\",\"order_by\":0,\"name\":\"Hong Su\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Harbin Medical University\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Hong\",\"middleName\":\"\",\"lastName\":\"Su\",\"suffix\":\"\"},{\"id\":359508364,\"identity\":\"ad91fb07-80df-4fc0-b6c4-ba54ccdd5d4a\",\"order_by\":1,\"name\":\"Qi Li\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Harbin Medical University\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Qi\",\"middleName\":\"\",\"lastName\":\"Li\",\"suffix\":\"\"},{\"id\":359508366,\"identity\":\"3be63f1f-080c-4667-9b5d-1c44ec7bd1d8\",\"order_by\":2,\"name\":\"Yuke Zhang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Harbin Medical University\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Yuke\",\"middleName\":\"\",\"lastName\":\"Zhang\",\"suffix\":\"\"},{\"id\":359508367,\"identity\":\"fe02a5b2-38ee-4176-9689-11fb4303fbaf\",\"order_by\":3,\"name\":\"Yuqiu Zhou\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6klEQVRIiWNgGAWjYBACNvnzHx//qLCRY+Pvf/ggoaKGsBY+CQZjY4YzacZ8EmeYDR6cOUZYi5wEg5kwY9uhRDmGHDbJhy3MRDhMuiGNubDtQAIbw9ljFYkNbAz87d0J+LXIHDj2eMa5O3lszH1pNxJ3yDBInDm7Ab8WhsR2A56yZ8VsDAfMbiSeYWMwkMglpCWZTYKH7XBiG0OCWUFiGzMRWiTS2KR52kBacswYiNPCc4bZcAYwkNkkjiVLJJw5xkPQL/LtPYwPPgCjUr6/+eDHHxU1cvztvfi1YAAe0pSPglEwCkbBKMAKAMcISotKfFIUAAAAAElFTkSuQmCC\",\"orcid\":\"\",\"institution\":\"Harbin Medical University\",\"correspondingAuthor\":true,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Yuqiu\",\"middleName\":\"\",\"lastName\":\"Zhou\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2024-08-27 06:49:46\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-4982086/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-4982086/v1\",\"draftVersion\":[],\"editorialEvents\":[{\"content\":\"https://doi.org/10.1186/s12877-026-07174-7\",\"type\":\"published\",\"date\":\"2026-03-02T15:58:44+00:00\"}],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":68992039,\"identity\":\"757d9b7a-bb2d-4a20-a834-a8ffdc7fc40f\",\"added_by\":\"auto\",\"created_at\":\"2024-11-14 09:51:49\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":138436,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003e\\u003cstrong\\u003eQualitative Interview Thematic Structure Diagram for the Cognition and Intervention Needs of the Decline in Intrinsic Capacity Among Rural Elderly\\u003c/strong\\u003e\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"1.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-4982086/v1/378ec1b2ad377624b206dadf.png\"},{\"id\":104250822,\"identity\":\"cee67e98-a926-4a82-8ccc-b537ba42dae0\",\"added_by\":\"auto\",\"created_at\":\"2026-03-09 16:09:21\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":1418720,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-4982086/v1/c3135c0d-76ba-47b3-be52-f736d585a61d.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"The rural elderly's perception of the decline in intrinsic capacity and their needs for intervention: a qualitative study\",\"fulltext\":[{\"header\":\"1. Introduction\",\"content\":\"\\u003cp\\u003eBy the end of 2018, the number of elderly people with disability or partial disability in China had reached 40\\u0026nbsp;million, with rural elderly accounting for 64.5%. It is projected that by 2050, the number of rural elderly with disability or partial disability will reach 97.5 million[\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]. Enhancing and maintaining the intrinsic capacity of the elderly is key to preventing and delaying disability and promoting healthy aging[\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e]. Intrinsic capacity refers to the combination of all physical and mental abilities that an individual can utilize at any time, including cognitive, psychological, sensory functions, vitality, and activity across five domains, which can reflect the overall health status of the elderly[\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e]. Results from a nationally representative sample survey indicate that the overall incidence rate of intrinsic capacity decline in China is 43%, and the incidence rate of intrinsic capacity decline among rural elderly is 1.36 times that of urban elderly[\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e]. Due to factors such as urban-rural population mobility, a decline in family care capabilities, a decrease in economic purchasing power, and insufficient service provision, the care for disabled elderly in rural areas faces more severe challenges[\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e]. Therefore, how to effectively prevent and delay the disability of rural elderly and extend healthy life expectancy is an urgent issue to be addressed in the process of healthy aging.\\u003c/p\\u003e \\u003cp\\u003eHealth promotion behaviors such as cognition, exercise, social interaction, and nutrition are effective intervention models for addressing the decline in intrinsic capacity. They can improve an individual's overall health level and prevent the occurrence of disability[\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e]. In China, there is a lack of empirical interventions regarding intrinsic capacity, and the care for the elderly in communities and rural areas still centers around disease management[\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e], no studies have yet delved into the intervention needs for the intrinsic capacity of the elderly in rural areas. With the development of science and technology and the advancement of informatization, the health promotion needs of the elderly have changed. Compared to quantitative research, qualitative research can more clearly understand the true thoughts and feelings of the rural elderly, thereby better analyzing and comprehending the intrinsic capacity intervention needs of the rural elderly within specific cultural contexts. The Social-Ecological Systems Theory emphasizes that individuals are nested within a series of interrelated environmental systems (such as family, community, society), and categorizes these system environments into microsystems, mesosystems, and macrosystems[\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e]. Environmental systems interact with and influence the development of rural elderly individuals. Based on the Social-Ecological Systems Theory, this study deeply explores the intervention needs for the intrinsic capacity of rural elderly, providing a basis for constructing an intervention framework for their intrinsic capacity, in order to improve their overall health level and reduce adverse health outcomes.