The Impact of a Behavior Change Wheel-Based Personalized mHealth Intervention on Physical Activity Participation in Older Adults with Mild Cognitive Impairment: A Feasibility Study (Preprint)

BACKGROUND Mild cognitive impairment (MCI) is recognized as a critical stage for dementia prevention. Physical activity is an important intervention to prevent cognitive decline, but challenges still remain in improving or maintaining cognitive function in older adults with MCI through increased physical activity. Personalized mobile health (mHealth) promotion strategies based on the Behaviour Change Wheel (BCW) hold promise for enhancing physical activity levels in this population. OBJECTIVE This study aims to evaluate the feasibility and preliminary effectiveness of a personalized mobile application (App) named ActiveAide, developed based on the BCW framework, for promoting physical activity among older adults with MCI. METHODS This feasibility study employed a single‑arm, pre‑ and post‑test design. 18 participants received an 8‑week personalized intervention via ActiveAide. Feasibility measures included recruitment rate, retention rate, App usage data, App usability evaluation, and user experience with the App. Effectiveness measures encompassed physical activity level, physical fitness, physical activity self‑efficacy, and social support. Quantitative data were analyzed using paired‑sample t‑tests and Wilcoxon signed‑rank tests, while qualitative data underwent content analysis. RESULTS The study achieved a recruitment rate of 90.9% and a retention rate of 90%. The mean strategy completion rate was 78.5%, with the mean number of App accesses of 71. The mean System Usability Scale (SUS) score was 74.86 ± 8.81, indicating good usability. Qualitative interviews identified three themes: strengths of MotiveAide, limitations of MotiveAide, and suggestions to improve MotiveAide. Post-intervention, statistically significant improvements were observed in participants’ physical activity level (P