Health Behaviour, Messaging, Mobile Applications, Older Adults (65 Years and Older), Psychosocial Factors, Walking
Conditions
Keywords
health behaviour change, physical activity, walking, older adults, persuasive communication, messages, self-monitoring, self-continuity
Brief summary
Physical inactivity increases substantially after age 60 and represents a major public health challenge in older adults, as it is linked to increased risk of functional and cognitive decline and aging problems. Walking is one of the most accessible and recommended forms of light-to-moderate physical activity for this population. However, promoting sustained engagement in walking remains difficult, as traditional informational approaches often fail to activate personally meaningful motivations. This study tests whether persuasive affective messages can promote walking by leveraging self-continuity, meaning the use of autobiographical memory to maintain the sense of being the same person across time and contexts, connecting the past, present, and future self. Self-continuity is associated with psychological resources such as self-esteem, self-efficacy, and a sense of meaning in life. The affective mechanism that sustains self-continuity is nostalgia: both promote emotional and behavioral regulation and support goal achievement. Building on this framework, the present trial examines whether activating feelings of self-continuity and positive nostalgic memories can strengthen older adults' motivation to engage in walking behavior. In addition, the study investigates whether combining self-continuity messaging with a self-regulation strategy (daily step monitoring) enhances intervention effectiveness. Self-monitoring is a well-established behavioral technique that supports goal pursuit by increasing awareness and feedback. Using a 4-arm randomised controlled factorial design, the study compares the effects of self-continuity messages, step-monitoring reminders, their combination, and an active control condition on walking behaviour and its psychological determinants. A national sample of 1,000 Italian adults aged 65-74, recruited through a certified panel provider (Ipsos) and balanced for age, gender, and geographic region, will be randomly assigned to one of the four conditions. All participants will receive one message per day through a mobile application over a 14-day period. Participants in the step-monitoring conditions will also be asked to track and report their daily step count using a pedometer application. Behavioral, psychological, and process measures will be collected at baseline, post-intervention, and follow-up. The study therefore aims to provide experimental evidence on the role of self-continuity as a motivational driver of health behaviour change, and to clarify whether combining affective and self-regulatory strategies enhances intervention effectiveness in older adults.
Interventions
BEHAVIORALSelf-continuity prompts
The Day 1 introductory message presents a daily walking goal consistent with WHO recommendations and informs participants that subsequent messages describe the benefits of walking. Participants will be encouraged to pursue the physical activity goal according to their individual capabilities. Messages delivered from Day 2 to Day 13 aim to activate different positive nostalgic experiences related to walking and movement, including past memories, emotions, bodily sensations, personal values, and self-concepts. The messages link walking behaviour to such positive experiences using counterfactual formulations (e.g., "If you walk a little more today, you may reconnect with sensations your body knows well."). Message openings vary and include exclamatory statements, memory prompts, or rhetorical questions. The Day 14 message concludes the intervention.
BEHAVIORALStep-monitoring reminders
The Day 1 introductory message presents a daily walking goal consistent with WHO recommendations and informs participants that subsequent messages prompt them to monitor their daily step count. Participants will be encouraged to pursue the physical activity goal according to their individual capabilities. Messages delivered from Day 2 to Day 13 provide reminders to monitor step counts throughout the day using the pedometer app and to record the total number of daily steps in PsyMe at the end of the day (e.g., "During the day, monitor your step count using the pedometer app. This evening, record the total number of steps in the app."). The Day 14 message concludes the intervention.
BEHAVIORALWater intake messages
The Day 1 introductory message presents a daily water-intake goal consistent with standard recommendations and informs participants that subsequent messages describe the benefits of adequate hydration. Participants will be encouraged to pursue the goal according to their individual capabilities. Messages delivered from Day 2 to Day 13 provide brief information about different beneficial effects of adequate water intake and link hydration to each outcome using counterfactual formulations (e.g., "If you drink the recommended amount of water today, you may support your energy levels and help prevent lapses in concentration"). Message openings vary and include exclamatory statements, memory prompts, or rhetorical questions. The Day 14 message concludes the intervention.
Sponsors
Catholic University, Italy
IPSOS
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Intervention model description
The study is a randomized controlled trial with four parallel arms and allocation ratio 1:1:1:1. Participants will be recruited through a certified panel provider on the basis of eligibility criteria, and randomly assigned to one of four conditions: control, self-continuity, step-monitoring, or self-continuity + step-monitoring. Randomization will be implemented by the panel provider after informed consent is obtained through the delivery of access codes that direct participants to an arm-specific version of PsyMe. The intervention will last 14 days with one message delivered via the PsyMe app every day at the same hour. The content of the messages varies depending on the condition. Self-report data will be collected via questionnaires uploaded on Qualtrics and administered through the PsyMe app at three time points: baseline (T1, before the start of messaging intervention), post-intervention (T2, immediately after the 14-day messaging period), and follow-up (2 weeks after T2).
Eligibility
Sex/Gender
ALL
Age
65 Years to 74 Years
Healthy volunteers
Yes
Inclusion criteria
* Age between 65 and 74 years * Willingness and ability to install and use the mobile applications required for study participation * Sufficient proficiency in the Italian language to understand study materials and complete the questionnaires.
