Goal Setting for Exercise Adherence in Midlife Adults

Overseen By Molly Maxfield, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Arizona State University

Must not be taking: Alzheimer's drugs, Antidepressants

Disqualifiers: Pregnancy, Stroke, Major depression, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

144 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests different goal-setting methods to help adults in midlife maintain exercise routines. The researchers aim to determine how setting goals can boost motivation and help meet national exercise guidelines, potentially lowering the risk of Alzheimer's and related dementias. Participants will explore various ways of setting exercise goals, such as choosing their own goals, increasing goals weekly, or adhering to a fixed exercise amount. This trial suits adults aged 45 to 65 who weigh at least 110 pounds, have a BMI between 30 and 50, and currently engage in less than 60 minutes of moderate exercise per week. Participants must also own a smartphone to track their activity with a Fitbit. As an unphased trial, this study offers a unique opportunity to explore innovative goal-setting strategies that could enhance exercise routines and overall health.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it does exclude those taking two or more antidepressants or those previously prescribed Alzheimer's medications.

What prior data suggests that these goal-setting techniques are safe for promoting physical activity?

Research shows that setting goals can safely and effectively help people become more active. Studies have found that when people set goals for physical activity, they tend to exercise more. For instance, one study discovered that individuals who set higher activity goals moved more, benefiting their health.

Importantly, programs using goal setting present no major safety concerns. These programs aim to motivate people to be more active, often with reminders or support. The primary goal is to encourage regular exercise, which offers many health benefits, such as reducing the risk of diseases like Alzheimer's.

Overall, evidence suggests that goal setting to increase physical activity is safe and well-received. Participants generally respond well to these programs, making them a good option for promoting a healthier lifestyle. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to boost exercise adherence in midlife adults. Unlike traditional methods that often prescribe a fixed exercise routine or rely on general advice, this study examines personalized goal-setting strategies. Participants either set their own weekly exercise goals, work towards incrementally increasing their activity levels, or aim for a static target of 150 minutes of exercise per week. These approaches focus on tailoring exercise plans to individual needs and preferences, potentially leading to more sustainable lifestyle changes. By understanding which strategy fosters better commitment to physical activity, the trial could pave the way for more effective and engaging exercise programs.

What evidence suggests that this trial's goal-setting techniques could be effective for promoting physical activity adherence in midlife adults?

This trial will compare different goal-setting strategies to help middle-aged adults maintain exercise routines. Research has shown that setting goals can increase activity levels. Studies have found that aiming for higher activity levels encourages more movement, even if targets aren't always met. Goals that adjust based on progress prove more effective than fixed ones in promoting moderate-to-vigorous exercise. Immediate feedback and rewards also enhance motivation and activity levels. These findings suggest that goal-setting can effectively help middle-aged adults maintain exercise routines, potentially reducing their risk of Alzheimer's disease and related dementias over time. ^{3 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for midlife adults aged 45-65 with a BMI of 30-50, engaging in minimal physical activity and owning a smartphone. They must weigh at least 110 pounds and not be on Alzheimer's meds, have high blood pressure without clearance, or planning pregnancy/moving from Phoenix soon.

Inclusion Criteria

Self-reported ownership of a smartphone with an iOS or Android operating system (necessary for participants to track their activity using a Fitbit activity monitor)

Engaging in 60 minutes or less of self-reported moderate-to-vigorous physical activity at screening (based on Exercise Vital Sign Questionnaire)

My BMI is between 30 and 50.

Exclusion Criteria

Incarcerated individuals (i.e., Prisoners)

I have been diagnosed with major depression.

I have had a stroke in the past.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Phase 1 Pilot Study

Establish feasibility and refine the intervention

Not specified

Phase 2 Treatment

9-month 4-arm proof-of-concept mechanistic trial with 6-month active intervention

6 months

Monthly assessments

Follow-up

3-month no contact follow-up to monitor adherence and outcomes

3 months

What Are the Treatments Tested in This Trial?

Interventions

• Goal Setting

Trial Overview The study tests goal-setting techniques to increase physical activity among midlife adults. It aims to improve self-regulation behaviors to meet national guidelines and reduce the risk of Alzheimer's disease through regular exercise adherence.

How Is the Trial Designed?

Group I: Static weekly physical activity goal of 150 minutes/week Experimental Treatment 1 Intervention

Participants will receive a physical activity action planning intervention and assigned a static weekly physical activity goal of 150 minutes/week of moderate-intensity activity; action planning sessions will focus on the participant achieving this weekly goal.

