The Effect of Mobile Software "Let's Move" Program Developed Based on Transtheoretical Model on Sedentary Life Behaviors of University Students
Phase: NA
Conditions: Public Health Nursing
Sponsor: Marmara University

Researcher Study Protocol 
Official Title: The Effect of Mobile Software "Let's Move" Program Developed Based 
on Transtheoretical Model on Sedentary Life Behaviors of University Students   
NCT ID: not yet assigned 
Record Verification: 14.07.2022  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

SUMMARY and KEYWORDS: 
Sedentary life means a physically inactive, sedentary life and is the fourth leading risk factor 
for global deaths. It is reported that 70% to 85% of young people between the ages of 15-24, 
who make up 15.6% of the population of our country, are sedentary. This rate does not meet 
the physical activity guidelines recommended by the World Health Organization for young 
people. Sedentary lifestyle causes physical, biological and mental problems, increases the 
prevalence of non-communicable diseases and negatively affects academic achievement. 
Integration of technology into human life in the health dimension; It aims to reduce the 
obstacles of individuals to change their unhealthy behaviors and to increase their motivation to 
gain healthy behaviors. The Transtheoretic Model (TTM) is an easy-to-use and proven effective 
model for changing the prevalence of activity. Schools are the most effective medium to reach 
young individuals. However, considering the density of the school population and the 
inadequacy of school health nurses in our country; New approach techniques and innovative 
strategies are needed to reduce costs and save time. Therefore, in the first stage of this two-
stage research, it was aimed to develop the TTM-based 'Hadi Move' mobile software program 
and to test the effect of the mobile software program developed in the second stage on changing 
the sedentary life behaviors of university students. The universe of this research consisted of 
290 students studying at a foundation university in Istanbul. The sample was calculated using 
the G-power (3.1.9.4) program. By taking 10% more of the sample, 97 students in the 
experimental group and 97 students in the control group will be randomly assigned through the 
SPSS program. TTM-based "Let's Move" mobile software program developed for the 
experimental group will be applied for 12 weeks. The effectiveness of the program will be 
evaluated with pre-test, post-test and follow-up test, International Physical Activity 
Questionnaire, daily step count smart bracelet and sedentary lifestyle TTM Sedentary Life 
Scales (Stages of Change, Change Process Scale, Self-Efficacy and Decisional Balance Scale). 
At the end of the research, the effectiveness of the 'Hadi Move' mobile software program 
developed in this research in changing the sedentary life will be tested. In addition, it is aimed 
to increase the number of steps, decrease in sedentary behaviors and make an active lifestyle 
permanent. All initiatives developed for TTM sedentary life behavior change stages will be 
made into a book and the results of the experimental research will be published, contributing 
and providing evidence to the international literature. 
OBJECTIVE/REASON: 

The aim of the project is to develop the "Let's Move" mobile software program based on the 
Transtheoretic Model (TTM) and to test the effect of the developed program on changing the 
sedentary life behaviors of its students. 
Project Goals 
 The developed TTM based 'Let's Move' mobile software program will be effective in 
changing the sedentary behaviors of students. 
 The number of steps of the experimental group will increase. 
 The physical activity Metabolic Equivalent (MET) scores of the experimental group will 
increase. 
 The ratio of inactive and minimally active students in the experimental group will 
decrease, and the ratio of students in the very active category will increase. 
 The percentage of students in the experimental group TTM behavior change preparation 
and action phase will increase. 
 The cognitive change processes scores of the experimental group will increase. 
 The behavioral change processes scores of the experimental group will increase. 
 The self-efficacy score of the experimental group will increase. 
 Decision-making utility perception score of the experimental group will decrease. 
 The decision-making harm perception score of the experimental group will increase. 
 The proportion of those with normal Body Mass Index (18.5-24.99) in the experimental 
group will increase. 
 The International Physical Activity Questionnaire (IPAQ) scores of the experimental 
group will increase. 
 Total body muscle ratio of the experimental group will increase. 
 The body fat ratio of the experimental group will decrease. 
SUBJECT and SCOPE 
Sedentary lifestyle is an important behavioral problem that threatens health and is reported to 
be common among young people (WHO, 2020; Ceylan, 2020; Kim et al., 2020; Han et al., 
2017; Prochaska et al., 2017). University years include adolescence and young adulthood. In 
order to reach the healthy adults of the future, it is very important to spend these periods active, 
to gain healthy lifestyle behaviors and to make them permanent. Adopting an inactive lifestyle 
of young people causes many non-communicable diseases (diabetes, hypertension, 
hyperlipidemia, etc.) in later ages (Kleis et al. 2022; Güler, 2022). For this reason, developing 

an active lifestyle and changing an inactive lifestyle during the youth years are the most 
important components of reaching healthy societies. 
When the studies are examined, it is seen that the majority of the studies conducted to reduce 
sedentary life focus on adults aged >30 years (Kleis et al., 2022; Fabio et al., 2020; Tanyeri, 
2019; Menekli et al., 2019; Kim et al., 2018; Ya -Ke Wu&Nain-Feng Chu, 2015; Wang et al., 
2015; Savcı et al., 2006; Andersan et al., 2006) and a limited number of experimental studies 
based on the Transtheoretic Model (TTM) for university students (Kim&Lee, 2022; Kim et al., 
2021; Chen et al., 2020; Lee et al., 2020; Ceylan, 2020; Başakçı, 2019). 
The Transtheoretic Model argues that change is a process, not a result, that the individual 
changes behavior by going through certain stages, and that in order to be successful in change, 
appropriate initiatives should be planned for the stage of change that the individual is in. The 
model recommends appropriate biopsychosocial and behavioral interventions by evaluating the 
individual's readiness for change with the stages of change questionnaire and the self-efficacy 
and determination levels with scales. It constantly monitors the stage of change that the 
individual has reached as a result of the initiatives, offers initiatives to prevent returns and to 
make the behavior permanent (Han et al., 2017; Procha et al., 2017; Başakçı, 2019; Kim et al., 
2020; Ceylan, 2020; Lee et al., 2020). 
LITERATURE REVIEW: 
In the examination made with the keyword Transtheoretic Model (TTM) on the YÖK Thesis 
website; It has been observed that 34 theses based on TTM were conducted in our country 
between the years 2008-2021. One of these studies was the validity and reliability study of the 
transtheoretic model sedentary life scales (Tok, 2017), and seven of them aimed to increase 
physical exercise (Ünver, 2021; Sönmez, 2020; Ceylan, 2020; Tanyeri, 2019; Serin, 2017; 
Baysal, 2013; Kafalı). , 2009) was found to be oriented. It was determined that three of them 
were aimed at preventing obesity (Ceylan, 2020; Başakçı, 2019; Cangöl, 2016;), and 12 of them 
aimed at quitting smoking (Deniz, 2021; Sözer, 2020; Ersoy, 2019; Yalçınkaya, 2019; Avcı, 
2018; Çavuşoğlu, 2018). ; Durmaz, 2017; Çamözü, 2017; Taş, 2015; Koyun, 2013; Prosecutor 
Minister, 2013; Güngörmüş, 2008). Others are sun protection (Duran, 2019; Aygün, 2012), 
reproductive health (Karatana, 2021; Aksoy, 2019), safe cycling (Erdem, 2021), diabetes 
education (Tosun, 2015), controlled internet use (Bayrak, 2021). ), prevention of suicidal 
behavior (Bahar, 2021), education for patients with hypercholesterolemia (İncazlı, 2019), safe 
drug administration (Arslan, 2017) and nurse navigation program in cancer screening 

