Social media-based health education plus exercise programme (SHEEP) to improve muscle function among community-dwelling young-old adults with possible sarcopenia: A feasibility study

Social media-based health education plus exercise programme (SHEEP) to improve muscle function among community-dwelling young-old adults with possible sarcopenia: A feasibility 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 Article Social media-based health education plus exercise programme (SHEEP) to improve muscle function among community-dwelling young-old adults with possible sarcopenia: A feasibility study Ya Shi, Emma Stanmore, Lisa McGarrigle, Xiuhua Wang, Can Gu, Ying Ye, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7624386/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 08 Apr, 2026 Read the published version in npj Digital Medicine → Version 1 posted 9 You are reading this latest preprint version Abstract Possible sarcopenia is common among community-dwelling young-old adults, yet effective social media interventions remain scarce. We developed a TikTok-based multi-component program (SHEEP) integrating health education and exercise via co-design. A single-arm mixed-methods feasibility study was conducted (May-August 2024) with 35 adults aged 60–69 with possible sarcopenia in Changsha, China. Participants received one week of health education videos and six weeks of exercise intervention, with follow-up testing. Feasibility, acceptability, and physical and behavioural outcomes were assessed. Recruitment (80% female), adherence, and procedures were feasible and acceptable. Preliminary improvements were observed in handgrip strength, walking speed, sit-to-stand performance, knowledge, self-efficacy, and self-management. Qualitative feedback indicated enhanced physical and mental well-being. SHEEP is feasible and acceptable and may improve physical function in older adults with possible sarcopenia. A randomized controlled trial is warranted. Health sciences/Health care Health sciences/Medical research Sarcopenia feasibility study social media health education exercise community-dwelling young-old adults Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 BACKGROUND The 2024 conceptual definition established by the Global Leadership Initiative in Sarcopenia (GLIS) defines sarcopenia as an age-related generalised disease of skeletal muscle, marked by reduced muscle mass and strength, which may lead to compromised physical performance 1 . Sarcopenia can be classified into three categories (possible/probable, confirmed, and severe sarcopenia) according to distinct diagnostic criteria recommended by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) 2 and the Asian Working Group for Sarcopenia 2 (AWGS2) 3 , aimed at addressing the requirements of the community and clinical practice more effectively. Possible sarcopenia is characterised by diminished muscle strength, with or without decreased physical performance, and is strongly advocated by both EWGSOP2 and AWGS2 as a critical threshold for screening and prevention in primary care, particularly in community environments 2 , 3 . Possible sarcopenia is highly prevalent among older adults in the community and is affected by various factors, as indicated by studies from multiple nations. A cross-sectional study 4 evaluated 5,237 Colombian older adults (≥ 60 years) in accordance with EWGSOP2 guideline, indicating a 46.5% prevalence of possible sarcopenia; those with physical inactivity, diabetes, arthritis, or osteoarthritis and rheumatism exhibited a higher prevalence of possible sarcopenia. Tsekoura et al. 5 identified a 25.4% prevalence of possible sarcopenia using EWGSOP2 criteria among Greek older people (> 60 years) in a study involving 402 participants, revealing a positive correlation with age, gender, body mass index, skeletal muscle mass index, calf circumference, and comorbidities. A population-based study 6 involving 651 older persons (≥ 60 years) in Brazil indicated a 19.2% prevalence of possible sarcopenia using EWGSOP2 criteria, with associations seen for sex, age, underweight status, diabetes mellitus, and hospitalisation within the preceding year. Chen et al. 7 examined data from 4,866 participants (≥ 60 years) in China, revealing a 46.0% prevalence of possible sarcopenia according to AWGS2 criteria. The findings indicated that advanced age and depressive symptoms correlated with a heightened prevalence of possible sarcopenia, whereas education and moderate to high physical activity were linked to a reduced risk of its prevalence 7 . A study involving 431 participants (≥ 65 years) in Korea indicated that possible sarcopenia had a 23.7% prevalence in older persons, and was particularly prevalent among those with reduced weight, body mass index, skeletal muscle mass, or fat-free mass 8 . Due to the advocacy for sarcopenia prevention in primary care and community settings by worldwide organisations, research on interventions for possible sarcopenia has progressively intensified in recent years. For example, Merchant et al. 9 evaluated the impact of a community-based dual-task exercise programme on older adults with possible sarcopenia, revealing its effectiveness in enhancing gait speed and Short Physical Performance Battery scores, and reducing the prevalence of poor handgrip strength. Ullevig et al. 10 conducted a double-blinded randomised controlled pilot study, demonstrating that daily supplementation with egg white protein enhanced protein consumption and bolstered upper body physical function in primarily low-income Latina older women with possible sarcopenia. Pan et al. 11 designed a 12-week randomised controlled trial which indicated that progressive resistance training and nutrition effectively decreased body fat percentage, augmented appendicular muscle mass, enhanced handgrip strength, and diminished sitting duration of Chinese older adults in the community. Dong et al. 12 discovered that a 12-week regimen of resistance band training enhanced total muscle mass, skeletal muscle index, grip strength, and Berg balance scale scores in older individuals with possible sarcopenia residing in nursing homes. However, in contrast to the studies on sarcopenia treatment, the research into sarcopenia prevention is rather under-researched. Our scoping review compared 59 studies about non-pharmacological interventions for community-dwelling older adults with three categories of sarcopenia and indicated that the number of studies involving older adults with sarcopenia (72.9%) far surpassed that of studies involving those with possible sarcopenia (11.9%) 13 . Additionally, digital health interventions have gradually attracted the attention of scholars in the sarcopenia area. The ongoing advancement of the Internet, big data, artificial intelligence, augmented reality, mobile applications, and other technologies is establishing a robust technical foundation for the swift evolution of digital health. Concurrently, the global COVID-19 pandemic has resulted in an increased demand for tele-medicine worldwide, hence advancing the development and implementation of digital health technologies, with digital health interventions being actively advocated across numerous research areas 14 – 18 . Interventions for sarcopenia have increasingly used digital health technologies; however, this integration is still in its early stages. Our recent systematic review identified only four studies about digital health exercise interventions in older adults with three categories of sarcopenia, but these concentrated primarily on the treatment of sarcopenia rather than its prevention, and no research explored the use of social media in this area 19 . Besides, the corresponding meta-analysis indicated that digital health exercise alone did not confer any benefit in enhancing muscle mass or sit-to-stand function in older people with sarcopenia, and there is limited data regarding the effect of digital health exercise on handgrip strength 19 . Hence, it is novel and valuable to explore the possibility of a social media-based multicomponent intervention for sarcopenia prevention in community-dwelling older adults. We have completed an intervention development study to provide a theoretical conceptual framework for social media-based interventions and to formulate a health education plus exercise intervention utilising TikTok for sarcopenia prevention (SHEEP) through co-design with pertinent stakeholders 20 , 21 . This study extends our prior research to further validate the feasibility and acceptability of the research design and the SHEEP intervention among young-old adults with possible sarcopenia living in the community. The specific objectives include evaluating outcomes related to feasibility, including recruitment capability, data collection procedure, intervention suitability, outcome assessment process, researcher management ability, implementation feasibility, and research acceptability 22 . The corresponding study protocol delineates a more comprehensive research background and the detailed research objectives of this study programme 23 . The findings of this feasibility study will facilitate and establish a foundation for our forthcoming randomised controlled trial, and aid in supporting, guiding, and enhancing subsequent pertinent studies. METHODS Study design and reporting The study employs a single-arm prospective pre-post design to assess the feasibility, acceptability, and preliminary impact of the SHEEP on preventing sarcopenia in community-dwelling young-old individuals with possible sarcopenia. Both quantitative and qualitative methods are employed to evaluate the research outcomes. This study is reported in accordance with the CONSORT extension to pilot and feasibility trials 24 (excluding items that are specific to the randomisation nature of the study) and the Guidelines for Reporting Outcomes in Trial Reports (the CONSORT-Outcomes 2022 Extension) 25 . We also refer to the guidelines for reporting non-randomised pilot and feasibility studies proposed by Lancaster et al. 26 . This study was registered at the ISRCTN registry (trial registration number: ISRCTN17269170; date: 14 September 2023). The study protocol has been previously published in PLOS ONE 23 . Research setting and ethics This feasibility study was conducted in Changsha city, Hunan Province, China. The recruitment and intervention procedures were carried out in two communities: Sanchaji Community and Guanshaling Community. This study was approved by the University of Manchester Research Ethics Committee (Project ID: 2024-19302-34066), and appropriate permissions were also granted by the two collaborating community health centres and the Community Nursing Department of Xiang Ya Nursing School, Central South University, China. Participants, recruitment, consent, and withdrawal The principal investigator (PI) visited the two community health centres to present the research to the managers and obtain their agreement. The PI explained the eligibility criteria for participation given in the information leaflets 23 . The managers facilitated the distribution of printed informational leaflets to older people visiting community health centres and disseminated electronic recruitment leaflets to community WeChat groups. Older persons expressed their interest in this study by contacting the PI through the managers or using the contact information provided in the leaflet. In accordance with the inclusion and exclusion criteria, the PI conducted an initial eligibility screening via phone or email, and upon confirmation, carried out assessments in an office provided by the community health centre. Eligible participants received a comprehensive explanation of the research along with a Participant Information Sheet and were afforded a minimum of 24 hours to decide upon participation. Informed consent, either written or verbal, was obtained via face-to-face interactions or telephone calls from participants who agreed to take part in the study. Participants were allowed to withdraw at any time without explanation. A comprehensive account of participants, recruitment, consent, and withdrawal procedures is provided in the published protocol 23 . Intervention Participants received one week’s health education, six weeks’ exercise training and a six-week follow-up. 1) Health education: Participants viewed seven health education videos (4–6 minutes each) concerning sarcopenia prevention, which were posted on TikTok (TikTok ID: 73296723633) throughout the initial week. Participants faced no limitations on the number of views, permitting them to decide the number of times they viewed videos daily. 2) Physical exercise: Participants attended exercise training on TikTok, which was fixed at 30 minutes and comprised four types of exercise, including 3 minutes’ warm-up training, 8 minutes’ aerobic training, 16 minutes’ resistance training, and 3 minutes’ flexibility training. The frequency of exercise was at least 3 times/week, and the overall exercise intensity was moderate using the Borg Category-Ratio 10 (CR-10) Scale 27 , 28 . Resistance exercise was performed using two plastic water-bottles of 500ml or 1000ml or 1500ml or 2000ml capacity. Participants started with 500ml or 1000ml, then added 100-500ml of weight every three weeks according to their individual situation. 3) Follow-up: Participants were monitored for six weeks, during which the researcher assisted them in completing their activity diaries and documenting their feelings through brief telephone calls or text messages each week. The components of the health education and exercise intervention programmes were based on our prior study 21 and protocol 23 . Outcomes Socio-demographic information, primary outcomes and secondary outcomes were all collected during full details of which are outlined as in the protocol 23 . In brief, the primary outcomes involved evaluating five domains. 1) Recruitment capability and participant characteristics; 2) Intervention and study procedures' acceptability and suitability; 3) Data collection procedures and outcome measurements; 4) Research duration and the ability of researcher to conduct the study and intervention; 5) Participant responsiveness to intervention. The secondary outcomes assessed two main categories: 1) Muscle-related outcomes: muscle strength (handgrip strength), muscle mass (skeletal muscle mass, skeletal mass index, upper-extremity skeletal muscle mass, lower-extremity skeletal muscle mass, and trunk skeletal muscle mass), and physical performance (walking speed and sit-to-stand function); 2) Other measurements: other body parameters (e.g., height, weight, calf circumference, abdominal circumference, body fat, body mass index, protein, and bone mineral), questionnaires (e.g., nutrition state, perceived knowledge, personal motivation, behavioural skills, and monitoring of behaviour change). Study protocol delineated the diverse instruments used and the various time points at which the outcomes were evaluated during the research 23 . Statistical analysis Continuous variables were represented by mean and standard deviation (M ± SD), and categorical variables were represented by number (percentage). Descriptive statistics were used to analyse the percentage of recruitment, baseline characteristics of participants (e.g., age, gender, educational background, long-term condition, and medication), attrition rate, compliance rate, etc. Secondary outcome measures were compared between baseline (T0) and different intervention stages (T1, T4, T7, T10, T13) using 95% confidence intervals (CIs) of mean values, such as handgrip strength, skeletal muscle mass, and physical performance. If the 95%CI of mean values at any intervention stage did not overlap compared to the 95%CI of mean values at baseline, the difference was statistically significant. In a single-group design, the effect size is typically calculated using Cohen's d to measure the intervention's impact before (T0) and after (T13). Cohen's d is calculated using the following formula 29 , 30 : $$\:d=\frac{{M}_{post}-{M}_{pre}}{{SD}_{pooled}}$$ Where: · \(\:{M}_{post}\:\) is the mean score after the intervention · \(\:{M}_{pre}\) is the mean score before the intervention · \(\:{SD}_{pooled}\) is the pooled standard deviation, calculated as: $$\:SDpooled=\sqrt{\frac{\left({n}_{pre}-1\right)·{SD}_{pre}^{2}+\left({n}_{post}-1\right)·{SD}_{post}^{2}}{{n}_{pre}+{n}_{post}-2}}$$ Where: · \(\:{n}_{pre}\) and \(\:{n}_{post}\) are the sample sizes before and after the intervention, respectively. · \(\:{SD}_{pre}\) and \(\:{SD}_{post}\) are the standard deviations before and after the intervention, respectively. The effect size was divided into four grades: small (0.2), medium (0.5), large (0.8), and very large (1.3) 31 . The value of the effect size can be positive, negative, or zero, depending on the direction of the relationship between the variables. A positive effect size indicates that an increase in one variable is associated with an increase in the other variable. Conversely, a negative effect size suggests that an increase in one variable is associated with a decrease in the other variable. If no relationship exists between the two variables, the effect size is zero. All statistical analyses were conducted using SPSS Statistics 27.0 (IBM Corp., Armonk, NY, USA). Interviews were transcribed verbatim and analysed using thematic analysis 32 . This approach included six phases: familiarising with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report. QSR International’s NVivo 12 qualitative analysis software was used to assist and facilitate the coding and analysis process of qualitative data. Codes were interpreted to determine the feasibility and acceptability of the SHEEP programme, including barriers and facilitators of the implementation process, and then organised into themes that reflected the views of participants regarding the SHEEP programme. Data collection, data management and more detailed analysis methods were detailed in the published protocol 23 . RESULTS Primary outcomes · Recruitment capability The information leaflets were distributed to older people who visited the community health centres, and the electronic leaflets were also sent to community WeChat groups. Between 06 May 2024 and 19 May 2024, in total 91 older adults expressed interest in joining this research programme though phone call or text messages: 63 in Sanchaji Community Health Service Centre and 28 in Guanshaling Community Health Service Centre. These people learned of this research primarily via paper information leaflets (n = 33, 36.3%), electronic leaflets in WeChat groups (n = 46, 50.5%), and word-of-mouth among residents (n = 12, 13.2%). After a brief introduction to the study over the phone, 79 (86.8%) older adults accepted the preliminary eligibility screening over the phone (e.g. confirmed items 1–3 and 6 on eligibility list, and exclusion criteria); sixty-eight (74.7%) older people participated in further screening measurement, including SARC-CalF and handgrip strength according to AWGS 2 3 , face to face in the community, and 43 (47.3%) of them met all the screening criteria. After being given a full explanation of the study and the Participant Information Sheet for the research, 35 provided informed consent and decided to join in this study: 33 in Sanchaji Community and 2 in Guanshaling Community, as shown in Fig. 1 . Hence, the total recruitment rate was 38.5%, while the recruitment rate in Sanchaji Community (52.4%) was much higher than that in Guanshaling Community (7.1%). · Participant characteristics The mean age (M ± SD) of the 35 included participants was 66.40 ± 2.90 years. Some 80% of participants were aged 65–69 years, with 20% aged 60–64 years. Some 80% of participants were female; 20% male. Three distinct educational backgrounds were of similar proportions; primary school (31.4%), junior high school (34.3%), senior high school (34.3%). The prevalence of long-term conditions among the participants, ranked in descending order, was as follows: hypertension (45.7%), diabetes (22.9%), hyperlipidaemia (17.1%), lumbar disc herniation (5.7%), coronary heart disease (2.9%), and arthritis (2.9%). More than half of the participants (51.4%) were taking medications related to chronic diseases. Only one participant (2.9%) was using a walking stick during the research period, as shown in Table 1 . Table 1 Sample characteristics (n = 35) Variable M ± SD Range N (%) Age, years 66.40 ± 2.90 60–69 Age group 60–64 7 (20.0) 65–69 28 (80.0) Female 28 (80.0) Education Primary school 11 (31.4) Junior high school 12 (34.3) Senior high school 12 (34.3) Long-term condition Hypertension 16 (45.7) Diabetes 8 (22.9) Hyperlipidaemia 6 (17.1) Coronary heart disease 1 (2.9) Lumbar disc herniation 2 (5.7) Arthritis 1 (2.9) Medication Yes 18 (51.4) Significant health problems affecting the ability to undertake physical activity Yes 0 (0.0) Mobility aid Yes 1 (2.9) · Intervention acceptability Of the 35 participants who signed the informed consent form, 26 (74.3%) of them finished the whole study, while nine (25.7%) withdrew at various stages of the study. The reported reasons are detailed in Fig. 2 , and most are related to the inconvenient schedule. The compliance rate was different in different stages: 100% during the health education process, 97.1% during the exercise intervention, 91.4% at the follow-up stage, and 88.6% in the semi-structured interviews. · Acceptability of data collection We recorded the measurement time of the secondary outcomes required for each participant (n = 32) in five measurement timepoints, with a minimum of 28.02mins and a maximum of 42.02mins (Table 2 ). The 95%CI of the mean measurement time of the five stages overlapped, indicating that the difference was not statistically significant. Table 2 Measurement time of the secondary outcomes in five measurement timepoints Assessment timepoint Measurement time (mins) M ± SD (95%CIs) T 0 36.21 ± 2.59 (35.28, 37.14) T 4 36.35 ± 2.81 (35.34, 37.36) T 7 35.94 ± 2.74 (34.95, 36.93) T 10 35.55 ± 2.58 (34.62, 36.48) T 13 35.37 ± 2.50 (34.47, 36.27) Note: T 0 = Baseline; T 4 = Week 4 (exercise); T 7 = Week 7 (exercise); T 10 = Week 10 (follow-up); T 13 = Week 13 (follow-up). · Management