CClinicalTrials.gg
CompletedNCT04869644Updated Nov 30, 2022Results posted

A Trial of Habit Formation Theory for Exercise in Older Adults

A Phase 1 interventional study of Goal setting and Action Planning in Sedentary Behavior, Aging and Activity, Motor, sponsored by Northwell Health. Completed at 1 site in United States. Open to participants aged 45 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-11-30.

Sponsored by Northwell Health · Phase 1, Interventional, and Health services research

Phase
Phase 1
Study type
Interventional
Enrollment
49
Allocation
Not applicable
Ages
45 Years to 75 Years
Sex
All
01

Study summary

This personalized trial will evaluate the effects of five behavioral change techniques (BCTs) described in Habit Formation Theory (Goal setting, Action Planning, Self-Monitoring, Behavioral Practice/Rehearsal and Habit Formation) delivered by text message to enhance low-intensity walking by 2,000 more steps per day/5 days per week in healthy Northwell employees aged 45-75 years old.

Read the detailed description

This pilot study uses a virtual, single-arm, personalized design to evaluate the effects of the five behavioral change techniques (BCTs) described in Habit Formation Theory (Goal Setting, Action Planning, Self-Monitoring, Behavioral Practice/Rehearsal and Habit Formation) delivered by text message to enhance low-intensity walking by 2,000 more steps per day/5 days per week in healthy Northwell employees aged 45-75 years old. Up to sixty participants will complete a 12-week personalized trial of their walking behavior and assess all five behavioral change techniques described in habit formation theory. Prior to beginning the trial, participants will be sent a Fitbit® activity tracking watch that monitors number of steps per day. Participants will be instructed to wear the Fitbit device all day and night, even when they are sleeping. The single-arm, personalized trial will be comprised of a 2-week baseline/screening phase and a 10-week intervention phase. During the baseline phase, participant's baseline levels of physical activity (operationalized as average steps per day measured using the Fitbit device) and adherence to the trial protocol (operationalized as wearing the Fitbit device for a minimum of 10 hours per day and completing daily survey measure) will be assessed. Participants who are adherent to the study protocol, defined as adherence to Fitbit use and survey measures on 80% or more days during baseline, will proceed to the intervention phase. At the beginning of the intervention, participants will develop a walking plan with the goal of walking 2,000 more steps per day than their average levels of baseline activity (e.g., if you walked an average of 6,000 steps per day during baseline, the new goal would be 8,000). The walking plan will include details about the day, time, and location of walking behavior. Participants will commit to walking according to this plan 5 days per week (e.g., walking 8,000 steps per day on 5 planned days. A time-sensitive text of all 5 BCTs will delivered to the participant when the context (e.g., day of week, time of day) that they pre-selected is encountered. Participants will later receive a text message with a link to a secure survey in which they will note whether they engaged with the five behavioral change techniques which were prompted. The goal of the intervention is to help participants make their walking behavior habitual and automatic. Participants will be assessed in terms of their satisfaction with the personalized trial design, their Fitbit-measured daily steps, adherence to their walking plan, and the automaticity of their walking behavior. After completion of the intervention phase, participants will be allowed to keep the Fitbit device.

02

Conditions studied

  • Sedentary Behavior
  • Aging
  • Activity, Motor
  • Behavior, Health

Keywords

  • Habit Formation
  • Physical Activity
  • Behavior Change
  • Virtual
  • Personalized Trial
  • Personalized
  • Feasibility
03

In context

Lead sponsor

Northwell Health is the lead sponsor of 463 studies on the registry; 109 are open to participants now.

Of its 40 completed or terminated interventional studies of FDA-regulated products, 20 (50%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
45 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Eligibility criteria

Inclusion Criteria:

Men and women who:

  • Age 45 - 75 years old of age
  • Fluent in English
  • Employed in the Northwell Health system
  • Community-dwelling
  • Report they are in good general health, walk regularly and have never been informed by a clinician that it was not advisable/safe to participate in a low-intensity walking program
  • Owns and can regularly access a smartphone capable of receiving text messages
  • Owns and can regularly access an e-mail account

Exclusion Criteria for Factors that May Limit Adherence to Interventions or Affect Conduct of the Trial

  • \< 45 years old or > 75 years old
  • Unable to speak/comprehend English
  • Not employed in Northwell Health system
  • Have self-reported poor health, limited mobility and/or have been advised by a clinician not to increase their low-intensity walking
  • Pregnancy
  • Previous diagnosis of a serious mental health condition or psychiatric disorder, such as bipolar disorder
05