\\u003c/p\\u003e\"},{\"header\":\"2. Methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.1 Sampling and recruitment of participants\\u003c/h2\\u003e \\u003cp\\u003eThe study was carried out in Daqing, China, from 2023.9\\u0026ndash;2023.12. We used purposive sampling to selec the elderly population from Dongfeng Village. Inclusion criteria: ① Local permanent residents (registered as rural); ② Age\\u0026thinsp;\\u0026ge;\\u0026thinsp;60 years; ③ Conscious and able to communicate normally with the survey personnel without any barriers; ④ Informed consent and voluntary participation in the study. Exclusion criteria: ① Those with severe sensory impairments such as vision and hearing; ② Those with serious mental and physical illnesses. The sample size was determined based on the principle of data saturation, i.e., when information began to repeat and no new information emerged from the data analysis, the data collection was stopped. Ultimately, 14 rural elderly individuals were included in this study, and their general information is presented in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e. This study has been approved by the Ethics Review Committee of Harbin Medical University (HMUDQ20231116110), and informed consent was obtained from all research subjects.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eSociodemographics of participants(n\\u0026thinsp;=\\u0026thinsp;14)\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"8\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c8\\\" colnum=\\\"8\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNumber\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eGender\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eAge\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c5\\\" namest=\\\"c4\\\"\\u003e \\u003cp\\u003eMarital status\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eEducational level\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eChronic disease\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eWhether they live with their children\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e73\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eSecondary school\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e76\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003ePrimary school and below\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e68\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eSecondary school\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e72\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003ePrimary school and below\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e70\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003ePrimary school and below\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e63\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eWidowed\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eSecondary school\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e87\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003ePrimary school and below\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e60\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eHigh school\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e82\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eWidowed\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003ePrimary school and below\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e69\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eSecondary school\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP11\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e71\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003ewidowed\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003ePrimary school and below\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP12\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e76\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003ePrimary school and below\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP13\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e73\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003ePrimary school and below\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP14\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c4\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003e65\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eMarried\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eSecondary school\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec4\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.2 Data collection\\u003c/h2\\u003e \\u003cp\\u003eContact the participants by phone to inform them about the purpose, importance, and methods of the study. Before the interview, select a local health clinic or village activity room as the meeting place. The researcher is a psychotherapist and had received specific training to conduct interviews. According to the aim of the study, the interview outline (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e) was initially formulated and revised by consulting relevant experts. The interviews were conducted in the participant's language (Chinese). During the interview, use a one-on-one, face-to-face, semi-structured in-depth interview method. Reintroduce yourself to the interviewee and explain the purpose and importance of the study. Record the interview using audio equipment and take notes, including the interviewee's movements, expressions, and other non-verbal information. If the interviewee becomes emotionally agitated, pause the interview, provide appropriate comfort, and then decide whether to continue the interview based on their wishes. After the interview, exchange contact information with the interviewee for later verification of the interview materials. At the end of the interview, express gratitude to the interviewee, with each interview lasting 30 to 40 minutes.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eOutline of the interview.