ability We completed the feasibility study within the allotted time as originally proposed, but there were minor tweaks to details. We initially set a two-week deadline for recruiting, baseline assessments, and training, but needed to expand this to three weeks. The health education, exercise intervention and follow-up period were successfully completed according to the original protocol. Hence, this feasibility study required a total of 17 weeks to be completed, including two weeks’ recruitment, one week’s baseline assessment and training, one week’s health education, six weeks’ exercise, a six-week follow up, and one week’s semi-structured interviews (Fig. 3 ). The researchers demonstrated effective organisational and managerial skills, facilitating the seamless advancement of the study process. Secondary outcomes · Indicators with obvious changes Table 3 demonstrates that for the total sample the upper limit of the 95%CI at baseline was less than the lower limit of the 95% CI at week 13 for handgrip strength on both hands, 4-metre walking speed, sarcopenia prevention quizzes, Self-Efficacy for Managing Chronic Disease 6-item Scale, Self-management Behaviour for Chronic Disease Scale (exercise and cognitive), Exercise Adherence Rating Scale, and numbers of exposures to sarcopenia and exercise information videos on TikTok, and the lower limit of the 95%CI at baseline was greater than the upper limit of the 95% CI at week 13 for sit to stand time, indicating that the difference of these changes was statistically significant. Among these indicators, Self-management Behaviour for Chronic Disease Scale (cognitive) in the female sample and the five indicators [handgrip strength on both hands, 4-metre walking speed, sit to stand time, Self-Efficacy for Managing Chronic Disease 6-item Scale, Self-management Behaviour for Chronic Disease Scale (cognitive)] in the male sample were not statistically significant, as the 95%CI of mean values across the five measurement timepoints overlapped. The values of Cohen’s d suggest that the effect size of the SHEEP intervention for these indicators in the total sample (0.765 ⁓ 10.394) and in the female sample (0.817 ⁓ 10.089) was large to very large, but in the male sample (0.324 ⁓ 11.197) was small to very large. Table 3 Indicators with obvious changes from baseline to week 13 Variables Assessment timepoint M ± SD (95%CIs) Total (n = 32) Male (n = 7) Female (n = 25) Right handgrip strength, kg T 0 17.34 ± 4.73 (15.63, 19.04) 25.39 ± 2.02 (23.51, 27.26) 15.08 ± 1.92 (14.29, 15.87) T 4 18.35 ± 4.77 (16.63, 20.07) 26.55 ± 1.97 (24.73, 28.38) 16.05 ± 1.80 (15.31, 16.79) T 7 19.35 ± 4.85 (17.60, 21.10) 27.60 ± 2.27 (25.50, 29.69) 17.04 ± 1.93 (16.24, 17.84) T 10 20.25 ± 4.93 (18.47, 22.03) 28.35 ± 2.75 (25.80, 30.89) 17.98 ± 2.25 (17.05, 18.91) T 13 21.54 ± 5.28 (19.63, 23.44) 29.57 ± 3.79 (26.06, 33.07) 19.29 ± 2.89 (18.10, 20.48) Cohen’s d + 0.838 + 1.376 + 1.716 Left handgrip strength, kg T 0 16.08 ± 4.73 (14.37, 17.79) 23.36 ± 3.35 (20.27, 26.46) 14.04 ± 2.52 (13.00, 15.08) T 4 17.08 ± 4.89 (15.32, 18.84) 24.82 ± 3.50 (21.59, 28.05) 14.91 ± 2.32 (13.95, 15.87) T 7 18.06 ± 4.98 (16.27, 19.86) 26.04 ± 3.12 (23.16, 28.93) 15.83 ± 2.40 (14.84, 16.82) T 10 19.08 ± 4.86 (17.33, 20.84) 26.89 ± 3.10 (24.02, 29.75) 16.90 ± 2.31 (15.95, 17.85) T 13 19.95 ± 5.37 (18.01, 21.88) 28.14 ± 4.13 (24.32, 31.96) 17.66 ± 2.82 (16.49, 18.82) Cohen’s d + 0.765 + 1.271 + 1.353 4-metre walking speed, m/s T 0 1.29 ± 0.16 (1.23, 1.35) 1.24 ± 0.30 (0.97, 1.53) 1.30 ± 0.11 (1.25, 1.34) T 4 1.32 ± 0.16 (1.26, 1.38) 1.26 ± 0.28 (0.99, 1.52) 1.33 ± 0.11 (1.29, 1.38) T 7 1.35 ± 0.17 (1.29, 1.41) 1.28 ± 0.29 (1.02, 1.55) 1.37 ± 0.12 (1.33, 1.42) T 10 1.39 ± 0.17 (1.33, 1.45) 1.31 ± 0.30 (1.03, 1.58) 1.41 ± 0.12 (1.37, 1.46) T 13 1.44 ± 0.18 (1.38, 1.51) 1.35 ± 0.31 (1.06, 1.64) 1.47 ± 0.11 (1.42, 1.51) Cohen’s d + 0.913 + 0.324 + 1.568 Sit to stand time, s T 0 8.13 ± 1.51 (7.58, 8.67) 8.88 ± 2.41 (6.65, 11.11) 7.91 ± 1.13 (7.45, 8.38) T 4 7.80 ± 1.47 (7.27, 8.33) 8.63 ± 2.51 (6.30, 10.95) 7.57 ± 0.98 (7.16, 7.97) T 7 7.49 ± 1.48 (6.96, 8.02) 8.43 ± 2.58 (6.05, 10.82) 7.22 ± 0.91 (6.85, 7.60) T 10 7.14 ± 1.48 (6.61, 7.68) 8.22 ± 2.54 (5.87, 10.57) 6.84 ± 0.89 (6.47, 7.20) T 13 6.85 ± 1.53 (6.30, 7.41) 8.00 ± 2.66 (5.54, 10.46) 6.53 ± 0.89 (6.17, 6.90) Cohen’s d -0.836 -0.347 -1.363 Sarcopenia prevention quizzes T 0 4.63 ± 2.17 (3.84, 5.41) 4.14 ± 2.04 (2.26, 6.03) 4.76 ± 2.22 (3.84, 5.68) T 1 19.22 ± 1.64 (18.63, 19.81) 19.00 ± 1.29 (17.81, 20.19) 19.28 ± 1.74 (18.56, 20.00) T 4 19.81 ± 1.18 (19.39, 20.24) 19.43 ± 1.51 (18.03, 20.83) 19.92 ± 1.08 (19.48, 20.36) T 7 20.50 ± 0.72 (20.24, 20.76) 20.43 ± 0.79 (19.70, 21.16) 20.52 ± 0.71 (20.23, 20.81) T 10 20.59 ± 0.61 (20.37, 20.82) 20.29 ± 0.76 (19.59, 20.98) 20.68 ± 0.56 (20.45, 20.91) T 13 20.81 ± 0.40 (20.67, 20.96) 20.71 ± 0.49 (20.26, 21.17) 20.84 ± 0.37 (20.69, 20.99) Cohen’s d + 10.394 + 11.197 + 10.089 Self-Efficacy for Managing Chronic Disease 6-item Scale T 0 29.56 ± 4.35 (28.00, 31.13) 28.57 ± 5.44 (23.54, 33.60) 29.84 ± 4.08 (28.16, 31.52) T 4 30.00 ± 4.78 (28.28, 31.72) 28.29 ± 6.52 (22.25, 34.32) 30.48 ± 4.21 (28.74, 32.22) T 7 31.75 ± 4.64 (30.08, 33.42) 29.71 ± 5.96 (24.20, 35.23) 32.32 ± 4.16 (30.60, 34.04) T 10 33.09 ± 4.54 (31.46, 34.73) 31.14 ± 5.37 (26.18, 36.11) 33.64 ± 4.24 (31.89, 35.39) T 13 34.34 ± 4.39 (32.76, 35.93) 32.29 ± 4.79 (27.86, 36.71) 34.92 ± 4.19 (33.19, 36.65) Cohen’s d + 1.095 + 0.725 + 1.228 Self-management Behaviour for Chronic Disease Scale (exercise) T 0 1.44 ± 0.84 (1.13, 1.74) 0.57 ± 0.53 (0.08, 1.07) 1.68 ± 0.75 (1.37, 1.99) T 4 7.97 ± 2.25 (7.16, 8.78) 6.86 ± 0.90 (6.03, 7.69) 8.28 ± 2.42 (7.28, 9.28) T 7 7.38 ± 1.70 (6.76, 7.99) 6.86 ± 1.21 (5.73, 7.98) 7.52 ± 1.81 (6.77, 8.27) T 10 7.25 ± 1.93 (6.55, 7.95) 6.29 ± 0.49 (5.83, 6.74) 7.52 ± 2.10 (6.65, 8.39) T 13 7.00 ± 1.80 (6.35, 7.65) 6.29 ± 0.49 (5.83, 6.74) 7.20 ± 1.98 (6.38, 8.02) Cohen’s d + 3.967 + 11.166 + 3.690 Self-management Behaviour for Chronic Disease Scale (cognitive) T 0 7.56 ± 2.68 (6.60, 8.53) 4.86 ± 1.07 (3.87, 5.85) 8.32 ± 2.50 (7.29, 9.35) T 4 8.81 ± 3.13 (7.69, 9.94) 5.86 ± 1.57 (4.40, 7.31) 9.64 ± 2.96 (8.42, 10.86) T 7 9.22 ± 3.44 (7.98, 10.46) 6.43 ± 1.72 (4.84, 8.02) 10.00 ± 3.42 (8.59, 11.41) T 10 9.66 ± 3.45 (8.41, 10.90) 6.71 ± 1.11 (5.69, 7.74) 10.48 ± 3.44 (9.06, 11.90) T 13 9.91 ± 3.19 (8.76, 11.06) 7.29 ± 1.60 (5.80, 8.77) 10.64 ± 3.15 (9.34, 11.94) Cohen’s d + 0.797 + 1.782 + 0.817 Exercise Adherence Rating Scale T 0 3.72 ± 2.14 (2.95, 4.49) 3.43 ± 2.23 (1.37, 5.49) 3.80 ± 2.16 (2.91, 4.69) T 4 19.22 ± 3.61 (17.92, 20.52) 17.71 ± 3.30 (14.66, 20.77) 19.64 ± 3.64 (18.14, 21.14) T 7 18.72 ± 3.78 (17.36, 20.08) 17.14 ± 2.61 (14.73, 19.56) 19.16 ± 3.98 (17.52, 20.80) T 10 18.03 ± 4.40 (16.45, 19.62) 16.43 ± 4.79 (12.00, 20.86) 18.48 ± 4.27 (16.72, 20.24) T 13 17.19 ± 4.56 (15.54, 18.83) 15.29 ± 4.03 (11.56, 19.01) 17.72 ± 4.63 (15.81, 19.63) Cohen’s d + 3.780 + 3.643 + 3.851 Number of exposures to sarcopenia information videos on TikTok T 0 0.00 ± 0.00 (0.00, 0.00) 0.00 ± 0.00 (0.00, 0.00) 0.00 ± 0.00 (0.00, 0.00) T 1 3.41 ± 0.62 (3.18, 3.63) 3.43 ± 0.79 (2.70, 4.16) 3.40 ± 0.58 (3.16, 3.64) T 4 2.50 ± 0.72 (2.24, 2.76) 2.43 ± 0.54 (1.93, 2.92) 2.52 ± 0.77 (2.20, 2.84) T 7 2.44 ± 0.72 (2.18, 2.70) 2.57 ± 0.79 (1.84, 3.30) 2.40 ± 0.71 (2.11, 2.69) T 10 1.72 ± 0.77 (1.44, 2.00) 1.71 ± 0.49 (1.26, 2.17) 1.72 ± 0.84 (1.37, 2.07) T 13 1.00 ± 0.80 (0.71, 1.29) 0.71 ± 0.76 (0.02, 1.41) 1.08 ± 0.81 (0.74, 1.42) Cohen’s d + 1.761 + 1.336 + 1.880 Number of exposures to exercise information videos on TikTok T 0 0.22 ± 0.49 (0.04, 0.40) 0.00 ± 0.00 (0.00, 0.00) 0.28 ± 0.54 (0.06, 0.50) T 1 0.25 ± 0.51 (0.07, 0.43) 0.00 ± 0.00 (0.00, 0.00) 0.32 ± 0.56 (0.09, 0.55) T 4 1.63 ± 0.75 (1.35, 1.90) 1.14 ± 0.38 (0.79, 1.49) 1.76 ± 0.78 (1.44, 2.08) T 7 2.16 ± 0.85 (1.85, 2.46) 1.71 ± 0.49 (1.26, 2.17) 2.28 ± 0.89 (1.91, 2.65) T 10 1.94 ± 0.76 (1.66, 2.21) 1.57 ± 0.79 (0.84, 2.30) 2.04 ± 0.74 (1.74, 2.34) T 13 1.94 ± 0.84 (1.63, 2.24) 1.57 ± 0.79 (0.84, 2.30) 2.04 ± 0.84 (1.69, 2.39) Cohen’s d + 2.498 + 2.825 + 2.489 Note: T 0 = Baseline; T 1 = Week 1 (health education); T 4 = Week 4 (exercise); T 7 = Week 7 (exercise); T 10 = Week 10 (follow-up); T 13 = Week 13 (follow-up). The symbol ‘+’ denotes a positive direction of intervention effect, whereas the symbol ‘-’ indicates a negative direction of intervention effect. Figure 4 shows that from baseline to week 13 the mean handgrip strength in both hands, 4-metre walking speed, mean scores of Self-Efficacy for Managing Chronic Disease 6-item Scale and Self-management Behaviour for Chronic Disease Scale (cognitive) appeared to progressively increase, while sit to stand time appeared to progressively decrease. The sarcopenia prevention scores soared from the baseline to the first week of completing health education and then rose slowly. The mean values of Self-management Behaviour for Chronic Disease Scale (exercise) and Exercise Adherence Rating Scale increased rapidly from the baseline to the fourth week and then showed a slow downward trend until the thirteenth week. The average number of exposures to exercise information videos on TikTok did not change obviously from the baseline to the first week, and the subsequent number rose to the peak in the seventh week and then slightly decreased in the thirteenth week. · Behaviour changes monitoring The monitoring of behaviour change comprises five aspects: exercise adherence rating scale, exposure percentage of exercise and sarcopenia-related videos on TikTok, exercise diaries, behaviour of sharing sarcopenia-related information to others, and willingness to formulate habits of regular exercise in the future. The data analysis of the first two was detailed in Table 3 and Fig. 4 . 1) Exercise diaries Mean value of weekly exercise duration in the exercise diaries of participants was calculated using Mean ± SD, which indicated that the mean frequency of weekly exercise increased a little from 0 at baseline to 0.69 ± 0.97 times in week 1, surged significantly in week 2 to 4.31 ± 1.40 times, and then declined slightly to 3.59 ± 1.19 times by week 13 (Fig. 5 ). 2) Behaviour regarding sharing sarcopenia-related information with others Figure 6 depicts the percentage trend of participants sharing information about sarcopenia at different stages. The findings indicate that the proportion of individuals sharing information regarding sarcopenia was at its peak (54.3%) during the initial week of health education and thereafter declined steadily to 12.5% in the concluding follow-up phase. 3) Willingness to formulate habits of regular exercise in the future All participants (100%) expressed their intention to persist in exercising after the study's conclusion. A total of 24 (75%) participants indicated that they would engage in exercise a minimum of three times weekly and augment it when feasible, while 8 (25%) participants believed that they lacked a predetermined weekly exercise regimen and would engage in exercise when their schedules permitted. · Indicators exhibiting minimal variation The 95%CIs of the mean values across the five measurement timepoints overlapped for the following indices, skeletal muscle mass, trunk skeletal muscle mass, upper-extremity skeletal muscle mass, lower-extremity skeletal muscle mass, skeletal mass index, body fat, body fat percentage, body mass index, protein, bone mineral, upper arm dimension, upper arm muscle dimension, height, weight, calf circumference, abdominal circumference, Mini-Nutritional Assessment Short Form, Self-management Behaviour for Chronic Disease Scale (communication), indicating that the differences experienced minimal fluctuation, either for the overall sample or for men or women, as shown in Supplemental Material − 2. The values of Cohen’s d suggest that the effect size of the SHEEP intervention for these indicators in the total sample (0.003 ⁓ 0.391) and in the female sample (0.011 ⁓ 0.278) was very small to small, but in the male sample (0.000 ⁓ 1.156) was very small to large, as shown in Supplemental Material − 1. Semi-structured interview The study concluded with 26 participants undergoing semi-structured interviews. The interviews were categorised into three primary themes and eight sub-themes: the comprehensive evaluation for this research (study procedures, data collection and measurement, researcher), the participant’s personal experience of the intervention (health education; exercise; behaviour, physical and mental changes), and recommendations for future promotion (challenges encountered, improvement suggestions) as shown in Fig. 7 . Some examples of interview responses are summarized according to different themes, as detailed Supplemental Material − 3. · Theme 1: participants’ comprehensive evaluation of this research 1) Study procedures All 26 participants expressed satisfaction with their involvement in the study and reported feeling at ease and content throughout its duration. 2) Data collection and measurement The 26 participants concurred that the data collecting, and measurement processes were acceptable, with no reported stress or discomfort. 3) Researcher Fourteen (53.85%) participants actively mentioned and expressed favourable opinions of the PI, such as being patient, kind and responsible. · Theme 2: participants’ personal experience of the intervention 1) Health education Using the Likert-5 score, 25 (96.15%) participants rated the health education strategy as very satisfactory, with one (3.85%) rating it as satisfactory. The evaluation of health education strategy was categorised in four aspects: health education content, duration, frequency, and delivery tool. ① Health education content: All participants reportedly found the health education information easy to understand and said that they benefited from the knowledge of sarcopenia prevention to varying degrees. ② Health education duration: 23 (88.46%) participants believed 4–6 minutes per video was appropriate, but three participants thought it could be extended a bit, as they wished to gain more regarding sarcopenia prevention. ③ Health education frequency: participants exhibited variability in the frequency of video viewership during the initial week. Twelve (46.15%) participants reported viewing 1–2 videos at a time, five (19.23%) indicated they preferred to watch all videos in one go, while the remaining nine (34.62%) participants stated that their viewing quantity was contingent upon their mood, but they would complete all videos within the first week. ④ Delivery tool for health education: all participants deemed the acquisition of health education knowledge via TikTok to be acceptable and user-friendly. 2) Exercise intervention Using the Likert-5 score, all participants reported their overall assessment of the exercise strategy as being very satisfied. The evaluation can be distilled into five aspects: exercise content, duration, frequency, promotional film, and delivery tool. ① Exercise content: all participants deemed the exercise content satisfactory and the movement design adequate. Using water bottles for resistance exercise was considered novel by the participants. Furthermore, all participants reported no adverse reactions or discomfort during the exercise. ② Exercise duration: 22 (84.62%) participants stated that an exercise duration of 25 to 30 minutes was suitable, while the remaining 4 (15.38%) individuals deemed it acceptable to moderately extend the duration. ③ Exercise frequency: all participants deemed a frequency of doing exercise at least three times weekly to be entirely attainable. ④ Promotional films about exercise: all participants agreed that the promotional films about resistance exercise for sarcopenia prevention contributed to increasing their awareness of sarcopenia prevention and improving their motivation to exercise. ⑤ Delivery tool of exercise: all participants deemed the use of TikTok for exercise acceptable, citing advantages such as independence of time, location, and climate. 3) Behaviour, physical and mental changes All participants reported experiencing varying degrees of benefit to their subjective feelings, encompassing behaviour, physical, and psychological aspects. Following the exercise intervention, 25 (96.15%) participants reported enhanced strength in their hands and feet, 18 (69.23%) noted an improved mood, 17 (65.38%) experienced greater overall relaxation of the whole body, 16 (61.54%) indicated improved sleep quality, 12 (46.15%) reportedly altered their diet, including increased protein consumption, eight (30.77%) reported an enhanced appetite, five (19.23%) indicated an enhancement in gastrointestinal function, including alleviation of constipation, and four (15.38%) said they had increased energy levels when doing chores in their daily life. In addition, all participants expressed their willingness to learn more about sarcopenia after finishing this project, and to persist in exercising to prevent sarcopenia, and to disseminate information regarding sarcopenia to their family and friends. · Theme 3: recommendations for future promotion Ten participants identified obstacles and dilemmas regarding future promotion of this study. For instance, there are barriers in promoting it to older adults without smartphones, or who have diminished cognitive capacity or low health literacy. Three participants proposed potential solutions, such as creating a hybrid of online and offline formats and enhancing early-stage publicity. DISCUSSION The above findings indicate that SHEEP was both feasible and acceptable for community-dwelling older adults with possible sarcopenia, with the potential to improve their muscular function and physical performance. This study builds upon previous research 21 that demonstrates the viability of a multicomponent intervention (health education plus exercise) based on social media for older persons by enhancing our understanding of sarcopenia prevention in community-dwelling young-old adults. Preliminary evidence from this one-arm pre-post study found trends towards improvement in handgrip strength, walking speed, sit-to-stand function, knowledge of sarcopenia prevention, self-efficacy in managing chronic disease, self-management behaviours for chronic disease (particularly in exercise and cognitive domains), and exercise adherence. The effect size of the SHEEP intervention for these indices was large to very large, which may aid in determining sample size for any forthcoming randomised controlled trial. However, other information supporting the sample size calculation needs to be fully integrated, as small sample sizes in this study may generate inaccurate effect sizes 33 . As for study design, the rationale for employing a one-arm pre-post feasibility study, rather than a feasibility study of a randomised controlled trial, mostly stemmed from constraints in time and researcher resources. The recruiting period was limited to two to three weeks, making the recruitment of 35 individuals feasible; nevertheless, securing 60–70 participants posed significant challenges. Additionally, all research processes were solely managed by the principal investigator. Despite being an online intervention, it was challenging to complete the measurements for 60–70 participants concurrently, necessitating increased research resources in any future randomised controlled trial. Regarding recruitment capability, while this research achieved the target sample size, there were difficulties recruiting a representative sample. The percentage of participants aged 65–69 years (80.0%) was markedly greater than that of those aged 60–64 years (20.0%). The proportion of male participants was much lower, at 20.0%, in contrast to females, at 80.0%. Greater representation of those aged 65–69 may reflect a higher frequency of possible sarcopenia in these groups. In our last study involving 30 participants 21 , the proportion of those aged 65–69 (70.0%) also exceeded that of those aged 60–64 (30.0%). Therefore, the prevalence of possible sarcopenia may be indeed higher in 65-69year olds than those aged 60-64years; however stratified descriptions of these two age groups were lacking in the previous studies 4 , 7 , 34 , 35 . Prior work has also identified lower research engagement by community-dwelling older males in exercise interventions for sarcopenia treatment and prevention 9 , 36 – 38 , which aligns with the findings of this study. We also cannot dismiss the possibility that these two issues stem from inadequate publicity. Only three recruitment channels were used in this study, namely electronic leaflets, paper leaflets, and word of mouth among residents. Electronic leaflets have demonstrated a significant advantage in recruitment throughout the Internet era. Two participants in the semi-structured interviews expressed a desire to improve the study's visibility through a collaborative initiative by community health service centres, such as hosting events or talks. This may pertain to the cultural background of the community in China. Typically, the initiatives conducted by the community health service centres will earn the trust and backing of local inhabitants. In addition, among the 35 participants recruited, a greater number of participants came from Sanchaji Community (33) than from Guanshaling Community (2). This may be because the former has an activity centre for seniors, which facilitated the sharing and dissemination of recruitment information. This suggests that communities without senior centres require increased extra publicity and recruitment effort, and future RCTs may be more viable in settings with a community health service centre. The entire research process was acceptable and progressed seamlessly. All participants in the interviews expressed satisfaction with their involvement in the study, and acceptance of the measurement process. The mean value of total measurement time was gradually reduced from 36.26 ± 2.48 mins at the initial baseline to 35.37 ± 2.50 mins at the end of the study. This small difference may relate to increased familiarity with the assessment process on the part of both researchers and participants. Participants exhibited a high compliance rate with health education and exercise interventions, both above 