Study design

Phase
Phase 1
Primary purpose
Health services research
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
49 participants (actual)

Study arms

  • Experimental
    Intervention: Behavioral Change Techniques to encourage Habit Formation

    Individuals will receive daily text messages with the goal of increasing daily walking by 2,000 more steps 5 days per week. Participants will be enrolled for a baseline period lasting 2 weeks where their average daily activity level will be assessed using a Fitbit device to generate an average daily step counts. Following completion of baseline, participants will be asked to generate a walking plan with the goal of walking an additional 2,000 steps above their baseline activity level on 5 days per week. This walking plan will include details about day of the week, time of day, and location of walking. Once participants have completed their walking plan, they will receive daily texts based on the 5 identified BCTs for the duration of the 10-week intervention. All BCTs will be delivered daily. The goal of the text messages will be to encourage habit formation for walking behavior.

    Behavioral: Goal setting · Behavioral: Action Planning · Behavioral: Self-monitoring of behavior · Behavioral: Behavioral Practice/Rehearsal · Behavioral: Habit Formation

Interventions

  • BehavioralGoal setting

    Goal setting: set or agree on a goal defined in terms of behavior to be achieved.

  • BehavioralAction Planning

    Action planning: prompt detailed planning of performance of behavior (must include a setting \[walking to the mailbox\], frequency, duration, and intensity.

  • BehavioralSelf-monitoring of behavior

    Self-Monitoring of behavior: establish a method for person to monitor and record their number of steps based on their Fitbit.

  • BehavioralBehavioral Practice/Rehearsal

    Behavioral rehearsal: prompt practice or rehearsal of walking one or more times in a context when the performance may not be necessary, in order to increase habit and skill.

  • BehavioralHabit Formation

    Prompt rehearsal \& repetition of walking 2,000 steps or more in the same context repeatedly so that the context elicits the behavior.

06

What researchers measure

Primary outcomes

  1. Change in Automaticity Score.

    Automaticity of behavior is assessed by a 4-item questionnaire asking about the automaticity of participant's walking behavior using a 4-point Likert scale with responses ranging from "Strongly Disagree" to "Strongly Agree". Items are summed together to form a total score ranging from 0 to 12, with higher scores indicating that participant's new walking behaviors have become more habitual and automatic. Change in daily automaticity levels over the course of the intervention period will be examined until scores level out and reach a score of 8 or more on 7 consecutive days. Participants will be judged to have reached an asymptote at this point in time. The proportion of the sample that has achieved automaticity will be reported as a number with percentage \[N(%)\]. Time-to-event analyses will be conducting examining participant differences in reaching an asymptote for automaticity and overall time-to-event will represented using Kaplan-Meier curves.

    Time frame: Assessed daily via online survey for participants across the duration of the 10-week intervention. Daily assessments will be aggregated by week to generate weekly means for automaticity.

  2. Participant Satisfaction With Personalized Trial Components.

    Participants will rate their satisfaction with the Personalized Trial overall and with individual elements of the trial in a satisfaction survey developed for this trial. Participants will rate 9 items assessing satisfaction with methods and process of the trial on a 4-point Likert scale with responses ranging from "0 - Not at all satisfied" to "3 - Very satisfied". Higher scores indicate greater levels of satisfaction. Means and standard deviations will be reported for each element of satisfaction.

    Time frame: Assessed once after completion of the study at 12 weeks.

Secondary outcomes

  1. Within-person Change in Daily Steps.

    Participant steps will be assessed continuously using a Fitbit mobile device. Daily steps for participants will be aggregated by baseline and intervention phases to generate average daily steps in each phase. Changes in daily steps between baseline and intervention phases will be compared using Generalized Linear Mixed Model analyses.

    Time frame: Steps will be assessed continuously via worn activity tracker and step counts will be reported daily.

  2. Proportion of Days Adhering to Walking Habit.

    This is assessed using a single yes/no item assessed daily asking participants "Did you walk according to your walking plan today?". For each participant, we will identify the proportion of days during the 10-week intervention where the participant adhered to the walking plan. Proportions of adherence will reported across all participants with means and standard deviations.

    Time frame: Assessed once after completion of the study at 12 weeks.