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"1\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e1.Are you aware of the phenomenon of declining intrinsic capacity (i.e., compared to the past, recently feeling a decline in physical condition, including reduced physical function, weakness, fatigue, diminished vision or hearing, low mood, lack of desire to engage in activities, and slowed walking speed)?\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2.What impact do you think the decline in intrinsic capacity will have (on the elderly themselves, their families, society, etc.)?\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e3.What do you think are the factors influencing intrinsic capacity, and who is at a higher risk of experiencing a decline in intrinsic capacity?\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e4.Do you believe that the risk of declining intrinsic capacity can be reduced? What methods do you know that can lower the risk of intrinsic capacity decline in the elderly (to prevent the decline of intrinsic capacity)?\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e5.Do you think these health behaviors (such as physical exercise, healthy eating, frequent socializing, cognitive training) are helpful in improving intrinsic capacity? Do you engage in these behaviors regularly? Why or why not?\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e6.Do you wish to acquire knowledge and information about enhancing your inner capabilities? Through what means or channels would you like to learn about this information?\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec5\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.3 Data analysis\\u003c/h2\\u003e \\u003cp\\u003eWe used NVivo 12 to code and managed all interview data. This study adopts the Colaizzi descriptive analysis framework[\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e]. Including the following steps: (1) Transcribe the interview content into written form and review it carefully; (2) Extract key statements without introducing the researcher's personal views; (3) Identify meaningful ideas from the key statements; (4) Code the meaningful ideas; (5) Categorize and summarize similar codes into themes, and write detailed and clear descriptions; (6) Merge similar themes and distill the concept of the theme; (7) Feedback the results to the interviewees for further confirmation.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"3. Results\",\"content\":\"\\u003cp\\u003eThrough interviews with 14 rural elderly individuals and a comprehensive analysis of the interview data, this study has identified three themes, Microsystem: The demand for intervention content for the intrinsic capacity of rural elderly, Mesosystem: The demand for health behaviors among rural elderly, and Macrosystem: Seeking social support and information support. The conceptual framework of the themes is shown in Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cdiv id=\\\"Sec7\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e3.1 Microsystem: The intervention content needs for the intrinsic capacity of rural elderly individuals.\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec8\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.1.1 Knowledge needs regarding intrinsic capacity.\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec9\\\" class=\\\"Section4\\\"\\u003e \\u003ch2\\u003e3.1.1.1 Guidance needs for the concept of intrinsic capacity.\\u003c/h2\\u003e \\u003cp\\u003eAlmost no elderly people have heard of intrinsic capacity. Some elderly individuals lack understanding of the manifestations, progression, and harms of declining intrinsic capacity, considering it a natural result of aging. P1: \\\"I don't know about this. I haven't read books, I'm not literate.\\\" P2: \\\"What kind of disease is this? If I can eat, drink, and move around, why should I worry about it? Isn't that just causing myself trouble?\\\" P4: \\\"For us elderly who haven't had much schooling, understand little of what's on TV, and no one explains things to us, we don't know anything about our health and healthcare knowledge.\\\" P14: \\\"What is the decline in intrinsic capacity? I've never heard of this before. Is it just getting old? Not being able to walk?\\\" P7: \\\"This is what happens when you get old; it's either discomfort here or there.\\\"\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec10\\\" class=\\\"Section4\\\"\\u003e \\u003ch2\\u003e3.1.1.2 Cognitive needs for attributing the decline in intrinsic capacity.\\u003c/h2\\u003e \\u003cp\\u003eMost elderly people are unable to articulate the causes of the decline in intrinsic capacity, leading to misattribution of the decline. Elders P9 and P12 attribute the decline to diseases; P9: \\\"This condition is related to the shrinkage of the cerebellum, right?\\\" P12: \\\"This condition must be related to high blood pressure. When the blood pressure is high, one becomes confused, can't speak clearly, and can't walk properly.\\\" P3 and P6 believe that intrinsic capacity is related to psychology; P3: \\\"People with a narrow mind and unsociable personality get sick easily when they encounter problems.\\\" P6: \\\"With my children not around, I get worried over every little cold or headache, and the psychological stress is high.\\\" P5 attributes the decline to family life events: \\\"The family has been unsettled in recent years, with my spouse's poor health and frequent hospitalizations, which cost a lot of money, and then my grandson got sick. So, my decline in intrinsic capacity is purely from worry.\\\" P2: \\\"It's mainly about personal quality. Those with poor physical quality tend to suffer from such conditions.\\\"\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec11\\\" class=\\\"Section4\\\"\\u003e \\u003ch2\\u003e3.1.1.3 Knowledge needs for adverse health outcomes\\u003c/h2\\u003e \\u003cp\\u003eMost elderly people believe that the decline in intrinsic capacity will not affect daily life nor increase the care burden on family members. The decline in intrinsic capacity has not received sufficient attention, and there is a lack of clear understanding of its consequences. P5: \\\"This isn't a big deal, we rural folks don't have high demands, as long as we can eat and drink.\\\" P7: \\\"What impact does this (decline in intrinsic capacity) have? We're old, and there aren't any important things to do, so it's fine if our bodies are a bit worse off.