90%. Despite three participants withdrawing from the study during the intervention, none did so for reasons related to this research. The good compliance rate may be attributed to two factors. Firstly, participants demonstrated very high satisfaction with the health education and exercise intervention strategies, including the content, duration, frequency. This may be linked to the co-design method employed throughout the intervention development phase and may also be related to the advantages offered by social media, which are unaffected by time, location, or climate 21 . Secondly, some participants specifically identified the researchers' patient, enthusiastic, empathetic demeanour and good communication as motivating factors for their commitment to the intervention. Participants cited this issue as directly linked to the prevailing lack of medical resources in China and the strained dynamics between physicians and patients 39 , 40 . Physicians often lack the requisite time and patience to communicate effectively with patients 41 , 42 , hindering the provision of comprehensive health education for illness prevention. This underscores the value and significance of social media-based interventions. The study was completed within the stated timeframe, but the scheduling of each component required adjustment based on the actual circumstances. First, we prolonged the original two-week recruitment and training period to three weeks, despite having already acquired some recruiting experience from the previous study 21 , including familiarity with communities and managers. This indicates that a duration of three weeks is insufficient for conducting a larger recruitment in new communities. As mentioned above, alongside strengthened cooperation with community health service centres and enhanced advocacy initiatives, a suitable prolongation of the recruitment timeframe may prove beneficial if a more representative sample is planned. In addition, the cultural context and lifestyle practices of the research location must be thoroughly considered. For example, our original recruitment plan included an email contact option; however, the older population in China seldom used email. Besides telephone communication, younger older adults also prefer to use social media platforms, such as WeChat and WhatsApp 43 , 44 , for interaction, which might be explored in future research. The measurement indices, both subjective and objective, demonstrated that the intervention outcomes have shown trends in a positive direction. According to their subjective reports, participants exhibited notable enhancements in knowledge regarding sarcopenia prevention, self-efficacy and self-management behaviour for managing chronic disease, and exercise adherence. This may be related to the formulation of a robust theoretical framework in our previous work 20 . Interventions based on the Behaviour Change Wheel 45 could effectively improve knowledge, attitudes, and behaviours related to health promotion, which is corroborated by other studies 46 – 48 . Moreover, all subjects reportedly experienced varying degrees of beneficial changes in their physical and mental health, including increased strength in their hands and feet, improved mood, greater overall relaxation, enhanced sleep quality, increased protein intake, heightened appetite, improved gastrointestinal function, and elevated energy levels. This reflects the potential benefits of exercise interventions. Exercise therapy typically addresses multiple physiological systems concurrently, in contrast to pharmaceutical methods that usually focus on a single outcome in disease management. In certain conditions, such as sarcopenia, where no effective pharmacological therapy exists, exercise may play an important role in prevention and treatment 49 . From the perspective of objective measurements, SHEEP may have the potential to improve the muscular function and physical performance of community-dwelling young-old adults with possible sarcopenia, especially for handgrip strength, walking speed, and sit-to-stand ability. Several RCT studies of sarcopenia treatment using digital interventions have yielded comparable findings in handgrip strength 50 , 51 , but not in walking speed or sit-to-stand function 52 . This may be due to different aspects of the intervention, such as the intervention content, frequency, delivery tool, and varying sample sizes. However, in our study, only the overall sample and the female sample exhibited a very-large effect size in the analysis of these three indices, whereas the male sample lacked statistical significance on 95%CIs, probably due to very small sample size. This indicates the necessity of increasing male participant recruitment in future research. Furthermore, our study found a progressive upward trend in trunk and upper-extremity skeletal muscle mass, although without statistical significance. This may be attributed to the resistance training in our exercise strategy and the nutrition section in our health education strategy having resulted in some participants augmenting their daily protein consumption. The evidence suggests that resistance training positively and significantly impacts muscle mass in older persons 53 , while a combination of exercise and nutrition interventions based on digital tools can indeed also improve muscle mass in older people with sarcopenia 50 – 52 . Furthermore, upper arm muscle dimension also exhibited an upward trend, which indicates that the exercise intervention in the SHEEP may be more efficacious for the upper limb musculature. However, a comprehensive randomised controlled trial is necessary in the future to validate the effectiveness of the SHEEP. It is important to highlight that the minimum exercise duration (90 minutes per week = 30 minutes each session × 3 sessions per week) proposed in the final SHEEP exercise strategy falls short of the recommended standard (150 minutes per week) set by the UK’s Department of Health and Social Care and the USA’s Centres for Disease Control and Prevention 54 , 55 . This is probably related to the exercise habits and concepts of older people in China. Senior Chinese individuals engage in the cultural practice of walking post-meal and uphold the ancient custom of caring for family and children. They consider post-meal walks and household chores to be irreplaceable physical activities which are integral to their lives. Consequently, most older individuals persisted in undertaking both activities during the exercise intervention in our study, leading to an inability to sustain moderate-intensity exercise five times weekly over an extended period. This is evidenced by the gradual decrease in the average frequency of exercise from 4.31 ± 1.40 times in the first week of the feasibility study to 3.59 ± 1.19 times in the twelfth week. In addition, our exercise strategy adheres to the progressive principle, as the current minimum exercise duration of 90 minutes a week is intended for older individuals without exercise habits, while the ultimate objective is 150 minutes a week. This goal cannot be attained in this short-term feasibility study; therefore, a prolonged intervention period must be established in future RCTs to accomplish it. CONCLUSION This study demonstrated that it was feasible and safe to deliver a social media-based multicomponent intervention for community-dwelling older adults with possible sarcopenia, including recruitment, training, assessment, and intervention procedure. The whole research process was also acceptable to both researchers and participants. This is the first research exploring the operability of a social media-based intervention for older adults with possible sarcopenia in a real-world environment. The findings may enhance our comprehension of the implementation of health education and exercise using TikTok within community settings, encompassing possible effects, benefits, and challenges. The anonymised participant-level dataset will not be publicly available but will be available from the principal investigator upon reasonable request. There were still some limitations to this research. First, the study lacked a control group, making it difficult to eliminate the influence of confounding factors. To tackle this issue, a future RCT will be required. Secondly, this study recruited samples from only two communities, possibly leading to a sample that was not adequately representative. The representativeness of future studies could be enhanced by expanding the recruitment time and area. Thirdly, small sample sizes in this study may yield inaccurate effect estimates; therefore, it is advisable to use this data in conjunction with additional information to estimate sample sizes for subsequent study. Fourthly, among the 35 participants, three withdrew at different stages and did not participate in the final measurement after the intervention. We ultimately employed the data of 32 participants for analysis, while this approach is straightforward but might result in a decrease in statistical efficiency and introduce bias when the data missing is not random. In subsequent studies, attention should be given to the collection of data from those who drop out. Fifthly, the exercise design failed to include older persons who depend on mobility aids such as wheelchairs. Future studies could explore the creation of customised exercise programmes for this specific demographic. Finally, this study excluded older people who did not have Internet access. Therefore, exploring the possibility of integrating both online and offline interventions to prevent sarcopenia is also an area for innovation in the future. Declarations Competing interests The authors declare that they have no competing interest. Author Contribution Y.S.: conceptualization, methodology, investigation, trial management, data analysis & interpretation, writing – original draft, writing – reviewing & editing, supervision, funding acquisition. E.S.: conceptualization, methodology, writing – reviewing & editing, supervision. L.M.: conceptualization, methodology, writing – reviewing & editing, supervision, funding acquisition. X.H.W.: methodology, writing – reviewing & editing. C.G.: methodology, writing – reviewing & editing. Y.Y.: methodology, data analysis & interpretation, writing – reviewing & editing. C.T.: conceptualization, methodology, writing – reviewing & editing, supervision, funding acquisition. All authors read and approved of the final manuscript. Acknowledgement We extend our sincere appreciation to Mr. Guojun Xiong, Ms. Fenghui Liu, and Mr. Heng Chen, managers of the Guanshaling and Sanchaji Community Health Service Centres in Changsha, China, for their invaluable support in facilitating participant recruitment for this study. Besides, this work was supported by the University of Manchester - China Scholarship Council Joint Scholarship (Award No. 202108320049 to Dr Ya Shi). Additional support was provided by the National Institute for Health and Care Research (NIHR) through a Senior Investigator Award (NIHR200299 to Prof Chris Todd) and the NIHR Policy Research Unit in Healthy Ageing, Older People and Frailty (Grant Refs: NIHR206119 and NIHR PR-PRU-1217-2150 to Dr Lisa McGarrigle). Data Availability Original data will be provided by the corresponding author upon reasonable request. References Kirk B, Cawthon PM, Arai H, et al. The Conceptual Definition of Sarcopenia: Delphi Consensus from the Global Leadership Initiative in Sarcopenia (GLIS). Age Ageing . 2024; 53(3): afae052. doi: 10.1093/ageing/afae052 Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing . 2019;48(4):601. doi: 10.1093/ageing/afz046 Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc . 2020;21(3):300–307.e2. doi: 10.1016/j.jamda.2019.12.012 Pérez-Sousa MÁ, Pozo-Cruz JD, Cano-Gutiérrez CA, et al. High Prevalence of Probable Sarcopenia in a Representative Sample from Colombia: Implications for Geriatrics in Latin America. J Am Med Dir Assoc . 2021; 22 (4): 859–864.e1. doi:10.101 6/j.jamda.2020.10.021 Tsekoura M, Billis E, Matzaroglou C, et al. Prevalence of probable sarcopenia in community-dwelling older Greek people. J Frailty Sarcopenia Falls . 2021; 6(4): 204–208. doi: 10.22540/JFSF-06-204 Paludo CDS, Gonzalez TN, Soares PSM, Meucci RD. Prevalence and factors associated with probable sarcopenia in southern Brazil: a population-based study. Rural Remote Health . 2024;24(3):8711. doi: 10.22605/RRH8711 Chen Z, Ho M, Chau PH. Prevalence, Incidence, and Associated Factors of Possible Sarcopenia in Community-Dwelling Chinese Older Adults: A Population-Based Longitudinal Study. Front Med (Lausanne) . 2022; 8:769708.10. doi: 10.3389/fmed.20 21.769708 Lim SK, Kong S. Prevalence, physical characteristics, and fall risk in older adults with and without possible sarcopenia. Aging Clin Exp Res . 2022; 34(6):1365–1371. doi: 10.1007/s40520-022-02078-z Merchant RA, Chan YH, Hui RJY, et al. Possible Sarcopenia and Impact of Dual-Task Exercise on Gait Speed, Handgrip Strength, Falls, and Perceived Health. Front Med (Lausanne) . 2021; 8:660463. doi: 10.3389/fmed.2021.660463 Ullevig SL, Zuniga K, Austin Lobitz C, et al. Egg protein supplementation improved upper body muscle strength and protein intake in community-dwelling older adult females who attended congregate meal sites or adult learning centres: A pilot randomized controlled trial. Nutr Health . 2022; 28(4):611–620. doi: 10.1177/02601060211051592 Pan WM, Huang G, Wang B, et al. Effects of integrated intervention on muscle mass and physical functions in the elderly individuals with possible sarcopenia in a community hospital. Chin J Mult Organ Dis Elderly . 2022; 21(2): 021. doi: 10.11915/j.issn.1671-5403.2022.02.021 . Dong X, Mo YH, Wang XH, et al. Effects of resistance exercise on muscle mass, muscle strength and physical performance in the elderly at risk of sarcopenia. Chinese Nursing Management . 2021; 21(8): 1190–1195. doi: 10.3969/j.issn.1672-1756.2021.08 . 015. Shi Y, Tang Y, Stanmore E, et al. Non-pharmacological interventions for community-dwelling older adults with possible sarcopenia or sarcopenia: a scoping review. Arch Gerontol Geriatr . 2023; 112: 105022. doi: 10.1016/j.archger.2023.105022 Lipschitz JM, Van Boxtel R, Torous J, et al. Digital Mental Health Interventions for Depression: Scoping Review of User Engagement. J Med Internet Res . 2022; 24(10): e39204. doi: 10.2196/39204 Marvel FA, Spaulding EM, Lee MA, et al. Digital Health Intervention in Acute Myocardial Infarction. Circ Cardiovasc Qual Outcomes . 2021; 14(7): e007741. doi: 10.1161/CIRCOUTCOMES.121.007741 Lee S, Rajaguru V, Baek JS, et al. Digital Health Interventions to Enhance Tuberculosis Treatment Adherence: Scoping Review. JMIR Mhealth Uhealth . 2023; 11: e49741. doi: 10.2196/49741 Reinders P, Augustin M, Kirsten N, et al. Digital health interventions in dermatology-Mapping technology and study parameters of systematically identified publications. J Eur Acad Dermatol Venereol . 2023; 37(12): 2440–2449. doi: 10.1111/jdv. 19392 Willis VC, Thomas Craig KJ, Jabbarpour Y, et al. Digital Health Interventions to Enhance Prevention in Primary Care: Scoping Review. JMIR Med Inform . 2022; 10(1): e33518. doi: 10.2196/33518 Shi Y, Stanmore E, McGarrigle L, et al. Effectiveness of digital health exercise interventions on muscle function and physical performance in older adults with possible, confirmed, or severe sarcopenia: A systematic review and meta-analysis. ( In preparation for submission to an appropriate journal ) Shi Y, Stanmore E, McGarrigle L, et al. Social-media based Health Education plus Exercise Programme (SHEEP) to improve muscle function among community-dwelling young-old adults with possible sarcopenia in China: A study protocol for intervention development. PLoS One . 2024;19(3): e0286490. doi: 10.1371/journal.pone. 0286490 Shi Y, Stanmore E, McGarrigle L, et al. Development of a community intervention combining social media-based health education plus exercise programme (SHEEP) to improve muscle function among young-old adults with possible sarcopenia: Co-design approach. Maturitas . 2024;186:108027. doi: 10.1016/j.maturitas.2024.108027 Orsmond GI, Cohn ES. The Distinctive Features of a Feasibility Study: Objectives and Guiding Questions. OTJR (Thorofare N J). 2015; 35(3):169–177. doi: 10.1177/1539449215578649 Shi Y, Stanmore E, McGarrigle L, et al. Social-media based health education plus exercise programme (SHEEP) to improve muscle function among young-old adults with possible sarcopenia in the community: A feasibility study protocol. PLoS One . 2025; 20(1): e0303481. doi: 10.1371/journal.pone.0303481 Eldridge SM, Chan CL, Campbell MJ, et al. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ . 2016; 355: i5239. doi: 10.1136/bmj.i52 39 Butcher NJ, Monsour A, Mew EJ, et al. Guidelines for Reporting Outcomes in Trial Reports: The CONSORT-Outcomes 2022 Extension. JAMA . 2022; 328(22): 2252–2264. doi: 10.1001/jama.2022.21022 Lancaster GA, Thabane L. Guidelines for reporting non-randomised pilot and feasibility studies. Pilot Feasibility Stud . 2019; 5:114. doi: 10.1186/s40814-019-0499-1 Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc . 1982; 14(5): 377–381. doi: 10.1249/00005768-198205000-00012 Nerys W. The Borg Rating of Perceived Exertion (RPE) scale. Occupational Medicine . 2017; 67(5): 404–405. https://doi.org/10.1093/occmed/kqx063 Cohen J. Statistical Power Analysis for the Behavioural Sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates. 1988. https://doi.org/10.4324/97802037 71587 Morris SB, DeShon RP. Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychological Methods . 2002; 7 (1): 105–125. doi: 10.1037/1082-989X.7.1.105 Sullivan GM, Feinn R. Using Effect Size-or Why the P Value Is Not Enough. J Grad Med Educ . 2012;4(3):279–282. doi: 10.4300/JGME-D-12-00156.1 Braun V, Clarke V. Thematic analysis: practical guide. London: Sage; 2022. Sim J. Should treatment effects be estimated in pilot and feasibility studies? Pilot Feasibility Stud . 2019; 5: 107. doi: 10.1186/s40814-019-0493-7 Yao J, Wang Y, Yang L, et al. Prevalence of possible sarcopenia in community-dwelling older Chinese adults: a cross-sectional study. BMJ Open . 2022; 12(12): e067 425. doi: 10.1136/bmjopen-2022-067425 Wu X, Li X, Xu M, et al. Sarcopenia prevalence and associated factors among older Chinese population: Findings from the China Health and Retirement Longitudinal Study. PLoS One . 2021; 16(3): e0247617. doi: 10.1371/journal . pone.0247617 Makizako H, Nakai Y, Tomioka K, et al. Effects of a Multicomponent Exercise Program in Physical Function and Muscle Mass in Sarcopenic/Pre-Sarcopenic Adults. J Clin Med . 2020; 9(5): 1386. doi: 10.3390/jcm9051386 Jones C, Chen KM, Weeks B, et al. Healthy Beat Acupunch exercise program: Validation and feasibility study for older adults with reduced physical capacity or probable sarcopenia. Explore (NY) . 2021; 17(6): 498–504. doi:10.1016/j. explore.2020. 05.010 Chang KV, Wu WT, Huang KC, et al. Effectiveness of early versus delayed exercise and nutritional intervention on segmental body composition of sarcopenic elders - A randomized controlled trial. Clin Nutr . 2021; 40(3): 1052–1059. doi:10.1016/j. clnu.2020.06.037 Nie JB, Cheng Y, Zou X, et al. The vicious circle of patient-physician mistrust in China: health professionals' perspectives, institutional conflict of interest, and building trust through medical professionalism. Dev World Bioeth . 2018; 18(1): 26–36. doi: 10.1111/dewb.12170 Wu ZJ, Trigo V. Views on Current Situation, Causes and Responses of Doctor-Patient Conflicts in New Situations. Proceedings of the 2020 4th International Seminar on Education, Management and Social Sciences (ISEMSS 2020). 2020.10.2991/assehr. k.200826.184 Chen L, Tang H, Guo Y. Effect of Patient-Centered Communication on Physician-Patient Conflicts from the Physicians' Perspective: A Moderated Mediation Model. J Health Commun . 2022; 27(3):164–172. doi: 10.1080/10810730.2022.2071505 Zhou P, Grady SC. Three modes of power operation: Understanding doctor-patient conflicts in China's hospital therapeutic landscapes. Health Place . 2016; 42: 137–147. doi: 10.1016/j.health place.2016.09.005 Wei N, Sun D, Huang W. Effects of WeChat use on the subjective health of older adults. Front Psychol . 2022; 13: 919889. doi: 10.3389/fpsyg.2022.919889 Braunwalder R, Reiner J, Pauli C, et al. Older Adults’ Use of Whatsapp in a Polymedia Environment: Managing Timing, Content, Form and Practicality. In: Ziefle, M., Guldemond, N., Maciaszek, L.A. (eds) Information and Communication Technologies for Ageing Well and e-Health. ICT4AWE 2020. Communications in Computer and Information Science . 2021; 1387. https://doi.org/10.1007/978-3-030-70807-8_4 Michie S, van Stralen MM, et al. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci . 2011; 6:42. doi: 10.1186/1748-5908-6-42 Hakvoort L, Dikken J, van der Wel M, et al. Minimizing the knowledge-to-action gap; identification of interventions to change nurses' behavior regarding fall prevention, a mixed method study. BMC Nurs . 2021; 20(1): 80. doi: 10.1186/s12912-021-00598-z Younas F, Gutman LM. Using the Behaviour Change Wheel (BCW) to Characterise Parenting Interventions to Prevent Intergenerational Child Abuse. Int. Journal on Child Malt . 2022; 5:133–154. https://doi.org/10.1007/s42448-021-00103-8 Chen D, Zhang H, Cui N, et al. Development of a behavior change intervention to improve physical activity adherence in individuals with metabolic syndrome using the behavior change wheel. BMC Public Health . 2022; 22(1): 1740. doi: 10.1186/s12889-022-14129-1 Izquierdo M, Merchant RA, Morley JE, et al. International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. J Nutr Health Aging . 2021; 25(7): 824–853. doi: 10.1007/s12603-021-1665-8 Li Z, Cui M, Yu K, et al. Effects of nutrition supplementation and physical exercise on muscle mass, muscle strength and fat mass among sarcopenic elderly: a randomized controlled trial. Appl Physiol Nutr Metab . 2021; 46(5): 494–500. doi: 10.1139/apnm-2020-0643 Zhang Y, Li JL, Deng WH. Application effect of Internet combined with H2H nutritional management mode in older patients with sarcopenia [J]. Medical theory and practice . 