An optimization trial of a meaning and theory-based digital intervention to increase physical activity (map to health)

The National Institute on Aging awarded Healthpartners Institute $1.489 million on July 1, 2026, under the Aging Research program (CFDA 93.866) to conduct an optimization trial of MAP TO HEALTH, a digital intervention designed to increase physical activity in midlife adults. The award extends through June 30, 2031.

The project develops and tests a meaning- and theory-based digital behavior change intervention that delivers personalized, timely messages reminding users of their personal reasons for being active and supporting motivation through autonomy, competence, and relatedness principles grounded in self-determination theory. A 4-way factorial optimization trial will randomize 368 participants across 16 experimental conditions testing combinations of four behavioral intervention strategies: meaning-based messaging (yes/no), action planning with just-in-time messages versus randomly timed messages, physical activity choice versus walking, and buddy support (yes/no). These experimental factors target four hypothesized mechanisms of change—meaning salience, competence, autonomy, and relatedness—designed to improve long-term physical activity adherence in adults who currently fall short of the recommended 150 minutes of weekly physical activity.

Work is performed in Bloomington, Minnesota. The assistance type is a Project Grant.

Abstract

Physical activity (PA) plays a key role in healthy aging and overall well-being, yet more than half of adults do not achieve the recommended 150 minutes of PA per week. Although many programs aim to help people become more active, their effects are often modest and tend to fade over time. One promising approach is to develop PA programs that focus on the underlying psychological processes that support long-term behavior change. Our team previously identified two key behavior change mechanisms that may help people stay active: awareness of personal meaning (meaning salience) and motivation supported by self-determination theory (SDT), which emphasizes the basic psychological needs of feeling autonomous, competent, and connected to others (relatedness). We systematically incorporated these principles into a digital behavior change intervention called map to health. The program delivers personalized, timely messages that remind users of their personal reasons for being active and support their motivation through different behavioral strategies. Initial testing showed promise but also suggested that the program needed refinement before launching a larger trial. Using the obesity-related behavioral intervention trials (orbit) framework for developing behavioral treatments, this project aims to optimize map to health to better support adults in midlife achieve PA goals. In a 4-way factorial optimization trial, 368 participants will be randomized to one of 16 experimental conditions representing all possible combinations of four behavioral intervention strategies (2 [meaning-based, yes v. No] x 2 [action planning with just-in-time messages v. Randomly timed messages] x 2 [PA choice v. Walking] x 2 [buddy, yes v. No]) that target four hypothesized mechanisms of change (meaning salience, competence, autonomy, and relatedness). The 3-month active intervention phase will be followed by a 3-month maintenance phase and a 6 month no-intervention follow-up to assess durability of intervention effects. Survey and accelerometer outcomes will be measured at baseline (0 months), mid-active intervention (1.5 months), post-active intervention (3 months), post-maintenance intervention (6 months), and at follow-up (9 and 12 months). The study has three aims: (1) compare accelerometer-measured mvpa between participants randomized to each of four theory-based intervention strategies; (2) assess whether each of the four behavioral intervention strategies is associated with greater increases in the associated mechanism of change; and (3) use semi-structured qualitative interviews (up to n=48) to facilitate a deeper understanding of whether and how participants experience map to health intervention strategies as acting on target mechanisms. Map to health aims be both efficient and engaging, with the potential to support large-scale improvements in the health and well-being of insufficiently active adults in midlife.