(Temuçin, 2017). The results of all these studies show that TTM is an effective model for 
changing behavior. 
As a result of the literature review, TTM-based mobile software program to increase physical 
activity could not be reached in the national and international literature. However, there are 
applications for changing exercise, physical activity, smoking, weight management and 
nutritional behaviors with TTM-based web-based platforms (Smith et al., 2014; Chen et al., 
2017; Kenned et al., 2017; Jimoh et al. , 2018; Ludwig et al., 2018; He et al., 2021; Choi et al., 
2021; Allman-Farinelli et al., 2016; Hebden et al., 2014; Epton et al., 2014; Partridge et al., 
2015; Peyman et al., 2018). 
Choi et al. (2021) developed a smartphone application (AnSim) that sends messages based on 
a transtheoretical model for healthy eating, physical activity, stress relief and smoking cessation 
for individuals with coronary artery disease. They stated that health promotion approaches 
using mobile technology have great potential (Choi et al., 2021). Prochaska et al (2007) 
developed the TTM-based LiveWell program to improve healthy lifestyle behaviors such as 
exercise, eating and stress management in university students. The program is a computer 
online intervention program that plans dynamic initiatives suitable for each student and their 
readiness for behavior change, with personalized questions and feedback. At New York 
University, the LiveWell program was applied to all students with the motto of 'healthy 
campuses'. At the end of the program, it was shown that there was a significant increase in 
students' self-efficacy and quality of life values (Prochaska et al., 2017).  
In a study conducted by Başakçı (2019) to determine the effect of TTM-based initiative 
enriched with whatsapp messages on weight management; It has been determined that there is 
an increase in the physical activity levels of individuals, a decrease in the Body Mass Index 
values and a positive change in the nutritional behaviors in the desired direction (Başakçı, 
2019). According to the results of the study; They suggested that more work should be done by 
developing whatsapp messages suitable for TTM change stages and adding mobile health 
applications. Ceylan (2020) conducted a TTM-based quasi-experimental research by sharing 
trainings, messages, videos and images to increase physical activity in adolescents via 
WhatsApp. According to the research findings, it was found that the adolescents progressed in 
the exercise change stages, increased their self-efficacy and benefit perception scores, and 
decreased their harm perception scores. He also stated that individuals continue physical 
activity despite the pandemic conditions (Ceylan, 2020). Lee et al. (2017) developed a smart 

phone program containing special nutritional information messages based on a transtheoretical 
model to prevent and manage obesity in primary school students. 
ORIGINAL VALUE 
The difference of the 'Let's Move' mobile software program, which is planned to be developed 
in this research, is that it provides ease of use and includes special initiatives for the behavior 
change stage of the individual (not thinking, thinking, preparation, acting, continuing). The 
mobile software program includes five stage-specific educational videos that increase the 
individual's motivation for change and self-efficacy, appropriate physical activity visuals, 
stimulating or motivating messages, and daily step counts. In addition, students will complete 
the International Physical Activity Questionnaire once a week through the program, and the 
program will calculate students' weekly activity status (inactive, minimally active and very 
active). Students will be able to send messages to the researcher through the program. 
The most basic literature gains of the research; It provides an accessible, effective and 
technologically innovative program prepared by health professionals to reduce sedentary life. 
The program is evidence-based; It will include practices that are entertaining, interesting, 
encouraging, empowering individuals to live actively and enabling/supporting them to take 
responsibility. It is thought that if the program, which is created with a multidisciplinary 
perspective, can be delivered to young individuals free of charge, it will be effective in 
increasing physical activity. In addition, all initiatives developed for TTM sedentary life 
behavior change stages will be made into a book and the results of the experimental research 
will be published, contributing and providing evidence to the international literature. 
This experimental research consists of two stages. In the first stage of the research, it was aimed 
to develop TTM-based 'Let's Move' mobile software program and to test the effect of the mobile 
software program developed in the second stage on changing the sedentary life behaviors of 
university students. 
WIDE IMPACT/ADDED VALUE 
Effect Type 
 
Effect 
 
Projected Time 
to Achieve the 
Effect  

Social/Cultural Impact: 
 
Contribution to Quality of Life, 
 
Contribution to Sustainable 
Environment and Energy, 
 
Contribution to the 
Improvement of Welfare or 
Education Level, 
 
Solutions to an Important 
Social Problem at Country or 
World Level, etc. 
 
If the developed mobile application program is 
found effective, the program link will be shared 
free of charge via the apple store. 
 
It will contribute to the development of active 
living habits of young people. 
 
The program, created with a multidisciplinary 
perspective, will contribute to young 
individuals getting accurate information about 
physical activity and adopting this information. 
 
It is thought that it will contribute to the 
prevention of obesity, which is an important 
problem in the world and in our country. 
 
0-18 months 
Academic Impact: 
 New R&D Decisions, 
 National/International R&D 
Collaborations, 
 Change in Number and 
Qualification of Researchers, 
 Contribution to University-
Industry Cooperation etc. 
 
The program content tested in the research 
can be adapted to different age groups by 
working with software engineers. 
 
Research can be done by other researchers 
using it on different university students. 
 
If the program is found effective, it can be 
adapted to different languages and opened to 
international use. 
 
The program can be developed and expanded 
on the basis of the Android operating system 
by working with software engineers. 
 
6-12 months 
Economic Impact: 
 
Potential Sectoral Application 
Areas, 
 
Global Market Forecasts, 
 
Employment Contribution, 
 
Competitiveness (Effect on 
Export, Import Substitution, 
Formation of New Firms, 
Triggering Foreign Capital 
Investment, etc.) 
 
It will be cost effective by saving time and 
personnel to reduce sedentary life behaviors in 
young people. 
 
Health expenses will decrease due to the 
prevention of physical and mental diseases 
caused by sententary life. 
 
Since it is a mobile software that students use 
constantly, its use will be easier, faster and 
can be expanded. 
 
12-18 ay 
months 
Long Term Effects 
 
If the program is effective in reducing 
sedentary lifestyles, it will be cost-effective by 
reducing chronic diseases (diabetes, 
hypertension, etc.) that increase health costs 
in adulthood. 
 
5-10 years 
MATERIALS AND METHODS: 
1. Type of research; The research will be conducted with methodological and experimental 
research design. 
2. The place and time of the research; The research was planned to be carried out between 
September 2021 and September 2023 with university students studying in Istanbul Beykent 
University Vocational School health program. 
3. The universe of the research; The universe of the research consists of Anesthesia Program 
(n=57), Operating Room Services Program (n=64), Oral and Dental Health Program (n=89), 
Medical Imaging Techniques (n=27) and First and Emergency Aid Program at Istanbul 

Beykent University Vocational School. (n=53) university freshman students studying in 
departments with a high number of students and meeting the criteria for inclusion in the 
research constituted N=290. Students who meet the inclusion criteria and volunteer to 
participate will be included. 
4. Sample; The sample of the study was calculated with the G-power (3.1.9.4) program, 
means: difference between two independent means analysis. When the effect size was 0.5, 
type error α= 0.05, power 1-β= 0.95, the sample size was found to be 176 (experimental 
group 88, control group 88). Considering the sample loss that may occur due to various 
reasons, it was decided to include 194 (experimental group 97, control group 97) more than 
10% of the sample. The groups will be randomly assigned to the experimental control 
groups through the SPSS program. 
5. Inclusion, Exclusion, and Exclusion Criteria 
5.1.Inclusion criteria for the study; 
 First year students studying in Istanbul Beykent University Vocational School health 
program between September 2021 and September 2023, 
 18-25 years old, 
 Being in the inactive (category 1) and minimally active (category 2) categories 
according to the International Physical Activity Evaluation Questionnaire, 
 Not included in any physical activity program, 
 Do not have any physical (orthopedic, chronic diseases, etc.) and mental problems 
diagnosed by a doctor, 
 Accepting the measurement of body weight, height, body fat and muscle ratio and 
calculation of BMI before starting the research, at the 12th week and at the 6th month 
after its completion, 
 Agreeing to use pedometer (pedometer), 
 Having an iPhone, iPod touch and android based smart phone, 
 Have an active internet connection on their phone, 
 Students who voluntarily agree to participate in the research will be formed. 
5.2.Exclusion and Exclusion Criteria; 
 Willingness to leave the research. 
6. Data Collection Tools and Format 
 Data Collection Tools; Data of the study, Socio-demographic characteristics 
questionnaire (Appendix 1), Transtheoretic Model (TTM) Sedentary Life Stages of 
Change (Appendix-2), TTM Sedentary Life Change Process Scale (Appendix 3), TTM 

