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NCT Number: NCT07570303

Promoting Walking Among Older Adults Through Affective Communication and Step-Monitoring

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.

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Key information

Conditions

Walking Behavior Health Behaviour Messaging Mobile Applications Motor Activity Older Adults (65 Years and Older) Psychosocial Factors

Age range

65 year–74 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Catholic University of the Sacred Heart (Milan)

Milan, 20123, Italy

Location contact

Patrizia Catellani, PhD in Social Psychology

CONTACT

[email protected]

393356741468

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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:
  • medical advice or prescription prohibiting engagement in light to moderate physical activity, assessed via a close-ended screening question;
  • positive screening on a study specific close-ended question assessing ability to perform physical activity;
  • positive screening on the adapted revised Physical Activity Readiness Questionnaire (rPAR-Q), indicating that participant may be unsafe.

Treatment and study plan

Self-continuity prompts

Behavioral

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.

Step-monitoring reminders

Behavioral

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.

Water intake messages

Behavioral

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.

Primary outcomes

  1. Change from Baseline in Self-Reported Walking Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  2. Change from Baseline in Self-Reported Walking Intensity at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  3. Change from Baseline in Daily Step Count at 2-Week Post-Intervention as Measured Via Pedometer App

    Time frame: Baseline and 2 weeks

    Higher self-reported step counts indicate greater walking activity over the past week and in a usual week.

Secondary outcomes

  1. Change from Baseline in Self-Reported Sedentary Behaviour Duration at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  2. Change from Baseline in Self-Reported Light Physical Activity Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  3. Change from Baseline in Self-Reported Moderate Physical Activity Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  4. Change from Baseline in Self-Reported Vigorous Physical Activity Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  5. Change from Baseline in Pedometer Usage and Usage Frequency (Past Week) at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  6. Change from Baseline in Attitude toward Walking at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  7. Change from Baseline in Intention to Walk at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  8. Change from Baseline in Self-Efficacy to Walk at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  9. Change from Baseline in Anticipated Positive Emotions Toward Walking at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  10. Change from Baseline in Anticipated Negative Emotions Toward Walking at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: 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.

  11. Change from Baseline in Self-Reported Daily Water Intake at 2-Week Post-Intervention

    Time frame: 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.

  12. Change from Baseline in Attitude toward Water Intake at 2-Week Post-Intervention

    Time frame: 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.

  13. Change from Baseline in Intention to Drink Water at 2-Week Post-Intervention

    Time frame: 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.

Other outcomes

  1. Change from Baseline in Self-Continuity at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: Baseline and 2 weeks and 4 weeks

    Assessed using a 4-item scale translated from the Self-Continuity Index to measure perceived continuity and stability between past and present self. Responses are given on a 7-point Likert scale ranging from 1 (completely disagree) to 7 (completely agree), with higher scores indicating greater self-continuity.

  2. Change from Baseline in State Nostalgia at 2-Week Post-Intervention and 4-Week Follow-up

    Time frame: Baseline and 2 weeks and 4 weeks

    Assessed using a study-adapted 3-item scale to measure recent feelings of nostalgia. The scale asks participants to indicate their agreement with statements such as "During the past week, I have felt rather nostalgic." Responses are given on a 7-point Likert scale ranging from 1 (completely disagree) to 7 (completely agree), with higher scores indicate greater state nostalgia.

  3. Change from Baseline in Temporal Comparison at 2-Week Post-Intervention

    Time frame: Baseline and 2 weeks

    Assessed using a 11-item scale translated from the Measure of Temporal Comparison Orientation to assess how frequently and intensely a person engages in temporal comparisons. Responses are given on a 7-point Likert scale ranging from 1 (completely disagree) to 7 (completely agree), with higher scores indicating greater temporal comparison proneness.

  4. Change from Baseline in Attitudes Toward Aging at 2-Week Post-Intervention

    Time frame: Baseline and 2 weeks

    Assessed using a study-adapted 4-item scale based on the Positive View of Aging subscale of the AgeCog scale of Ongoing Development to measure positive attitudes toward aging. Responses are given on a 7-point Likert scale ranging from 1 (completely disagree) to 7 (completely agree), with higher values reflecting more positive attitudes toward aging.

  5. Change from Baseline in Psychological Well-Being at 2-Week Post-Intervention

    Time frame: Baseline and 2 weeks

    Assessed using the Italian translation of the 5-item Short Warwick-Edinburgh Mental Well-Being Scale to measure psychological well-being over the past two weeks. Responses are given on a 7-point Likert scale ranging from 1 (completely disagree) to 7 (completely agree), with higher values reflecting greater psychological well-being.

Study contacts

Contact information is provided by the study sponsor or research team.

Patrizia Catellani, PhD in Social Psychology

CONTACT

[email protected]

393356741468

Valentina Carfora, PhD in Social Psychology

CONTACT

[email protected]

393338569908

Sponsors and collaborators

Lead sponsor

Catholic University, Italy

Other

Collaborators

  • IPSOS

Registry information

Official study title

Self-Continuity Messages and Step-Monitoring to Promote Walking Among Older Adults: Protocol of a 4-Arm Randomised Controlled Trial

Acronym: NOSTEP

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
May 6, 2026
Registry last updated
Jun 12, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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