Group II: Self-selected weekly physical activity goal Experimental Treatment 1 Intervention

Participants will receive a physical activity action planning intervention and will self-select their own moderate-intensity physical activity goal each week; action planning sessions will focus on helping participants achieve their self-selected goal.

Group III: No stated weekly physical activity goal (comparison group) Experimental Treatment 1 Intervention

Participants will receive a physical activity action planning intervention that does not include explicitly stated physical activity goals to achieve.

Group IV: Incremental weekly physical activity goal increase Experimental Treatment 1 Intervention

Participants will receive a physical activity action planning intervention and assigned a weekly physical activity goal that is 20% greater than the level of moderate-intensity physical activity performed the previous week; action planning sessions will focus on the participant achieving their assigned goal.

Who Is Running the Clinical Trial?

Arizona State University

Lead Sponsor

Trials

311

Recruited

109,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Published Research Related to This Trial

In a study of 30 healthy older women participating in a 9-month exercise program, adherence to exercise sessions was nearly 100% for intensity, but varied by group for duration adherence, with rates of 95% for resistance training, 91% for higher intensity, and 85% for moderate intensity.

The strongest predictor of adherence to the exercise program was the prescribed duration of exercise, indicating that older women may prioritize the length of workouts over intensity when it comes to sticking to a structured exercise regimen.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Factors predicting adherence to 9 months of supervised exercise in healthy older women. Visek, AJ., Olson, EA., DiPietro, L.[2021]

A systematic review of 17 randomized controlled trials involving 6,391 older adults found that various interventions, such as self-monitoring and supervised exercise, led to significant increases in physical activity among aging adults.

Despite these increases, the levels of activity achieved often fell short of the standards needed for positive health outcomes, highlighting the need for more effective and rigorously designed strategies to promote sustained physical activity in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integrative review of physical activity intervention research with aging adults. Conn, VS., Minor, MA., Burks, KJ., et al.[2022]

A scoping review of 51 articles on physical activity interventions for midlife women revealed that while many interventions are based on theoretical models and include behavior change techniques, descriptions often lack detail on how these techniques are implemented.

The review highlighted the need for clearer definitions of 'midlife' and 'sedentary' populations, as well as the importance of tailoring interventions to specific groups, especially marginalized populations, to improve their effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A scoping review of behavior change techniques used to promote physical activity among women in midlife. Arigo, D., Romano, KA., Pasko, K., et al.[2022]

The 'Physical Activity at Home' trial is a 2-year study comparing the effectiveness and adherence of home-based versus group exercise programs for middle-aged adults, targeting those who prefer not to attend group sessions.

If successful, the physiotherapy-led home-based program could offer a viable alternative for promoting physical activity among sedentary adults, potentially improving long-term adherence and health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

'Physical activity at home (PAAH)', evaluation of a group versus home based physical activity program in community dwelling middle aged adults: rationale and study design. Freene, N., Waddington, G., Chesworth, W., et al.[2021]

In a review of over 5,500 participants from 11 physical activity interventions, no serious study-related adverse events were reported, indicating a high level of safety in these exercise programs.

While minor musculoskeletal injuries were noted, the studies emphasized a 'start low and go slow' approach, suggesting that moderate-intensity physical activity is safe and effective for sedentary, chronically ill, or older populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Screening, safety, and adverse events in physical activity interventions: collaborative experiences from the behavior change consortium. Ory, M., Resnick, B., Jordan, PJ., et al.[2022]

A 6-month supervised exercise program of either swimming or walking led to high retention (86%) and adherence (76.3% for swimming and 74.3% for walking) among previously sedentary older women, with these rates maintained over 12 months.

The addition of a behavioral intervention did not significantly improve retention or adherence rates, suggesting that the exercise modes themselves were effective in keeping participants engaged.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Short and long-term adherence to swimming and walking programs in older women--the Sedentary Women Exercise Adherence Trial (SWEAT 2). Cox, KL., Burke, V., Beilin, LJ., et al.[2022]

In a study of 385 adults in rural Iowa, increased frequency of goal setting was positively linked to the use of specific dietary and physical activity strategies over a one-year period.

Goal setting focused on diet or physical activity was more effective in predicting the use of related strategies than general weight loss goals, highlighting the importance of targeted goal setting for behavior change.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Goal setting frequency and the use of behavioral strategies related to diet and physical activity. Nothwehr, F., Yang, J.[2007]

A study involving 24 older adults (aged 60+) found that goal setting for physical activity (PA) is crucial for maintaining health and preventing age-related decline, with motivations primarily being health improvement and sustaining mental well-being.

