Feasibility Test of Personalized (N-of-1) Trials for Increasing Middle-Aged and Older Adults’ Physical Activity

Purpose

To test the effectiveness and feasibility of a remotely delivered intervention to increase physical activity (walking) in middle-aged and older adults.

Design

This study used a personalized (N-of-1) trial design.

Setting

This study took place at a major healthcare system from November 2021 to February 2022.

Subjects

Sixty adults (45–75 years, 92% female, 80% white) were recruited.

Intervention

A 10-week study comprising a 2-week baseline, followed by four 2-week periods where four behavior change techniques (BCTs) — self-monitoring, goal setting, action planning, and feedback — were delivered one at a time in random order.

Measures

Activity was measured by a Fitbit, and intervention components delivered by email/text. Average daily steps were compared between baseline and intervention. Participants completed satisfaction items derived from the System Usability Scale and reported attitudes and opinions about personalized trials.

Results

Participants rated personalized trial components as feasible and acceptable. Changes in steps between baseline and intervention were not significant, but a large heterogeneity of treatment effects existed, suggesting some participants significantly increased walking while others significantly decreased.

Conclusions

Our intervention was well-accepted but use of BCTs delivered individually did not result in a significant increase in steps. Feasibility and heterogeneity of treatment effects support adopting a personalized trial approach to optimize intervention results.