Sedentary Life Self-Efficacy Scale (Appendix- 4), TTM Sedentar Life Decisional 
Balance Scale (Annex-5) and International Physical Activity Questionnaire (IPAQ) 
(Annex-6). The height of the students will be measured with a telescopic height meter 
and a scale that measures body weight, fat and muscle ratios. Step counts will be 
collected with the Smart Bracelet. 
 Data Collection Path; Students in the universe will be contacted through class 
representatives and informed about the right to research, and they will be invited to 
apply the data collection forms. Ethics committee permission, institutional permission 
document, voluntary consent form, socio-demographic questionnaire form, TTM 
Sedentary Life Scales and International Physical Activity Questionnaire will be sent to 
the accepted participants in the form of online forms via Google Drive. 
6.1.Socio-demographic Questionnaire Form (Annex 1) 
The sociodemographic characteristics diagnosis form was created by examining the relevant 
literature (Han et al, 2017; Tok, 2017; Baysal, 2013; Tanyeri, 2019; Ceylan, 2020). The form 
consists of 32 questions. In the questionnaire, there are research-oriented questions that question 
socio-demographic characteristics and participation in physical activity. 
6.2.TTM Sedentary Life Scales 
TTM sedentary life scales were developed by Han et al. (2015), and Turkish Validity and 
Reliability study was conducted by Tok (2017) with young people aged 18-24. The scale 
consists of 4 different parts. These; Stages of Change, Process of Change, Self-efficacy and 
Decisional Balance Scale (Han et al., 2015; Tok, 2017). 
6.2.1. Sedentary Life Stages of Change (SL-SC) (Annex 2); 
Sedentary life change stages constitute the core structure of the Transtheoretic Model. It reflects 
the individual's attitudes, intentions and behaviors during the change phase. Behavior change; 
It is a situation assessment consisting of five options and two questions: precontemplation, 
contemplation, preparation, action and maintenance.  
1. Precontemplation (PC); The individual is either unaware of the problem or has little 
awareness of it. He has no intention of changing his problematic behavior within 6 
months. Despite trying, he has failed and is reluctant. The social environment is aware 
of his problematic behavior and the individual feels the situation as pressure. The 
individual should be informed about health behavior and encouraged to think. 
2. Contemplation (C); The individual considers the positive and negative aspects of 
his/her problematic behavior and is the stage where he/she thinks to change within 6 
months. The individual is willing to acquire information and is ready for open 

communication. However, this period consists of chronic thinking, delaying behavior 
and procrastination. 
3. Preparation (P); The individual intends to change their problematic behavior within 
30 days. He has made previous attempts at behavior change, but has been unsuccessful. 
There are action plans such as receiving training and counseling and doing research, but 
they are not regular. 
4. Action (A); The individual changed his problematic behaviors within 6 months. It is a 
critical period when acquired behaviors need to be reinforced, and a return to old 
behaviors (relapse) may occur. At this stage, individuals need to be taught and supported 
skills to cope with difficulties. 
5. Maintenance (M); The individual has changed his unhealthy behavior 6 months ago at 
this stage. The individual is less affected by sedentary stimuli. Risky behaviors are less 
likely to recur. The individual's self-confidence has increased (Han et al., 2015). 
6.2.2. Transtheoretic Model Sedentary Life Change Process Scale (SL-CPS) (Annex 3); 
The process of change defines the experiences through which the individual changes behavior 
such as thinking, preparation, movement and maintenance. The scale consists of 40 items and 
two sub-dimensions, cognitive change processes and behavioral change processes. The change 
process scale is a 5-point Likert type. The answers to the questions are given by ticking one of 
the options 1: Never, 2: Rarely, 3: Sometimes, 4: Often, 5: Always (Tok, 2017). 
6.2.2.1. Cognitive Change Processes Scale; They are structures that evaluate the cognitive 
information content that the individual needs to be conscious of in order to change 
behavior. Individuals use cognitive change processes more in stages such as not 
thinking about change, thinking and preparation. The scale consists of 20 items and 
five sub-dimensions. These; 
 Consciousness Raising; It is the increase of the individual's awareness of the 
problematic behavior, its negative sides, consequences and solutions. Training and 
conferences etc. There may be events. It consists of items 3, 15, 25, and 36 of the scale, 
and the Cronbach Alpha reliability coefficient of the Turkish version was found to be 
0.81. 
 Dramatic Relief; It refers to being warned with negative experiences related to 
problematic behavior. Obesity experience with sedentary life can be given as an 
example. It consists of items 2, 16, 21, and 31 of the scale, and the Cronbach Alpha 
reliability coefficient of the Turkish version is 0.81. 
 Self-Reevaluation; The individual re-evaluates healthy and unhealthy behaviors in 

himself. Weighing values, using imagination, and re-evaluating healthy role models can 
prompt the individual to take action. It consists of items 1, 19, 26, and 38 of the scale, 
and the Cronbach Alpha reliability coefficient of the Turkish version is 0.80. 
 Environmental Reevaluation; It is the individual's cognitive and emotional thinking 
about the effects of unhealthy behaviors on his/her physical and social environment. It 
consists of items 7, 14, 28, and 34 of the scale, and the Cronbach Alpha reliability 
coefficient of the Turkish version was specified as 0.73. 
 Social Liberation-environmental opportunities; It is an increase in the awareness of 
the opportunities provided in the society against the risky behaviors of the individual. 
For example; Creating areas for sports in parks and gardens. It consists of items 6, 13, 
22, and 32 of the scale, and the Cronbach Alpha reliability coefficient of the Turkish 
version is 0.74 (Tok, 2017). 
6.2.2.2.Behavioral Change Processes Scale; It defines the behaviors that the individual 
chooses during the change phase. Individuals use the processes of preparation, 
movement and continuation more during the behavioral change phase. The scale 
consists of 20 items and five sub-dimensions (Tok, 2017). These; 
 Helping relationships; It includes relationships that provide trust, support and 
acceptance. For example, receiving counseling support, having friends and social 
support groups that support positive behavior. It consists of items 8, 18, 23, and 33 of 
the scale, and the Cronbach Alpha reliability coefficient of the Turkish version is 0.82. 
 Counter Conditioning; It is the individual's choosing healthier behaviors to replace 
unhealthy behaviors. For example, exercising instead of playing computer. It consists 
of items 5, 20, 27, and 39 of the scale, and the Cronbach Alpha reliability coefficient of 
the Turkish version was specified as 0.85. 
 Reinforcement management; It refers to self-reward as the individual changes 
unhealthy behaviors. It consists of items 10, 17, 29, and 40 of the scale, and the 
Cronbach Alpha reliability coefficient of the Turkish version was specified as 0.81. 
 Stimulus Control; The individual controls the stimuli and replaces it with a healthy 
behavior in order to reduce the risk of relapse of the problematic behavior. For example, 
removing objects that support immobile behavior. It consists of items 9, 12, 24, 37 of 
the scale and the Cronbach Alpha reliability coefficient of the Turkish version was 
specified as 0.86. 
 Self-Liberation; It is the individual's revealing his belief in change and adapting to 
change. For example, making decisions for sedentary behavior and making a promise 

to himself. It consists of items 4, 11, 30, and 35 of the scale, and the Cronbach Alpha 
reliability coefficient of the Turkish version was stated as 0.74 (Tok, 2017). 
6.2.3. Transtheoretic Model Sedentary Life Self-Efficacy Scale (SL-SES) (Appendix 4); 
Self-efficacy Scale; It is an individual's belief about himself/herself that he/she can perform a 
certain behavior successfully, reflecting self-confidence (Han et al., 2015; Tok, 2017). The 
scale consists of 6 items that include self-confidence in quitting sedentary behavior. It is a five-
point Likert type. It ranges from 1: Not at all trusting to 5: Very confident. The Cronbach Alpha 
reliability coefficient of the Turkish form of the scale was stated as 0.75 (Tok, 2017). 
6.2.4. Transtheoretic Model Sedentary Life Decisional Balance Scale (SL-DBS) (Annex 
5) 
The decision-making scale consists of two sub-dimensions that measure the benefits and harms 
of making a behavior change decision. The sedentary life decision-making scale consists of 12 
items containing the positive and negative aspects of sedentary life. 
6.2.4.1. Decision-making utility sub-dimension; A high score on this sub-dimension indicates 
that they are aware of the benefits of behavior change and that they are more likely to change 
their behavior. The scale consists of 1, 3, 5, 7, 9, and 11 items, and the Cronbach Alpha 
reliability coefficient of the Turkish version is 0.87.  
6.2.4.2. Decision making harm sub-dimension; A high score on this sub-dimension indicates 
that the harms of behavior change attract more attention and the probability of changing 
behavior is less. It consists of items 2, 4, 6, 8, 10, and 12 of the scale, and the Cronbach Alpha 
reliability coefficient of the Turkish version was stated as 0.73 (Tok, 2017). 
6.2.5. International Physical Activity Questionnaire (IPAQ) (Annex 6); 
The International Physical Activity Survey (IPAQ) was developed as a tool for international 
monitoring of physical activity and inactivity. It consists of seven questions to determine the 
average daily time spent sitting, walking, and moderate to vigorous activity over the past seven 
days. Between 1997 and 1998, an International Association Group developed four long and 
four short forms of IPAQ tools (phone call or self-administration, two alternate reference 
periods, "last 7 days" or "regular week" "remembered physical activity)" (IPAQ research 
Committee Guidelines for data processing and analysis of International Physical Activity 
Questionnaire (http://www.ipaq.ki.se, accessed 28.04.2021). 
Scoring and Scoring the IPAQ Questionnaire 
Short form (7 questions); provides information on time spent walking, moderate and vigorous 
activities, and time spent sitting. Calculation of the total score of the short form includes the 
sum of the duration (minutes) and frequency (days) of walking, moderate-intensity activity, and 

