Improving Affective Associations With Physical Activity via a Message-Based mHealth Intervention (WalkToJoy): Proof-of-Concept Study.

BACKGROUND

Traditional mobile health interventions for physical activity (PA) primarily rely on reflective self-regulatory processes, often neglecting the role of affective associations in sustaining long-term engagement. The WalkToJoy intervention addresses this gap by applying the affective-reflective theory to enhance intrinsic motivation for PA among adults aged ≥40 years through affective message framing, evaluative conditioning, and belief updating.

OBJECTIVE

This proof-of-concept study evaluated the feasibility of the message-based WalkToJoy intervention package and examined the impact of its 3 components-walking suggestion prompts, salience messages, and planning prompts-on affective and behavioral outcomes related to walking.

METHODS

We conducted a fully remote, 6-week full factorial experiment with an embedded microrandomized trial (MRT) involving 49 adults aged ≥40 years. Statistical analyses, including paired t tests and generalized estimating equations, assessed pretest-posttest changes and the effects of smile-inducing walking suggestion prompts with short animated images (GIF images), salience messages, and planning prompts on weekly affective measures and daily step counts. In addition, MRT analyses evaluated the proximal effects of these components. Poststudy interviews were thematically analyzed to contextualize participants' experiences and engagement with the intervention.

RESULTS

Significant pretest-posttest improvements were observed across affective outcomes on a 7-point Likert scale-affective attitudes improved by 0.547 points (P<.001), affective valuations improved by 0.718 points (P<.001), affective reflection improved by 0.692 points (P<.001), and anticipated affect improved by 0.692 points (P<.001). While the average daily steps showed a nonsignificant pretest-posttest increase of 80 steps (P=.79), further analysis revealed an increase of 506 steps (P=.07) when comparing baseline to the average of weeks 4 to 6. Among the intervention components, GIF prompts significantly increased anticipated affect by 0.345 points (P=.046) and average daily step count by 1834 steps (P=.05) compared to identical text-only prompts. However, MRT analysis found no significant increase in 4-hour step counts following the walking suggestion prompts (P=.55), which was explained by qualitative findings suggesting that participants interpreted messages as flexible day-long reminders rather than immediate calls to action. Salience and planning prompts did not yield substantial quantitative effects but were positively received by participants for promoting mindfulness and personalized engagement.

CONCLUSIONS

The WalkToJoy intervention is a feasible and promising approach for improving affective associations with walking. Walking suggestion prompts were particularly effective in boosting engagement and mitigating message fatigue, highlighting the potential of affect-driven interventions to enhance PA motivation and adherence.