2023, 36(23): 4105–4108. doi: 10.19381/j.issn.1001-7585.2023.23.057 . Wang Z, Xu X, Gao S, et al. Effects of Internet-Based Nutrition and Exercise Interventions on the Prevention and Treatment of Sarcopenia in the Elderly. Nutrients . 2022; 14(12): 2458. doi: 10.3390/nu14122 Beckwée D, Delaere A, Aelbrecht S, et al. Exercise Interventions for the Prevention and Treatment of Sarcopenia. A Systematic Umbrella Review. J Nutr Health Aging . 2019; 23(6): 494–502. doi: 10.1007/s12603-019-1196-8 National Health Service. Physical activity guidelines for older adults. September 24, 2021. https://www.nhs.uk/live-well/exercise/exercise-guidelines/physical-activity-guidelines-older-adults/ Centers for Disease Control and Prevention (CDC). How much physical activity do older adults need? June 3, 2022. https://www.cdc.gov/physicalactivity/basics/older_adults/index.htm Additional Declarations No competing interests reported. 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1","display":"","copyAsset":false,"role":"figure","size":981271,"visible":true,"origin":"","legend":"\u003cp\u003eDetailed recruitment and withdrawal process\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7624386/v1/e47c876e124af5b964e6241f.jpeg"},{"id":92575421,"identity":"a47cef2b-3930-4f28-9433-08587ed3c359","added_by":"auto","created_at":"2025-10-01 08:20:57","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":655435,"visible":true,"origin":"","legend":"\u003cp\u003eDetailed intervention and withdrawal process\u003c/p\u003e","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7624386/v1/31a9bd5bae112f7221d9c776.jpeg"},{"id":92576661,"identity":"20c9c198-bf18-46f7-a241-7d6b678ad9a0","added_by":"auto","created_at":"2025-10-01 08:28:57","extension":"jpeg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":793592,"visible":true,"origin":"","legend":"\u003cp\u003eA practical timeline for conducting the feasibility study\u003c/p\u003e","description":"","filename":"floatimage3.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7624386/v1/244c8ed89b224fb78abd14c1.jpeg"},{"id":92575411,"identity":"f856f7b1-1603-4ae1-a10d-681f11db87fa","added_by":"auto","created_at":"2025-10-01 08:20:57","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":354440,"visible":true,"origin":"","legend":"\u003cp\u003eTrend of the 95%CIs of the mean values in indicators with obvious changes from baseline to week 13\u003c/p\u003e\n\u003cp\u003eNote: T\u003csub\u003e0 \u003c/sub\u003e= Baseline; T\u003csub\u003e1\u003c/sub\u003e= Week 1 (health education); T\u003csub\u003e4\u003c/sub\u003e= Week 4 (exercise); T\u003csub\u003e7\u003c/sub\u003e = Week 7 (exercise); T\u003csub\u003e10\u003c/sub\u003e = Week 10 (follow-up); T\u003csub\u003e13\u003c/sub\u003e = Week 13 (follow-up).\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-7624386/v1/1f018de577f04ef5e272541b.png"},{"id":92575427,"identity":"984c5701-c474-459c-9a35-0fa52d6fba68","added_by":"auto","created_at":"2025-10-01 08:20:57","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":115230,"visible":true,"origin":"","legend":"\u003cp\u003eTrend of the mean exercise duration reported in participants’ exercise diaries over the course of the study\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-7624386/v1/ea474beef68652d1a9b475f1.png"},{"id":92575417,"identity":"793dd315-96ba-49b4-8ab0-36b388d93274","added_by":"auto","created_at":"2025-10-01 08:20:57","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":85185,"visible":true,"origin":"","legend":"\u003cp\u003eTrend of percentage of participants sharing information in different measurement points\u003c/p\u003e\n\u003cp\u003eNote: T\u003csub\u003e0 \u003c/sub\u003e= Baseline; T\u003csub\u003e1\u003c/sub\u003e= Week 1 (health education); T\u003csub\u003e4\u003c/sub\u003e= Week 4 (exercise); T\u003csub\u003e7\u003c/sub\u003e = Week 7 (exercise); T\u003csub\u003e10\u003c/sub\u003e = Week 10 (follow-up); T\u003csub\u003e13\u003c/sub\u003e = Week 13 (follow-up).\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-7624386/v1/d9111525a736d9bc514b15b4.png"},{"id":92575416,"identity":"b262314a-137f-4ab9-b7f4-82378664a08c","added_by":"auto","created_at":"2025-10-01 08:20:57","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":131496,"visible":true,"origin":"","legend":"\u003cp\u003eTheme analysis results of the semi-structured interviews\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-7624386/v1/6ad6c346538548572dc20f9b.png"},{"id":106809872,"identity":"0f172df2-90fa-4850-b851-005ca181e9d0","added_by":"auto","created_at":"2026-04-13 16:13:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4246991,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7624386/v1/e0887f0a-8fb9-4c2c-93b1-64ffe03fccfc.pdf"},{"id":92575403,"identity":"83aa7786-605a-4ac6-bc9a-f113d1a86e3f","added_by":"auto","created_at":"2025-10-01 08:20:56","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":1142749,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementmaterials.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7624386/v1/d83a2c408478a95f1db7d8bf.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Social media-based health education plus exercise programme (SHEEP) to improve muscle function among community-dwelling young-old adults with possible sarcopenia: A feasibility study","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eThe 2024 conceptual definition established by the Global Leadership Initiative in Sarcopenia (GLIS) defines sarcopenia as an age-related generalised disease of skeletal muscle, marked by reduced muscle mass and strength, which may lead to compromised physical performance\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Sarcopenia can be classified into three categories (possible/probable, confirmed, and severe sarcopenia) according to distinct diagnostic criteria recommended by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2)\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e and the Asian Working Group for Sarcopenia 2 (AWGS2)\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003c/sup\u003e aimed at addressing the requirements of the community and clinical practice more effectively. Possible sarcopenia is characterised by diminished muscle strength, with or without decreased physical performance, and is strongly advocated by both EWGSOP2 and AWGS2 as a critical threshold for screening and prevention in primary care, particularly in community environments\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003ePossible sarcopenia is highly prevalent among older adults in the community and is affected by various factors, as indicated by studies from multiple nations. A cross-sectional study\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e evaluated 5,237 Colombian older adults (\u0026ge;\u0026thinsp;60 years) in accordance with EWGSOP2 guideline, indicating a 46.5% prevalence of possible sarcopenia; those with physical inactivity, diabetes, arthritis, or osteoarthritis and rheumatism exhibited a higher prevalence of possible sarcopenia. Tsekoura et al.\u003csup\u003e5\u003c/sup\u003e identified a 25.4% prevalence of possible sarcopenia using EWGSOP2 criteria among Greek older people (\u0026gt;\u0026thinsp;60 years) in a study involving 402 participants, revealing a positive correlation with age, gender, body mass index, skeletal muscle mass index, calf circumference, and comorbidities. A population-based study\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e involving 651 older persons (\u0026ge;\u0026thinsp;60 years) in Brazil indicated a 19.2% prevalence of possible sarcopenia using EWGSOP2 criteria, with associations seen for sex, age, underweight status, diabetes mellitus, and hospitalisation within the preceding year. Chen et al.\u003csup\u003e7\u003c/sup\u003e examined data from 4,866 participants (\u0026ge;\u0026thinsp;60 years) in China, revealing a 46.0% prevalence of possible sarcopenia according to AWGS2 criteria. The findings indicated that advanced age and depressive symptoms correlated with a heightened prevalence of possible sarcopenia, whereas education and moderate to high physical activity were linked to a reduced risk of its prevalence\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. A study involving 431 participants (\u0026ge;\u0026thinsp;65 years) in Korea indicated that possible sarcopenia had a 23.7% prevalence in older persons, and was particularly prevalent among those with reduced weight, body mass index, skeletal muscle mass, or fat-free mass\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eDue to the advocacy for sarcopenia prevention in primary care and community settings by worldwide organisations, research on interventions for possible sarcopenia has progressively intensified in recent years. For example, Merchant et al.\u003csup\u003e9\u003c/sup\u003e evaluated the impact of a community-based dual-task exercise programme on older adults with possible sarcopenia, revealing its effectiveness in enhancing gait speed and Short Physical Performance Battery scores, and reducing the prevalence of poor handgrip strength. Ullevig et al.\u003csup\u003e10\u003c/sup\u003e conducted a double-blinded randomised controlled pilot study, demonstrating that daily supplementation with egg white protein enhanced protein consumption and bolstered upper body physical function in primarily low-income Latina older women with possible sarcopenia. Pan et al.\u003csup\u003e11\u003c/sup\u003e designed a 12-week randomised controlled trial which indicated that progressive resistance training and nutrition effectively decreased body fat percentage, augmented appendicular muscle mass, enhanced handgrip strength, and diminished sitting duration of Chinese older adults in the community. Dong et al.\u003csup\u003e12\u003c/sup\u003e discovered that a 12-week regimen of resistance band training enhanced total muscle mass, skeletal muscle index, grip strength, and Berg balance scale scores in older individuals with possible sarcopenia residing in nursing homes. However, in contrast to the studies on sarcopenia treatment, the research into sarcopenia prevention is rather under-researched. Our scoping review compared 59 studies about non-pharmacological interventions for community-dwelling older adults with three categories of sarcopenia and indicated that the number of studies involving older adults with sarcopenia (72.9%) far surpassed that of studies involving those with possible sarcopenia (11.9%)\u003csup\u003e13\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eAdditionally, digital health interventions have gradually attracted the attention of scholars in the sarcopenia area. The ongoing advancement of the Internet, big data, artificial intelligence, augmented reality, mobile applications, and other technologies is establishing a robust technical foundation for the swift evolution of digital health. Concurrently, the global COVID-19 pandemic has resulted in an increased demand for tele-medicine worldwide, hence advancing the development and implementation of digital health technologies, with digital health interventions being actively advocated across numerous research areas\u003csup\u003e\u003cspan additionalcitationids=\"CR15 CR16 CR17\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. Interventions for sarcopenia have increasingly used digital health technologies; however, this integration is still in its early stages. Our recent systematic review identified only four studies about digital health exercise interventions in older adults with three categories of sarcopenia, but these concentrated primarily on the treatment of sarcopenia rather than its prevention, and no research explored the use of social media in this area\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. Besides, the corresponding meta-analysis indicated that digital health exercise alone did not confer any benefit in enhancing muscle mass or sit-to-stand function in older people with sarcopenia, and there is limited data regarding the effect of digital health exercise on handgrip strength\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eHence, it is novel and valuable to explore the possibility of a social media-based multicomponent intervention for sarcopenia prevention in community-dwelling older adults. We have completed an intervention development study to provide a theoretical conceptual framework for social media-based interventions and to formulate a health education plus exercise intervention utilising TikTok for sarcopenia prevention (SHEEP) through co-design with pertinent stakeholders\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. This study extends our prior research to further validate the feasibility and acceptability of the research design and the SHEEP intervention among young-old adults with possible sarcopenia living in the community. The specific objectives include evaluating outcomes related to feasibility, including recruitment capability, data collection procedure, intervention suitability, outcome assessment process, researcher management ability, implementation feasibility, and research acceptability\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. The corresponding study protocol delineates a more comprehensive research background and the detailed research objectives of this study programme\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. The findings of this feasibility study will facilitate and establish a foundation for our forthcoming randomised controlled trial, and aid in supporting, guiding, and enhancing subsequent pertinent studies.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003eStudy design and reporting\u003c/p\u003e\u003cp\u003eThe study employs a single-arm prospective pre-post design to assess the feasibility, acceptability, and preliminary impact of the SHEEP on preventing sarcopenia in community-dwelling young-old individuals with possible sarcopenia. Both quantitative and qualitative methods are employed to evaluate the research outcomes. This study is reported in accordance with the CONSORT extension to pilot and feasibility trials\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e (excluding items that are specific to the randomisation nature of the study) and the Guidelines for Reporting Outcomes in Trial Reports (the CONSORT-Outcomes 2022 Extension)\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. We also refer to the guidelines for reporting non-randomised pilot and feasibility studies proposed by Lancaster et al.\u003csup\u003e26\u003c/sup\u003e. This study was registered at the ISRCTN registry (trial registration number: ISRCTN17269170; date: 14 September 2023). The study protocol has been previously published in PLOS ONE\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eResearch setting and ethics\u003c/p\u003e\u003cp\u003eThis feasibility study was conducted in Changsha city, Hunan Province, China. The recruitment and intervention procedures were carried out in two communities: Sanchaji Community and Guanshaling Community. This study was approved by the University of Manchester Research Ethics Committee (Project ID: 2024-19302-34066), and appropriate permissions were also granted by the two collaborating community health centres and the Community Nursing Department of Xiang Ya Nursing School, Central South University, China.\u003c/p\u003e\u003cp\u003eParticipants, recruitment, consent, and withdrawal\u003c/p\u003e\u003cp\u003eThe principal investigator (PI) visited the two community health centres to present the research to the managers and obtain their agreement. The PI explained the eligibility criteria for participation given in the information leaflets\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. The managers facilitated the distribution of printed informational leaflets to older people visiting community health centres and disseminated electronic recruitment leaflets to community WeChat groups. Older persons expressed their interest in this study by contacting the PI through the managers or using the contact information provided in the leaflet. In accordance with the inclusion and exclusion criteria, the PI conducted an initial eligibility screening via phone or email, and upon confirmation, carried out assessments in an office provided by the community health centre. Eligible participants received a comprehensive explanation of the research along with a Participant Information Sheet and were afforded a minimum of 24 hours to decide upon participation. Informed consent, either written or verbal, was obtained via face-to-face interactions or telephone calls from participants who agreed to take part in the study. Participants were allowed to withdraw at any time without explanation. A comprehensive account of participants, recruitment, consent, and withdrawal procedures is provided in the published protocol\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIntervention\u003c/p\u003e\u003cp\u003eParticipants received one week\u0026rsquo;s health education, six weeks\u0026rsquo; exercise training and a six-week follow-up. 1) Health education: Participants viewed seven health education videos (4\u0026ndash;6 minutes each) concerning sarcopenia prevention, which were posted on TikTok (TikTok ID: 73296723633) throughout the initial week. Participants faced no limitations on the number of views, permitting them to decide the number of times they viewed videos daily. 2) Physical exercise: Participants attended exercise training on TikTok, which was fixed at 30 minutes and comprised four types of exercise, including 3 minutes\u0026rsquo; warm-up training, 8 minutes\u0026rsquo; aerobic training, 16 minutes\u0026rsquo; resistance training, and 3 minutes\u0026rsquo; flexibility training. The frequency of exercise was at least 3 times/week, and the overall exercise intensity was moderate using the Borg Category-Ratio 10 (CR-10) Scale\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e,\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. Resistance exercise was performed using two plastic water-bottles of 500ml or 1000ml or 1500ml or 2000ml capacity. Participants started with 500ml or 1000ml, then added 100-500ml of weight every three weeks according to their individual situation. 3) Follow-up: Participants were monitored for six weeks, during which the researcher assisted them in completing their activity diaries and documenting their feelings through brief telephone calls or text messages each week. The components of the health education and exercise intervention programmes were based on our prior study\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e and protocol\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eOutcomes\u003c/p\u003e\u003cp\u003eSocio-demographic information, primary outcomes and secondary outcomes were all collected during full details of which are outlined as in the protocol\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. In brief, the primary outcomes involved evaluating five domains. 1) Recruitment capability and participant characteristics; 2) Intervention and study procedures' acceptability and suitability; 3) Data collection procedures and outcome measurements; 4) Research duration and the ability of researcher to conduct the study and intervention; 5) Participant responsiveness to intervention. The secondary outcomes assessed two main categories: 1) Muscle-related outcomes: muscle strength (handgrip strength), muscle mass (skeletal muscle mass, skeletal mass index, upper-extremity skeletal muscle mass, lower-extremity skeletal muscle mass, and trunk skeletal muscle mass), and physical performance (walking speed and sit-to-stand function); 2) Other measurements: other body parameters (e.g., height, weight, calf circumference, abdominal circumference, body fat, body mass index, protein, and bone mineral), questionnaires (e.g., nutrition state, perceived knowledge, personal motivation, behavioural skills, and monitoring of behaviour change). Study protocol delineated the diverse instruments used and the various time points at which the outcomes were evaluated during the research\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eContinuous variables were represented by mean and standard deviation (M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD), and categorical variables were represented by number (percentage). Descriptive statistics were used to analyse the percentage of recruitment, baseline characteristics of participants (e.g., age, gender, educational background, long-term condition, and medication), attrition rate, compliance rate, etc. Secondary outcome measures were compared between baseline (T0) and different intervention stages (T1, T4, T7, T10, T13) using 95% confidence intervals (CIs) of mean values, such as handgrip strength, skeletal muscle mass, and physical performance. If the 95%CI of mean values at any intervention stage did not overlap compared to the 95%CI of mean values at baseline, the difference was statistically significant.\u003c/p\u003e\u003cp\u003eIn a single-group design, the effect size is typically calculated using Cohen's d to measure the intervention's impact before (T0) and after (T13). Cohen's d is calculated using the following formula\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e:\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$\\:d=\\frac{{M}_{post}-{M}_{pre}}{{SD}_{pooled}}$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eWhere:\u003c/p\u003e\u003cp\u003e\u0026middot; \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{M}_{post}\\:\\)\u003c/span\u003e\u003c/span\u003eis the mean score after the intervention\u003c/p\u003e\u003cp\u003e\u0026middot; \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{M}_{pre}\\)\u003c/span\u003e\u003c/span\u003e is the mean score before the intervention\u003c/p\u003e\u003cp\u003e\u0026middot; \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{SD}_{pooled}\\)\u003c/span\u003e\u003c/span\u003e is the pooled standard deviation, calculated as:\u003cdiv id=\"Equb\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equb\" name=\"EquationSource\"\u003e\n$$\\:SDpooled=\\sqrt{\\frac{\\left({n}_{pre}-1\\right)\u0026middot;{SD}_{pre}^{2}+\\left({n}_{post}-1\\right)\u0026middot;{SD}_{post}^{2}}{{n}_{pre}+{n}_{post}-2}}$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eWhere:\u003c/p\u003e\u003cp\u003e\u0026middot; \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{n}_{pre}\\)\u003c/span\u003e\u003c/span\u003e and \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{n}_{post}\\)\u003c/span\u003e\u003c/span\u003e are the sample sizes before and after the intervention, respectively.