vigorous activity. The energy required for activities is calculated with the MET-minute score. 
Standard MET values have been established for these activities.  
By using these values, daily and weekly physical activity level is calculated. These; 
For example; The walking MET-min/week score of a person walking for 3 days and 30 
minutes is calculated as 3.3 X 3 X 30 = 297 MET-min/week. 
Physical activity categories according to total MET scores according to UAFA; 
 Inactive Level; 599 MET and below 
 Minimal Level; Between 600 MET-3000 MET 
 Very Active Level; 3001 MET and above. 
The IPAQ residency question is an additional determinant. It is not part of the scoring of 
physical activity. Residence data is not reported with medians and quartiles. There is little data 
on sedentary (sitting) behaviors and there is no accepted threshold value shown as a categorical 
level (Öztürk, 2005). 
6.2.6. Measurement of Body Weight, Fat and Muscle Ratios, Height and Body Mass 
Index (BMI) (Annex 7) 
6.2.6.1. Standardization of body weight measurements; Body weight will be measured 
with a digital scale. 
 Not doing any sports, not eating and not drinking liquids at least 3 hours before the 
measurement, 
 Before the measurement, shoes, heavy clothing and jewelry are removed. 
 When the person is standing, both feet are in the middle of the scale, the arms are 
comfortably at the sides and the head is facing, 
Physical Activities 
 
MET value 
(min.) 
Weekly MET score calculation (min*day) 
Walk 
 
3.3 MET 
Walking MET-min/week = 3.3 x walking minutes x 
number of walking days 
Moderately Vigorous 
Physical Activity 
 
4.0 MET 
Moderate-intensity MET-min/week = 4.0 x minutes of 
moderate-intensity activity x number of days of 
moderate-intensity activity 
Severe 
Physical 
Activity 
8.0 MET 
Severe MET-min/week = 8.0 x minutes of vigorous 
activity x number of days of vigorous activity 
Total MET score per week 
 
Total MET-min/week= walking + moderate + severe 
(MET-min/week) 

 The bladder is empty, 
 Absence of menstrual cycle one week before in women, 
 All measurements will be made in the same environment, at the same standard, at the 
same time and with the same tools. 
6.2.6.2.Measurement of fat and muscle ratios: It will be evaluated with a digital scale during 
weight measurement. 
6.2.6.3.Standardization of height measurements (stadiometer); will be measured with a 
telescopic height meter. 
 Height measurement will be made without shoes, with heels together, head and back in 
an upright position, eyes facing forward, arms at your sides comfortably, heels against 
the tape measure and leaning back. 
 The measurement will be made with a portable stadiometer (height meter). 
 During deep inspiration, the distance between the thin bar parallel to the ground in 
contact with the head and the sole of the foot and the highest point of the head will be 
measured with an accuracy of 0.5 cm. 
 All measurements will be made in the same environment, at the same standard, at the 
same time and with the same tools. 
6.2.6.4.Body mass index (BMI); calculated by dividing the body weight by the square of the 
height. 
 According to the World Health Organization body mass index data, those below 18.5 
kg/m2 are "thin", 18.5-24.99 range values are "normal", 25.0-29.9 kg/m2 are "slightly 
obese" and 30.0 kg/m2 m 2 or more is considered as "obese". When the study is 
completed, participants will be evaluated for body mass index (WHO, 2021). 
Measurements; 
All measurements will be made by the researchers. Measurements (T.C. Ministry of Health 
Patient Follow-up Guide; https://hsgm.saglik.gov.tr/depo/birimler/saglikli-bebek-hareketli-
hayat-db/Haberler/Diyetsenler-Izlem-rehberi/Dietisyen_icin_hasta_izleme_rehberi.pdf, access 
date; 27.04.2022) was made using the source. In addition, the opinions of dietitians and physical 
therapists working in this field were taken. 
6.2.7. Use of Pedometer (Smart Wristband) and Classification of Daily Step Count 
(Appendix 8) 
A smart bracelet is a device used to monitor physical activity, showing how many steps are 
taken during the day. Step count measurement will be made with the Smart Bracelet. The smart 
bracelet has a Global Positioning System (GPS), that is, a global positioning system. 

The smart bracelet is compatible with Android and iOS devices. The smart bracelet has a 
colorful, large and aesthetic display for blood pressure, pedometer, notification and message 
reading. It automatically records the number of steps and calculates the calories burned. The 
bracelet will vibrate slowly and give a warning when sitting or standing still for a long time. 
Charging time is one hour. On average, there is a need for a charge once a week. It has many 
features such as stopwatch, calendar, alarm clock. 
Smart Wristband Usage: 
Students will wear smart wristbands on their arms outside of sleep and shower. The smart 
bracelet will stay on the wrist for an average of 16 hours. 
Number of Steps per Day: Tudor-Locke et al. divided the individuals into categories according 
to the number of steps. These; 
Number of Steps Taken per Day 
Category 
less than 2500 steps 
“basal activity” 
2500-4999 steps 
 “limited activity” 
Those who take 5000-7499 steps 
“low active” 
7500-9999 steps 
 “somewhat active” 
10000-12499 steps taken 
"active" 
Those who take more than 12500 steps 
“high active” 
He/She defines individuals who take less than 5000 steps a day as “sedentary” (Tudor-Locke 
et al. (2009)). The severity and duration are as important as the pedometer values. It emphasizes 
that the number of steps taken in 1 minute can be a criterion for determining the intensity of the 
step number. In young healthy adults, the mean number of steps for both sexes was stated as 
100 steps/min or 300 steps/30min as 3 METs (Tudor-Locke et al (2004)., Tudor-Locke et al. 
2009), Marshall-Levy et al. et al (2009)). 
7. 
“Let's Move” Mobile Software Program Based on Transtheoretic Model 
This program has two phases. The first stage is the creation of the software of the program and 
the second stage is the implementation of this program. 
Software of the Program: This program will be developed for iOS and Android compatible 
devices using JavaScript programming language and technologies. Source codes written during 
development will be kept in a private repository on githud. After the development of the 
application based on the design template is completed, it will be published on the app store and 
google play. Users will be able to download and use this application on their Android and iOS 
compatible devices from the app store and google play. The user data that will use the 

application will be kept on the cloud-based MySQL Database. Notifications can be sent to users 
via OneSignal, video can be uploaded and broadcast to users, and users will be able to download 
the data obtained. 
Additional information; 
Minimum iOS and Android version: iOS 14 and Android 13 
Data Storage: A page will be created by the researcher over the cloud and the data storage will 
remain on the researcher's self-defined page (Cloud can store data up to 10 GB). The data will 
be stored via mysql Database. 
Data Security: User name (school number) and password (his/her own) will be logged into the 
system and only the researcher will be able to follow up. 
Software completion time: 2 months (160 hours) 
Internet Usage: Internet connection is required in order to follow the users of the researcher 
and to receive data for research purposes. In addition, after users install the program, using the 
internet connection, "Let's Move" Program's message, message, etc. must be allowed to share. 
If it is not confirmed, the screen will appear in red. 
Program Design: 
“Let's Move” Program, which is a computer software program and planned as a phone 
application; 
Content and Features of the Software 
1.screen 
 Participants will set the school number as their username and will create 
their own passwords. 
 There will be an article explaining that the program is suitable for those who 
are minimally active and inactive, and it will include a video about using 
the "Lets’s Move" mobile software program. 
2.screen 
 Participants will enter their body weight, muscle and fat ratios, and height 
into the system. 
 The program will calculate the Body Mass Index and display your avatar 
(Female/Male). 
3.screen 
 The experimental group (n=97) will fill in the Sedentary Life Change Stages 
questionnaire, the International Physical Activity Questionnaire, and the 
Sedentary Life Scales through the Program. 
 According to IPAQ, those who are minimally active and inactive will be 
directed to the appropriate intervention program according to their sedentary 