\\\" P11: \\\"It's nothing, it doesn't affect work, no need to worry about it, it might get better after some time.\\\" P13: \\\"I do feel that my body isn't as good as before, but let it be, I don't want to be a burden to my children, just muddle along.\\\"\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec12\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.1.2 Intrinsic capacity promotion motivation\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec13\\\" class=\\\"Section4\\\"\\u003e \\u003ch2\\u003e3.1.2.1 Enhance demand perception\\u003c/h2\\u003e \\u003cp\\u003eMost rural elderly individuals have a weak perception of the need for prevention of the decline in intrinsic capacity, mainly manifested as a weak sense of health awareness and a lack of awareness of the need to improve intrinsic capacity. P10: \\\"When a person gets old, it's easy to have all sorts of problems; how can you prevent it? This thing can't be prevented.\\\" P7: \\\"As you get older, some health issues may naturally arise, which is hard to completely avoid.\\\" P3: \\\"At such an advanced age, the body's parts are all worn out; there's no need to worry about it.\\\" Some elderly people believe that the decline in intrinsic capacity can be prevented through taking measures, however, they do not have a complete understanding of specific prevention strategies and methods. P2: \\\"In all aspects of life, the elderly should pay attention to some details. For example, going out for a walk and relaxing is beneficial for their physical and mental health.\\\" P5: \\\"Exercising regularly is definitely beneficial. Those who don't like to exercise might be more prone to various diseases.\\\" P6: \\\"I think the decline in intrinsic capacity can be prevented. Don't always confine yourself at home; you should go out, meet friends, talk and chat, and you won't get sick.\\\"\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec14\\\" class=\\\"Section4\\\"\\u003e \\u003ch2\\u003e3.1.2.2 Correcting the misconceptions about preventing the decline in intrinsic capacity\\u003c/h2\\u003e \\u003cp\\u003eLack of relevant knowledge is one of the main barriers to participating in the prevention of the decline in intrinsic capacity. Some elderly people hold misconceptions, believing that the decline in intrinsic capacity is unavoidable, or they are unaware of the risk factors for such a decline. At the same time, there are elderly individuals who wish to enhance their intrinsic capacity but are unclear about the specific preventive measures. P7: \\\"The general public doesn't know much about these things; maintaining good living habits is enough. As for the specifics, I'm not very clear either.\\\" P8: \\\"Exercising should be able to improve this intrinsic capacity, but how exactly should one exercise?\\\" P11: \\\"I like to play cards for fun, I don't know if it's good for my health.\\\" Due to limited medical resources, many elderly people indicate that in rural or town areas, the rate of awareness about preventive knowledge is very low. P4: \\\"To be honest, in rural areas, few people understand these contents (prevention of intrinsic capacity decline); most people are not very concerned or knowledgeable about it.\\\" P2: \\\"I think it should be preventable, like regularly moving around and chatting with others. It would be nice if there was a senior activity room. Our large village doesn't even have one such place. If you want to find a place to exercise your legs, there's simply nowhere to go.\\\"\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec15\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e3.2 Mesosystem: The health behavior needs of rural elderly individuals\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec16\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.2.1 Family involvement needs\\u003c/h2\\u003e \\u003cp\\u003eSome elderly individuals indicate that family members may have a direct impact on the health behaviors of the elderly, as they encourage the elderly to change their unhealthy habits. P6: \\\"My spouse used to cook with a lot of oil and preferred strong flavors, liking to add a lot of salt and sugar. Since I was diagnosed with this condition, we both started to eat more lightly.\\\" P6: \\\"My spouse passed away several years ago, and my children can't be around all the time, so I just make do with meals.\\\" P5: \\\"My kids always say I'm too fat and keep an eye on me, making sure I take a walk after eating.\\\" Some elderly people lack social support and face difficulties in promoting health behaviors. P3: \\\"I used to love dancing, but now that my grandson is with me and my son and daughter-in-law are out working, I really don't have the time to dance anymore, I have to take care of the child every day.\\\"\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec17\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.2.2 Need for companionship with neighbors\\u003c/h2\\u003e \\u003cp\\u003eSome elderly individuals express that the influence of peers can encourage them to engage in healthy behaviors. Therefore, there is an urgent need for systematic and scientific intrinsic capacity management groups to facilitate communication, discussions, and companion activities. P14: \\\"I go for a walk with my neighbors every night after dinner, we usually walk for about an hour or more, and if I don't go for a walk on a particular day, I feel like something is missing.\\\" P12: \\\"In my daily life, I often ask my neighbors for basic health knowledge because I can't ask a doctor at any time.\\\" P9: \\\"There are too few elderly people around me, either they have passed away or moved to the city, and I feel very lonely.\\\"\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec18\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e3.3 Macrosystem: Seeking social support and information support\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec19\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.3.1 Demand for social support.\\u003c/h2\\u003e \\u003cp\\u003eMost elderly individuals indicate that their community or primary care hospitals do not provide guidance on health behaviors. They believe that the village should promote more about the importance of intrinsic capacity and pay more attention to the overall health of the elderly. P2: \\\"I think there should be more dissemination and promotion of this knowledge, so that the elderly can understand better how to improve their intrinsic capacity and reduce the burden on their children.