\u003c/p\u003e\u003cp\u003e\u0026middot; \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{SD}_{pre}\\)\u003c/span\u003e\u003c/span\u003e and \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{SD}_{post}\\)\u003c/span\u003e\u003c/span\u003e are the standard deviations before and after the intervention, respectively.\u003c/p\u003e\u003cp\u003eThe effect size was divided into four grades: small (0.2), medium (0.5), large (0.8), and very large (1.3)\u003csup\u003e31\u003c/sup\u003e. The value of the effect size can be positive, negative, or zero, depending on the direction of the relationship between the variables. A positive effect size indicates that an increase in one variable is associated with an increase in the other variable. Conversely, a negative effect size suggests that an increase in one variable is associated with a decrease in the other variable. If no relationship exists between the two variables, the effect size is zero. All statistical analyses were conducted using SPSS Statistics 27.0 (IBM Corp., Armonk, NY, USA).\u003c/p\u003e\u003cp\u003eInterviews were transcribed verbatim and analysed using thematic analysis\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. This approach included six phases: familiarising with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report. QSR International\u0026rsquo;s NVivo 12 qualitative analysis software was used to assist and facilitate the coding and analysis process of qualitative data. Codes were interpreted to determine the feasibility and acceptability of the SHEEP programme, including barriers and facilitators of the implementation process, and then organised into themes that reflected the views of participants regarding the SHEEP programme. Data collection, data management and more detailed analysis methods were detailed in the published protocol\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003ePrimary outcomes\u003c/p\u003e\n\u003cp\u003e\u0026middot; Recruitment capability\u003c/p\u003e\n\u003cp\u003eThe information leaflets were distributed to older people who visited the community health centres, and the electronic leaflets were also sent to community WeChat groups. Between 06 May 2024 and 19 May 2024, in total 91 older adults expressed interest in joining this research programme though phone call or text messages: 63 in Sanchaji Community Health Service Centre and 28 in Guanshaling Community Health Service Centre. These people learned of this research primarily via paper information leaflets (n\u0026thinsp;=\u0026thinsp;33, 36.3%), electronic leaflets in WeChat groups (n\u0026thinsp;=\u0026thinsp;46, 50.5%), and word-of-mouth among residents (n\u0026thinsp;=\u0026thinsp;12, 13.2%).\u003c/p\u003e\n\u003cp\u003eAfter a brief introduction to the study over the phone, 79 (86.8%) older adults accepted the preliminary eligibility screening over the phone (e.g. confirmed items 1\u0026ndash;3 and 6 on eligibility list, and exclusion criteria); sixty-eight (74.7%) older people participated in further screening measurement, including SARC-CalF and handgrip strength according to AWGS 2\u003csup\u003e3\u003c/sup\u003e, face to face in the community, and 43 (47.3%) of them met all the screening criteria. After being given a full explanation of the study and the Participant Information Sheet for the research, 35 provided informed consent and decided to join in this study: 33 in Sanchaji Community and 2 in Guanshaling Community, as shown in Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. Hence, the total recruitment rate was 38.5%, while the recruitment rate in Sanchaji Community (52.4%) was much higher than that in Guanshaling Community (7.1%).\u003c/p\u003e\n\u003cp\u003e\u0026middot; Participant characteristics\u003c/p\u003e\n\u003cp\u003eThe mean age (M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD) of the 35 included participants was 66.40\u0026thinsp;\u0026plusmn;\u0026thinsp;2.90 years. Some 80% of participants were aged 65\u0026ndash;69 years, with 20% aged 60\u0026ndash;64 years. Some 80% of participants were female; 20% male. Three distinct educational backgrounds were of similar proportions; primary school (31.4%), junior high school (34.3%), senior high school (34.3%). The prevalence of long-term conditions among the participants, ranked in descending order, was as follows: hypertension (45.7%), diabetes (22.9%), hyperlipidaemia (17.1%), lumbar disc herniation (5.7%), coronary heart disease (2.9%), and arthritis (2.9%). More than half of the participants (51.4%) were taking medications related to chronic diseases. Only one participant (2.9%) was using a walking stick during the research period, as shown in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eSample characteristics (n\u0026thinsp;=\u0026thinsp;35)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eRange\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge, years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66.40\u0026thinsp;\u0026plusmn;\u0026thinsp;2.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60\u0026ndash;69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eAge group\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60\u0026ndash;64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7 (20.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65\u0026ndash;69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28 (80.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28 (80.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eEducation\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11 (31.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eJunior high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12 (34.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSenior high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12 (34.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eLong-term condition\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16 (45.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (22.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHyperlipidaemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (17.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCoronary heart disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLumbar disc herniation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eArthritis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMedication\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18 (51.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003e\u003cem\u003eSignificant health problems affecting the ability to undertake physical activity\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eMobility aid\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026middot; Intervention acceptability\u003c/p\u003e\n\u003cp\u003eOf the 35 participants who signed the informed consent form, 26 (74.3%) of them finished the whole study, while nine (25.7%) withdrew at various stages of the study. The reported reasons are detailed in Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e, and most are related to the inconvenient schedule. The compliance rate was different in different stages: 100% during the health education process, 97.1% during the exercise intervention, 91.4% at the follow-up stage, and 88.6% in the semi-structured interviews.\u003c/p\u003e\n\u003cp\u003e\u0026middot; Acceptability of data collection\u003c/p\u003e\n\u003cp\u003eWe recorded the measurement time of the secondary outcomes required for each participant (n\u0026thinsp;=\u0026thinsp;32) in five measurement timepoints, with a minimum of 28.02mins and a maximum of 42.02mins (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). The 95%CI of the mean measurement time of the five stages overlapped, indicating that the difference was not statistically significant.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eMeasurement time of the secondary outcomes in five measurement timepoints\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eAssessment timepoint\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMeasurement time (mins)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (95%CIs)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36.21\u0026thinsp;\u0026plusmn;\u0026thinsp;2.59 (35.28, 37.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36.35\u0026thinsp;\u0026plusmn;\u0026thinsp;2.81 (35.34, 37.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35.94\u0026thinsp;\u0026plusmn;\u0026thinsp;2.74 (34.95, 36.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35.55\u0026thinsp;\u0026plusmn;\u0026thinsp;2.58 (34.62, 36.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35.37\u0026thinsp;\u0026plusmn;\u0026thinsp;2.50 (34.47, 36.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003eNote: T\u003csub\u003e0\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;Baseline; T\u003csub\u003e4\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;Week 4 (exercise); T\u003csub\u003e7\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;Week 7 (exercise); T\u003csub\u003e10\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;Week 10 (follow-up); T\u003csub\u003e13\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;Week 13 (follow-up).\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026middot; Management ability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe completed the feasibility study within the allotted time as originally proposed, but there were minor tweaks to details. We initially set a two-week deadline for recruiting, baseline assessments, and training, but needed to expand this to three weeks. The health education, exercise intervention and follow-up period were successfully completed according to the original protocol. Hence, this feasibility study required a total of 17 weeks to be completed, including two weeks\u0026rsquo; recruitment, one week\u0026rsquo;s baseline assessment and training, one week\u0026rsquo;s health education, six weeks\u0026rsquo; exercise, a six-week follow up, and one week\u0026rsquo;s semi-structured interviews (Fig. \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). The researchers demonstrated effective organisational and managerial skills, facilitating the seamless advancement of the study process.\u003c/p\u003e\n\u003cp\u003eSecondary outcomes\u003c/p\u003e\n\u003cp\u003e\u0026middot; Indicators with obvious changes\u003c/p\u003e\n\u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e demonstrates that for the total sample the upper limit of the 95%CI at baseline was less than the lower limit of the 95% CI at week 13 for handgrip strength on both hands, 4-metre walking speed, sarcopenia prevention quizzes, Self-Efficacy for Managing Chronic Disease 6-item Scale, Self-management Behaviour for Chronic Disease Scale (exercise and cognitive), Exercise Adherence Rating Scale, and numbers of exposures to sarcopenia and exercise information videos on TikTok, and the lower limit of the 95%CI at baseline was greater than the upper limit of the 95% CI at week 13 for sit to stand time, indicating that the difference of these changes was statistically significant.\u003c/p\u003e\n\u003cp\u003eAmong these indicators, Self-management Behaviour for Chronic Disease Scale (cognitive) in the female sample and the five indicators [handgrip strength on both hands, 4-metre walking speed, sit to stand time, Self-Efficacy for Managing Chronic Disease 6-item Scale, Self-management Behaviour for Chronic Disease Scale (cognitive)] in the male sample were not statistically significant, as the 95%CI of mean values across the five measurement timepoints overlapped.\u003c/p\u003e\n\u003cp\u003eThe values of Cohen\u0026rsquo;s\u0026nbsp;\u003cem\u003ed\u003c/em\u003e suggest that the effect size of the SHEEP intervention for these indicators in the total sample (0.765 ⁓ 10.394) and in the female sample (0.817 ⁓ 10.089) was large to very large, but in the male sample (0.324 ⁓ 11.197) was small to very large.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eIndicators with obvious changes from baseline to week 13\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eAssessment\u003c/p\u003e\n \u003cp\u003etimepoint\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (95%CIs)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;32)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMale (n\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFemale (n\u0026thinsp;=\u0026thinsp;25)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eRight handgrip strength, kg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.34\u0026thinsp;\u0026plusmn;\u0026thinsp;4.73 (15.63, 19.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25.39\u0026thinsp;\u0026plusmn;\u0026thinsp;2.02 (23.51, 27.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.08\u0026thinsp;\u0026plusmn;\u0026thinsp;1.92 (14.29, 15.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.35\u0026thinsp;\u0026plusmn;\u0026thinsp;4.77 (16.63, 20.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.55\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97 (24.73, 28.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.05\u0026thinsp;\u0026plusmn;\u0026thinsp;1.80 (15.31, 16.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.35\u0026thinsp;\u0026plusmn;\u0026thinsp;4.85 (17.60, 21.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27.60\u0026thinsp;\u0026plusmn;\u0026thinsp;2.27 (25.50, 29.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.04\u0026thinsp;\u0026plusmn;\u0026thinsp;1.93 (16.24, 17.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.25\u0026thinsp;\u0026plusmn;\u0026thinsp;4.93 (18.47, 22.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.35\u0026thinsp;\u0026plusmn;\u0026thinsp;2.75 (25.80, 30.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.98\u0026thinsp;\u0026plusmn;\u0026thinsp;2.25 (17.05, 18.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.54\u0026thinsp;\u0026plusmn;\u0026thinsp;5.28 (19.63, 23.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.57\u0026thinsp;\u0026plusmn;\u0026thinsp;3.79 (26.06, 33.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.29\u0026thinsp;\u0026plusmn;\u0026thinsp;2.89 (18.10, 20.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.376\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.716\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eLeft handgrip strength, kg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.08\u0026thinsp;\u0026plusmn;\u0026thinsp;4.73 (14.37, 17.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.35 (20.27, 26.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.04\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52 (13.00, 15.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.08\u0026thinsp;\u0026plusmn;\u0026thinsp;4.89 (15.32, 18.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24.82\u0026thinsp;\u0026plusmn;\u0026thinsp;3.50 (21.59, 28.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.91\u0026thinsp;\u0026plusmn;\u0026thinsp;2.32 (13.95, 15.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.06\u0026thinsp;\u0026plusmn;\u0026thinsp;4.98 (16.27, 19.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.04\u0026thinsp;\u0026plusmn;\u0026thinsp;3.12 (23.16, 28.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.83\u0026thinsp;\u0026plusmn;\u0026thinsp;2.40 (14.84, 16.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.08\u0026thinsp;\u0026plusmn;\u0026thinsp;4.86 (17.33, 20.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.89\u0026thinsp;\u0026plusmn;\u0026thinsp;3.10 (24.02, 29.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.90\u0026thinsp;\u0026plusmn;\u0026thinsp;2.31 (15.95, 17.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.95\u0026thinsp;\u0026plusmn;\u0026thinsp;5.37 (18.01, 21.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.14\u0026thinsp;\u0026plusmn;\u0026thinsp;4.13 (24.32, 31.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.66\u0026thinsp;\u0026plusmn;\u0026thinsp;2.82 (16.49, 18.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.765\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.353\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003e4-metre walking speed, m/s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.16 (1.23, 1.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.24\u0026thinsp;\u0026plusmn;\u0026thinsp;0.30 (0.97, 1.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.11 (1.25, 1.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.16 (1.26, 1.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.26\u0026thinsp;\u0026plusmn;\u0026thinsp;0.28 (0.99, 1.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.11 (1.29, 1.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17 (1.29, 1.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.28\u0026thinsp;\u0026plusmn;\u0026thinsp;0.29 (1.02, 1.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.37\u0026thinsp;\u0026plusmn;\u0026thinsp;0.12 (1.33, 1.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.39\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17 (1.33, 1.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.31\u0026thinsp;\u0026plusmn;\u0026thinsp;0.30 (1.03, 1.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.41\u0026thinsp;\u0026plusmn;\u0026thinsp;0.12 (1.37, 1.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.44\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18 (1.38, 1.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.31 (1.06, 1.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.47\u0026thinsp;\u0026plusmn;\u0026thinsp;0.11 (1.42, 1.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.913\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.324\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.568\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eSit to stand time, s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.13\u0026thinsp;\u0026plusmn;\u0026thinsp;1.51 (7.58, 8.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.88\u0026thinsp;\u0026plusmn;\u0026thinsp;2.41 (6.65, 11.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.91\u0026thinsp;\u0026plusmn;\u0026thinsp;1.13 (7.45, 8.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.80\u0026thinsp;\u0026plusmn;\u0026thinsp;1.47 (7.27, 8.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.63\u0026thinsp;\u0026plusmn;\u0026thinsp;2.51 (6.30, 10.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.98 (7.16, 7.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.49\u0026thinsp;\u0026plusmn;\u0026thinsp;1.48 (6.96, 8.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.43\u0026thinsp;\u0026plusmn;\u0026thinsp;2.58 (6.05, 10.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.91 (6.85, 7.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.14\u0026thinsp;\u0026plusmn;\u0026thinsp;1.48 (6.61, 7.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.22\u0026thinsp;\u0026plusmn;\u0026thinsp;2.54 (5.87, 10.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89 (6.47, 7.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.85\u0026thinsp;\u0026plusmn;\u0026thinsp;1.53 (6.30, 7.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.00\u0026thinsp;\u0026plusmn;\u0026thinsp;2.66 (5.54, 10.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.53\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89 (6.17, 6.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.836\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.363\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"6\"\u003e\n \u003cp\u003eSarcopenia prevention quizzes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.63\u0026thinsp;\u0026plusmn;\u0026thinsp;2.17 (3.84, 5.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.14\u0026thinsp;\u0026plusmn;\u0026thinsp;2.04 (2.26, 6.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.76\u0026thinsp;\u0026plusmn;\u0026thinsp;2.22 (3.84, 5.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e1\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.64 (18.63, 19.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.00\u0026thinsp;\u0026plusmn;\u0026thinsp;1.29 (17.81, 20.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.28\u0026thinsp;\u0026plusmn;\u0026thinsp;1.74 (18.56, 20.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.81\u0026thinsp;\u0026plusmn;\u0026thinsp;1.18 (19.39, 20.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.43\u0026thinsp;\u0026plusmn;\u0026thinsp;1.51 (18.03, 20.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.92\u0026thinsp;\u0026plusmn;\u0026thinsp;1.08 (19.48, 20.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.50\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72 (20.24, 20.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.79 (19.70, 21.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71 (20.23, 20.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61 (20.37, 20.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76 (19.59, 20.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56 (20.45, 20.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40 (20.67, 20.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49 (20.26, 21.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37 (20.69, 20.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;10.394\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;11.197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;10.089\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eSelf-Efficacy for Managing Chronic Disease 6-item Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.56\u0026thinsp;\u0026plusmn;\u0026thinsp;4.35 (28.00, 31.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.57\u0026thinsp;\u0026plusmn;\u0026thinsp;5.44 (23.54, 33.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.84\u0026thinsp;\u0026plusmn;\u0026thinsp;4.08 (28.16, 31.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.00\u0026thinsp;\u0026plusmn;\u0026thinsp;4.78 (28.28, 31.