life change stage. 
4.screen 
 Students will enter the module system prepared according to five different 
stages of change [precontemplation (1), contemplation (2), preparation (3), 
action (4), maintenance (5)] of Sedentary Life.  
 There will be 12 different initiatives specific to each stage/module in the 
program. 
 There will be a total of 60 different initiatives for all phases. 
 Initiatives are aimed at increasing change self-efficacy and decision-
making, prepared by using TTM change processes specific to the TTM 
change stage in which the individual is in order to accelerate behavior 
change. 
 Initiatives; The harms of sedentary life, the benefits of active life, how to be 
physically active, physical activity categories (inactive, minimally active 
and very active), trainings on physical activity types (light, moderate, 
vigorous) and related multiple choice questions, specific exercise for the 
change phase proposal (recipe), change plan schedule, physical 
activity/exercise videos that can be done at home, at school, in hot/cold 
weather, with and without tools, photos, daily step count, breathing 
exercises, exercise diaries, weekly informative message about the progress 
in physical activity categories , recommendation messages on how to deal 
with barriers to change, information, empowerment and motivation 
messages about support groups (cycling groups, running groups, nature 
trips, etc.) (Resources are shown in Appendix 1). 
 Participants will be able to repeat all the initiatives (training, video and 
others) in the change phase as many times as they want. 
 It will be recorded how long the participants participated in which initiative. 
 Summarizing and reinforcing questions will be added at the end of each 
attempt. If the participants do not answer the questions, they will not be able 
to continue the next week's initiative. A warning will appear that the system 
does not answer your questions. 
 At all stages, daily warning/reinforcing messages related to the initiative of 
that week will be sent. 
 Students will apply the program prepared for the exchange phase they are 

in for six weeks. At the end of the sixth week, students will fill out the 
Sedentary Life Change Stages questionnaire, the International Physical 
Activity Questionnaire, and the Sedentary Life Scales through the Program. 
 According to the results of the survey and scale, the students of the program 
will be directed to the modules again according to the stage of change they 
have reached. 
5.screen 
 The student will be able to see the number of steps taken daily, the activity 
category according to the number of steps, and their activity category 
ranking within the whole group. 
 At the end of the sixth and 12th weeks, a certificate of success will be sent 
to the first three students with the highest number of steps in each 
exchange phase. 
6.screen 
 Start date, end date etc. dates will be displayed 
7.screen 
 There will be a calendar and notepad screen. 
 Participants will be able to record their daily step counts on the smart 
bracelet to the 'Let's Move' mobile software program. 
8.screen 
 There will be an interactive messaging screen with the researcher. 
Module Titles 
1. Precontemplation 
Aim; The aim of the initiatives at this stage is to make the participants think about changing 
their sedentary life behaviors. In order to achieve this goal, there are initiatives that include 
training presentations, videos, photographs, messages and learning questions to raise awareness 
(Tudor-Locke et al., 2004; Öztürk, 2005; Bearman et al. 2006; Tudor-Locke et al. (Tudor-Locke 
et al., 2004; Öztürk, 2005; Bearman et al., 2006). 2009); Marshall-Levy et al (2009); Buettner, 
2011; Gürkan et al. 2012; Bucchianeri et al., 2013; Bulut, 2013; Çam, H. H., 2014; Ersoy, 2016; 
Ersoy, 2016; Aydın et al., 2016; Bressa et al., 2017; Ünlü, 2017; Arıkan et al., 2018; Yıldırım, 
2018; Turkey Nutrition and Health Research, 2019; Alp, 2019; Yılmaz, 2019; TUIK, 2019; 
Önal et al., 2019; Taş & Akyol, 2019; Genç & Zorba, 2019; Çiçek, 2020; WHO, 2020; Demir, 
2020; WHO, 2021; WHO, 2022). 
TTM Processes to be Used: 
Sedentary Life TTM Cognitive Change Processes Scale: Interventions were prepared using 
the processes of raising awareness, emotional arousal, and self-reappraisal. 
Decisional Balance Scale: Initiatives have been prepared to increase the harm perception of 
sedentary life. 

Self-Efficacy Scale: Attempts to increase self-efficacy were prepared to change sedentary life 
behavior. 
NOTE: 12-week interventions related to the not thinking phase are shown in Appendix 1. 
Content preparations for initiatives for other phases continue. 
2. Contemplation 
Aim; The aim of the initiatives at this stage is to make the participants think about change by 
increasing their motivation and self-confidence that they can change. It is the application made 
to activate the obese individuals who lead a sedentary life, those with muscle wasting, 
Stimulating Learning Questions That Promote Thinking (Clicking on each question 
will direct the student to the initiative) 
Week 1 
What is a sedentary lifestyle (inactive lifestyle)? (Awareness) 
Week 2 
Who is a sedentary individual? (Awareness) 
Week 3 
Let's get to know ourselves (who is an active, inactive, minimally active 
individual?) Self-Reassessment) 
What do our step counts tell us? (Emotional Arousal) 
Week 4 
Shall we get to know our body with measurements and determine our body 
type? (Awareness/Self-Re-evaluation) 
Week 5 
Shall we get to know our body with our vital signs? (Awareness/Self-Re-
evaluation) 
Week 6 
Do you know how a sedentary lifestyle affects your movement system (muscles, 
bones, joints) and skin system? (Awareness/Self-Re-evaluation) 
Week 7 
Do you know the effect of sedentary life on mental health (stress, depression, 
etc.)? (Awareness/Emotional Arousal) 
Week 8 
Do you know how sedentary life affects the circulatory and respiratory system? 
(Awareness/Emotional Arousal) 
Week 9 
Do you know how sedentary life affects the digestive and excretory system? 
(Awareness/Emotional Arousal) 
Week 10 
Do you know the effect of sedentary life on your immune system? 
(Awareness/Emotional Arousal) 
Week 11 
Do you know what physiological pains a sedentary life causes and how it affects 
your sleep quality? (Awareness/Emotional Arousal) 
Week 12 
Do you know how sedentary life affects your brain health and academic 
success? (Awareness/Emotional Arousal) 

individuals with chronic diseases, to re-evaluate themselves by recognizing them, and to learn 
the parks and activity areas around them that provide social liberation by perceiving their future 
situation. It is to increase the self-efficacy of the individual that will change the sedentary life 
(İnceoğlu, 2000; Ersoy, 2016; Bayramlı, 2017; Yıldırım, 2018; Arıkan et al., 2018; Alp, 2019; 
TUIK, 2019; Ünal, 2019; Pınar, 2020; Çiçek, 2020; WHO, 2020; WHO, 2021; Adolescent, 
2021; WHO, 2022). 
TTM Processes to be Used: 
TTM Sedentary Life Cognitive Change Process Scale; Initiatives were prepared by 
using/utilizing sub-dimensions of awareness, emotional stimulation, self-reappraisal, social 
liberation-environmental opportunities. 
Sedentary Life Decisional Balance Scale: Initiatives have been prepared to increase the 
perception of the harms of sedentary life. 
Sedentary Life Self-Efficacy Scale: Attempts to increase self-efficacy were prepared to 
change sedentary life behavior. 
Stimulating Learning Questions That Promote Thinking (Clicking on each question 
will direct the student to the initiative) 
Week 1 
Do you know the relationship of sedentary lifestyle with our hematology and 
hormone values? (Awareness) 
Week 2 
Do you know the relationship between the sedentary lifestyle and the elements in 
our body? (Awareness) 
Week 3 
Do you know how sedentary life affects the risk of chronic diseases such as 
obesity, diabetes, hypertension and cancer? (Awareness/Emotional Arousal) 
Week 4 
Do you know the effect of a sedentary lifestyle on our senses (sight, hearing, taste, 
smell, etc.) and its relationship with our personality traits (temperament)? 
(Awareness/Self-Re-evaluation) 
Week 5 
Do you know the relationship between sedentary lifestyle and culture (our 
country/global) (biological, social, social and psychological)? (Social Liberation- 
Environmental Opportunities) 
Week 6 
Do you know how an active lifestyle will affect vital signs (respiration, pulse, 
blood pressure, fever)? (Awareness/Self-Re-evaluation) 
Week 7 
What obstacles do you face to lead an active life? (Awareness/Self-Re-
evaluation)  
Week 8 
Do you know how lifestyle will affect physical, social and communication skills 

when you are an active individual? (Awareness/Self-Re-evaluation) 
Week 9 
Do you know the importance of being an active individual in diseases? 
(Awareness/Emotional Arousal) 
Week 10 What can you do to lead an active life? What are the environmental 
opportunities? (Social Liberation-Environmental Opportunities) 
Week 11 What goals can you have for leading an active life? (Awareness/Self-Re-
evaluation) 
Week 12 Do you wonder how active individuals cope with their sedentary lifestyle? (Social 
Liberation-Environmental Opportunities)  
3. Preparation Phase 
Aim; The purpose of this phase is the attempts made for the participants to prepare a change 
plan so that they can be physically active. 
It is the activation of the individual for an active life. It is the stage where individuals determine 
what physical activities they should do for their own body, what activities they can do during 
the day, what activities they can do during the day, make a schedule for change, from whom 
they can get counseling, and buy sports clothes for themselves (İnceoğlu, 2000; Öz & Roizen, 
2005; Güney, 2006; Ergen, 2012; Bilge, 2013; Ersoy, 2016; Bayramlı, 2017; Arıkan et al., 
2018; Yıldırım, 2018; Alp, 2019; TUIK, 2019; Ünal, 2019; Pınar, 2020; Çiçek, 2020; WHO, 
2020; WHO, 2021; Adolescent, 2021; WHO, 2022). 
TTM Processes to be Used: 
Sedentary Life Change Process Scale; Interventions were prepared by using/utilizing the sub-
dimensions of self-re-evaluation, social liberation-environmental opportunities, supportive 
relationships, counterconditioning, self-conciliation. 
Sedentary Life Decisional Balance Scale; Initiatives aiming to increase the perception of harm 
of a sedentary life and to reduce the perception of benefit from a sedentary life are included. 
Sedentary Life Self-Efficacy Scale; Initiatives have been planned to increase self-efficacy in 
changing behavior. 
Stimulating Learning Questions That Promote Thinking (Clicking on each question 
will direct the student to the initiative) 
Week 1 
How do you prepare a change plan to start a regular active life? (Self-
Reassessment/Self-Compromise) 