The research suggests that interventions, like PA apps, that encourage older adults to set specific and meaningful goals can enhance their motivation and participation in physical activity, leading to better health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Active older adults goal setting outcomes for engaging in a physical activity app and the motivation characteristics of these goals (MOVEAGE-ACT). Lynch, AM., Kilroy, S., McKee, H., et al.[2023]

A tailored intervention for exercise adoption was effective in helping older adults progress in their exercise stage of change over 24 months, particularly for those not already in the maintenance stage.

While the intervention did not show overall differences in physical activity or function for all participants, it significantly helped those in earlier stages of change to become more motivated and ready to exercise compared to a comparison group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Long-term effects of a stage-based intervention for changing exercise intentions and behavior in older adults. Greaney, ML., Riebe, D., Ewing Garber, C., et al.[2019]

Promoting physical activity among older adults in clinical research faces challenges such as time commitment and perceived benefits, highlighting the need for tailored interventions that meet participant expectations.

Effective strategies to enhance adherence include developing theory-based programs, fostering self-regulatory skills, and utilizing phone support for home-based activities, suggesting a comprehensive approach to encourage ongoing physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise adherence among older adults: challenges and strategies. Chao, D., Foy, CG., Farmer, D.[2022]

A systematic review of 18 studies found that effective goal setting for diet and physical activity in overweight and obese adults includes specific, timely goals, participant involvement, and regular feedback.

While goal setting appears beneficial for promoting health behavior changes, the study could not determine which specific intervention components were most effective due to their concurrent implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Goal setting as a health behavior change strategy in overweight and obese adults: a systematic literature review examining intervention components. Pearson, ES.[2022]

In a study of 135 participants in a walking program, those who received weekly phone prompts were significantly more likely to meet exercise goals (46%) compared to those prompted every three weeks (13%).

The structure of the prompts (high vs. low) did not show a significant difference in effectiveness, indicating that the frequency of reminders is more crucial for improving exercise adherence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Walking to meet health guidelines: the effect of prompting frequency and prompt structure. Lombard, DN., Lombard, TN., Winett, RA.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7928044/

Goal Setting and Achievement for Walking: A Series of N- ... Setting a higher physical activity goal leads to engaging in higher physical activity levels, but concurrently lower goal achievement.

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1469029218307064

Comparing the effects of goal types in a walking session ... This study aimed to experimentally compare the effects of open, SMART and do-your-best goals with a control condition on distance walked and psychological ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11102891/

A Behavioral Perspective for Improving Exercise Adherence Adherence to exercise is a crucial aspect of behavioral changes related to exercise. However, current models fail to predict behavioral change.

4. researchgate.net researchgate.net/publication/346626289_Goal_Setting_and_Achievement_for_Walking_A_Series_of_N-of-1_Digital_Interventions

Goal Setting and Achievement for Walking: A Series of N- ... This study examined (a) the association between performance goal difficulty and physical activity and (b) the association between performance ...

5. ajpmonline.org ajpmonline.org/article/S0749-3797(21)00546-8/fulltext

Adaptive Goals and Reinforcement Timing to Increase ... This trial found that adaptive goals outperformed static goals for initiating any MVPA, and immediate reinforcement outperformed delayed ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT05425641

MoST-Influenced Behavioral Intervention for Walking Individuals will receive daily text messages that include the Goal Setting behavior change technique (BCT) with the goal of increasing daily walking by 1,000 ...

7. withpower.com withpower.com/trial/phase-2-physical-inactivity-5-2022-2a314

Behavioral Intervention for Increasing Walking in ... Research shows that frequent prompting, such as regular phone calls, can significantly increase exercise adherence, with 46% of participants meeting walking ...

8. researchgate.net researchgate.net/publication/354305503_Effect_of_Goal-Setting_Approaches_Within_a_Gamification_Intervention_to_Increase_Physical_Activity_Among_Economically_Disadvantaged_Adults_at_Elevated_Risk_for_Major_Adverse_Cardiovascular_Events_The_

Effect of Goal-Setting Approaches Within a Gamification ... Several gamified interventions have been employed to counter sedentary behavior by promoting physical activity. However, the existing approaches have ...

9. tandfonline.com tandfonline.com/doi/full/10.1080/17437199.2019.1706616

Updating goal-setting theory in physical activity promotion We aimed to critically review and update the application of goal-setting theory in physical activity promotion, by examining core developments in this theory ...