\\\" P7: \\\"If someone could freely tell us how to do it, we would follow it, and if it's good for our health, it's better than taking medicine.\\\" P11: \\\"Of course, I want to know, at this age, good health is more important than anything else. Life is so good now, I want to live a few more years.\\\"\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec20\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.3.2 Demand for scientific and systematic health promotion information\\u003c/h2\\u003e \\u003cp\\u003eSome elderly individuals raised concerns about the uncertainty of online information and expressed a desire for guidance from professionals. P1: \\\"There are all sorts of things said online, I don't know if they're true or not.\\\" P8: \\\"It's more believable and reliable when a doctor from a major hospital speaks.\\\" P10: \\\"It would be ideal if professional doctors could provide us with more information and help.\\\" Some elderly people believe that general health information is too broad and abstract, making it difficult to apply in real life. They hope that enhancing intrinsic capacity does not just remain at the level of education and theoretical knowledge but also includes practical guidance. Additionally, they expect to receive detailed information about health behaviors or some targeted, personalized lifestyle suggestions. P12: \\\"It would be best if someone could give on-site guidance, like how to exercise, for example, what kind of exercise is suitable for me with high blood pressure? The more detailed, the better.\\\" P5: \\\"It would be best if they could provide some suggestions based on our personal circumstances. I also know that exercise is important, but I have leg problems and can't do intense exercises. Can you tell me what kind of exercise I can do? For example, just sitting there and stretching my arms and legs, does that count as exercise?\\\" P11: \\\"I like to play with walnuts in my hand, does that count as exercise, is it good for my health? Sometimes I don't know what to do that is beneficial for my health.\\\" P9: \\\"I don't understand what you mentioned very clearly, and I'm not very knowledgeable about professional knowledge. I just know that exercising is good for the body, but I'm not sure where the benefits lie or how to exercise. Anyway, as long as we have the time, we will go out for a walk.\\\"\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec21\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.3.3 Demand for diverse forms of information\\u003c/h2\\u003e \\u003cp\\u003eRural elderly individuals choose various methods to acquire knowledge about intrinsic capacity, including face-to-face guidance, online knowledge dissemination, and health education. P5: \\\"If someone from the village team could guide us every day, telling us how to eat and exercise, that would be great.\\\" P2: \\\"I think the village should promote more through broadcasts and such, which would be helpful to us elderly.\\\" P4: \\\"Now there is no fixed village doctor in the village, just one doctor for three villages, and sometimes I can't even buy medicine. If there was a fixed village doctor who could tell everyone how to do things, that would be good.\\\" Some elderly people hope to learn through mobile phones, televisions, and other forms. P3: \\\"It's still TV, everyone has a TV, and anyway, we usually watch TV when we have nothing to do.\\\" P7: \\\"I find mobile phones very convenient, I can watch them while lying on the kang (traditional Chinese bed).\\\" P12: \\\"Anyway, if someone teaches us, we will learn. Whatever they say, we will do as they instruct.\\\"\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e\"},{\"header\":\"4. Discussion\",\"content\":\"\\u003ch3\\u003e4.1\\u0026nbsp;The knowledge of intrinsic capacity among rural elderly individuals is in urgent need of improvement\\u003c/h3\\u003e\\n\\u003cp\\u003eRural elderly individuals have a limited understanding of intrinsic capacity, and their comprehension of the specific manifestations, etiology, and risk factors of its decline is not comprehensive, often leading to misunderstandings. The analysis may include the following reasons. Firstly, the nationwide knowledge of intrinsic capacity is low, especially in rural areas where the overall level of education among the elderly is relatively low, and the access to information is limited[11].\\u0026nbsp;Currently, the main sources of health information for the elderly are relatively limited, primarily including family members, friends, and online resources[12]. However, the accuracy of information on the internet is often insufficient, which leads to doubts among the public about certain health knowledge.\\u003c/p\\u003e\\n\\u003cp\\u003eGiven that health knowledge is constantly evolving, sometimes ambiguous, and may vary, obtaining information from reliable sources is crucial for enhancing the health literacy of the elderly[13]. Electronic health tools and online resources can be used to promote the intrinsic capacity of the elderly by providing accurate and credible information through various platforms to encourage them to improve their lifestyle[14].\\u0026nbsp;In addition, time constraints can be a barrier to acquiring health knowledge. Family responsibilities may make it difficult for some elderly individuals to find time to learn about health management, affecting their ability to take health measures[15]. At the same time, faced with the competition of multiple health issues, elderly people may focus more on urgent diseases that need to be treated, such as diabetes or chronic pain, and neglect the importance of intrinsic capacity.