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

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

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.

Study Overview

• Status: Not yet recruiting
• Conditions: Mobile Applications; Walking; Health Behaviour; Psychosocial Factors; Older Adults (65 Years and Older); Messaging
• Intervention / Treatment: Behavioral: Water intake messages; Behavioral: Self-continuity prompts; Behavioral: Step-monitoring reminders

• Study Type: Interventional
• Enrollment (Estimated): 1000
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Patrizia Catellani, PhD in Social Psychology; Phone Number: 393356741468; Email: patrizia.catellani@unicatt.it
• Study Contact Backup: Name: Valentina Carfora, PhD in Social Psychology; Phone Number: 393338569908; Email: valentina.carfora@unicatt.it

Study Locations

• Italy
  • Milan
    • Milan, Milan, Italy, 20123
      • Catholic University of the Sacred Heart (Milan)
      • Contact: Patrizia Catellani, PhD in Social Psychology; Phone Number: 393356741468; Email: patrizia.catellani@unicatt.it

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: Yes

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Control; Participants assigned to this arm will receive daily messages about the benefits of recommended daily water intake via the PsyMe app over 14 days.	Behavioral: Water 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.
Active Comparator: Step-monitoring; Participants assigned to this arm will receive daily reminders to monitor and record their step count through a step-tracking application via the PsyMe app over 14 days.	Behavioral: Step-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.
Experimental: Self-continuity + Step-monitoring; Participants assigned to this arm will receive daily messages via the PsyMe app over 14 days. These messages combine prompts recalling relevant past experiences and promoting walking behavior with reminders to monitor and record their daily step count.	Behavioral: Self-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.; Behavioral: Step-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.
Experimental: Self-continuity; Participants assigned to this arm will receive daily messages via the PsyMe app over 14 days. These messages are designed to prompt recall of personally relevant past experiences and to promote walking behavior.	Behavioral: Self-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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from Baseline in Self-Reported Walking Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Self-Reported Walking Intensity at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Daily Step Count at 2-Week Post-Intervention as Measured Via Pedometer App	Higher self-reported step counts indicate greater walking activity over the past week and in a usual week.	Baseline and 2 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from Baseline in Attitude toward Walking at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Intention to Walk at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Self-Efficacy to Walk at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Anticipated Positive Emotions Toward Walking at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Anticipated Negative Emotions Toward Walking at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Self-Reported Daily Water Intake at 2-Week Post-Intervention	Measured using an ad-hoc close-ended single-item measure assessing usual number of glasses of water consumed in an ordinary day.	Baseline and 2 weeks
Change from Baseline in Attitude toward Water Intake at 2-Week Post-Intervention	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.	Baseline and 2 weeks
Change from Baseline in Intention to Drink Water at 2-Week Post-Intervention	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.	Baseline and 2 weeks
Change from Baseline in Self-Reported Sedentary Behaviour Duration at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Self-Reported Light Physical Activity Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Self-Reported Moderate Physical Activity Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Self-Reported Vigorous Physical Activity Frequency and Duration at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Pedometer Usage and Usage Frequency (Past Week) at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from Baseline in Self-Continuity at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in State Nostalgia at 2-Week Post-Intervention and 4-Week Follow-up	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.	Baseline and 2 weeks and 4 weeks
Change from Baseline in Temporal Comparison at 2-Week Post-Intervention	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.	Baseline and 2 weeks
Change from Baseline in Attitudes Toward Aging at 2-Week Post-Intervention	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.	Baseline and 2 weeks
Change from Baseline in Psychological Well-Being at 2-Week Post-Intervention	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.	Baseline and 2 weeks

Collaborators and Investigators

• Sponsor: Catholic University, Italy
• Collaborators: IPSOS
• Investigators: Principal Investigator: Patrizia Catellani, Social Psychology, Catholic University, Italy

Publications and helpful links

General Publications

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• Williamson C, Baker G, Mutrie N, Niven A, Kelly P. Get the message? A scoping review of physical activity messaging. Int J Behav Nutr Phys Act. 2020 Apr 15;17(1):51. doi: 10.1186/s12966-020-00954-3.
• Varma VR, Dey D, Leroux A, Di J, Urbanek J, Xiao L, Zipunnikov V. Re-evaluating the effect of age on physical activity over the lifespan. Prev Med. 2017 Aug;101:102-108. doi: 10.1016/j.ypmed.2017.05.030. Epub 2017 Jun 1.
• Thogersen-Ntoumani C, Papathomas A, Foster J, Quested E, Ntoumanis N. "Shall We Dance?" Older Adults' Perspectives on the Feasibility of a Dance Intervention for Cognitive Function. J Aging Phys Act. 2018 Oct 1;26(4):553-560. doi: 10.1123/japa.2017-0203. Epub 2018 Sep 8.
• Subramaniam P, Singh DKA, Al-Shahrani HF, Hammad MA, Lim EV, Hoh XJ, Tay KW, Alavi K. Effects of combined group reminiscence and exercise therapy on psychological wellbeing and functional fitness among older adults with dementia. Sci Rep. 2025 Nov 27;15(1):42449. doi: 10.1038/s41598-025-26503-1.
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• Sedikides C., Wildschut T., Routledge C., and Arndt J. (2015) Nostalgia counteracts self-discontinuity and restores self-continuity, Eur. J. Soc. Psychol., 45, 52-61, doi: 10.1002/ejsp.2073.
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Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): August 1, 2026

Study Registration Dates

• First Submitted: April 30, 2026
• First Submitted That Met QC Criteria: April 30, 2026
• First Posted (Actual): May 6, 2026

Study Record Updates

• Last Update Posted (Actual): June 12, 2026
• Last Update Submitted That Met QC Criteria: June 10, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: physical activity; older adults; walking; self-monitoring; health behaviour change; messages; persuasive communication; self-continuity
• Additional Relevant MeSH Terms: Behavior; Motor Activity
• Other Study ID Numbers: 6069838_48_26

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Time Frame: They will be made available before

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No