Week 2 
Using what criteria methods (direct observation, direct calorimetry, indirect 
calorimetry, and double-layer water method) can you assess that you are 
physically active enough on a weekly basis? (Self-Reassessment) 
Week 3 
Which subjective methods (diaries, records, reminder surveys, retrospective 
historical data, global surveys) can you use to assess your weekly physical 
activity? (Self-Reassessment) 
Week 4 
Which objective methods (heart rate monitoring, pedometer, accelerometer) can 
you use to evaluate that you are physically active enough on a weekly basis? 
(Self-Reassessment) 
Week 5 
How can you organize the work or home environment so that you can continue 
to engage in regular physical activity? (Social Liberation-Environmental 
Opportunities) 
Week 6 
What physical activities can you do with tools to reduce inactive time at home? 
(Counter Conditioning/ Social Liberation-Environmental Opportunities) 
Week 7 
What physical activities can you do without tools to reduce inactive time at 
home? (Counter Conditioning/ Social Liberation-Environmental Opportunities) 
Week 8 
What physical activities can you do to reduce the inactive time at school? What 
physical activities can you do at school? (Counter Conditioning/ Social 
Liberation-Environmental Opportunities) 
Week 9 
Where are the areas where you can do physical activity in the area you live in? 
(Social Liberation-Environmental Opportunities) 
Week 10 
What are the motivation sources and methods of your active friends? 
(Supporting Relationships) 
Week 11 
How can you be physically active even when you don't have time? (Deal with 
Yourself) 
Week 12 
Shall we prepare a change plan chart for active living? (Deal with Yourself) 
4. Action Phase 
Aim; The aim of the initiatives to be made at this stage is for the participants to review the 
exercise plan in order to maintain the movement stage and to gain the ability to cope with 
obstacles (İnceoğlu, 2000; Ergen, 2012; Bilge, 2013; Ersoy, 2016; Bayramlı, 2017; Yıldırım, 
2018; Arıkan et al., 2018; Alp, 2019; TUIK, 2019; Ünal, 2019; Pınar, 2020; Çiçek, 2020; WHO, 
2020; Pınar, 2020; WHO, 2021; Ergen, 2021; WHO, 2022). 
TTM Processes to be Used: 

Sedentary Life Change Process Scale; Initiatives prepared using the sub-dimensions of 
supportive relationships, counterconditioning, stimulus control, reinforcement (reward), and 
self-conciliation are included. 
Sedentary Life Decisional Balance Scale; Initiatives have been planned to decrease the 
perception of benefit and increase the perception of harm in sedentary life. 
Sedentary Life Self-Efficacy Scale; Initiatives have been planned to increase self-efficacy that 
sedentary life can change behavior. 
Stimulating Learning Questions That Promote Thinking (Clicking on each question will 
direct the student to the initiative) 
Week 1 
What can you do to reach your daily target physical activity level (10,000 steps, 
moderate or vigorous physical activity, etc.)? (Agreement Himself) 
Week 2 
How can you do breathing exercises during and after physical activity? 
(Agreement with Himself) 
Week 3 
What warm-up exercises can you do before physical activity and how? 
(Agreement with Himself) 
Week 4 
What cool-down exercises can you do after physical activity and how? 
(Agreement with Himself) 
Week 5 
What physical activity movements, how and where can you do in a hot 
environment? (Strengthening) 
Week 6 
What physical activity movements, how and where can you do in a cold 
environment? (Strengthening) 
Week 7 
What physical activities can you do that provide mobilization and stabilization? 
(Agreement with Himself) 
Week 8 
What physical activities can you do that increase strength? (Agreement with 
Himself, Counterconditioning) 
Week 9 
What physical activities can you do that provide strength to your body? 
(Agreement with Himself) 
Week 10 
What physical activities can you do to increase balance and coordination? 
(Agreement with Himself) 
Week 11 
What physical activities can you do to strengthen your body's muscles and bones? 
(Agree with Himself) 
Week 12 
What physical activities can you do to strengthen your body's cardiovascular 
system? (Agreement with Himself) 

5. Maintenance Phase 
Aim; This stage includes the practices made to find a solution to the motivation losses that may 
occur and to support the success of the participants (İnceoğlu, 2000; Güney, 2006; Bilge, 2013; 
Ersoy, 2016; Bayramlı, 2017; Yıldırım, 2018; Arıkan et al., 2018; Alp, 2019; TUIK, 2019; 
Ünal, 2019; Pınar, 2020; Çiçek, 2020; WHO, 2020; WHO, 2021; Ergen, 2021; WHO, 2022). 
TTM Processes to be Used: 
Sedentary Life Change Process; Attempts to prevent relapse and to make behavior change 
permanent are included by making use of the dimensions of supportive relationships, 
counterconditioning, stimulus control, reinforcement (rewarding), and self-conciliation. 
Sedentary Life Decision Making; Preventive interventions are planned to reduce the 
perception of benefit in sedentary life and to maintain a high perception of harm. 
Sedentary Life Self-Efficacy; Initiatives to increase self-efficacy are planned for lifelong 
continuation of active life.  
Stimulating Learning Questions That Promote Thinking (Clicking on each question 
will direct the student to the initiative) 
Week 1 
Have you made plans for the future to maintain an active life for life? What could 
happen? (Agreement with Himself) 
Week 2 
How did you reward yourself for living an active life for more than six months? 
What other rewards are you considering? (Self Deal/Strengthen) 
Week 3 
What can you do when your motivation is lost? (Strengthening) 
Week 4 
Who are your friends that you can get support when your motivation is lost and 
how can you get support? (Supporting Relationships/Control of Stimuli) 
Week 5 
How can you get support from your family to continue physical activity? What 
activities can you do with family members? (Supporting Relationships) 
Week 6 
What support groups can you join to lead an active life? (Supporting 
Relationships) 
Week 7 
How can you deal with situations that prevent you from doing regular physical 
activity? (Stimulus Control) 
Week 8 
Have you planned to continue your physical activity by participating in group 
sports (football, basketball, volleyball, water polo, etc.) in your spare time? 
(Supporting Relations/Agreement with Himself) 
Week 9 
How can you continue to lead an active life with the individuals in your social 
circle you spend time with? (Supporting Relationships) 

Week 10 How would you imagine yourself in 10/20 years if you stopped doing regular 
physical activity? (Deal with Yourself) 
Week 11 If you continue to exercise regularly, how would you imagine yourself in 10/20 
years? (Deal with Yourself) 
Week 12 General repeat-important reminders (Stimulus Control) 
Educational videos to be used in the mobile software program will be prepared in the form of 
animation. Opinions and suggestions 
of sports 
trainers/trainers, physiotherapists and 
physicians/psychiatrists were received on the contents of the "Let's Move" Program prepared by the 
researchers. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

8. 
Intervention Plan of the Research 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Students whose activity scores are inactive and minimally active according to the results of the International Physical 
Activity Survey (IPAQ) will be included in the study. 
194 students who accepted to participate and met the inclusion criteria will be randomly assigned to the experimental 
(n=97) and control (n=97) groups. 
PRE-TEST: Experimental Group (n=97) 
 
Contact information will be obtained. 
 
Students' pre-test data will be collected online, 
 
Socio-demographic characteristics form, 
 
International physical activity survey 
 
TTM Sedentary Life Scales (Stages of Change survey, Self 
Effectiveness Scale and Decision Making Scale). 
 
Smart Wristband will be given and its usage will be explained. 
 
The "Let's Move" Program, which is a smart phone application, will be 
installed on the students' phones. 
 