Exclusion criteria
\- Physical disabilities or medical conditions that preclude engagement in light to moderate physical activity, specifically: 1. medical advice or prescription prohibiting engagement in light to moderate physical activity, assessed via a close-ended screening question; 2. positive screening on a study specific close-ended question assessing ability to perform physical activity; 3. positive screening on the adapted revised Physical Activity Readiness Questionnaire (rPAR-Q), indicating that participant may be unsafe.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline in Self-Reported Walking Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Assessed by International Physical Activity Questionnaire - Short Version (IPAQ). Higher scores (mean daily time spent in walking activities, number of days per week with walking activity, and mean time spent in walking activities multiplied by the number of days per week with walking activity) indicate greater self-reported walking activity over the past week and in a usual week. |
| Change from Baseline in Self-Reported Walking Intensity at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Assessed by International Physical Activity Questionnaire - Short Version (IPAQ). Higher scores indicate greater self-reported walking intensity over the past week and in a usual week, with 3 ordinal response options: slow, moderate, and vigorous intensity. |
| Change from Baseline in Daily Step Count at 2-Week Post-Intervention as Measured Via Pedometer App | Baseline and 2 weeks | Higher self-reported step counts indicate greater walking activity over the past week and in a usual week. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline in Self-Reported Sedentary Behaviour Duration at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Assessed by International Physical Activity Questionnaire - Short Version (IPAQ). Higher self-reported minutes spent in sedentary activities indicate greater sedentary behaviour in a usual week. |
| Change from Baseline in Self-Reported Light Physical Activity Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Adapted from the International Physical Activity Questionnaire - Short Version (IPAQ), specifically for light physical activity. Higher scores (mean daily time spent in light physical activities, number of days per week with light physical activity, and mean daily time multiplied by the number of days per week with light physical activity) indicate greater self-reported light physical activity in a usual week. |
| Change from Baseline in Self-Reported Moderate Physical Activity Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Assessed by International Physical Activity Questionnaire - Short Version (IPAQ). Higher scores (mean daily time spent in moderate physical activities, number of days per week with moderate physical activity, and mean daily time multiplied by the number of days per week with moderate physical activity) indicate greater self-reported moderate physical activity in a usual week. |
| Change from Baseline in Self-Reported Vigorous Physical Activity Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Assessed by International Physical Activity Questionnaire - Short Version (IPAQ). Higher scores (mean daily time spent in vigorous physical activities, number of days per week with vigorous physical activity, and mean daily time multiplied by the number of days per week with vigorous physical activity) indicate greater self-reported vigorous physical activity in a usual week. |
| Change from Baseline in Pedometer Usage and Usage Frequency (Past Week) at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Measured using a study-specific single item with 5 ordinal response options. Higher scores indicate more frequent mean daily use of the pedometer app/device. |
| Change from Baseline in Attitude toward Walking at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Measured using an ad-hoc 7-point semantic differential scale assessing anticipated attitude toward walking in the next two weeks, across six bipolar adjective pairs. Higher scores are associated with more positive attitudes toward walking. |
| Change from Baseline in Intention to Walk at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Measured using an ad hoc 7-point Likert scale comprising 3 items and assessing intention to walk as much as possible over the next two weeks. Responses range from 1 (completely disagree) to 7 (completely agree), with higher values indicating stronger intention to walk. |
| Change from Baseline in Self-Efficacy to Walk at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Measured using a 12-item scale adapted from the Self-efficacy to Regulate Exercise scale (Carfora et al., 2022) to assess confidence in being able to walk as much as possible over the next two weeks under a variety of challenging circumstances. Responses are given on a 7-point Likert scale ranging from 1 (completely disagree) to 7 (completely agree), with higher scores indicating greater self-efficacy to walk. |
| Change from Baseline in Anticipated Positive Emotions Toward Walking at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Evaluated using an ad-hoc 6-item scale assessing anticipated positive emotions associated with walking as much as possible over the next two weeks. Responses are given on a 7-point Likert scale ranging from 1 (completely disagree) to 7 (completely agree), with higher scores indicating stronger anticipated positive emotions toward walking. |
| Change from Baseline in Anticipated Negative Emotions Toward Walking at 2-Week Post-Intervention and 4-Week Follow-up | Baseline and 2 weeks and 4 weeks | Evaluated using an ad-hoc 6-item scale assessing anticipated negative emotions associated with not walking as much as possible over the next two weeks. Responses are given on a 7-point Likert scale ranging from 1 (completely disagree) to 7 (completely agree), with higher scores indicating stronger anticipated negative emotions toward not walking. |
| Change from Baseline in Self-Reported Daily Water Intake at 2-Week Post-Intervention | Baseline and 2 weeks | Measured using an ad-hoc close-ended single-item measure assessing usual number of glasses of water consumed in an ordinary day. |
| Change from Baseline in Attitude toward Water Intake at 2-Week Post-Intervention | Baseline and 2 weeks | Measured using an ad-hoc 7-point semantic differential scale assessing anticipated attitude toward drinking at least 2 liters of water per day over the next two weeks, across six bipolar adjective pairs. Higher scores are associated with more positive attitudes toward drinking water. |
| Change from Baseline in Intention to Drink Water at 2-Week Post-Intervention | Baseline and 2 weeks | Measured using an ad hoc 7-point Likert scale comprising 3 items and assessing intention to drink at least 2 liters of water per day over the next two weeks. Responses range from 1 (completely disagree) to 7 (completely agree), with higher values indicating stronger intention to drink water. |
Countries
Italy
Contacts
CONTACTPatrizia Catellani, PhD in Social Psychology
CONTACTValentina Carfora, PhD in Social Psychology
PRINCIPAL_INVESTIGATORPatrizia Catellani, Social Psychology
Catholic University, Italy
Outcome results
None listed