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003e4.2 Establishing a diversified health promotion model to promote the health behaviors of rural elderly individuals in multiple aspects\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003ePromoting health behaviors is a key method to enhance the intrinsic capacity of the elderly[16]. This study found that, from a mesosystem analysis, the health behaviors of rural elderly individuals require family support and peer support. Social Cognitive Theory points out that health behaviors are the result of the combined influence of personal intrinsic factors and external environmental factors. Therefore, on one hand, it is necessary to enhance the intrinsic motivation of the elderly, by education and increasing their understanding of the benefits of health, to strengthen their willingness to participate[17]. Knowledge enhancement is crucial for enhancing intrinsic capacity. Studies show that knowledge is a key motivating factor for behavior change and enhancing the freedom of choice[18]. Perceived benefits are not only important factors in promoting behavior change but also potential motivations for participating in interventions[19]. People are more likely to actively participate in certain health behaviors if they believe they can prevent diseases. The neglect of some elderly people in rural areas to enhance their intrinsic capacity may be related to their weakened sense of value and reduced expectations for the future.\\u003c/p\\u003e\\n\\u003cp\\u003eIn addition, enhancing external support is also key, with systematic strategies to drive behavioral change among the elderly. In this study, the elderly generally believe that increasing exercise is the main preventive measure for enhancing intrinsic capacity, but they are unfamiliar with specific methods. Future intervention measures should promote daily activities that are beneficial to the overall health of the elderly, while clearly defining the content and execution methods of the activities. In terms of physical activity, although the elderly generally recognize its importance, their types of activity are usually quite limited, such as outdoor walking, and they lack detailed information about appropriate types of activity and optimal activity levels[20]. It is necessary to assist the elderly in developing more systematic intervention plans in the future. Peer health influence is particularly significant in the elderly population. Group activities, as a form of social interaction, have a positive impact on health behaviors, emotional support, and cognitive functions, and may be an important strategy for enhancing intrinsic capacity[21]. At the same time, the attention of family members to the health of the elderly will significantly affect the attitude of the elderly towards their health behaviors[22].\\u0026nbsp;Educating family members about the risks of declining intrinsic capacity can encourage them to better remind and supervise the elderly, thereby enhancing their health promotion behaviors. Therefore, in interventions, emphasis should be placed on group interventions and peer influence to promote the health behaviors of the elderly, actively developing group and small group activities.\\u003c/p\\u003e\\n\\u003ch3\\u003e4.3\\u0026nbsp;Improve the external system to meet the intervention needs and preferences of rural elderly individuals for intrinsic capacity\\u003c/h3\\u003e\\n\\u003cp\\u003eRural elderly individuals generally lack understanding of intrinsic capacity, and they yearn for professional help and guidance. They hope that someone can accompany them to promote healthy behaviors. Cognitive behavioral interventions can help elderly individuals explore and resolve contradictions, correct their misconceptions about unhealthy behaviors, and subsequently lead to behavioral changes, effectively enhancing health behaviors that promote intrinsic capacity[23]. Traditional cognitive-behavioral intervention models have weak penetration, focusing primarily on individual factors and neglecting the influence of professional support, peer support, and social cultural factors. This results in a gradual decrease or disappearance of behavioral compliance when individuals cannot obtain professional and sustained support. Studies have shown that group health management models can provide long-term support, encouragement, and collaborative management for intervention subjects, effectively improving clinical indicators and quality of life[24]. However, the group health management currently led by medical staff often places patients in a passive compliance and passive change position, lacking intrinsic motivation and making it difficult to maintain the long-term effects of the intervention. Moreover, there is a lack of suitable carriers for its application and promotion in rural areas.\\u003c/p\\u003e\\n\\u003cp\\u003eTherefore, how to adopt more targeted intervention methods and mobilize the intrinsic motivation of individual and group health behaviors among rural elderly is the key to continuously improving their health behaviors[25]. Health coaching techniques, as an active health intervention method, refer to helping individuals acquire the knowledge, skills, and confidence to become active participants in self-health management, thereby promoting behavior change. Among rural elderly populations, they are decisive factors for changing health behaviors[26]. Rural elderly individuals are grouped into teams based on their residence location and type of chronic diseases, and team leaders are selected. As high-quality individuals and active members in the group, the team leaders play a crucial role as a bridge between medical staff and the elderly. Through the guidance, demonstration, supervision, and promotion of the team leaders, the health behaviors of the elderly within the group can transition from \\\"short-term passive individual compliance behaviors\\\" to \\\"sustained active group interaction behaviors.\\\"\\u003c/p\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003eThis study conducted semi-structured interviews with 14 elderly individuals in rural areas. Based on the social ecological system theory, it aimed to understand the rural elderly\\u0026apos;s cognitive decline in intrinsic capacity and their needs for intervention, and distilled three themes: the microsystem \\u0026ndash; the needs for intervention content in the intrinsic capacity of rural elderly, the mesosystem \\u0026ndash; the needs for health behaviors of rural elderly, and the macrosystem \\u0026ndash; the needs for seeking social support and information support. Nursing staff should accurately assess the intervention needs for declining intrinsic capacity, pay attention to the individual needs of rural elderly, as well as their needs for family or peer support and social support. They should develop personalized and comprehensive health education programs targeting the intrinsic capacity of rural elderly, construct a multi-dimensional health education model, and integrate various resources to provide social support. This study did not employ quantitative research for validation. In future studies, mixed-method research can be conducted to further explore the intervention model for the intrinsic capacity of rural elderly in China, contributing to the promotion of healthy aging.