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.29\u0026thinsp;\u0026plusmn;\u0026thinsp;6.52 (22.25, 34.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.48\u0026thinsp;\u0026plusmn;\u0026thinsp;4.21 (28.74, 32.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.75\u0026thinsp;\u0026plusmn;\u0026thinsp;4.64 (30.08, 33.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.71\u0026thinsp;\u0026plusmn;\u0026thinsp;5.96 (24.20, 35.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.32\u0026thinsp;\u0026plusmn;\u0026thinsp;4.16 (30.60, 34.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.09\u0026thinsp;\u0026plusmn;\u0026thinsp;4.54 (31.46, 34.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.14\u0026thinsp;\u0026plusmn;\u0026thinsp;5.37 (26.18, 36.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.64\u0026thinsp;\u0026plusmn;\u0026thinsp;4.24 (31.89, 35.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.34\u0026thinsp;\u0026plusmn;\u0026thinsp;4.39 (32.76, 35.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.29\u0026thinsp;\u0026plusmn;\u0026thinsp;4.79 (27.86, 36.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.92\u0026thinsp;\u0026plusmn;\u0026thinsp;4.19 (33.19, 36.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.095\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.725\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.228\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eSelf-management Behaviour for Chronic Disease Scale (exercise)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.44\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84 (1.13, 1.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.53 (0.08, 1.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.75 (1.37, 1.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.97\u0026thinsp;\u0026plusmn;\u0026thinsp;2.25 (7.16, 8.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90 (6.03, 7.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.28\u0026thinsp;\u0026plusmn;\u0026thinsp;2.42 (7.28, 9.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.38\u0026thinsp;\u0026plusmn;\u0026thinsp;1.70 (6.76, 7.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.86\u0026thinsp;\u0026plusmn;\u0026thinsp;1.21 (5.73, 7.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.52\u0026thinsp;\u0026plusmn;\u0026thinsp;1.81 (6.77, 8.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.25\u0026thinsp;\u0026plusmn;\u0026thinsp;1.93 (6.55, 7.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49 (5.83, 6.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.52\u0026thinsp;\u0026plusmn;\u0026thinsp;2.10 (6.65, 8.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.00\u0026thinsp;\u0026plusmn;\u0026thinsp;1.80 (6.35, 7.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49 (5.83, 6.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.20\u0026thinsp;\u0026plusmn;\u0026thinsp;1.98 (6.38, 8.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;3.967\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;11.166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;3.690\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eSelf-management Behaviour for Chronic Disease Scale (cognitive)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.56\u0026thinsp;\u0026plusmn;\u0026thinsp;2.68 (6.60, 8.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.86\u0026thinsp;\u0026plusmn;\u0026thinsp;1.07 (3.87, 5.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.32\u0026thinsp;\u0026plusmn;\u0026thinsp;2.50 (7.29, 9.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.81\u0026thinsp;\u0026plusmn;\u0026thinsp;3.13 (7.69, 9.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.86\u0026thinsp;\u0026plusmn;\u0026thinsp;1.57 (4.40, 7.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.64\u0026thinsp;\u0026plusmn;\u0026thinsp;2.96 (8.42, 10.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.22\u0026thinsp;\u0026plusmn;\u0026thinsp;3.44 (7.98, 10.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.43\u0026thinsp;\u0026plusmn;\u0026thinsp;1.72 (4.84, 8.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.00\u0026thinsp;\u0026plusmn;\u0026thinsp;3.42 (8.59, 11.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.66\u0026thinsp;\u0026plusmn;\u0026thinsp;3.45 (8.41, 10.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.71\u0026thinsp;\u0026plusmn;\u0026thinsp;1.11 (5.69, 7.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.48\u0026thinsp;\u0026plusmn;\u0026thinsp;3.44 (9.06, 11.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.91\u0026thinsp;\u0026plusmn;\u0026thinsp;3.19 (8.76, 11.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.29\u0026thinsp;\u0026plusmn;\u0026thinsp;1.60 (5.80, 8.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.64\u0026thinsp;\u0026plusmn;\u0026thinsp;3.15 (9.34, 11.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.797\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.782\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;0.817\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003eExercise Adherence Rating Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.72\u0026thinsp;\u0026plusmn;\u0026thinsp;2.14 (2.95, 4.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.43\u0026thinsp;\u0026plusmn;\u0026thinsp;2.23 (1.37, 5.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.80\u0026thinsp;\u0026plusmn;\u0026thinsp;2.16 (2.91, 4.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.22\u0026thinsp;\u0026plusmn;\u0026thinsp;3.61 (17.92, 20.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.71\u0026thinsp;\u0026plusmn;\u0026thinsp;3.30 (14.66, 20.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.64\u0026thinsp;\u0026plusmn;\u0026thinsp;3.64 (18.14, 21.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.72\u0026thinsp;\u0026plusmn;\u0026thinsp;3.78 (17.36, 20.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.14\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61 (14.73, 19.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.16\u0026thinsp;\u0026plusmn;\u0026thinsp;3.98 (17.52, 20.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.03\u0026thinsp;\u0026plusmn;\u0026thinsp;4.40 (16.45, 19.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.43\u0026thinsp;\u0026plusmn;\u0026thinsp;4.79 (12.00, 20.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.48\u0026thinsp;\u0026plusmn;\u0026thinsp;4.27 (16.72, 20.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.19\u0026thinsp;\u0026plusmn;\u0026thinsp;4.56 (15.54, 18.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.29\u0026thinsp;\u0026plusmn;\u0026thinsp;4.03 (11.56, 19.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.72\u0026thinsp;\u0026plusmn;\u0026thinsp;4.63 (15.81, 19.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;3.780\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;3.643\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;3.851\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"6\"\u003e\n \u003cp\u003eNumber of exposures to sarcopenia information videos on TikTok\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00 (0.00, 0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00 (0.00, 0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00 (0.00, 0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e1\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.41\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62 (3.18, 3.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.79 (2.70, 4.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58 (3.16, 3.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.50\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72 (2.24, 2.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.54 (1.93, 2.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77 (2.20, 2.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.44\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72 (2.18, 2.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.79 (1.84, 3.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71 (2.11, 2.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77 (1.44, 2.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49 (1.26, 2.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84 (1.37, 2.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.80 (0.71, 1.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76 (0.02, 1.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.08\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81 (0.74, 1.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.761\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.336\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;1.880\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"6\"\u003e\n \u003cp\u003eNumber of exposures to exercise information videos on TikTok\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e0\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49 (0.04, 0.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00 (0.00, 0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.28\u0026thinsp;\u0026plusmn;\u0026thinsp;0.54 (0.06, 0.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e1\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.51 (0.07, 0.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00 (0.00, 0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56 (0.09, 0.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e4\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.75 (1.35, 1.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.38 (0.79, 1.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.78 (1.44, 2.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e7\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85 (1.85, 2.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49 (1.26, 2.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.28\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89 (1.91, 2.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e10\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.94\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76 (1.66, 2.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.79 (0.84, 2.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74 (1.74, 2.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT\u003csub\u003e13\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.94\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84 (1.63, 2.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.79 (0.84, 2.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84 (1.69, 2.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;2.498\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;2.825\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e+\u0026thinsp;2.489\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eNote: T\u003csub\u003e0\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;Baseline; T\u003csub\u003e1\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;Week 1 (health education); T\u003csub\u003e4\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;Week 4 (exercise); T\u003csub\u003e7\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;Week 7 (exercise); T\u003csub\u003e10\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;Week 10 (follow-up); T\u003csub\u003e13\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;Week 13 (follow-up). The symbol \u0026lsquo;+\u0026rsquo; denotes a positive direction of intervention effect, whereas the symbol \u0026lsquo;-\u0026rsquo; indicates a negative direction of intervention effect.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e shows that from baseline to week 13 the mean handgrip strength in both hands, 4-metre walking speed, mean scores of Self-Efficacy for Managing Chronic Disease 6-item Scale and Self-management Behaviour for Chronic Disease Scale (cognitive) appeared to progressively increase, while sit to stand time appeared to progressively decrease. The sarcopenia prevention scores soared from the baseline to the first week of completing health education and then rose slowly. The mean values of Self-management Behaviour for Chronic Disease Scale (exercise) and Exercise Adherence Rating Scale increased rapidly from the baseline to the fourth week and then showed a slow downward trend until the thirteenth week. The average number of exposures to exercise information videos on TikTok did not change obviously from the baseline to the first week, and the subsequent number rose to the peak in the seventh week and then slightly decreased in the thirteenth week.\u003c/p\u003e\n\u003cp\u003e\u0026middot; Behaviour changes monitoring\u003c/p\u003e\n\u003cp\u003eThe monitoring of behaviour change comprises five aspects: exercise adherence rating scale, exposure percentage of exercise and sarcopenia-related videos on TikTok, exercise diaries, behaviour of sharing sarcopenia-related information to others, and willingness to formulate habits of regular exercise in the future. The data analysis of the first two was detailed in Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e and Fig. \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e\n\u003ch3\u003e1) Exercise diaries\u003c/h3\u003e\n\u003cp\u003eMean value of weekly exercise duration in the exercise diaries of participants was calculated using Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD, which indicated that the mean frequency of weekly exercise increased a little from 0 at baseline to 0.69\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97 times in week 1, surged significantly in week 2 to 4.31\u0026thinsp;\u0026plusmn;\u0026thinsp;1.40 times, and then declined slightly to 3.59\u0026thinsp;\u0026plusmn;\u0026thinsp;1.19 times by week 13 (Fig. \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003e2) Behaviour regarding sharing sarcopenia-related information with others\u003c/h3\u003e\n\u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e depicts the percentage trend of participants sharing information about sarcopenia at different stages. The findings indicate that the proportion of individuals sharing information regarding sarcopenia was at its peak (54.3%) during the initial week of health education and thereafter declined steadily to 12.5% in the concluding follow-up phase.\u003c/p\u003e\n\u003ch3\u003e3) Willingness to formulate habits of regular exercise in the future\u003c/h3\u003e\n\u003cp\u003eAll participants (100%) expressed their intention to persist in exercising after the study\u0026apos;s conclusion. A total of 24 (75%) participants indicated that they would engage in exercise a minimum of three times weekly and augment it when feasible, while 8 (25%) participants believed that they lacked a predetermined weekly exercise regimen and would engage in exercise when their schedules permitted.\u003c/p\u003e\n\u003cp\u003e\u0026middot; Indicators exhibiting minimal variation\u003c/p\u003e\n\u003cp\u003eThe 95%CIs of the mean values across the five measurement timepoints overlapped for the following indices, skeletal muscle mass, trunk skeletal muscle mass, upper-extremity skeletal muscle mass, lower-extremity skeletal muscle mass, skeletal mass index, body fat, body fat percentage, body mass index, protein, bone mineral, upper arm dimension, upper arm muscle dimension, height, weight, calf circumference, abdominal circumference, Mini-Nutritional Assessment Short Form, Self-management Behaviour for Chronic Disease Scale (communication), indicating that the differences experienced minimal fluctuation, either for the overall sample or for men or women, as shown in Supplemental Material \u0026minus;\u0026thinsp;2. The values of Cohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e suggest that the effect size of the SHEEP intervention for these indicators in the total sample (0.003 ⁓ 0.391) and in the female sample (0.011 ⁓ 0.278) was very small to small, but in the male sample (0.000 ⁓ 1.156) was very small to large, as shown in Supplemental Material \u0026minus;\u0026thinsp;1.\u003c/p\u003e\n\u003cp\u003eSemi-structured interview\u003c/p\u003e\n\u003cp\u003eThe study concluded with 26 participants undergoing semi-structured interviews. The interviews were categorised into three primary themes and eight sub-themes: the comprehensive evaluation for this research (study procedures, data collection and measurement, researcher), the participant\u0026rsquo;s personal experience of the intervention (health education; exercise; behaviour, physical and mental changes), and recommendations for future promotion (challenges encountered, improvement suggestions) as shown in Fig. \u003cspan class=\"InternalRef\"\u003e7\u003c/span\u003e. Some examples of interview responses are summarized according to different themes, as detailed Supplemental Material \u0026minus;\u0026thinsp;3.\u003c/p\u003e\n\u003cp\u003e\u0026middot; Theme 1: participants\u0026rsquo; comprehensive evaluation of this research\u003c/p\u003e\n\u003ch3\u003e1) Study procedures\u003c/h3\u003e\n\u003cp\u003eAll 26 participants expressed satisfaction with their involvement in the study and reported feeling at ease and content throughout its duration.\u003c/p\u003e\n\u003ch3\u003e2) Data collection and measurement\u003c/h3\u003e\n\u003cp\u003eThe 26 participants concurred that the data collecting, and measurement processes were acceptable, with no reported stress or discomfort.\u003c/p\u003e\n\u003ch3\u003e3) Researcher\u003c/h3\u003e\n\u003cp\u003eFourteen (53.85%) participants actively mentioned and expressed favourable opinions of the PI, such as being patient, kind and responsible.\u003c/p\u003e\n\u003cp\u003e\u0026middot; Theme 2: participants\u0026rsquo; personal experience of the intervention\u003c/p\u003e\n\u003ch3\u003e1) Health education\u003c/h3\u003e\n\u003cp\u003eUsing the Likert-5 score, 25 (96.15%) participants rated the health education strategy as very satisfactory, with one (3.85%) rating it as satisfactory. The evaluation of health education strategy was categorised in four aspects: health education content, duration, frequency, and delivery tool.\u003c/p\u003e\n\u003cp\u003e① Health education content: All participants reportedly found the health education information easy to understand and said that they benefited from the knowledge of sarcopenia prevention to varying degrees.\u003c/p\u003e\n\u003cp\u003e② Health education duration: 23 (88.46%) participants believed 4\u0026ndash;6 minutes per video was appropriate, but three participants thought it could be extended a bit, as they wished to gain more regarding sarcopenia prevention.\u003c/p\u003e\n\u003cp\u003e③ Health education frequency: participants exhibited variability in the frequency of video viewership during the initial week. Twelve (46.15%) participants reported viewing 1\u0026ndash;2 videos at a time, five (19.23%) indicated they preferred to watch all videos in one go, while the remaining nine (34.62%) participants stated that their viewing quantity was contingent upon their mood, but they would complete all videos within the first week.\u003c/p\u003e\n\u003cp\u003e④ Delivery tool for health education: all participants deemed the acquisition of health education knowledge via TikTok to be acceptable and user-friendly.\u003c/p\u003e\n\u003ch3\u003e2) Exercise intervention\u003c/h3\u003e\n\u003cp\u003eUsing the Likert-5 score, all participants reported their overall assessment of the exercise strategy as being very satisfied. The evaluation can be distilled into five aspects: exercise content, duration, frequency, promotional film, and delivery tool.\u003c/p\u003e\n\u003cp\u003e① Exercise content: all participants deemed the exercise content satisfactory and the movement design adequate. Using water bottles for resistance exercise was considered novel by the participants. Furthermore, all participants reported no adverse reactions or discomfort during the exercise.\u003c/p\u003e\n\u003cp\u003e② Exercise duration: 22 (84.62%) participants stated that an exercise duration of 25 to 30 minutes was suitable, while the remaining 4 (15.38%) individuals deemed it acceptable to moderately extend the duration.\u003c/p\u003e\n\u003cp\u003e③ Exercise frequency: all participants deemed a frequency of doing exercise at least three times weekly to be entirely attainable.\u003c/p\u003e\n\u003cp\u003e④ Promotional films about exercise: all participants agreed that the promotional films about resistance exercise for sarcopenia prevention contributed to increasing their awareness of sarcopenia prevention and improving their motivation to exercise.\u003c/p\u003e\n\u003cp\u003e⑤ Delivery tool of exercise: all participants deemed the use of TikTok for exercise acceptable, citing advantages such as independence of time, location, and climate.\u003c/p\u003e\n\u003ch3\u003e3) Behaviour, physical and mental changes\u003c/h3\u003e\n\u003cp\u003eAll participants reported experiencing varying degrees of benefit to their subjective feelings, encompassing behaviour, physical, and psychological aspects. Following the exercise intervention, 25 (96.15%) participants reported enhanced strength in their hands and feet, 18 (69.23%) noted an improved mood, 17 (65.38%) experienced greater overall relaxation of the whole body, 16 (61.54%) indicated improved sleep quality, 12 (46.15%) reportedly altered their diet, including increased protein consumption, eight (30.77%) reported an enhanced appetite, five (19.23%) indicated an enhancement in gastrointestinal function, including alleviation of constipation, and four (15.38%) said they had increased energy levels when doing chores in their daily life. In addition, all participants expressed their willingness to learn more about sarcopenia after finishing this project, and to persist in exercising to prevent sarcopenia, and to disseminate information regarding sarcopenia to their family and friends.\u003c/p\u003e\n\u003cp\u003e\u0026middot; Theme 3: recommendations for future promotion\u003c/p\u003e\n\u003cp\u003eTen participants identified obstacles and dilemmas regarding future promotion of this study. For instance, there are barriers in promoting it to older adults without smartphones, or who have diminished cognitive capacity or low health literacy. Three participants proposed potential solutions, such as creating a hybrid of online and offline formats and enhancing early-stage publicity.