A Tailored Phone- and Text-message Program to Promote Well-being and Physical Activity in Mid-life Adults with Low Physical Activity

Background and Significance: Midlife, the period between ages 45-64, is the period during which the majority of cardiac risk conditions (e.g., hypertension, type 2 diabetes) arise. Physical activity is associated with fewer cardiac risk factors, lower overall cardiac risk, and higher rates of survival in midlife, but the majority of midlife persons are unable to complete recommended physical activity in the context of high stress and multiple competing life demands. Existing programs for cardiac prevention are often time-intensive and are not tailored specifically to the needs of midlife adults, and they do not work to promote psychological well-being, which is associated with greater participation in physical activity and superior cardiac health.

Methods: Our team developed a midlife-specific, remotely delivered intervention that combines: (a) positive psychology (to promote well-being), motivational interviewing (focused on physical activity goal-setting), and optional midlife-specific stress reduction modules (focused on time management, financial stress, caregiving stress, and occupational stress). The intervention was designed to be delivered via 6 phone weekly sessions and 12 weeks of text messages. We then pilot tested the intervention in midlife adults with low baseline physical activity to assess its feasibility, acceptability, and impact on well-being and physical activity. We assessed feasibility via rates of session completion, acceptability via participant ratings of sessions/texts, and impact via pre-post changes (assessed via mixed effects models) in self-report measures of mental and physical health and accelerometer-measured physical activity.

Results: We enrolled a total of 12 midlife adults in this pilot trial. All 12 completed at least one session, and more than 80% will have provided follow-up data; the trial is set to be complete in April 2021. We will report specific information about rates of session completion, participant mean ratings of session/text ease and utility, and pre-post changes in positive affect, depression, anxiety, perceived stress, and physical activity (moderate to vigorous physical activity, measured objectively using an accelerometer) during this presentation.

Conclusions: The findings from this initial pilot trial will inform intervention development and testing in larger randomized trials. If this intervention appears to be effective in this and subsequent trials, it may represent a scalable intervention to promote midlife health.

References:

Lachman ME, Teshale S, Agrigoroaei S. Midlife as a Pivotal Period in the Life Course: Balancing Growth and Decline at the Crossroads of Youth and Old Age. Int J Behav Dev 2015;39:20-31. PMID: 25580043.

Gomez-Bernal F, Madva EN, Puckett J, Amonoo HL, Millstein RA, Huffman JC. Relationships Between Life Stressors, Health Behaviors, and Chronic Medical Conditions in Mid-Life Adults: A Narrative Review. Psychosomatics 2019;60:153-63. PMID: 30691935.

Huffman JC, Massey CN, Chung WJ, Feig EH, Ibrahim NE, Celano CM. The case for targeted midlife interventions to prevent cardiovascular disease. Acta Cardiologica 2019;75(8):805-807.