Daily Goal Setting to Increase Everyday Physical Activity and Promote Cognitive Health in Midlife

August 10, 2026 updated by: Christopher Sciamanna, MD, MPH, Milton S. Hershey Medical Center

Mechanisms of Adherence to Light Intensity Physical Activity to Prevent Alzheimer's Disease and Related Dementias (ADRD)

The purpose of this study is to determine whether interaction with an adaptive Fitbit-based goal setting application can increase levels of everyday light intensity physical activity in middle-aged adults.

Study Overview

Detailed Description

The study is designed to examine the efficacy of a Fitbit-based, goal setting, mHealth intervention to increase light intensity physical activity. The study design is a 2-arm randomized controlled trial. Both groups will receive the underlying goal-setting intervention (adaptive daily step goals). The study involves 3 phases: a run-in ("calibration") phase, the intervention ("training") phase, and follow-up (1- and 12-months post-intervention).

To support goal maintenance our team has developed a Fitbit application designed to operate on the Fitbit Versa series watch as a 'clockface'. The application will first calibrate participants' average level of physical activity by recording daily step counts for a period of 14 days (calibration phase). After this period (and following a health education session) the application will begin delivering the underlying intervention to both treatment and control groups for a period of 1 month. The intervention is composed of daily step goals presented via the Fitbit clockface. Each day the application will suggest a daily step goal. The algorithm used to make these suggestions relies on the participant's own activity during the calibration period and is updated each day in study, ensuring all proposed step goals are within their existing repertoire. Follow-up assessments will be completed at 1- and 12-monts post-intervention.

Outcomes and moderators will be measured via activity monitors (the Fitbit application and activPals), surveys, and ecological momentary assessments (self-ratings and performance-based ambulatory cognitive assessments) conducted via the Mobile Monitoring of Cognitive Change ("M2C2") platform.

Some of the details of the intervention, algorithm, experimental manipulations, and outcomes have been omitted to preserve the scientific integrity of the study. These details will be added after the study is closed.

Study Type

Interventional

Enrollment (Estimated)

200

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Pennsylvania
      • Hershey, Pennsylvania, United States, 17033
        • Milton S. Hershey Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria*:

  • Between 30 and 70 years of age
  • BMI ≥ 25

Exclusion Criteria*:

  • Clinical diagnosis of ADRD or other neurodegenerative disease
  • Health condition contraindicated for increased physical activity
  • Medical conditions or medications that would prohibit participation in an exercise test (e.g., decompensated heart failure, severe aortic stenosis, uncontrolled arrhythmia, and acute coronary syndromes)
  • Limitations in use of a smart phone (e.g., issues with manual dexterity or visual impairment)
  • Inability to walk unassisted
  • BMI > 50
  • Plan to have surgery or other procedure over the next 12 months that could affect mobility or light intensity physical activity maintenance
  • Concurrent participation in a weight loss, physical activity, or cognitive training trial
  • Failure to comply with Run-in Period activity monitoring (<70% valid wear days for the Fitbit and activPal)
  • Anyone who will not discontinue the use of their own personal smartwatch during the training period.
  • Anyone who scores below 19 on the MoCA-B would not be randomized after the Run-in Calibration Period.

Note: The eligibility criteria are deliberately incomplete to preserve the scientific integrity of the study. These details will be added after study closure.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Control
Participants receive the adaptive daily step goal mHealth intervention
Daily step goals displayed by the study application
Experimental: Treatment
Participants receive the adaptive daily step goal mHealth intervention plus interim goal setting prompts each day
Daily step goals displayed by the study application
Short-term step goals

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Short-term adherence
Time Frame: 1-month follow-up
Average of 14-day step count totals collected via ActivPal monitors
1-month follow-up
Long-term adherence
Time Frame: 12-month follow-up
Average of 14-day step count totals collected via ActivPal monitors
12-month follow-up

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Self-Monitoring Behavior
Time Frame: Daily during intervention period
Number of times participant checks their step count progress per day
Daily during intervention period
Change in Cognitive Health (Processing Speed)
Time Frame: Change in mean performance between the 2-week calibration phase and 12-month follow-up
Change in performance on ambulatory cognitive assessments of processing speed (response time during the "Symbol Search" task). This task is administered twice daily (2 "sessions" per day) throughout the 2-week, baseline "calibration phase" and twice daily throughout the 2-week, 12-month follow-up phase. The outcome to be modeled is median response time to trials administered during each session. Aggregation of data collected over these 2-week data collection periods will be model-based (in other words, all 'session' data will be modeled nested within phase, within persons).
Change in mean performance between the 2-week calibration phase and 12-month follow-up
Change in Cognitive Health (Working Memory Binding)
Time Frame: Change in mean performance between the 2-week calibration phase and 12-month follow-up
Change in performance on ambulatory cognitive assessments of working memory binding (corrected recognition rate during the "Color Shapes" task). This task is administered twice daily (2 "sessions" per day) throughout the 2-week, baseline "calibration phase" and twice daily throughout the 2-week, 12-month follow-up phase. The outcome to be modeled is corrected recognition rate (hit rate minus false alarm rate) for trials administered during each session. Aggregation of data collected over these 2-week data collection periods will be model-based (in other words, all 'session' data will be modeled nested within phase, within persons).
Change in mean performance between the 2-week calibration phase and 12-month follow-up
Change in Self-Efficacy for light intensity physical activity
Time Frame: Change between pre-enrollment baseline survey and end of training phase (an average of 2 months)
Self-efficacy for exercise scale (adapted to light intensity physical activity; range 0-90 points; higher scores reflect better outcomes)
Change between pre-enrollment baseline survey and end of training phase (an average of 2 months)
Executive Control (Working Memory Capacity)
Time Frame: Twice daily during the final 2 weeks of the training phase
Performance on ambulatory cognitive assessments of working memory capacity (span score during the "Rotation Span" task). This task is administered twice daily (2 "sessions" per day) during the last 2 weeks of the "training phase". The outcome to be modeled is the total recalled arrows across the 3 trials assessed during each session. Data will not be aggregated, but instead modeled as a time-varying covariate.
Twice daily during the final 2 weeks of the training phase
Executive Control (Inhibitory Control)
Time Frame: Twice daily during the final 2 weeks of the training phase
Performance on ambulatory cognitive assessments of inhibitory control (commission errors during the "Go/NoGo" task). This task is administered twice daily (2 "sessions" per day) during the last 2 weeks of the "training phase". The outcome to be modeled is the total commission errors across the trials assessed during each session. Data will not be aggregated, but instead modeled as a time-varying covariate.
Twice daily during the final 2 weeks of the training phase

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Jonathan G Hakun, PhD, Milton S. Hershey Medical Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 20, 2024

Primary Completion (Estimated)

May 1, 2027

Study Completion (Estimated)

March 1, 2028

Study Registration Dates

First Submitted

March 15, 2023

First Submitted That Met QC Criteria

April 11, 2023

First Posted (Actual)

April 24, 2023

Study Record Updates

Last Update Posted (Actual)

August 12, 2026

Last Update Submitted That Met QC Criteria

August 10, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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