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe above findings indicate that SHEEP was both feasible and acceptable for community-dwelling older adults with possible sarcopenia, with the potential to improve their muscular function and physical performance. This study builds upon previous research\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e that demonstrates the viability of a multicomponent intervention (health education plus exercise) based on social media for older persons by enhancing our understanding of sarcopenia prevention in community-dwelling young-old adults. Preliminary evidence from this one-arm pre-post study found trends towards improvement in handgrip strength, walking speed, sit-to-stand function, knowledge of sarcopenia prevention, self-efficacy in managing chronic disease, self-management behaviours for chronic disease (particularly in exercise and cognitive domains), and exercise adherence. The effect size of the SHEEP intervention for these indices was large to very large, which may aid in determining sample size for any forthcoming randomised controlled trial. However, other information supporting the sample size calculation needs to be fully integrated, as small sample sizes in this study may generate inaccurate effect sizes\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eAs for study design, the rationale for employing a one-arm pre-post feasibility study, rather than a feasibility study of a randomised controlled trial, mostly stemmed from constraints in time and researcher resources. The recruiting period was limited to two to three weeks, making the recruitment of 35 individuals feasible; nevertheless, securing 60\u0026ndash;70 participants posed significant challenges. Additionally, all research processes were solely managed by the principal investigator. Despite being an online intervention, it was challenging to complete the measurements for 60\u0026ndash;70 participants concurrently, necessitating increased research resources in any future randomised controlled trial.\u003c/p\u003e\u003cp\u003eRegarding recruitment capability, while this research achieved the target sample size, there were difficulties recruiting a representative sample. The percentage of participants aged 65\u0026ndash;69 years (80.0%) was markedly greater than that of those aged 60\u0026ndash;64 years (20.0%). The proportion of male participants was much lower, at 20.0%, in contrast to females, at 80.0%. Greater representation of those aged 65\u0026ndash;69 may reflect a higher frequency of possible sarcopenia in these groups. In our last study involving 30 participants\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e, the proportion of those aged 65\u0026ndash;69 (70.0%) also exceeded that of those aged 60\u0026ndash;64 (30.0%). Therefore, the prevalence of possible sarcopenia may be indeed higher in 65-69year olds than those aged 60-64years; however stratified descriptions of these two age groups were lacking in the previous studies\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e,\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e. Prior work has also identified lower research engagement by community-dwelling older males in exercise interventions for sarcopenia treatment and prevention\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan additionalcitationids=\"CR37\" citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e, which aligns with the findings of this study.\u003c/p\u003e\u003cp\u003eWe also cannot dismiss the possibility that these two issues stem from inadequate publicity. Only three recruitment channels were used in this study, namely electronic leaflets, paper leaflets, and word of mouth among residents. Electronic leaflets have demonstrated a significant advantage in recruitment throughout the Internet era. Two participants in the semi-structured interviews expressed a desire to improve the study's visibility through a collaborative initiative by community health service centres, such as hosting events or talks. This may pertain to the cultural background of the community in China. Typically, the initiatives conducted by the community health service centres will earn the trust and backing of local inhabitants. In addition, among the 35 participants recruited, a greater number of participants came from Sanchaji Community (33) than from Guanshaling Community (2). This may be because the former has an activity centre for seniors, which facilitated the sharing and dissemination of recruitment information. This suggests that communities without senior centres require increased extra publicity and recruitment effort, and future RCTs may be more viable in settings with a community health service centre.\u003c/p\u003e\u003cp\u003eThe entire research process was acceptable and progressed seamlessly. All participants in the interviews expressed satisfaction with their involvement in the study, and acceptance of the measurement process. The mean value of total measurement time was gradually reduced from 36.26\u0026thinsp;\u0026plusmn;\u0026thinsp;2.48 mins at the initial baseline to 35.37\u0026thinsp;\u0026plusmn;\u0026thinsp;2.50 mins at the end of the study. This small difference may relate to increased familiarity with the assessment process on the part of both researchers and participants. Participants exhibited a high compliance rate with health education and exercise interventions, both above 90%. Despite three participants withdrawing from the study during the intervention, none did so for reasons related to this research. The good compliance rate may be attributed to two factors. Firstly, participants demonstrated very high satisfaction with the health education and exercise intervention strategies, including the content, duration, frequency. This may be linked to the co-design method employed throughout the intervention development phase and may also be related to the advantages offered by social media, which are unaffected by time, location, or climate \u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. Secondly, some participants specifically identified the researchers' patient, enthusiastic, empathetic demeanour and good communication as motivating factors for their commitment to the intervention. Participants cited this issue as directly linked to the prevailing lack of medical resources in China and the strained dynamics between physicians and patients\u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e,\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e. Physicians often lack the requisite time and patience to communicate effectively with patients\u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e,\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e, hindering the provision of comprehensive health education for illness prevention. This underscores the value and significance of social media-based interventions.\u003c/p\u003e\u003cp\u003eThe study was completed within the stated timeframe, but the scheduling of each component required adjustment based on the actual circumstances. First, we prolonged the original two-week recruitment and training period to three weeks, despite having already acquired some recruiting experience from the previous study\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e, including familiarity with communities and managers. This indicates that a duration of three weeks is insufficient for conducting a larger recruitment in new communities. As mentioned above, alongside strengthened cooperation with community health service centres and enhanced advocacy initiatives, a suitable prolongation of the recruitment timeframe may prove beneficial if a more representative sample is planned. In addition, the cultural context and lifestyle practices of the research location must be thoroughly considered. For example, our original recruitment plan included an email contact option; however, the older population in China seldom used email. Besides telephone communication, younger older adults also prefer to use social media platforms, such as WeChat and WhatsApp\u003csup\u003e\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e,\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e, for interaction, which might be explored in future research.\u003c/p\u003e\u003cp\u003eThe measurement indices, both subjective and objective, demonstrated that the intervention outcomes have shown trends in a positive direction. According to their subjective reports, participants exhibited notable enhancements in knowledge regarding sarcopenia prevention, self-efficacy and self-management behaviour for managing chronic disease, and exercise adherence. This may be related to the formulation of a robust theoretical framework in our previous work\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. Interventions based on the Behaviour Change Wheel\u003csup\u003e\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e could effectively improve knowledge, attitudes, and behaviours related to health promotion, which is corroborated by other studies\u003csup\u003e\u003cspan additionalcitationids=\"CR47\" citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e. Moreover, all subjects reportedly experienced varying degrees of beneficial changes in their physical and mental health, including increased strength in their hands and feet, improved mood, greater overall relaxation, enhanced sleep quality, increased protein intake, heightened appetite, improved gastrointestinal function, and elevated energy levels. This reflects the potential benefits of exercise interventions. Exercise therapy typically addresses multiple physiological systems concurrently, in contrast to pharmaceutical methods that usually focus on a single outcome in disease management. In certain conditions, such as sarcopenia, where no effective pharmacological therapy exists, exercise may play an important role in prevention and treatment\u003csup\u003e\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eFrom the perspective of objective measurements, SHEEP may have the potential to improve the muscular function and physical performance of community-dwelling young-old adults with possible sarcopenia, especially for handgrip strength, walking speed, and sit-to-stand ability. Several RCT studies of sarcopenia treatment using digital interventions have yielded comparable findings in handgrip strength\u003csup\u003e\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e,\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e\u003c/sup\u003e, but not in walking speed or sit-to-stand function\u003csup\u003e\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u003c/sup\u003e. This may be due to different aspects of the intervention, such as the intervention content, frequency, delivery tool, and varying sample sizes. However, in our study, only the overall sample and the female sample exhibited a very-large effect size in the analysis of these three indices, whereas the male sample lacked statistical significance on 95%CIs, probably due to very small sample size. This indicates the necessity of increasing male participant recruitment in future research. Furthermore, our study found a progressive upward trend in trunk and upper-extremity skeletal muscle mass, although without statistical significance. This may be attributed to the resistance training in our exercise strategy and the nutrition section in our health education strategy having resulted in some participants augmenting their daily protein consumption. The evidence suggests that resistance training positively and significantly impacts muscle mass in older persons\u003csup\u003e\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e\u003c/sup\u003e, while a combination of exercise and nutrition interventions based on digital tools can indeed also improve muscle mass in older people with sarcopenia\u003csup\u003e\u003cspan additionalcitationids=\"CR51\" citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u003c/sup\u003e. Furthermore, upper arm muscle dimension also exhibited an upward trend, which indicates that the exercise intervention in the SHEEP may be more efficacious for the upper limb musculature. However, a comprehensive randomised controlled trial is necessary in the future to validate the effectiveness of the SHEEP.\u003c/p\u003e\u003cp\u003eIt is important to highlight that the minimum exercise duration (90 minutes per week\u0026thinsp;=\u0026thinsp;30 minutes each session \u0026times; 3 sessions per week) proposed in the final SHEEP exercise strategy falls short of the recommended standard (150 minutes per week) set by the UK\u0026rsquo;s Department of Health and Social Care and the USA\u0026rsquo;s Centres for Disease Control and Prevention\u003csup\u003e\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e,\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e\u003c/sup\u003e. This is probably related to the exercise habits and concepts of older people in China. Senior Chinese individuals engage in the cultural practice of walking post-meal and uphold the ancient custom of caring for family and children. They consider post-meal walks and household chores to be irreplaceable physical activities which are integral to their lives. Consequently, most older individuals persisted in undertaking both activities during the exercise intervention in our study, leading to an inability to sustain moderate-intensity exercise five times weekly over an extended period. This is evidenced by the gradual decrease in the average frequency of exercise from 4.31\u0026thinsp;\u0026plusmn;\u0026thinsp;1.40 times in the first week of the feasibility study to 3.59\u0026thinsp;\u0026plusmn;\u0026thinsp;1.19 times in the twelfth week. In addition, our exercise strategy adheres to the progressive principle, as the current minimum exercise duration of 90 minutes a week is intended for older individuals without exercise habits, while the ultimate objective is 150 minutes a week. This goal cannot be attained in this short-term feasibility study; therefore, a prolonged intervention period must be established in future RCTs to accomplish it.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis study demonstrated that it was feasible and safe to deliver a social media-based multicomponent intervention for community-dwelling older adults with possible sarcopenia, including recruitment, training, assessment, and intervention procedure. The whole research process was also acceptable to both researchers and participants. This is the first research exploring the operability of a social media-based intervention for older adults with possible sarcopenia in a real-world environment. The findings may enhance our comprehension of the implementation of health education and exercise using TikTok within community settings, encompassing possible effects, benefits, and challenges. The anonymised participant-level dataset will not be publicly available but will be available from the principal investigator upon reasonable request.\u003c/p\u003e\u003cp\u003eThere were still some limitations to this research. First, the study lacked a control group, making it difficult to eliminate the influence of confounding factors. To tackle this issue, a future RCT will be required. Secondly, this study recruited samples from only two communities, possibly leading to a sample that was not adequately representative. The representativeness of future studies could be enhanced by expanding the recruitment time and area. Thirdly, small sample sizes in this study may yield inaccurate effect estimates; therefore, it is advisable to use this data in conjunction with additional information to estimate sample sizes for subsequent study. Fourthly, among the 35 participants, three withdrew at different stages and did not participate in the final measurement after the intervention. We ultimately employed the data of 32 participants for analysis, while this approach is straightforward but might result in a decrease in statistical efficiency and introduce bias when the data missing is not random. In subsequent studies, attention should be given to the collection of data from those who drop out. Fifthly, the exercise design failed to include older persons who depend on mobility aids such as wheelchairs. Future studies could explore the creation of customised exercise programmes for this specific demographic. Finally, this study excluded older people who did not have Internet access. Therefore, exploring the possibility of integrating both online and offline interventions to prevent sarcopenia is also an area for innovation in the future.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eCompeting interests\u003c/h2\u003e\u003cp\u003eThe authors declare that they have no competing interest.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eY.S.: conceptualization, methodology, investigation, trial management, data analysis \u0026amp; interpretation, writing \u0026ndash; original draft, writing \u0026ndash; reviewing \u0026amp; editing, supervision, funding acquisition. E.S.: conceptualization, methodology, writing \u0026ndash; reviewing \u0026amp; editing, supervision. L.M.: conceptualization, methodology, writing \u0026ndash; reviewing \u0026amp; editing, supervision, funding acquisition. X.H.W.: methodology, writing \u0026ndash; reviewing \u0026amp; editing. C.G.: methodology, writing \u0026ndash; reviewing \u0026amp; editing. Y.Y.: methodology, data analysis \u0026amp; interpretation, writing \u0026ndash; reviewing \u0026amp; editing. C.T.: conceptualization, methodology, writing \u0026ndash; reviewing \u0026amp; editing, supervision, funding acquisition. All authors read and approved of the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003e We extend our sincere appreciation to Mr. Guojun Xiong, Ms. Fenghui Liu, and Mr. Heng Chen, managers of the Guanshaling and Sanchaji Community Health Service Centres in Changsha, China, for their invaluable support in facilitating participant recruitment for this study. Besides, this work was supported by the University of Manchester - China Scholarship Council Joint Scholarship (Award No. 202108320049 to Dr Ya Shi). Additional support was provided by the National Institute for Health and Care Research (NIHR) through a Senior Investigator Award (NIHR200299 to Prof Chris Todd) and the NIHR Policy Research Unit in Healthy Ageing, Older People and Frailty (Grant Refs: NIHR206119 and NIHR PR-PRU-1217-2150 to Dr Lisa McGarrigle).\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eOriginal data will be provided by the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References ","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKirk B, Cawthon PM, Arai H, et al. The Conceptual Definition of Sarcopenia: Delphi Consensus from the Global Leadership Initiative in Sarcopenia (GLIS). \u003cem\u003eAge Ageing\u003c/em\u003e. 2024; 53(3): afae052. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1093/ageing/afae052\u003c/span\u003e\u003cspan address=\"10.1093/ageing/afae052\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. \u003cem\u003eAge Ageing\u003c/em\u003e. 2019;48(4):601. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1093/ageing/afz046\u003c/span\u003e\u003cspan address=\"10.1093/ageing/afz046\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. \u003cem\u003eJ Am Med Dir Assoc\u003c/em\u003e. 2020;21(3):300\u0026ndash;307.e2. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jamda.2019.12.012\u003c/span\u003e\u003cspan address=\"10.1016/j.jamda.2019.12.012\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eP\u0026eacute;rez-Sousa M\u0026Aacute;, Pozo-Cruz JD, Cano-Guti\u0026eacute;rrez CA, et al. High Prevalence of Probable Sarcopenia in a Representative Sample from Colombia: Implications for Geriatrics in Latin America. \u003cem\u003eJ Am Med Dir Assoc\u003c/em\u003e. 2021; 22 (4): 859\u0026ndash;864.e1. doi:10.101 6/j.jamda.2020.10.021\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTsekoura M, Billis E, Matzaroglou C, et al. Prevalence of probable sarcopenia in community-dwelling older Greek people. \u003cem\u003eJ Frailty Sarcopenia Falls\u003c/em\u003e. 2021; 6(4): 204\u0026ndash;208. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.22540/JFSF-06-204\u003c/span\u003e\u003cspan address=\"10.22540/JFSF-06-204\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePaludo CDS, Gonzalez TN, Soares PSM, Meucci RD. Prevalence and factors associated with probable sarcopenia in southern Brazil: a population-based study. \u003cem\u003eRural Remote Health\u003c/em\u003e. 2024;24(3):8711. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.22605/RRH8711\u003c/span\u003e\u003cspan address=\"10.22605/RRH8711\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChen Z, Ho M, Chau PH. Prevalence, Incidence, and Associated Factors of Possible Sarcopenia in Community-Dwelling Chinese Older Adults: A Population-Based Longitudinal Study. \u003cem\u003eFront Med (Lausanne)\u003c/em\u003e. 2022; 8:769708.10. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fmed.20 21.769708\u003c/span\u003e\u003cspan address=\"10.3389/fmed.20 21.769708\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLim SK, Kong S. Prevalence, physical characteristics, and fall risk in older adults with and without possible sarcopenia. \u003cem\u003eAging Clin Exp Res\u003c/em\u003e. 2022; 34(6):1365\u0026ndash;1371. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s40520-022-02078-z\u003c/span\u003e\u003cspan address=\"10.1007/s40520-022-02078-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMerchant RA, Chan YH, Hui RJY, et al. Possible Sarcopenia and Impact of Dual-Task Exercise on Gait Speed, Handgrip Strength, Falls, and Perceived Health. \u003cem\u003eFront Med (Lausanne)\u003c/em\u003e. 2021; 8:660463. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fmed.2021.660463\u003c/span\u003e\u003cspan address=\"10.3389/fmed.2021.660463\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUllevig SL, Zuniga K, Austin Lobitz C, et al. Egg protein supplementation improved upper body muscle strength and protein intake in community-dwelling older adult females who attended congregate meal sites or adult learning centres: A pilot randomized controlled trial. \u003cem\u003eNutr Health\u003c/em\u003e. 2022; 28(4):611\u0026ndash;620. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/02601060211051592\u003c/span\u003e\u003cspan address=\"10.1177/02601060211051592\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePan WM, Huang G, Wang B, et al. Effects of integrated intervention on muscle mass and physical functions in the elderly individuals with possible sarcopenia in a community hospital. \u003cem\u003eChin J Mult Organ Dis Elderly\u003c/em\u003e. 2022; 21(2): 021. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.11915/j.issn.1671-5403.2022.02.021\u003c/span\u003e\u003cspan address=\"10.11915/j.issn.1671-5403.2022.02.021\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDong X, Mo YH, Wang XH, et al. Effects of resistance exercise on muscle mass, muscle strength and physical performance in the elderly at risk of sarcopenia. \u003cem\u003eChinese Nursing Management\u003c/em\u003e. 2021; 21(8): 1190\u0026ndash;1195. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3969/j.issn.1672-1756.2021.08\u003c/span\u003e\u003cspan address=\"10.3969/j.issn.1672-1756.2021.08\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. 015.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShi Y, Tang Y, Stanmore E, et al. Non-pharmacological interventions for community-dwelling older adults with possible sarcopenia or sarcopenia: a scoping review. \u003cem\u003eArch Gerontol Geriatr\u003c/em\u003e. 2023; 112: 105022. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.archger.2023.105022\u003c/span\u003e\u003cspan address=\"10.1016/j.archger.2023.105022\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLipschitz JM, Van Boxtel R, Torous J, et al. Digital Mental Health Interventions for Depression: Scoping Review of User Engagement. \u003cem\u003eJ Med Internet Res\u003c/em\u003e. 2022; 24(10): e39204. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2196/39204\u003c/span\u003e\u003cspan address=\"10.2196/39204\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMarvel FA, Spaulding EM, Lee MA, et al. Digital Health Intervention in Acute Myocardial Infarction. \u003cem\u003eCirc Cardiovasc Qual Outcomes\u003c/em\u003e. 2021; 14(7): e007741. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1161/CIRCOUTCOMES.121.007741\u003c/span\u003e\u003cspan address=\"10.1161/CIRCOUTCOMES.121.007741\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLee S, Rajaguru V, Baek JS, et al. Digital Health Interventions to Enhance Tuberculosis Treatment Adherence: Scoping Review. \u003cem\u003eJMIR Mhealth Uhealth\u003c/em\u003e. 2023; 11: e49741. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2196/49741\u003c/span\u003e\u003cspan address=\"10.2196/49741\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eReinders P, Augustin M, Kirsten N, et al. Digital health interventions in dermatology-Mapping technology and study parameters of systematically identified publications. \u003cem\u003eJ Eur Acad Dermatol Venereol\u003c/em\u003e. 2023; 37(12): 2440\u0026ndash;2449. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/jdv. 19392\u003c/span\u003e\u003cspan address=\"10.1111/jdv. 19392\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWillis VC, Thomas Craig KJ, Jabbarpour Y, et al. Digital Health Interventions to Enhance Prevention in Primary Care: Scoping Review. \u003cem\u003eJMIR Med Inform\u003c/em\u003e. 2022; 10(1): e33518. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2196/33518\u003c/span\u003e\u003cspan address=\"10.2196/33518\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShi Y, Stanmore E, McGarrigle L, et al. Effectiveness of digital health exercise interventions on muscle function and physical performance in older adults with possible, confirmed, or severe sarcopenia: A systematic review and meta-analysis. (\u003cem\u003eIn preparation for submission to an appropriate journal\u003c/em\u003e)\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShi Y, Stanmore E, McGarrigle L, et al. Social-media based Health Education plus Exercise Programme (SHEEP) to improve muscle function among community-dwelling young-old adults with possible sarcopenia in China: A study protocol for intervention development. \u003cem\u003ePLoS One\u003c/em\u003e. 2024;19(3): e0286490. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pone. 0286490\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone. 0286490\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShi Y, Stanmore E, McGarrigle L, et al. Development of a community intervention combining social media-based health education plus exercise programme (SHEEP) to improve muscle function among young-old adults with possible sarcopenia: Co-design approach. \u003cem\u003eMaturitas\u003c/em\u003e. 2024;186:108027. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.maturitas.2024.108027\u003c/span\u003e\u003cspan address=\"10.1016/j.maturitas.2024.108027\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOrsmond GI, Cohn ES. The Distinctive Features of a Feasibility Study: Objectives and Guiding Questions. \u003cem\u003eOTJR (Thorofare N J).\u003c/em\u003e 2015; 35(3):169\u0026ndash;177. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/1539449215578649\u003c/span\u003e\u003cspan address=\"10.1177/1539449215578649\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShi Y, Stanmore E, McGarrigle L, et al. Social-media based health education plus exercise programme (SHEEP) to improve muscle function among young-old adults with possible sarcopenia in the community: A feasibility study protocol. \u003cem\u003ePLoS One\u003c/em\u003e. 2025; 20(1): e0303481. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pone.0303481\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0303481\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEldridge SM, Chan CL, Campbell MJ, et al. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. \u003cem\u003eBMJ\u003c/em\u003e. 2016; 355: i5239. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmj.i52 39\u003c/span\u003e\u003cspan address=\"10.1136/bmj.i52 39\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eButcher NJ, Monsour A, Mew EJ, et al. Guidelines for Reporting Outcomes in Trial Reports: The CONSORT-Outcomes 2022 Extension. \u003cem\u003eJAMA\u003c/em\u003e. 2022; 328(22): 2252\u0026ndash;2264. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1001/jama.2022.21022\u003c/span\u003e\u003cspan address=\"10.1001/jama.2022.21022\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLancaster GA, Thabane L. Guidelines for reporting non-randomised pilot and feasibility studies. \u003cem\u003ePilot Feasibility Stud\u003c/em\u003e. 2019; 5:114. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s40814-019-0499-1\u003c/span\u003e\u003cspan address=\"10.1186/s40814-019-0499-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBorg GA. Psychophysical bases of perceived exertion. \u003cem\u003eMed Sci Sports Exerc\u003c/em\u003e. 1982; 14(5): 377\u0026ndash;381. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1249/00005768-198205000-00012\u003c/span\u003e\u003cspan address=\"10.1249/00005768-198205000-00012\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNerys W. The Borg Rating of Perceived Exertion (RPE) scale. \u003cem\u003eOccupational Medicine\u003c/em\u003e. 2017; 67(5): 404\u0026ndash;405. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1093/occmed/kqx063\u003c/span\u003e\u003cspan address=\"10.1093/occmed/kqx063\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCohen J. Statistical Power Analysis for the Behavioural Sciences (2nd ed.). \u003cem\u003eHillsdale, NJ: Lawrence Erlbaum Associates.\u003c/em\u003e 1988. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4324/97802037 71587\u003c/span\u003e\u003cspan address=\"10.4324/97802037 71587\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMorris SB, DeShon RP. Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. \u003cem\u003ePsychological Methods\u003c/em\u003e. 2002; 7 (1): 105\u0026ndash;125. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1037/1082-989X.7.1.105\u003c/span\u003e\u003cspan address=\"10.1037/1082-989X.7.1.105\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSullivan GM, Feinn R. Using Effect Size-or Why the P Value Is Not Enough. \u003cem\u003eJ Grad Med Educ\u003c/em\u003e. 2012;4(3):279\u0026ndash;282. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4300/JGME-D-12-00156.1\u003c/span\u003e\u003cspan address=\"10.4300/JGME-D-12-00156.1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBraun V, Clarke V. Thematic analysis: practical guide. London: Sage; 2022.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSim J. Should treatment effects be estimated in pilot and feasibility studies? \u003cem\u003ePilot Feasibility Stud\u003c/em\u003e. 2019; 5: 107. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s40814-019-0493-7\u003c/span\u003e\u003cspan address=\"10.1186/s40814-019-0493-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYao J, Wang Y, Yang L, et al. Prevalence of possible sarcopenia in community-dwelling older Chinese adults: a cross-sectional study. \u003cem\u003eBMJ Open\u003c/em\u003e. 2022; 12(12): e067 425. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmjopen-2022-067425\u003c/span\u003e\u003cspan address=\"10.1136/bmjopen-2022-067425\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWu X, Li X, Xu M, et al. Sarcopenia prevalence and associated factors among older Chinese population: Findings from the China Health and Retirement Longitudinal Study. \u003cem\u003ePLoS One\u003c/em\u003e. 2021; 16(3): e0247617. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal\u003c/span\u003e\u003cspan address=\"10.1371/journal\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. pone.0247617\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMakizako H, Nakai Y, Tomioka K, et al. Effects of a Multicomponent Exercise Program in Physical Function and Muscle Mass in Sarcopenic/Pre-Sarcopenic Adults. \u003cem\u003eJ Clin Med\u003c/em\u003e. 2020; 9(5): 1386. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/jcm9051386\u003c/span\u003e\u003cspan address=\"10.3390/jcm9051386\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eJones C, Chen KM, Weeks B, et al. Healthy Beat Acupunch exercise program: Validation and feasibility study for older adults with reduced physical capacity or probable sarcopenia. \u003cem\u003eExplore (NY)\u003c/em\u003e. 2021; 17(6): 498\u0026ndash;504. doi:10.1016/j. explore.2020. 05.010\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChang KV, Wu WT, Huang KC, et al. Effectiveness of early versus delayed exercise and nutritional intervention on segmental body composition of sarcopenic elders - A randomized controlled trial. \u003cem\u003eClin Nutr\u003c/em\u003e. 2021; 40(3): 1052\u0026ndash;1059. doi:10.1016/j. clnu.2020.06.037\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNie JB, Cheng Y, Zou X, et al. The vicious circle of patient-physician mistrust in China: health professionals' perspectives, institutional conflict of interest, and building trust through medical professionalism. \u003cem\u003eDev World Bioeth\u003c/em\u003e. 2018; 18(1): 26\u0026ndash;36. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/dewb.12170\u003c/span\u003e\u003cspan address=\"10.1111/dewb.12170\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWu ZJ, Trigo V. Views on Current Situation, Causes and Responses of Doctor-Patient Conflicts in New Situations. \u003cem\u003eProceedings of the 2020 4th International Seminar on Education, Management and Social Sciences (ISEMSS\u003c/em\u003e 2020). 2020.10.2991/assehr. k.200826.184\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChen L, Tang H, Guo Y. Effect of Patient-Centered Communication on Physician-Patient Conflicts from the Physicians' Perspective: A Moderated Mediation Model. \u003cem\u003eJ Health Commun\u003c/em\u003e. 2022; 27(3):164\u0026ndash;172. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1080/10810730.2022.2071505\u003c/span\u003e\u003cspan address=\"10.1080/10810730.2022.2071505\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhou P, Grady SC. Three modes of power operation: Understanding doctor-patient conflicts in China's hospital therapeutic landscapes. \u003cem\u003eHealth Place\u003c/em\u003e. 2016; 42: 137\u0026ndash;147. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.health place.2016.09.005\u003c/span\u003e\u003cspan address=\"10.1016/j.health place.2016.09.005\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWei N, Sun D, Huang W. Effects of WeChat use on the subjective health of older adults. \u003cem\u003eFront Psychol\u003c/em\u003e. 2022; 13: 919889. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fpsyg.2022.919889\u003c/span\u003e\u003cspan address=\"10.3389/fpsyg.2022.919889\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBraunwalder R, Reiner J, Pauli C, et al. Older Adults\u0026rsquo; Use of Whatsapp in a Polymedia Environment: Managing Timing, Content, Form and Practicality. In: Ziefle, M., Guldemond, N., Maciaszek, L.A. (eds) Information and Communication Technologies for Ageing Well and e-Health. ICT4AWE 2020. \u003cem\u003eCommunications in Computer and Information Science\u003c/em\u003e. 2021; 1387. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/978-3-030-70807-8_4\u003c/span\u003e\u003cspan address=\"10.1007/978-3-030-70807-8_4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMichie S, van Stralen MM, et al. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. \u003cem\u003eImplement Sci\u003c/em\u003e. 2011; 6:42. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/1748-5908-6-42\u003c/span\u003e\u003cspan address=\"10.1186/1748-5908-6-42\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHakvoort L, Dikken J, van der Wel M, et al. Minimizing the knowledge-to-action gap; identification of interventions to change nurses' behavior regarding fall prevention, a mixed method study. \u003cem\u003eBMC Nurs\u003c/em\u003e. 2021; 20(1): 80. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12912-021-00598-z\u003c/span\u003e\u003cspan address=\"10.1186/s12912-021-00598-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYounas F, Gutman LM. Using the Behaviour Change Wheel (BCW) to Characterise Parenting Interventions to Prevent Intergenerational Child Abuse. \u003cem\u003eInt. Journal on Child Malt\u003c/em\u003e. 2022; 5:133\u0026ndash;154. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s42448-021-00103-8\u003c/span\u003e\u003cspan address=\"10.1007/s42448-021-00103-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChen D, Zhang H, Cui N, et al. Development of a behavior change intervention to improve physical activity adherence in individuals with metabolic syndrome using the behavior change wheel. \u003cem\u003eBMC Public Health\u003c/em\u003e. 2022; 22(1): 1740. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12889-022-14129-1\u003c/span\u003e\u003cspan address=\"10.1186/s12889-022-14129-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eIzquierdo M, Merchant RA, Morley JE, et al. International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. \u003cem\u003eJ Nutr Health Aging\u003c/em\u003e. 2021; 25(7): 824\u0026ndash;853. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s12603-021-1665-8\u003c/span\u003e\u003cspan address=\"10.1007/s12603-021-1665-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLi Z, Cui M, Yu K, et al. Effects of nutrition supplementation and physical exercise on muscle mass, muscle strength and fat mass among sarcopenic elderly: a randomized controlled trial. \u003cem\u003eAppl Physiol Nutr Metab\u003c/em\u003e. 2021; 46(5): 494\u0026ndash;500. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1139/apnm-2020-0643\u003c/span\u003e\u003cspan address=\"10.1139/apnm-2020-0643\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhang Y, Li JL, Deng WH. Application effect of Internet combined with H2H nutritional management mode in older patients with sarcopenia [J]. \u003cem\u003eMedical theory and practice\u003c/em\u003e. 2023, 36(23): 4105\u0026ndash;4108. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.19381/j.issn.1001-7585.2023.23.057\u003c/span\u003e\u003cspan address=\"10.19381/j.issn.1001-7585.2023.23.057\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWang Z, Xu X, Gao S, et al. Effects of Internet-Based Nutrition and Exercise Interventions on the Prevention and Treatment of Sarcopenia in the Elderly. \u003cem\u003eNutrients\u003c/em\u003e. 2022; 14(12): 2458. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/nu14122\u003c/span\u003e\u003cspan address=\"10.3390/nu14122\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBeckw\u0026eacute;e D, Delaere A, Aelbrecht S, et al. Exercise Interventions for the Prevention and Treatment of Sarcopenia. A Systematic Umbrella Review. \u003cem\u003eJ Nutr Health Aging\u003c/em\u003e. 2019; 23(6): 494\u0026ndash;502. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s12603-019-1196-8\u003c/span\u003e\u003cspan address=\"10.1007/s12603-019-1196-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNational Health Service. Physical activity guidelines for older adults. September 24, 2021. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.nhs.uk/live-well/exercise/exercise-guidelines/physical-activity-guidelines-older-adults/\u003c/span\u003e\u003cspan address=\"https://www.nhs.uk/live-well/exercise/exercise-guidelines/physical-activity-guidelines-older-adults/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCenters for Disease Control and Prevention (CDC). How much physical activity do older adults need? June 3, 2022. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.cdc.gov/physicalactivity/basics/older_adults/index.htm\u003c/span\u003e\u003cspan address=\"https://www.cdc.gov/physicalactivity/basics/older_adults/index.htm\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"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":"[email protected]","identity":"npj-digital-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"npjdigitalmed","sideBox":"Learn more about [npj Digital Medicine](http://www.nature.com/npjdigitalmed/)","snPcode":"41746","submissionUrl":"https://submission.springernature.com/new-submission/41746/3","title":"npj Digital Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"NPJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Sarcopenia, feasibility study, social media, health education, exercise, community-dwelling young-old adults","lastPublishedDoi":"10.21203/rs.3.rs-7624386/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7624386/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePossible sarcopenia is common among community-dwelling young-old adults, yet effective social media interventions remain scarce. We developed a TikTok-based multi-component program (SHEEP) integrating health education and exercise via co-design. A single-arm mixed-methods feasibility study was conducted (May-August 2024) with 35 adults aged 60\u0026ndash;69 with possible sarcopenia in Changsha, China. Participants received one week of health education videos and six weeks of exercise intervention, with follow-up testing. Feasibility, acceptability, and physical and behavioural outcomes were assessed. Recruitment (80% female), adherence, and procedures were feasible and acceptable. Preliminary improvements were observed in handgrip strength, walking speed, sit-to-stand performance, knowledge, self-efficacy, and self-management. Qualitative feedback indicated enhanced physical and mental well-being. SHEEP is feasible and acceptable and may improve physical function in older adults with possible sarcopenia. A randomized controlled trial is warranted.\u003c/p\u003e","manuscriptTitle":"Social media-based health education plus exercise programme (SHEEP) to improve muscle function among community-dwelling young-old adults with possible sarcopenia: A feasibility study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-01 08:20:51","doi":"10.21203/rs.3.rs-7624386/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-05T18:36:19+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-04T03:07:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"33421210167369770429873516644575385033","date":"2025-11-10T07:00:49+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-05T12:52:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"26988435246183077962505712043270557259","date":"2025-10-14T14:18:54+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-14T10:08:53+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-13T00:50:55+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-11T16:37:21+00:00","index":"","fulltext":""},{"type":"submitted","content":"npj Digital Medicine","date":"2025-09-15T23:48:05+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"npj-digital-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"npjdigitalmed","sideBox":"Learn more about [npj Digital Medicine](http://www.nature.com/npjdigitalmed/)","snPcode":"41746","submissionUrl":"https://submission.springernature.com/new-submission/41746/3","title":"npj Digital Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"NPJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"18d3df7a-5c80-4d22-8fbf-91c006a97ad6","owner":[],"postedDate":"October 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":55179003,"name":"Health sciences/Health care"},{"id":55179004,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2026-04-13T16:07:43+00:00","versionOfRecord":{"articleIdentity":"rs-7624386","link":"https://doi.org/10.1038/s41746-026-02585-7","journal":{"identity":"npj-digital-medicine","isVorOnly":false,"title":"npj Digital Medicine"},"publishedOn":"2026-04-08 15:57:46","publishedOnDateReadable":"April 8th, 2026"},"versionCreatedAt":"2025-10-01 08:20:51","video":"","vorDoi":"10.1038/s41746-026-02585-7","vorDoiUrl":"https://doi.org/10.1038/s41746-026-02585-7","workflowStages":[]},"version":"v1","identity":"rs-7624386","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7624386","identity":"rs-7624386","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}