  3. Participant Attitudes and Opinions Towards Personalized Trials.

    Participants will be asked via survey about their attitudes and opinions regarding the personalized trial implementation (e.g., Did the trial feel burdensome?). Participants will rate items on a 7-point Likert scale with responses ranging from "0 - Strongly Disagree" to "6 - Strongly Agree". Higher scores indicate greater levels of agreement. Scores on each item will be reported with means and standard deviations.

    Time frame: Assessed once after the completion of the intervention period.

  4. Participant Adherence to Self-Monitoring.

    This will be measured via a single survey item delivered following a participant's scheduled walking time asking them to record the number of steps they took on their walk. Individuals who complete this item and record their steps will be judged to be adherent to self-monitoring of their walking behavior. Participant adherence will be aggregated over the course of the 10-week intervention and will be reported as proportion of days adherent to self-monitoring. Proportions of adherence will be reported across all participants with means and standard deviations.

    Time frame: Assessed daily via online survey for participants across the duration of the 10 week intervention. Daily responses will be aggregated across the intervention to determine an overall proportion of days adherent self-monitoring of behavior.

07

Results

Posted Nov 30, 2022

Participant flow

Assessed for Eligibility
Participant flow — Assessed for Eligibility
MilestoneIntervention: Behavioral Change Techniques to Encourage Habit Formation
Started114
Did not meet or complete inclusion criteria35
Did not consent to study30
Completed49
Not completed65
Enrolled in Study
Participant flow — Enrolled in Study
MilestoneIntervention: Behavioral Change Techniques to Encourage Habit Formation
Started49
Withdrew from study5
Completed44
Not completed5
Baseline
Participant flow — Baseline
MilestoneIntervention: Behavioral Change Techniques to Encourage Habit Formation
Started44
Ineligible after baseline8
Withdrew from study2
Completed34
Not completed10
Intervention
Participant flow — Intervention
MilestoneIntervention: Behavioral Change Techniques to Encourage Habit Formation
Started34
Discontinued intervention2
Completed32
Not completed2

Outcome measures

PrimaryChange in Automaticity Score.

Automaticity of behavior is assessed by a 4-item questionnaire asking about the automaticity of participant's walking behavior using a 4-point Likert scale with responses ranging from "Strongly Disagree" to "Strongly Agree". Items are summed together to form a total score ranging from 0 to 12, with higher scores indicating that participant's new walking behaviors have become more habitual and automatic. Change in daily automaticity levels over the course of the intervention period will be examined until scores level out and reach a score of 8 or more on 7 consecutive days. Participants will be judged to have reached an asymptote at this point in time. The proportion of the sample that has achieved automaticity will be reported as a number with percentage \[N(%)\]. Time-to-event analyses will be conducting examining participant differences in reaching an asymptote for automaticity and overall time-to-event will represented using Kaplan-Meier curves.

Time frame:
Assessed daily via online survey for participants across the duration of the 10-week intervention. Daily assessments will be aggregated by week to generate weekly means for automaticity.
Reported as:
Count of participants · Participants
Change in Automaticity Score.
ParticipantsIntervention: Behavioral Change Techniques to Encourage Habit Formation
Change in Automaticity Score.17
PrimaryParticipant Satisfaction With Personalized Trial Components.

Participants will rate their satisfaction with the Personalized Trial overall and with individual elements of the trial in a satisfaction survey developed for this trial. Participants will rate 9 items assessing satisfaction with methods and process of the trial on a 4-point Likert scale with responses ranging from "0 - Not at all satisfied" to "3 - Very satisfied". Higher scores indicate greater levels of satisfaction. Means and standard deviations will be reported for each element of satisfaction.

Time frame:
Assessed once after completion of the study at 12 weeks.
Reported as:
Mean · Score for Participant Satisfaction Item
Participant Satisfaction With Personalized Trial Components.
Score for Participant Satisfaction ItemIntervention: Behavioral Change Techniques to Encourage Habit Formation
"Please rate your overall satisfaction with the BCT text messages"2.53 ± 0.78
"Please rate your satisfaction with the ease of using the BCT text messages"2.97 ± 0.18
"Please rate your satisfaction with the overall effectiveness of the BCT text messages"2.50 ± 0.82
"Video explanations and demonstrations of study devices and procedures"2.38 ± 0.67
"Text messaging for reminders (e.g. synch your Fitbit)"2.76 ± 0.54
"Text messaging for data collection (i.e. surveys)"2.65 ± 0.67
"Use of the Fitbit device to track your activity and sleep"2.60 ± 0.60
"Study communications"2.67 ± 0.58
"Presentation of your results"2.38 ± 0.92
SecondaryWithin-person Change in Daily Steps.

