Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Sep 19, 2025
Date Accepted: Jun 15, 2026
Personalized Mobile App-Based Messaging and Step Tracking for Improving Walking Behavior in Adults: Randomized Controlled Trial
ABSTRACT
Background:
Walking is one of the most effective forms of physical activity; however, there are limitations in maintaining the long-term effects of digital step counting interventions.
Objective:
This study aimed to evaluate the effects of personalized message interventions that integrate the information-motivation-behavioral skills (IMB) model and Regulatory Focus Theory (RFT) on walking behavior
Methods:
A 12-week randomized controlled trial targeting 174 adults in Mapo-gu, Seoul, Korea was conducted from April 1 to June 22, 2024. A total of 141 participants who actually participated in the intervention (67 in intervention group, 74 in control group) were analyzed. Both groups received incentives based on goal achievement and general health information, whereas the intervention group received personalized messages based on weekly step count performance. The primary outcome variables were weekly goal achievement rate (25,000 steps), step count patterns, and consecutive 2-week goal achievement failure events. Analyses were conducted using Generalized Estimating Equations (GEE), Linear Mixed Models (LMM), and Cox proportional hazards models.
Results:
The overall 12-week average goal achievement rate was 87.2% in the intervention group and 86.6% in the control group, with no significant difference between the groups (OR = 0.70, 95% CI: 0.27-1.81, P = .459). Weekly step count patterns also showed no significant differences (group × time interaction: estimate = -417, SE = 409, P = .313). However, the risk of consecutive 2-week goal achievement failure events was significantly lower in the intervention group (HR=0.67, 95% CI: 0.52–0.86, P = .002). The intervention group showed an approximately 33% lower likelihood of consecutive 2-week goal achievement failure events than the control group.
Conclusions:
Personalized message interventions did not show significant effects on overall step count increase but proved effective in preventing consecutive 2-week goal achievement failure events. These results confirm that personalized messages play an important role in improving behavioral change sustainability and failure resilience. The results emphasize that incorporating personalized messaging strategies is essential in digital health intervention design. Clinical Trial: Clinical Research Information Service (CRiS) of Republic of Korea KCT0010966; https://cris.nih.go.kr/cris/search/detailSearch.do?search_lang=E&focus=reset_12&search_page=M&pageSize=10&page=undefined&seq=30474&status=5&seq_group=30474
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