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgements\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eWe thank the participants and staff involved in the data collection.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor Contributions\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eHong Su, conception and design of the study, drafting the article and approval of the version to be published; Qi Li,contributed to data collection; Yuke Zhang, contributed to data collection; Yuqiu Zhou, interpretation of data, drafting the article and approval of the version to be published. All authors have read and approved the final version of the manuscript.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThis research was supported by Heilongjiang Provincial Natural Science Foundation of China (grant no.: LH2022G015) , National Natural Science Foundation of China(grant no.: 72304078).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eData Availability Statement\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eDatasets are available on request by the corresponding author.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eEthics approval and consent to participate\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThis study has been approved by the Ethics Review Committee of Harbin Medical University (HMUDQ20231116110), and informed consent was obtained from all research subjects.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent for publication\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCompeting interests\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors declare no competing interests.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eClinical Trial Number in the manuscript\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eClinical trial number: not applicable\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n\\u003cli\\u003eNational Health Commission. Transcript of the Press Conference Held by the Office of the Healthy China Action Promotion Committee on July 29, 2019.[EB/OL].(2019-07-29). [2022-02-16].http://www.nhc.gov. cn/ xcs /s7 847/ 201907/ 520f21e5ac2785bc c363a286866fb0.shtml.\\u003c/li\\u003e\\n\\u003cli\\u003eJohn B, Alana O, Andrew C. World Report on Ageing and Health. World Health Organization, 2015.\\u003c/li\\u003e\\n\\u003cli\\u003eStolz E, Mayerl H, Freidl W, Roller-Wirnsberger R, Gill TM. Intrinsic capacity predicts negative health outcomes in older adults. Journals of Gerontology Series a-Biological Sciences and Medical Sciences, 2022, 77（1）: 101-105.\\u003c/li\\u003e\\n\\u003cli\\u003eLiu S, Kang L, Liu XH, et al. Trajectory and correlation of Intrinsic Capacity and Frailty in a Beijing Elderly Community. Frontiers in Medicine, 2021, 8:751586.\\u003c/li\\u003e\\n\\u003cli\\u003eYao X, Pei XT, Qu Z. Trends in the prevalence, awareness, treatment, and control rates of hypertension among Chinese adults from 1991 to 2015 and their influencing factors. Chinese General Practice, 2022, 25(7): 803-814.\\u003c/li\\u003e\\n\\u003cli\\u003eBlancafort Alias S, Cuevas-Lara C, Mart\\u0026iacute;nez-Velilla N, et al. A Multi-Domain Group-Based Intervention to Promote Physical Activity, Healthy Nutrition, and Psychological Wellbeing in Older People with Losses in Intrinsic Capacity: AMICOPE Development Study. Int J Environ Res Public Health. 2021, 18 （11）: 1-6. \\u003c/li\\u003e\\n\\u003cli\\u003eTay L, Tay EL, Mah SM, et al. Intrinsic capacity rather than intervention exposure influences reversal to robustness among prefrail community-dwelling older adults: A non-randomized controlled study of a multidomain exercise and nutrition intervention. Front Med （Lausanne）, 2022, 9, 971497.\\u003c/li\\u003e\\n\\u003cli\\u003eLiang YT, An LR, Gao YX, et al. Research progress on the intrinsic capacity of the elderly. Nursing Research, 2022, 36(19): 3481-3484.\\u003c/li\\u003e\\n\\u003cli\\u003eMcLeroy KR，Bibeau D，Steckler A，et al. An ecological perspective on health promotion programs.Health Educ Q，1988， 15（4）：351-377.\\u003c/li\\u003e\\n\\u003cli\\u003eBahler C, Huber C. A, Brungger B, Reich O. Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study. Bmc Health Services Research, 2015, 23（15）:1472-6963.\\u003c/li\\u003e\\n\\u003cli\\u003eBahler C, Huber C. A, Brungger B, et al. Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study. Bmc Health Services Research, 2015, 23（15）:1472-6963.\\u003c/li\\u003e\\n\\u003cli\\u003eCheng ZH, He ZF, Xu XL, et al. Study on health knowledge, health behaviors, and influencing factors among the elderly in rural areas. Chinese Health Service Management, 2022, 39(08): 600-605.\\u003c/li\\u003e\\n\\u003cli\\u003eBelloni G, Cesari M. Frailty and Intrinsic Capacity: Two Distinct but Related Constructs. Front Med （Lausanne）, 2019, 6:133.\\u003c/li\\u003e\\n\\u003cli\\u003eXiong H, Luo AJ, Xie WZ, et al. Current status and influencing factors of health information literacy among rural elderly. Journal of Agricultural Documentation and Information, 2022, 34(10): 44-56.\\u003c/li\\u003e\\n\\u003cli\\u003eRobinson L, Dickinson C, Magklara E, et al. Proactive approaches to identifying dementia and dementia risk; a qualitative study of public attitudes and preferences. BMJ Open, 2018, 8（2）:e018677.\\u003c/li\\u003e\\n\\u003cli\\u003eYao L, Xu L, Pan X, et al. Research progress on ecological momentary assessment of health behaviors in the elderly. Chinese Journal of Nursing, 2022, 57(20): 2542-2546.\\u003c/li\\u003e\\n\\u003cli\\u003eBandura A. Health promotion from the perspective of social cognitive theory. Psychology \\u0026amp; Health, 1998, 13（4）: 623-649.\\u003c/li\\u003e\\n\\u003cli\\u003eBosco A, Jones KA, Di Lorito C, et al. Changing lifestyle for dementia risk reduction: Inductive content analysis of a national UK survey. PLoS One. 2020, 15 （5）:e0233039.