The students' body weight, height, body fat and muscle ratio will be 
measured by the researcher, BMI will be calculated and entered into the 
mobile software program by the students. 
 
According to the pre-test data, the "Let's Move" Program will direct 
students to initiatives according to the stages of change they are in (not 
thinking, thinking, preparation, acting and maintaining). 
 
To determine the weekly activity status of the students, they will fill in 
the UAFAA program at the end of each week. 
 PRE-TEST: Control Group (n=97) 
 
Contact information will be obtained. 
 
Students' pre-test data will be collected online. 
 
Socio-demographic characteristics form, 
 
International physical activity survey 
 
TTM Sedentary Life Scales (Stages of Change 
survey, Self Effectiveness Scale and Decision 
Making Scale). 
 
The students' body weight, height, body fat and 
muscle ratio will be measured by the researcher and 
BMI will be calculated. 
 
Smart Wristband will be given and its usage will be 
explained. 
 
 
 
For twelve weeks, the experimental group will continue to receive 
sedentary life behavior change initiatives with the mobile software 
'Let's Move' program. 
No intervention will be applied to the control group. 
LAST TEST (Week 12/3rd Month), 
 
The attempt of the experimental group will be terminated. 
 
The students' body weight, height, body fat and muscle ratio will be 
measured by the researcher and BMI will be calculated. 
 
Students' post-test data will be collected through the 'Let's Move' 
mobile software program. 
 
Socio-demographic characteristics form, 
 
International physical activity survey 
 
TTM Sedentary Life Scales (Change Process Scale, Self 
Effectiveness Scale and Decision Making Scale) 
 
You will be notified that the work has been terminated. 
 
Access to the Let's Move app will be stopped. 
 LAST TEST (Week 12/3rd Month), 
 
The students' body weight, height, body fat and muscle ratio 
will be measured by the researcher and BMI will be calculated. 
 
Students' post-test data will be collected online. 
 
Socio-demographic characteristics form, 
 
International physical activity survey 
 
TTM Sedentary Life Scales (Change Process Scale, Self 
Effectiveness Scale and Decision Making Scale). 
 
Step numbers will be written. 
FOLLOW-UP TEST (24 weeks/6 months), 
 
Follow-up test data will be collected online via google forms. 
 
The students' body weight, height, body fat and muscle ratio will be 
measured by the researcher and BMI will be calculated. 
 
You will be notified that the work has been terminated. 
 
Step numbers will be written. 
FOLLOW-UP TEST (24 weeks/6 months), 
 
Follow-up test data will be collected online via google forms. 
 
The students' body weight, height, body fat and muscle ratio 
will be measured by the researcher and BMI will be calculated. 
 
You will be notified that the work has been terminated. 
At the end of the study, the participants will evaluate the "Let's Move" 
Program with an online satisfaction survey. 
The "Let's Move" Program will be shared with the control group. 

9. 
Independent, Dependent and Control Variables of the Study 
 The independent variable of the study; Mobile Software “Let's Move” Program 
Developed Based on Transtheoretical Model 
 Dependent variables of the study; Number of Steps per Day, Physical activity MET score 
categories, Transtheoretic Model sedentary life Stages of Change, SL-SES score, SL-DBS 
benefit perception score averages, SL-DBS harm perception score averages, Physical 
activity walking, moderate, severe and total MET score averages, Body Mass Index 
categories, fat and muscle ratio values. 
 Control variables of the study; age, gender, socio-economic level, people who do sports 
in the family, weather conditions, environmental conditions (areas where sports can be 
done), previous sports status 
 Limitation of the research; The inability to include students who do not have an active 
internet connection was accepted as a limitation of the study. 
10. 
Analysis and evaluation of research data 
 The analysis of the data will be carried out on the computer with the SPSS (Statistical 
Package for Social Sciences) 21 package program. In the statistical analysis of the data, 
descriptive analyzes will be given as percentage, mean and frequency. Chi-square will 
be used to evaluate the homogeneity of the Experimental and Control groups, and the t 
test or Mann Whitney U test will be used in the analysis of the data in the experimental 
and control groups. One Way Anova or Kruskal Wallis analysis of variance will be 
applied when comparing three or more groups. Statistical significance level will be 
accepted as p<0.05. 
11. 
Ethical Permissions 
 In order to carry out the study, permission was obtained from the Clinical Research 
Ethics Committee of a state (X) University Faculty of Medicine (date 14.07.2022, 
protocol code: 09.2021.713). Permission was obtained from the institution where the 
research would be conducted (dated 11.08.2021, numbered E-61952817-044-21669). 
Permission to use the scale was obtained from the researchers who adapted the scales to 
be used in the study into the Turkish language. A voluntary consent form will be 
obtained from the participants. 
12. 
Survey and Scales 
Appendix 1. Socio-demographic characteristics diagnostic form 
Your name and last name... 

Your age... 
Your gender: 
(    ) Female 
(    ) Male 
1) Work status 
1. (   ) Working 
2. (   ) Not working 
2) How would you rate your family's economic situation? 
1. (   ) Very bad-bad 
2. (   ) Average 
3. (   ) Good-Very good 
3) Are you satisfied with your weight? 
1. (   ) Yes 
2. (   ) No 
4) Do you smoke? 
1. (   ) Yes 
2. (   ) No 
5) Do you drink alcohol? 
1. (   ) Yes 
2. (   ) No 
6) On average, how much time do you spend on the phone per day? 
1. (    ) 0-59 minutes 
2. (    ) 1-2 hours 59 minutes 
3. (    ) 3-4 hours 59 minutes  
4. (    ) More than 5 hours 
7) On average, how much do you watch TV per day? 
1. (    ) 0-59 minutes 
2. (    ) 1-2 hours 59 minutes 
3. (    ) 3-4 hours 59 minutes 
4. (    ) More than 5 hours 
8) On average, how much time do you spend in front of the computer per day?  

1. (    ) 0-59 minutes 
2. (    ) 1-2 hours 59 minutes 
3. (    ) 3-4 hours 59 minutes 
4. (…) More than 5 hours  
9) 
I don't do physical activity because I don't find time for it 
1. ( ) Yes   2. (  ) No 
10) I don't do physical activity because I don't feel the need to do 
them 
1. ( ) Yes   2. (  ) No 
11) I don't do physical activity because there is no suitable 
environment in my area where I live 
1. ( ) Yes   2. (  ) No 
12) I don't do physical activity because I'm afraid of getting hurt 
1. ( ) Yes   2. (  ) No 
13) I do not do physical activity because I don't have the financial 
means for the sport I am interested in. 
1. ( ) Yes   2. (  ) No 
14) I don't engage in physical activity because I've have other plans 
for my free time 
1. ( ) Yes   2. (  ) No 
15) I don't do it because my family and friends don't do physical 
activity 
1. ( ) Yes   2. (  ) No 
16) I don't do it because I've been injured while doing physical 
activity before 
1. ( ) Yes   2. (  ) No 
17) I don't do it because I feel pressured to do physical activity 
1. ( ) Yes   2. (  ) No 
18) I don't do it because I don't know the health benefits of physical 
activities 
1. ( ) Yes   2. (  ) No 
19) I don't do it because I don't have the motivation to do physical 
activity 
1. ( ) Yes   2. (  ) No 
20) What are your other reasons for not being physically active? Write..... 
 
Appendix 2. International Physical Activity Questionnaire Short Form  
We would like to know about the activities you do in your daily life. Below you will find 
questions about your physical activity in the last 7 days. Please answer all questions even 
if you do not consider yourself a very active person. Think about your housework and yard 
work, the activities you do at work, the things you do to get from one place to another, the 
activities you do in your free time such as exercise or sports. 

Think of any vigorous, strenuous activity you have done for 10 minutes or more in the last 
7 days. 
1 
How many days in the past week did you engage in an activity that required heavy 
physical activity, such as heavy lifting, digging, aerobics, basketball, soccer, or fast 
cycling? 
o ............ days per week  
o I did not do vigorous physical activity. (If you have ticked this option, proceed 
to Question 3) 
2 
How much time did you usually spend doing vigorous physical activity on one of 
these days? 
o I don't know / I'm not sure  
o ............minutes per day  
o ............ hours per day 
3 
Think about moderate physical activities you've done in the past week. These are 
activities that last 10 minutes or longer, require moderate physical exertion, and 
cause shortness of breath somewhat more often than usual. 
 
