A mobile-based educational tool for training medical students in emergency trauma management: development and pilot study.

Physical activity (PA) is critical for preserving health, functional independence, and quality of life in later adulthood. A substantial body of evidence has demonstrated that regular PA is associated with reduced risks of all-cause mortality, cardiovascular disease, functional decline, and disability, while also contributing to improved mental health and well-being among older adults [, , ], Izquierdo Mikel et al., 2021). As the global population ages, healthy aging has become a pressing public health priority, with increasing emphasis on maintaining functional ability and promoting active lifestyles across the lifespan []. The World Health Organization [] estimates that by 2030, one in six individuals worldwide will be 60 years or older. Regular PA contributes substantially to both physical and psychological well-being, reducing the risk of all-cause mortality, cardiovascular disease, hypertension, type 2 diabetes, certain cancers, and falls, while enhancing cognitive function, mental health, sleep quality, and body composition []. Accordingly, the WHO recommends that older adults accumulate 150–300 min of moderate-intensity aerobic activity, 75–150 min of vigorous-intensity activity, or an equivalent combination per week. In Taiwan, a recent survey showed that 68.3% of older adults met these recommendations, however, 15.7% were classified as physically inactive (Tsai et al., 2024). Despite this encouraging finding, understanding why some Taiwanese older adults meet PA recommendations while others remain inactive is critical for tailoring effective health promotion strategies. In addition to PA, sedentary behavior (SB) has been identified as an independent behavioral risk factor. A study of sedentary patterns among older adults in Taiwan reported that over one-third accumulated more than six hours of sedentary time per day []. SB is defined as any waking behavior characterized by an energy expenditure of ≤ 1.5 METs while in a sitting, reclining, or lying posture and is conceptually distinct from physical inactivity (Tremblay et al., 2017). Increasing evidence indicates that prolonged SB adversely affects metabolic health—contributing to metabolic syndrome, obesity, and impaired glycemic regulation—and is associated with cognitive decline and mental health disorders [, , ]. These risks may be further exacerbated by age-related declines in mobility, limited awareness of SB-related health implications, and entrenched sedentary routines [], McGowan et al., 2019). Taken together, insufficient PA and prolonged SB pose significant threats to older adults’ health, highlighting the urgent need to identify effective strategies to promote more active lifestyles and reduce sedentary time. Physical literacy (PL) has emerged as a promising framework for addressing physical inactivity and sedentary behavior while supporting healthy aging. Whitehead [] conceptualized PL as “the motivation, confidence, physical competence, knowledge, and understanding to value and take responsibility for engaging in PA for life,” emphasizing that both capability and disposition are essential for sustained engagement in movement. Building on this perspective, Cairney (2019) positioned PL as an upstream determinant of health through its influence on PA participation. By integrating motor competence, motivation, confidence, affective engagement, and knowledge, PL facilitates sustained PA involvement and generates both physiological and psychological benefits that reduce the risk of chronic disease. Conversely, lower levels of PL have been consistently associated with inactivity, suggesting that PL may shape long-term behavioral patterns that either promote or hinder healthy aging [].