\\u003c/li\\u003e\\n\\u003cli\\u003eKulmala J, Rosenberg A, Ngandu T, et al. Facilitators and barriers to implementing lifestyle intervention programme to prevent cognitive decline. EUR J PUBLIC HEALTH, 2021, 31 （4）:816-822. \\u003c/li\\u003e\\n\\u003cli\\u003eEVANTHIA L, ADRIAN C. Analysis of Qualitative Psychological Data. Translated by Bi Chongzeng. Chongqing: Chongqing University Press, 2010, 23-30.\\u003c/li\\u003e\\n\\u003cli\\u003eLuo WH, Zhang X The impact of peer support education on the self-management ability of elderly diabetes patients in the community . Chinese Community Doctors, 2021, 37(36): 179-180+183.\\u003c/li\\u003e\\n\\u003cli\\u003eZhang YY. A study on the impact of family support on the health of the elderly [J]. Survey World, 2022, (03): 64-74.\\u003c/li\\u003e\\n\\u003cli\\u003eCurran E, Chong TWH, Godbee K, et al. General population perspectives of dementia risk reduction and the implications for intervention: A systematic review and thematic synthesis of qualitative evidence. PLoS One, 2021, 16 （9）:e0257540.\\u003c/li\\u003e\\n\\u003cli\\u003ePan JX, Chen LQ, Wang JL, et al. Interactive group management for the elderly with mild cognitive impairment in the community. Journal of Nursing Science, 2021, 36(13): 99-103+107.\\u003c/li\\u003e\\n\\u003cli\\u003eLiu SH. A study on the correlation between health promotion behaviors and self-efficacy of the elderly with mild cognitive impairment in the community [D]. Hubei University of Chinese Medicine, 2021.\\u003c/li\\u003e\\n\\u003cli\\u003eGray R, Bressington D, Ivanecka A, et al. Is adherence therapy an effective adjunct treatment for patients with schizophrenia spectrum disorders?A systematic review and meta-analysis. BMC Psychiatry, 2016, 16: 90.\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":true,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-geriatrics\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"bgtc\",\"sideBox\":\"Learn more about [BMC Geriatrics](http://bmcgeriatr.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/bgtc/default.aspx\",\"title\":\"BMC Geriatrics\",\"twitterHandle\":\"BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Social-Ecological Systems Theory, Rural Elderly, Intrinsic Capacity, Need, Qualitative Research\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-4982086/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-4982086/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cstrong\\u003eBackgronud:\\u003c/strong\\u003eThe decline in intrinsic capacity is widespread among the elderly in rural areas.This study explored the cognitive and intervention needs of the decline in intrinsic capacity among rural elderly individuals from the perspective of the Social-Ecological Systems Theory.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eMethods:\\u003c/strong\\u003e 14 rural elderly individuals in Dongfeng Village, Daqing City, China, were selected for semi-structured interviews from September to December 2023. The interview recordings were transcribed by the research team, and transcripts were analyzed by two independent coders with Colaizzi's descriptive analysis framework. The process employed NVivo 12 software.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFindings: \\u003c/strong\\u003eThree themes were extracted regarding the cognitive and intervention needs for the decline in intrinsic capacity among rural elderly individuals. Microsystem: The needs for intervention content of intrinsic capacity (knowledge needs; promotion motivation). Mesosystem: The needs for health behaviors (family involvement needs; neighborhood companionship needs). Macrosystem: The need for social and information support (social support needs; scientific and systematic health promotion information needs; diverse information formats).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConclusion: \\u003c/strong\\u003eThe rural elderly have insufficient awareness of intrinsic capacity and intervention, with intervention participation influenced by various factors. The needs for intrinsic capacity intervention are multidimensional and require targeted programs based on the facilitators and barriers of intervention to meet the needs of rural elderly individuals for intrinsic capacity intervention.\\u003c/p\\u003e\",\"manuscriptTitle\":\"The rural elderly's perception of the decline in intrinsic capacity and their needs for intervention: a qualitative study\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2024-11-14 09:51:44\",\"doi\":\"10.21203/rs.3.rs-4982086/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"decision\",\"content\":\"Revision requested\",\"date\":\"2024-09-26T20:10:14+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2024-09-19T02:57:21+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2024-09-19T02:56:44+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"BMC Geriatrics\",\"date\":\"2024-08-27T06:48:06+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-geriatrics\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"bgtc\",\"sideBox\":\"Learn more about [BMC Geriatrics](http://bmcgeriatr.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/bgtc/default.aspx\",\"title\":\"BMC Geriatrics\",\"twitterHandle\":\"BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"771524da-2f97-41b2-91e3-3f366289756d\",\"owner\":[],\"postedDate\":\"November 14th, 2024\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"published-in-journal\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-03-09T16:05:22+00:00\",\"versionOfRecord\":{\"articleIdentity\":\"rs-4982086\",\"link\":\"https://doi.org/10.1186/s12877-026-07174-7\",\"journal\":{\"identity\":\"bmc-geriatrics\",\"isVorOnly\":false,\"title\":\"BMC Geriatrics\"},\"publishedOn\":\"2026-03-02 15:58:44\",\"publishedOnDateReadable\":\"March 2nd, 2026\"},\"versionCreatedAt\":\"2024-11-14 09:51:44\",\"video\":\"\",\"vorDoi\":\"10.1186/s12877-026-07174-7\",\"vorDoiUrl\":\"https://doi.org/10.1186/s12877-026-07174-7\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-4982086\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-4982086\",\"identity\":\"rs-4982086\",\"version\":[\"v1\"]},\"buildId\":\"ApUGefWb6u5IBVtyqm6d5\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}