How many days in the last week did you do moderate physical activity, such as 
carrying light loads, cycling at a normal speed, folk dances, dancing, bowling, or 
tennis? (other than walking)? 
o ............ days per week  
o I did not do any moderate physical activity. (If you have ticked this option, 
proceed to Question 5) 
4 
How much time did you usually spend doing moderate physical activity on one of 
these days? 
o I don't know/I'm not sure  
o ............ minutes per day  
o ........... hours per day 
5 
Think about the time you spent walking in the past week. This could be walking at 
work, at home, to get around, or just for recreation, exercise, or as a hobby. 
 
In the past 7 days, how many days have you walked for at least 10 minutes at a 
time? 

o ............ days per week 
o I did not walk (If you checked this option, skip to question 7) 
6 
How much time did you usually spend walking on one of these days? 
o I don't know / I'm not sure 
o …... minutes per day 
o ….... hours per day 
7 
This is about the amount of time you spent sitting during the past week. This includes 
the time you spent at work, at home, working, or resting. This also includes the time 
you spent sitting at your desk, visiting a friend, reading, sitting, or watching TV while 
lying down. 
 
How much time per day have you spent sitting in the past week?  
o I don't know / I'm not sure 
o ............ minutes per day 
o ............ hours per day 
Scoring and Scoring of the IPAQ Survey 
Short form (7 questions); provides information on time spent walking, moderate and 
vigorous activities, and time spent sitting. Calculation of the total score of the short 
form includes the sum of the duration (minutes) and frequency (days) of walking, 
moderate-intensity activity, and vigorous activity. The energy required for activities is 
calculated with the MET-minute score. Standard MET values have been established 
for these activities. By using these values, daily and weekly physical activity level is 
calculated. These; 
Physical Activities 
MET value 
(min.) 
Weekly 
MET 
score 
calculation 
(min*day) 
Vigorous Physical Activity 
(questions 1 and 2) 
8.0 METs 
Vigorous MET-min/week = 8.0 x 
minutes of vigorous activity x number of 
days of vigorous activity 
Moderate-Intensity 
Physical Activity (questions 
3 and 4)  
4.0 MET 
Moderate-intensity MET-min/week = 
4.0 x minutes of moderate-intensity 
activity x number of days of moderate-
intensity activity 

Walking 
(5th 
and 
6th 
questions)  
3.3 MET 
Walking MET-min/week = 3.3 x walking 
minutes x number of walking days 
Total weekly MET score 
Total 
MET-min/week= 
walking 
+ 
moderate + severe (MET-min/week) 
For example; The walking MET-min/week score of a person walking for 3 days and 
30 minutes is calculated as 3.3 X 3 X 30 = 297 MET-min/week. 
Physical activity categories according to total MET scores according to IPAQ; 
 Inactive Level; 599 MET and below 
 Minimal Level; Between 600 MET-3000 MET  
 Very Active Level; 3001 MET and above  
7. Evaluation of the Problem; The IPAQ residency question is an additional 
determinant. It is not part of the scoring of physical activity 
 
 
 
 
 
  

 
 
 
 
 
 
 
 
 
 
 
TTM Sedentary Life Stages Of Change Scale (SL-SCS); 
Sedentary behaviors; It is defined as sitting, leaning, or physical activities that burn less 
than 1.5 METs of energy other than rest time and sleep. For example: sitting, studying, 
watching TV, playing video games and using a computer, etc. Some people go for a 
walk or do stretching exercises to reduce their sedentary time. they do. 
Consider your long-term sedentary behavior while answering the questions below. 
Please be sure to read the questions carefully and choose the one that best describes 
your opinion from the 5 sentences below while answering the questions. 
1) Can you do enough physical activity almost every day? 
Yes (   )      
No (   )  
2) Do you think you spend most of your day inactive? 
1. (    ) Yes, and I don't plan to give up my sedentary lifestyle (sitting all the time, etc.) 
these days. (Not Thinking Phase) 
2. (   ) Yes, but I plan to give up a sedentary lifestyle (sitting all the time, etc.) in the 
next 6 months. (Thinking Phase) 
3. (    ) Yes, but within the next 30 days, I plan to give up a sedentary lifestyle or reduce 
these behaviors by doing small exercises from time to time. (Preparation 
Phase) 
4. (    ) No, I am not inactive. In the last 6 months, I gave up my sedentary lifestyle and 
started doing physical activity frequently. (Movement Phase) 
5. (    ) No, I am not inactive. I gave up the sedentary lifestyle for more than 6 months 
and started doing frequent and regular physical activity. (Continuation Phase) 

 
TTM Sedentary Life Self-Efficacy Scale (SL-SES) 
 
 
Self-Efficacy Scale 
Some situations where people are sedentary are listed below. We 
would like to know how much you can avoid sedentary behavior in 
the following situations. Tick the appropriate number for your 
answer for each situation. 
I don't trust at all 
I trust a little 
I am moderately confident 
I trust so much 
I am extremely confident 
1. 
I tell myself that I will not be inactive while doing my 
schoolwork. 
1 2 3 4 
5 
2. 
When I feel tired, I tell myself that I will not stay still. 
1 2 3 4 
5 
3. 
While playing a video game, using a computer, or watching 
TV, I tell myself that I will not stay still ………….. 
1 2 3 4 
5 
4. 
When I spend time with my friends or family who want to sit, 
I tell myself that I will not stay still ………….. 
1 2 3 4 
5 
5. 
When I'm on vacation or in my spare time, I tell myself that I 
won't be sedentary……. 
1 2 3 4 
5 
6. 
When I feel lazy, I ……………….. to myself that I will not stay 
still. 
1 2 3 4 
5 
Self-efficacy Scale; It is an individual's belief about himself/herself that he/she can 
successfully perform a certain behavior, and it reflects self-confidence. The scale 
consists of 6 items that include self-confidence in quitting sedentary behavior. It is a 
five-point Likert type. It ranges from 1: Not at all trusting to 5: Very confident. The 
minimum score to be taken from these scales will be '6' and the maximum score will 
be '30'. A high score on the self-efficacy scale indicates that the student's self-efficacy 
in changing sedentary life behavior has increased. 
 
 

Appendix 7. TTM Sedentary Life Decision Balance Scale (SL-DBS) 
Decision Balance Scale 
This section examines the positive and negative aspects of 
sedentary behaviors. 
Read the following statements carefully and consider the degree of 
significance of these statements. 
In each statement, think about how you feel now, not how you felt 
or wanted to feel in the past. Please circle the number that best 
describes you. 
Does not matter 
Somewhat Important 
moderately important 
Very important 
Highly important 
1. 
Reducing my sitting time allows me to have a more positive 
outlook on life. 
1 2 3 4 
5 
2.  If I reduce the amount of time I sit, I will feel tired during the 
day. 
1 2 3 4 
5 
3.  Avoiding inactivity will be beneficial for my health. 
1 2 3 4 
5 
 
4.  
When I do something to avoid inactivity, I feel like I'm wasting 
my time. For example, taking a walk instead of sitting and 
studying. 
1 2 3 4 
5 
5.  If I avoid inactivity, I feel more industrious. 
1 2 3 4 
5 
6.  When I take a break to move while studying, my 
concentration breaks down. 
1 2 3 4 
5 
7.  I feel proud of myself when people see my effort not to be too 
inactive and accept me as a role model. 
1 2 3 4 
5 
8.  Spending sedentary time is very convenient and comfortable 
for me. 
1 2 3 4 
5 
9.  Avoiding inactivity makes me an active person. 
1 2 3 4 
5 
10
.  
When I reduce the energy I spend by being inactive, I feel 
good. 
1 2 3 4 
5 
11
.  
avoiding inactivity; It helps to regenerate both my body and 
my brain. 
1 2 3 4 
5 
 
12
.  
It bothers me to move around where everyone is still. For 
example, getting up and moving while reading a book in the 
library or watching TV with friends. 
1 2 3 4 
5 
Transtheoretic Model Sedentary Life Decision Balance Scale (SL-DBS) (Annex7) 

The decision-making scale consists of two sub-dimensions that measure the benefits 
and harms of making a behavior change decision. The sedentary life decision-making 
scale consists of 12 items containing the positive and negative aspects of sedentary 
life. 
 Sedentary life behavior change decision-making benefit perception sub-
dimension; It consists of 1, 3, 5, 7, 9, and 11 items of the scale. The minimum 
score to be taken from these scales will be '6' and the maximum score will be '30'. 
A high score on this sub-dimension indicates that they are aware of the benefits 
of behavior change and that they are more likely to change their behavior. 
 Sedentary life behavior change decision making harm sub-dimension; It 
consists of the 2nd, 4th, 6th, 8th, 10th, and 12th items of the scale. The minimum 
score to be taken from these scales will be '6' and the maximum score will be '30'. 
A high score on this sub-dimension indicates that the harms of behavior change 
attract more attention and the probability of changing behavior is less.