Participant steps will be assessed continuously using a Fitbit mobile device. Daily steps for participants will be aggregated by baseline and intervention phases to generate average daily steps in each phase. Changes in daily steps between baseline and intervention phases will be compared using Generalized Linear Mixed Model analyses.

Time frame:
Steps will be assessed continuously via worn activity tracker and step counts will be reported daily.

Results for this outcome have not been posted.

SecondaryProportion of Days Adhering to Walking Habit.

This is assessed using a single yes/no item assessed daily asking participants "Did you walk according to your walking plan today?". For each participant, we will identify the proportion of days during the 10-week intervention where the participant adhered to the walking plan. Proportions of adherence will reported across all participants with means and standard deviations.

Time frame:
Assessed once after completion of the study at 12 weeks.

Results for this outcome have not been posted.

SecondaryParticipant Attitudes and Opinions Towards Personalized Trials.

Participants will be asked via survey about their attitudes and opinions regarding the personalized trial implementation (e.g., Did the trial feel burdensome?). Participants will rate items on a 7-point Likert scale with responses ranging from "0 - Strongly Disagree" to "6 - Strongly Agree". Higher scores indicate greater levels of agreement. Scores on each item will be reported with means and standard deviations.

Time frame:
Assessed once after the completion of the intervention period.

Results for this outcome have not been posted.

SecondaryParticipant Adherence to Self-Monitoring.

This will be measured via a single survey item delivered following a participant's scheduled walking time asking them to record the number of steps they took on their walk. Individuals who complete this item and record their steps will be judged to be adherent to self-monitoring of their walking behavior. Participant adherence will be aggregated over the course of the 10-week intervention and will be reported as proportion of days adherent to self-monitoring. Proportions of adherence will be reported across all participants with means and standard deviations.

Time frame:
Assessed daily via online survey for participants across the duration of the 10 week intervention. Daily responses will be aggregated across the intervention to determine an overall proportion of days adherent self-monitoring of behavior.

Results for this outcome have not been posted.

Adverse events

Collected over Data for adverse events were collected for each participant over 12 weeks (2-week baseline and 10-week intervention).. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Intervention: Behavioral Change Techniques to Encourage Habit Formation0/44 (0%)0/44 (0%)2/44 (4.5%)
Most frequent other events
Most frequent other events
EventIntervention: Behavioral Change Techniques to Encourage Habit Formation
RashProduct Issues2/44

Baseline characteristics

Of those enrolled in the study, 44 participants began baseline assessment.

Age, Customized
Age, Customized(Participants)Intervention: Behavioral Change Techniques to Encourage Habit Formation
45 to 5512
46 to 6526
66 to 756
Over 750
Declined to Respond0
Sex: Female, Male
Sex: Female, Male(Participants)Intervention: Behavioral Change Techniques to Encourage Habit Formation
Female37
Male7
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Intervention: Behavioral Change Techniques to Encourage Habit Formation
Hispanic or Latino6
Not Hispanic or Latino38
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Intervention: Behavioral Change Techniques to Encourage Habit Formation
American Indian or Alaska Native0
Asian3
Native Hawaiian or Other Pacific Islander0
Black or African American3
White34
More than one race1
Unknown or Not Reported3
08

Study locations

1 site
  • Center for Personalized Health
    New York, New York 10022, United States
09

References and documents

Study documents

  • Protocol and statistical analysis plan · Dec 23, 2021

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — All collected IPD will be de-identified and pooled before sharing on the Open Science Framework, along with a data dictionary.

Supporting information: Study protocol, Sap, Icf

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 30, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04869644
Lead sponsor
Northwell Health
Collaborators
National Institute on Aging (NIA), Columbia University
Responsible party
Karina Davidson (Senior Vice President, Research & Dean of Academic Affairs, Northwell Health) — Principal investigator
First posted
May 3, 2021
Start date
Mar 26, 2021
Primary completion
Feb 1, 2022
Completion
May 31, 2022
Results posted
Nov 30, 2022
Last update
Nov 30, 2022

Study contacts

Karina W Davidson
principal investigator · Northwell Health

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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